This study investigated the experiences of caregivers regarding their participation in community-based rehabilitation for children with physical disabilities in two selected communities in Botswana. The experiences included the impact of disability on the immediate family, coping strategies, enabling factors and barriers to participation in community-based rehabilitation.

The continued development of the American health care system and evolving technology have led to an increased life expectancy within the general population. In fact, these advancements have also resulted in growing numbers of young people with chronic illnesses living into adulthood. Approximately one third of children ages 10-17 have a chronic disease, and the vast majority of these children will survive beyond their 20th birthday (Blum, 1995; Lotstein, McPherson, Strickland, & Newacheck, 2005; White, 2002). The main objective of this study was to explore the healthcare transition (HCT) practices of health care providers and the HCT experiences of chronically ill young adults living with sickle cell disease, cystic fibrosis, and/or diabetes. Meleis, Sawyer, Im, Hifinger Messias, & Schumacher’s (2000) theory on transition and Boykin and Schoenhofer’s (2001) theory of Nursing as Caring provided the theoretical lenses throughwhich study findings were viewed. This was a descriptive exploratory mixed methods design that consisted of survey data and used conventional content analysis to analyze the qualitative data. The quantitative portion of this study incorporated a 41-question survey that was completed by 33 health care providers working with chronically ill young adults in the southeast Florida region. Additionally, semi-structured interviews were conducted with eight young adults (18-24 years of age) living with a sickle cell disease, cystic fibrosis, and/or diabetes. Five themes emerged from an analysis of the data describing the healthcare transition (HCT) experience: Transition Confusion, Familial Reliance, Lost in Transition, Fiscal Stressors, and Transition Uneasiness. The findings of this study demonstrate that there are, at minimum, three general parts of the HCT process that remain deficient: educational preparation, consistent communication between all parties involved in the HCT process, and guidance for the independent negotiation of the present healthcare system. Recommendations for healthcare providers that work with chronically ill young adults include establishing a HCT framework that incorporates consistent communication among team members and patients/families, individualized educational formats, and guidance for navigational skills to negotiate the healthcare system. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection

The purpose of this study is to identify the main stessors that parents experience when raising an autistic child and parents' perceptions of what can help them cope better. It is important that parenting stressors and coping strategies are identified as they relate to the age of the child with autism.

Reported cases of incest in Multnomah County, Oregon, as in the rest of the country, are increasing yearly. Effective networking between agencies is important in order to successfully work with the problem. The research problem of this study was to determine the effectiveness of the present network of agencies working with incest in Multnomah County. In order to evaluate network effectiveness the following objectives were established: to provide a "cultural" description of the major components of the Multnomah County network; to determine whether a common definition of incest among practitioners exists and to compare the networking system in this county with others throughout the country.

It was recommended by the American Psychological Association and the American Bar Association in October 1999, that the time had come for psychologists to do more than act as expert witnesses, and that their influence should be felt " ... at the first level of intervention" (Foxhall, 2000, p. 1). The first level of intervention is considered, in this study, to be the decision-making process. This research examines the decision-making processes used by four of the disciplines integral to the child abuse multi-disciplinary team. Social workers, child protection officers of the South African Police Services, psychologists and prosecutors currently involved in the child abuse arena in South Africa were given case vignettes to anchor their decision-making on simulated examples. On the basis of these in-depth interviews, using a Grounded Theory methodology, three specific questions are addressed, namely: how decisions are made and substantiated; how they differ across disciplines; and how they compare to recommended protocol. Results indicate interesting differences across these four disciplines. The differences between the decision-making processes in the disciplines seem to be rooted in their philosophical tenets, which give rise to specific aims in addressing child abuse. Differences between the decision-making processes and recommended protocol were also noted in cases where guidelines are available. In addition differences in expected outcomes of the vignettes, use ofassumptions and a level of mistrust between professionals was shown. If this research can help to sensitise professionals to begin to understand their own decision-making processes and those of their fellow decision-makers, then perhaps key role players and policy makers may be one step closer to responding to the challenge of child sexual abuse in South Africa. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 2002.

The extent to which customers are satified with the care they receive from the health professionals has been an important area of interest for researchers, managers and health care workers. The physiotherapy cerebral palsy clinic at Mulago Hospital in Kampala Uganda provides physiotherapy services for parents/caregivers of children with cerebral palsy. The parents/caregivers visit the clinic seeking physiotherapy services that will address their problems and those of the child. The purpose of this study was to explore the satisfaction that the parents/caregivers of children with cerebral palsy get from utilising the physiotherapy services at the clinic and to identify the barriers/problems that they encounter that might affect their attendance.

