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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.

The development of scales to measure fatigue in people with rheumatoid arthritis

Nicklin, Joanna Karen January 2009 (has links)
Background: The problem of fatigue in Rheumatoid Arthritis (RA) was brought to the attention of healthcare professionals by patients at an international meeting in 2002. Since then research has established that fatigue is an important problem for patients. In order for effective interventions to be developed reliable and robust tools are required to measure RA fatigue. This research first set out to evaluate tools to measure RA fatigue in UK patients, but found there were none that captured the fatigue experienced by RA patients. It was therefore necessary that new scales should be developed to address this issue. Identifying the patient perspective: First, interview transcripts of patients describing their fatigue experience (n=15) were explored to identify the language that patients used to express their fatigue and its' consequences. These data were utilised to identify 12 concepts of fatigue: Cognition, Coping, Duration, Emotion, Energy, Frequency, Impact, Planning, Quality of Life, Relationships, Sleep, Social life, (Study 1, Chapter 2). Focus groups: To ensure data generalisability and robustness three focus groups were conducted to further explore the issues identified in Study 1. In addition, the focus group members developed the wording for visual analogue scales and numerical rating scales to measure fatigue severity, effect of fatigue and ability to cope with fatigue (Chapter 3). Scale design: Using these data and sources from the literature a preliminary multi-item questionnaire and a set of short scales to measure fatigue were developed (Chapter 4). To ensure that the scales were understood by patients in the way intended a "think aloud" study was conducted, which led to changes in wording and layout of the scales (Chapter 5). Scale validation: Quantitative research was employed to conduct validation of the scales. The short scales were found to be valid and able to measure the concepts of severity, effect and ability to cope with fatigue (Chapter 6). The multi-item questionnaire contained four separate dimensions of fatigue, namely Cognition, Emotion, Living and Physical (Chapter 7). Preliminary exploration of the data found differences in fatigue experience between genders and within genders (Chapter 8). Conclusion: These scales will allow the individual experience of RA fatigue to be measured and facilitate development of individually tailored fatigue interventions.

Out of time : the experiences of younger people living with dementia : a qualitative study of their accounts, augmented by carer perspectives

Beattie, Angela Mary January 2010 (has links)
This thesis provides insight into the experiences of younger people (under 65 years) living with dementia. Hitherto, little was known about these experiences, as research has largely concentrated upon older people in the early stages of dementia, focusing on loss, coping and awareness. Until recently, people with dementia were excluded from research, as it was thought they were incapable of expressing themselves or reflecting on their experiences. This is now seriously challenged. This thesis presents the results of a study involving 14 younger people living with dementia. Sixteen carer accounts augment these experiences. Through in-depth semi-structured interviews, the younger people describe their experiences of living with dementia on a daily basis. Constructivist grounded theory was used to explore and analyse these data. Four key categories emerged that captured participants' experiences: the search for meaning, experiencing loss, coping practically and making sense of the experience of living with dementia. Loss was a major experience for the younger people, encompassing loss of memory, skills, independence and control over key decisions about their future. For carers, the experience of loss related to their partner as well as to the lifestyle changes brought about by their partner's condition. In terms of coping, the younger people seemed to adopt a 'use it or lose it' approach, focusing on abilities that remained. Carers' responses seemed less positive, focusing on what was lost. Most participants sought explanations why they or their partner had developed dementia, often finding medical explanations inadequate. Younger people and carers also sought to make sense out of the experience of living with dementia. Theories of biographical disruption and narrativisation were helpful in exploring these questions of meaning. Most younger people adopted narratives of acceptance and fatalism. Carers struggled to make sense why their partner developed dementia. Their accounts seemed closer to chaos narratives with little hope for the future. The experience of dementia seems to come at an untimely time in mid-life. With little cultural representations to draw upon to normalise memory loss to old age, younger people felt they were 'out of time' and 'too young' to be experiencing dementia. Carers felt similarly, their role in caring for a partner also appears to have come too soon.

