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A enfermeira e o cuidado da criança para o desenvolvimento na unidade de terapia intensiva pediátrica / The nurse and the care for the development of the child in the Intensive Care Unit PediatricDanielle Aparecida Pereira Braga 24 May 2013 (has links)
Introdução: A criança que requer cuidados intensivos deve ser considerada tanto no aspecto biológico como no seu desenvolvimento, os processos que podem agredi-la devem ser minimizados, ou eliminados, e ela deve ser apoiada sempre que enfrente alguma situação potencialmente estressante, para seu atendimento não se tornar iatrogênico, buscando atender suas necessidades e pautar na perspectiva da integralidade, o que significa um cuidado além da prática biomédica. Objetivo: Descrever e analisar o cuidado da enfermeira à criança hospitalizada na Unidade de Terapia Intensiva Pediátrica (UTIP), com foco no desenvolvimento infantil. Método: Estudo qualitativo, descritivo e exploratório, realizado numa UTIP, de um hospital privado de grande porte, filantrópico, geral, localizado na cidade de São Paulo e aprovado pelo Comitê de Ética e Pesquisa. A coleta de dados em oficinas pedagógicas incluiu oito enfermeiras, cada uma participando de dois encontros. Dados submetidos à análise temática de conteúdo, interpretados de acordo com o referencial das necessidades essenciais da infância. Resultados: A categoria Concepções e práticas da enfermeira no cuidado para o desenvolvimento infantil na UTIP descreve as ações das enfermeiras e aspectos relativos à situação da internação que impactam sobre a criança e, portanto, devem ser considerados em suas atividades de cuidado, visando as necessidades da criança para além do motivo da hospitalização. Contudo, as enfermeiras não nominam essas ações como cuidado de enfermagem e sim como comportamentos naturais, e, deste modo, são realizados de acordo com a visão de cada enfermeira, sem sistematização, ou constância. A categoria Facilidades e dificuldades da enfermeira no cuidado para o desenvolvimento infantil na UTIP descreve os aspectos facilitadores nas práticas institucionalizadas como atenção ao conforto físico, à história e hábitos da criança, o brincar, as informações fornecidas na admissão, os laços entres os familiares, aspectos que fortalecem o cuidado e o processo de hospitalização. Inclui também as dificuldades, decorrentes do modelo hegemônico biomédico, que vão de encontro ao cuidado para a promoção do desenvolvimento, e atividades burocráticas existentes no contexto de trabalho que reduzem o tempo da enfermeira voltado ao cuidado da criança e da família. A categoria Perspectivas da enfermeira sobre o cuidado para o desenvolvimento da criança na UTIP descreve a necessidade de uma filosofia, teoria e instrumentos para orientar o cuidado, comuns a toda a equipe multiprofissional, a partir da mudança de compreensão dos profissionais acerca do cuidado integral à criança, que poderia ser alcançada por meio de reflexão sobre o fazer envolvendo a todos, em atividades como workshops e cursos sobre promoção do desenvolvimento e cuidado integral. Conclusões: Embora as enfermeiras se percebam realizando ações favoráveis ao desenvolvimento da criança reconhecem que garantir o desenvolvimento infantil saudável, na situação de hospitalização na UTIP, é algo a ser alcançado, mediante ações sistematizadas e norteadas por objetivos comuns a toda a equipe de saúde e reconhecidas como cuidado profissional. As oficinas pedagógicas contribuíram para a reflexão, troca de experiência e proposição de ações de melhoria do cuidado à saúde da criança, referidas como estratégias formativas que podem favorecer tais mudanças. / Introduction: Children who require intensive care should be considered both in their biological aspect as in their development; procedures that may hurt them should be minimized or eliminated and they should be supported all the times they face some potentially stressing situations. This provides a non iatrogenic care which attends their needs and support the perspective of integrality, what means a care beyond the biomedical practice. Objective: to describe and analyze the care of the nurse towards child hospitalized in the Intensive Care Unit Pediatric (ICUP), with focus on the child development. Method: qualitative, descriptive and exploratory study, done in the ICUP of a private, large sized, philanthropic and general hospital situated in São Paulo City and approved by the Ethics Research Committee. Data were collected in pedagogical workshops with eight nurses, each one taking part in two meetings, and were submitted to the thematic analyses of contents and interpreted according to the referential of essential needs of the childhood. Results: The category Nurses conceptions and practices to care for the child development in the ICUP describes actions of the nurses and aspects of hospitalization that have impact on the child and so should be considered in their care activities aiming the needs of the child beyond the reason for the hospitalization. However, the nurses do not nominate these actions as nursing care but as natural behaviors and, so, they are performed according to the vision of each nurse, without any systematization or constancy. The category Facilities and difficulties