本研究是一項關於北京中年抑鬱症患者主觀經驗的敘事分析。研究的目的在於探尋患者對於自身患病歷程的主觀詮釋，他們的服務需求以及對於中國大陸精神衛生社會工作進行反思。研究的參與對象為目的性抽樣所得到的來自北京的一個抑鬱癥自助團體的八名中年抑鬱癥患者。 / 患者回顧了他們不同階段的經歷：發病期、住院期以及康復期。然後他們對於這些經歷做了詮釋。基於不同領域的社會服務需求，對於醫院、社區、大眾傳媒以及政府，他們都給出了寶貴的意見。 / 研究發現，既有的理論觀點對於關著對自身經歷的詮釋有著重要的影響，尤其是生物醫學模型。認知觀點和性別觀點也可以在患者們的敘事中找到蹤跡。精神科醫生在患者的整個經歷中都處於重要的地位，他們的觀點和行為對患者也產生了重要的影響。 / 患者還受到社會和歷史因素的影響。他們的詮釋會受到社會觀念和文化價值的影響，比如命運、面子、孝順以及性別角色等等。而歷史事件諸如文化大革命以及天安門事件也會對他們的人生經歷以及他們的主觀詮釋造成影響。而中國目前的社會情境也是另一項重要的影響因素。 / 從他們的故事中，我們可以看到，最重要的主題就是他們在患病過程中認知模式的轉變，包括對待抑鬱癥本身，所接受的服務以及自身的看法。在他們的敘述中，另外兩個主題也是非常值得注意的，那就是和抑鬱症有關的“喪失以及醫院裡非人道的治療方式。 / 他們的故事為我們對於北京中年抑鬱症患者經歷的理解提供了非常豐富詳實的材料。這些發現對於知識理論的發展、政策的制定以及針對抑鬱症患者的臨床社會工作實踐都有著很大的啟示。整個社會以及不同領域的精神衛生專業人士都應該攜起手來幫助他們，共同去創造一個更加包容和諧的社會。 / This research was a narrative analysis of the subjective experiences of the depressed middle-aged adults in Beijing, China. The purposes of the research were to explore the clients’ subjective interpretation of their lived experience of depression, their service needs and reflect on the improvement of mental health social work in Mainland China. A purposive sample of eight depressed clients from a self-help group in a mental health hospital in Beijing participated in this study. / The clients talked about their experiences at different stages: the onset, in the hospital and the rehabilitation, and interpreted their experiences. They also gave some advice to the hospital, the community, the mass media and the government based on their social service needs. / The theoretical perspectives influenced the clients’ interpretations of their experiences, especially the biomedical model. The cognitive perspective and the gender perspective could also be found in the client’s narratives. The psychiatrists were very important in the whole process of the clients’ experiences. Their perspectives and behaviors also influenced the clients. / It is found that the clients were also influenced by social and historical factors. Their interpretations were affected by social beliefs and cultural values such as fate, face, filial piety and gender roles. The historical events such as Cultural Revolution and June.4th Movement also affected their experiences and interpretations. The current social context in China was another important factor affecting them. / From their stories, we could see that the main theme was change of their cognitive styles, including view of depression, service and themselves. Another two themes were highlighted in their narratives as well: the linkage of their losses with depression and the dehumanized treatment in the hospital. / Their stories have provided comprehensive materials for an in-depth understanding of depressed middle-aged adults in Beijing. Based on the findings, recommendations are made to knowledge development, policymakers and clinical social workers in helping the depressed clients. It is necessary for our society and mental health professionals in different areas to work together to help them and build an inclusive society. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Shi, Song. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 228-245). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts and appendixes also in Chinese. / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Rationale of the study --- p.1 / Chapter 1.2 --- Background of the study --- p.2 / Chapter 1.3 --- Research Questions --- p.3 / Chapter 1.4 --- Purposes and significance of the research --- p.4 / Chapter Chapter 2 --- Literature Review --- p.7 / Chapter 2.1 --- Adult depression --- p.7 / Chapter 2.1.1 --- Definition of adults’ depression --- p.7 / Chapter 2.1.2 --- Different perspectives on “depression“ --- p.9 / Chapter 2.1.3 --- Social factors associated with adult depression --- p.24 / Chapter 2.1.4 --- Cultural influences in Chinese society --- p.32 / Chapter 2.2 --- Treatment of depressed adults --- p.36 / Chapter 2.2.1 --- Psychotherapy --- p.36 / Chapter 2.2.2 --- Medication --- p.38 / Chapter 2.3 --- Research on subjective experiences of people with mental disorders --- p.39 / Chapter 2.4 --- Research on depression in Mainland China --- p.48 / Chapter 2.5 --- The roles of social work in mental health services --- p.51 / Chapter Chapter 3 --- Research Methodology --- p.58 / Chapter 3.1 --- Paradigmatic Considerations --- p.58 / Chapter 3.1.1 --- Social constructionism --- p.58 / Chapter 3.1.2 --- Social construction and mental illness --- p.61 / Chapter 3.1.3 --- Theoretical Framework --- p.63 / Chapter 3.2 --- Research Design --- p.70 / Chapter 3.2.1 --- Qualitative research strategy --- p.70 / Chapter 3.2.2 --- Sampling