Magister Curationis - MCur / In South Africa, mental health nursing forms part of the basic (pre-registration) education of Professional Nurses, in order to equip them for employment as general nurses in the comprehensive health services of the country. Mental health nursing is an interpersonal process, in which counselling is aimed at supporting and facilitating healthy lifestyle functioning. At the higher education institution of interest, psychiatry nursing is incorporated at the final year level of nursing. The student nurses are prepared with the theory of psychiatric nursing, two weeks before their clinical placement in hospitals and clinics. At the end of the year, they are expected to pass both the theory and practical component. The aim of the study was to explore the experiences of final year student nurses, regarding their preparedness for psychiatric clinical placement. The objective of the study was to describe the experiences of the students, regarding their preparedness for psychiatric clinical placement. A descriptive design, with a qualitative approach, was used to explore and describe the phenomenon under investigation. The researcher used purposive sampling to select participants for the study from a population of final year student nurses of a higher education institution in the Western Cape. They met the sampling criteria because they knew a great deal about the phenomenon of interest, had completed the two-week orientation programme and worked in a clinical placement for at least three months. Their participation in the study was on a voluntary basis. The researcher used unstructured interviews to collect data from the participants. The data analysis was done following Coliazzi's seven steps. The findings indicated that the students were not prepared for their psychiatric placements, even though they attended a two-week orientation programme, prior to their placements. It was revealed that anxiety played a huge role in the unpreparedness of students. The participants, therefore, suggest that the orientation period be extended. The researcher, however, applauds the staff members in the clinical placements and urges them to maintain their positive attitude towards the students, as the participants acknowledged and appreciated their support.

Background: Multiple Sclerosis (MS) is a chronic degenerative condition. It presents with highly varied physical and psychological symptoms and an unpredictable prognosis, causing difficulties for both professionals and patients. A high prevalence of comorbid psychological symptoms are reported in MS research, yet these may be underreported and underdiagnosed clinically in people with MS. Previous research has taken a dualistic approach, focussing on physical and psychological symptoms separately, resulting in a lack of knowledge on how MS is managed holistically. The aim of this research was to explore the experiences of both people with MS and professionals in the management of physical and psychological symptoms throughout the care pathway for people with MS.Methods: A qualitative approach was used. A systematic review was conducted to investigate existing qualitative literature exploring United Kingdom (UK) health care experiences of people with MS. A qualitative study using semi-structured interviews to explore the experiences of receiving or providing care for people with MS (n =24), general practitioners (n = 13), practice nurses (n = 13) and MS specialist nurses (n = 9). People with MS were purposively sampled from primary care and community settings in North West England. Primary care professionals were purposively sampled from across the North West. Specialist Nurses were purposively sampled from four NHS Foundation Trusts across the North of England. Transcripts formed the data and these were analysed using constant comparison analysis. Once themes had been derived from the data, this data was then interrogated using the concepts of candidacy and recursivity as a theoretical framework (Dixon Woods et al., 2006; Rogers, Hassell & Nicolaas, 1999).Results: Five studies meeting the review criteria were identified from the systematic review. The findings showed that previous UK research had focussed on the beginning (diagnosis) and the end (palliative care) of the care pathway for MS, resulting in a paucity of information regarding experiences of care between these points, for both people with MS and professionals. The subsequent qualitative study addressed this and identified central themes for people with MS: experiences of MS, managing self-care, access to services, interactions with health care professionals and continuity of care. For professionals the central themes identified were: the role of primary care for MS, patient-centred care for MS, access for MS care and management of people with MS. Conclusion: This study provides a unique contribution to the literature on the health care experiences of both people with MS and health care professionals responsible for their care. It has addressed the gaps in knowledge regarding the ongoing health care experiences of people with MS and the holistic management of psychological and physical symptoms. This study showed that candidacy is an appropriate theoretical framework to explain help-seeking and access to health care for MS: use of health services is based on both patient and professionals' interpretation of symptoms, perceptions of services and previous experiences. To improve identification of candidacy there is a need for greater education for patients and professionals on symptoms of MS and information on availability of local services.

The study aimed to explore and describe the experiences of people treated for multidrug resistant tuberculosis (MDR-TB) in Omaheke region, Namibia in order to make relevant recommendations regarding their management. A descriptive qualitative design approach was used. Data was collected using in-depth individual interviews with six participants. The interview transcripts were analysed using thematic content analysis. Three themes emerged namely (1) Stressors related to MDR-TB diagnosis and treatment which involved nature of disease and compulsory hospitalisation (2) Impact of being treated for MDR-TB which related to emotional , social , spiritual and financial impact (3) Support structures for people treated for MDR-TB which included family members, health care professionals and friends. Systemic practical patient-centred, staff-centred and community-centred recommendations are suggested as well as recommendations for future research and an appraisal of the limitations of this study. / Health Studies / M.A. (Public Health)

