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Mediators and Moderators of the Association Between Self-Silencing and DepressionTippett, Corie E. January 2014 (has links)
No description available.
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Sjuksköterskors erfarenheter av att stödja patienter med diabetes typ 2 till egenvård inom primärvården : En allmän litteraturstudie / Nurses` experiences of supporting patients withtype 2 diabetes to selfcare in primary health caresettings : A general literature studyAbadi, Mahnour, Akter, Mst Tohmina January 2024 (has links)
Background: Type 2 diabetes is an increasingly prevalent public health issue characterized by a progressive disease course. It is attributed to various factors, including lifestyle, reduced physical activity, and genetics. Enhanced knowledge among primary care nurses can enable patients to implement lifestyle changes effectively. Aim: The purpose was to describe nurses’ experiences of supporting patients with type 2 diabetes to selfcare in primary health care settings. Method: This study employs a general literature review methodology with qualitative approaches, drawing on 10 scientific articles. Results: The analysis identified two main categories: communication as well as knowledge and motivation. These categories were crucial from the nurse´s side to achieve self-care in the patient. Different experiences emerged from nurse´s side to achieve motivation and communication. Conclusion: Type 2 diabetes is a growing public health concern. A significant barrier to effective management is the lack of knowledge among both nurses and patients. There is a critical need for competent nurses in primary care to motivate patients towards lifestyle modification and self-care.
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The Flourishing Trainee: Operationalizing Self-Care Education in Clinical Psychology Training ProgramsZinn, Bonnie B. 29 June 2022 (has links)
No description available.
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Autocuidado com a estomia intestinal e equipamento coletores: perspectiva das pessoas estomizadas intestinais, familiares e equipe multidisciplinar do programa de ostomizados / Self-care with intestinal ostomy and collecting equipment: perspective of ostomized people, relatives, and the multidisciplinary team of the Program for Ostomized PeopleSasaki, Vanessa Damiana Menis 13 April 2018 (has links)
Resumo: Trata-se de um estudo de desenho misto, do tipo sequencial explanatório, sendo que na primeira etapa quantitativa descritiva e transversal o objetivo foi analisar as características sociodemográficas, clínicas e de capacidade de autocuidado de pessoas estomizadas intestinais cadastradas em um Programa de Ostomizados do interior paulista; e na segunda etapa qualitativa exploratória foi analisar e construir o significado da experiência de autocuidado com a estomia intestinal, na perspectiva de pessoas estomizadas intestinais, familiares e da equipe multidisciplinar do Programa de Ostomizados (Parecer nº 896.782/2014 CEP/EERP-USP). Na etapa quantitativa aplicou-se dois instrumentos, um para caracterização sociodemográfica de pessoas estomizadas e seu familiar e outro para mensurar a capacidade de autocuidado de pessoas estomizadas intestinais e de seus familiares, mediante critérios de inclusão e exclusão. A análise estatística descritiva dos dados indicou, que do total de 120 pessoas estomizadas intestinais, predominou 57,5% participantes do sexo masculino; 64,9% com idade até 73 anos; 68,4% com até cinco anos de estudo e 71,0% casados; 76,0% possuíam colostomia, sendo 62,6% por neoplasia colorretal; com presença complicações em 54,2% destas pessoas, principalmente a hérnia paraestomal em 39,1%; e 68,5% utilizavam a bolsa coletora de uma peça drenável. Quanto à capacidade de autocuidado geral, 95,9% pessoas estomizadas apresentaram capacidade plena, contudo, 56,8% apresentaram capacidade plena para o autocuidado específico com a estomia intestinal e equipamentos coletores. Ainda, participaram desta etapa, 32 familiares, com predomínio de 75% do sexo feminino; 56,2% acima de 60 anos; 46,9% com estudo entre 5 e 10 anos; com 71,9% casados/amasiados; 68,8% sem atividade laboral e 50,0% com renda familiar entre 3 e 4 salários mínimos. Estes resultados possibilitaram dimensionar o contexto do estudo e refinar os critérios de seleção dos possíveis participantes para a etapa qualitativa. Esta foi desenvolvida por meio de entrevistas em profundidade com a técnica do grupo focal, distintamente para os participantes estomizados, familiares e profissionais do Programa de Ostomizados, além do diário de campo, da observação não participante e participante para a obtenção dos dados, com utilização da Análise Temática e do Modelo Social da Deficiência