Thesis--University of Oklahoma. / Includes bibliographical references (leaves 57-61).

Background: Most procedures in healthcare were described to cause the child pain. Anxiety was also strongly linked to pain and painful experience can generate future consequences for the child in contact with health services. Administering medication to children was considered difficult to adapt while non-pharmacological treatment is considered to be both time- and cost efficient. Purpose: To describe nurses' use of non-pharmacological treatment of procedural pain in children and to examine the included articles research group.Method: This descriptive literature studies results was based on 15 articles sought in the databases Cinahl, PsycINFO and PubMed. Eight of the included articles were qualitative studies, four were quantitative studies and three were studies with mixed approach. Main Results: Non-pharmacological treatment of procedural pain in children was considered effective when it was formed based on each unique child and occasion. The nurses described distraction as a useful method that can be performed in several ways, ranging from the child's needs. The importance of a good relationship, a working cooperation and that the nurse had the ability to get the child's confidence was described as key elements in non-pharmacology. The research group characteristics were examined and in all articles the participants profession consists in the majority of nurses. Conclusion: Non-pharmacological treatment of procedural pain should be adjusted based on the unique child and the situation. Distraction was considered by the majority of nurses to be a positive and useful non-pharmacological treatment of procedural pain in children and can be performed by both nurses and parents to reduce the child's pain and future fears. / Bakgrund: Ett flertal procedurer inom vården beskrevs kunna orsaka barnet smärta. Oro var vidare starkt kopplat till smärta och en tidigare smärtsam upplevelse kan komma att generera framtida konsekvenser för barnet i kontakt med sjukvården. Administreringen utav läkemedel till barn ansågs vara svårt att anpassa samtidigt som icke-farmakologisk behandling anses vara både tids- och kostnadseffektiv. Syfte: Att beskriva sjuksköterskors användning av icke-farmakologisk behandling vid procedursmärta hos barn, samt att granska de inkluderade artiklarnas undersökningsgrupp. Metod: Denna beskrivande litteraturstudies resultat grundades på 15 artiklar eftersökta i databaserna Cinahl, PsycINFO och PubMed. Åtta av studiens inkluderade artiklar hade kvalitativ ansats, fyra hade kvantitativ ansats och tre var studier med mixad ansats. Huvudresultat: Icke-farmakologisk behandling vid procedursmärta hos barn ansågs effektivt när den formades utifrån varje unikt barn och tillfälle. Sjuksköterskorna beskrev distraktion som en användbar metod som kan utföras på flertalet sätt, allt utifrån barnets behov. Vikten av en fungerande relation, ett fungerande samarbete och att sjuksköterskan hade förmåga att få barnets förtroende beskrevs vidare som centrala delar inom icke-farmakologin. Artiklarnas beskrivning av undersökningsgrupp granskades och deltagarnas yrkeskategori utgjordes i majoritet av sjuksköterskor i samtliga fall. Slutsats: Icke-farmakologisk behandling vid procedursmärta bör anpassas utifrån det unika barnet och situationen. Distraktion ansågs av majoriteten sjuksköterskor vara en positiv och användbar icke-farmakologisk behandling vid procedursmärta hos barn och kan utföras av både sjuksköterskor och föräldrar för att minska barnets smärta och framtida rädslor.

