This dissertation, employing an array of theoretical approaches under the rubric of Systems Thinking, explores the reality and experiences of family members that mainly provide care at home for their loved ones who live with or are directly affected by HIV & AIDS. Employing a multidisciplinary approach, the dissertation demonstrates how Systems Thinking, feminist and indigenous knowledge principles can be employed for a better understanding of the contemporary construction of family and experiences of caregivers in an HIV & AIDS context. The discussion of the dissertation is based on data analysed following in-depth interviews with fifteen caregivers of the Bhambayi community. The findings of the study reflect a significant change in the definition and practice of parenting. It was found that HIV & AIDS forces a re-definition of the concept and practice of parenting beyond the traditional boundaries of age, sex and gender. Aligned with this main finding was that parenting practices and coping strategies are largely influenced by a strong commitment to the well-being of the children as well as societal constructs. The thesis of this dissertation is that the HIV & AIDS context and associated gender and cultural stereotypes are principally responsible for a significant shift in the understanding of the concept and practice of parenting within an African context. The study thus submits that a Systems Thinking approach ought to be used by interventionists to better understand and thus contribute towards improving the lives of families or communities in similar circumstance as that of the Bhambayi families. / Thesis (M.Com.)-University of KwaZulu-Natal, Westville, 2009.

The assumption underlying this study is that a spatially well planned and appropriately furnished nursing home facility will help the nurses to perform their work more effectively and accordingly lead to more satisfaction for the residents. Research in the forms of a literature review, a movie analysis, and a field study of nursing homes in Germany and the USA, including plan annotations and observational mapping, trace study analyses and survey techniques, was conducted and revealed an unexpected urgent need for nursing home design improvement, especially in the U.S. The research results led to the development of a catalogue of patterns which are useful in the design and planning of a nursing home to improve nurses’ effectiveness in administering care to fulltime residents of nursing homes. With the help of the developed patterns, suggestions for building renovations of two of the researched nursing homes, one American and one German, were given. / Department of Architecture

Increasing numbers of older persons, service provision within the home and shrinking resources have resulted in the need to evaluate service provision. This study examined agency process and client-perceived health in a single point of entry case managed program in a community health centre. The participatory evaluative model involved a dossier review, interviews with workers, and a description of client functioning using the SF-12(TM). Examination of files (N = 100) revealed that objectives were not being obtained: client involvement was low, services were late, and files were poorly completed. Only 14 (9%) of clients were referred for the SF-12(TM); further investigation revealed systemic difficulties such as lost clients (N = 4). Worker interviews (N = 12) explained that heavy caseloads result in reactive services, poor completion of case management functions, and service implications for clients. Strengths included the multi-disciplinary approach and single point of entry. Recommendations include a cost benefit analysis, an outcome measure, a caseload standard and a quality assurance model that assures accountability and monitoring.

Thesis (M.S.)--University of Michigan, 1985.

Thesis (M.S.)--University of Michigan, 1985.

Thesis (M.S.)--University of Michigan, 1990.

Thesis (M.S.W.)--University of Hong Kong, 1993. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1990.

The development of innovative techniques in healthcare leveraged, significantly, the life expectancy of human beings. This new scenario raises concern in society to create a health care network able to absorb this demand and provide conditions for access to a range of needs. The decreasing family constitution and the increasing number of seniors are targeted to meet this emerging new customer, independent, connected technologies and services often alone. The figure of Home Care in this environment provides an inherent carefully for the characteristics of these people, who depend on daily monitoring of health and quality of life. The advent of computer technology streamlines this interaction, creating a support capable of providing real-time monitoring of physical conditions that might suggest a situation of medical emergency or specific monitoring of the person. The study advocated here is to create an information network for home monitoring via Home Care. The system, through pervasive computing, will capture vital signs through electronic devices and other relevant information conditions of the person. Be able to trigger a predetermined career or monitoring center, in specific cases, where an official with technical expertise in the healthy area, take steps to stabilize the frame. The same system will be able to store all kinds of information captured or entered by the professional records and issue reports as requested . / O desenvolvimento de técnicas inovadoras na área de saúde alavancou, de forma significativa, a expectativa de vida do ser humano. Esse novo cenário gera na sociedade a preocupação de criar uma rede assistencial capaz de absorver essa demanda e oferecer condições de acesso aos mais variados tipos de necessidades. A constituição familiar decrescente e o aumento do número de idosos fazem surgir serviços direcionados a atender esse novo cliente, independente, conectado as tecnologias e muitas vezes sozinho. A figura da Home Care, nesse ambiente, proporciona um cuidado inerente as características dessas pessoas, que dependem de uma monitorização diária da saúde e da qualidade de vida. O advento da informática agiliza essa interação, criando um suporte capaz de oferecer em tempo real uma monitorização de condições físicas que podem sugerir uma situação de urgência médica ou de acompanhamento específico da pessoa. O estudo aqui defendido é a criação de uma rede de informações para monitorização residencial via Home Care. O sistema, através de computação pervasiva, fará a captação de sinais vitais por meio de dispositivos eletrônicos e de outras informações pertinentes as condições da pessoa. Será capaz de acionar um cuidador pré-determinado ou uma central de monitoramento, em casos específicos, onde um responsável, com capacitação técnica na área de saúde, tomará providências para o atendimento do paciente. O mesmo sistema será capaz de armazenar todo tipo de informação captada ou inserida pelo profissional no prontuário e emitir relatórios conforme solicitação.

Magister Scientiae - MSc (Mathematics) / The high prevalence of HIV/AIDS in Zambia has led to the development of innovative ways of coping with sickness related to this infection. HIV/AIDS home-based care is one such innovation designed in Chikankata Hospital in 1987. Home-based care depends on the availability of family members and community volunteers in the provision of care and support for People Living with HIV/AIDS (PLWHA).This minithesis is based on a qualitative descriptive case study exploring perspectives regarding skills, supervision and support mechanisms for carers in the Chikankata HIV/AIDS Community-Home Based Care (CHBC) program. The study utilized documented research, focus group discussions with carers and structured interviews with local CHBC supervisors, national experts in CHBC, and PLWHA and their families, to collect data from 32 study participants.The findings were that CHBC was being delivered by community volunteers with limited involvement from the local health services; that carers were highly motivated, personally and collectively mobilizing resources to meet the needs of CHBC clientele; that local arrangements for training, skills and support of carers were not aligned to national guidelines regarding process, content and duration of programmes; and that carers acquired skills in CHBC through formal and informal training processes and were facing challenges related to inadequate skills, poor infrastructure and extreme poverty in households caring for PLWHA.Based on the findings the local arrangements for coordination of CHBC need to be strengthened and linked to formal processes for technical support, financial resources and materials for delivery of CHBC in line with existing guidelines on CHBC. The picture of the real situation of the carers that emerges from this qualitative study might inform the supervising organizations and policymakers on the gaps in the training and support of this crucial cadre in the provision of quality care for People Living with HIV/AIDS (PLWHA) at community level. / South Africa