Healthy maternal–infant attachment is the foundation on which a child’s physical, cognitive, psychological, and emotional development rests. This relationship between the dyad does not begin at birth but rather prior to conception or any time throughout pregnancy. Our understanding of how this relationship develops between a mother and her fetus remains largely intangible for researchers and clinicians alike as it is a highly complex process with many variables influencing the evolving bond. Situated within a poststructural critical feminist framework, the purpose of this qualitative study using a grounded theory approach was to gain a better understanding of how women who use substances during pregnancy experience the process of a developing relationship with their fetuses, and to identify intersecting variables that may influence their health behaviours. Five main categories emerged including choosing the mothering path, balancing the risks, needing safe passage, breaking the cycle, and mothering against all odds. All of the women in the study described feeling an increase in maternal–fetal attachment as the pregnancy progressed and demonstrated efforts to reduce substance use, engage with the health care system, and improve dietary choices to limit negative consequences for their developing fetuses. Barriers to changing health behaviours were identified by the participants as well as by health care providers working with this population. In gaining a deeper understanding of the variables that influence maternal–fetal attachment in women who use substances and development of a substantive theory, nursing practice may be informed by providing direction around how best to support harm reduction approaches in this population.

Surgeons regularly make changes in their practice to ensure they are providing high quality patient care. This includes the process of learning and safely integrating new skills, techniques and technologies into practice. When faced with the challenge of integrating a new surgical procedure into practice, surgeons must determine when they are ready to overcome the associated risks. This study sought to understand how surgeons experience risk when learning and integrating a new procedure into practice. A modified constructivist, grounded theory approach was utilized. Eighteen surgeons were purposively sampled from two Canadian academic medical institutions. Semi-structured interviews were conducted and interpreted through constant comparative analysis. Emergent themes were identified and a conceptual framework was developed for understanding the surgeon experience associated with adopting and integrating a new procedure into practice. Regardless of personal risk tolerance, surgeons described a similar approach to learning and implementing new skills. The experience of risk was one of several factors that affected their adoption of new techniques. They also described being influenced by individual, personality-driven factors, logistical considerations and the culture inherent to their departmental, institutional, professional and societal contexts. A framework for understanding the surgeon experience when adopting and integrating new skills was constructed. The complex, nuanced multifactorial interplay between a surgeon’s individual willingness to engage risk, his/her motivations and the systemic and cultural factors that serve to facilitate or hinder the implementation of a new surgical skill is at the core of this experience. An increased awareness of these factors highlights the challenges that surgeon face in adopting new procedures and may lead to the development of policies which support surgeons learning and implementing new skills, techniques and technologies while maximizing patient safety.

Social Protection, and in particular social assistance, has emerged as a key area of international development policy. Recognition of the important role of social protection policies is aligned to a growing consensus on their role in reducing poverty and vulnerability and in preventing people from falling into poverty and facilitating exit from poverty. In the late 1990s, the World Bank (WB) developed the Social Risk Management (SRM) framework as a new conceptual framework for analysing social protection in developing countries. In the SRM, risk taking, the proactive management of risk at household level, was argued to be essential in enabling poor households to invest and grasp opportunities for economic development and poverty reduction. This research examines and conceptualizes the why and the how of investment by households in poverty. The research also examines the extent to which access to social assistance interventions may play a positive or negative role in the process. The thesis argues that the SRM oversimplifies and underestimates a variety of factors and processes that play a role in the household’s investment behaviour in three dimensions of their life, namely savings, education and health. In the research, household decision making is conceptualised as a two stage process of ‘constructing’ investment preferences (what they are willing to do), and of ‘realizing’ or ‘revealing’ household choices (what they actually do). The empirical findings indicate that access to social assistance did not appear to have a role in constructing investment preferences. However, it had limited role under certain circumstances in favouring the realization of households’ investment preferences. The research suggests that the SRM fails to encapsulate the complexity of household investment decisions, crucial to exiting poverty. Building on some of the concepts emerged in the research, I develop a ‘behavioural’ variation of the ‘risk taking /poverty exit’ component of the SRM in an attempt to improve the explanatory capacity of this framework. The research utilises the grounded theory framework (GT), adapted to a low income country context, and investigates the role of social assistance in household behaviour through an extensive field work in Bangladesh with urban households targeted by the Old Age Allowance Scheme (OAA), one of the largest social assistance schemes in Bangladesh.

