Thesis (M.N.) -- Memorial University of Newfoundland, 2003. / Typescript. Bibliography: leaves 168-176. Also available online.

Thesis (M.S.)--University of Michigan, 1981.

Thesis (M.S.)--University of Michigan, 1981.

Thesis (M.A.)--University of Toronto, 2006. / Source: Masters Abstracts International, Volume: 44-06, page: 2521.

Objectifs : Mesurer le niveau de handicap perceptif secondaire à une surdité unilatérale par approches psychoacoustique, questionnaires de qualité de vie et IRMf. Ce travail repose sur deux études qui étudient un lien entre : 1) les performances psychoacoustiques et le ressenti de qualité de vie et 2) les performances psychoacoustiques et le niveau de réorganisation centrale. Matériels et méthodes : Pour l'étude 1, 49 sujets adultes présentant une surdité unilatérale (UHL) et 11 contrôles ont été recrutés. Ils ont été évalués en psychoacoustique par le test FrMatrix en champ libre et dans trois conditions et ont répondu aux questionnaires de qualité de vie le Speech, Spatial and Quality of Hearing Scale (SSQ) et le Glasgow Health Status Inventory (GHSI). Pour l'étude 2, 15 sujets UHL et 15 contrôles ont été recrutés. Outre les tests psychoacoustiques de l'étude 1, les sujets ont écouté activement des sons naturels en IRMf. Résultats : L'étude 1 retrouve une corrélation significative (rho = 0.38) entre le score global au SSQ et le test FrMatrix lorsque le signal est envoyé à l'oreille déficiente et le bruit à l'oreille saine (condition dichotique). L'étude 2 démontre une corrélation significative entre le niveau de réorganisation et le FrMatrix (rho = 0.66) en condition dichotique. Conclusion : La surdité unilatérale engendre un niveau de réorganisation corticale qui s'accompagne d'une baisse significative des performances psychoacoustiques et de la qualité de vie. Ce travail souligne donc la nécessité d'une prise en charge thérapeutique des sujets présentant une surdité unilatérale. / Objectives: We evaluated the consequences of unilateral hearing loss (UHL) for speech recognition in spatially separated competing noise, quality of life and brain activity via fMRI. In the first study we investigated the relationship between speech recognition and quality of life (Study 1), and in the second between speech recognition and the reorganization of brain activity. Materials and methods: In the first study 49 UHL subjects and 11 controls were recruited. Speech recognition in three speech and noise configurations was assessed with the FrMatrix test and quality of life with the Speech Spatial and Quality of Hearing Scale (SSQ) and the Glasgow Health Status Inventory. In the second study, 14 UHL and 14 matched controls were recruited. They underwent the same speech recognition testing as in the first study and also participated in a fMRI experiment that involved actively listening to naturals sounds. Results: The first study showed a significant correlation (r = 0.38) between SSQ scores and speech recognition where the competing noise was send to the better ear and the noise contralaterally (dichotic). The second study showed a significant correlation (r = 0.66) between speech recognition scores (dichotic listening situation)and brain reorganization. Conclusion: Unilateral hearing loss induces brain reorganization that significantly correlates with deficits in speech recognition in noise and overall quality of life. This work highlights the need for greater attention to improve the understanding and rehabilitation of unilateral hearing loss.

Doctor of Philosophy / Department of Agricultural Economics / Vincent R. Amanor-Boadu / Public health policies seek to address health issues that pose significant concerns to public health policymakers. Because these initiatives have economic costs, economic agents’ response to them would be driven by the outcome of their benefit-cost assessment of the policies. Therefore, the congruence between perception and reality of economic agents’ health becomes important in evaluating the potential effectiveness of these initiatives. This research sought to determine the extent of congruence between objective and subjective health status at the individual level. The results would contribute to the framing and implementation of health policies that have higher probability of adoption by economic agents. The National Health and Nutrition Examination Survey (NHANES) 2005-2006 data were used for this research. The dependent variables defined in the study are subjective health status perception and objective metrics of individuals’ health status proxied by their body mass index (BMI), waist circumference, high density lipoprotein (HDL) cholesterol level, and fasting blood glucose. The nature of these dependent variables demanded that both categorical dependent variable and ordinary least squares models be employed in the estimation of the models. Chow tests were used to determine the extent of congruence between perception and reality of respondents’ health status. The study did not find any differences between perception and reality based on waist circumference but the same could not be said about BMI. Additionally, there were differences between subjective health perceptions and objective measures of health status based on receiving information about their health status from a health care professional. If it is assumed that the cost of responding to health policies are reduced with higher congruence between subjective and objective health status, then this study’s results suggest that policy must begin with increasing the objective information that people have about their health. While the provision of this information at the individual level could be expensive, it will improve the success rate of health promotion initiatives. The increase in these initiatives’ success should contribute to a reduction in the nation’s health care costs attributable to lifestyle related diseases such as obesity.

