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Puerto Rican women experience increased risk of bio-psychosocial challenges due to their ethnicity. This phenomenological study examined Puerto Rican HIV-positive women's perceptions of intimate partner violence (IPV), which consists of physical, sexual, verbal, and psychological abuse. Although HIV-positive status and IPV have been a focus of previous research, specific research examining the phenomenological experiences of HIV-positive Puerto Rican women who experienced IPV has not been studied. The basis of the study was feminist intersectionality theory, which supported the process used to explore and understand the essence of the participants' experiences. Feminist intersectionality theory examines intersecting social systems including gender, ethnicity, and cultural influences in assessing the lived experiences of the participants. Purposive sampling was used to recruit six participants. Data collection consisted of in-depth, audio-recorded interviews, and data were analyzed by transcribing interviews to explore common themes. Some of the themes that evolved from the research findings are traumatic experiences, feelings about the abuse, reaction to the abuse, trust issues, cultural influences, and positive life changes. The results of this research study provided valuable information of the participants' lived experiences. This research may provide domestic violence specialists, health care providers, law enforcement providers, public advocates, and government agencies with explanation and understanding of the unique challenges Puerto Rican women face. This research has the potential to impact social change in improving IPV screening, offering bi-lingual and bi-cultural service providers, and educating individuals in the helping profession of the impact of IPV.

Pain has a significant burden on individuals and society; however challenges remain in the measurement of pain-related utility. Research was conducted to design a measurement framework for valuing pain states, for use in policy making. Within the theoretical framework of utility theory, the bio-psychosocial model of pain was used to select co-variates impacting the pain-utility relationship. The applicability of two utility theories (prospect theory and hedonist theory) to pain was evaluated, with EQ-5D-5L and utility values for scenarios of different pain intensities elicited using time-trade-off (TTO) and willingness-to-pay (WTP). Prospect theory was tested using the pain-utility relationship in 600 members of the general population (‘genpop’) by examining the presence of a reference point and the relationship between pain decreases/increases (gains/losses) and utility. Hedonist theory was tested through examination of predicted, experienced and remembered utilities, and ‘peak-end’ effects, principally using data from 56 university athletes experiencing training pain. Pain intensity had the greatest influence on EQ-5D values, with present and worst pain showing additive effects. Duration of the pain episode, general health, mood, age and gender also had significant impacts. In addition to pain intensity, TTO ‘genpop’ models included age, income, experienced pain and general health; WTP ‘genpop’ models included residual pain, age and income. The TTO and WTP models did not fit the athletes’ data well and alternative models were developed. The data did not confirm prospect theory: a reference point could not be identified (‘genpop’ and athletes) and the shape of the utility curve contradicted theory (athletes). Results for hedonist theory were inconclusive: predicted utility was consistently higher than experienced utility in athletes but the relationship depended on pain levels in ‘genpop’; remembered and experienced utility differed despite being consistent for pain levels; peak-end effects were not found. Further research in controlled environments is recommended for further theory testing.