Researchers continue to emphasize the important role supervisors have in creating a safe space for supervisees to effectively navigate and engage in honest multicultural conversations while also addressing potential biases (e.g., Ancis & Marshall, 2010). However, much of the literature on multicultural supervision provides limited guidance on what characteristics define a safe space. The purpose of this study was to examine accounts of counseling psychology graduate students to learn about their understanding and definitions of safe space and brave space within multicultural supervision, using grounded theory methodology (Corbin & Strauss, 2015). Specifically, the purpose of the study was threefold: (a) to define what a safe space and a brave space is from supervisees’ perspective, (b) to determine if the concept of a safe space is viewed similarly or differently to a brave space, and (c) to identify specific behaviors and interventions that supervisors perform that make a supervisee feel they are in a safe or brave space. Results yielded a model characterized by three core dimensions that comprise safe and brave spaces including: (a) safety within the physical space, (b), definitions and use of brave and safe spaces, and (c) supervisor actions and behaviors. This study adds to the current multicultural supervision training scholarship by providing new perspectives on how supervisees in counseling psychology doctoral programs make sense of safe and brave spaces during multicultural supervision and what supervisors can do to create such spaces.

The purpose of this thesis is to explore the experiences of single mothers raising rebellious adolescent boys. A qualitative methodological design was followed. Thirteen single mothers were interviewed, as well as five clergies and six social workers. An in-depth qualitative analysis was undertaken, in order to investigate the subject of single mothers raising adolescent boys. The study results are presented in an integrated and descriptive tabula format. The participant’s stories were re-encountered through the researcher’s own frame of reference in which common themes of the single motherhood and adolescence were constructed. They were elaborated on and a comparative active analysis was undertaken to link them with the available literature. This information gained from the research could contribute to the existing body of knowledge; on the impact of the rebellious behaviour of the adolescent boys on the single mother, by offering a new perspective. The project was done within The Chief Albert Luthuli Municipality under the Gert Sibande District of Mpumalanga Province. It was found that most single mothers were suffering silently as there is no adequate support either from the community or the church. The study found that the behaviour of girls reflected better on their mothers compared to their counterparts who are boys. / Thesis (PhD)--University of Pretoria, 2020. / Practical Theology / PhD / Unrestricted

Forensics, or competitive speech and debate, has a history stretching back to the ancient Greeks. Although practitioners, students, and coaches have long sung its praises, limited research has been done to demonstrate the long-term value of forensics competition for students. This study used narrative interviews to discover the perceived value of forensics competition to individuals who were at least ten years removed from competition and had not remained active in forensics. After interviewing 34 individuals, this study used grounded theory (Glaser, 1965; 2002; Glaser & Strauss, 1967) to analyze the results. Analysis revealed that individuals followed a similar pattern of becoming involved in forensics and remaining as participants. Additionally, they believed they learned academic skills, social skills, and had more opportunities because of their participation in forensics, despite having to overcome some negative effects of participation. Participants noted that they used many of the skills they developed in forensics every day. Participants also demonstrated that forensics was a part of their identity and many remained connected to former teammates, former competitors, and their alma mater. Analysis led to the development of the Narrative of the Professional, which is the story of the forensics competitor.

Thesis advisor: Lisa A. Goodman / Recent research suggests that half or more of today’s domestic violence (DV) advocates are survivors of intimate partner violence (IPV) or other forms of abuse, consistent with the survivor-led early stages of the DV movement. Advocates who are themselves survivors (survivor-advocates) are at risk of experiencing vicarious trauma and other negative outcomes in response to their challenging work. Emerging research has also identified the possibility of deriving personal growth and healing from the work of advocacy, which bolster survivor-advocates against the stressors in their work. However, the processes by which survivor-advocates navigate their work and cope with its challenges are poorly understood. To date, only one qualitative study has asked survivor-advocates about their experiences. This study began illustrating some of the ways that survivor-advocates approach and experience their work; however, it is vital that we develop a richer understanding of how survivor-advocates experience their work as both healing and harmful, in order to maintain the sustainability and effectiveness of the services they provide. This study used grounded theory methodology to explore how survivor-advocates apply their survivorship to their work, and how their work influenced their well-being and recovery. The theoretical model that emerged was anchored by a central process called bringing my whole self to work, which participants described as consisting of four interrelated components: 1) constructing a personal narrative about how their identity connects to their work, 2) applying those connections to shape their work in numerous ways, 3) experiencing healing as an outcome of the previous two components and 4) the organizational contexts that shaped the process through validating or invalidating the survivor identity. Successfully engaging in this process helped survivor-advocates feel a greater sense of connection and integrity to their survivor identity and work, as well as possibly enhanced well-being. This process suggests numerous ways for DV organizations to encourage and support survivor-advocates to engage more openly, meaningfully, and effectively in their work and points toward new directions in understanding vicarious trauma. / Thesis (PhD) — Boston College, 2019. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental and Educational Psychology.

