The goal of this work is to explore the role of theological bioethics in influencing the formulation of existing or proposed policies dealing with treatment decisions for seriously disabled newborns in our pluralist society. Part I of the paper attempts to determine as precisely as possible what bioethics is, particularly Judeo-Christian bioethics. After comparing the latter to the Hippocratic tradition and to secular bioethics, the distinctive characteristics and potential contribution of theological bioethics are identified. The policies then examined in Part II are: medical policies formulated by physicians, bioethical policies proposed by bioethicists and legal policies enunciated by court decisions and legal writers. In each case they are evaluated in the light of a number of specific ethical tests proposed as central to Judeo-Christian bioethics. The paper concludes that Judeo-Christian bioethics has not been particularly influential in our pluralist society. A final section proposes a model treatment policy.

This study investigated the relationship between cognitive development and children’s understanding of the hospital nurse’s role. A group of 35 hospitalized children with chronic conditions and without neurological deficits, aged 4 to 10 years, were given three tasks (i.e., the Nurse’s Role Task, the Balance Beam Task, and the Task of Intrapersonal Understanding), scored for developmental level using Case’s (1992) neo-Piagetian theory of cognitive development as a framework. A full sample of 4—year—olds was not pursued due to the distracting hospital environment which, in combination with the shorter attention span of the 4-year-olds, rendered the interviews extremely difficult to complete. Descriptive results indicated a moderately advanced understanding of the hospital nurse’s role by 8— and lO—year—olds, being on the order of one—third of a substage (i.e., approximately 8 months ahead in development), whereas 4— and 6—year—olds showed an age— appropriate level of understanding of the hospital nurse’s role. Analysis of Variance indicated a statistically significant effect for age on all three tasks (p < .01). Six levels of social—cognitive development in understanding the hospital nurse’s role were found, which were, in successive order: (1) Roles of the nurse as scripted actions (i.e., 4-year-old level), (2) Roles of the nurse as motivated action sequences (i.e., 6—year—old level), (3) Roles of the nurse as planned action sequences (i.e., 8— year—old level), (4) Roles of the nurse as generalized dispositions toward action (i.e., 10—year-old level), (5) Roles of the nurse as demonstrating logically planned decisions towards action (i.e., 12-year—old level), and (6) Roles of the nurse as demonstrating logically planned action sequences (i.e., 14—year—old level). Furthermore, results indicate that a few 6- and 8-year-olds and the majority of l0—year—olds could give an accurate description of the duties of the hospital nurse, that is, 1) nurses are there to help children, 2) nurses have a responsibility for the well-being of their patients, 3) nurses want to improve the physical and emotional health of their patients, 4) nurses also see their own shortcomings in their care for children and have good intentions, and 5) nurses are human and have their own feelings, thoughts, doubts, and ideas. Suggestions for future research have been provided in order to further improve communication between health care professionals and hospitalized children with chronic conditions. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

No description available.

Thesis (MA)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: This research investigates the indicators, different role players and the assessment process of intentional physical injuries to children who are hospitalized. The basic premise for this research is the importance of professionals working with children in acquiring skills and knowledge on handling physically abused children. Physical abuse affects and requires the involvement of the entire family of the physically abused child. It is therefore necessary to consider the physically abused child as a part of the larger family system, and not assessed or treated in isolation. The purpose of this research is to broaden the theoretical knowledge of professionals working with children, and specifically social workers, in identifying and assessing physically abused children. This research report includes an investigation of risk factors, consequences and the adjustment process of physically abused children. Knowledge of these indicators of physical abuse will increase the awareness and the ability of the social worker or other professional to identify the injury as intentional. The assessment process by the multi-professional team in the hospital is also examined, focusing on the central role of the social worker in managing cases of physically abused children. The phases of the assessment process, the role of each team member, the various techniques applied as well as factors influencing assessment are described. The empirical research involved the use of both qualitative and quantitative methods in order to explore the theoretical part of the research. This section can be divided into three