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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
101

Communication with Healthcare Providers at End of Life: The Perspective of Decedents' Next of Kin: A Dissertation

Terrien, Jill M. 01 May 2007 (has links)
Communication with healthcare providers (HCP’s) at the end-of-life (EOL) is a crucial process that can make a difference in the quality of the EOL experience for patients and their families. Targeting EOL communication interventions between patients, their families, and HCP’s is better informed from an understanding of what family members perceive as good and bad communication. The purpose of this study was to explore experiences related to communication with HCP’s in central Massachusetts during EOL care. Data from the parent study (n = 373) included responses from an open ended question at the end of the survey. The larger, qualitative descriptive study, from the parent study, (n = 218 ) that examined the open ended question revealed communication as the overarching theme. A secondary analysis of this open ended survey data using qualitative content analysis was used to describe next of kin’s perspectives of communication with HCP’s during the decedents’ end-of-life experience (n = 171). Family members (children = 38.4% and spouse = 22.0%) comprised the majority of the sample. Decedents were mostly 80 or older (47.6%), died in an acute care setting of mostly cancer (33.0 %) and cardiovascular disease (32.3%). Accessing information, emerged as the overarching theme. Continuum of information, healthcare provider sensitivity, having the answers and raising awarenesswere revealed as subthemes. The majority of respondents reported good aspects versus bad aspects of communication at the EOL. The framework for a good death (Emanuel & Emanuel (1998) under-girded the study but was not supported as it relates to these findings. The framework was useful in capturing the multidimensional process that each patient and their family could experience during the EOL process. The findings from this study provide insight for HCP’s about which aspects of communication are helpful at the EOL. Continuing education of the health care team on these identified helpful communication aspects will provide better access for patients and families for a quality EOL experience.
102

Leftover women's choices in marriage and childbearing: navigating through the complexities of state law, social attitudes, and parental expectations

Liu, Qian 22 July 2020 (has links)
In recent years, unmarried women in China face great pressure to marry when they reach their late 20s and beyond. These women are referred to as leftover women, a terminology that plays into the notion that they fail to sell themselves in the marriage market at the best timing. Based on interviews and focus groups with leftover women in China, this dissertation situates their choices in the complexities of social and legal orders in today’s China to make sense of their decisions. Starting with a postcolonial critique of current literature on leftover women, this dissertation revisits leftover women’s decisions and demonstrates how their choices are made after evaluating all the available options rather than decisions made out of false-consciousness. I discuss how societal and parental expectations interact with state law to affect leftover women’s choices in marriage and childbearing. To understand how leftover women navigate through multiple levels of social ordering, I investigate the legal consciousness of these women when they judge which level(s) of social ordering they should follow. My analysis of leftover women’s strategies in engaging with state law challenges the assumption that ordinary Chinese people’s reluctance to use the formal legal system is a result of their lack of legal knowledge. My interviewees’ emphasis on family relations and public attitudes regarding marriage and childbearing complicates and contributes to feminist relational theory by questioning its strong attachment to autonomy. Building on postcolonial feminist legal thoughts, I advocate that feminist relational theorists need to distance themselves from autonomy in order to understand the choices made by women who prioritize familialism over individualism. To unsettle feminist relational theory’s unconditional attachment to autonomy, I elaborate on leftover women’s understandings of the relationship between the self and the family and other people in their social networks. This elaboration is achieved by investigating the impact of societal and parental expectations, as well as leftover women’s participation in constructing the notions of filial piety and motherhood. This dissertation offers a detailed discussion of leftover women’s choices in marriage and childbearing by demonstrating their navigation through multiple levels of social ordering. It also provides a postcolonial analysis of the approach of “blaming culture,” which has been used by many scholars who study leftover women, as well as other issues concerning marginalized populations in authoritarian states such as China. At the same time, this dissertation illustrates a way of analyzing women’s choices without focusing on autonomy, which is of great importance for research on women whose culture prioritizes familialism over individualism. This dissertation also contributes to the areas of legal consciousness and legal pluralism by explaining ordinary people’s reluctance to separate state law and non-state social ordering. This is a timely empirical study aiming to serve as a springboard to invite future research on law and emotions, and law and family relations, relationships and legal consciousness, and postcolonial analysis of the impact of patriarchal Confucian culture and Chinese legal culture in general. / Graduate / 2022-06-02
103