I sin profession använder tandhygienisten tre olika kompetenser; faktakunskap, procedurkunskap och värdekunskap. Den praktiska yttringen av hennes värdekunskap - bemötandet - är dock otydlig i utbildningen och utbildningsresultatet blir därför slumpmässigt på detta område. Detta trots att bemötandet - såväl av experter som av patienter -numera anses utgöra en viktig del av vårdkvaliteten.   En av orsakerna till att bemötandet är otydligt i utbildningen är att det saknas teoretisk kunskap och teorier på området. Denna studie genererar en teoretisk beskrivning av patientens syn på bemötandet och dess konsekvenser i munhälsovård. Som metod användes Grounded Theory.   Det goda bemötandet beskrivs i tre kategorier: "att tandhygienisten bekräftar patienten", " att tandhygienisten visar patienten att hon vill henne väl" samt "att tandhygienisten betjänar patienten". Det dåliga bemötandet innefattar motsvarande tre kategorier; "att tandhygienisten ej bekräftar patienten alternativt förnekar patienten", "att tandhygienisten inte visar att hon vill patientens väl alternativt visar att hon vill henne illa" samt "att tandhygienisten inte betjänar patienten". Vidare visar resultaten att tandhygienisten uttrycker sitt bemötande genom verbal kommunikation och genom icke-verbal kommunikation via ögonen, händerna eller kroppshållningen. Hon uttrycker det också genom sin attityd gentemot patienten (i form av förhållningssätt) eller i omhändertagandet av patienten.   Ett gott bemötande får bl a de konsekvenserna att patienten tar till sig informationen, blir mer motiverad till egenvård och koopererar bättre medan ett dåligt bemötande har motsatt effekt. Vidare resulterar ett gott bemötande i att patienten rekommenderar tandhygienisten till bekanta medan ett dåligt får henne att sluta behandlingen och byta behandlare. Bemötandet har alltså betydelse för såväl patientens munhälsa som för tandhygienistens konkurrenskraft på marknaden.   Med hjälp av denna teoretiska beskrivning av bemötandet och dess konsekvenser i munhälsovård kan man för det första få ett verktyg att inom utbildningen undervisa såväl teoretiskt som praktiskt i bemötande. För det andra kan beskrivningen ligga till grund för att generera teori och  för att utföra kvantitativt beskrivande studier inom området bemötande i munhälsovård.

It is a qualitative study about political socialization of first-generation ethnic Russian immigrants in Central and South Florida. The method used is a constructivist grounded theory with two-level coding. Based on data collected in forty in-depth interviews, I constructed a model of political socialization. It incorporates a starting point (the legal status in the US), triggers (English language proficiency, spousal support, and parenting), political socialization agencies (English as Second Language classes, a spouse, volunteering, the church) and output structures (bureaucratic institutions). Using respondents’ opinions about American vs. Russian political systems and mass media, their political participation, and views about political efficacy, I created an original classification of immigrants’ political attitudes and behavior. The classification consists of four groups: the Admirers, the Skeptics, the Incurious, and the Recluses. This study fills the gap in the literature about Russian-speaking immigrants in the US. It also contributes to the cache of micro-theories on immigrant political socialization.