phases. The first phase included setting up a profile, over a period of four months, of physically abused children under the age of five, who were admitted to the hospital and their families (N = 24). Of this sample, the characteristics and circumstances of four parents/perpetrators (n = 4) were investigated in the form of interviews, which formed part of the second phase of the empirical research. The third phase included conducting a survey with the social workers (n = 5) that assessed physically abused children in the hospital. This was done III the form of questionnaires, which included closed and open-ended questions. The findings and responses of the respondents were analyzed and compared with the findings from previous studies undertaken by various authors. The findings of this research can be used as guidelines for professionals in general who work with children, and more specifically social workers in a hospital that assess children presenting with intentional physical injuries. / AFRIKAANSE OPSOMMING: Hierdie navorsing ondersoek die aanduidende faktore, die rolspelers en die asseseringsproses van fisies mishandelde kinders wat gehospitaliseer word. Die uitgangspunt is die noodsaaklikheid van professionele persone wat met kinders werk, en veral maatskaplike werkers, om kennis en vaardighede te hê, ten einde kinders wat fisies mishandel is te kan hanteer. Omdat die hele gesin van die mishandelde kind geaffekteer word en betrokke is, is dit belangrik om die fisies mishandelde kind nie in isolasie, maar as deel van die familie sisteem te kan benader. Die navorsingsondersoek het ten doel om die teoretiese kennis basis van professionele persone wat met kinders werk, en spesifiek maatskaplike werkers, oor die identifisering en assesering van fisies mishandelde kinders uit te brei. Ten einde maatskaplike werkers se kennis van die probleem onders aandag uit te bou, vervat die navorsingsverslag 'n bespreking van die risiko faktore, gevolge en aanpassingsproses van die fisies mishandelde kind. Kennis van hierdie aanduiders sal die bewusdheid asook die vermoë van professionele persone om die fisiese mishandeling te identifiseer, verhoog. Die asseseringsproses deur die multiprofessionele span in die hospitaal word ook ondersoek, met fokus op die sentrale rol van die maatskaplike werker in die hantering van fisies mishandelde kinders. Die fases van die asseseringsproses, die rol van elke spanlid, verskeie tegnieke en faktore wat assesering beïnvloed, word bespreek. Die teoretiese doel van die verslag word uitgebrei in die empiriese ondersoek, deur 'n bespreking van die bevindinge wat deur veskeie metodes verkry is. Kwalitatiewe asook kwantitatiewe metodes is benut tydens die drie fases van die empiriese ondersoek. Die eerste fase was die opstel van 'n profiel wat oor 'n tydperk van vier maande geneem is, van fisies mishandelde kinders wat toegelaat is in die hospitaal en hul gesinne (N = 24). Vanuit hierdie streekproef, is die eienskappe en omstandighede van vier ouers/oortreders (n = 4) ondersoek deur middel van onderhoude, wat die tweede fase van die ondersoek bevat. Die derde fase was om 'n opname te doen met die maatskaplike werkers (n = 5) wat die fisies mishandelde kinders in die hospitaal asseseer. Die bevindinge en response van die respondente is geanaliseer en vergelyk met die bevindinge van vorige studies wat deur verskeie outeurs onderneem is. Die bevindinge van hierdie navorsing kan as 'n riglyn gebruik word deur professionele persone wat oor die algemeen met kinders werk, en meer spesifiek maatskaplike werkers wat fisies mishandelde kinders in 'n hospitaal asseseer.

The present research examines the effect of music therapy on the affect of hospitalised children. It took place on a paediatric ward of a New Zealand public hospital. This study aimed to investigate the role of music therapy in addressing patients’ psychosocial needs. Literature on the impact of hospitalisation, and on the use of music therapy in hospitals and paediatrics was reviewed. The research involved an audit of the therapist’s clinical notes from music therapy sessions over the course of seven months. The clinical notes included measurements of children’s mood from the beginning and end of sessions, using McGrath’s (1990) Affective Facial Scale. It was hypothesised that mood measures following music therapy would be higher than pre-music therapy scores. Statistical analysis of the facial scale data did not show a significant difference between ‘before’ and ‘after’ measures. These results were discussed with regard to a ceiling effect (this is, the measurements indicated patients were at the happy end of the scale before the music therapy session, so there was little room on the scale for mood to improve following music therapy). The measurement of emotion did not prove to be straightforward. The hospital environment may have influenced the patients’ responses in a number of ways. These environmental influences are discussed with reference to examples from the clinical notes. The usefulness of facial scales in this context is discussed, as well as other limitations of the research. Suggestions for future research include the use of other mood measures, and the inclusion of measurements of parental mood and how this affects the child.