para a interpretação. A experiência de pessoas estomizadas intestinais foi categorizada com o tema \"A experiência da necessidade do autocuidado após o processo de estomização intestinal\", com dois núcleos temáticos \"Assistência interdisciplinar necessária às pessoas estomizadas intestinais\"; e \"O autocuidado para a reabilitação da pessoa estomizada intestinal\", que evidenciou a necessidade de assistência especializada hospitalar e a continuidade do suporte profissional interdisciplinar para o seguimento ambulatorial. Os dados dos familiares foram discutidos mediante o tema: \"Desafios do familiar no convívio com a pessoa estomizada intestinal\", com as unidades temáticas \"A sobrecarga da responsabilização pelo cuidado e o preconceito da estomia intestinal\"; e \"Nova dinâmica familiar para a reabilitação da pessoa estomizada intestinal\", que enfatizou a importância da inserção da família no planejamento da assistência especializada e o suporte profissional para estes. A experiência dos profissionais foi explorada com o tema \"Desafios para a implementação do Programa de Ostomizados\", composta pelos núcleos temáticos \"Em busca do trabalho em equipe no Programa de Ostomizados\"; e \"Demandas de assistência especializada para pessoas estomizadas intestinais\", que evidenciou as suas expectativas sobre as necessidades de assistência especializada de pessoas estomizadas intestinais e o trabalho em equipe. Diante da consonância da análise interpretativa sobre as experiências das pessoas estomizadas, dos familiares e dos profissionais do Programa de Ostomizados, o significado construído para a experiência de necessidade de autocuidado com a estomia e equipamentos coletores foi \"a luta cotidiana para adoção de um novo estilo de vida para além da estomia e dos equipamentos coletores, em busca de reabilitação\". Os resultados das duas etapas do estudo evidenciaram a complexidade sobre o autocuidado para esta clientela, que constitui o início de sua reabilitação. Para tanto, há necessidade da inclusão do conceito de deficiência física, no preparo das pessoas estomizadas intestinais e dos familiares, assim como na capacitação dos profissionais de saúde, para o enfrentamento do estigma e preconceito social e do auto preconceito, assim como dos desafios cotidianos para o estabelecimento de um novo estilo de vida, com seguimento especializado interdisciplinar / Abstract: This is a study of mixed design, typified as explanatory sequential, where, in the first quantitative, descriptive and cross-sectional stage, the objective was to analyze the sociodemographic, clinical and self-care characteristics of ostomized individuals enrolled in a Program for Ostomized People in the countryside of the state of São Paulo; and, in the second exploratory qualitative stage, it aimed to analyze and to construct the meaning of the self-care experience with intestinal ostomy, from the perspective of patients, relatives, and the multidisciplinary team of the Program for Ostomized People (Opinion nº 896.782/2014 CEP/EERP-USP). In the quantitative stage, we applied two instruments, one for the sociodemographic characterization of the ostomized subjects and their relatives, and another to measure the self-care capacity of the ostomized subjects and their relatives, through inclusion and exclusion criteria. The descriptive statistical analysis of the data indicated that, of the total of 120 surveyed ostomized subjects, there was a predominance of 57.5% male; 64.9% aged up to 73 years; 68.4% with up to five years of schooling and 71.0% married; 76.0% had colostomy, of which 62.6% due colorectal neoplasm; with complications present in 54.2% of ostomized patients, mainly the parastomal hernia in 39.1%; and 68.5% used the one-piece drainage bag. As for the general self-care capacity, 95.9% of ostomized subjects showed full capacity; however, 56.8% showed full capacity for the specific self-care with intestinal ostomy and collecting equipment. Moreover, 32 relatives took part in this stage, with a predominance of 75% female; 56.2% aged over 60 years; 46.9% with schooling between 5 and 10 years; with 71.9% married/stable relationship; 68.8% without work activity and 50.0% with family income between 3 and 4 minimum wages. These results allowed us to measure the context of the study and to refine the criteria for selecting the possible participants for the qualitative stage. This was developed by means of in-depth interviews with the focal group technique, distinctly for the ostomized participants, relatives, and the professionals of the Program for Ostomized People, besides field diary, non-participant and participant observation to obtain the data, using Thematic Analysis and the Social Model of Disability for interpreting them. The experience of the ostomized patients