Young children's understanding of and engagement in social conventions

Wyman, Emily January 2009 (has links)
Adult social life is shaped by conventional practices, and these are often mediated by the use of conventional objects. For instance, we have conventional locations at which to gather for our meetings, conventional ways of cooperating with each other and conventional procedures for conducting formal ceremonies such as weddings. Objects with conventional functions are embedded within these practices, such that we may use train tickets that enable us to travel to those meetings, words to communicate with fellow cooperators, and wedding rings to signal our newly married statuses. This thesis investigates several aspects of children's engagement in, and understanding of social conventional practice. The question of what social conventions are, is complex. Chapter 1 reviews some influential philosophical attempts to tackle the issue, along some particular dimensions of disagreement. Special attention is given to the following questions: whether social conventions are solutions to situations in which people try to coordinate together, whether there is a normative dimension to social conventions, how the notion of 'fiction' relates to conventional phenomena, and what the psychological prerequisites are for understanding and engaging in conventional practice. Chapter 2 reviews existing developmental data on children's understanding of conventionality. This starts with the work of Jean Piaget and his investigation of children's understanding of the underlying structures of social convention through their games. More recent empirical work is then reviewed in which children's understanding of conventionality across the domains of language, tool use and games have been explored. Chapter 3 presents a series of studies in which children's understanding of conventional object functions were investigated. Children (mean age 3;0) played with an object whose pretend identity changed between two different pretend games. They competently tailored their pretend actions to this object when it changed between pretend contexts, showing a grasp of the context-relativity of conventional object functions. The pair of studies presented in Chapter 4, examined children's understanding of the normative aspects of conventional object functions. Children (mean age 3;0) observed a puppet use an object endowed with a pretend identity according to its real function or according to a different pretend identity. They protested when the puppet did this having joined the pretend game but not when he did so outside the game context. This shows a grasp of the way conventional object functions are normatively governed, and a tendency to enforce those normative rules in joint pretence. In Chapter 5, a new study is presented in which children's willingness to adopt a cooperative convention was investigated. Children (mean age 4;9) were engaged in a coordination game in which they could either cooperate with an adult to retrieve some high-value prizes, or act alone to retrieve a low-value prize. It was found that the establishment of joint attention to the high value prizes induced more children to coordinate towards the cooperative convention than did conditions of individual attention. The idea that joint attention may operate as a developmentally primitive form of 'mutual knowledge' in children, enabling coordination is discussed. Chapter 6 summarizes the results and theoretical implications of these studies, and highlights directions for future research.

Empirical tests of the metacognitive model of obsessive-compulsive disorder

Myers, Samuel G. January 2009 (has links)
The metacognitive model of OCD (Wells & Matthews, 1994; Wells, 1997, 2000), stresses the role of two types of metacognitive knowledge in the aetiology and maintenance of obsessive-compulsive symptoms: 1) beliefs concerning the meaning and power of thoughts and 2) beliefs about rituals. The first set of beliefs has been termed fusion beliefs and lead intrusions to be appraised as dangerous or important. The second domain, beliefs about rituals, guides the coping responses to these negative appraisals. It has two components: 1) declarative beliefs about the need to carry out rituals (e.g., "I need to perform my rituals otherwise I will never have peace of mind"), 2) a plan or program for monitoring and controlling action. Part of this plan is a goal which is indicated by a stop criterion or "stop signal." This thesis carried out a series of tests of hypotheses arising from the model, using studies with different populations and methodologies. Cross-sectional studies using different populations showed that, consistent with the model, metacognitive measures designed to assess thought-fusion, beliefs about rituals and stop signals were positively and significantly correlated with o-c symptom measures. A series of hierarchical regression analyses were also carried out, with the overlap between o-c symptoms and worry controlled. Results demonstrated that each metacognitive domain when entered in their hypothesised causal sequence explained incremental variance in obsessive-compulsive symptoms. Further analysis showed that metacognition remained a significant predictor when non-metacognitive beliefs (e.g., responsibility and perfectionism) which have been linked to OCD in other theories were controlled for. The hypothesised causal role of thought-fusion in o-c symptomology was examined in a prospective and an experimental study. The results showed that thoughtfusion was a significant positive prospective predictor of obsessive-compulsive symptoms independent of worry and non-metacognitive beliefs. Increasing thoughtfusion beliefs experimentally led to significant increases in OCD-like behaviours. These results are supportive of the hypothesised role of thought-fusion in the metacognitive model. The specificity of metacognitive beliefs was also assessed. Using a non-clinical population, the best independent metacognitive predictors of worry and obsessions were examined, with symptom overlap controlled. Different independent metacognitive predictors of worry and o-c symptoms emerged. Thought-fusion, beliefs about rituals and stop signals were independent predictors of obsessions but not worry, supporting their hypothesised specificity. Further support for specificity came from a study using a clinical population which showed that OCD patients had significantly higher scores than GAD patients on measures of thought-fusion and beliefs about rituals. The results provide further support for the metacognitive model. Theoretical and clinical implications are discussed as well as limitations of the thesis and directions for future studies.