Bakgrund: Människor är sexuella varelser från födseln till döden och att kunna uttrycka sin sexualitet är viktigt för människans hälsa, välbefinnande, livskvalitet och ingår dessutom i de mänskliga rättigheterna. Forskning har visat att samhället har en tes om att äldre människor inte har sexuella begär eller sexuella känslor. I dagens läge speglar media de äldres sexualitet som antingen obefintlig eller oacceptabel. Vårdpersonalens roll är att främja välbefinnande och livskvalitet vilket även omfattar sexuell hälsa, därför är det viktigt att få mera kunskap om vårdpersonalens inställning och förhållningssätt till äldres sexualitet. Syfte: Syftet var att genom en litteraturöversikt beskriva vårdpersonalens attityd gentemot äldres sexualitet. Metod: En litteraturöversikt genomfördes med hjälp av åtta vetenskapliga studier, varav tre med kvalitativ design, fyra med kvantitativ design och en mixad metod. Begränsningar som gjordes var åren 2000-2015, Ålder 65 och uppåt, peer rewied samt engelska. Sökord är aging, Sexuality, Nursing care, Sexual behavior, Nursing Homes, Attitudes, Health personnel, Aged sexuality, older people, Nurses. Dessa kombinerades i olika konstellationer för att få fram material till resultatet. Resultat: Resultatet visade positiva attityder så som att vårdpersonalen menade att saker och ting inte måste förändras bara för att man är äldre, negativa attityder så som att de äldres sexuella behov beskrevs som olämpliga av vårdpersonalen. Resultatet visade även att vårdmiljön, rutiner och policys samt utbildning och kunskap hade inflytande på vårdpersonalens attityder. Diskussion: Resultatet diskuterades med hjälp av Virginia Hendersons omvårdnadsteori om människans behov. Vidare diskuterades risken att äldre undertrycker sitt sexuella behov om vårdpersonalen uppvisar en fördömande attityd mot sexualitet hos äldre, men om vårdpersonalen däremot har en öppen attityd gentemot fortsatta sexuella relationer så bejakar äldre sina behov och vågar visa sexuellt intresse. / Background: People are sexual beings from birth to death and to be able to express one’s sexuality is important for one´s health, well-being, quality of life, and is also part of the human rights. Notwithstanding, there are theories in society that older people do not have sexual desires or sexual feelings. In today’s media it is reflected that the elderly’s sexuality is either non-existent or unacceptable. The role of health personnel is to promote the well-being and quality of life of humans which also includes sexual health. This is why it is important to acquire more knowledge about health personnel’s attitudes to older people's sexuality. Aim: The aim was that through a literature review describe the nursing staff 's attitude towards older people 's sexuality. Method: A literature review was conducted with the help of eight scientific studies out of which three have a qualitative design, four a quantitative design and one uses a mixed method. Restrictions included 2000-2015 , Age 65 and up, peer rewied and English. Selected keywords were Aged sexuality, Aging, Attitudes, Health Personnel, Nurses, Nursing care , Nursing Homes, Older People Sexual Behavior , Sexuality. Results: The results showed positive attitudes such as the health personnel meant that things do not have to change just because of old age, negative attitudes such as the healthpersonnel described elderly people 's sexual needs as inappropriate. The results also showed that the care environment , procedures and policies, education and knowledge had influence on health personnels attitudes. Discussions: The results were discussed with the help of Virginia Henderson nursing theory of human needs. Also discussed was the risk för older people to suppress their sexual needs due to healthpersonnels judgmental attitude toward elderly sexuality.

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

This is an explorative study into the challenges and ethical dilemmas that practitioners face when assessing the intellectual functioning of black learners. Participants were registered psychologists and intern psychologists involved in assessing black African learners. Data were collected by means of an interview schedule that had been designed for this purpose, based on the literature in the field. All participants were interviewed individually. The psychological practitioners interviewed in this study reported linguistic barriers, limited cultural knowledge, and lack of scientific validation as posing the major challenges for them in assessing black African learners. Among the ethical dilemmas that were reported were confidentiality and informed consent which were sometimes compromised by their dual responsibilities to the client and the schooling system or another third party. Forming discussion forums, development of new and appropriately normed assessment tools and incorporating relevant skills in training programs were recommended as some of the strategies to overcome these challenges and ethical dilemmas. / Thesis (M.Soc.Sci.)-University of KwaZulu-Natal, Pietermaritzburg, 2010.

