Thesis (Ph. D.)--University of Wisconsin--Madison, 1968. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (M.N.) -- Memorial University of Newfoundland. / Typescript. Bibliography : leaves 154-167. Also available online.

Thesis--University of Minnesota. / Photocopy of typescript. Ann Arbor, Mich. : University Microfilms International, 1977. -- 21 cm. Includes bibliographical references (leaves [119]-125).

Thesis (doctoral)--Universiteit Utrecht, 1992.

Experiences of women regarding unexpected neonatal resuscitation were studied in this research. The objective of the study was to explore and describe the experiences of labouring women whose babies required unexpected resuscitation at birth. Recommendations were made based on the findings of the study. Labour and birth do not always go as well as expected as deviations could happen at any of the four stages of labour. Midwives tend to focus on the neonate when resuscitation is needed and leave the mother unattended and wondering what is happening as they rush away with the neonate. The situation motivated the researcher to conduct the study. The focus was on the experience of during the time of resuscitation. The study is qualitative, and exploratory, descriptive, contextual and narrative research approaches were used to reach the objective. The research population included women who delivered in the identified site from six hours to six weeks post delivery period. Inclusion criteria were the following: Women must have attended antenatal care at least four times. Their pregnancies were categorized as low risk. The ages of the women were 18-35 years. Gestational age was 38-41 weeks. The neonate should have been resuscitated successfully and admitted for observation in the nursery. Non-probability, purposive sampling was used. Data was collected by conducting semi-structured one-on-one interviews using a tape recorder. The site for the study was a public hospital, and the managers and operational midwives were used as gatekeepers. Fifteen participants gave permission to participate in the study willingly and were interviewed individually and anonymously. The interviews were transcribed, and Creswell’s data analysis spiral image was used. The period for data collection was seven months in one academic year. An independent coder’s services were utilized to increase the trustworthiness of the findings. The trustworthiness of the study was also ensured by conforming to Lincoln and Guba’s model of trustworthiness. Strategies used to ensure trustworthiness were credibility, transferability, dependability and conformability. The researcher maintained the ethical standards for conducting research by adhering to ethical principles, such as human rights, beneficence and justice. Confidentiality was maintained by using numbers instead of names, and only the researcher knows the participants’ names. Only the researcher, supervisor and the independent coder have access to the information. The data is kept in a locked cabinet and will be kept for the next five years following the publication of results. Two main themes emerged from the data analysis with each having two sub-themes Mothers verbalized varying emotions regarding their neonates’ inability to breathe properly. Mothers verbalized the importance of receiving support and information from midwives. To optimise the discussion of research findings, direct quotes were used from the raw data of interviews to support the description of experiences. Recommendations for midwives were to prepare the pregnant women during antenatal care for unexpected emergencies during labour and to reinforce this information on admission when labour commences. Managers are to update the guidelines on maternity care and the health education checklist. Nursing schools should train student midwives in debriefing and counselling skills. Both study objectives were successfully met.

The aim of this inquiry was to gain a deeper understanding of the hospitalisation of learners living with severe epilepsy. Much current research focuses on the attitudes and perceptions of teachers and relatively little has been done on learners with severe epilepsy and the kinds of support they require in a school setting. The latest policy document on inclusion, White Paper 6 of 2001 refers to support as essential in accommodating diversity. This involves the provision of supportive teaching and learning for all. Particularly in supporting learners with severe epilepsy, parents, teachers and all role players are regarded as important. From the literature review, it was evident that support for learners with epilepsy plays an important role in enhancing teaching and learning. It was also apparent that, where support is lacking, their learning abilities is negatively affected. This study therefore aims to examine the ways in which hospitalisation affects epileptics’ learning abilities and, consequently, the support they require as a result of their barriers to learning. This information may be used as a point of departure in the training of teachers, in order to facilitate support and promote the successful removal of barriers to learning. In order to achieve this goal, two focus group interviews were conducted with teachers and learners; furthermore, two individual interviews were also conducted with the hospital head sister attached to the school, and with the school principal. The main patterns of concern that emerged from the data related to the learners, teachers, parents and the policy of inclusive education. From the analysis of data, it was clear that hospitalisation impacts negatively on learning and that little or no support is provided. It would probably be advisable for the Department of Education, teachers, parents and hospital staff to take note of these results and concerns so that all role players can be trained in the provision of adequate support. Moreover, the Department of Education is urged to speed up the process of implementing the policy on curriculum adaptation, which will benefit all learners, including those with severe epilepsy. Collaborative working relationships between parents, teachers, learners, the hospital staff and other role-players must be characterised by warmth, love, perseverance, tolerance, acceptance and understanding. This working relationship should, at all times, provide the means for enabling learners to cope in the classroom. Parents, as partners in the education of learners, should be involved as classroom aides, and can be enlisted to visit learners who are hospitalized and to offer them support. The establishment of this commitment is a key element in supporting learners living with severe epilepsy. / Mrs. J.V. Fourie

No description available.

