Lam, Yin Hung. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (p. 89-97). / Abstracts in English and Chinese. / ABSTRACT --- p.iii / 摘要(ABSTRACT IN CHINESE) --- p.iv / ACKNOWLEDGEMENTS --- p.v / TABLE OF CONTENTS --- p.vi / TlST OF TABLES --- p.viii / LIST OF FIGURES --- p.ix / LIST OF APPENDIX --- p.x / Chapter CHAPTER I: --- INTRODUCTION --- p.1 / PSYCHOTIC DISORDERS --- p.1 / EXPRESSED EMOTION & RELAPSE OF PSYCHOTIC DISORDERS --- p.2 / POSITIVE EXPRESSED EMOTION COMPONENTS --- p.3 / ASSESSMENT TOOLS OF EXPRESSED EMOTION --- p.5 / CULTURAL CONSIDERATIONS OF EXPRESSED EMOTION --- p.7 / PSYCHOSOCIAL WELL-BEING OF PPD --- p.10 / RECOVERY: EMPOWERMENT & LIFE SATISFACTION --- p.11 / EMPOWERMENT --- p.13 / LIFE SATISFACTION --- p.14 / PSYCHOSOCIAL WELL-BEING OF RELATIVES --- p.14 / AIMS OF STUDY --- p.15 / HYPOTHESES OF STUDY --- p.16 / Chapter CHAPTER II: --- METHOD --- p.17 / PARTICIPANTS --- p.17 / MEASURES --- p.21 / PROCEDURE --- p.33 / Chapter CHAPTER III: --- RESULTS --- p.33 / INTER-RATER RELIABILITY OF FMSS CATEGORIZATIONS --- p.33 / NEGATIVE AND POSITIVE EE SCORES --- p.34 / RELATIONSHIP BETWEEN OVERALL EE AND SUB-EE --- p.36 / RELATIONSHIP BETWEEN FMSS AND SELF-REPORT MEASURES --- p.38 / "RELATIONSHIP BEWTEEN DEMOGRAPHIC CHARACTERISTICS, SELF-REPORT EE AND OUTCOME VARIABLES" --- p.39 / RELATIVES' EE: BREAKDOWN BY DEMOGRAPHIC CHARACTERISTICS --- p.43 / COVARIATES RELATED TO PPD´بS LIFE SATISFACTION CONTROLLED FOR --- p.47 / RELATIONSHIP BETWEEN RELATIVES´ة EXPRESSED EMOTION AND PSYCHOSOCIAL WELL-BEING OF RELATIVES AND PPD --- p.49 / PROPOSED MODEL (MODEL 1): SELF-REPORT AND FMSS --- p.49 / REFINED MODEL (MODEL 2): SELF-REPORT AND FMSS --- p.52 / FINAL MODEL (MODEL 3 A): SELF-REPORT AND FMSS --- p.56 / ALTERNATIVE MODEL (MODEL 3B): SELF-REPORT AND FMSS --- p.61 / Chapter CHAPTER IV: --- DISCUSSION --- p.67 / EXPRESSED EMOTION --- p.68 / SCORING SCHEME FOR EE --- p.68 / FMSS EE CATEGORIZATION --- p.68 / FMSS & SELF-REPORT OVERALL & SUB-EE --- p.69 / RELATIONSHIP BETWEEN FMSS & SELF-REPORT EE --- p.71 / "RELATIONSHIP BETWEEN DEMOGRAPHICS, SELF-REPORT EE & OUTCOME VARIABLES" --- p.71 / COVARIATES RELATED TO PPD，S LIFE SATISFACTION --- p.73 / "RELATIONSHIP BETWEEN RELATIVES, EE AND PSYCHOSOCIAL WELL-BEING OF RELATIVES & PPD" --- p.74 / OVERALL COMPARISON BETWEEN FMSS & SELF-REPORT MODELS --- p.78 / IMPLICATIONS --- p.79 / LIMITATIONS OF THE STUDY AND FUTURE DIRECTION --- p.82 / REFERENCES --- p.89

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Estudo exploratório, de abordagem mista, que objetivou analisar o perfil materno-infantil e verificar a associação entre tratamento adequado da sífilis na gestação e variáveis maternas e do recém-nascido em Ribeirão Preto, SP; compreender o significado da experiência do diagnóstico, tratamento e acompanhamento ambulatorial da criança com sífilis congênita, atribuído pelas mães, e conhecer a rede social e o apoio social das famílias de crianças com sífilis congênita em acompanhamento ambulatorial em um serviço de referência, a partir da perspectiva materna. Após aprovação de Comitê de Ética em Pesquisa, operacionalizou-se a coleta em duas etapas, a primeira, quantitativa, a partir de 112 prontuários de crianças notificadas com sífilis congênita, atendidas em dois serviços de referência, entre maio de 2014 e maio de 2016, analisados pelo IBM SPSS Statistics versão 25, utilizando-se testes Qui-Quadrado, exato de Fisher e regressão logística. Na segunda etapa, qualitativa, participaram 30 mães de crianças em acompanhamento ambulatorial para sífilis congênita no Centro de Referência em Especialidades do município. Adotou-se, por referencial teórico, o interacionismo simbólico; para a coleta de dados, elaboraram-se genogramas e ecomapas e realizou-se entrevista semiestruturada, com análise mediante a Análise Temática Indutiva. Verificouse a associação entre tratamento adequado da sífilis na gestação e idade materna (p=0,016), estado civil (p=0,013), idade gestacional (p=0,011), peso ao nascimento (p=0,045) e prolongamento da internação do neonato (p=0,001). Mães com menos de 20 anos 17,14 vezes mais chance de ter realizado tratamento adequado da sífilis do que mães acima de 35 anos. Ter