Published Article / Health effects associated with Ni-Cu mining on learners living within the mining area at Selebi Phikwe were investigated through the administration of questionnaires. Results depicted learners suffering from a wide range of different symptoms and illnesses. 70% of the learners complained of coughs, 77% had influenza / common cold, and 80% had headaches. The repeated coughing, constant influenza / common cold and persistent headaches from which learners suffered, were very significantly higher than those at the control site; and incidences of their occurrence increased with closeness to the mining area. The unusual high occurrences of these ailments and illnesses coupled with associated diseases among learners were attributed to several environmental factors including contaminated particulate air matter (PAM) (rich in sulphur and heavy metals) linked to the mining and smelting of Ni-Cu.

<p>A severe burn is a trauma fraught with stress and pain and may change the entire course of life. This thesis focuses on care utilisation, care experiences and patient satisfaction after a severe burn.</p><p>The patients studied were treated at the Burn Unit at Uppsala University Hospital between 1980 and 2006. Burn-related health was examined using the Burn Specific Health Scale-Brief (BSHS-B), personality traits with the Swedish universities Scales of Personality (SSP), psychological symptoms using the Hospital Anxiety and Depression scale (HADS), symptoms of posttraumatic stress with the Impact of Event Scale-Revised (IES-R) and satisfaction with care using the Patient Satisfaction-Results and Quality (PS-RESKVA) questionnaire.</p><p>Those utilising care years after injury reported poorer functioning on three of the BSHS-B subscales. Personality traits had a greater impact on care utilisation than injury severity.</p><p>Social desirability was lower among care utilisers and was associated with burn-related health aspects.</p><p>The participants reported a low level of negative care experiences, the most common of which was Powerlessness.</p><p>Most patients were satisfied with care, more with quality of contact with the nursing staff, and less with treatment information. Multiple regressions showed that the BSHS-B Interpersonal relationships subscale was an independent variable related to all measured aspects of patient satisfaction. The highest adjusted R² was 0.25.</p><p>In a prospective assessment with multiple regression analyses, Age and Education, the personality traits of Stress susceptibility, Trait irritability, Detachment and Social desirability, in addition to the post-traumatic stress symptoms Intrusion and Hyperarousal, were predictors of satisfaction with care. The highest adjusted R² was 0.19.</p><p>The thesis has pointed out that interpersonal factors are related to care utilisation as well as satisfaction with care. However, satisfaction with care was only moderately associated with health and individual characteristics, which may imply that the care itself is of major importance.</p>