The present research examines the effect of music therapy on the affect of hospitalised children. It took place on a paediatric ward of a New Zealand public hospital. This study aimed to investigate the role of music therapy in addressing patients’ psychosocial needs. Literature on the impact of hospitalisation, and on the use of music therapy in hospitals and paediatrics was reviewed. The research involved an audit of the therapist’s clinical notes from music therapy sessions over the course of seven months. The clinical notes included measurements of children’s mood from the beginning and end of sessions, using McGrath’s (1990) Affective Facial Scale. It was hypothesised that mood measures following music therapy would be higher than pre-music therapy scores. Statistical analysis of the facial scale data did not show a significant difference between ‘before’ and ‘after’ measures. These results were discussed with regard to a ceiling effect (this is, the measurements indicated patients were at the happy end of the scale before the music therapy session, so there was little room on the scale for mood to improve following music therapy). The measurement of emotion did not prove to be straightforward. The hospital environment may have influenced the patients’ responses in a number of ways. These environmental influences are discussed with reference to examples from the clinical notes. The usefulness of facial scales in this context is discussed, as well as other limitations of the research. Suggestions for future research include the use of other mood measures, and the inclusion of measurements of parental mood and how this affects the child.

The present research examines the effect of music therapy on the affect of hospitalised children. It took place on a paediatric ward of a New Zealand public hospital. This study aimed to investigate the role of music therapy in addressing patients’ psychosocial needs. Literature on the impact of hospitalisation, and on the use of music therapy in hospitals and paediatrics was reviewed. The research involved an audit of the therapist’s clinical notes from music therapy sessions over the course of seven months. The clinical notes included measurements of children’s mood from the beginning and end of sessions, using McGrath’s (1990) Affective Facial Scale. It was hypothesised that mood measures following music therapy would be higher than pre-music therapy scores. Statistical analysis of the facial scale data did not show a significant difference between ‘before’ and ‘after’ measures. These results were discussed with regard to a ceiling effect (this is, the measurements indicated patients were at the happy end of the scale before the music therapy session, so there was little room on the scale for mood to improve following music therapy). The measurement of emotion did not prove to be straightforward. The hospital environment may have influenced the patients’ responses in a number of ways. These environmental influences are discussed with reference to examples from the clinical notes. The usefulness of facial scales in this context is discussed, as well as other limitations of the research. Suggestions for future research include the use of other mood measures, and the inclusion of measurements of parental mood and how this affects the child.

O presente estudo teve como objetivo a avaliação psicológica de crianças hospitalizadas por meio do Desenho da Figura Humana (DFH) e do Desenho da Pessoa Doente (DPD) usando os Indicadores Emocionais e Indicadores Maturacionais de Koppitz (1973) e o levantamento de elementos complementares relativos à doença e à hospitalização. A amostra foi composta por 120 crianças de ambos os sexos, com faixa etária de 7 a 11 anos, divididas em dois grupos, um grupo de crianças hospitalizadas e outro de escolares. Os resultados indicaram que os dois desenhos das crianças hospitalizadas apresentaram um número maior de Indicadores Emocionais do que as escolares e menor média nos Indicadores Maturacionais, mostrando um maior comprometimento no primeiro grupo. Os Indicadores Emocionais com diferenças significantes no DFH foram figura pequena e pernas fechadas, mais freqüentes nas crianças hospitalizadas. Quanto aos Indicadores Maturacionais foram observadas diferenças significantes entre os dois grupos, a favor do grupo de escolares, tanto no DFH como no DPD. Nos dois grupos e também na amostra total, o DFH apresentou uma produção mais elaborada, em comparação com o DPD. No DPD os Indicadores Emocionais com maior freqüência do que no DFH foram integração pobre, sombreamento no rosto, sombreamento no corpo/membros, sombreamento no rosto/pescoço, figura pequena, mãos cortadas e omissão de pescoço. No DPD das crianças hospitalizadas ficou evidente a presença dos elementos complementares caracterizando doenças mais graves em relação ao DPD dos escolares, com mais representação do ambiente hospitalar, de objetos de procedimentos