Section A: Article 1.Due to the increasing number of people being infected with or affected by HIV or AIDS, the need for home-based care services has increased. The psycho-social needs of families have also increased due to HIV infection resulting in a need for more extensive service rendering by relevant service providers. By exploring the role of Hospice T.L.C. caregivers in meeting these needs, recommendations could be made for service rendering to families infected with or affected by HIV or AIDS. Main focus areas for service rendering to these families were identified. / Section B, Article 1: In Kokstad, Kwazulu-Natal Hospice caregivers have been rendering services to families infected with and affected by HIV and AIDS. The role of these caregivers was explored by means of a qualitative study making use of focus groups. The focus of this article is the role that Hospice caregivers fulfil in meeting the needs of these families. Through their training and knowledge they obtain access to families infected with and affected by HIV and AIDS. From the study, certain recommendations could be made that could improve future service rendering, and assist the caregivers in meeting the needs of their patients more effectively. / Section B, Article 2: Literature indicates that people are widely affected by the presence of HIV or AIDS in their lives. The effects are of a physical, psychological, as well as a social nature. This has several implications for the affected families. In this study the bio-psychosocial needs, as identified by families themselves, receive attention. This qualitative study was conducted with the help of caregivers of Hospice T.L.C. operating in the Kokstad area, Kwazulu-Natal and involved home visits to affected families where an interview schedule guided the process of data collection. Material needs, as well as a need for emotional support were the most prevalent. The relationship between the caregivers and affected families are very positive, allowing an open door for further service rendering. / Section B, Article 3: Hospice T.L.C. is a non-profit organization (NPO) operating since 2006. They are rendering holistic, palliative and frail care services to ail patients in the Kokstad area, southern. KwaZulu-Natal. This qualitative study was aimed at exploring the extent of involvement of welfare organisations in meeting the bio-psychosocial needs of families infected with and affected by HIV or AIDS. This article deals with the stakeholders rendering services to these families and possible ways in which service rendering could be improved. Data was obtained during a focus group session with the caregivers and their supervisor. Interviews were conducted with members of the relevant resources that could meet the bio-psychosocial needs of families infected with or affected by HIV and AIDS. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2010.

Section A: Article 1.Due to the increasing number of people being infected with or affected by HIV or AIDS, the need for home-based care services has increased. The psycho-social needs of families have also increased due to HIV infection resulting in a need for more extensive service rendering by relevant service providers. By exploring the role of Hospice T.L.C. caregivers in meeting these needs, recommendations could be made for service rendering to families infected with or affected by HIV or AIDS. Main focus areas for service rendering to these families were identified. / Section B, Article 1: In Kokstad, Kwazulu-Natal Hospice caregivers have been rendering services to families infected with and affected by HIV and AIDS. The role of these caregivers was explored by means of a qualitative study making use of focus groups. The focus of this article is the role that Hospice caregivers fulfil in meeting the needs of these families. Through their training and knowledge they obtain access to families infected with and affected by HIV and AIDS. From the study, certain recommendations could be made that could improve future service rendering, and assist the caregivers in meeting the needs of their patients more effectively. / Section B, Article 2: Literature indicates that people are widely affected by the presence of HIV or AIDS in their lives. The effects are of a physical, psychological, as well as a social nature. This has several implications for the affected families. In this study the bio-psychosocial needs, as identified by families themselves, receive attention. This qualitative study was conducted with the help of caregivers of Hospice T.L.C. operating in the Kokstad area, Kwazulu-Natal and involved home visits to affected families where an interview schedule guided the process of data collection. Material needs, as well as a need for emotional support were the most prevalent. The relationship between the caregivers and affected families are very positive, allowing an open door for further service rendering. / Section B, Article 3: Hospice T.L.C. is a non-profit organization (NPO) operating since 2006. They are rendering holistic, palliative and frail care services to ail patients in the Kokstad area, southern. KwaZulu-Natal. This qualitative study was aimed at exploring the extent of involvement of welfare organisations in meeting the bio-psychosocial needs of families infected with and affected by HIV or AIDS. This article deals with the stakeholders rendering services to these families and possible ways in which service rendering could be improved. Data was obtained during a focus group session with the caregivers and their supervisor. Interviews were conducted with members of the relevant resources that could meet the bio-psychosocial needs of families infected with or affected by HIV and AIDS. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2010.