Résumé : Cette étude a pour but de proposer une modélisation théorique du processus de transition des perceptions de l’état de santé de femmes diagnostiquées d’un cancer du sein selon une perspective infirmière. Les objectifs sont d’explorer les perceptions de l’état de santé en phase pré et post transitoire, définir le processus de devenir malade d’un cancer du sein et modéliser la transition des perceptions de l’état de santé. Un devis qualitatif de théorisation ancrée a été utilisé. Trente-deux femmes ont participé à une entrevue semi-dirigée soit 30 femmes à différents moments dans la trajectoire de la maladie, une femme en santé porteuse du gène Breast Cancer 1 BRCA1 et Breast Cancer 2 (BRCA2) et une femme en santé sans historique de cancer du sein dans sa famille. Le recrutement s’est déroulé dans trois milieux de la région Mauricie Centre-du-Québec: un centre hospitalier tertiaire, un centre hospitalier secondaire et une université. L’analyse des données a été réalisée simultanément avec la collecte selon les trois niveaux de codage (ouvert, axial et sélectif) de Strauss et Corbin (1998). Les résultats découlant de cette recherche sont une modélisation du processus de transition des perceptions de l’état de santé de femmes atteintes d’un cancer du sein. Il ressort de cette modélisation trois grandes catégories a) les perceptions de la santé et de la maladie avant la transition, b) la transition et c) les perceptions de la santé et de la maladie après la transition. La première catégorie, soit avant la transition, se divise selon les concepts d’invulnérabilité, d’opposition à la maladie, de mort, de peur et de doute si hérédité. La transition des perceptions de l’état de santé s’échelonne sur une période de deux ans, soit un an entre le moment de l’annonce du diagnostic et la fin des traitements et une autre année jusqu’à l’atteinte d’un état de santé-modifié, pendant laquelle les participants traversent quatre étapes itératives (réagir émotionnellement, faire face à la situation, développer une nouvelle conception de la vie et réagir aux représentations du cancer) qui peuvent être simultanées à travers desquelles elles ne se sentent pas malades d’un cancer du sein. Puis, les perceptions de la santé et de la maladie après la transition changent pour devenir un état de santé caractérisé par la perception plus holistique et précieuse de la santé. Le cancer est désormais une épreuve surmontable dont personne n’est à l’abri. Cette étude met en évidence l’apprentissage de vivre avec une épée de Damoclès au-dessus de la tête une fois la transition terminée. La poursuite d’une analyse de concept comparative entre la transition, la trajectoire de la maladie, le deuil et l’adaptation est une piste de développement à poursuivre en recherche. Du côté clinique, la présente étude offre une modélisation qui est utile aux infirmières, afin de mieux comprendre les phases transitoires et ainsi adapter les soins, donner de l’information, des ressources et, surtout, normaliser les perceptions selon les étapes de la transition. Il est important de former les infirmières sur l’exploration des perceptions de l’état de santé des femmes atteintes d’un cancer du sein. / Abstract : This study aims to propose a theoretical model of the transition process perceptions of health status of women diagnosed with breast cancer in a nursing perspective. Although the experience of living with a diagnosis of breast cancer has been an increasing number of studies over the past two decades, it still raises many conceptual questions. Thus, the transition between being healthy, being diagnosed with breast cancer overnight without experiencing systemic symptoms and being healthy again was the subject of this thesis. Considering the current state of the literature and the purpose of research, the author has used a Grounded Theory methodology (Strauss & Corbin, 1998) to guide this study because it emphasizes the study processes and social interactions. Thus, to reach diversity of women, the author uses three settings: a tertiary hospital, a secondary hospital and a university. Collection and data analysis were carried out from 32 semi-structured interviews with women at different times in the course of chronic disease (n = 30), healthy women carrying the BRCA1 gene and a woman without health history of breast cancer in her family. From the conceptualization emerged three broad categories or concepts defined by their attributes and articulated in an explanatory model. These categories are: a) perceptions of health and disease before the transition, b) transition and c) perceptions of health and illness after the transition. The first category of perceptions of health and disease before the transition is divided according to the concepts of invulnerability, opposite to the disease perceptions of health and death, fear and doubt if heredity. The transition begins at the moment of the diagnosis and lasts up to one year following the end of treatments. React emotionally to deal with the situation, develop a new conception of life and respond to representations of cancer are circular stages of transition process. The central category of the transition is defined by not feeling sick. The personal, interpersonal and social factors influence these perceptions. Then, once the chemotherapy and radiotherapy are completed, women are in a state of health change. The changing perceptions of health and illness after the transition begins is characterized by perception of health that are more holistic and valuable. Cancer is now a surmountable event that nobody is immune. The salient point emerging from this research is to learn to live with a sword of Damocles over the head when the participants find themselves in a state of health changed.

A multivariate model of health self-perceptions was postulated based upon a comprehensive set of health related variables suggested by previous bivariate research. Components of the model included measures of health attitudes, health practices, health locus of control, a measure of stress/ coping, and a physical health measure. A stratified random sampling technique was used to select 10 8 subjects based upon the external measure of physical health which included categories ranging from disability-severe to symptom free-high energy level. All subjects completed a health questionnaire comprised of measures of the model components, two measures of health self-perceptions, and the Health Resource Task, an author designed instrument measuring a subject's ability to generate flexible health alternatives/resources. Bivariate correlational analysis revealed that the physical health, stress/coping, health practices, and locus of control measures and certain of the health attitude subscales were significantly correlated to general health self-ratings. A multivariate model including these variables accounted for almost 50 percent of the variance in one of the general health self-ratings measures and approximately 38 percent of the variance in the Health Resource Task. Suggestions for refining the proposed model were made.