Compulsory community service programmes have been initiated in many countries to recruit health care professionals to provide services in rural and under-served areas. However, the success or failure of the Community Service Programme depends largely on the attitudes of the professionals, their understanding of the programme's objectives, their preparedness for working in these areas and their ability to adapt to a new and challenging experience. Aim The aim ofthis study was to assess therapist's perceptions and attitudes about the compulsory Community Service Programme in KwaZulu-Natal in 2005 and to assess whether these changed during the year. Methods An observational cross sectional study with a descriptive and analytic component was conducted on commencement and after completion of community service. The therapists completed a self-administered questionnaire before and after their community service. Results A total of 126 (89% of 142) therapists responded to the initial questionnaire, 59 (42%) completed the exit questionnaire of which 47 (33%) completed both the questionnaire at commencement and completion of community service. Despite the poor response rate, similarities in perceptions and attitudes were noted with other studies conducted nationally and internationally. At onset 50% indicated that they would work in the public sector in the future and this proportion declined to 35% by exit. Even fewer (24%) said they would work in a rural area in the future. Only 16% reported that they would stay on at the same institution the year after community service. There was also no significant association between therapists collecting a rural allowance and expressing an interest to work in a rural area in the future (p=0.78) or staying at the same institution in the years after community service (p=0.32). However, therapists working in urban areas were more likely to say they would work in a rural area in the future (p=0.018). The comparisons between the occupational catergories showed that for support and supervision, the Speech Therapy and Audiology Forum was considered significantly (p=O.OOI) supportive compared to the Physiotherapy Forum. There was no significant difference within the occupational catergories in their perceptions of support, mentoring and supervision, attitude, psychological coping, personal and professional gains, safety issues and the amount of community outreach conducted. All groups were similarly resource constrained. Language was a barrier for 50% of all community service therapists and impeded their professional functioning. Discussion Despite the challenges experienced by community service therapists the majority felt that they had made a difference in the community in which they have been placed. The obligation to work in rural and under-served areas was personally and professionally rewarding. Particular concerns centred on support, supervision, training, resources and language barriers in providing better service delivery. Recommendations To achieve its objectives in relation to compulsory community service, which is to ensure an improved provision of health services to all citizens ofthe country, the Department ofHealth should consider multiple strategies including financial incentives such as rural allowances and non-financial incentives to retain health care personnel in rural and under-served areas. A long-term strategy that addresses human resources in a comprehensive manner needs to be developed to improve staffing and quality health services in these areas. / Thesis (MMed.)-University of KwaZulu-Natal, Durban, 2009.

Syftet med föreliggande studie var att beskriva erfarna sjuksköterskors reflektioner om hur de uppnår ett gott bemötande av patienter. Studien hade en beskrivande design och genomfördes som en semistrukturerad intervjustudie. Sex erfarna sjuksköterskor verksamma inom somatiska vuxenvården intervjuades. Materialet analyserades med kvalitativ innehållsanalys. Resultatet av denna studie visar att sjuksköterskan vill skapa en öppen atmosfär. Kommunikationen måste fungera med patienten, det är viktigt att sjuksköterskan ser till att vara tillgänglig och att aktivt lyssna och vara lyhörd. Sjuksköterskan tänker på att kroppsspråket ska visa samma som det som sägs verbalt och använder medvetet kroppskontakt som en form av kommunikation. Öppenhet och respekt ska förmedlas så patienten känner och vill vara involverad i sin vård. Sjuksköterskan måste ibland tackla patientens tidigare sjukvårdserfarenheter. Det är också av värde att sjuksköterskan är medveten om sina egna begränsningar vilket underlättar bemötandet med patienten. Ett tecken på ett gott bemötande är när patienten visar trivsel och har förtroende för sjuksköterskan. Ett gott bemötande betyder också mycket för sjuksköterskan själv. / The aim of this study was to describe experienced registrered nurses (RNs) reflections regarding creating a good interaction with patients i.e how the RNs are/behave towards patients, how the RNs come across. The study had a descriptive design and was conducted as six semi structured interviews with experienced RNs, all working on different adult somatic wards. The results were analysed using qualitative content analysis. It highlighted the importance of creating an open atmosphere by being available and the key aspects of communication such as, actively listening and being perceptive to the unspoken word. Consciously mirroring their own spoken word with their body language and using body contact also conveyed positive communication to patients. Conveying open mindness and respect motivated patients to be involved in their own care. The RNs had to be aware of past patient hospital experiences and being self aware, in particular of their own limitations, benefitted both patients and RNs. Positive effects were shown when patients responded with signs of well-being and faith in the RNs. When RNs came across well generated this too personal satisfaction for the RNs.

