Chemical dependency in the health profession is a growing concern. With easy access to controlled substances, many nurses divert prescription drugs and even work while under the influence. Nurses who are under the influence and working with patients are an obvious public hazard. Many states in the USA have non-punitive programs to offer recovery to nurses with chemical dependency and return them to work. In California this program is named the Diversion Program. Part of the requirements of successful completion of the Diversion Program is to attend weekly meetings called support groups. These support groups are facilitated by other nurses experienced in the field of chemical dependency. This study explored the experiences of nurse facilitators of support groups for nurses with chemical dependency in the California, USA, Diversion Program. Data were collected through twelve individual interviews selected through purposeful, non-probability convenience sampling. A phenomenological research design was used that was descriptive, explorative, and contextual. The data analysis revealed four major themes: (1) experience of communication within the Diversion Program; (2) experience of the structure of the Diversion Program; (3) experience of their role within the Diversion Program; and (4) experience of facilitation of support groups. The study revealed that even though many of the nurse facilitators‟ experiences were positive with respect to the support groups they expressed concern about the communication patterns within the Diversion Program. To offer support for the nurse facilitators, guidelines and a conceptual framework were created to enhance their experience and mitigate their feelings of marginalization from the Diversion Program. / Health Studies / D.Litt. et Phil. (Health Studies)

Estudo sobre o fenômeno dos grupos de apoio aos pacientes sob a ótica da Ciência da informação, tendo em vista as questões relacionadas ao acesso à informação e ao conhecimento no campo da saúde pública. O contexto preparatório da transição paradigmática da modernidade para a pós-modernidade tem como fenômeno inovador a ação dos grupos de apoio aos pacientes na promoção da saúde e da melhoria global da qualidade de vida, por meio de ações de informação. As ações desses grupos são observadas por meio de pesquisa empírica qualitativa. São investigadas de forma específica as fontes às quais recorrem os pacientes de doenças crônicas não transmissíveis para lidar com a incerteza. Os resultados de entrevistas com profissionais de saúde e pacientes reforçam a importância dos grupos e a confiança e solidariedade subjacentes a eles. Conclui-se que os pacientes recorrem em primeiro lugar ao médico quando necessitam de informação de alta confiabilidade, mas também aos enfermeiros, amigos e à mídia. Os resultados sugerem a necessidade de ampliação da operação pública dos grupos de apoio com vistas à promoção da saúde, ao acesso livre e aberto à informação científica transliterada em saúde pública. Sugerem também a necessidade de criação de sistemas de informação voltados especificamente para os mediadores dos grupos de apoio aos pacientes, segmento ainda não contemplado com dispositivos informacionais adequados de apoio ao desenvolvimento de suas ações. / Study on the phenomenon of the support groups for the patients under the optics of Information Science, with a view to the issues related to the information access and knowledge in public health; in the context of the paradigmatic transition of the modernism to post modernism, the support groups are considered as innovative input for patients under the standpoint of the support for the health promotion and the quality of life improvement. The research, a qualitative empirical survey, analyzes entities that promote support groups for patients of non communicable chronicle diseases, aims to identify which information sources the patients seek in order to deal with the uncertainty, and distress in face of the diagnosis of a chronicle disease. The results of the interviews with health professionals and patients show the importance of the groups and their character of confidence and underlying solidarity. It concludes that the patients consider physicians as their most important sources of information, but also ask the nurses, friends and the media for more information. The study suggests some parameters for the expansion of the public operation of the support groups with a view to the health promotion, to the free and open access to \"translated\" scientific information in public health. It suggests also that there is a lack of specific information systems to support the professionals that work as information intermediaries in such groups.