Informe del Proyecto de Intervención: Promoción de la salud mental y bioseguridad frente a la COVID-19 en un entorno familiar, Chorrillos – Lima, 2020 / Intervention Project Report: Promotion of mental health and biosecurity against COVID-19 in a family environment, Chorrillos - Lima, 2020

Díaz Vilela, Elizabeth Alexandra 19 August 2020 (has links)
Introducción: El coronavirus ha afectado distintos países del mundo, incluyendo al Perú. Ataca principalmente al sistema respiratorio viéndose afectada la población de Chorrillos, dado que su principal causa de morbilidad y mortalidad son las infecciones de las vías respiratorias agudas. Asimismo, las medidas preventivas tomadas por el gobierno peruano como el aislamiento social obligatorio amenaza la salud mental de las personas aumentando los niveles de estrés y ansiedad. Descripción del proyecto: Partiendo de un análisis de involucrados, del diagnóstico participativo comunitario y la priorización de problemas, el objetivo general fue promover hábitos favorables para la salud mental y la bioseguridad frente a la COVID-19 en el hogar de la familia Diaz Vilela. Se establecieron 3 objetivos específicos: Incrementar medidas preventivas frente a la COVID-19, aumentar la actividad física y disminuir los niveles de estrés y ansiedad. Se desarrollaron sesiones educativas, talleres demostrativos, socialización de mensajes, fichas de registro, entre otras; para los cuales, se utilizaron herramientas virtuales como Power Point, Canva, Google Forms, YouTube y WhatsApp. Además, todas las actividades fueron supervisadas y monitoreadas permanentemente. Resultados: Se observó que el 100% de las participantes obtuvo una variación positiva en la práctica de medidas preventivas frente a la COVID-19, aumentaron su actividad física de bajo a intenso y disminuyeron sus niveles de estrés y ansiedad de alto a bajo/aceptable. Conclusión: La intervención promovió hábitos favorables para la salud mental y la bioseguridad en un entorno familiar. / Introduction: Coronavirus has affected different countries of the world, including Peru. It mainly attacks the respiratory system, the population of Chorrillos being affected, since it’s main cause of morbidity and mortality is acute respiratory tract infections. Likewise, preventive measures taken by the Peruvian government, such as compulsory social isolation, threaten people's mental health, increasing levels of stress and anxiety. Project description: Starting from a stakeholder analysis, participatory community diagnosis and prioritization of problems, the general objective was to promote favorable habits for mental health and biosecurity against COVID-19 in the home of the Diaz Vilela family. 3 specific objectives were established: Increase preventive measures against COVID-19, increase physical activity and decrease stress and anxiety levels. Educational sessions, demonstration workshops, message socialization, registration cards, among others, were development. For this, virtual tools such as Power Point, Canva, Google Forms, YouTube and WhatsApp were used. Furthermore, all activities were permanently supervised and monitored. Results: It was observed that 100% of the participants obtained a positive variation in the practice of preventive measures against COVID-19, they increased their physical activity from low to intense and their stress and anxiety levels decreased from high to low/aceptable. Conclusion: The intervention promoted favorable habits for mental health and biosecurity in a family environment. / Trabajo de investigación
104

Building Research and Evaluation Into the Collaborative Family Healthcare Association With Intention