was categorized with the theme \"The experience of the need for self-are after the process of intestinal ostomization\", with two thematic cores \"Interdisciplinary care required for the ostomized people\"; and \"Self-care for rehabilitating the ostomized person\", which highlighted the need for specialized hospital care and the continuity of interdisciplinary professional support for outpatient follow-up. The data about the relatives were discussed through the theme: \"Challenges of the relative in living with the ostomized person\", with the thematic units \"The overload of responsibility for caring for and the prejudice arising from intestinal ostomy\"; and \"New family dynamics for rehabilitating the ostomized people\", which underlined the importance of inserting the family in planning specialized care and professional support for them. The experience of the professionals was explored with the theme \"Challenges for implementing the Program for Ostomized People\", composed by the thematic cores \"Seeking teamwork in the Program for Ostomized People\"; and \"Demands for specialized care for ostomized people\", which highlighted their expectations about the needs for specialized care of ostomized people and teamwork. Given the consonance of the interpretative analysis about the experiences of the ostomized people, relatives, and the professionals of the Program for Ostomized People, the meaning constructed for the experience of need for self-care with ostomy and collecting equipment was \"the daily fight to adopt a new lifestyle that goes beyond the ostomy and the collecting equipment, seeking rehabilitation\". The results of the two stages of the study highlighted the complexity of the self-care for this clientele, which constitutes the beginning of its rehabilitation. Accordingly, there is a need to include the concept of physical disability in preparing ostomized people and their relatives, as well as in training health professionals, with the purpose of facing stigma, social prejudice and self-prejudice, in addition to dealing with daily challenges for establishing a new lifestyle, with specialized interdisciplinary follow-up
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Soigner la maladie chronique : quand le travail d'équipement révèle autonomie et attachements / Treating chronic illness : when the equipping work reveals autonomy and attachmentsVaillant, Marie-France 17 December 2012 (has links)
Le discours commun plaide en faveur l'autonomie du malade. Pourtant soigner la maladie chronique révèle aussi des attachements. C'est ce que nous proposons de mettre en évidence, à travers notre thèse qui prend pour exemple le diabète et envisage, à travers le développement de la notion de travail d'équipement, de questionner l'autonomie, qui est loin d'aller de soi. A partir d'entretiens, d'observations de terrain et d'objets, de recherche de traces, nous interrogeons des pratiques telles que l'éducation thérapeutique, l'introduction des médicaments, des équipements (lecteur de glycémie, pompe à insuline). Tous ces éléments sont autant de médiations, pour le malade, son entourage, les professionnels de santé, les associations de malades, qui influencent le cours de la vie avec la maladie. Le travail d'équipement permet de faire le lien entre la sociologie de la santé et de la maladie, l'interactionnisme, la phénoménologie et la sociologie de l'acteur réseau. Il offre une grille de lecture de la maladie chronique et du soin, au regard de tous les équipements qui contribuent à la prise en charge la maladie. Il permet de définir ce qu'est l'autonomie dans le cadre d'une maladie qui tient le malade et va plus loin ouvrant vers la construction identitaire de l'homme-avec-la-maladie. / Common speech calls for patient autonomy. Yet chronic illness care also reveals attachments. This is what we propose to highlight, through our thesis that takes for example diabetes and plans through the development of the concept of ‘the equipping work', questioning the autonomy, which is far to go self. From interviews, field observations, objects screening, and search of traces, we interrogate such practices as therapeutic education, the introduction of drugs and equipment (glucometer, insulin pump). These elements are all mediations, for the patient, family members, health professionals, patient organisations, which influence the course of living with the disease. Equipping can make the link between the sociology of health and illness, symbolic interactionism, phenomenology and the actor network theory. It provides a grid of chronic illness and care, with all the equipements that contribute to the management of disease. It allows defining autonomy despite the strength of disease ties and leads to rebuild the identity of the man-with-the-sickness.
