Made available in DSpace on 2013-01-07T15:55:04Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 10.pdf: 705461 bytes, checksum: a38cec626fdd7cdbe12a632cae8b09aa (MD5) Previous issue date: 2006 / Os estudos sobre doenças possibilitam análises sobre articulações e mudanças na sociedade. A doença quase sempre é um elemento de desorganização e reorganização social. Os estudos nesse campo devem levar em conta a articulação entre a patologia de uma época, a configuração histórica e ideológica que a contextualiza e o estágio de desenvolvimento da Medicina. Ao avaliarmos a dimensão social da doença, trilhamos um dos caminhos para a compreensão de uma sociedade, uma vez que esta funciona como suporte e expressão da mesma. Doença é uma construção social e um indivíduo doente sempre o é em função da sociedade e segundo moldes fixados pela mesma. Dessa maneira, podemos pensar a doença como um objeto histórico, uma vez que esta é fenômeno social, ao mesmo tempo em que transforma a sociedade. Ao perceber que doenças são representações carregadas de culpa e comiseração o Cinema as usou como tema, personagens ou pano de fundo, construindo painéis de uma determinada época ou sociedade. Este trabalho pretende discutir a construção do doente na filmografia de Pedro Almodóvar, uma vez que percebo que este as usa como elemento de transformação de indivíduos ou da própria sociedade.

This study was designed to investigate psychological factors involved in the adjustment to Rheumatoid Arthritis (RA). In particular, the study examined perceptions of control over daily symptoms, knowledge of RA and the use of coping strategies, and looked at how these factors related to emotional adjustment, clinical disease activity and subjective physical functioning in RA outpatients. The study also aimed to determine aspects of RA which patients perceived as most stressful. The main study was cross-sectional and designed in two parts. The first part was a quantitative design in which 50 participants completed questionnaires to assess perceptions of RA stressors; health locus of control beliefs over RA symptoms; levels of RA-related knowledge; coping strategies used; emotional adjustment and physical functioning. An objective measure of disease activity was also taken. The second part was a qualitative design consisting of semi-structured interviews with 14 participants, exploring perceptions of stress, control, knowledge, coping and adjustment. Quantitative data were statistically analysed and compared with previous research findings. Qualitative data were transcribed into predefined themes and compared with the quantitative data. Results showed that participants consistently rated fatigue and disability as the most stressful aspects of RA. Participants reported more symptoms of anxiety than depression and used a wide range of coping strategies. Quantitative data suggested that participants perceived high levels of chance control over their daily RA symptoms, however, qualitative findings did not support this view. Participants knew most about RA-related issues that were directly relevant to them. Significant associations were found between coping strategies and psychological outcome, particularly for positive affect. Associations were also found between maladaptive coping and positive physical adjustment and between adaptive coping and negative physical adjustment. Adaptive coping strategies were associated with `internal' and `doctor' locus of control and increased knowledge. Few associations were found between outcome and either control or knowledge. Regression analyses found coping strategies to account for some of the variance in outcome variables, particularly positive affect. The implications for clinical practice were considered. Methodological limitations of the study and implications for future research were also discussed.

Class of 2012 Abstract / Specific Aims: The specific aim of this study was to assess the impact of public mental health benefit changes on patients with a serious mental illness. Methods: A comprehensive literature search was conducted using several databases. Articles that were included in the analysis met the following inclusion criteria: 1) Study conducted in the United States 2) Study population composed of adults (≥18) with a diagnosis indicative of a serious mental illness (psychotic disorders, bipolar disorders, major depressive disorder, anxiety disorders, dysthymic disorder, or a personality disorder) 3) Study evaluated a change or discontinuation of mental health services, 4) Study reported outcomes. Main Results: Of the 117 studies originally identified, 27 met all the inclusion criteria. Data was then extracted from each study regarding the design of the study, patient demographics, and impact of the various outcomes. Five studies looked at the implementation of prior authorizations required for psychiatric medications, which all showed increased rates of treatment discontinuation. Two of these five studies also looked at the impact on emergency department (ED) visits and hospitalizations with both studies showing increased ED visits, but no effect on hospitalizations. Three studies looked at the implementation of Medicare Part D, which all showed increased rates of medication access problems and increased rates of ED visits. Other studies that examined medication access issues found increased rates of suicide ideation or behavior, increased rates of treatment discontinuation, and increased rates of ED visits. Conclusions: Given the amount of variability among the studies, it is difficult to determine the impact specific benefit changes have on patients diagnosed with a serious mental illness. In order to draw conclusions regarding specific benefit changes, more studies looking at similar outcomes need to be conducted. This is critical as the studies examined, in general, showed negative outcomes for patients with a serious mental illness when mental health benefit changes were implemented.