of the nurse to care for the child development in the ICUP describes aspects in the institutionalized practices that strengthen to care for child development as attention to the physical comfort, to know the child story and habits, the playing, the information given in the reception, and relationships between relatives. It also includes the difficulties related to the hegemonic biomedical model that opposes the care for the promotion of development and bureaucratic activities that reduce the nurses time dedicated to child and family care. The category Perspectives of the nurse about the care for the child development in the ICUP describes the need of a philosophy, or theory, and instruments to guide the comprehensive care, common to all the multi professional team. This could be reached through reflection about the work in ICUP involving all the professionals in activities like workshops and courses on promotion of development and integral care. Conclusions: Although the nurses feel doing actions in favor to the development of the child, they realize that to ensure the healthy development of the child, in the situation of hospitalization in the ICUP, is something to be reached, through systematized actions and guided by common objectives to the whole health team and recognized as Professional care. The data collection workshops contributed to the reflection, exchange of experiences and proposals of actions to improve the care for children, and so nurses indicated them as formative strategies which can encourage such changes.
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Cuidado infantil e (não) vacinação no contexto de famílias de camadas médias em São Paulo/SP / Child care and (not) vaccination in the context of middle class families in São Paulo/SPCarolina Luisa Alves Barbieri 20 August 2014 (has links)
A vacinação é uma das medidas de maior impacto na diminuição da morbimortalidade de doenças. No entanto, sua história é marcada por êxitos e contratempos. No contexto brasileiro, a vacinação se afirmou como premissa do cuidado infantil, extrapolando a perspectiva médica e alcançando a população geral. Em contraponto, desde os anos 2000, foi observada uma diminuição da cobertura vacinal infantil em estratos de alta renda e escolaridade em São Paulo-SP, segmento social que valoriza a individualidade e a autonomia dos sujeitos. Esse estudo tem por objetivo compreender o processo de (não) vacinação dos filhos e sua interface com o cuidado infantil, em casais de camada média e alta escolaridade em São Paulo/SP. Foi utilizada a abordagem qualitativa, por meio de entrevistas em profundidade com dezesseis casais, dos quais cinco vacinaram, cinco selecionaram as vacinas e seis não vacinaram os filhos. O percurso analíticointerpretativo dos dados empíricos foi realizado pelo referencial metodológico da antropologia interpretativa geertziana com o recurso da análise de conteúdo temático e os achados foram discutidos em articulação com os referenciais teóricos interrelacionados de cuidado, família e gênero. O estudo encontrou diferenças significativas quanto à tomada de decisão dos casais, variando de uma postura de aceitação plena a uma questionadora, porém, todos eles convergiram nos aspectos de buscar argumentação científica e orientação médica para suas escolhas. O contexto do parto humanizado e as informações sobre vacina, sobretudo da internet, foram os principais elementos que deflagraram a problematização da vacina, com destaque ao protagonismo feminino nesse percurso. Apesar das diferentes concepções acerca da vacinação, para todos os casais, a escolha por vacinar ou não o filho baseou-se no mesmo sentimento de cuidado parental e valores de proteção e responsabilidade. A vacinação assumiu significado de proteção para os que vacinaram e risco para os que não vacinaram. As justificativas pela não vacinação se assemelharam às da literatura internacional. As decisões sobre vacinação e saúde no âmbito privado familiar foram majoritariamente apropriadas pelas mulheres, a despeito de evidências de uma maior participação dos homens nos afazeres domésticos e no cuidado filial. Os casais que não vacinaram relataram sentimento de medo diante da possibilidade de perda da autonomia nas decisões sobre a saúde de seus filhos. A defesa dessa autonomia, porém, não foi estendida a toda população. Todos os casais participantes, independentemente da postura quanto à vacinação, tomaram suas decisões norteadas por uma perspectiva individual, não sendo mencionada a função coletiva da imunização. A compreensão da aceitabilidade das vacinas na sua interface com o cuidado infantil, no contexto das camadas médias de São Paulo, remete a uma reflexão sobre a interação sociedade e práticas de saúde e ressalta a importância que o cuidado, no tocante à vacinação, é uma questão que extrapola o âmbito individual, pois diz respeito a uma responsabilidade que também é coletiva / Vaccination is one of the measures of greatest impact in reducing the morbiditymortality of diseases. However, its history is scarred by successes and setbacks. In the Brazilian context, vaccination consolidated itself as the premise of child care, exceeding the medical perspective and reaching out the population in general. In contrast, it has been observed since the 