The Friends for Life program is an evidence-based practice being used in schools to assist children to learn skills to manage anxiety. The Friends for Life program has been used by school districts in British Columbia, Canada, for over 10 years, yet there is little research on how the program is being implemented in schools by teachers. This qualitative case study investigated the implementation practice of the Friends for Life program by teachers in Grades 4 and 5. Semi-structured interviews were conducted with 8 teachers from a smaller school district in British Columbia, Canada. The results yielded themes, which described critical factors that helped or hindered teachers in implementing the program with fidelity. A key finding of the study demonstrated teachers were running the program weekly, as per program guidelines. A key factor that was identified as helping teachers to implement the program with fidelity was support of school counselors, district staff, and the building administrator. The implications for social change include providing school administrators with information, which can help them to support teachers to implement the Friends for Life program with fidelity. As a result of these findings the Friends for Life program may consider updating the training materials and program implementation protocols in order to ensure teachers are implementing the program with fidelity and therefore, children are learning the skills they need to manage their anxieties and worries.

published_or_final_version / Nursing Studies / Master / Master of Nursing

Coronary artery disease (CAD) is known as the second killer in Hong Kong. The Hong Kong Hospital Authority reported nearly 7000 patients suffered from acute myocardial infarction (AMI) in year 2010 to 2011. Percutaneous transluminal coronary angioplasty (PTCA) is a minimal access surgical treatment for coronary artery disease but studies have shown that patients experienced different levels of anxiety before and during PTCA which led negative impact to the patients. Music can be regarded as a safe, cost-effective therapy to reduce one’s anxiety level. It can be carried out by nurses without any specific technique. However, there was no systemic review for using music therapy to patients undergoing PTCA. Therefore, this dissertation aims to evaluate the best available evidence on using music therapy for patients undergoing PTCA. Four electronic databases, Medline, CINAHL, Embase & PsycINFO, were searched for studies to investigate the efficacy of music therapy in patients undergoing PTCA. There were seven studies were eligible with data extracted and quality assessment performed by the critical appraisal skill programme (CASP) checklist. Four studies were graded as high quality, which consistently demonstrated a statistically significant more reduction in the anxiety level of patients who received music therapy either before and/or during PTCA than those who had no music therapy. Consequently, an evidence-based guideline of using music therapy for patients undergoing PTCA was developed according to the guideline development process of SIGN (2010). The use of music therapy is transferable and feasibly in the local setting with little manpower concern. The total cost estimated for running the innovation for a year was HKD 83,775 which was considered as cost-effective to reduce patients’ anxiety level and avoid associated adverse events. A 14-months programme including communication with the stakeholders, pilot testing, staff training and clinical application of the proposed music therapy was designed. Qualitative and quantitative data on patient, healthcare provider and system outcomes would be accounted throughout the programme. The effectiveness of the guideline would be determined by the reduction of patient’s anxiety level by using the Chinese version of State-Trait Anxiety Inventory (STAI) (Shek, 1993). Moreover, healthcare provider outcome would be evaluated by questionnaire and the expenditure of the proposed music therapy would be monitored closely. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Anxiety disorders are among the most prevalent psychiatric disorders in children and adolescents, with ten to fifteen percent of young children experiencing internalising problems (Briggs-Gowan, Carter, Irwin, Wachtel, & Cicchetti, 2004; Egger & Angold, 2006). Researchers have indicated that clinically significant anxiety can exist in preschool aged children and can be sub-typed into patterns similar to that of older children. This early identification of anxiety has lead researchers to recommend that prevention efforts occur early in the life course (Beinvenu & Ginsburg, 2007), before the onset of disorder(s). Research remains scarce as to when the ultimate time to intervene would be, as anxiety research with young children is minimal. The studies presented in this thesis attempt to expand the current literature within in the area of early childhood anxiety. The first objective of this thesis was to extend the literature in the field of early childhood anxiety by examining the aetiology of anxiety and behavioural inhibition (BI) through the investigation of potential risk factors. This study (Study One) represents one of the first investigations within the research to examine risk factors for early childhood anxiety. Two hundred and thirty-six children aged four to six years participated in this study. Parents of the children completed self-report questionnaires at one time point. Results revealed that BI did not significantly predict anxiety, nor did any of the risk factors significantly predict BI. Significant predictors of anxiety included mother’s negative affect and mother’s parenting stress. Father’s parenting stress was found to play a mediating role between mother’s parenting stress and child anxiety. Overall, the findings highlight the importance of both parents (directly or through mediation) in the aetiology of early childhood anxiety. The findings of Study One provide important information regarding the aetiology of early childhood anxiety and provide important implications for the development of preventative intervention programs. Study Two sought to examine the efficacy of a preventative intervention program (Fun FRIENDS; Barrett, 2007a) for preschool aged children, delivered as a school- based, universal intervention. This was the first study conducted evaluating the Fun FRIENDS program and was one of only a few prevention trials cited within the literature examining early childhood anxiety. The study involved a cohort of 263 children enrolled in one of 16 preschool classes. Children were aged between four and six years. Schools were randomly allocated to either an intervention group (IG) or a waitlist control group (WLG). Parents of the children and teachers completed self-report questionnaires at preintervention, postintervention, and at 12-month follow-up (parents in the IG only). Parent report data revealed no significant differences between intervention conditions on anxiety at postintervention, although participants in the IG experienced larger reductions in anxiety than participants in the WLG. Children in both conditions decreased in BI symptoms at postintervention, except for boys in the IG. Significant increases in social-emotional strength were found for girls in both conditions, but not for boys. When examining the IG only over the long-term (pre, post, 12 month follow-up), nearly significant decreases in anxiety were found at postintervention and significant decreases were found again at 12-month follow-up. Improvements in BI were found at all time points for girls but not for boys and improvements on social-emotional strength were found from preintervention to 12-month follow-up, with girls scoring significantly higher than boys. For teacher report, children in the IG improved significantly more on BI compared to the WLG at postintervention indicating that the intervention program may have had a positive impact on these children in learning strategies to manage BI symptoms. However, at pr-intervention, scores on BI were significantly different between the IG and the WLG. Similar to parent report, girls in the IG experienced the largest decrease in BI symptoms at postintervention. On social-emotional strength, children in the IG improved significantly more than children in the WLG at postintervention with girls in the IG experiencing the largest improvement from pre to postintervention. Overall, these findings suggest that the intervention program had a positive impact on some children as evidenced by improvements in anxiety, BI, and social-emotional strength at postintervention and at 12-month follow-up. Parent report indicated that children in the WLG also improved on these measures, making it difficult to contribute positive changes solely to the program. However, teacher report did indicate that children in the IG improved significantly more than children in the WLG. The improvements gained at 12-month follow-up highlight the potential long-term impact of the program although, without a comparison group, it is unknown whether significant differences would exist between both conditions. Implications of these results are discussed along with limitations and directions for future research.