Polaha, Jodi, Shepardson, Robyn L. 01 March 2022 (has links)
In 2013, a bunch of us ran around collecting paper surveys off chairs after a plenary address at the Collaborative Family Healthcare Association's (CFHA) annual conference. From 150 responses, we found that less than a quarter would take the time to attend a workshop about research and evaluation. Fast forward 5 years: The organization showed robust attendance at research and evaluation training sessions, and interest in a preconference had risen to 77%. What prompted this shift? In response to survey findings, the Research and Evaluation Committee (REC), supported by the CFHA, engaged a data-informed and stakeholder-responsive approach to cultivating empiricism within the CFHA. The activities led by the REC demonstrate the need for creativity and leadership in this area and the CFHA's strong. organizational values around such efforts. As past and present leaders in the CFHA's REC initiatives, we write this editorial to make explicit the value of research to the organization and the value of the organization to the evidence base. In addition, we document some key institutional history in this area and, with input from the CFHA's current chief executive officer, Neftali Serrano, and REC chair, Will Lusenhop, forecast a vision for the future. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
105

Postmodern power plays: A linguistic analysis of postmodern comedy

Karman, Barbara Ann January 1998 (has links)
No description available.
106

Soběslavské testamenty a písemnosti pozůstalostního řízení 1455-1550: možnosti jejich využití / The testaments of Soběslav and the papers of probate proceeding 1455-1550: the possibilities their usage

Vandrovcová, Lenka January 2012 (has links)
Práce se zabývá městem Soběslav, které patřilo pánům z Rožmberka a dochoval se v něm soubor testamentů z let 1455-1550. Soubor se skládá celkem z 83 listinných testamentů. Práce nejprve popisuje testamentární praxi (proces vzniku testamentu) a soubor soběslavských testamentů. Samotný výzkum se zabývá nejprve testátory, kteří byli spřízněni nějakým druhem rodinné vazby. Podrobněji se práce zabývá jednou z těchto rodin, rodinou Račmanů. Druhá část výzkumu se věnuje dluhům a pohledávkám uvedených v testamentech. Tato část se zabývá lokalitami, se kterými vedli testátoři své obchody. Klíčová slova: Soběslav, testamenty, rodinné vztahy, dluhy, pohledávky Annotation Object my diploma's work is Soběslav town, which it belonged to lord of Rozumberk. There was still in existence collection of testaments from years 1455-1550. Collection is comprised of 83 testaments. The work discribes proces sof genesis testaments and collection Soběslav's testaments. First part of study pursue testátore, which they were akin to families. The work detailed discribes of family Račman. Second part of study disciribes by analysis debts and outstandings debt in testaments. This part discribes lokalities, where testátore made their business. Keywords: Soběslav, testaments, family relations, debts, outstanding debts
107

Engajamento familiar na manutenção do tratamento em saúde mental após o primeiro episódio psicótico / Familiar engagement in mental health treatment maintenance after the first episode psychosis