This study investigated the experiences of caregivers regarding their participation in community-based rehabilitation for children with physical disabilities in two selected communities in Botswana. The experiences included the impact of disability on the immediate family, coping strategies, enabling factors and barriers to participation in community-based rehabilitation.

This study of early years services in India explores the take-up of the government ICDS (Integrated Child Development Services Scheme) and RGNCS (Rajiv Gandhi National Crèche Scheme), and the factors affecting their uptake by working mothers in a Delhi slum. Policy cannot assess programme outcomes effectively without understanding how services are implemented. Existing literature indicates that programme impact is related to programme take-up, with non-take-up being a complex phenomenon affected by factors operating at multiple levels of the policy process. The study makes original contributions by examining user perspectives on early childhood education and care (ECEC) in the Indian context; in being the first to research any aspect of the RGNCS; and in utilizing Critical Realism as the underlying philosophical, theoretical and methodological paradigm for studying programme uptake. It poses five research questions that examine mothers' childcare arrangements and needs/expectations from services, their take-up of government programmes and component services, and the combination of factors affecting uptake. Study findings are based on surveys with 200 working mothers and 37 children's centre workers, and interviews with 15 policy experts. Findings reveal childcare arrangements and needs/expectations to vary by family structure, child's age, and mother's age and employment. ICDS uptake is found to be higher (54.3% of all mothers), than RGNCS (18.6%). An explanatory framework for analysing take-up reveals that low take-up results from a combination of multiple factors, most significantly programme characteristics for the ICDS, and participant characteristics for the RGNCS. Two theoretical frameworks frame this analysis - Wolman's (1981) determinants of programme success and failure, and the 'barriers and bridges' to programme uptake. Critical policy analysis further identifies the effects of the policy meaning-making processes, and the role of local 'street-level bureaucrats' in take-up. Both programmes display 'conflicted policy success' vis-à-vis take-up when categorised using McConnell's (2010) criteria for programme 'success' and 'failure'. Policy implications include strategies for increasing programme uptake, and a policy focus upon service users and women in the informal economy, recognition of the dual role of ECEC, and the importance of evidence-creation for interactive governance.

HIV-positive adolescents are an increasingly numerous and challenging population in the South African HIV/AIDS epidemic. Their access to, and retention in, ART care has become a pressing public health concern. Comprised of four journal articles, this thesis explores the practice of antiretroviral treatment (ART) among a cohort of HIV-positive adolescents (age 10-19) in South Africa's Eastern Cape. By 'practice', I mean the volatile, situated and relational 'work' that goes into young people's everyday achievement of ART - into consuming daily medication, regularly attending health appointments, and participating in HIV programmes. Through an exploration of the ways in which some HIV-positive adolescents use, appropriate, or reject ART care; this thesis contributes to a much-needed evidence-base on the needs and survival strategies of adolescent ART users. Data for this study was gathered through eight months of multi-method ethnographic fieldwork with 23 HIV-positive youth, their families, and local health workers. The findings elucidate adolescent ART as a complex (and often volatile) form of social incorporation, through which young people negotiate survival, care and moral connection in contemporary South Africa. Enrolling in ART meant being encompassed into a (often hierarchical) set of social relationships, through which adolescents sought belonging, recognition and protection, amid profound insecurity. Through ART and its associated programmes, adolescents and their families attempted to strengthen familial ties, appeal to powerful patrons, petition for care, and access basic resources. Yet these pursuits were often deeply ambivalent, as discipline, blame, and resentment often came encased in the terms of care. At the crux of each article is an attempt to understand how adolescents, often alongside their families, negotiated both the social stakes and possibilities of ART. Through these discussions, we might better be able to grasp the fragility and complexity of young people's retention in ART.

This study examines the impact of children’s grants on household access to food, education and health care. In the face of increased poverty and socio-economic inequalities, social grants are a critical poverty alleviation intervention implemented by the government of South Africa. The children’s grants are offered as part of the social security system which is provided for in the Republic of South Africa Constitution of 1996 and the Social Assistance Act of 2004. The basic needs conceptual framework is the lens informing the focus of the study. Among other major findings, the study reveals that (a) childrens grants play a critical role in improvement of access to food, health care and education, (b) childrens grants are used as collateral, to access short term loans, and (c) social networks and home gardens play a significant role in aiding children’s grants to ensure household access to food, education and health care.