Anxiety disorders are among the most prevalent psychiatric disorders in children and adolescents, with ten to fifteen percent of young children experiencing internalising problems (Briggs-Gowan, Carter, Irwin, Wachtel, & Cicchetti, 2004; Egger & Angold, 2006). Researchers have indicated that clinically significant anxiety can exist in preschool aged children and can be sub-typed into patterns similar to that of older children. This early identification of anxiety has lead researchers to recommend that prevention efforts occur early in the life course (Beinvenu & Ginsburg, 2007), before the onset of disorder(s). Research remains scarce as to when the ultimate time to intervene would be, as anxiety research with young children is minimal. The studies presented in this thesis attempt to expand the current literature within in the area of early childhood anxiety. The first objective of this thesis was to extend the literature in the field of early childhood anxiety by examining the aetiology of anxiety and behavioural inhibition (BI) through the investigation of potential risk factors. This study (Study One) represents one of the first investigations within the research to examine risk factors for early childhood anxiety. Two hundred and thirty-six children aged four to six years participated in this study. Parents of the children completed self-report questionnaires at one time point. Results revealed that BI did not significantly predict anxiety, nor did any of the risk factors significantly predict BI. Significant predictors of anxiety included mother’s negative affect and mother’s parenting stress. Father’s parenting stress was found to play a mediating role between mother’s parenting stress and child anxiety. Overall, the findings highlight the importance of both parents (directly or through mediation) in the aetiology of early childhood anxiety. The findings of Study One provide important information regarding the aetiology of early childhood anxiety and provide important implications for the development of preventative intervention programs. Study Two sought to examine the efficacy of a preventative intervention program (Fun FRIENDS; Barrett, 2007a) for preschool aged children, delivered as a school- based, universal intervention. This was the first study conducted evaluating the Fun FRIENDS program and was one of only a few prevention trials cited within the literature examining early childhood anxiety. The study involved a cohort of 263 children enrolled in one of 16 preschool classes. Children were aged between four and six years. Schools were randomly allocated to either an intervention group (IG) or a waitlist control group (WLG). Parents of the children and teachers completed self-report questionnaires at preintervention, postintervention, and at 12-month follow-up (parents in the IG only). Parent report data revealed no significant differences between intervention conditions on anxiety at postintervention, although participants in the IG experienced larger reductions in anxiety than participants in the WLG. Children in both conditions decreased in BI symptoms at postintervention, except for boys in the IG. Significant increases in social-emotional strength were found for girls in both conditions, but not for boys. When examining the IG only over the long-term (pre, post, 12 month follow-up), nearly significant decreases in anxiety were found at postintervention and significant decreases were found again at 12-month follow-up. Improvements in BI were found at all time points for girls but not for boys and improvements on social-emotional strength were found from preintervention to 12-month follow-up, with girls scoring significantly higher than boys. For teacher report, children in the IG improved significantly more on BI compared to the WLG at postintervention indicating that the intervention program may have had a positive impact on these children in learning strategies to manage BI symptoms. However, at pr-intervention, scores on BI were significantly different between the IG and the WLG. Similar to parent report, girls in the IG experienced the largest decrease in BI symptoms at postintervention. On social-emotional strength, children in the IG improved significantly more than children in the WLG at postintervention with girls in the IG experiencing the largest improvement from pre to postintervention. Overall, these findings suggest that the intervention program had a positive impact on some children as evidenced by improvements in anxiety, BI, and social-emotional strength at postintervention and at 12-month follow-up. Parent report indicated that children in the WLG also improved on these measures, making it difficult to contribute positive changes solely to the program. However, teacher report did indicate that children in the IG improved significantly more than children in the WLG. The improvements gained at 12-month follow-up highlight the potential long-term impact of the program although, without a comparison group, it is unknown whether significant differences would exist between both conditions. Implications of these results are discussed along with limitations and directions for future research.