companheiro aumentou em 2,95 vezes a chance de a mãe ter tratado adequadamente, a doença e o não prolongamento da internação da criança ao nascimento aumentou 13,33 vezes esta chance. Da análise da segunda etapa, emergiram cinco temas: \"Sífilis materna: vivenciando o impacto do diagnóstico e os cuidados em saúde para evitar a transmissão vertical\", evidenciando a trajetória da mãe ao se descobrir com sífilis, incluindo pré-natal, pré-natal do parceiro, como se infectou e o preconceito em relação à doença; \"Buscando informações sobre a doença\", discutindo o conhecimento prévio sobre sífilis e como se informou (profissionais de saúde, internet), e a importância atribuída às medidas de prevenção após essa experiência; \"Sentindo e agindo diante da doença\", retratando como a mãe se sentiu e agiu ao descobrir a doença, ao compreender sobre a transmissão vertical e ao acompanhar os cuidados de saúde da criança; \"Sífilis Congênita: trajetória de cuidados com a saúde da criança\", que detalha a trajetória dos cuidados com a saúde da criança desde o nascimento até o acompanhamento ambulatorial; e \"Configuração familiar e rede e apoio social\", com destaque para relações interpessoais, familiares, com sistemas de saúde e setores que ofertam suporte e apoio. As contribuições do estudo envolvem o incremento da prevenção, com fortalecimento de programas efetivos para acompanhamento da gestante e tratamento oportuno da sífilis, que considerem os aspectos intersubjetivos dessa experiência, a promoção de ações para minimizar a ocorrência na criança por meio de cuidado qualificado e focado na família e análise detalhada dos eventos sentinela / This is an exploratory study, with a mixed approach, aimed at analyzing the maternalinfant profile and checking the association between adequate treatment of syphilis in pregnancy and maternal and newborn variables in Ribeirão Preto, state of São Paulo; understanding the meaning of the experience of the diagnosis, treatment and outpatient follow-up of the child with congenital syphilis, attributed by the mothers and knowing the social network and social support of the families of children with congenital syphilis in outpatient follow-up at a reference service, from the maternal perspective. After approval of the Research Ethics Committee, data collection was carried out in two stages; the first, quantitative, from 112 medical records of children diagnosed with Congenital Syphilis, attended at two reference services between May 2014 and May 2016; analyzed by the IBM SPSS Statistics version 25, using Chi-Square, Fisher\'s exact tests and logistic regression. In the second stage, qualitative, 30 mothers of children participated in outpatient follow-up for congenital syphilis at the Municipal Specialty Reference Center. Symbolic Interactionism was adopted as theoretical reference; for data collection, genograms and ecomaps were elaborated and a semi-structured interview was conducted, with analysis by Inductive Thematic Analysis. There was an association between adequate syphilis treatment during gestation and maternal age (p=0.016), marital status (p=0.013), gestational age (p=0.011), birth weight (p=0.045) and prolongation of neonatal hospitalization (p=0.001). A mother under 20 was 17.14 times more likely to have had adequate syphilis treatment than mothers over 35 years. Having a companion increased by 2.95 times the chance that the mother had adequately treated the disease and the non-prolongation of the child\'s hospitalization at birth increased 13.33 times this chance. From the analysis of the second stage, five themes emerged: \"Maternal syphilis: experiencing the impact of diagnosis and health care to avoid vertical transmission\", showing the trajectory of the mother when she discovered she had syphilis, including prenatal, prenatal of the partner, how she became infected and the prejudice regarding the disease; \"Seeking information about the disease\", discussing prior knowledge about syphilis and how she was informed (health professionals, internet), and the importance given to prevention measures following this experience; \"Feeling and acting in the face of illness\", representing how the mother felt