Current deficits in the rehabilitation psychology literature involving longitudinal studies investigating positive outcomes following acquired disabilities have deserved research attention. In the current study, data on happiness as an enduring mood tone, as measured by the Life Satisfaction Index (LSI) was collected from 1271 individuals (“insiders”) having incurred either a traumatic brain injury (TBI), spinal cord injury (SCI), severe burn, or intra-articular fracture (IAF) or from someone who felt close enough to speak on their behalf (“outsiders”). Data on happiness, functional independence as measured by the Functional Independence Measure (FIM), and other variables of interest were collected at 12 months, 24 months, 48 months, and 60 months after being medically discharged. Hierarchical Linear Modeling (HLM) analyses showed that trajectories of happiness remained stable across participants and did not change significantly over five years post-discharge regardless of injury type, FIM, or insider/outsider status. Happiness was significantly predicted by FIM, injury type, and whether the respondent was an insider or outsider. Those who were more impaired and less functionally independent were less happy. Those with a TBI were consistently less happy than those with an IAF or SCI and outsiders reported greater happiness on behalf of the insider than did the insiders themselves. This study shows that there is stability in happiness levels that can be sustained at least five years post-discharge and that there are discrepancies between insider and outsider reports of subjective happiness. Proxy reports can be used as valuable and valid secondary sources of information but should not be used as substitutes for first hand reports unless absolutely necessary.

Objective: A neglected issue in literature on nutrition and HIV/AIDS is how other health professionals view their role in that arm. The purpose of this study was to understand professional nurses' perception regarding their ability to render effective nutritional care to people living with HIV/AIDS (PLWHA). Design: A qualitative approach was used. Twenty-three, in-depth, semi-structured interviews were conducted with nurses (mean age 38) working in eight (five rural and three urban) Wellness clinics within public hospitals providing antiretroviral therapy (ART) in North West Province, South Africa. Brief structured demographic questionnaires were also administered. All interviews and focus group discussions were recorded for transcription and open-coding. NVivo was used for open coding, whilst descriptive statistics were done using SPSS for windows (version 14, SPSS Inc., Chicago. IL). A research team of professionals and researchers collaboratively analysed data for emerging themes. Results: All the hospitals that participated had at most three nurses, having at least one professional nurse working in the Wellness clinic for PLWHA. More than half of the participants interviewed were diploma holders, eight (35%) were degree holders and three (13%) had certificates in nursing. Five main themes (previously guided by the interview questions) emerged during the analysis of data and these portrayed participants' perceptions regarding their ability to render effective nutritional care to PLWHA. The themes were 1) challenges faced by nurses dealing with PLWHA on a daily basis, 2) concerns of PLWHA, 3) nurses’ perception on the importance of nutrition in HIV/AIDS care, 4) nurses’ perceived ability to deal with nutritional issues in HIV/AIDS, 5) the role of traditional healers, traditional medicine in HIV/AIDS. Thirty five percent of participants mentioned poor socio-economic status of PLWHA as a barrier to the participants to talk about good nutrition to people that are food insecure. Furthermore, 13% of participants indicated that they are constantly facing the dilemma of PLWHA mixing traditional medicines and ART. Participants perceived the following skills to be important in the area of nutrition and HIV/AIDS: communication, listening and knowledge. Although knowledge could be debated as it is not a skill per se, the participants believed that on needs to acquire nutrition knowledge first and then improve on the communication and listening skills with more exposure and training. Ten (41%) of the participants interviewed rated themselves as average, 11 (48%) participants as good whilst only 4%, representing one participant, felt they were very good at giving out nutrition education. Sixty one percent of participants said they would require more knowledge, whilst 39% said they would need to acquire communication and listening skills for them to be able to render effective nutritional cart to PLWHA. In this study, participants perceived nutritional care to PLWHA as their responsibility and that lack of knowledge was influencing their inability to offer this service effectively. All the participants indicated a need for collaboration with nutrition professionals, ill-service training us well as exposure to clear communication channels for nutrition and HIV/AIDS information. Participants were concerned with the lack of policy implementation regarding nutrition and policy documents. Of the 23 participants interviewed, only two (9%) confirmed having seen and rend the South African Guidelines on Nutritional Care for People Living with TB, HIV/AIDS and other Chronic Debilitating Conditions. Conclusion: All participants interviewed believed that nutrition knowledge in the area of HIV/AIDS can be improved if poor people who are infected and affected by HIV/AIDS are food secure. Concerning practice, it is recommended that nutrition and HIV/AIDS as a topic be introduced in both undergraduate mid postgraduate training for nurses. The lack of policy implementation, level of qualification and years spent in the nursing profession may have influenced participants' perception regarding their ability, as well as confidence, to render nutritional care to PLWHA. Possible interventions to improve policy implementation could be the development of user-friendly information, education and communication materials for health institutions as these may serve as constant reminders to health care service providers. It was found that participants' perceptions regarding their ability to render effective nutritional care to PLWHA was affected by a complex number of factors which emerged as themes that need to be addressed. Participants' experience suggests that more research and inquiries are needed into traditional medicines and traditional healing, as the issue of ARVs and traditional medicine is becoming a public health dilemma, riot only to the nurses, but to every stakeholder involved in the field of HIV/AIDS. Furthermore, a need exists for nurse-specific outreach, collaboratively done by nutrition professionals and other stakeholders. This work thus provides a foundation for further exploring ways to improve the ability of other health care workers such as nurses in the nutritional care of PLWHA which will ultimately improve the quality of life of PLWHA. / Thesis (M.Sc. (Nutrition))--North-West University, Potchefstroom Campus, 2007