This thesis focuses on relationship between specific learning disorders and conduct disorders in puberty. The theoretical part explains the basic terms apearing in the thesis such as specific learning disorders, conduct disorders, puberty and prevention of conduct disorder formation. It presents Czech and foreign research which have already been done in this and related areas. The empirical part uses a quantitative method to measure anxiety and occurrence of conduct disorders in second grade students in 2. ZŠ in Třeboň and ZŠ Londýnská in Prague. Data gained from children with specific learning disorder are compared with data from children without disorder.

No description available.

The newly revised 2017-2018 British Columbian high school curriculum, as a prevention education response to a growing concern around children and youths’ mental health, indicates that students will learn the signs and symptoms of stress, anxiety and depression and be able to explain strategies to promote mental well-being (Province of British Columbia, 2016). Youth voices may help in shaping this curriculum objective. This study explores the meaning that five high school students, who were trained to facilitate an anxiety-prevention program, make of the problem of anxiety and prevention through their narratives, applying a narrative methodology and analysis. These youth narratives do not provide a singular explanation, truth or understanding of anxiety; like all narratives, they hold multiple truths. The youth narratives are drawn from the participants’ local experiential knowledge as well as prevailing discourses that shape their understanding. The types of narratives in this inquiry include: i) the quest for problem-free childhoods; ii) the genesis of knowledge; and iii) overcoming giant stigma by connecting. There are implications and considerations pulled from the narratives, including how a prevailing psychologized discourse may obscure contextual factors in making sense of anxiety and prevention. This inquiry may help educators and other professionals to imagine what else could be possible in conceptualizing the problem of anxiety and implementing prevention programs. It is hoped that this study will add to the current dialogue around prevention and support strategies in British Columbian schools and beyond. / Graduate / 0525 / 0680 / 0519 / 0533 / 0347 / arfelix3@gmail.com