Dissertation submitted to the Faculty of Health Sciences at The Durban University of Technology in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, 2008. / Objective: To determine the current knowledge and perceptions of biokineticists with respect to the chiropractic profession in South Africa. Design: A descriptive design was utilized in a qualitative questionnaire in order to evaluate, in a structured manner, the knowledge and perceptions of biokineticists with respect to Chiropractic. Subjects: The total population size used in the study was 657 (response rate n=78; 11.87%). Outcome Measures: These were based on a questionnaire which addressed biokineticists knowledge of Chiropractic, interaction with Chiropractic, Chiropractic terminology and scope of Chiropractic practice. Results: Of the 657 questionnaires that were mailed, only 78 questionnaires were returned and this gave a response rate of 11.87%. The most frequent view or attitude towards chiropractic was that it had a valuable role in the health care system (64%). About 50% of the respondents believed chiropractors to be greatly competent in examination and diagnosis whilst 40% felt that chiropractors were moderately competent in examination and diagnosis. Nevertheless, the rate of communication between biokineticists and chiropractors was found to be quite high, in this study. All together, 67% of biokineticists had communicated with chiropractors. Of those that had communicated, the communication was rated as positive (94.4%). Of those who had referred patients to chiropractors, 41.8% had received treatment feedback reports and of those who had received reports, 68.8% said they were concise and valuable. Conclusion: The results of this study show that the mean knowledge score was 60%. Thus the overall knowledge of chiropractic was high. The only factor that significantly affected respondents’ knowledge was their self reported knowledge of chiropractic. In congruence with this, the most common attitude towards chiropractic was that it had a valuable role to play in the health care system (64%).

An exploratory study covering phase 1 stages 1, 2 and 3 only was undertaken in this large hybrid research project to determine perceptions and understandings of the practitioners and the community about mental health problems of children and adolescents in Zambia because so far there is little known about this phenomenon. The aim of this exploratory study was to gain new insights into the phenomenon by undertaking a preliminary investigation to determine priorities for the future post doctoral research before a more structured study to develop the PHC innovative curriculum. The process first 'explored' social reality on the ground to better comprehend the perceptions and understandings of mental health problems of CA and the curricula model preferences as perceived by the practitioners and the community respectively. This was done to appreciate the "reality of practice" on the ground using the Systems, Ecological, and Biopsychosocial theories which underpinned the four field areas of the study which are: Mental Health, Curriculum Development, INSET and Action Research (AR). The total project is open-ended with three (3) phases and eight (8) stages, from the initial exploration of perceptions (phase 1), through reports to government and stakeholders, curriculum development and piloting with health educators (phase 2) and finally implementing the reconstructed curriculum and integration (phase 3) in such a way as to empower primary health workers to themselves do further research. This thesis, covering the initial explorations of perception, encompasses ONLY the first phase and three stages of this larger qualitative research project because of the Higher Education requirements and funding to try to complete in 4 years. This entails literature review of all 4 field areas because in order to orientate the first phase and three stages of such research and to see the implications of results, it is necessary to have a good grounding in all four. The research study process commenced with an orientation and introduction of the context and purpose of the study, followed by the search conferences and focus group meetings using Qualitative Research Design and Methodology. Search conferences, focus group discussions, hospital registers and clinic records were the three sources of data collection. Analysis of Qualitative and Quantitative Data used NVIVO and SPSS 13.0 Statistical Data Analysis Soft ware respectively. The study showed that mental health problems of Children and Adolescents perceived by the community and the practitioners were also referred and recorded in various hospital registers. The analysis of data from hospital records on referred cases further showed that there are serious psychotic mental health disorders in children and adolescents referred for further consultations to hospitals from the community, some of which are: acute psychotic states, with some associated with HIV/Aids. In addition to these psychotic states, epilepsy, drug and alcohol abuse, child defilement, rape cases, mental retardation and conversion disorders particularly in female children/adolescents appeared to be relatively significant mental health concerns and problems in the researched community sites. The conclusion of the study suggests that there were more environment related factors perceived to cause mental health challenges to children and adolescents. This finding further suggests that there are similarities of cases referred from the community with those seen in clinical practice areas. The significance of these findings in the reality of practice, implies that the preferred PRISMS curriculum model to be developed later as a post doctoral activity for 'INSET' of PHC practitioners in Zambia should have deliberate blending of curriculum content with more socio-environment related issues than the current traditional curricula models which are more clinical in structure, process and content. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2007.