Este é um estudo descritivo e correlacional que teve, como objetivo, identificar e descrever classes de comportamentos da conversa de idosos institucionalizados, medir suas frequências de ocorrência e verificar suas relações com a estrutura da rede social e com o tipo de apoio que eles recebiam. Inicialmente, foi feita uma revisão da literatura científica para identificar os comportamentos envolvidos na conversa. Com base nesses comportamentos, foi elaborado um primeiro roteiro de observação sistemática, constituído por 19 comportamentos, e o teste de interação real planejada para coletar uma amostra da conversa com os idosos. Participaram da pesquisa 30 idosos institucionalizados que tinham, em média, 74 anos. Esses idosos fornecerem seus consentimentos livre e esclarecido para a coleta de dados. Durante dois encontros com cada idoso foram aplicados quatro instrumentos: entrevista, diagrama de escolta, teste de interação real planejada e escala de apoio social. A aplicação dos instrumentos foi gravada em vídeo. Utilizou-se o primeiro roteiro de observação para observar os comportamentos da conversa dos idosos, gravados nos vídeos do teste de interação real planejada. Este roteiro foi modificado com inserção de novos comportamentos. O segundo roteiro passou a conter 26 comportamentos (18 verbais e oito não-verbais). Este foi utilizado para verificar a frequência dos comportamentos identificados. Foram observados 343 minutos de conversa. Os comportamentos foram redefinidos e apresentados a seis juízes para avaliar a fidedignidade das definições e observações. Os juízes avaliaram, também, três tipos globais de habilidades comunicativas dos idosos. Os índices de concordância oscilaram entre 83% e 100%. As habilidades comunicativas foram avaliadas como boas, com algumas variações. A frequência dos comportamentos verbais e não-verbais variou entre os idosos e interferiram na duração da conversa com a pesquisadora. Por isso, eles foram classificados como idosos que dominaram o turno da fala, idosos que fizeram comentários amplos e idosos que fizeram pequenos comentários. Foram calculadas as correlações entre os tempos de duração das conversas e as habilidades comunicativas dos idosos. Os idosos que fizeram pequenos comentários foram menos expressivos não-verbalmente e apresentaram menos informações gratuitas. De maneira geral, a maioria dos idosos fez poucas perguntas e demonstrou excessivo interesse em falar de si e desinteresse pelas autorrevelações da pesquisadora, sugerindo dificuldades comunicativas. Os idosos possuíam, em média, 6,2 pessoas na rede, quantidade pequena quando comparada com as redes sociais relatadas em estudos da literatura científica. Ocorreram variações na quantidade de pessoas da rede social, no número de pessoas que os idosos trocavam apoio e no tipo e quantidade de apoio recebido. Os idosos que fizeram pequenos comentários, além de serem mal avaliados pelos juízes, tinham, em média, menos pessoas nas suas redes e recebiam menos apoio de interação positiva. Os coeficientes de correlação sustentam esta afirmação. As análises comparativas entre os grupos e as tendências desses coeficientes indicam que boas habilidades comunicativas estão relacionadas com uma maior quantidade de pessoas na rede social e mais apoio afetivo e de interação positiva. Portanto, estes resultados indicam a necessidade de programas de desenvolvimento de habilidades comunicativas para auxiliarem os idosos institucionalizados a conquistarem e a manterem uma boa rede social de apoio / This is a descriptive and correlational study that aimed to identify and describe the categories of behavioral speech patterns of the elderly who have been institutionalized, with its focus on measuring said behavioral speech and its frequency in relation to the social care networks and the type of care the institutionalized receive. A review of the scientific literature was initially carried out to indentify the behavioral patterns involved in the conversational abilites of the institutionalized. With this information, a systematic report of observations was made, including 19 behavioral patterns, and a planned interactive test to collect a sample conversation of the subjects. Thirty people participated in the research with a median age of 74. All thirty gave their full consent to take part in the research and release any information that might have been needed for the researchers. Two meetings were conducted with each person, where four types of analytical instruments were applied: interviews, the convoy of social support, interactive tests and also the social support scale (SSS). These tests were video recorded. The first reported video observations were used to identify the speech behavior of the institutionalized. This report has been modified by inserting newly observed behavioral patterns of the institutionalized. The second report contained twenty-six types of behavioral patterns eighteen verbal and eight nonverbal and was utilized to verify the