strategies --- p.75 / Chapter 3.2.3 --- Data collection procedures --- p.84 / Chapter 3.2.4 --- Data analysis procedures --- p.86 / Chapter 3.2.5 --- Strategies for validating findings --- p.88 / Chapter 3.3 --- Ethical issues --- p.91 / Chapter Chapter 4 --- Research findings --- p.93 / Chapter 4.1 --- The experiences of the participants --- p.93 / Chapter 4.1.1 --- The experience during the onset of depression --- p.94 / Chapter 4.1.2 --- The experience in hospital --- p.118 / Chapter 4.1.3 --- The experience in the rehabilitation period --- p.131 / Chapter 4.2 --- The interpretation of their experiences --- p.142 / Chapter 4.2.1 --- The interpretation of the process of suffering from depression --- p.143 / Chapter 4.2.2 --- The interpretation of the process of recovery --- p.148 / Chapter 4.3 --- Advice on their needs --- p.154 / Chapter 4.3.1 --- The hospital --- p.154 / Chapter 4.3.2 --- The community --- p.159 / Chapter 4.3.3 --- Mass media --- p.161 / Chapter 4.3.4 --- The government --- p.164 / Chapter 4.4 --- Summary --- p.170 / Chapter Chapter 5 --- Discussion and Recommendation --- p.171 / Chapter 5.1 --- Characteristics of the participants in this study --- p.171 / Chapter 5.2 --- Social and historical factors affecting the clients’ interpretation of suffering from depression --- p.173 / Chapter 5.2.1 --- Social beliefs and cultural values --- p.174 / Chapter 5.2.2 --- Social context --- p.183 / Chapter 5.2.3 --- Historical events --- p.184 / Chapter 5.3 --- Themes --- p.186 / Chapter 5.3.1 --- Change of Cognitive Style --- p.187 / Chapter 5.3.2 --- The linkage of loss with depression --- p.190 / Chapter 5.3.3 --- The dehumanized treatment of hospitalization --- p.193 / Chapter 5.3.4 --- The interrelationships among the themes --- p.195 / Chapter 5.4 --- Revisiting the proposed conceptual framework --- p.197 / Chapter 5.5 --- Significance and recommendations --- p.200 / Chapter 5.5.1 --- Significance and recommendations --- p.201 / Chapter 5.5.2 --- Limitations --- p.214 / Chapter Appendix A: --- Possible Probes for interview (English Version & Chinese Version) --- p.218 / Chapter Appendix B: --- Oral Consent form (English Version & Chinese version) --- p.225 / References --- p.228

Falls in the elderly Canadian population pose a serious health problem; they are the leading cause of accidental death in persons aged 65 and older. The most common serious injuries associated with falling are hip fractures; more than 19,000 Canadians sustain a hip fracture yearly as a result of a fall. A review of the literature reveals that most of the studies on falling have been conducted in institutional settings. Community-based studies have identified the risk factors associated with falling to assist in case-finding and fall prevention. However, qualitative studies of falling for elderly community-dwelling individuals are non-existent. The purpose of this study is to describe the meaning of falling for elderly community-dwelling individuals. The phenomenological approach to qualitative methodology was used for this study. This approach seeks to describe human experience as it is lived. Individuals 65 years of age or older were contacted through a Long Term Care Unit. Eight women became informants, participating in repeated interviews guided by open-ended questions. From the content analysis of the data, three major categories of data that were common to the participants were identified and developed. The three categories represent levels of perception in relation to falling, which together represent the entire meaning of falling. At the first level, participants interpreted the various aspects of their falls. The second level describes the reactions to falling. The third level describes how participants coped with falling in the context of coping with aging. These findings revealed that falling was viewed as a symbol of aging and therefore, the emotional reaction to falling occurred in the context of growing old. Furthermore, it was found that coping with falling occurred in the broader context of coping with aging. The implications for nursing practise, education, and research were identified in light of the research findings. / Applied Science, Faculty of / Nursing, School of / Graduate