Objective: A neglected issue in literature on nutrition and HIV/AIDS is how other health professionals view their role in that arm. The purpose of this study was to understand professional nurses' perception regarding their ability to render effective nutritional care to people living with HIV/AIDS (PLWHA). Design: A qualitative approach was used. Twenty-three, in-depth, semi-structured interviews were conducted with nurses (mean age 38) working in eight (five rural and three urban) Wellness clinics within public hospitals providing antiretroviral therapy (ART) in North West Province, South Africa. Brief structured demographic questionnaires were also administered. All interviews and focus group discussions were recorded for transcription and open-coding. NVivo was used for open coding, whilst descriptive statistics were done using SPSS for windows (version 14, SPSS Inc., Chicago. IL). A research team of professionals and researchers collaboratively analysed data for emerging themes. Results: All the hospitals that participated had at most three nurses, having at least one professional nurse working in the Wellness clinic for PLWHA. More than half of the participants interviewed were diploma holders, eight (35%) were degree holders and three (13%) had certificates in nursing. Five main themes (previously guided by the interview questions) emerged during the analysis of data and these portrayed participants' perceptions regarding their ability to render effective nutritional care to PLWHA. The themes were 1) challenges faced by nurses dealing with PLWHA on a daily basis, 2) concerns of PLWHA, 3) nurses’ perception on the importance of nutrition in HIV/AIDS care, 4) nurses’ perceived ability to deal with nutritional issues in HIV/AIDS, 5) the role of traditional healers, traditional medicine in HIV/AIDS. Thirty five percent of participants mentioned poor socio-economic status of PLWHA as a barrier to the participants to talk about good nutrition to people that are food insecure. Furthermore, 13% of participants indicated that they are constantly facing the dilemma of PLWHA mixing traditional medicines and ART. Participants perceived the following skills to be important in the area of nutrition and HIV/AIDS: communication, listening and knowledge. Although knowledge could be debated as it is not a skill per se, the participants believed that on needs to acquire nutrition knowledge first and then improve on the communication and listening skills with more exposure and training. Ten (41%) of the participants interviewed rated themselves as average, 11 (48%) participants as good whilst only 4%, representing one participant, felt they were very good at giving out nutrition education. Sixty one percent of participants said they would require more knowledge, whilst 39% said they would need to acquire communication and listening skills for them to be able to render effective nutritional cart to PLWHA. In this study, participants perceived nutritional care to PLWHA as their responsibility and that lack of knowledge was influencing their inability to offer this service effectively. All the participants indicated a need for collaboration with nutrition professionals, ill-service training us well as exposure to clear communication channels for nutrition and HIV/AIDS information. Participants were concerned with the lack of policy implementation regarding nutrition and policy documents. Of the 23 participants interviewed, only two (9%) confirmed having seen and rend the South African Guidelines on Nutritional Care for People Living with TB, HIV/AIDS and other Chronic Debilitating Conditions. Conclusion: All participants interviewed believed that nutrition knowledge in the area of HIV/AIDS can be improved if poor people who are infected and affected by HIV/AIDS are food secure. Concerning practice, it is recommended that nutrition and HIV/AIDS as a topic be introduced in both undergraduate mid postgraduate training for nurses. The lack of policy implementation, level of qualification and years spent in the nursing profession may have influenced participants' perception regarding their ability, as well as confidence, to render nutritional care to PLWHA. Possible interventions to improve policy implementation could be the development of user-friendly information, education and communication materials for health institutions as these may serve as constant reminders to health care service providers. It was found that participants' perceptions regarding their ability to render effective nutritional care to PLWHA was affected by a complex number of factors which emerged as themes that need to be addressed. Participants' experience suggests that more research and inquiries are needed into traditional medicines and traditional healing, as the issue of ARVs and traditional medicine is becoming a public health dilemma, riot only to the nurses, but to every stakeholder involved in the field of HIV/AIDS. Furthermore, a need exists for nurse-specific outreach, collaboratively done by nutrition professionals and other stakeholders. This work thus provides a foundation for further exploring ways to improve the ability of other health care workers such as nurses in the nutritional care of PLWHA which will ultimately improve the quality of life of PLWHA. / Thesis (M.Sc. (Nutrition))--North-West University, Potchefstroom Campus, 2007