and acted when discovered the disease, by understanding about the vertical transmission and accompanying the child\'s health care; \"Congenital syphilis: child health care trajectory\", which details the trajectory of child health care, from birth to outpatient follow-up; and \"Family configuration and social network and support\", highlighting interpersonal, family relations, relationships with health systems and sectors that offer support and backing. The contributions of the study involve increasing prevention, strengthening effective programs for follow-up of the pregnant woman and timely treatment of syphilis, which consider the intersubjective aspects of this experience, the promotion of actions to minimize the occurrence in the child through qualified care and focused on the family and the detailed analysis of sentinel events

<p>The aim of this study is to contribute to understanding of how children try to understand and interpret their own father and his (possibly) violent actions against their mother in relation to their general conceptualizations concerning fathers and violence. A general social psychological and interactionist approach is related to the children’s selves as the organizing and experiencing structures, the family as the arena for experiences and communicative interaction, and society as a structure of norms and general ideas. </p><p>The study is based on interviews with ten children, who were eight to twelve years old at the time of the interview and whose mothers had escaped from their fathers’ violence to a Women’s House. Qualitative interpretation of each child’s complex abstracted and generalized conceptualizations of fathers and violence enabled the understanding of individual themes as crucial parts of each child’s logically unified and conciliated symbolic meaning through the theoretical construct of negotiation. </p><p>The study results in the identification of three alternative theoretical approaches to meaning-conciliation. One can be described as ‘conceptual fission’ in the general conception of fathers, one as ‘conceptual fission’ in the conception of the own father and one as negotiating the extension of the opposite of violence, described as ‘goodness’. These negotiations can be understood as parts of distancing violence from either one subgroup of fathers, from the overall, essential or principle understanding of the own father within the child’s relationship with him, or from fathers altogether, including the child’s own. The children’s attempts to combine normalization of their father as an individual with resistance to his violent acts are interpreted as indicating the difficulty that the combination of the social deviancy of violence and the family context constitutes for many children. </p>

<p>Studiens syfte var att undersöka sjuksköterskors upplevelser av att ge stöd till anhöriga till patienter inom palliativ hemsjukvård.</p><p>Designen var deskriptiv med en kvalitativ ansats. Informanterna var strategiskt utvalda och bestod av fem sjuksköterskor som arbetade i ett palliativt hemsjukvårdsteam i Upplands län. Bandinspelade personliga intervjuer analyserades med en kvalitativ innehållsanalys.</p><p>Sjuksköterskorna upplevde att deras arbete kändes meningsfullt och utvecklande. Att arbeta i team var en mycket positiv aspekt. De svårigheter som framkom handlade om att anpassa sig efter olika situationer. Sjuksköterskorna gav stöd till anhöriga främst genom att kommunicera och samtala, samt förmedla trygghet. Det var viktigt att även både verbalt och praktiskt visa anhöriga att det fanns tid även för detta.</p><p>Eftersom det blir allt vanligare med palliativ vård i hemmet och den inte kan ske utan de anhörigas insats är det mycket viktigt att utveckla och optimera sjuksköterskans stöd till dem. Denna studie kan ge en insikt i de problem som finns i anhörigstödet, men även ge en insikt om de organisatoriska och personella insatser som fungerar.</p> / <p>The aim of this study was to investigate nurses' experiences in supporting next of kin to patients in palliative home care.