The establishment of intermediate care facilities in British Columbia, as well as the establishment of similar facilities throughout the rest of Canada, was and still is a well-intentioned approach to meet the long term care needs of the elderly. The practices and procedures adopted by long term care facilities, however, tend to inhibit the personal autonomy of residents (Thomasma, 1985). Specifically, a facility's practices and procedures tend to inhibit residents' latitude of choice regarding daily living activities. Residents' latitude of choice may also be lessened when nurses implement well-intentioned helping interventions based on their own motivations and goals, rather than those of elderly residents. Latitude of choice measures the extent to which an individual's perceived degree of choice includes activities of importance to him/her. At present, there is limited research addressing both resident and staff perceptions regarding the autonomy (freedom of choice) of residents, particularly in relation to their daily activities. Accordingly, this study's purpose was to determine the institutionalized elderly residents' and their caregivers' perceptions of residents' latitude of choice regarding activities of daily living. From determining these specific staff and resident perceptions, significant differences were isolated. This study was conducted in two intermediate care facilities located in a large city within the province of B.C. The data collection instruments in this study included selected questions from Hulicka et al.'s (1975) revised Importance, Locus and Range of Activities Checklist, as well as a demographic data sheet developed by the researcher. Forty-five intermediate care 1 residents and forty-five nurses (Registered Nurses, Licensed Practical Nurses and Nurses' Aides) completed the study questionnaire and the demographic data sheet. The researcher studied the residents' and staff's responses to the Importance, Locus and Range of Activities Checklist by using non-parametric techniques for statistical analysis. The researcher used these techniques to determine the existence and location of differences in perceptions among the residents and staff. Significant differences exist in residents' and staff's perceptions when each group's importance ratings are combined with choice ratings. Isolation of the above importance and choice components for individual analyses indicate that the residents and staff had significantly different response patterns regarding a) the importance residents attach to daily living activities and b) the degree of choice residents associate with daily living activities. The above findings indicated that residents' latitude of choice may not be realized to a greater extent if the staff do not attach a degree of importance to a particular activity(ies) similar to that attached by the residents. Residents' latitude of choice may not be recognized to a greater extent if staff do not perceive that residents associate "some" or "no choice" with an activity of particular importance to them. / Applied Science, Faculty of / Nursing, School of / Graduate

Before the main study commenced, empirical work was conducted to establish and validate the Chinese version of the Satisfaction with the Nursing Home Instrument (SNHI-C), which was an instrument used to measure resident satisfaction in the main study. Testing was conducted on a cluster sample of 330 residents from 16 elderly residential care homes in Hong Kong. Findings demonstrated that the SNHI-C had good content validity with an index of .93. It also demonstrated high construct validity by having significant correlation with depression (r = -.42, p < .001), the physical component of health-related quality of life (r = .16, p < .05), the mental component of health-related quality of life (r = .41, p < .001), and global quality of care (r = .49, p < .001). The SNHI-C also demonstrated satisfactory internal consistency and good stability by having a Cronbach's alpha of .79 and intra-class correlation coefficient of .94, respectively. / Current study adds new knowledge to the psychosocial health benefits of Tai Chi for the residents living in elderly residential care homes. Findings were discussed in relation to previous research findings and in the context of elderly residential care setting. The present study has the strength of evaluating the health benefit of Tai Chi using a more stringent research design, in comparing with the previous studies. Limitations of this study included the use of convenience sampling, without random assigning participants into groups, and inadequacy in quantifying Tai Chi learning. The implications of the findings support incorporating Tai Chi training in routine elderly residential care. Based on the study experience, recommendations for a successful implementation of a Tai Chi program were provided. Future research is advised to