Acute rehabilitation hospitals assist brain injury patients and families who face a life- changing event to achieve greater independence and quality of life. During the acute rehabilitation phase of recovery, care is focused on the patient; however, there is a nationwide movement to implement patient- and family-centered care because caregivers experience grief and uncertainty about how to care for their loved one during hospitalization and upon discharge. The purpose of this staff education project was to educate rehabilitation staff on how to identify and to meet the needs of family members of brain injury patients in an acute rehabilitation center in the western United States. The patient- and family-centered care theoretical framework and Knowles's theory of adult learning supported the development and implementation of the educational program. The project site stakeholders identified educational opportunities to assist staff to meet caregiver needs and improve outcomes. Thirty-two staff including registered nurses, licensed vocational nurses, patient care technicians, and nurse managers, received education for the support of caregivers for patients with brain injuries. The program was evaluated using a 5-point Likert type questionnaire. After receiving the education all participants agreed or strongly agreed that content increased their knowledge, skills, and confidence in caring for family caregivers of brain injury patients. Implications of this project for social change include the potential to improve patient outcomes through caregiver knowledge and skills to provide care to patients with brain injury.

Each psychotherapist has a personal theoretical framework, that is, a set of assumptions on which his or her psychotherapy is based. It appears from the published writings and opinions of therapists that therapists generally concur that a major factor in the formation of an individual therapist's theoretical framework is the therapist's personality. This study was designed to address this issue by examining the relationship between the psychogenic needs and theoretical framework of the therapist. From an accessible population of 178, responses were obtained from 153 therapist participants (108 males and 45 females) from five Utah training programs and three experience levels. Each of the participants completed a measure of theoretical framework (developed by the author) which assessed general adherence to the principles and techniques of person-centered, behavioral, and rational-emotive therapy. Based on scales from Jackson's Personality Research Form the following psychogenic need variables were also derived: Need for Achievement, Need for Affiliation, Need for Dominance, Need for Exhibition, Need to Give Nurturance, and Need for Order. Other independent variables were based on the experience levels and training programs of the therapists. Multiple regression analyses yielded uniformly small (less than 13.5% variance accounted for), generally non-significant relationships. The only clear relationship between a psychogenic need and the theoretical framework variables was between Need for Affiliation and the person-centered therapy variables. The experience level of the therapist accounted for the greatest portion of variance in the behavior therapy variables. There was no clear relationship between the rational-emotive therapy variables and any of the independent variables. The low magnitude of these results may be partially explained by the relatively low reliability of the research variables. Further, if a relationship does exist between psychogenic needs and theoretical framework, it may not be a linear relationship which was the assumptive basis of the analyses used in the research. An interesting finding was that scores of concurrence with the three theoretical schools had positive intercorrelations of between .14 and .54. An implication of this finding is that theoretical framework may be multidimensional versus unidimensional as it has previously been conceptualized. In summary, this research does not support the relationship between the psychogenic needs and theoretical framework of the therapist. However, given the theoretical emphasis placed on the topic, and the difficulties with this research, further research in the area appears warranted before the issues can be more definitely resolved.

This study proposes a seven step evaluation model for evaluating library services using criteria based on community needs. The evaluation modal does not concern itself with direct measures of library processes but with examining the end product of those library processes in the form of services offered to the library's community. The model is intended to reveal discrepancies between community needs and library outputs and provide planning steps which will assist the professionally competent librarian to match library outputs to community needs. The final step in the evaluation model is intended to provide data on library effectiveness in meeting community needs. For the purposes of this study "library community" is defined as the target population for a particular library, encompassing non-users as well as actual users. Every library is intended to provide services to a specific community unique to itself. The model is presented as a general model, with implementation guidelines and checklists, as a basis for developing an evaluation plan for the specific situation of each individual library. A pilot study based on the evaluation model is described. The pilot study consisted of an evaluation of the Audiovisual Services section of the Australian National University Library and was conducted over an eighteen month period. The pilot study demonstrated the effectiveness of the evaluation model as a planning tool for matching library services to community needs.

<p>The purpose of an audit is to improve the performance of a company. By analyzing its current performance parameters the needs can be diagnosed as well as new opportunities and challenges. Different theories on organizational management will be discussed as well as current used audit methodologies seen from a marketing perspective. An explicit aim is to find the links between performance parameters and the appropriate tools in meeting the founded needs. A case study, using the described methodology, is analyzed to give a practical example.</p><p>The method was mainly “learning by doing”, the case study foremost. As the tools which each management consultant use in detail is not published, starting out by what is described in literature made a first practical iterative step in the process. The authors own development in creating this tool has foremost been to integrate the two (the Balanced Scorecard and Three levels of performance). They complement each other well as the later makes it possible to obtain a structural approach (as is highly convenient in large organizations), the former has a clear and consistent parameter coupling between cause and effect in business processes.</p>