</p><p>The design was descriptive with a qualitative approach. The informants were strategically selected and consisted of five nurses, working in a palliative home care team in Uppland, in Sweden. Tape-recorded personal interviews were analysed with a qualitative content analysis.</p><p>The nurses experienced that their work felt meaningful and developing. To work in a team was a very positive aspect. Difficulties that appeard involved adjusting to different situations. The nurses supported next of kin mainly by communicating and conversing, and mediating safety. It was important to as well both verbally and practically show next of kin that there was also time for this.</p><p>Since palliative care in the home is getting more common, and since it cannot happen without the effort of next of kin, it is very important to develop and optimize the nurses' support to them. This studie can give insight in the problems that exist in this support, but also give insight about the organizational and personal achievements that work.</p>

Aim: The overall aim of this thesis is, from the point of view of parents of a child with asthma, to describe meanings of being a parent, parents’ quality of life, and to describe how family relations are influenced by their child’s disease. The aim is also to increase the understanding of what strategies professional caregivers use in their work with teenagers suffering from asthma. Methods: Informants in the three qualitative studies were 29 parents (17 mothers and 12 fathers) of children with asthma and 7 professional caregivers. Informants in a quantitative quality of life study were 371 parents. The data collections were undertaken by means of interviews, observations and a questionnaire. The data was analysed by means of a phenomenological-hermeneutic method, grounded theory and statistics. Results: A meaning of being a parent of a child with asthma is to live a strenuous life and to fear that the child might die during a severe asthma attack. The parents’ actions involve both protecting and liberating and their feelings involve sadness as well as acceptance. Mostly the mothers act in a protecting manner and express feelings of sadness. The fathers mostly act in a liberating manner and express feelings of acceptance. The core concern in families of a child with asthma was found to be disease-engendered uncertainty. The mothers describe that feelings of uncertainty always are present owing to the unpredictability of the disease. These feelings make the mothers more or less available for family members. For the child with asthma the mothers’ experience that they are always available. Thus, control and tight bonds characterize the mother-child relationships. The mothers’ constant availability for the child with asthma is experienced to lead to a decreased availability for other family members and theses relationships are characterised by feelings of forsakenness and lack of understanding. However, when parents of children with asthma estimate their quality of life by a questionnaire, they estimate it as comparatively high. In the same family the parents scoring of separate items was to a large extent similar. The result also shows that professional caregivers’ central concern is to assist teenagers with asthma to conquer life. This gives rise to five strategies: showing respect, being at hand, promoting personal sense of responsibility, promoting exceeding boundaries, and promoting reflections. In professional caregivers’ attempt to assist teenagers to conquer life some differences are seen in the way they support boys and girls. Conclusion: One conclusion drawn from this thesis is that being a parent of a child with asthma involves feelings of uncertainty. In meeting the parents in question, caregivers should reflect upon these feelings and consider how the parents could be assisted. As mothers and fathers describe different attitudes in relation to the care of the child, it is also important to reflect upon how professional caregivers can assist the balance between the mothers’ protecting and the fathers’ liberating attitudes. It is also important for professional caregivers to reflect upon how they meet teenage girls and boys with asthma respectively, and to take their needs and understanding of the situation into consideration.