further explore the most beneficial mode of a Tai Chi program particularly for the elderly residential care home residents. Evaluation of its effect over a longer period of time and using various approaches are also suggested for obtaining a more comprehensive picture of the health benefit of Tai Chi. Finally, it is also worthwhile to investigate the experience of practicing Tai Chi through a qualitative approach to complement present findings. / Like many areas in the world, Hong Kong is facing an aging population. To accommodate the increasing elderly population, particularly those who are frail and have limited family support, elderly residential care homes are growing in size and number. Despite of the escalating demand, it has been documented repeatedly that the nature of residential living can predispose the residents to a number of psychosocial challenges. Study findings highlight consistently that residents are prone to experience lowered self-esteem, poor social support, and poor health-related quality of life. Providing psychosocial support to the residents is an important dimension in elderly residential care. It is because older residents, despite of their deteriorating physical functions that cannot be cured, can still have the potential to live with optimum psychosocial well-being. Even though a number of interventions have been considered in the past to address the residents' psychosocial needs, evaluation on the effectiveness of these interventions is inconclusive. There is still a paucity of evidence suggesting a promising intervention that can promote psychosocial health for the residents. Given the general consensus that exercise is beneficial for the psychosocial health, and considering that the characteristics of Tai Chi are particularly suitable for the elderly population, Tai Chi is considered as a possible means to promote psychosocial health for the residents. This study aimed to examine the psychosocial effects of a Tai Chi program on the residents of the elderly residential care homes. / The main study adopted a non-equivalent pretest-posttest control group design to examine the psychosocial effect of Tai Chi on residents of elderly residential care homes. Residents were recruited from six elderly residential care homes in Hong Kong by convenience sampling. The experimental group (n = 66) joined a 26-week Tai Chi program three times per week with each session lasted for one hour. The control group (n = 73) continued their daily activities as usual. Outcome variables encompassing state self-esteem, the physical component of health-related quality of life, the mental component of health-related quality of life, social support network, and social support satisfaction were assessed at baseline, the 13th and 26th week of the intervention period. Doubly multivariate analysis of covariance was performed to examine the effect of the Tai Chi program. / With the confounding effect of resident satisfaction controlled, findings demonstrated that participants in the experimental group experienced greater improvement in the psychological composite outcome of state self-esteem, the physical component of health-related quality of life, and the mental component of health-related quality of life (p < .05). No significant changes were detected in any of the three individual psychological outcome variables. Non-significant result was also found regarding the social effect of Tai Chi program on the participants. / Lee Yin King. / "May 2006." / Advisers: Diana Lee; Jean Woo. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1558. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 249-269). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Diante do aumento do número de idosos, na população mundial e brasileira, tornase importante a realização de estudos e pesquisas na área que apontem formas eficazes de intervenção e que contribuam para nortear os profissionais das ciências humanas e sociais no atendimento e na implantação de serviços e programas voltados para esta população. Este trabalho constitui uma pesquisa realizada na cidade de Paulo Afonso, interior baiano, com seis idosos do sexo masculino participantes do projeto da 3 idade (Universidade Aberta a 3 Idade) e seis idosos da comunidade. O objetivo geral foi investigar sua percepção acerca dos papéis vivenciados ao longo do ciclo vital da família. Foram realizadas entrevistas individuais, as quais foram transcritas e analisadas por temas. O estudo mostra a rigidez dos papéis do homem idoso em nossa cultura, iniciando-se com o papel de filho, tio, irmão, marido, provedor