2000s, a diminishing of infant immunization coverage in highincome strata and education in São Paulo-SP, a social segment that values the individuality and autonomy of individuals. This study aims to understand the process of (not) vaccination of children by couples in middle and high schooling level in São Paulo-SP, and its interface with child care. A qualitative approach through in-depth interviews with sixteen couples was employed. Among them: 05 vaccinated their children, 05 selected the vaccines and 06 did not vaccinate their children. The analytical and interpretative path of empirical data was performed by methodological framework of geertzian interpretative anthropology, with the use of thematic content analysis, and the findings were discussed in conjunction with the interrelated theoretical frameworks of care, family and gender. The study found significant differences concerning the decision making process of the couples, ranging from a position of full acceptance to questioning the vaccination itself, however, all of them converged on aspects of seeking scientific argumentation and medical advice to guide their choices. The context of humanized childbirth and information on vaccine, mostly from the internet, were the main elements that triggered the questioning of the vaccine, particularly the female role in this pathway. Despite distinct views about vaccination, for all couples, the choice to vaccinate or not the child was based on the same sense of parental care, protection values and responsibility. Vaccination assumed a meaning of protection for those who vaccinated and a risk for those who did not vaccinate. The reasons for the nonvaccination were similar to those reported in the literature. Decisions about vaccination and health in the family scope were mostly appropriated by women, despite evidences of a greater participation of men in the housework and child care. Couples who did not vaccinate reported a sense of fear under losing the autonomy of taking decisions on their children`s health. The defense of this autonomy, however, did not reach the entire population. All attendant couples, regardless of vaccination stance, made their decisions guided by an individual perspective, not mentioning the collective function of immunization. Understanding the acceptability of vaccines and its interface with child care in the context of the middle class of São Paulo, points to a reflectance on the relationship between society and health practices and emphasizes the importance that care, with regard to vaccination, is a question that goes beyond the individual scope, as it relates to a responsibility which is also collective
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Criança: “futuro da nação”, “célula do vício” - políticas de assistência à infância em Juiz de Fora/MG na transição Império/ RepúblicaOliveira, Paloma Rezende de 19 June 2009 (has links)
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Previous issue date: 2009-06-19 / Este trabalho é fruto de reflexões em torno das políticas de assistência à infância em Juiz de Fora, vinculadas à escolaridade, na passagem do regime monárquico para o republicano, momento crucial na formação do pensamento social brasileiro. Durante as leituras sobre a historiografia da infância e da assistência destacaram-se três elementos em torno deste tema: as discussões em torno de minha hipótese de trabalho, que é a de que ocorreram mudanças nas políticas de assistência à infância na República em relação às políticas do período imperial; os apontamentos sobre a criança e a infância como categoria de análise; bem como, as reflexões acerca da abordagem da História da Cultura e da História das Idéias como método de pesquisa para se tratar dessas políticas. Esses elementos ajudam a traçar um conjunto de temas que desenham o perfil institucional da assistência que se tem àquele tempo, não só nas dimensões materializadas dos prédios das escolas, asilos, institutos, com suas regras e funcionamentos, como também nas idéias que são expressas por essas construções. Trata-se de uma pesquisa documental, que analisa correspondências, atas, tutelas, fotografias, legislação e jornais do Arquivo Municipal, Arquivo da Biblioteca Murilo Mendes e Arquivo da Igreja da Glória, em Juiz de Fora. / This investigation is based on reflections concerning child welfare state associated with the education, in Juiz de Fora / MG. This research analyzes the period of transition from Monarchy to Republic – a crucial moment in the Brazilian social idea formation. The child and the child welfare work historiography highlight three elements: 1) the child welfare state in the period of Monarchy changes with the Republic; 2) the child and the childhood as category of analysis; 3) the cultural history and the ideas history as method of investigation. These elements draw a group of themes that form the welfare work institutional profile of that period, not only in the dimension of physical buildings and their rules, but also in the ideas expressed by those buildings. This is a documental research that analyses documents letters, legal or juridical records, photographs, legislation, tutelage cases and journal from the Town Hall Files, Murilo Mendes Library and Gloria Church Files, all in Juiz de Fora city.