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Autocuidado com a estomia intestinal e equipamento coletores: perspectiva das pessoas estomizadas intestinais, familiares e equipe multidisciplinar do programa de ostomizados / Self-care with intestinal ostomy and collecting equipment: perspective of ostomized people, relatives, and the multidisciplinary team of the Program for Ostomized PeopleVanessa Damiana Menis Sasaki 13 April 2018 (has links)
Resumo: Trata-se de um estudo de desenho misto, do tipo sequencial explanatório, sendo que na primeira etapa quantitativa descritiva e transversal o objetivo foi analisar as características sociodemográficas, clínicas e de capacidade de autocuidado de pessoas estomizadas intestinais cadastradas em um Programa de Ostomizados do interior paulista; e na segunda etapa qualitativa exploratória foi analisar e construir o significado da experiência de autocuidado com a estomia intestinal, na perspectiva de pessoas estomizadas intestinais, familiares e da equipe multidisciplinar do Programa de Ostomizados (Parecer nº 896.782/2014 CEP/EERP-USP). Na etapa quantitativa aplicou-se dois instrumentos, um para caracterização sociodemográfica de pessoas estomizadas e seu familiar e outro para mensurar a capacidade de autocuidado de pessoas estomizadas intestinais e de seus familiares, mediante critérios de inclusão e exclusão. A análise estatística descritiva dos dados indicou, que do total de 120 pessoas estomizadas intestinais, predominou 57,5% participantes do sexo masculino; 64,9% com idade até 73 anos; 68,4% com até cinco anos de estudo e 71,0% casados; 76,0% possuíam colostomia, sendo 62,6% por neoplasia colorretal; com presença complicações em 54,2% destas pessoas, principalmente a hérnia paraestomal em 39,1%; e 68,5% utilizavam a bolsa coletora de uma peça drenável. Quanto à capacidade de autocuidado geral, 95,9% pessoas estomizadas apresentaram capacidade plena, contudo, 56,8% apresentaram capacidade plena para o autocuidado específico com a estomia intestinal e equipamentos coletores. Ainda, participaram desta etapa, 32 familiares, com predomínio de 75% do sexo feminino; 56,2% acima de 60 anos; 46,9% com estudo entre 5 e 10 anos; com 71,9% casados/amasiados; 68,8% sem atividade laboral e 50,0% com renda familiar entre 3 e 4 salários mínimos. Estes resultados possibilitaram dimensionar o contexto do estudo e refinar os critérios de seleção dos possíveis participantes para a etapa qualitativa. Esta foi desenvolvida por meio de entrevistas em profundidade com a técnica do grupo focal, distintamente para os participantes estomizados, familiares e profissionais do Programa de Ostomizados, além do diário de campo, da observação não participante e participante para a obtenção dos dados, com utilização da Análise Temática e do Modelo Social da Deficiência para a interpretação. A experiência de pessoas estomizadas intestinais foi categorizada com o tema \"A experiência da necessidade do autocuidado após o processo de estomização intestinal\", com dois núcleos temáticos \"Assistência interdisciplinar necessária às pessoas estomizadas intestinais\"; e \"O autocuidado para a reabilitação da pessoa estomizada intestinal\", que evidenciou a necessidade de assistência especializada hospitalar e a continuidade do suporte profissional interdisciplinar para o seguimento ambulatorial. Os dados dos familiares foram discutidos mediante o tema: \"Desafios do familiar no convívio com a pessoa estomizada intestinal\", com as unidades temáticas \"A sobrecarga da responsabilização pelo cuidado e o preconceito da estomia intestinal\"; e \"Nova dinâmica familiar para a reabilitação da pessoa estomizada intestinal\", que enfatizou a importância da inserção da família no planejamento da assistência especializada e o suporte profissional para estes. A experiência dos profissionais foi explorada com o tema \"Desafios para a implementação do Programa de Ostomizados\", composta pelos núcleos temáticos \"Em busca do trabalho em equipe no Programa de Ostomizados\"; e \"Demandas de assistência especializada para pessoas estomizadas intestinais\", que evidenciou as suas expectativas sobre as necessidades de assistência especializada de pessoas estomizadas intestinais e o trabalho em equipe. Diante da