frequency of these identified behavioral patterns. A total of three hundred and forty-three minutes of observed conversations were conducted. The behavioral patterns were defined and then presented to six analysts to evaluate the accuracy of the reported observations. The analysts also verified three general types of communicative abilities of the institutionalized. The rates of agreement concerning their communicative abilities varied between eighty-three percent and a hundred percent. The frequency of their communicative abilities was evaluated as good, with few variations. The frequency of verbal behavior patterns and nonverbal patterns varied between the institutionalized and interfered in the conversation between the researcher and the subject. Because of this they were classified into the following three groups: the subjects who dominated the conversation, the subjects who made considerable comments, and those who hardly participated. The length of the conversation and the communicative abilities of the subjects were calculated in a correlational form. The subjects who made fewer comments were nonverbally less expressive and showed less information willingly. Generally speaking, the majority of the subjects asked few questions and showed extreme interest in talking about themselves and was uninterested in listening to the researcher, making communication difficult. In median, the subjects had 6,2 people in their social network, which is considered relatively small when compared to the scientific literature. There were variations in the quantity of people in the social networks, and the number of people that the subjects exchanged support with, as well as the quality and type of support received between the three subject groups. Besides being poorly assessed by the analysts, the subjects who made the fewest comments had in median, less people in their social network and received less positive interaction support. The correlation coefficients supported this fact. The comparative analysis between the groups and the correlation coefficient made evident that good communicative abilities are related to the number of people in the social networks and the amount of positive care and interaction exchanged. Therefore, these results indicate there is a need for developing programs which focus on improving communicative abilities to aid the institutionalized to achieve and maintain proper social support networks

Este é um estudo descritivo e correlacional que teve, como objetivo, identificar e descrever classes de comportamentos da conversa de idosos institucionalizados, medir suas frequências de ocorrência e verificar suas relações com a estrutura da rede social e com o tipo de apoio que eles recebiam. Inicialmente, foi feita uma revisão da literatura científica para identificar os comportamentos envolvidos na conversa. Com base nesses comportamentos, foi elaborado um primeiro roteiro de observação sistemática, constituído por 19 comportamentos, e o teste de interação real planejada para coletar uma amostra da conversa com os idosos. Participaram da pesquisa 30 idosos institucionalizados que tinham, em média, 74 anos. Esses idosos fornecerem seus consentimentos livre e esclarecido para a coleta de dados. Durante dois encontros com cada idoso foram aplicados quatro instrumentos: entrevista, diagrama de escolta, teste de interação real planejada e escala de apoio social. A aplicação dos instrumentos foi gravada em vídeo. Utilizou-se o primeiro roteiro de observação para observar os comportamentos da conversa dos idosos, gravados nos vídeos do teste de interação real planejada. Este roteiro foi modificado com inserção de novos comportamentos. O segundo roteiro passou a conter 26 comportamentos (18 verbais e oito não-verbais). Este foi utilizado para verificar a frequência dos comportamentos identificados. Foram observados 343 minutos de conversa. Os comportamentos foram redefinidos e apresentados a seis juízes para avaliar a fidedignidade das definições e observações. Os juízes avaliaram, também, três tipos globais de habilidades comunicativas dos idosos. Os índices de concordância oscilaram entre 83% e 100%. As habilidades comunicativas foram avaliadas como boas, com algumas variações. A frequência dos comportamentos verbais e não-verbais variou entre os idosos e interferiram na duração da conversa com a pesquisadora. Por isso, eles foram classificados como idosos que dominaram o turno da fala, idosos que fizeram comentários amplos e idosos que fizeram pequenos comentários. Foram calculadas as correlações entre os tempos de duração das conversas e as habilidades comunicativas dos idosos. Os idosos que fizeram pequenos comentários foram menos expressivos não-verbalmente e apresentaram menos informações gratuitas. De maneira geral, a maioria dos idosos fez poucas perguntas e demonstrou excessivo interesse em falar de si e desinteresse pelas autorrevelações da pesquisadora, sugerindo dificuldades comunicativas. Os idosos possuíam, em média, 