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Ontwerp en ontwikkeling van 'n praktykmodel vir kinderterapieVan Niekerk, Corne 22 August 2012 (has links)
M.A. / Children are so often seen as unproductive, dependents that are vulnerable and not responsible for their own actions. Children are in fact individuals in the process of development that can learn to act in a responsible way and to manage their lives. Because children are in the process of development and change, it is a challenge for the therapist to meet the unique needs of the child. This study was developed as a response to a need under social workers for structure in the handling of children with adaptation problems. Social workers need more than just techniques that can be utilized with children in therapy. They also need guidelines on the best techniques to utilize in different phases of the process. This programme aimed at developing an integrated model for child therapy that can be utilized for children who have experienced trauma, who have difficulties adapting to new circumstances, who have behavioural problems or who are in need of personal skills. The Intervention Design and Development Model of Rothman and Thomas (1994) was utilized in the development of the new technological item. The different phases used in the development of the model for child therapy were the following: The problem analysis and planning phase, which included the planning of the study and the setting of goals for the study. The information gathering and synthesis phase, which included an investigation into the available sources for the development of new technology for child therapy. The first focus of the actions in this phase was to identify applicable sources that could be utilized to formulate a theoretical basis for the new technology. The theoretical basis served as a frame of reference to identify the most important aspects of a child that a therapy model should take into account. The next focus was to select existing interventions and technologies that could be used to formulate a practice model that would address the needed aspects of a child. The design phase, consisted of setting a preliminary product. The evaluation phase, which included the implementation of the pilot test and both the process and outcome evaluation. The aim of this phase was to test the programme and to see what can be done to improve on the results and to refine the final product. The implementation and dissemination phase which concluded the study by setting the final product ready for distribution. This product, a model for Functional child therapy, does not provide a recipe for child therapy, nor does it only help children to work through present traumas. The main focus of the model is to help children to become unique individuals within a world that is dominated and structured by adults. Children learn with this model not just to react on adult behaviour, but to become active, responsible role players in their own world.
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Caregivers in nonprofit and private child care centers: a qualitative analysis of perceptions of auspice and job satisfactionClark, Kathryn Anne Mack 11 1900 (has links)
This study focused on two factors, auspice and job
satisfaction, which have been shown to impact on the quality of
child care programs. However, while research has indicated that
auspice, job satisfaction, and program quality are intertwined,
there is a lack of research which explores these factors
qualitatively. There is also a dearth of research which has
considered auspice from the caregivers' perspectives. Hence, the
purpose of this study was to explore the meaning that caregivers
give to auspice in their work in nonprofit and for-profit child
care centers. As well, this study sought to examine the
relationship between auspice and job satisfaction from the
caregiver's point of view, paying close attention to differences
in job satisfaction that existed between staff employed in
nonprofit centers and staff who worked in private or for-profit
centers.
A series of qualitative, in-depth interviews were conducted
with eight child care workers from the Vancouver Metropolitan
area. Four of the participants were employed in or owned private
centers and four of the participants worked in nonprofit centers.
Positive and negative perceptions of both nonprofit and private
auspice emerged. In particular, the nonprofit participants
believed that child care should be operated as a service and not
a business. They perceived that the motive to make a profit in
child care lead for-profit centers to sacrifice quality in order
to cut costs and maximize profits. On the other hand, the for-
profit participants perceived that their centers provided high quality care and were dedicated to putting the needs of children
and staff first.