Casaburi, Luiza Elena 09 September 2016 (has links)
A maioria dos estudos sobre o papel da família na continuidade do tratamento após o primeiro episódio psicótico investigam os casos de abandono de tratamento e apontam para aspectos \"negativos da família\". Poucos estudos investigam o papel da família nos casos de pacientes que se mantém no tratamento. Objetivo: Compreender a experiência de cuidar de um familiar no PEP e evidenciar as motivações para manter-se no cuidado. Método: Trata-se de pesquisa qualitativa que utilizou a teoria sistêmica familiar como referencial teórico e a narrativa como referencial metodológico. Foram entrevistados 13 familiares cuidadores de 12 pacientes. Para a realização das entrevistas em profundidade com enfoque narrativo foi utilizada a seguinte questão norteadora: Nós sabemos que poucos familiares se mantêm no tratamento em saúde mental junto ao seu jovem familiar adoecido após o primeiro episódio psicótico. Se manter no tratamento conjuntamente ao paciente e cuidar do mesmo é chamado por nós de engajamento. São ações como levar nas consultas, administrar a medicação, modo de se relacionar, cuidar da higiene e assim por diante. Sendo assim, gostaríamos que você nos contasse sobre o que te motiva a permanecer cuidando e tudo que você e sua família fazem pelo seu familiar adoecido. Para a exploração das narrativas foi utilizada a técnica de análise de conteúdo indutiva. Resultados: A análise das narrativas definiu o engajamento familiar em três grandes categorias interdependentes. Uma é relacionada ao contexto de sentimentos envolvidos no cuidar denominada \"Motivações para o engajamento\", as outras duas referem-se às ações relacionadas ao cuidar denominadas \"As ações de engajamento\" e \"Avaliação constante do cuidar\". Conclusão: A pesquisa contribui com o conhecimento ao apresentar famílias ativamente envolvidas no cuidado com o jovem em tratamento para o primeiro episódio psicótico. O referencial teórico - metodológico possibilitou destacar e valorizar as histórias, experiências e as relações familiares envolvidos no cuidado de um ente querido. Os cuidados foram descritos e contextualizados nos valores culturais das famílias. Verificamos que os familiares percebem o cuidado como uma responsabilidade do seu papel na família / Most studies of the family\'s role in the continuity of treatment after the first epidode psychosis investigate cases of abandonment treatment and point to \"negative aspects of family\". Few studies have investigated the role of the family in cases of patients who remain in treatment. Objective: Understand the experience of caring of a familiar in PEP and highlight the motivations to remain in care. Method: This is a qualitative research that used the systemic family theory as the theoretical framework and the narrative as a methodological framework. 13 family caregivers of 12 patients were interviewed. To carry out the interviews with narrative approach was used the following question: We know that few families remain in mental health treatment of their sick young familiar after the first episode psychosis. Maintain the treating and taking care of the patient is called engagement. These are actions like take into consultations, administer medications, so as to relate, take care of hygiene and so on. Therefore, we would like you to tell us what motivates you to stay caring after everything you and your family are sickened by his family. For the exploration of the narratives was used the inductive content analysis technique. Results: The analysis of the narrative set the familiar engagement in three major interdependent categories. One is related to the context of feelings involved in the care called \"Motivations for engagement,\" the other two refer to actions related to care called \"The engagement actions\" and \"The assessment of care.\" Conclusion: The study contributes to the knowledge to present actively involved families in caring of the young in treatment of first episode psychosis. The theoretical - methodological possible highlight and enhance the stories, experiences and family relations involved in the care of a loved one. Care were described and contextualized in the cultural values of families. We found that family members perceive care as a responsibility of their role in the family
108

Consulta terapêutica com pais de crianças autistas: a interface entre a parentalidade e a conjugalidade / Therapeutic consultation with parents of autistic children: the interface between parenthood and the conjugal relationship