6,2 pessoas na rede, quantidade pequena quando comparada com as redes sociais relatadas em estudos da literatura científica. Ocorreram variações na quantidade de pessoas da rede social, no número de pessoas que os idosos trocavam apoio e no tipo e quantidade de apoio recebido. Os idosos que fizeram pequenos comentários, além de serem mal avaliados pelos juízes, tinham, em média, menos pessoas nas suas redes e recebiam menos apoio de interação positiva. Os coeficientes de correlação sustentam esta afirmação. As análises comparativas entre os grupos e as tendências desses coeficientes indicam que boas habilidades comunicativas estão relacionadas com uma maior quantidade de pessoas na rede social e mais apoio afetivo e de interação positiva. Portanto, estes resultados indicam a necessidade de programas de desenvolvimento de habilidades comunicativas para auxiliarem os idosos institucionalizados a conquistarem e a manterem uma boa rede social de apoio / This is a descriptive and correlational study that aimed to identify and describe the categories of behavioral speech patterns of the elderly who have been institutionalized, with its focus on measuring said behavioral speech and its frequency in relation to the social care networks and the type of care the institutionalized receive. A review of the scientific literature was initially carried out to indentify the behavioral patterns involved in the conversational abilites of the institutionalized. With this information, a systematic report of observations was made, including 19 behavioral patterns, and a planned interactive test to collect a sample conversation of the subjects. Thirty people participated in the research with a median age of 74. All thirty gave their full consent to take part in the research and release any information that might have been needed for the researchers. Two meetings were conducted with each person, where four types of analytical instruments were applied: interviews, the convoy of social support, interactive tests and also the social support scale (SSS). These tests were video recorded. The first reported video observations were used to identify the speech behavior of the institutionalized. This report has been modified by inserting newly observed behavioral patterns of the institutionalized. The second report contained twenty-six types of behavioral patterns eighteen verbal and eight nonverbal and was utilized to verify the frequency of these identified behavioral patterns. A total of three hundred and forty-three minutes of observed conversations were conducted. The behavioral patterns were defined and then presented to six analysts to evaluate the accuracy of the reported observations. The analysts also verified three general types of communicative abilities of the institutionalized. The rates of agreement concerning their communicative abilities varied between eighty-three percent and a hundred percent. The frequency of their communicative abilities was evaluated as good, with few variations. The frequency of verbal behavior patterns and nonverbal patterns varied between the institutionalized and interfered in the conversation between the researcher and the subject. Because of this they were classified into the following three groups: the subjects who dominated the conversation, the subjects who made considerable comments, and those who hardly participated. The length of the conversation and the communicative abilities of the subjects were calculated in a correlational form. The subjects who made fewer comments were nonverbally less expressive and showed less information willingly. Generally speaking, the majority of the subjects asked few questions and showed extreme interest in talking about themselves and was uninterested in listening to the researcher, making communication difficult. In median, the subjects had 6,2 people in their social network, which is considered relatively small when compared to the scientific literature. There were variations in the quantity of people in the social networks, and the number of people that the subjects exchanged support with, as well as the quality and type of support received between the three subject groups. Besides being poorly assessed by the analysts, the subjects who made the fewest comments had in median, less people in their social network and received less positive interaction support. The correlation coefficients supported this fact. The comparative analysis between the groups and the correlation coefficient made evident that good communicative abilities are related to the number of people in the social networks and the amount of positive care and interaction exchanged. Therefore, these results indicate there is a need for developing programs which focus on improving communicative abilities to aid the institutionalized to achieve and maintain proper social support networks