In general, the participants'' perceptions of factors that
influenced their job satisfaction were similar across auspices.
The nature of child care work and supportive relationships with
co-workers were factors which positively influenced job
satisfaction while the perceived lack of status in the eyes of
society negatively affected satisfaction. Differences in job
satisfaction according to auspice were found on several factors,
such as government policies and a perceived lack of enough time
to accomplish job duties. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate
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Předběžná úprava poměrů dítěte / Provisional regulation of the circumstances of a childKoropecká, Veronika January 2017 (has links)
This thesis focuses on the important private law institute of preliminary injunctions used for the provisional regulation of the circumstances of minors. The fundamental legal principle on which the paper is based is the principle of the best interests of the child, largely based on Art. 3 of the Convention on the Rights of the Child, which states that the best interests of the child shall be a primary consideration in any decision-making concerning children. Emphasis is placed on the child's legal status as a party to the proceedings for a preliminary injunction and the consequent rights of the minor, focusing on the child's right to be heard. The individual chapters are devoted to a detailed analysis of Czech legislation relating to the topic in question, both under the current wording of the law and current application in practice. The first chapter offers a concise introduction to the addressed issue. The second chapter provides definitions of the key concepts related to the topic. The third chapter discusses the position of the child as a party to the proceedings for the issue of a preliminary injunction, their procedural personality and procedural capacity, representation of the child in the process itself and, last but not least, the interests of the child, and their fundamental rights to be...
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Experiences of community care givers on nutritional assessment of children under 5 years in eThekwini DistrictNdlovu, Pretty Gabisile January 2017 (has links)
Submitted in fulfillment of the requirements for the Degree in Masters in Health Sciences in Nursing, Durban University of Technology, Durban, South Africa, 2017. / Introduction
Malnutrition continues to be a major public health problem, especially in children under 5 years of age. Nutritional status is one of the indicators of overall well-being and human resources development of a nation.
Aim of the study
The aim of the study was to explore and describe experiences of Community Care Givers regarding the assessment of malnutrition in children under 5 years of age in eThekwini District Health Sub-district North area six.
Methodology
A qualitative, exploratory, descriptive study was used to conduct the study. Semi-structured individual face to face interviews were conducted with 13 participants. The study was guided by Pender’s Model of Health Promotion.
Results
The findings of the study revealed that participants were dissatisfied with mid upper arm circumference training. They reported lack of support and supervision in their performance such that mid upper arm circumference was non-prioritized. They were dissatisfied with remuneration and they worked under unsafe conditions.
Conclusion
In order to combat malnutrition in children under 5 years in the community, Community Care Givers need to be vigorously educated on the rationale of malnutrition assessment of children under 5 years in the communities so that they can have insight into what they are doing. Community Care Givers have multiple roles and may need to prioritize their work; this is not easy and requires specific guidance and training from skilled health professionals. / M
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Community-based child care (CBCC) resource assessment: the case of Zomba District in MalawiChibwana, Khama 01 March 2010 (has links)
Within this study, the aspirations that communities are striving to realise in bettering the outcomes for their children have been explored. Their achievements are extraordinary and remarkable in the face of serious resource limitations. Nevertheless, some room still exists within the reach of communities themselves to improve the current situation of early childhood services. The roles of other early childhood development stakeholders who partner with communities in supporting the community-based child care centres have also been explored. Their greatest impact in infrastructure, play and learning resources is greatly appreciated. However, an apparent lack of need-based and systemic criterion for allocating resources creates serious disproportionate resource distribution among communities.
While some limitations are obviously within the ability of communities to manage. some are obviously not. Substantial and systematic resource allocation by the Government, cooperating partners and all stakeholders in early childhood development, local and international if channelled through highly committed members of the communities, has great potential to ensure that children in these communities develop optimally. Greater synergy among all stakeholders that are supporting community-based child care centres in Malawi is therefore an indispensable password to unlocking the many aspirations that communities are striving to achieve through the community-based child care centres.
