La Belgique et la France ont notamment intégré en 2002 dans leurs systèmes législatifs respectifs une loi consacrée aux droits des patients qui met au centre du système de santé le patient et le devoir de respecter son autonomie. Partant de l’idée selon laquelle les concepts et principes ne peuvent être pensés indépendamment de la manière dont ils sont susceptibles de s’articuler au sein de la « vie ordinaire », j’ai adopté une démarche de philosophie empirique impliquant un terrain d’enquête au sein de laquelle j’ai choisi d’explorer une situation que l’on peut qualifier de limite, en portant mon attention sur la question du consentement aux soins des patients atteints de la maladie d’Alzheimer hospitalisés en gériatrie pour un événement de santé aigu. En effet, la maladie d’Alzheimer implique une diminution des capacités (notamment cognitives) des personnes qui en sont affectées, mettant ainsi l’autonomie du sujet à l’épreuve. Les spécificités liées à cette maladie, doublées du caractère aigu de la prise en charge des personnes qui en sont affectées, font de ce contexte un terrain extrêmement fécond pour examiner les significations et les limites de ce principe tel qu’il est actuellement valorisé dans le domaine des soins de santé. La réflexion proposée dans le cadre de cette thèse s’est ainsi élaborée autour d’éléments recueillis lors d’une enquête de terrain comparative (comprenant différents sites hospitaliers belges et français) spécifiquement mise en place pour les besoins de ce travail. Cette enquête s’est concentrée sur la relation entre les patients et les « soignants de proximité » (infirmières et aides-soignantes), étant donné que c’est dans le cadre de cette relation que la question de la capacité d’autonomie du sujet atteint de la maladie d’Alzheimer émerge principalement en contexte de soin à l’hôpital. En outre, cette enquête s’est en grande partie intéressée à la problématique du refus de soin des patients, ainsi qu’à celle du recours à la contrainte. En effet, c’est essentiellement dans ce type de situations que la question du respect de l’autonomie des patients et du recueil de leur consentement se pose avec le plus d’acuité dans le secteur qui nous occupe. La mise en place de ce terrain d’enquête doit être comprise comme un outil méthodologique et épistémologique ayant pour objectif de nourrir la réflexion conceptuelle, critique et normative liée à la problématique du respect de l’autonomie des patients atteints de la maladie d’Alzheimer. L’ensemble de ce travail m’a permis de développer une nouvelle conception de l’autonomie qui se distingue des réponses les plus fréquemment proposées au sein de la littérature médicale, juridique et philosophique. L’idée principale défendue ici consiste à penser que le problème relatif à la question du respect de la capacité d’autonomie des patients atteints de la maladie d’Alzheimer ne réside pas tant au niveau de la capacité propre des personnes, mais qu’elle dépend avant tout de ce que je présente comme un geste d’octroi, résultant d’un processus de co-construction collectif des professionnels de santé, marqués par des affects et des motivations qui leur sont propres / In 2002, Belgium and France implemented a law that places patients and their right to autonomy at the center of the healthcare system. Based on the assumption that concepts and principles cannot be perceived independently of the way they are likely to be implemented in “ordinary life”, I applied an empirical-philosophical approach to the research field by choosing to examine what can be described as a borderline situation, bringing my attention to the issue of consent to medical care of patients with Alzheimer’s disease hospitalized in geriatric units for an acute health issue. Indeed, Alzheimer’s disease involves a decline of the patient’s abilities (including cognitive skills), thereby jeopardizing his autonomy. The specific characteristics of the disease coupled with the acute medical care it requires single it out as the perfect ground to question the meaning and limitations of the principle and its current use in the healthcare system. The reflection proposed in this thesis is based on information gathered during a comparative field study (including various Belgian and French hospital sites) specifically set up for the purpose of this work. The research focused on the relationship between the patients and the “immediate caregivers” (nursing staff), where the capacity of autonomy of Alzheimer patients in a hospital setting is most frequently questioned. Moreover, the present study largely dealt with the issue of treatment refusal by patients as well as the use of coercion. It is indeed mainly in this type of situation that the problem of respecting patient’s autonomy and obtaining their consent is most vividly debated in the present field of study. The introduction of this research field must be seen as a methodological and epistemological tool that aims at providing further conceptual, critical and normative inputs to the issue of respect of autonomy for patients suffering from Alzheimer’s disease. This work allowed me to develop a new understanding of autonomy, which differs from the most frequently proposed responses that are to be found in medical, legal and philosophical literature. The main advocated idea here is that the question of respect of autonomy for Alzheimer patients does not lie so much in the person’s own capacity, but actually depends on what I consider a granting gesture that results from a collective construction process of health professionals, biased by their own affects and motivations