This study examines the workings of the ground rules which make up the framework of psychotherapy, in an institutional context, by analysing transcripts of twelve audio taped sessions of therapy conducted in a psychiatric hospital. The breaks in the ground rules of the sessions are noted and the patients' responses to these breaks are analysed using Langs's (1982, 1988) method for decoding patients' material, suitably modified for use as a hermeneutic research method. Although all of the ground rules are broken in the institutional context, only one of the ten ground rules appears to be essentially affected by this particular institutional context. Other ground rules are broken out of choice of technique or through error. The institutional context has a structural impact only on the ground rule requiring a one to one relationship with privacy and confidentiality and this ground rule is transgressed in a number of ways in all twelve sessions examined in this study. However the patients' responses to this breach only occur in ways predicted by communicative theory when the break in the ground rule involves actual entry into the therapy space by another person. Other contraventions to this ground rule that do not involve such an entry do not elicit the predicted patient responses. The many other ground rule breaks occurring in the institutional context evoke the predicted responses in the patients' material. In the study, no therapist interventions are found to comply with the communicative therapy requirements for sound interventions; concomitantly it was found that no therapist interventions receive the required derivative validation. The results indicate that it is possible to conduct therapy of a substantially secure frame variety in this institutional context with minimum effort on the part of therapists and given proper training and supervision of therapists in the techniques of communicative psychotherapy. Furthermore the results lend weight to the importance of the communicative methodology for listening to patients' material in psychotherapy in an institutional context. However, further rigorous study of competently performed therapy, executed within the context of a secure frame within an institutional context, is needed in order to demonstrate the benefits of the communicative psychotherapy interventions and interpretations in this context.

Nurses in neonatal special care nurseries with a philosophy of family centered care involve parents in the care of preterm infants. There is little research describing nurses' perspectives of parental participation in care. Using interview data obtained from one secondary level neonatal special care nursery, this study attempts to understand the meaning parental participation in care has for neonatal nurses and the way that meaning is expressed in various nursing activities. Twelve nurses were interviewed about their reaction to parental participation in various activities such as feeding and bathing their babies. These nurses are all full time staff members in the nursery. Findings of the research are that there are two main nursing perspectives of parental participation in the care of preterm infants in a special care nursery. These two perspectives are labelled the 'our baby' and 'their baby' perspective. The 'our baby' group of subjects maintain a traditional role of control of care. The 'their baby' group are committed to the philosophy of family centered care within certain boundaries. An example of the difference., in the two perspectives was discovered in the area of infant feeding. The 'our baby' nurses thought that parents engaged in this activity increased the workload while the 'their baby' nurses thought that parents decreased workload. The 'our baby' nurses treated most parents in a similar way but the 'their baby' nurses individualized their approach to parents. The 'their baby' nurses' enjoyed spending time with parents but the other group said that there were less parents to deal with when they were working at night. Both groups work side by side with little conflict. Implications for the selection and training of nurses are noted as well as implications for further research. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

The quality of health and hospital care is usually measured by one of three basic approaches. Structure measures assess the inputs used or available for use in the treatment of patients. Assessments of process look at "how" patients were treated. Outcomes measures are concerned with the end-results of care. Outcomes have considerable intuitive appeal to consumers and it is assumed in this thesis that quality is defined in terms of outcomes; providers (e.g. physicians) however may have preferences for hospital structure for its own sake. Structure and process measures are generally regarded as proxies for outcomes measures. They are used because they are easier to measure than outcomes, but the relations between the proxies and outcomes have not been completely tested. This thesis is concerned with the empirical verification of the relationship between two types of measures, structure and outcomes of hospital care at the aggregate level, and a possible link between provider preferences for structure and observed "excess" structure. The outcomes measures are based on adjusted hospital death rates. The adjustment factors draw on detailed diagnostic and demographic information available in the British Columbia hospital reporting system. Several possible adjustment factors (proxies for severity) are considered. The structure measures include measures of inputs per case, and measures of the facilities and services offered by a hospital. The discussion centres on three hypotheses. The first two concern the empirical relation between structure and outcomes. The first hypothesis that the two types of assessment are equivalent was tested using correlation analysis of alternative outcomes measures and structure measures. The results indicate that structure cannot be substituted for outcomes measures in the evaluation of quality. The second hypothesis is that there is ineffective or "excess" structure. This is demonstrated if the impact of incremental structure on outcomes is not positive. The results generally support the existence of excess structure. Extensive regression analysis and exploration of possible weakness did not result in the modification of the basic conclusion. The third hypothesis is that such "excess" structure arises and persists because providers value structure for its own sake, and are able to impose their preferences on hospitals. The discussion is essentially theoretical and considerable evidence supporting the hypothesis is provided, although no formal proof is offered. Physicians value structure because it enables them to increase their income and/or leisure, and also to satisfy their professional desires with respect to their working environment. Arguments are presented to support the claim that physicians get some of the structure they want because of imperfections in real-world agency relations and the institutional features of the health care system. Given the basic premise of the thesis (that consumers would define quality in terms of outcomes), the results of both the empirical and theoretical investigations have implications for policy. Policy changes suggested in the discussion that concludes the thesis are concerned with resource allocation within the hospital system, quality measurement, monitoring of policy changes, and incentives and programs to modify provider preferences. / Arts, Faculty of / Vancouver School of Economics / Graduate