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Die waardes en waarde-oriëntasies van gekommitteerde dogters in kindersorgskoleVan Aswegen, Jan Daniël 27 March 2014 (has links)
M.Ed. (Philosophy of Education) / The central aim of the study was to make an analysis of the values and value-orientations of girls committed to a child-care school in order to understand better their thought processes and behaviour. It was necessary to focus on values and value orientations as these are indicative of what is important to the girls and can be regarded as underlying motives for human behaviour. The motivation for this study lies in the fact that committal is a sensitive and often problematic situation. Children in ordinary schools are committed to child-care schools, and committed children in chid care schools are transferred to reform schools. The most important grounds for committal are need of care and unacceptable behaviour, hence the importance of examining values and value-orientations as underlying motives for behaviour. The primary expectation when committing a child to a child-care school is that the child will be guided towards a positive behaviour change. This study revealed that the value-orientation of an individual is subject to influence and that behaviour changes can be brought about through purposeful coaching of values. Bearing in mind the purposeful influencing of the value orientation of the committed pupil, it is essential that the educator should take special note of the various aspects of the committal, the living conditions, values and value-orientation of these learners. In this respect the most important aspects described in the study are: * an analysis and description of the grounds for committal and the legal stipulations applicable in cases of need of care. * The identifying of a hierarchy of fifteen main type values which can be regarded as possible determinants in assessing the behaviour of girls. * The identifying of characteristics which are typical of the lifestyle of committed girls, and which have an influence on their values, value-orientation and behaviour. With reference to the above aspects of the investigation the following are important findings: * Generally, the girls are committed on grounds of being in need of care for unacceptable behaviour. 'In need of care' refers to material inadequacies and a poor socio-economic existence. The 'unacceptable behaviour' which motivated most committals were serious disobedience, contact with undesirable friends, truancy, petty thieving, chronic absence from home and absconding from home. * With regard to the hierarchy of values it was discovered during the investigation that the values most affected were economic, relationship related, life- and personal values. Those least affected were moral, intellectual, physical and authoritative. The hierarchy of values is indicative of what is important to committed girls and affects their behaviour. * The characteristics of the lifestyle of most of the committed girls were: large families (more than five children) broken families (step parents) age at committal: 13/14 years home language: Afrikaans church attendance of parents: fairly good. Living conditions have an effect on value-orientation and contributes to behaviour on the grounds of which committal takes place.
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'n Bevoegdheidsgebaseerde raamwerk vir die opleiding van kinder- en jeugsorgpraktisyns in Suid-AfrikaDe Jonge, Hester 15 August 2012 (has links)
M.A. / A number of recent variables have influenced the professionalisation of the child and youth care discipline in South Africa. These variables have had a direct impact on the training of child and youth care practitioners. The first variable is the establishment of the National Qualifications Framework, the National Qualification Authority and the focus on lifelong learning possibilities as well as competency-based training. The second variable is the establishment of the Inter-Ministerial Committee on Young People at Risk (IMC) and the accompanying transformation of the South African child and youth care system. The third variable is the transformation of the Interim Council for Social Work with the associated recognition of Child and Youth Care as an independent discipline. The fourth variable is the ratification of the United Nations Convention on the Rights of the Child by South Africa in 1995 in which certain rights of children are recognised. The fifth variable is the knowledge that South African children have special protection under the South African Constitution. The sixth variable is the Africanisation of the profession in South Africa. These variables have stressed the importance of compiling a competency-based framework for the training of child and youth care practitioners in South Africa that embraces all these variables. Child and Youth Care is a phenomenon that is quite unfamiliar as an independent discipline in South Africa, and therefore the researcher chose a qualitative paradigm that is exploratory, descriptive, contextual and phenomenological to develop a competency-based framework for the training of Child and Youth Care practitioners in South Africa. The empirical research included phenomenological interviews with child and youth care trainers and a focus group interview with child and youth care practitioners. Literature was consulted in two stages, namely at the beginning to pose the problem and at the conclusion of the research to compare and contrast the findings (Cresswell, 1994:24). The four criteria to ensure trustworthiness are credibility, transferability, dependability and confirmability. The criteria to obtain this included the triangulation of various methods of data collection and by confirming results with respondents. Detailed descriptions were done to enhance the study's chance of being replicated in another setting. The services of an external coder were utilised. A detailed protocol for data collection is provided. The categories that emerged from the research were compared with literature and used to compile a competencybased framework for the training of Child and Youth Care Practitioners in South Africa.
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