This dissertation explores the lives of baby boomers turning sixty as they use narrative to review their past by focusing on turning points. They reflect upon their present, and anticipate their future. The story begins at the St. Pius X High School Class of 1965's fortieth reunion, and proceeds to a class sixtieth birthday celebration and focus group. In addition, five members of the class record their life stories retrospectively. This research explores issues of identity, both personal and generational; the social construction of aging; grief, loss and death; and resilience, meaning, and spirituality. Methods used are autoethnography, narrative, participant observation, and writing as inquiry.

The attrition rate among special education teachers is ranked among the highest in the education profession. Retaining teachers early in their careers continues to be a concern due to increased job responsibilities, larger caseloads, challenging student behaviors, minimal support from colleagues, increased paperwork, and diminishing resources. The purpose of this phenomenological study was to examine the meaning of satisfaction special education teachers made of their careers. The transactional model developed by Lazarus and Folkman (1984) can help to explain how the occurrence of stressful events can impact an individual. A purposive sample of 9 tenured, certified special education teachers currently working in the field for at least 10 years were interviewed using individual, in-person, semistructured questions. Emergent themes and patterns were identified following the 6-step data analysis process for interpretive phenomenological analysis. The findings revealed two superordinate themes (a) effective practices and (b) making a difference. The participants in the study described strategies to minimize stress that included exercising, having quiet times, making time for leisure activities, being able to vent to coworkers, laughing and using humor, and spending time with pets. All of the participants in the study indicated a sense of commitment to the field of special education and their students. Participants articulated the importance of student success and acting as a helper for students to achieve their goals. The data from this study may be used to highlight career sustaining behaviors and job satisfaction from veteran teachers contributing to the longevity for teachers in the special education profession and improving retention rates of teachers early in their careers.

While fraternity and sorority life continues to make headlines and is called upon regularly to validate the purpose it holds to remain on college campuses today, many still believe that when fraternity and sorority are done right, it is one of the best opportunities on college campuses today outside of the classroom. Much of their success is due to the efforts and support of the fraternity and sorority life professionals. This dissertation will offer the first Scholarly Personal Narrative of a mid-level, seasoned, fraternity and sorority life professional working in higher education. Current research shows the average age of a fraternity and sorority life professional is twenty-seven and over half the professionals have been at their place of employment for two years or less. I will explore my own personal journey over the last twelve years with hopes of finding meaning in this uncommon career path and explore where resilience and passion resulted in professional longevity.

What are a person’s core beliefs? What do they hold dear and to be true? How does one go about examining their ideals and challenging them risking discovering there is a different way of living, thinking, or showing up? These questions and more are what drove me to enroll in the University of Vermont Graduate College and the Interdisciplinary Studies (IDS) program. I probably could have attended a few self-help seminars, paid a life coach or seen some type of counselor to help me explore these issues. Doing the exploring via higher education and the IDS program seemed much more meaningful, especially as the program progressed. Through Scholarly Personal Narrative (SPN) I have been able to closely examine myself, my life stories, with a different lens, even different then using the advantage of hindsight, in hopes of finding a path toward different self-realization. Important to note I said different, not better, as each person’s experience is valid, something you will see as you read the thesis. In so doing, you will be exposed to three basic explorations, my personal stories, my professional stories, and my political stories. All intertwine and relate to each other, but each have their own narrative to contribute to this journey. By the end, you, as the reader and consumer of these stories, may find similar paths to search for yourself in whatever place you currently find your life.