Nunes, Maria Angela Favero 11 June 2010 (has links)
A presente tese teve por objetivo compreender as repercussões da condição da criança autista, na vida familiar e conjugal dos pais. Interrogamo-nos, ainda, acerca da utilização da entrevista clínica não-dirigida, seguindo o modelo da consulta terapêutica. Utilizamos também dados de prontuário como recurso auxiliar para obtenção de informações da criança e de seus pais. Participaram deste estudo cinco casais (dez participantes), pais de crianças autistas, cujo filho tinha sido diagnosticado recentemente, tendo iniciado as atividades em uma instituição para tratamento educacional especializado, localizada em um município do interior do Estado de São Paulo. O critério de inclusão empregado foi a participação de ambos os membros do casal nas entrevistas. Tratou-se de uma pesquisa de metodologia clínico-qualitativa, em que a Psicanálise foi a teoria de referência, especialmente a abordagem de Donald W. Winnicott. Além disso, apoiamo-nos nos estudos da Psicanálise familiar e de casal, para a análise do material clínico. O estudo pormenorizado das entrevistas estimulou reflexões a partir de três núcleos temáticos levantados: parentalidade e o lugar ocupado pela criança na dinâmica familiar; interface entre parentalidade e conjugalidade; a entrevista como um espaço de holding aos pais, diante da experiência de sofrimento vivenciado. De acordo com as narrativas dos casais, os resultados apontaram que pais e mães foram afetados pela problemática da criança, assim como a relação conjugal foi suplantada pela necessidade iminente de cuidados com o filho autista. Emergiram sentimentos de impotência frente à precariedade dos serviços de saúde, tanto em termos materiais como humanos. Observou-se que, como a descoberta do diagnóstico era recente, muitas angústias surgiram, principalmente por parte das mães, com referência ao tratamento institucional. Dentre elas, estavam as incertezas sobre o atendimento, a problemática da medicação e a inclusão escolar. O reconhecimento dessa condição do filho alterava a autoestima dos pais, levando-os a oscilarem entre momentos de crença e de descrença em face do desenvolvimento do filho, predominando sentimentos ambivalentes de desamparo e de esperança. Cada casal utilizou o setting proposto de forma singular e única, configurando-o de acordo com suas necessidades. Percebemos que a situação da entrevista favoreceu a criação de uma demanda que estava latente, tendo sido adotada como um espaço de escuta e de holding aos pais. Predominou um sentimento de urgência concernente à criança autista que tomava o lugar da vida conjugal e do cuidado com os outros filhos, quando existiam. Diante da complexidade das situações e da variedade de temas emergentes, verificamos que alguns casais puderam se questionar sobre a criação do filho, todavia, manifestaram-se pouco sobre o tipo de conjugalidade construída. Acreditamos que o modelo da consulta terapêutica representa uma proposta ampla e flexível de atendimento aos pais que pode ajudá-los no alívio de suas angústias. Preconizamos que essa modalidade possa servir como um dispositivo de atenção à saúde mental, nos serviços relacionados à problemática em questão / The objective of this thesis is to comprehend the impact of the condition of autistic children on family life and the conjugal relationship of the parents. We also explore the use of the clinical, non-directed interview, following the model of therapeutic consultation. We use data from medical records as an additional resource to obtain information about the child and its parents. Five couples (ten participants), parents of autistic children, whose child had recently been diagnosed and had commenced activities in an educational institution for specialist educational treatment, located in a municipality in the interior of the state of Sao Paulo, participated in this study. The inclusion criterion was the participation of both members of the couple in the interviews. This was a clinical-qualitative study in which psychoanalysis was the theory of reference, especially the approach of Donald W. Winnicott. In addition, we rely on studies of psychoanalysis of families and of couples for the analysis of the clinical material. The detailed study of the interviews prompted reflections on three core themes that emerged: parenting and the space occupied by children in family dynamics; the interface between parenthood and the conjugal relationship; the interview as a holding space for parents on the experience of suffering. According to the narratives of the couples, the results indicated that fathers and mothers were affected by the childrens problem and the conjugal relationship has been superseded by the urgent need to care for the autistic child. Feelings of powerlessness in the face to the precariousness of Health Services, in both material and human terms, emerged. It was observed that, as the discovery of the diagnosis was recent a lot of anguish has arisen, principally for mothers, in relation to institutional treatment. Among them were the uncertainties about the service, the issue of medication and of school inclusion. The recognition of the child\'s condition altered the self-esteem of parents causing them to oscillate between moments of belief and disbelief in the face of the development of the child, predominantly ambivalent feelings of helplessness and hope. Each couple used the setting proposed in a singular and unique way, according to their needs. We perceived that the interview situation favored the creation of a demand that was latent and this was taken as a listening and holding space for the parents. A feeling of urgency prevailed concerning the autistic child, who took the place of the conjugal relationship and the care of other children, when they existed. Given the complexity of the situations and the variety of emerging themes, we found that some couples might question the creation of the child, however, reveal little about the type of conjugal relationship construction. We believe that the model of therapeutic consultation represents a comprehensive and flexible proposal for the assistance of parents which can help to alleviate their anguish. We advocate that this method can serve as a means of care for mental health in the services related to the issue in question
109