The goal of this study was to determine the bio-psychosocial treatment needs of dual diagnosis patients with depressive episodes and alcohol misuse. In order to achieve this goal, a qualitative research approach was adopted to gain a holistic understanding of dual diagnosis, as well as to explore and to describe the bio-psychosocial treatment needs of these individuals. This research study aimed to contribute towards solving a practical problem in practice by offering recommendations for a multidisciplinary team approach with regard to the treatment of patients diagnosed with depressive episodes and alcohol misuse in South African treatment centres. To this end, the collective case study design guided the research study. A two-stage sampling strategy was implemented in the study. Firstly, purposive sampling was used to identify potential participants, and it was followed up with, secondly, volunteer sampling to recruit 10 individuals with co-occurring depressive episodes and alcohol misuse from a private psychiatric clinic in Pretoria, which formed the research sample. Furthermore, a semi-structured one-on-one interview, guided by questions contained in an interview schedule, was used as a data collection method. The researcher implemented the qualitative data analysis process of Creswell (1998, in Schurink, Fouché & De Vos, 2011) to extrapolate themes and sub-themes from the raw data through thematic analysis. The trustworthiness of the data interpretation was confirmed through peer debriefing, member checking, as well as the assurance of confidentiality. An analysis of two different sources of data, namely the literature review and interviews, was used to answer the following research question: What are the bio-psychosocial treatment needs of dual diagnosis patients suffering from depressive episodes and alcohol misuse? The key findings indicated that persons suffering from a dual diagnosis of depressive episodes and alcohol misuse have idiosyncratic biological, psychological and social treatment needs. On a biological level it was found that patients with a dual diagnosis lead a less active and an unhealthy lifestyle and are therefore more prone to the development of chronic illnesses, such as hypertension and cardiovascular disease. It was also found that these individuals exhibit addictive behaviours apart from the alcohol misuse. With regard to psychological needs, the research found that dual diagnosis patients experience difficulties in expressing their needs and emotions to others. In this regard the research indicated that these individuals have poorly developed coping mechanisms and limited resources for gaining an improved sense of well-being. Identified areas in which these individuals may need assistance on a psychological level include: general coping mechanisms, communication skills, problem solving skills, and conflict management. With regard to violent and aggressive behaviour, it was found that these individuals are more likely to internalise their frustration and aggress towards themselves. On a social level it was found that individuals with a dual diagnosis of depressive episodes and alcohol misuse experience more relationship breakdown and less social support. Additionally, on a social level these individuals experience difficulties in coping in the workplace, as well as having problems with financial management. It is recommended that the multidisciplinary team participate in the development of psycho-educational groups that focus on the education of dual diagnosis patients regarding their needs on each level of functioning. Furthermore, it is recommended that effective clinical communication patterns are in place to prevent fragmented service delivery to individuals with a dual diagnosis. It is recommended that service delivery takes place in all forms of service delivery, including individual therapy, psycho-educational groups, group work activities, as well as family counselling. Further research could focus on the following: 1) Extending the research population to areas outside the Gauteng Province, or even South Africa, in order to determine if these findings can be generalised to all patients with a dual diagnosis of depressive episodes and alcohol misuse; 2) Conducting the research in public health care centres to determine if the findings of this study are also prevalent in lower socio-economic classes (taking into consideration that the present study was conducted at a private psychiatric clinic); 3) Repeating the study with different combinations of psychiatric illnesses, as well as substances of abuse, to determine if the conclusions drawn from this study can be made applicable to dual diagnosis in general, or only to dual diagnosis with depressive episodes and alcohol misuse in particular. / Dissertation (MSW)--University of Pretoria, 2014. / tm2015 / Social Work and Criminology / MSW / Unrestricted

This study compared the differences in treatment length, cost, cost effectiveness, dropout, and recidivism between a biomedical, talk therapy, and a collaborative mental health model for outpatient psychotherapy insurance claims. A biomedical model was the most cost effective with fewer sessions, but had a significantly higher dropout rate. Collaborative care had the least dropout, but also had higher costs and recidivism rates. Within collaborative care, differences between modality type, diagnosis, and provider type combinations were also examined. Within collaborative models, mixed modes of therapy had the lowest dropout, but at significantly higher costs and recidivism rates. Family therapy had the lowest recidivism and cost, with the highest dropout rate. In terms of specific problems, eating disorders had significantly more sessions and were significantly less cost-effective than any other diagnoses, followed by mood disorders. Relational disorders had the fewest sessions, best cost-effectiveness, and lowest recidivism rates. Finally, the MD/MFT provider type combination had the lowest dropout and recidivism rates, with the lowest cost, and a significantly better cost effectiveness than the MD/psychologist combination. The MD/psychologist combination had a significantly higher recidivism rate, and the MD/MSW combination had the highest dropout. No significant differences were found for any RN/talk therapy combination. Implications of the findings are discussed, along with limitations and future directions for research.