consonância da análise interpretativa sobre as experiências das pessoas estomizadas, dos familiares e dos profissionais do Programa de Ostomizados, o significado construído para a experiência de necessidade de autocuidado com a estomia e equipamentos coletores foi \"a luta cotidiana para adoção de um novo estilo de vida para além da estomia e dos equipamentos coletores, em busca de reabilitação\". Os resultados das duas etapas do estudo evidenciaram a complexidade sobre o autocuidado para esta clientela, que constitui o início de sua reabilitação. Para tanto, há necessidade da inclusão do conceito de deficiência física, no preparo das pessoas estomizadas intestinais e dos familiares, assim como na capacitação dos profissionais de saúde, para o enfrentamento do estigma e preconceito social e do auto preconceito, assim como dos desafios cotidianos para o estabelecimento de um novo estilo de vida, com seguimento especializado interdisciplinar / Abstract: This is a study of mixed design, typified as explanatory sequential, where, in the first quantitative, descriptive and cross-sectional stage, the objective was to analyze the sociodemographic, clinical and self-care characteristics of ostomized individuals enrolled in a Program for Ostomized People in the countryside of the state of São Paulo; and, in the second exploratory qualitative stage, it aimed to analyze and to construct the meaning of the self-care experience with intestinal ostomy, from the perspective of patients, relatives, and the multidisciplinary team of the Program for Ostomized People (Opinion nº 896.782/2014 CEP/EERP-USP). In the quantitative stage, we applied two instruments, one for the sociodemographic characterization of the ostomized subjects and their relatives, and another to measure the self-care capacity of the ostomized subjects and their relatives, through inclusion and exclusion criteria. The descriptive statistical analysis of the data indicated that, of the total of 120 surveyed ostomized subjects, there was a predominance of 57.5% male; 64.9% aged up to 73 years; 68.4% with up to five years of schooling and 71.0% married; 76.0% had colostomy, of which 62.6% due colorectal neoplasm; with complications present in 54.2% of ostomized patients, mainly the parastomal hernia in 39.1%; and 68.5% used the one-piece drainage bag. As for the general self-care capacity, 95.9% of ostomized subjects showed full capacity; however, 56.8% showed full capacity for the specific self-care with intestinal ostomy and collecting equipment. Moreover, 32 relatives took part in this stage, with a predominance of 75% female; 56.2% aged over 60 years; 46.9% with schooling between 5 and 10 years; with 71.9% married/stable relationship; 68.8% without work activity and 50.0% with family income between 3 and 4 minimum wages. These results allowed us to measure the context of the study and to refine the criteria for selecting the possible participants for the qualitative stage. This was developed by means of in-depth interviews with the focal group technique, distinctly for the ostomized participants, relatives, and the professionals of the Program for Ostomized People, besides field diary, non-participant and participant observation to obtain the data, using Thematic Analysis and the Social Model of Disability for interpreting them. The experience of the ostomized patients was categorized with the theme \"The experience of the need for self-are after the process of intestinal ostomization\", with two thematic cores \"Interdisciplinary care required for the ostomized people\"; and \"Self-care for rehabilitating the ostomized person\", which highlighted the need for specialized hospital care and the continuity of interdisciplinary professional support for outpatient follow-up. The data about the relatives were discussed through the theme: \"Challenges of the relative in living with the ostomized person\", with the thematic units \"The overload of responsibility for caring for and the prejudice arising from intestinal ostomy\"; and \"New family dynamics for rehabilitating the ostomized people\", which underlined the importance of inserting the family in planning specialized care and professional support for them. The experience of the professionals was explored