Background: Contracting asexually transmitted disease is strongly associated with stigmaand shame. Stigma associated with these diseases has a significant impact on self-image andpropensityto seek care. Despitehigh incidencethere is a generallack of awareness about therisks and theeffectsthatthese diseases have on both mental and physical health. Health carepersonnel are experiencing difficulties to meet and care for these patients. Aim: The aim ofthis studyisto describe patients'experiences of health care after they were diagnosed with asexually transmitted disease. Method: The study was conducted as a systematic literaturereviewbased on tenoriginal articles. Ameta-synthesiswas used for the analysisandthe resultwasdiscussedwithHalldórsdóttir's (1996) theory;"Caring and Uncaring Encounters inNursing and Health Care–From the Patients Perspective". Result: Five themes emerged;The importance of emotional support;Beingjudged by the health personnel; The importanceof information;To (not) talk about sexandThe environmentalimpact on the confidentiality.Conclusion:Patients with sexually transmitted diseasesare experiencingencounters withhealth care bothnegativelyand positively, although there were mostlynegative experiencesofthe encounters. Several factors affect patients' experiences.Encounter with health care affectspatients' well-being and health. Clinical significance: The knowledge fromthis studymightenable a patientcentredapproach. Based on this knowledge,healthcouldbe developed so thatthe encounter itselfpromotesempowerment and an increased sense of well-being and health. / Bakgrund: Att få en sexuellt överförbar sjukdom är tydligt förknippatmed stigma och skam. Stigma har en betydande påverkan på individens självbild och benägenhet att testa sig. Trots hög incidensidentifieras en generellt bristande medvetenhet om de risker och effekter dessa sjukdomar har påbåde psykisk och fysisk hälsa. Vårdpersonal upplever svårigheter att bemötapatienter med sexuellt överförbara sjukdomar. Syfte: Studiens syfte är att beskriva patientersupplevelser av mötet med vården efter att de diagnostiserats meden sexuellt överförbarsjukdom. Metod: Studien genomfördes som en systematisk litteraturöversikt där tio originalartiklar sammanställdes med en metasyntes och diskuterades utifrån Halldórsdóttirs (1996) teori;"Vårdande och icke-vårdande möteni omvårdnad och hälso-och sjukvård–utifrån ett patientperspektiv". Resultat: Fem teman framkom som återkommande upplevelser; Betydelsen av emotionellt stöd; Att bli dömd av vårdpersonalen, Betydelsen avinformation; Att (inte) tala om sex och Den fysiska miljöns påverkan på konfidentialiteten. Slutsats: Patientermed sexuellt överförbara sjukdomar upplever mötet med vården ivarierande grad negativt och positivt. Dock framkom det övervägande negativa upplevelser av mötet. Flertalet faktorer påverkar patienternas upplevelse. Mötet med vården påverkar patienternas välbefinnande och hälsa. Kliniskbetydelse: Kunskapen från resultatet i denna studie kan möjliggöra en patientcentrerad vård. Utifrån resultatet kan vården utvecklas så att mötet upplevs som vårdande, och där mötet i sig samt kontakten med vården skapar egenmakt och en ökad känsla av välbefinnande och hälsa.