Práticas familiares e o apoio à amamentação: revisão sistemática e metassíntese / Familys practices and the breastfeeding support: systematic review and metasynteses

Sousa, Alder Mourão de 16 December 2010 (has links)
A amamentação (AM) é uma prática diretamente relacionada com a promoção da saúde infantil. A família e a rede social podem ser determinantes na ocorrência e na manutenção da amamentação. Com o objetivo de identificar as práticas familiares relacionadas à manutenção da AM, realizou-se uma revisão sistemática de literatura seguida de síntese dos resultados dos artigos selecionados. A metodologia baseou-se na busca de artigos publicados em inglês, espanhol e português, entre 1989 e 2009, nas bases de dados: SCOPUS, PubMed, Web of Science®, PsycINFO, Biblioteca Cochrane, Science Direct, CINAHL, EMBASE, LILACS, BDENF e ADOLEC. Tal busca guiou-se pela pergunta: Quais são as práticas familiares que favorecem a manutenção da amamentação? Como resultado da busca foram selecionados 14 artigos no formato de relatos de pesquisa. Estes foram submetidos à leitura criteriosa da metodologia utilizada, dos sujeitos investigados, dos resultados obtidos e das conclusões. As sínteses foram construídas a partir da análise temática dos resultados e discursos dos sujeitos das pesquisas, de onde emergiram novos discursos que identificavam práticas da mãe, do pai, da avó e da rede social que foram agrupadas em 5 categorias-sínteses: 1) apoio emocional, 2) apoio instrumental, 3) apoio informativo, 4) apoio presencial e 5) auto-apoio. As sínteses permitem destacar como práticas familiares favorecedoras da AM: 1) ter orgulho de amamentar; apoiar a decisão da mãe; fazer carinho; beijar; amar; valorizar e encorajar a mãe; conversar com ela sobre a AM desde a gravidez e continuar depois. 2) participar das consultas pré-natal, das ações educativas e visitas domiciliárias; não oferecer fórmula láctea; cuidar da mãe e do bebê; ajudar a posicioná-lo; oferecer líquidos durante a mamada; trocar fralda; dar banho; ajudar a mãe a descansar; manter ajuda além das primeiras semanas; flexibilizar as rotinas; assumir tarefas domésticas. 3) se identificar como possível apoiador(a); incentivar boa alimentação; prover aconselhamentos; evitar cobranças. 4) realizar visita social; disponibilizar tempo para ouvir; acompanhar o parto; fazer companhia e conversar durante as mamadas; contemplar o bebê. 5) manter expectativas realistas; manter postura eu me apoio; manter postura nosso pré-natal / nós estamos grávidos / eu vou amamentar; reconhecer que a AM afetará sua vida; reconhecer sua capacidade para ser apoiador(a); manter abertura para aprender. Conclui-se que existem evidências suficientes sobre a importância de e como os membros familiares apoiam a amamentação, no sentido de favorecer seu início e sua manutenção. Tais achados podem subsidiar reflexões sobre a ampliação da clínica no cuidado da mulher e da criança. E lançam luz sobre uma nova perspectiva para o trabalho da enfermagem em saúde coletiva na Atenção Básica, destacando a importância de uma abordagem familiar diferenciada para a Promoção da Saúde na perspectiva do desenvolvimento infantil durante a experiência da amamentação. / Breastfeeding (BF) is a practice extremely involved with child health promotion. The family and the social network can be determents of occurrence and maintenance of BF. Aiming to identify family practices related to BF, were realized a systematic review of literature with synthesis of findings of the selected articles. The methodology was based on a search for articles published in English, Spanish and Portuguese between 1989 and 2009, in databases: SCOPUS, PubMed, Web of Science®, PsycINFO, Cochrane Library, Science Direct, CINAHL, EMBASE, LILACS, BDENF and ADOLEC. This search was guided by the question: What are the family practices that further maintenance of breastfeeding? Were selected 14 articles as a research reports. They were subjected to careful reading of the methodology used, the subjects investigated, the findings and conclusions. The syntheses were developed from the results of thematic analysis and discourse of the studys subjects, out of which emerged new discourses the identify practices from mothers, fathers, grandmothers and the social network. These new discourses were grouped in 5 syntheses-categories: 1) emotional support, 2) tangible support, 3) informational support, 4) companionship support and 5) self support. The syntheses allow us to highlight as familys practice further BF: 1) be proud to breastfeeding, to support de the mothers decision, kiss, love, appreciate and encourage the mother, to talk to her about BF since the pregnancy and continue after it. 2) to participate in prenatal visits, educational activities and home visits, not offer formula milk, to take care of mother and baby, to help to position it, offer liquids during the feeding, changing diapers, bathing, helping the mother rest, maintain help beyond the first week, flexible routines, assume household chores. 3) identify themselves as a possible supporter, to encourage good nutrition, to provide advice, to avoid charges. 4) to carry out social visit, taking time to listen, to accompany delivery, accompany and talk during the breastfeeding, admire the baby. 5) to maintain realistic expectations, maintaining the position I support myself, maintaining the position our prenatal / were pregnant / Ill breastfeeding, recognizing that the BF will affect their life, recognize their ability to be supportive, maintaining openness to learning. We conclude that sufficient evidence exists about the importance of and how family members support breastfeeding, in order to promote its beginning and its maintenance. These findings may support the broadening of reflections on the clinical care of women and children. And throws light on a new perspective to the work of nurses in collective health in Brazilian Basic Care, highlighting the importance of a differentiated family approach in Health Promotion in the perspective of child development during the breastfeeding experience.
110