This qualitative study examined retrospective client accounts of hindering experiences that occurred during therapy. In order to explore in-depth and descriptive information about client experiences of hindering events, a structured thematic analysis methodology was used that resulted in conceptual ordering (Corbin & Strauss, 2008). Data collection was conducted through face-to-face semi-structured interviews of 9 participants who had previously experienced a hindering event. Structured thematic analysis (Braun & Clarke, 2006) was used to distill themes from the collected data, where four major themes emerged from the data that were relevant to the research questions of the present study: 1) Identified Hindering Events, 2) Subjective Experience of the Event, 3) Response to the Event, 4) Handling/ Addressing the Event. Results from this study contribute to further understanding of client experiences of hindering events that occur in therapy. Implications for therapeutic organizations, therapists/ counsellors, and educators are discussed.

abstract: When consumers make experiential purchases, they often have to decide between experiences that contain many or few features. Contrary to prior research demonstrating that consumers prefer feature-rich products before consumption but feature-poor products after consumption, the author reveals a reversal of this effect for experiences. Specifically, the author hypothesizes and finds that consumers prefer feature-poor experiences before consumption (a phenomenon denoted as `feature apprehension') but prefer feature-rich experiences after consumption. This feature apprehension occurs before consumption because consumers are concerned with the uncertainty associated with attaining a satisfying outcome from the experience. Manipulating the temporal distance with which consumers view the experience can attenuate this effect. Additionally, locus of control and social signaling moderate consumers' post-consumption preference for feature-rich experiences. The author proposes several recommendations for consumers and providers of experiences. / Dissertation/Thesis / Doctoral Dissertation Business Administration 2015

The intention of this study is to examine experiences of growing up in single-parent families. With in-depth interviews with six young grown ups we learned about their childhood and perspective of growing up in this kind of families. We analysed their life-stories together with theories about identity and the effect of modern society on individuals from a sociological point of view. Departing from symbolic interactionism and previous research which shows that people who grow up in this type of families often have a difficult childhood and adulthood we analysed the empirical material. The result shows that most people in this type of families experience a good and safe childhood with a close-knit family. However, during some certain periods and situations some have not felt completely satisfied, due to lack of experienced attention and support from their parent. Almost all respondents have been partially responsible for the household and have also felt big emotional responsibility for their parent. Although, the vast majority of informants does not consider themselves or their upbringing much different from others and none of the respondents has expressed a wish for another type of family.

Bakgrund: Det finns ungefär 25000 stomiopererade personer i Sverige. Stomi innebär att tarmens naturliga tömningsväg ändras genom en kirurgisk anläggning av öppning på buken. Det finns olika typer av stomi och orsaken till stomibildning är oftast inflammatoriska tarmsjukdomar eller cancer. Syfte: Att beskriva vuxna personers upplevelser av att leva med stomi samt att beskriva vilka datainsamlingsmetoder som har använts i de utvalda artiklarna. Metod: En beskrivande litteraturstudie som byggt på 14 vetenskapliga artiklar, varav tretton med kvalitativ ansats och en med kvantitativ ansats. Huvudresultat: Resultatet av föreliggande studie visar att personers liv förändrades genomgripande på grund av stomi. Patientutbildning och information samt sjuksköterskans bemötande och kompetens kring området behöver förbättras. Många kämpade för att återställa ett normalt liv trots stomi. Utifrån den metodologiska frågeställningen framkom att de studierna med kvalitativ ansasts hade intervjuer som datainsamlingsmetod och den kvantitativa studien samlade in data via enkät. Slutsats: Stomibildning innebär en genomgripande livsförändring för personer då alla aspekter av livet påverkas. Trots stomi kämpade många för att återställa ett normalt liv. Patientutbildning och information samt sjuksköterskansarbete behöver förbättras. Föreliggande studie ger en djupare förståelse för personer som har stomi och kunskapen kan gynna sjuksköterskans arbete och därmed höja vårdkvaliteten. / Background: There are about 25,000 ostomy-operated people in Sweden. An ostomy is a surgically created opening on the abdomen for the discharge of body wastes. There are different types of ostomies and the cause of ostomy formation is usually inflammatory bowel disease or cancer. Purpose: To describe adults’ experiences of living with an ostomy and to describe which data collection methods have been used in the selected articles. Method: A descriptive literature study based on 14 scientific articles, of which thirteen articles have qualitative approach and one article has quantitative approach. Main result: The result of the present study shows that the people’s lives have changed profoundly due to ostomy. Many struggled to restore a normal life despite ostomy. Patient education and information as well as nurses’ attitude and knowledge need to be improved. Based on the methodological question, it was found that the studies with qualitative approach had interviews as data collection methods and the quantitative study collected data by using questionnaire. Conclusion: Ostomy formation means a profound change of life for people when all aspects of life are affected. Many struggled to restore a normal life. Patient education and information and nurses work need to be improved. The present study provides a deeper understanding of people who have ostomy and the knowledge can benefit nurses’ work and thus raise the quality of care.