Obesity is highly prevalent and results in poor health outcomes and increased morbidity and mortality. Mentally ill patients are at increased risk for obesity and other health disparities that result in significantly reduced life expectancy. Primary care providers (PCP’s) are first line defense in the obesity epidemic. A brief education intervention on obesity management in patients with mental illness was presented to PCP’s at a community clinic to educate them on obesity management in patients with mental illness. A pre-and posttest was devised to assess current practice and intent to utilize knowledge. Results indicate that post intervention all provider agreed or strongly agreed that they felt more confident treating obesity indicating success of the presentation. Short-term implications of this project are better treatment for a high-risk population. More broadly, this project further adds to the current literature another example that brief educational interventions are beneficial for healthcare providers to help enable best evidence based practice.

D.Phil. (Social Work) / The research question answered in this thesis is: What is the place (role, attitude, aim) of medical social work as a component in the treatment of mental illness in a general hospital? Since the medical staff at a general hospital are primarily concerned with the treatment of physical illness, it is expected that the place and role of the medical social worker, as well as the mentally ill patient, create problems with role-functioning in this primary medical setting. In a general hospital, where life and death are vital issues, the doctor plays a major role in the treatment process and social workers and other persons, in ancilliary professions are expected to render a subordinate and secondary service. The patient's problems with role-functioning occur prior to admittance, during hospitalization and after discharge. In the process of becoming a patient the difference between the medical and psychiatric sick role is accentuated. Problems after discharge include unemployment and the fulfilment of roles such as marriage partner, roommate, neighbour, colleague and employer as determined by the social distance scale. Legislation, especially the Health Act (Act 63 of 1977) and the Mental Health Act (Act 18 of 1973) has made provision for psychiatric services to be incorporated in the general health services of the RSA and for the mentally ill to be treated in general hospitals. Despite the community-oriented approach, stigma is still attached to mental illness and the general public remains relatively ignorant regarding mental illness. One way of researching the influence of stigmatic labels in determining reactions to persons who are mentally ill is to investigate the attitudes of various sections of the community, including professionals in the health field. Attitudes towards mentally and public perception of the signs and symptoms of mental illness have for several years been the subject of considerable concern and research. The empirical data used in this study was obtained from collating the views of staff members attached to four training hospitals in South Africa. The investigation covered their knowledge of and attitude towards mental illness and the mentally ill patient. It al so determined whether respondents showed prejudice towards the treatment of the mentally ill patients in general hospitals. An analysis of the empirical data according to occupation indicates that professionals qualified in the human sciences comprise the smallest component of the personnel structure in hospitals. Compared to other personnel this group shows a more favourable attitude towards treatment of mentally ill patients in general hospitals and the acceptance and employment of mentally ill persons in the community. Although medical social work quantitatively form the smaller component in the treatment of mental illness in a general hospital it has a significant contribution to make with regard to the following aspects of social work service delivery: humanising the hospital system and the home environment of the mentally ill person; prouott ng mental health education; activating support systems; utilising social networks; enhancing effective role functioning; restoring social functioning as a facet of social health; preventing mental illness; promoting mental health and changing attitudes towards mental illness

Many international studies have been conducted on paediatric bipolar disorder, but few research studies have been conducted on parenting a child diagnosed with bipolar disorder, both on an international and national level. The researcher utilised Bronfenbrenner’s Ecological Systems Theory as the theoretical framework in exploring and describing this research field. The study has been conducted by means of a systematic review and all of the articles included in the review examined some aspect of parenting and paediatric bipolar disorder. The articles were systematically assessed, and six themes emerged which include: paediatric bipolar on the rise; the effects of paediatric bipolar disorder, post-paediatric bipolar disorder; managing paediatric bipolar disorder is a family responsibility; foundations for effective parenting; and supporting parents of a paediatric bipolar patient.

No description available.