Material ilustrado como estratégia para envolvimento familiar e adesão ao uso do AASI em crianças com deficiência auditiva / Illustrated material as a strategy for family involvement and adherence to the use of hearing aids in children with hearing loss

Monteiro, Raquel Regina Rodrigues 29 August 2013 (has links)
Made available in DSpace on 2016-04-27T18:12:02Z (GMT). No. of bitstreams: 1 Raquel Regina Rodrigues Monteiro.pdf: 5431649 bytes, checksum: b17fc531591bad1b39855d05f6483254 (MD5) Previous issue date: 2013-08-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / caretakers of children with hearing loss that would foster their adherence to the use of HA and their understanding of the initial orientation regarding auditory and language abilities. The applicability of the use of such material with Public Hearing Health Care Service users was investigated. Method: The material development was based on the underlying principles observed in clinical appointments at Centro Audição na Criança, which subsidized the structure and content to be addressed. A version was made using the following steps: organization of a prototype, partnership with a graphic designer and virtual group discussion with the professionals involved. The applicability of the material was assessed by means of its use with parents and caretakers during the routine process of HA selection/adaptation, the early stages of therapy and follow up appointments with children with hearing loss. The subjects were: parents/ caretakers accompanying the patients, children whose HA would allow daily measures of use, and audiologists responsible for the therapy sessions with these subject children. For the analysis of the preliminary version of the material, the following steps were used: a script for registering applicability, measurements of average daily use of HA and interview guides for parents/ caretakers and audiologists. A brainstorming session with qualified professionals in the area of hearing loss was conducted to refine and collect ideas to inform the production of the final version of the illustrated material. Results: The preliminary version of the illustrated material was presented in A5 size booklet format with spiral binding. The booklet content addressed the following matters: HA handling and care, and orientation on hearing and oral language development. Participants of this study were: eight audiologists and 16 families, whose children s chronological age ranged between 6 (six) and 53 (fifty-three) months. The communication strategy of the contents was an interactive and pictographic one. As for adherence, many factors interfered in daily average use of HA. As for the general evaluation of the material, all parents/ caretakers considered it good and fifteen of them (93,75%) used it at home. All audiologists reported that the material addressed important issues of the early stages of HA adaptation and supported families and audiologists during the development process. The most frequently treated subjects were: adherence to use of HA (45%) and HA care (32%). The final version was prepared taking into account comments from parents, audiologists/ speech therapists who applied the preliminary version of the illustrated material and brainstorming results. Conclusion: The material was used at home by families and seemed to contribute to family involvement, since it expanded its influence to beyond the person accompanying the child to therapy sessions. The audiologists of the Public Hearing Health Care Service demonstrated good acceptance to the material because it has guided the rehabilitation process and was regarded as support both for the family