Thesis (Ph.D.(Psychology))--University of the Witwatersrand, Faculty of Humanities, 2013. / The research entailed a comprehensive study of vicarious trauma in short-term insurance claims workers, compared to trauma counsellors and a control group of holiday booking consultants. A well-known, comprehensive model of compassion fatigue/secondary traumatic stress, developed for therapists formed the basis of the study. The research attempted to determine whether this model can be applied more widely to include administrative populations exposed to traumatised clients on a regular basis. To this end, the model was deconstructed into its eleven constituent parts and each element was investigated in addition to other variables of interest to the study. This was done to determine the importance and applicability of each model element and other selected variables to the administrative context. A mixed methods approach was utilised, which combined quantitative and qualitative data. The results yielded by the study were collectively utilised to construct an etic and an emic voice from the research. At the same time, effects from vicarious trauma were considered from an overarching bio-psychosocial stance, systematically gauging effects on various levels of functioning. Scores from quantitative measures on secondary traumatic stress, negative cognitive schemas, empathy, social support and compassion satisfaction were statistically analysed, which revealed significant differences between the worker groups. Widely accepted relationships between the study variables were tested and found to hold true within and across groups. Regression analysis determined the roles of empathy, social support and compassion satisfaction in vicarious trauma, as measured by secondary traumatic stress and negative cognitive schemas. In addition, constructivist selfdevelopment theory was employed to interpret the negative cognitive effects from vicarious traumatisation. Qualitative data were utilised to further elucidate the role and nature of vicarious trauma in each of the worker groups. The themes of exposure to client suffering, detachment, level of empathic engagement, personal trauma history and difficult life demands were unearthed from the qualitative data, which illuminated the importance and role of each of these elements to claims workers. Other areas of interest, being utilisation of sick-leave as a means to cope, work-related illness, attitudes towards professional counselling, feelings evoked by traumatised clients, and the language utilised by workers in response to client traumata were investigated. Further effects on participants as well iv as effects that reach beyond the person were identified and examined. Effects on the social and work contexts were also elucidated. Finally, interesting themes that emerged spontaneously from the data were considered. The consideration of the various model elements and other areas of interest systematically revealed that administrative workers dealing with traumatised clients are also affected by the process of vicarious trauma. Furthermore, the model was found to be largely suitable to the context of claims workers. However, the model was expanded to augment its usability within the more general administrative domain. Finally, the overarching aim was to enrich, contextualise and elaborate on the experiences of claims workers within their unique work context, to facilitate insight and a deeper understanding of vicarious trauma in more administrative populations that have largely been overlooked in research.