Few authors report comprehensive psychometric data for their acquired brain injury (ABI) outcome indices (e.g., items analyses, test-retest reliability, survivor-proxy agreement, internal consistency, convergent validity). Even fewer authors submit their indices to modern psychometric analyses, like Rasch analysis. The purpose of this dissertation was to evaluate the traditional and modern psychometric properties of a new index of brain injury outcome: the Functional Outcome Profile (FOP). One hundred and thirteen mixed (estimated mild, moderate, and severe injury) ABI survivors and 22 significant others participated in the study. Items analyses (n = 113) revealed that all items were endorsed by at least one ABI survivor, suggesting that the FOP assessed areas relevant to ABI survivors. However most items, composite scores, and the total score had distributions that were negatively skewed. One-week test-retest reliability correlations for the total score, composites, and items (n = 25) were generally in the moderate to strong range (r > 0.7), while survivor-proxy agreement correlations for the items (n = 22) were generally in the moderate range (r = 0.5 to 0.7). The internal consistency scores (n = 113) for 5 of the 8 composite scales and for the full FOP were good (Cronbach α > 0.7). Concurrent-convergent validity analyses revealed that the FOP correlated moderately well with the Mayo-Portland Adaptability Index (MPAI-4) (r = -0.75), but that it did not correlate with injury-related information (e.g., age at injury, time since injury, estimated severity). Rasch calibration of the FOP resulted in a 62-item index that fit the Rasch model well and that demonstrated good reliability and separation. Overall, the results suggest that the FOP has good traditional and modern psychometric properties when used with community-based outpatient ABI survivors. Future studies with the FOP should focus on improving the FOP’s clinical utility and further verifying its convergent and divergent validity.

Wayfinding is the process of determining and following a route. Survivors of acquired brain injury (ABI) may evince impaired wayfinding skills. Mobile technology offers a promising avenue for wayfinding support, but software is seldom designed for users with cognitive impairments. This research was intended to inform the design of mobile wayfinding software for survivors of ABI. Two qualitative studies were conducted to investigate wayfinding by survivors of ABI, and solicit views on a prospective mobile wayfinding aide. Data were used to generate a substantive theory of wayfinding in ABI. Participants were generally enthused by the prospect of a mobile wayfinding aide. They felt that it would be useful and bolster confidence, leading to improved community access. In conjunction with the theory and its implications, their remarks on usage and design indicate that mobile wayfinding software should: provide a simple interface; be context aware; afford an interactive user experience; integrate with calendar software; deliver [audio] notifications; and emphasize landmarks while affording map access. / Graduate

Diss. (sammanfattning) Linköping : Univ., 2001. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2005. / Härtill 4 uppsatser.

Thesis (Ph. D.)--University of Arizona, 1993. / Also issued in print.

Thesis (M.A. (Population and Reproductive Health Research))--Mahidol University, 1999.