The Role of emotions in children's responses to intergroup contexts

De Amicis, Leyla January 2009 (has links)
Researchc oncerningc hildren's intergroupr elationsh as mainly focusedo n prejudicial attitudesa nd stereotypesR. arely have children's emotionsb eene xaminedi n intergroup contexts,a lthougha few studiesh ave suggestedth e importanceo f this topic. In contrast, literature on intergroup relations in adults has recently highlighted how emotions can be important for predicting specific intergroup actions. The main purpose of this project was to explore the role of children's emotions in predicting expected intergroup behaviours. This issue was investigated in nine empirical studies. First, children's emotions were investigated in relation to general liking toward ingroup (White) and outgroup (Black) peers. Children were found to like same- and differentethnicity peers to the same extent, but some differences emerged in the emotions they experienced toward these targets. Moreover, positive and negative emotions contributed significantly to predictions of White children's intentional contact with specific White and Black members, above and beyond stereotypical beliefs and general liking. The effects of stereotypical beliefs were weaker, and were sometimes mediated by emotional factors. In addition, specific emotions (e. g., anger) were found to predict precise behaviours in a perpetrator-victim paradigm, in which targets' ethnicity was manipulated. In line with expectations, differentiated emotions predicted precise behaviours, but these effects were independent of the impact of social categorization on intervention/avoidance behaviours. A final study presented children with intergroup discriminatory scenarios, and considered whether asking children to focus on their emotions or cognitions would encourage more contact with outgroup members. Results indicated the need to consider gender and age when planning interventions designed to facilitate positive intergroup behaviours. In conclusion, this programme of empirical work has demonstrated that emotions contribute significantly to explaining intergroup behaviours in children. Future attention to the emotional component in intergroup relations in children is thus suggested as a major direction for future work in this area.

Sociocultural influences on body image concerns through adulthood. (BL: DXN057341)

Halliwell, E. January 2002 (has links)
This thesis focuses on body image concerns throughout adulthood, specifically on the impact of sociocultural attitudes concerning appearance on adults'body image concerns. To date research has concentrated on body image amongst young women and eating disordered populations. Little is known about the body image concerns of men, or adult women. Research indicates that sociocultural attitudes concerning appearance are transmitted to girls and young women through a variety of sources. However, the role of these in influencing adults' body image has not been investigated. Qualitative and quantitative methods are employed to address these gaps in the literature. The empirical programme consists of an in-depth interview study (N=42), two surveys - one with students (N=158) and one with a general population sample (N=366) - and an experimental study (N=203). The interview study indicates that adult body-focused concerns are highly gendered Also that ageing has a complex influence on body image concerns. The first quantitative study applies self-discrepancy theory to an investigation of body image. The findings suggest that ideal, but not ought, self-discrepancies have utility in explaining body image concerns. This is followed up in a questionnaire study of adults'body image concerns. In addition to internalised sociocultural attitudes towards appearance romantic relationships were found to constitute an important interpersonal influence on body image concerns. Also results from the experimental study suggest that average size models could be successful in advertising and, potentially, could decrease body anxiety in a large proportion of adult women relative to viewing thin models. Body image concerns continue to be relevant to women, and men, throughout adulthood. Gender differences are evident in conceptualisations of the body, as well as levels of body satisfaction Further more gendered conceptualisations of the body may explain differences in the consequences of body dissatisfaction of or women and men. This research suggests that existing measures may not reflect adequately gender and age differences in body image concerns.