Estudo sobre o fenômeno dos grupos de apoio aos pacientes sob a ótica da Ciência da informação, tendo em vista as questões relacionadas ao acesso à informação e ao conhecimento no campo da saúde pública. O contexto preparatório da transição paradigmática da modernidade para a pós-modernidade tem como fenômeno inovador a ação dos grupos de apoio aos pacientes na promoção da saúde e da melhoria global da qualidade de vida, por meio de ações de informação. As ações desses grupos são observadas por meio de pesquisa empírica qualitativa. São investigadas de forma específica as fontes às quais recorrem os pacientes de doenças crônicas não transmissíveis para lidar com a incerteza. Os resultados de entrevistas com profissionais de saúde e pacientes reforçam a importância dos grupos e a confiança e solidariedade subjacentes a eles. Conclui-se que os pacientes recorrem em primeiro lugar ao médico quando necessitam de informação de alta confiabilidade, mas também aos enfermeiros, amigos e à mídia. Os resultados sugerem a necessidade de ampliação da operação pública dos grupos de apoio com vistas à promoção da saúde, ao acesso livre e aberto à informação científica transliterada em saúde pública. Sugerem também a necessidade de criação de sistemas de informação voltados especificamente para os mediadores dos grupos de apoio aos pacientes, segmento ainda não contemplado com dispositivos informacionais adequados de apoio ao desenvolvimento de suas ações. / Study on the phenomenon of the support groups for the patients under the optics of Information Science, with a view to the issues related to the information access and knowledge in public health; in the context of the paradigmatic transition of the modernism to post modernism, the support groups are considered as innovative input for patients under the standpoint of the support for the health promotion and the quality of life improvement. The research, a qualitative empirical survey, analyzes entities that promote support groups for patients of non communicable chronicle diseases, aims to identify which information sources the patients seek in order to deal with the uncertainty, and distress in face of the diagnosis of a chronicle disease. The results of the interviews with health professionals and patients show the importance of the groups and their character of confidence and underlying solidarity. It concludes that the patients consider physicians as their most important sources of information, but also ask the nurses, friends and the media for more information. The study suggests some parameters for the expansion of the public operation of the support groups with a view to the health promotion, to the free and open access to \"translated\" scientific information in public health. It suggests also that there is a lack of specific information systems to support the professionals that work as information intermediaries in such groups.

PURPOSE: (1) Investigate supportive care needs and preferences of parents of children with cancer (2) Assess the feasibility and preliminary outcomes of a Parent Support Group Intervention (PSGI). METHODS: One-hundred and eight parents completed the Parent Support Survey (PSS). Data were utilized in the creation of a PSGI. The PSGI consisted of eight 1.5-hour sessions encompassing guided group discussion. As part of feasibility, acceptability, recruitment/retention and preliminary outcomes were assessed. Parents completed outcome measures assessing knowledge of disease/treatment management, community/hospital/family resources, perception of social support and feelings of distress/anxiety. RESULTS: From the PSS, 86/108 (80%) of parents expressed interest in a PSGI. Fourteen parents attended the PSGI only once and 14 parents attended the PSGI more than once. Outcome measure results depict favourable changes after group attendance. Recruitment and retention data highlight challenges. CONCLUSIONS: Information gained from this study will be used to improve planning and delievery of future PSGI’s.

PURPOSE: (1) Investigate supportive care needs and preferences of parents of children with cancer (2) Assess the feasibility and preliminary outcomes of a Parent Support Group Intervention (PSGI). METHODS: One-hundred and eight parents completed the Parent Support Survey (PSS). Data were utilized in the creation of a PSGI. The PSGI consisted of eight 1.5-hour sessions encompassing guided group discussion. As part of feasibility, acceptability, recruitment/retention and preliminary outcomes were assessed. Parents completed outcome measures assessing knowledge of disease/treatment management, community/hospital/family resources, perception of social support and feelings of distress/anxiety. RESULTS: From the PSS, 86/108 (80%) of parents expressed interest in a PSGI. Fourteen parents attended the PSGI only once and 14 parents attended the PSGI more than once. Outcome measure results depict favourable changes after group attendance. Recruitment and retention data highlight challenges. CONCLUSIONS: Information gained from this study will be used to improve planning and delievery of future PSGI’s.

