published_or_final_version / Architecture / Master / Master of Architecture

No description available.

Laws in South Africa, such as the Children’s Amendment Act 41 of 2007(Government Gazette, Act 38 of 2005), is developed with good intentions of promoting prevention and intervention on various health-related issues. Laws also dictate, based on developmental and evolving capabilities, chronological ages at which children and adolescents may access certain healthcare services without parental consent, whilst limiting them in other areas such as decision-making for research participation. Of interest to this study is how specialists in health care, conceptualise, understand and apply “sufficient maturity” in their encounters with minors presenting for treatment, in order to identify key concepts of sufficient maturity. From the interviews conducted, themes were identified that were relevant to the construct of “sufficient maturity.”Results indicated that there were two primary perspectives participants used to assess “sufficient maturity” when minors presented for treatment.Health care practitioners, depending on the health care context, assess minors’ sufficient maturity in relation to, either a competency based or a deficiency model. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.

The present study aims to explore the experiences of caregivers working with children living with HIV/AIDS in the context of a children's home. While there has been research conducted on family members as well as community based caregivers of people living with HIV/AIDS, there has been a paucity of research on caregivers of children living with HIV/AIDS in Children's homes. There is a strong need to address this area of deficit in order to identify and tackle areas of difficulty as well as rewarding aspects to enhance the caregiving experience This pilot study adopted the interpretive research paradigm, is qualitative in nature and utilized in depth interviews as a means of data collection. Four women working as caregivers at the children's home were interviewed and the data obtained was analysed using thematic content analysis. The present study highlights the positive as well as the negative aspects of caregiving from the perspective of the caregivers. While caregivers identify the difficulties that they face as a result of caregiving, they also acknowledge the rewards that they attain from their line of work. Furthermore the present study emphasises the coping strategies employed by the caregivers on a personal and an organisational level as well as the resources that aid coping and the constraints against utilising the coping resources. In addition issues of attachment and detachment associated with caring for children, that are particularly pertinent to these non -familial caregivers have been explored. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2005.

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.

Darbo tikslas. Ištirti Kauno Vaiko raidos klinikos „Lopšelis“ stacionaro teikiamų paslaugų kokybę nepilnamečių pacientų atstovų požiūriu. Uždaviniai. Įvertinti stacionaro teikiamų paslaugų apimtį nepilnamečių pacientų atstovų poži��riu, ištirti nepilnamečių pacientų atstovų nuomonę apie paslaugų prieinamumą, įvertinti pacientų atstovų pasitenkinimą suteiktomis paslaugomis. Tyrimo metodika. Anoniminė anketinė apklausa vyko 2007 m. sausio – gruodžio mėnesiais. Buvo išdalinta 131 anketa. Gautos 115 anketų (atsako dažnis 87,8 proc.). Ryšiai tarp požymių buvo vertinami chi kvadrato kriterijumi bei laisvės laipsnių skaičiumi. Statistinių hipotezių reikšmingumui įvertinti pasirinktas statistinio reikšmingumo lygmuo p. Rezultatai. Beveik trys ketvirtadaliai tyrime dalyvavusių pacientų atstovų (72,9 proc.) nurodė, jog juos pilnai patenkino paslaugų apimtis. Didžiąją dalį respondentų (80,5 proc.) pilnai tenkino procedūrų trukmė. Statistiškai reikšmingai didesnė dalis pasitikinčių specialistų kompetencija respondentų (77,9 proc.) lyginant su mažiau pasitikinčiais (33,3 proc.) teigia, jog juos pilnai patenkino įstaigoje teikiamų paslaugų įvairovė (p < 0,01). Beveik pusė (44,6 proc.) apklaustųjų teigė, jog iš karto buvo priimti į gydymo įstaigą. Beveik visi dalyvavę tyrime vaikus lydintys asmenys (96,5 proc.) teigė, jog atvykus į skyrių, jie buvo informuoti apie skyriaus darbo tvarką. Didžioji dalis dalyvavusių tyrime (89,1 proc.) nurodė, jog norėtų sugrįžti į šią gydymo įstaigą, jei to... [toliau žr. visą tekstą] / Aim of the study. To investigate the quality of in-patient service from the perspective of minor patients’ representatives at Kaunas child development clinic “Lopšelis”. Objectives. To evaluate in-patient service extent from the perspective of minor patients’ representatives, to examine the opinion of minor patients’ representatives about accessibility of service, to evaluate satisfaction of minor patients’ representatives with the provided service. Methods. Anonymous survey of 115 patients’ representatives (response rate – 87.8%) was carried out in 2007. SPSS statistical analysis program was used to process the data. Statistic data reliability was tested by chi square test of independence, degrees of freedom quantity and statistical significance (p). Results. Almost three thirds of surveyed patients‘ representatives (72.9%) indicated, that they were satisfied with the extent of service. The majority of respondents (80.5%) were satisfied with the duration of procedure. Statistically significant bigger part of respondents trusted in competence of specialists (77.9%) in comparison with the less trusted in competence of specialist (33.3 proc.) maintained, that they were satisfied with the diversity of provided service (p<0.01). Nearly half of the respondents (44.6%) revealed, that they were immediately admitted to the institution. Almost all survived entourage (96.5%) stated, that on the arrival at department, they were informed about procedure in the department. The majority... [to full text]