In this thesis I share stories of my journey to make meaning in my life, and explore how my relationship with dogs has helped me to overcome personal challenges. I break these experiences down into what I call my five Fs: family, faith, food, fear, and fido. After giving a history of the human-dog relationship, I extrapolate from my experiences ways in which I believe students and teachers could benefit from interactions with therapy dogs and other comfort animals within the public school day. Specifically, I examine the role dogs can play in helping students and teachers reduce stress and increase self-efficacy. I include the sample animal procedure I drafted for the school at which I teach. I also include some data from my time working with students and my dog. Written in Scholarly Personal Narrative format, I look to weave together my own realizations about anxiety, choice, and identity, with a call for others to find what self-efficacy strategies work for them to make meaning and purpose in their own lives.

The present thesis entitled The Meaning of Life Seniors permanently bedridden. The author has several aims: to define the concept of the meaning of life, quality of life, aging and age; determine the biological, psychological, social and spiritual changes in old age; map social and health services that can benefit the elderly bedridden; and find out how seniors perceive home in the home enviroment and in the institution. The thesis is divided into theoretical and research part. In the theoretical part in first three chapters there is determined the meaning of life, especially in relation to the categories of values defined by V. E. Frankl, further aging and age and environment for the conclusion of life: home versus institutions. In the fourth chapter, which is part of the research, the author conducted qualitative research by analyzing data from interviews with elderly bound to bed. Research includes six respondents, three respondents living in the home and three respondents living in a home for the elderly. The aim of the research was to determine whether seniors permanently bedridden perceive the meaning of life, or what. The results are summarized in the conclusion.

Enhancing Quality of Life: The Effects of Positive Cognitions by Claudine Antoniette Gerald M.S., Walden University, 2009 B.S., Florida Atlantic University, 2002 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy General Psychology Walden University August 2015 The purpose of this study was to test the nature of the relationship among cognitive factors to determine quality of life in a sample of 180 adult internet users. Theories of the positive psychology paradigm, salutogenesis, dynamic equilibrium model, family systems, and family resilience theories were the bases for examining the relative significance of the cognitive factors, positive illusions, optimism, perception of control, meaning in life, resilience, and sense of coherence to the development of quality of life. Factor analysis revealed the order of significance of these variables from the most influential to least influential: sense of coherence, meaning in life, positive illusions, perception of control, resilience, and optimism. Stepwise multiple regression analysis indicated that positive illusions have a negative influence on quality of life β = -0.198, t = -2.36, F = 5.58, p = 0.02. Standard multiple regression analysis indicated that these cognitive factors do not significantly contribute to quality of life when grouped together. These findings corroborate current research that cognitive factors do not work alone in enhancing quality of life and there must be a balance along factors on other levels, such as psychological, physiological, behavioral, and sociocultural to enhance quality of life. Social change may be influenced by this study's unique and exclusive emphasis on the effects of cognitive factors, demonstrating the relative significance of these cognitive factors, individually and combined, for the promotion of quality of life. This study has filled two research gaps because positive cognitions had not been studied together and the association between positive illusions and the known quality of life promoting cognitive factors needed clarification.

This qualitative study examined the phenomenology of advanced breast cancer (ABC) among 7 female participants between the ages of 20 and 45. Oral data were collected to extract participants' interpretations of their spiritual and psychosocial experiences of living with ABC. Findings suggest that these women experienced a dichotomous relationship with regard to their bodies and their relationships with others; this served as a means of making sense of their experiences and as a coping mechanism. Positive psychology and the theory of reasoned action and planned behavior provided the theoretical framework for examining the role of social reinforcements, beliefs, and attitudes and intentions on the health behavior of pre-menopausal African American women with ABC in Northern and Southern Delaware. Additionally, the theoretical framework provided answers to the overarching questions of how pre-menopausal African American women with advanced breast cancer applied meaning-making and spirituality to find purpose in their diagnosis. Inductive analysis of their narrative data suggested a set of themes: the body as a medical object, the body as a feminine object, honesty in relationships, missed opportunities from healthcare professionals, from wounded to mended, and the joy of purposeful living. The participants reported that an intimate relationship with God helped them feel supported in a way that family and friends could not. The findings in this study support potential spiritual and meaning-making interventions as well as promote a more positive quality of life for pre-menopausal women living with advanced breast cancer.-¬-¬-¬

Thesis (M.A. (Translation and Linguistics)) -- University of Limpopo, 2011.