Hintergrund: Vor dem Hintergrund des demografischen Wandels und damit einhergehenden Versorgungsbedarfen älterer pflegebedürftiger Personengruppen gewinnt die professionelle Altenpflege als Dienstleistungsberuf zunehmend an Bedeutung. Gleichzeitig zu diesem Bedeutungszuwachs befindet sich die professionelle Altenpflege in professionstheoretischer Hinsicht an einem Scheideweg (vgl. Twenhöfel 2011). Die Gründe hierfür sind in der Dominanz des Medizinsystems zu suchen sowie in der Tatsache, dass die Altenpflege sich bislang nicht hinreichend von der Leitdisziplin emanzipieren konnte. Dabei weist auch die pflegewissenschaftliche Grundlagendiskussion in diese Richtung: Es ist der Pflegewissenschaft als eigenständiger Disziplin bislang nicht gelungen, einen eigenen Wissenskanon zu etablieren und den Kern des Pflegerischen – die Pflege selbst – für sich zu reklamieren. Wissenschaftstheoretische Bemühungen, diesen Kern des Pflegerischen als eine spezifische Art der „Beziehungsarbeit“ (vgl. Remmers 2011) zu konturieren, scheinen in diesem Zusammenhang vielversprechend und erfordern tiefergehende Untersuchungen. Interessant ist auf dieser Grundlage die Kategorie des Vertrauens als eine eigenständige pflegewissenschaftliche Kategorie. Bislang hat die deutschsprachige Pflegeforschungslandschaft hiervon allerdings kaum Notiz genommen, was vermutlich dem Umstand geschuldet ist, dass Vertrauen in der alltäglichen Praxis als unhinterfragte Hintergrundfolie fungiert (vgl. Endreß 2002). In der öffentlichen Wahrnehmung ist zudem ein hoher Vertrauensvorschuss gegenüber der beruflichen Pflege vorhanden, was tendenziell zu einer größeren Selbstverständlichkeit des Umgangs mit Vertrauen in der Altenpflege führt. Unklar bleibt bislang, wie sich Vertrauen in der altenpflegerischen Praxis äußert und welche Kontextfaktoren es in der Altenpflege beeinflussen. Zur Bearbeitung dieser Forschungslücke kann auf zahlreiche Befunde der interdisziplinären Vertrauensforschung und der internationalen Pflegeforschung zurückgegriffen werden. Ziele: Ziel der vorliegenden Untersuchung ist es, einen pflegewissenschaftlichen Beitrag zur interdisziplinären Vertrauensforschung zu leisten. Dabei soll auf empirische Weise ein vertieftes Verständnis von Bedingungsfaktoren, Kontexteinflüssen und Handlungsweisen der in der beruflichen Altenpflege tätigen Personen erreicht werden. Studiendesign und Methode: Die Studie hat explorativen Charakter, indem sie subjektive Vorstellungen von Vertrauen in der Altenpflege erfasst und diese durch forscherseitige Abstraktionsleistungen in eine datengesättigte Theorie mittlerer Reichweite integriert. Die Untersuchung ist dem qualitativen Forschungsparadigma zuzuordnen und greift auf die Reflexive Grounded Theory (vgl. Breuer et al. 2017) zurück. Die Reflexive Grounded Theory stellt eine methodologische Weiterentwicklung der Grounded-Theory-Methodologie (vgl. Strauss u. Corbin 2010) dar. Insgesamt wurden 13 leitfadengestützte Interviews mit Pflegestudierenden, examinierten Altenpflegekräften und einer Altenpflegehilfskraft geführt und ausgewertet. Ergebnisse: Vertrauen ist auf vielschichtige Weise Bestandteil der altenpflegerischen Praxis. Den befragten Personen fällt es vergleichsweise schwer, die Kategorie im Hinblick auf ihre Bedeutung für den Pflegealltag zu beschreiben und zu erklären. Im Zentrum der ermittelten Theorie steht die Kernkategorie „Vertrauenserleben in der altenpflegerischen Beziehungsarbeit“. Um sie herum gruppieren sich verschiedene Dimensionen: Das Bedingungsgefüge auf personaler Ebene strukturiert die Perspektiven der Pflegekraft als die eine, und die der pflegebedürftigen Person als die andere Partei der Beziehungsarbeit. Der situative Kontext integriert weitere intervenierende Bedingungen (u. a. weitere Beteiligte im Pflegeprozess, die pflegerische Situation, die Arbeitsbedingungen sowie die materielle Umwelt), welche partiell wechselwirkend mit dem Vertrauenserleben in der altenpflegerischen Beziehungsarbeit interagieren. Darüber hinaus konnten verschiedene Handlungsweisen der Pflegekraft identifiziert werden, die die Kategorie teils förderlich, teils hemmend beeinflussen. Insgesamt wird deutlich, dass vor allem die Kenntnis professioneller Verhaltenstechniken sowie fürsorgliches Verhalten das Vertrauenserleben begünstigen, während konfliktäre Verhaltensweisen es eher beeinträchtigen. Neben diesen direkten Effekten auf das Vertrauenserleben wirkt sich das Erleben von Vertrauen zudem auf das jeweilige Selbstbild der Pflegekraft aus. Diskussion und Schlussfolgerungen: Die Ergebnisse verstehen sich als ein pflegewissenschaftlicher Beitrag, um den Wissensbestand verborgenen Praxiswissens zu reflektieren,d zu diskutieren und konzeptionell weiterzuentwickeln. Sie können zu einer wissenschaftlich fundierten Handlungsorientierung in der Praxis und zur professionellen Selbststeuerung innerhalb der Disziplin beitragen. Darüber hinaus erlaubt die Grounded Theory des Vertrauenserlebens in der altenpflegerischen Beziehungsarbeit konzeptionelle Anschlüsse an zukünftige Forschung.