Aim: This thesis reports the outcomes of a study designed to explore whether and how ethical and responsive interviewing of children in care with varying levels of sensitivity to topics that may threaten their felt security can be achieved. Background: Children come into care with a complex array of developmental challenges. They have often experienced maltreatment, loss and disrupted attachment relationships. Little is known about the effects of interviewing children in care with varying sensitivity to questioning strategies designed to measure felt security and their perceptions of being in care. Methods: The present study was iteratively designed using an exploratory mixed qualitative design. Children’s reports (N= 12) were collected using a series of iteratively designed interview methodologies supplemented by information provided by their kinship carers. Results: The following factors influence the comfort experiences of children in care: interviewer skill, interviewer and child role, child competence (perceived and real), child characteristics, external factors, ethical factors and the interview methods. The potential influence of mental health status and age were less clear. Factors related to felt insecurity were: relational, self-perceived competence and confidentiality related factors. The maintenance of the comfort experience of children in care when interviewing, cuts across many dimensions of the research context including relational, performance and methodological aspects. Children engaged in strategies to mediate their comfort, this was somewhat reliant on the methodologies and interviewer competency. Overall acceptable levels of comfort were reported to be maintained over the span of the research process. Conclusions: Children in care have vulnerabilities that need to be addressed when including them in research. Careful consideration to the design of studies and interview methodologies will ensure children in care can participate in protective research environments. The benefits to this are reflected in the gathering of quality data which can contribute to the timely provision of the appropriate services for children in care. The present study findings provide guidance for future research involving children in various types of alternate care.

This thesis reports on a study into the decision-making that takes place within the six monthly statutory review of the cases of children in the care or under the supervision of the Local Authority. The research had four aims: 1. To develop a typology of review decisions whereby decisions taken in reviews could be classified according to their salient features. 2. To ascertain the level of the subsequent implementation of the decisions taken in reviews and to consider what factors contribute to or hinder their implementation. 3. To identify the functions of statutory reviews and the perceptions of the members of social work teams of the functions appropriate to reviews. 4. To consider the role and the importance of statutory reviews within the context of overall child care practice. The empirical research was undertaken in three social work area offices within one local authority. Information was gathered from almost three hundred reviews. The researcher, having first read the case record, attended two consecutive six-monthly reviews on the child. The social workers involved in these reviews were questioned on their opinions on reviews in general and on each review attended. Those 'researched' reviews gave rise to almost nine hundred review decisions, which were analysed according to the typology of decisions, and the level of their subsequent implementation was assessed. This study was designed as a policy-orientated study. Hence the research is presented first, within the broad context of developments in child care policy since the war, and second, in relation to the literature on statutory sreviews arising both from research studies and from policy documents. Furthermore, the concluding chapter points to the policy implications that may be drawn from the research findings, together with suggestions for policy changes.

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 project investigated characteristics relating to family functioning and attitudes to mental illness, and caregiving, which distinguish families choosing to care for children of parents with mental illness (CPMI) from families who choose not to but do care for other children (NCPMI), and from families not involved in the adoptive care system (COMM). Welfare agencies seeking long term home based care for children of parents with mental illness (among other groups of children) report that potential caregivers are concerned about the child’s genetic risk, and the requirement that they facilitate access visits with the birth parent. Consequently it is more difficult to recruit caregivers to care for children of parents with mental illness. Previous studies found that families who adopt children with special needs had family systems that were flexible and able to adapt to changing needs, and in which family members felt close to one another. It was not known if the functioning of families who care for children of parents with mental illness would differ from other family groups. Nor was it known if these families would differ in motivation to be caregivers and attitudes to mental illness from other family groups. / Forty four families completed a questionnaire providing background information, and a family functioning questionnaire which included the FACES II measure (Family Adaptability and Cohesion Evaluation Scale) and questions assessing level of altruism, and tendency to respond in a socially desirable manner. Data from the FACES II measure was used to classify families according to the Circumplex Model of Marital and Family Systems. Q-methodology was used to assess participants’ attitudes to eight issues related to the research question: mental illness, children of parents with mental illness, parents having a mental illness, family environment, motivation to be caregivers, ongoing contact between child in care and parent, approval of others when deciding to be a caregiver, and flexibility in deciding to accept a certain child for placement. The Q-method required participants to rate 42 statements (a Q-set), concerning these issues, according to a fixed distribution, from statements with which they strongly agreed to statements with which they strongly disagreed. / Participants could also give open-ended responses to questions addressing the same issues in a semi-structured interview. The CPMI group were found to have a lower level of income and education than the other two groups, and were more likely to be full time caregivers. Both caregiver groups were unlikely to have children of their own. The profiles of the three groups on the cohesion and flexibility sub-scales of FACES II were similar. The classification of the family groups on the Circumplex model showed that the CPMI group were located in the balanced and mid-range levels of the model more so than the other two groups. Responses to the Q-sort and interview questions suggested that the CPMI families were more understanding of mental illness, and of the needs of the children and capacity of their parents. It is suggested that future studies increase the number of participants, and investigate in more detail the factors which motivate families who provide long term care for children of parents with mental illness.