do lar e avô. Esses idosos vieram de famílias tradicionais, onde os papéis eram rígidos e hierarquizados, sem abertura para o diálogo. O filho não tinha voz e o pai era provedor, distante, emocionalmente, e não mantinha um relacionamento de afeto, nem de abertura com os filhos e com a esposa. Essa postura fica clara ao longo dos relatos dos entrevistados. Esses idosos estão reproduzindo em seus relacionamentos a mesma dinâmica familiar de sua família de origem. Em ambos os grupos, a hierarquia ficou clara. A diferença se dá na perspectiva e planos futuros entre os idosos participantes do projeto Reviver e os idosos da comunidade. Enquanto os primeiros se mostraram mais otimistas, os da comunidade demonstraram maior comodismo e falta de perspectiva. Notam-se, também, contradições entre os dois grupos: ambos afirmaram que os idosos antigamente eram mais respeitados e queridos, apesar de haver poucas leis protegendo-os; no entanto, em relação a si mesmos, disseram que os jovens os respeitam e que no relacionamento familiar e social atual não têm do que reclamar. Esperamos que este trabalho possa contribuir para os interessados nas questões da velhice bem como para os que lidam com famílias / The more the number of the elderly people, in Brazil and in the world increase, the more important is the achievement of the study and the research in this field which carry out effective ways of intervention which can contribute to drive the human and socials sciences professionals in the attendancing and the setting of services and programs which have got this population as their main objective. The present work comes down to a research carried out in Paulo Afonso City, Bahia interland, with six male elderly who take part in the Third Age Project (Third Age Open University) as well as the community six elderly. The general purpose was to look over their perception about the roles experienced along the vital cycle of the family. Individual appointments were achieved, which were transcribed and analysed by topics. The study shows the strictness from the old mens role in our culture, which begins with the son, uncle, brother, husband, home supporter and grandfather. These old people came from traditional families in which the roles were strict and hierarchicals, without an opening for dialogues among one another. The son had no active voice in the family while the father was the supporter, emotionally far and without setting any affectionate relationship with wife or children. This behaviour is clearly presented along from the interviewers reports. These old people have been reproducing the same family dynamics in their general relationship, as they use to do with their own family. In both groups, the hierarchy was clearly presented. The difference is set up in the perspective and future plans between the Reviver Project old people and the community one. As the first ones show themselves more optimistcs, the community one show some bigger convenience as well as some lack of perspective. We can also realize some contraditions between the two groups: both groups asserted that beforetime they were more respected and beloved, despite of the few laws protecting them; although, they told that nowadays they have been respected by the young and that they shouldnt cry out against the family and the social relationship as well. We hope that this work may be a contribution to the ones who are interested in the old people affairs as well as to the ones who deal with families affairs

This descriptive correlational study was designed to examine the relationship between situational control, and both psychological and physical well-being, in the institutionalized elderly. A convenience sample of 52 elderly institutionalized subjects was selected from two intermediate care facilities. The subjects completed the Perceived Weil-Being Scale, the Situational Control Of Daily Activities Scale, and the Subject Information Sheet. All residents were found to have an overall perception of situational control. However, residents perceived a lack of control for the daily activities of eating and grooming. The majority of residents obtained a moderately high score on the psychological well-being and physical well-being scales. No significant relationship was found between situational control and psychological well-being, or situational control and physical well-being. A significant positive relationship was found between psychological well-being and physical well-being. / Applied Science, Faculty of / Nursing, School of / Graduate