PURPOSE: (1) Investigate supportive care needs and preferences of parents of children with cancer (2) Assess the feasibility and preliminary outcomes of a Parent Support Group Intervention (PSGI). METHODS: One-hundred and eight parents completed the Parent Support Survey (PSS). Data were utilized in the creation of a PSGI. The PSGI consisted of eight 1.5-hour sessions encompassing guided group discussion. As part of feasibility, acceptability, recruitment/retention and preliminary outcomes were assessed. Parents completed outcome measures assessing knowledge of disease/treatment management, community/hospital/family resources, perception of social support and feelings of distress/anxiety. RESULTS: From the PSS, 86/108 (80%) of parents expressed interest in a PSGI. Fourteen parents attended the PSGI only once and 14 parents attended the PSGI more than once. Outcome measure results depict favourable changes after group attendance. Recruitment and retention data highlight challenges. CONCLUSIONS: Information gained from this study will be used to improve planning and delievery of future PSGI’s.

PURPOSE: (1) Investigate supportive care needs and preferences of parents of children with cancer (2) Assess the feasibility and preliminary outcomes of a Parent Support Group Intervention (PSGI). METHODS: One-hundred and eight parents completed the Parent Support Survey (PSS). Data were utilized in the creation of a PSGI. The PSGI consisted of eight 1.5-hour sessions encompassing guided group discussion. As part of feasibility, acceptability, recruitment/retention and preliminary outcomes were assessed. Parents completed outcome measures assessing knowledge of disease/treatment management, community/hospital/family resources, perception of social support and feelings of distress/anxiety. RESULTS: From the PSS, 86/108 (80%) of parents expressed interest in a PSGI. Fourteen parents attended the PSGI only once and 14 parents attended the PSGI more than once. Outcome measure results depict favourable changes after group attendance. Recruitment and retention data highlight challenges. CONCLUSIONS: Information gained from this study will be used to improve planning and delievery of future PSGI’s.

This research study examined mothers’ experiences of gaining access to services following the death of a baby through stillbirth or a neonatal death. An exploratory research design was used to conduct applied research into the said topic through the use of a semi-structured interview schedule. The research sample consisted of fifteen mothers, all having lost a baby within the last five years to stillbirth or neonatal death. These mothers were met in propinquity and the interview schedule was conducted with them. The findings were analysed and presented both quantitatively, by means of percentages and graphs, and qualitatively, by means of themes and sub themes. The research was particularly relevant in that it is estimated that between three and five percent of all pregnant mothers in South Africa will lose their babies to a stillbirth or neonatal death every year. For this reason it is essential that adequate and quality services be offered to these mothers to prevent complications in their grief. The study conducted by the researcher focused on the accessibility of quality hospital, religious, formal and social support services to bereaved mothers following the death of a baby through stillbirth and neonatal death. The researcher then discussed, in detail, the literature informing the study. The discussion of the literature, as outlined by the researcher, was set in a logical progression – beginning with a discussion on grief, the grief process, dysfunctional grief and models of grief, then moving onto a discussion of the grief following the loss of a baby and maternal grief predictors. The theory ended with a discussion on the services, particularly hospital services, religious services and formal services, available to bereaved mothers. The researcher then presented the findings of the study, drawing comparisons between the literature and the empirical findings where relevant. Conclusions and recommendations were then formulated and presented. The researcher firmly believes that the research conducted holds the potential of providing significant practical suggestions to the functioning of the services that are available to bereaved mothers. / Dissertation (MSD (Play Therapy))--University of Pretoria, 2007. / Social Work and Criminology / unrestricted