Studiens syfte var att undersöka sjuksköterskors upplevelser av att ge stöd till anhöriga till patienter inom palliativ hemsjukvård. Designen var deskriptiv med en kvalitativ ansats. Informanterna var strategiskt utvalda och bestod av fem sjuksköterskor som arbetade i ett palliativt hemsjukvårdsteam i Upplands län. Bandinspelade personliga intervjuer analyserades med en kvalitativ innehållsanalys. Sjuksköterskorna upplevde att deras arbete kändes meningsfullt och utvecklande. Att arbeta i team var en mycket positiv aspekt. De svårigheter som framkom handlade om att anpassa sig efter olika situationer. Sjuksköterskorna gav stöd till anhöriga främst genom att kommunicera och samtala, samt förmedla trygghet. Det var viktigt att även både verbalt och praktiskt visa anhöriga att det fanns tid även för detta. Eftersom det blir allt vanligare med palliativ vård i hemmet och den inte kan ske utan de anhörigas insats är det mycket viktigt att utveckla och optimera sjuksköterskans stöd till dem. Denna studie kan ge en insikt i de problem som finns i anhörigstödet, men även ge en insikt om de organisatoriska och personella insatser som fungerar. / The aim of this study was to investigate nurses' experiences in supporting next of kin to patients in palliative home care. The design was descriptive with a qualitative approach. The informants were strategically selected and consisted of five nurses, working in a palliative home care team in Uppland, in Sweden. Tape-recorded personal interviews were analysed with a qualitative content analysis. The nurses experienced that their work felt meaningful and developing. To work in a team was a very positive aspect. Difficulties that appeard involved adjusting to different situations. The nurses supported next of kin mainly by communicating and conversing, and mediating safety. It was important to as well both verbally and practically show next of kin that there was also time for this. Since palliative care in the home is getting more common, and since it cannot happen without the effort of next of kin, it is very important to develop and optimize the nurses' support to them. This studie can give insight in the problems that exist in this support, but also give insight about the organizational and personal achievements that work.

Darbe atlikta teorinė šeimos, kaippirminės vaiką supančios aplinkos ryšių ir psichologinę situaciją įtakojančių santykių analizė mokslo darbuose. Empirinėje dalyje nagrinėjami rizikos šeimų socialiniai šeimyniniai santykiai; šeimos narių patirtų išgyvenimų atskirus vaikus, pasekmės ir šių šeimų santykių atkūrimo galimybės bendradarbiaujant socialiniams pedagogams ir VTAT. / Theoretical part of thesis includes analysis of scientific works about the family as a primary environment for a child and psychological analysis of the family relations in risk families. Practical part reveals social relations in risk families, experiences of the family members after their children have been separated from the parents; an ability to restore family relations with the help of social workers.

There is an accumulating body of evidence suggesting that being raised in a non-intact family may adversely affect child outcomes across a number of developmental domains. There are nevertheless questions re: interpretation for a number of methodological reasons ranging from conceptualization of exposure to analytic approach. Given the dynamic nature of family life for some children today, changes in family structure may need to be captured in a more comprehensive manner. The scientific question is how capturing dynamics of family structure can be achieved. Data were drawn from the National Longitudinal Survey of Children and Youth (NLSCY), an ongoing longitudinal population survey following cohorts of Canadian children from infancy to adulthood across a number of domains of health and well-being. The sample comprised individuals aged 11-14 in cycle five of the NLSCY. We examined different approaches to conceptualizing and modeling the effect of the family structure effect based on previous studies in this area and from the lifecourse epidemiological literature. We examined the effects of current family structure, previous family structures, trajectories of family structure, and change in family structure on externalizing and internalizing behavior in pre-adolescence. We found that the validity of each approach was largely dependent on the specific research question at hand, with each one having its own advantages and disadvantages. Main methodological findings included confounding of the current family structure effect by previous experience, collinearity among family structure main effects, and low analytic power for trajectories. Guided by a conceptual diagram of the underlying causal structure, we also considered the time-varying nature of family income and employment status of the primary household respondent using inverse probability weighting to estimate the causal parameters of a marginal structural model. In one of our most sophisticated conceptualizations of family structure effects, we found that recent change in family structure had a statistically significant effect on the odds of externalizing behavior, OR (95% CI) = 2.95 (1.73-5.02). Overall, our substantive findings were tempered by methodological caveats, which have important implications for future studies in the area and for broader issues related to data collection, study design, and analysis.

Diss. (sammanfattning) Umeå : Univ., 2005. / Härtill 4 uppsatser.