Psychology of bipolar disorder

Knowles, Rebecca Elizabeth January 2004 (has links)
A behavioural high risk paradigm was used to investigate cognitive vulnerability to bipolar disorder in a group of individuals at high risk of developing symptoms, and similar measures were administered to a group of bipolar patients whose symptoms were currently in remission. High risk was defined as a combination of elevated scores on both the Hypomanic Personality Questionnaire and the Dysfunctional Attitudes Scale. The research addressed several psychological models of bipolar disorder including response styles, behavioural engagement, circadian rhythm disruption, self-esteem instability and the manic defence, as well as cognitive reactivity to musical mood induction and the impact of mood on emotion recognition. In the initial analogue study, hypothetically low-, medium- and high-risk participants were compared on measures of the models listed. High-risk participants displayed a uniquely dysfunctional combination of rumination and risk-taking coping behaviours, high behavioural inhibition and activation scores, irregular and unrestful sleep, highly unstable self-esteem, heightened sensitivity to positive and negative mood induction, and a moodcongruent bias in their perception of ambiguous facial expressions relative to the low-risk participants. They had also experienced significant levels of affective symptomatology consistent with their high-risk status. The subsequent clinical study compared remitted bipolar patients to remitted unipolar depressed patients and healthy controls. The bipolar group displayed more ruminative coping, high behavioural inhibition, disrupted and inefficient sleep, unstable selfesteem, and a clear manic defence when compared to the controls. The remitted bipolar patients also reported greater shifts in mood and self-esteem following both mood induction procedures than the controls. The remitted bipolar patients were therefore very similar to both the unipolar depressed group and the high-risk analogue participants in cognitive terms. Taken together, the results support the use of behavioural high-risk paradigms in investigations of bipolar disorder, and confirm the involvement of the presently examined cognitive and psychosocial factors in conferring vulnerability to bipolar symptomatology.

Perceived physical health, psychological distress and social support among prison officers

Harvey, Joel January 2007 (has links)
This research examines perceived physical health, psychological distress and social support among prison officers. Specifically this study tests direct models, moderator models and mediator models of social support. The direct models allow an examination of whether social support (from a significant other and from within prison) has a direct effect on psychological distress. These models also allow an examination of whether perceived physical health has a direct effect on psychological distress. The moderator models examine whether social support (from a significant other outside prison or from within the prison) moderates the relationship between perceived physical health and psychological distress; and the mediator models examine whether perceived social support (now specifically within prison) mediates the relationship between perceived physical health and psychological distress. A total of 100 prison officers from a UK prison took part in this crosssectional study. The participants completed the Short Form-36 II (Ware, et al., 2002), the Significant Others Scale (SOS; Power et al., 1988), the Prison Social Support Scale (PSSS; a newly devised measure for this study) and the General Health Questionnaire (GHQ-12; Goldberg & Williams, 1988). The prison officers reported poor perceived physical health and a high proportion of officers (56.6%) reached caseness on the GHQ-12. There was evidence for a direct effect of perceived social support both from a significant other and from within the prison; however, social support within the prison was most strongly associated with psychological distress. There was also evidence for a direct effect of perceived physical health on psychological distress. There was also some evidence for a moderating effect of social support within the prison but there was no evidence for a mediating role of perceived social support within the prison. These results suggest that support from within prison is important to perceived physical health and Psychological distress. The limitations of the research are discussed before considering the research, clinical and organisational implications of the study.

A qualitative study exploring psychological therapists' experiences of working psychotherapeutically with individuals diagnosed with dementia

Blythe, Philippa January 2011 (has links)
In the past it was assumed that psychotherapy with the dementia population was not possible. There currently exists a growing evidence base for the use of a variety of psychotherapeutic models with individuals diagnosed with dementia. Less research, however, has focused on the actual subjective experiences of psychotherapy or the therapeutic process, including the therapeutic relationship. The current qualitative study therefore aimed to gain an in depth understanding of the subjective experiences of psychological therapists working psychotherapeutically with individuals diagnosed with dementia including experiences of the therapeutic process and relationship. Semistructured interviews were carried out with nine psychological therapists regarding their experiences of working psychotherapeutically with individuals diagnosed with Alzheimer's disease. Verbatim transcripts were analysed using Interpretative Phenomenological Analysis which resulted in the generation of three super-ordinate themes: Considering the Psychotherapeutic Work; Bridging between Two Worlds; and The Detrimental Effect of Dementia on the Therapist and the Therapeutic Work. These super-ordinate themes along with sub-themes are expanded into a narrative account of participants' experiences. Of particular interest, the concept of identity arose from the narratives. Dementia was conceived to act as a threat to participants' sense of identity preventing them from sustaining their usual roles or preserving their existence as therapists. This finding and additional results from the analysis were considered in light of existing theory. The implications of the findings for clinical practice, service provision and training were highlighted. Limitations of the current research study were outlined and recommendations were put forward for future research

An outcome measure for severe head injury rehabilitation : development, application and critical evaluation

Semlyen, Joanna January 2010 (has links)
No description available.

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