hospitalares, restrição de atividade, figura debilitada, expressão de tristeza e expressão de choro/dor. Pode-se concluir que o uso do DPD como instrumento de avaliação psicológica de crianças hospitalizadas permite emergir maior quantidade de indicadores de perturbação emocional em comparação ao DFH. Portanto, pode-se considerar que o DPD mostra-se como uma técnica eficaz para a avaliação de crianças hospitalizadas. / This study had the purpose to assess psychologically hospitalized children by the Human Figure Drawing (HFD) and by the Patient Person Drawing (PPD) using Koppitz Emotional and Maturational Indicators (1973) and by the survey of complementary elements related to illness and hospitalization. Sample was composed by 120 children, half of each sex, with age ranging from 7 to 11 years old, divided in two groups, one of hospitalized children and the other from schools. Results indicated that the hospitalized children drawings presented a bigger number of Emotional Indicators than school children and lower mean of Maturational Indicators, showing more emotional problems in the first group. The Emotional Indicators that had significant differences between groups were tiny figure and legs pressed together. In relation to Maturational Indicators were observed significant differences, in behalf of school children in HFD and in PPD. In both groups and in the whole sample, the HFD presented a more elaborate drawing than the PPD. In PPD the Emotional Indicators with more frequency than in HFD were poor integration, shading of face, shading of body and/or limbs, tiny figure, hands cut off and neck omission. In hospitalized children PPD it became evident the presence of complementary elements, characterizing serious illness in relation to PPD of school children, with more representation of hospital environment, hospital procedures objects, activity restriction, debilitated person, sadness and cry/pain expression. It can be concluded that the PPD use as a tool of psychological assessment with hospitalized children permits to emerge more indicators emotional disturbs comparing with the HFD. Therefore it can be considered that the PPD is a more efficient procedure to assess hospitalized children.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-05-25T13:30:59Z No. of bitstreams: 1 Denise Regina Disaró.pdf: 2573282 bytes, checksum: 6639bb953a5e32665d0fbf755ee62591 (MD5) / Made available in DSpace on 2017-05-25T13:30:59Z (GMT). No. of bitstreams: 1 Denise Regina Disaró.pdf: 2573282 bytes, checksum: 6639bb953a5e32665d0fbf755ee62591 (MD5) Previous issue date: 2017-04-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Palliative care (PC) is a new practice in the world and in Brazil, and even more recent with children. This study was developed in a palliative care setting. Its purpose is to reflect on psychoanalytic care of children in PC, their families, the health team and on the psychoanalyst. With psychoanalysis as a theoretical, technical and ethical reference, a three case study was developed which provided the opportunity to observe how psychoanalytic care occurs in this special condition. The traumatic potential present in the situational dimension tends to cause changes in the Self of the patients and their relatives, who present a psychic functioning and suffering, similar to the psychopathological dimension, such as narcissistic-identity disorders. Through this process, children and their families lose, even temporarily, some important Ego functions to face the circumstances, such as the capacity for mediation, organization, synthesis and integration of the elements present in the situational dimension. This requires that the analyst assume the deficient Ego functions until the people involved gradually rescue the dormant skills. It is as a mediator that the analyst can be a transformational object and enables the psychoanalytic work, the construction of meaning and the elaboration of experience. It is predominantly a more active care with an additional amount of implied presence, although the analyst has to keep, dialectically, the reserved presence which is essential for self-restraint, self-care and to avoid intrusion caused by the excess of implication / Cuidados paliativos (CP) são uma prática nova no mundo e no Brasil e ainda mais recente com crianças. É neste pano de fundo que se desenvolveu este estudo. Seu objetivo é refletir sobre os cuidados psicanalíticos destinados a crianças em CP e sua família, à equipe de saúde e ao próprio psicanalista. Tendo a psicanálise como referencial teórico, técnico e ético, foi desenvolvido um estudo de três casos, que permitiu observar como o cuidado psicanalítico ocorre nesta condição especial. O potencial traumático presente na dimensão situacional tende a provocar alterações no Eu dos pacientes e seus familiares, que passam a apresentar um funcionamento psíquico e um sofrimento semelhante ao da dimensão psicopatológica, isto é, aos