with the theme \"Challenges for implementing the Program for Ostomized People\", composed by the thematic cores \"Seeking teamwork in the Program for Ostomized People\"; and \"Demands for specialized care for ostomized people\", which highlighted their expectations about the needs for specialized care of ostomized people and teamwork. Given the consonance of the interpretative analysis about the experiences of the ostomized people, relatives, and the professionals of the Program for Ostomized People, the meaning constructed for the experience of need for self-care with ostomy and collecting equipment was \"the daily fight to adopt a new lifestyle that goes beyond the ostomy and the collecting equipment, seeking rehabilitation\". The results of the two stages of the study highlighted the complexity of the self-care for this clientele, which constitutes the beginning of its rehabilitation. Accordingly, there is a need to include the concept of physical disability in preparing ostomized people and their relatives, as well as in training health professionals, with the purpose of facing stigma, social prejudice and self-prejudice, in addition to dealing with daily challenges for establishing a new lifestyle, with specialized interdisciplinary follow-up
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Personers upplevelse av egenvård vid diabetes typ 2 : En litteraturöversikt / Persons’ experience of self-care in type 2 diabetes : A literature reviewBurgos Nunez, Tania, Haji, Fahmo January 2021 (has links)
Bakgrund: DMT2 debuterar vanligtvis hos vuxna personer som har haft dåliga hälsovanor eller har genetiska anlag för sjukdomen. Patienter med DMT2 kan få komplikationer på grund av brist på egenvård. Sjuksköterskan har en viktig roll för patienter med diabetes och det är att se till att patienterna förstår innebörden att leva med DMT2 och förespråka vikten av egenvård. Dessutom kan sjuksköterskan behöva ingripa om egenvården upplevs omöjlig att utföra. Syfte: Syftet var att beskriva personers upplevelse av egenvård vid diabetes typ 2. Metod: Metoden var en litteraturöversikt. Litteratursökningen genomfördes i databaserna Cinahl Complete och PubMed. Tio stycken kvalitativa vetenskapliga originalartiklar inkluderades i resultatet. Resultat: I resultatet framkom tre teman; svårigheter med förändringar i livet, vikten av stöd samt betydelsen av kunskap. Sammanfattning: DMT2 är en sjukdom som kräver mycket egenvård och förändringar i livet vilket blir en utmaning för individen. Slutsatsen som författarna kommit fram till är att närstående såväl som sjukvård är viktiga faktorer för patienter med DMT2. Stöd är viktigt för att stärka motivation att utveckla förmågan till egenvård på bästa sätt. Sjuksköterskor har en betydande roll i att stödja diabetespatienter och deras anhöriga under sjukdomsförloppet. / Background: DMT2 usually debuts in adults who have had poor health habits or have genetic predispositions to the disease. Patients with DMT2 may have complications due to lack of self-care. The nurse has an important role for patients with diabetes and that is to make sure that patients understand the consequences of living with DMT2 and advocate the importance of self-care. In addition, the nurse may need to intervene if self-care is perceived as impossible to perform. Aim: The purpose was to describe personal experience of self-care in type 2 diabetes. Method: The method was a literature review. The literature search was performed in the databases Cinahl Complete and Pub Med. Ten qualitative scientific original articles were included in the result. Results: The results are reported according to the three themes that emerged in the data analysis: difficulties with changes in life, The importance of the supportive significance of knowledge. Conclusion: DMT2 is a disease that requires a lot of self-care and changes in life, which becomes a challenge for the individual. The conclusion that the authors have come to is that relatives as well as healthcare are important factors for patients with DMT2. Support is important to strengthen motivation to develop the ability to self-care in the best way. Nurses have a significant role in supporting diabetic patients and their relatives during the course of the disease.