Made available in DSpace on 2016-04-27T18:47:20Z (GMT). No. of bitstreams: 1 PAULO GREVEN.pdf: 12070633 bytes, checksum: cf91d06cb70d823be9b6df8856b625af (MD5) Previous issue date: 2007-02-14 / This essay handles the discussion on the process of human aging. The attendance offer is respectful and shows dignity towards the elderly. It is a theme that seeks to open up space for a debate on a new vision other than what is aging in the 21st century. It is a case study, whose hypothesis is tested by means of a qualitative research done on elders which are hosted in an enterprise that is specifically designed for this age cluster. This research attempts to comprehend why and how the elder decides to venture out of his establishment to live in a hotel-residence, using the interviews with a group of elders living in the Solar Ville Garaude institution, located in Alphaville, district of Barueri, state of Sao Paulo, as backbone for the research. It analyses how the institution ministers to their bio psychosocial needs, using the method of participative observation. The analysis of the results consolidates itself within parameters defined by bibliographic researches and documentaries on the matter of aging and is complemented by the daily work experience of the researcher in institutions that are concentred on this segment. It discusses a question that shows itself to be valid in view of the constant increase of this population. It still reflects the importance of caring, creative and innovative attendance to this social group by the public and private institutions, avowing the value of respecting and even surpassing the basic principles of caring for elderly, fragile or active, in his moment in live and in his singularity. It is a calling towards a new culture, one in which the individual awareness of eudaemonia is the main parameter / Quais os motivos que levam o idoso, por vontade própria a sair de casa para morar em uma instituição de longa permanência? Esta foi a pergunta guia da entrevista feita a um grupo de 10 idosos de condição sócio cultural de classe média e alta, com 60 anos ou mais, de ambos os sexos, hospedados em um empreendimento voltado para essa faixa etária, conferindo se a proposta de uma casa construída, administrada e voltada para os cidadãos mais velhos, é viável. Analisa como a instituição, Solar Ville Garaude, localizado no município de Barueri, estado de São Paulo, atende suas necessidades biopsicossociais, usando o método da observação participante.Entre os principais motivos que levam o idoso a sair de casa para morar em um hotel-residência, podemos elencar: solidão, sensação de insegurança, dificuldades quanto a acessibilidade, cansaço em relação à administração da casa, percepção de fragilidade e medo de não ter a quem recorrer, além de relatos de estados de depressão. A análise dos resultados se apóia em parâmetros definidos a partir de pesquisas bibliográficas e documentais sobre o processo de envelhecimento e é complementada pela experiência do trabalho diário do pesquisador na instituição. É relevante e significativo entender por que e como o idoso com poder aquisitivo de padrão classe média, decide sair de sua moradia e morar em um hotel-residência. Questão que se mostra válida em vista do constante aumento dessa população. A pesquisa reflete ainda sobre a importância do bom atendimento, criativo e inovador, a esse grupo social pelas instituições públicas e privadas. Ressaltando o respeito e a superação dos princípios básicos de atendimento ao idoso, frágil ou ativo, em sua singularidade, e com diferentes situações de dependência. A moradia fora da residência familiar possibilita boa qualidade de vida, permitindo ao idoso e à família novos laços relacionais e atendimento satisfatório. O caso estudado mostrou que a instituição é um local de inclusão, apresentando a possibilidade de uma nova cultura de acolhimento ao cidadão que envelhece, em que a sensação individual de bem-estar e felicidade seja o parâmetro principal. Um ensaio que abre espaço para a discussão de uma nova visão sobre o morar no século XXI

The general aim for this research was to explore and describe the risk and protective variables in the bio–psychosocial field of adolescents with Cystic Fibrosis (CF) and to describe how these variables impact multi–dimensionally on such adolescents. From the literature search it seemed as if interventions regarding CF focus mainly on the medical condition. No literature could be found on the experiences of adolescents with CF. It is clear that there is a dearth of research on adolescents with CF in general but also specifically on the bio–psychosocial impact of this illness on adolescents in this challenging time of maturing. The research design was a case study and focused on exploration and description of risk and protective factors in the bio–psychosocial fields of adolescents with CF. Semi–structured interviews were used as a data collecting method. Questions were open–ended, but focused on the experience of adolescents having CF. Thematic analysis was used for data analysis based on the following steps, which entailed among others transcribing data, reading, re–reading, translation, coding, identifying and describing themes. Facing a chronic illness and the intensive medical treatment required is a harsh reality that influences the entire field of adolescents with CF. This research results expanded knowledge of CF in adolescents within a Gestalt field perspective. Themes identified outline risk and protective factors related to faith, daily routines and especially the effect of medical procedures on time management, emotions, health and body–related aspects, frequent hospitalisation, social support and future concerns. If the risk and protective variables in the field of adolescents with CF is better understood from their own perspective, it is assumed that trans–disciplinary interventions with a multi–dimensional focus will be targeted more accurately in intervention strategies for this vulnerable group. / Thesis (M.A. (Psychology))--North-West University, Potchefstroom Campus, 2012.