In Canada, nursing education and practice are enacted in the context of a white settler nation-state. As part of their mandates, nursing schools uphold concepts such as multiculturalism, equity, and diversity; however, studies in North America reflect that the reality contradicts these directives and suggest that nursing schools are hegemonic white spaces. This study challenges this white hegemony through the gaze of racialized nurses. Through in-depth interviews, ten self-identified racialized nurses shared narratives looking back at their experiences in nursing school, and their accounts indicate how they faced the complexities of learning within environments where systemic racism is enacted. Using a women of colour feminist approach, this study asked the following question: What are the experiences of racialized nurses in nursing education programs in Canada? Intersectional analysis was used to examine and address the multiplicity of experiences that emerged from the interviews. Racialized nurses’ narratives reveal complex experiences with the following prevailing themes: Othering, the white gaze, navigating white spaces, accent as marker, always proving myself, and racism impacting health. Beyond racism, participants’ experiences were also affected by the intersection with other markers of difference while in nursing school, such as gender, religion, class, and age. Participants identified that they were seen through a white gaze while in nursing school and engaged with this study as an opportunity to challenge and resist the systemic structures of racism they encountered. The findings point to the reality that nursing schools are permeated by systemic structures of white privilege and racism, due to a legacy of colonialism and imperialism, and those structures have a severe impact on racialized students. Furthermore, this study indicates the need for critical evaluations of nursing schools, and to challenge the enactment and maintenance of racist practices of exclusion and marginalization of racialized students. / Graduate / 2019-04-19

Pediatric obsessive-compulsive disorder (OCD) is a heterogeneous disorder associated with functional impairment and deleterious effects at the family level. Caregivers are often enmeshed in the disorder, coping with the child’s OCD-related distress and engaging in accommodating behaviors. Given the developmental level of these youth and the impactful nature of OCD, caregivers may experience considerable burden and decreased quality of life (QoL). However, extant literature on these constructs is largely limited to caregivers of patients with chronic illnesses, and the few existing studies examining OCD samples are limited to adult patients. As such, this study sought to examine burden and QoL in caregivers of youth enrolled in an intensive outpatient or partial hospitalization program for their severe OCD. Specifically, the relationships between caregiver QoL and burden and the following variables were investigated: OCD symptom severity, functioning (youth functional impairment, general family functioning), family (family accommodation, parental relationship satisfaction, positive aspects of caregiving), and comorbid psychopathology (caregiver anxiety and depressive symptoms, youth internalizing and externalizing behaviors). Seventy-two child and caregiver dyads participated in the study and completed a battery of clinician- and self-rated questionnaires. Different components of caregiver QoL correlated with caregiver-rated functional impairment, family accommodation, youth externalizing behaviors, and caregiver psychopathology. Various aspects of caregiver burden correlated with OCD symptom severity, functional impairment related to OCD, as well as caregiver and child comorbid psychopathology. Caregiver depressive symptoms predicted caregiver QoL, and caregiver depressive symptoms and child externalizing symptoms both predicted caregiver burden. Caregiver burden did not mediate the relationship between obsessive-compulsive symptom severity and caregiver QoL. Ultimately, elucidating factors associated with increased caregiver burden and poorer QoL are pertinent for the identification of at-risk families and development of targeted interventions.

This thesis is concerned with an exploration of counsellors’ and clients’ lived experiences of Buddhist Counselling, an indigenous Buddhist-based counselling approach in Thailand. Over the past decade, Buddhist Counselling has received a growing interest from Thai counselling trainees and practitioners, and it has also expanded to serve Thai people in various settings. Research on Buddhist Counselling is very limited and most of the existing studies in the field have focused on measuring the effectiveness of the approach. While these studies have consistently indicated the positive effects of Buddhist Counselling on psychological improvement across several population groups, the significant questions of how Buddhist Counselling brings about such outcome and how it is experienced are still largely unanswered. Moreover, existing research is concentrated much more on clients’ views than counsellors’ views, although counsellors’ views of their counselling practice can also serve as a knowledge base of the field. This thesis thus sets out to contribute to rectifying this omission by exploring Buddhist Counselling from the perspectives of both counsellors and clients. The thesis is based on two qualitative studies. The first study addressed Buddhist Counselling from the perspective of five counsellors through a focus group and semi-structured interviews. The second study explored Buddhist Counselling from the perspective of three clients, using two semi-structured interviews with each of them. All data received were analysed using interpretative phenomenological analysis (IPA). The study reveals counsellors’ and clients’ overall positive experience of engaging in Buddhist Counselling. Central to the accounts of the counsellors are the following perceptions: that their practice of Buddhist Counselling is culturally congruent with the existing values and beliefs of both themselves and their clients; that their personal and professional congruence is key to their therapeutic efficacy; and that they enhance such congruence through their application of Buddhist ideas and practices in their daily lives. Key to the clients’ accounts is their emphasis on the significant roles of the counsellors’ Buddhist ideas and personal qualities, and of their religious practices in facilitating healing and change. Key shared findings from both studies reveal that the participants’ accounts of their cultural background and their experiences of Buddhist Counselling are intertwined. Adopting hermeneutics to address this intertwinement, I reveal the cultural and moral dimensions underlying the practice of Buddhist Counselling. Based on such revelation, I suggest that Buddhist Counselling in particular, as well as psychotherapy in general, should be better understood as a historically situated, culturally bound, and morally constituted activity of people who are concerned with improving the quality of their lives and their community, rather than the transcultural and merely relational work of morally-neutral practitioners.