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Changing relationships with the self and others : an interpretative phenomenological analysis of a Traveller and Gypsy life in public careAllen, Daniel January 2013 (has links)
Background: The implementation of the Care Matters: Transforming the Lives of Children and Young People in Care Green Paper (Department for Education and Skills, (DfES) 2006) and the subsequent Care Matters: Time for Change White Paper (DfES, 2007), witnessed the consolidation of a universal ambition to improve the opportunities for all children living in care. Arguably, the most important recommendation in this pursuit is reflected in the need to provide people who have lived in care as children with independent support, which enables them to discuss their experiences, and suggest ways in which the care system might be improved. However, whilst this recommendation has been implemented with a diverse range of care leavers, the impact of the experience of living in care and the associated disadvantage experienced by Travellers and Gypsies remains under researched, understated, and unacknowledged (Cemlyn et al., 2009). Methodology: Guided by the philosophical assumptions of interpretative phenomenological analysis (IPA), this study represents and constructs the experience of living in public care by focusing on the voices 10 Travellers and Gypsies who lived in care as children. Testimonies were collected through a wide variety of methods that included face-to-face interviews, focus groups, telephone interviews, blogs, emails, letters, song lyrics, and poems. Findings: Following a considered application of IPA, six main themes emerged from the analysis. These were social intervention; an emotional rollercoaster of separation, transition, and reincorporation; a war against becoming settled; leaving care and the changing relationship with the self and others; inclusion and strength; and, messages for children living in care. In line with the tenets of phenomenology, these findings are presented in such a way to as to invite the reader to move away from their own personal understanding of the world in order to enter the ‘lifeworld’ (Husserl, 1970, 1982) of Travellers and Gypsies who lived in care as children. However, to assist in this sense making activity, this study also provides a discrete interpretation of the findings before developing this knowledge to form a more detailed theoretical construct entitled ‘the model of reflective self-concepts’. Taken together with the testimonies of each person who took part in the study, the thesis enables an understanding of how the experience of living in care is inextricably linked to a process of social and psychological acculturation. By staying close to the experiences provided, it reveals how a process of change is determined, more often than not, by a sense of personal resilience directly related towards a Traveller or Gypsy self-concept. In attempt to move towards service improvement, this thesis offers a series of recommendations and conclusions which aim to support social workers and carers empower Traveller and Gypsy children to develop a secure Traveller and Gypsy self-concept thus enabling them experience improved outcomes including those opportunities set out in Care Matters social policy agenda (DfES, 2006; 2007).
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Disease and disability in early rheumatoid arthritis : a 3-year follow-up of women and men in the Swedish TIRA project /Thyberg, Ingrid, January 2005 (has links) (PDF)
Diss. (sammanfattning) Linköping : Linköpings universitet, 2005. / Härtill 4 uppsatser.
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Patient empowerment in long-term conditions : development and validation of a new measureSmall, Nicola January 2012 (has links)
Background: Patient empowerment is viewed as a priority by policy makers, patients and practitioners worldwide. Although there are a number of measures available, none have been developed specifically for patients in the UK with long-term conditions. It is the aim of this study to report the development and preliminary validation of an empowerment instrument for patients with long-term conditions in primary care.Methods: The study involved three methods. Firstly, a systematic review was conducted to identify existing empowerment instruments, and to describe, compare and appraise their content and quality. The results supported the need for a new instrument. Item content of existing instruments helped support development of the new instrument. Secondly, empowerment was explored in patients with long-term conditions and primary care practitioners using qualitative methods, to explore its meaning and the factors that support or hinder empowerment. This led to the development of a conceptual model to support instrument development. Thirdly, a new instrument for measuring empowerment in patients with long-term conditions in primary care was developed. A cross-sectional survey of patients was conducted to collect preliminary data on acceptability, reliability and validity, using pre-specified hypotheses based on existing theoretical and empirical work. Results: Nine instruments meeting review inclusion criteria were identified. Only one instrument was developed to measure empowerment in long-term conditions in the context of primary care, and that was judged to be insufficient in terms of content and purpose. Five dimensions (‘identity’, ‘knowledge and understanding’, ‘personal control’, personal decision-making’, and ‘enabling other patients’) of empowerment were identified through published literature and the qualitative work and incorporated into a preliminary version of the new instrument. A postal survey achieved 197 responses (response rate 33%). Almost half of the sample reported circulatory, diabetic or musculoskeletal conditions. Exploratory factor analysis suggested a three factor solution (‘identity’, ‘knowledge and understanding’ and ‘enabling’). Two dimensions of empowerment (‘identity’ and ‘enabling’) and total empowerment showed acceptable levels of internal consistency. The measure showed relationships with external measures (including quality of chronic illness care, self-efficacy and educational qualifications) that were generally supportive of its construct validity.Conclusion: Initial analyses suggest that the new measure meets basic psychometric criteria and has potential for the measurement of patient empowerment in long-term conditions in primary care. The scale may have a role in research on quality of care for long-term conditions, and could function as a patient-reported outcome measure. However, further validation is required before more extensive use of the measure.
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