The complexities of man's current social universe permit little opportunity for him to function in a social environment that is undergoing constant change, without experiencing stress. Those who are unable to adapt or adjust to the stresses of modern living fall prey to the ravages of mental illness. Changing professional perspectives and the research of social scientists are re-awakening professional eyes to the significance of the patient in relation to his social environment. The experience of mental illness and all its ramifications are also the experience of those who shared in a reciprocal role relationship to the patient. Isolation - the remedy of old - today is a lost cause. For social work, current theories of social dynamics promise to add a new dimension, by which to understand the social structure of the mentally ill person and those who interact with him. The new theory requires inspection and testing. This thesis is an attempt to examine some of the clinical applications of a theory that might well have great consequences for social casework. Social role theory is reviewed as background, and the concepts of role and stress are explored in relation to the family, when one of its members becomes mentally ill and requires hospitalisation. To examine clinically the effects of hospitalization on family and patient, using role concepts, a small group of families was selected and studied. Structured interviews were used to elicit both descriptive details and feelings about the family, as well as the meaning and effect of hospitalisation. The sample group was drawn from both female and male sections of the Crease clinic of Psychological Medicine; and, where possible, both the patient and a reciprocal (close relative) were interviewed. The questions were directed particularly to roles and relationships before and after admission. The study reveals that patients and their reciprocals experienced stress in two phases: (a) when the patient is mentally ill, but living at home and (b) when the patient has been hospitalised. In the former, stress centres around changes in perception and performance in an effort to continue functioning, in spite of the maladaptive roles of the mentally ill family member. In the latter, stress centres around the absence of the family member, whose absence displaces role and relationships upon which the social structure of the family network is highly dependent. The study also reveals that hospitalisation is relieving for both patient and reciprocals, and in some cases leads to the resumption of certain roles discarded during the presence of the mentally ill member at home. / Arts, Faculty of / Social Work, School of / Graduate

This study of behaviour as displayed in art activities was carried out in the Child Art Research and Demonstration Centre, the University of British Columbia, Vancouver, British Columbia, from October, 1961 to March, 1962. The behaviour of ten individuals ranging in age from six to fifteen was observed and recorded in the form of time samples, anecdotal records and rating scales. This study consists of: 1. A survey of documents written by authorities in the field of art education. 2. A general analysis of the techniques used in the collection and treatment of the data. 3. Reports of individual cases indicating qualitative and quantitative results of the study. The need to substitute facts for opinions has prompted the study. In general, this study has disclosed that no significant relationships exist between certain personality characteristics and behaviour characteristics as displayed in art activities. Although the number of subjects has been limited, yet the accurate and detailed conclusions are able to supply topics for further investigation. / Education, Faculty of / Graduate

Psychiatrists and social workers are aware of the existence of relatives when a patient is hospitalized in a psychiatric treatment centre. Current research points to the importance, in the patient's environment, of many variables, and among these, the presence of relatives who inter-act with the patient is one which may have a significant bearing upon the outcome of treatment. This thesis examines the stress factors which influence the relatives behavior toward the patient, as they arise from the fact of hospitalization at the Crease Clinic of Psychological Medicine, and from the subsequent period of post hospital adjustment. Literature on the subject of environment in relation to personality has been consulted, and nine families were studied. The main technique employed was the structured research interview with the relatives. Supplementary information was obtained from a review of the Crease Clinic files on the patients, and from discussion with the caseworkers and the casework supervisor. The information obtained from the interviews concerned the relatives' responses to the fact of hospitalization, to their understanding of mental illness, and to the practical problems and emotional stresses of the rehabilitation period. The sample group was divided into two groups, wives and mothers, to examine the effect of family structure in the patient's post hospital experience. The sample also contained a number of cases receiving social casework services, but no conclusions could be reached in regard to this variable owing to the difficulty in placing specific research focus on this factor while examining the stress areas. The study reveals that the relatives of mentally ill patients experience stress in two phases, that of hospitalization and that of the post hospitalization period. In the first, stresses centre around fear of mental illness, the kind of hospital required, and the relative's isolation from the treatment program. In the latter phase, stresses originate in two sources, practical problems such as employment or housing, and the role relationships with the patient. The most forceful stresses are connected with interrelationships, and there are differences between the group of wives and the group of mothers in this regard. The results indicate a need for more family oriented casework both in hospital and community. Present trends to treat the patient in the community find support in the study. / Arts, Faculty of / Social Work, School of / Graduate