and therapist. Adherence to HA use was heterogeneous among subjects and suffered interference from several factors during the HA process of adaptation. The use of the material can be considered as a facilitator in the communication process between families and therapist / Objetivo: desenvolver e avaliar um material ilustrado para pais e responsáveis de crianças com deficiência auditiva que facilitasse a adesão ao uso do AASI e a compreensão das orientações iniciais quanto as habilidades auditivas e de linguagem. Investigou-se sua aplicabilidade em usuários do SUS. Método: Para o desenvolvimento do material realizou-se um levantamento das premissas observadas nos atendimentos feitos no CeAC que subsidiaram a estrutura e conteúdo a serem abordados. Foi confeccionada uma versão por meio das seguintes etapas: organização de um protótipo, parceria com designer gráfico e discussão em grupo virtual com os profissionais envolvidos. A aplicabilidade do material foi avaliada a partir do uso com pais/responsáveis na rotina do processo de seleção/adaptação de AASI, etapas iniciais de terapia (ADAPTI) e dos retornos para acompanhamento de crianças com deficiência auditiva. Foram sujeitos: os pais/responsáveis que acompanhavam as crianças no fluxo do serviço, crianças cujos os AASI possibilitassem a medida diária de uso e fonoaudiólogos que realizassem as terapias das crianças que entraram como sujeito. Para análise da versão preliminar do material foram utilizados: roteiro de registro de aplicabilidade, medidas de uso médio diário dos AASI e roteiros de entrevista para responsáveis e fonoaudiólogos. Foi realizado um brainstorming com profissionais habilitados na área da deficiência auditiva para aperfeiçoar e coletar ideias para subsidiar a confecção da versão final do material ilustrado. Resultados: A versão preliminar do material ilustrado se apresentou em formato de livreto no tamanho A5, com encadernação espiral. O conteúdo abordou questões referentes: ao manejo, cuidados com o AASI e orientações quanto ao desenvolvimento da audição e linguagem oral. Participaram desta pesquisa oito fonoaudiólogos e 16 famílias, cuja idade cronológica das crianças variou entre seis e 53 meses. Seu conteúdo teve como estratégia de comunicação um modelo interativo e pictográfico. Quanto à adesão, muitos fatores interferiram na média diária do uso dos AASI. Quanto a avaliação geral do material, todos os pais/responsáveis analisaram como bom e quinze deles (93,75%) o utilizaram em casa. Todos os fonoaudiólogos justificaram que o material abordou assuntos importantes da fase inicial de adaptação dos AASI e sobre o desenvolvimento, apoiou a família e o profissional durante esse processo. Os assuntos mais tratados estiveram centrados na adesão ao uso (45%) e cuidados com os AASI (32%). A versão final foi confeccionada considerando as observações dos pais, fonoaudiólogos que aplicaram a versão preliminar do material ilustrado e os resultados do brainstorming. Conclusões: O material foi utilizado em casa pelas famílias e pareceu colaborar para o envolvimento familiar, já que ampliou sua influência para além da pessoa que acompanhava a criança as sessões de terapia. Os fonoaudiólogos de um serviço do SUS demonstraram boa aceitação ao material pois norteou o processo de reabilitação e foi considerado como apoio à família e ao terapeuta. A adesão ao uso do AASI foi muito heterogênea entre os sujeitos e sofreu interferência de diversos fatores durante o processo de adaptação dos AASI. A utilização do material pode ser considerado como um facilitador no processo de comunicação entre famílias e terapeuta

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