Made available in DSpace on 2017-06-01T18:08:21Z (GMT). No. of bitstreams: 1 Ivanilza.pdf: 1827651 bytes, checksum: 25ba05fd24ada7a3aebf67daacd60f58 (MD5) Previous issue date: 2006-02-10 / The more the number of the elderly people, in Brazil and in the world increase, the more important is the achievement of the study and the research in this field which carry out effective ways of intervention which can contribute to drive the human and socials sciences professionals in the attendancing and the setting of services and programs which have got this population as their main objective. The present work comes down to a research carried out in Paulo Afonso City, Bahia interland, with six male elderly who take part in the Third Age Project (Third Age Open University) as well as the community six elderly. The general purpose was to look over their perception about the roles experienced along the vital cycle of the family. Individual appointments were achieved, which were transcribed and analysed by topics. The study shows the strictness from the old men s role in our culture, which begins with the son, uncle, brother, husband, home supporter and grandfather. These old people came from traditional families in which the roles were strict and hierarchicals, without an opening for dialogues among one another. The son had no active voice in the family while the father was the supporter, emotionally far and without setting any affectionate relationship with wife or children. This behaviour is clearly presented along from the interviewers reports. These old people have been reproducing the same family dynamics in their general relationship, as they use to do with their own family. In both groups, the hierarchy was clearly presented. The difference is set up in the perspective and future plans between the Reviver Project old people and the community one. As the first ones show themselves more optimistcs, the community one show some bigger convenience as well as some lack of perspective. We can also realize some contraditions between the two groups: both groups asserted that beforetime they were more respected and beloved, despite of the few laws protecting them; although, they told that nowadays they have been respected by the young and that they shouldn t cry out against the family and the social relationship as well. We hope that this work may be a contribution to the ones who are interested in the old people affairs as well as to the ones who deal with families affairs / Diante do aumento do número de idosos, na população mundial e brasileira, tornase importante a realização de estudos e pesquisas na área que apontem formas eficazes de intervenção e que contribuam para nortear os profissionais das ciências humanas e sociais no atendimento e na implantação de serviços e programas voltados para esta população. Este trabalho constitui uma pesquisa realizada na cidade de Paulo Afonso, interior baiano, com seis idosos do sexo masculino participantes do projeto da 3ª idade (Universidade Aberta a 3ª Idade) e seis idosos da comunidade. O objetivo geral foi investigar sua percepção acerca dos papéis vivenciados ao longo do ciclo vital da família. Foram realizadas entrevistas individuais, as quais foram transcritas e analisadas por temas. O estudo mostra a rigidez dos papéis do homem idoso em nossa cultura, iniciando-se com o papel de filho, tio, irmão, marido, provedor do lar e avô. Esses idosos vieram de famílias tradicionais, onde os papéis eram rígidos e hierarquizados, sem abertura para o diálogo. O filho não tinha voz e o pai era provedor, distante, emocionalmente, e não mantinha um relacionamento de afeto, nem de abertura com os filhos e com a esposa. Essa postura fica clara ao longo dos relatos dos entrevistados. Esses idosos estão reproduzindo em seus relacionamentos a mesma dinâmica familiar de sua família de origem. Em ambos os grupos, a hierarquia ficou clara. A diferença se dá na perspectiva e planos futuros entre os idosos participantes do projeto Reviver e os idosos da comunidade. Enquanto os primeiros se mostraram mais otimistas, os da comunidade demonstraram maior comodismo e falta de perspectiva. Notam-se, também, contradições entre os dois grupos: ambos afirmaram que os idosos antigamente eram mais respeitados e queridos, apesar de haver poucas leis protegendo-os; no entanto, em relação a si mesmos, disseram que os jovens os respeitam e que no relacionamento familiar e social atual não têm do que reclamar. Esperamos que este trabalho possa contribuir para os interessados nas questões da velhice bem como para os que lidam com famílias