transtornos narcísico-identitários. Nestes momentos, as crianças e suas famílias perdem, ainda que temporariamente, algumas funções egoicas importantes para o enfrentamento das circunstâncias, tais como a capacidade de mediação, de organização, síntese e integração dos elementos presentes na dimensão situacional. Este quadro requer que o analista assuma as funções egoicas deficientes naquele momento até que as pessoas resgatem gradativamente as habilidades perdidas. É como mediador que o analista pode ser um objeto transformacional e possibilitar o trabalho psíquico e a construção de sentido e de elaboração da experiência. Tratase, predominantemente, de um cuidado ativo com um quantum a mais de presença implicada, embora o analista tenha que manter dialeticamente a presença reservada, essencial para a autocontinência e o autocuidado e para evitar a intrusão provocada pelo excesso de implicação

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-03-16T12:13:41Z No. of bitstreams: 1 Annelisa Bruna Faccin.pdf: 2179534 bytes, checksum: 2ce833d1928cba2902946b886673f8ff (MD5) / Made available in DSpace on 2018-03-16T12:13:41Z (GMT). No. of bitstreams: 1 Annelisa Bruna Faccin.pdf: 2179534 bytes, checksum: 2ce833d1928cba2902946b886673f8ff (MD5) Previous issue date: 2018-02-28 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / INTRODUCTION: Animal Assisted Intervention (AAI) is a goal oriented and structured activity that intentionally includes animals in health and education fields to obtain humans therapeutic gains. Increasingly, hospitals incorporate these services to offer patients, adults and children, a possibility to improve their and their families well-being. The positive results of theses interventions in the field of health have been the target of desirable national and international scientific researches. In hospitalized pediatric patients, studies suggest that many benefits are obtained by the interaction of the child with the animal, among them, withdrawal from social isolation and decrease in the sensation of self-reported pain. OBJECTIVE: To evaluate the effects of Animal Assisted Intervention on verbal and nonverbal expression of psychic contents in hospitalized children. METHOD: It is a qualitative research. 05 subjects participated, in which 02 male and 03 female, from 06 to 10 years old, hospitalized at least 02 days. Co-therapist dogs: Thor, 04 years old and Kate, 03 years old, both Golden Retriever breed, selected by international protocols conducted by the researcher. Drawings and Wartegg Test were applied before and after AAI. RESULTS: In the studied population, it was verified that the presence of the dog favored greater contact with the emotional aspects and, by extension, attempts to cope with the disease. CONCLUSION: The results of this research suggest the AAI in the hospital environment provided the possibility of stagnating the pathological condition in favor of the Self reintegration experience, that is, a reappropriation of its subjective identity, partially blocked by the process of illness and hospitalization / INTRODUÇÃO: Intervenção Assistida por Animais (IAA) é toda atividade com objetivos orientados e estruturados que intencionalmente incorpora animais aos campos da saúde e educação com a finalidade de obter ganhos terapêuticos em humanos. Cada vez mais, hospitais incorporam esses atendimentos para oferecer aos pacientes, adultos e crianças, uma possibilidade de melhora no bem-estar do hospitalizado e seus familiares. As implicações positivas dessas intervenções no campo da saúde têm sido alvo de desejável investigação científica nacional e internacional. Em pacientes pediátricos hospitalizados, estudos sugerem que muitos benefícios são obtidos na interação da criança com o animal, entre os quais, afastamento do isolamento social e diminuição na sensação de dor autorreferida. OBJETIVO: Avaliar os efeitos da Intervenção Assistida por Animais na expressão verbal e não verbal de conteúdos psíquicos em crianças hospitalizadas. MÉTODO: Pesquisa de natureza qualitativa. Participaram 05 sujeitos, sendo 02 do sexo masculino e 03 do sexo feminino, de 06 a 10 anos, hospitalizados há pelo menos 02 dias. Cães co-terapeutas: Thor, 04 anos e Kate, 03 anos, ambos da raça Golden Retriever, selecionados de acordo com critérios de protocolos internacionais, conduzidos pela pesquisadora. Foram aplicados desenhos e teste de Wartegg antes e depois da IAA. RESULTADOS: Na população estudada verificou-se que a presença do cão favoreceu maior contato com os aspectos emocionais e, por extensão, tentativas de enfrentamento da doença. CONCLUSÃO: Os resultados dessa pesquisa sugerem que a IAA no ambiente hospitalar proporcionou, aos sujeitos estudados, a possibilidade de estancar a condição patológica em favor de uma experiência de reintegração do Eu, ou seja, uma reapropriação de sua identidade subjetiva, parcialmente tolhida pelo processo de adoecimento e hospitalização