The purpose of this study was to improve instructional system design at Small Business Development Centers by developing a best practice model for assessing client training needs. Two research questions were addressed: 1. Is self-directed learning an appropriate framework for instructional system design at Small Business Development Centers? 2. What are the components of a self-directed learning-based model for assessing the training needs of Small Business Development Center clients in Small Business Management programs? The theoretical framework that guided the research was constructivism. METHODS: Data collection included: 1) reviews of self-directed learning, instructional system design, needs assessment and Small Business Development Center literature; 2) preliminary interviews of Small Business Development Centers clients and instructors and university professors; 3) facilitation of a Delphi Method (using email); and 4) final interviews of the Delphi panelists. Analysis included qualitative and quantitative techniques. Findings included the compatibility of self-directed learning with Small Business Development Center educational practices and Delphi panel consensus on 34 training needs assessment items. CONCLUSIONS AND RECOMMENDATIONS: The conclusions were: 1. Self-directed learning is an appropriate framework for instructional system design at Small Business Development Centers. 2. Knowles' Andragogical Process Model is an appropriate foundation upon which to design instructional systems for Small Business Development Centers. 3. A self-directed learning-based training needs assessment model that incorporates the components of Knowles' Andragogical Process Model serves the needs of clients enrolled in the Small Business Management program at Small Business Development Centers. 4. Self-directed learning-based instructional systems for graduate programs in business and adult education will prepare personnel qualified to improve Small Business Development Center and other adult education programs. A model for assessing client training needs at Small Business Development Centers was developed from this study. The model illustrates the integration of self-directed learning with instructional design in Small Business Management programs. Recommendations were made for program development and further research. Self-directed learning-based instructional designs were recommended for Small Business Development Center and adult education program developers. Research is needed to test the model and to conduct action research that includes Small Business Development Center instructors and clients and university professors. / Graduation date: 1997

Thesis (M.A. (Tourism))--North-West University, Potchefstroom Campus, 2007.

The purpose of an audit is to improve the performance of a company. By analyzing its current performance parameters the needs can be diagnosed as well as new opportunities and challenges. Different theories on organizational management will be discussed as well as current used audit methodologies seen from a marketing perspective. An explicit aim is to find the links between performance parameters and the appropriate tools in meeting the founded needs. A case study, using the described methodology, is analyzed to give a practical example. The method was mainly “learning by doing”, the case study foremost. As the tools which each management consultant use in detail is not published, starting out by what is described in literature made a first practical iterative step in the process. The authors own development in creating this tool has foremost been to integrate the two (the Balanced Scorecard and Three levels of performance). They complement each other well as the later makes it possible to obtain a structural approach (as is highly convenient in large organizations), the former has a clear and consistent parameter coupling between cause and effect in business processes.

Canadian cancer clinics are straining to keep up with growing numbers of patients and, as a result, the capacity to provide follow-up care to cancer patients is being stretched. The Saskatchewan Cancer Agency has structured its community follow-up program to ensure the routine follow-up of patients who have finished active cancer treatments. Follow-up letters are routinely sent to family physicians and some specialists requesting information on the disease status of their cancer patients. For this thesis, I conducted a mail survey of 925 Saskatchewan physicians serving 21,000 patients to learn about general practitioners' and specialists' views of the follow-up program. A 52.5% response rate was achieved. <p>The program was considered useful for 91.5% of physicians, with the follow-up letter serving an important role in reminding physicians to see their cancer patients for follow-up. High percentages of physicians indicated a need for additional patient-specific information (59.3%), clinical information (73.0%) and training (34.9%) to do follow-up. Logistic regression analyses found female gender, a specialty in general practice and lower physician confidence in following cancer to be associated with the need for additional patient information. Lower physician confidence was associated with the need for additional clinical information and a specialty in general practice and lower physician confidence were associated with the need for more training.<p>Percentages of physicians saying they were very confident in following various cancers ranged widely from 19.1% for lymphomas to 54.2% for breast cancer. All regression models regarding physician confidence in following six different cancers had a common correlate: the need for additional training. A physician�s number of follow-up patients was a significant correlate in four of the six regression models and physician specialty was included in half of the models.<p> The results suggest areas of the program and physician need that should be addressed to ensure the delivery of quality follow-up care and the survey findings will be helpful in devising strategies to this end. At the same time, responses indicate the program to be an essential component in the delivery of community-based follow-up care in Saskatchewan.

I vårt examensarbete har vi valt att undersöka hur lärare i idrott och hälsa arbetar för att inkludera elever med funktionsnedsättning. Teoretiska studier och kvalitativa intervjuer av lärare i idrott och hälsa, är det vi använt oss av för att undersöka hur lärare arbetar med elever i behov av särskilt stöd. Vi har lyft begreppen inkludering och funktionsnedsättning för att lyfta fram en definition, som arbetet sedan har utgått ifrån. Vi har valt att belysa specialpedagogik, idrottslärarens kompetens, bemötande, skolans anda, organisation, miljön och materialets inverkan på lärarens möjligheter att inkludera elever med funktionsnedsättning. Vi redovisar resultatet av intervjuerna och gör sen en analys utifrån resultatet och ställer detta mot litteraturen. I slutet av arbetet förs en slutdiskussion där vi lyfter en del tankar om det vi har kommit fram till, bland annat angående inkluderingsbegreppets betydelse samt hur idrottslärarens kompetens för att möta elever i behov av särskilt stöd påverkar graden av inkludering av dessa elever.

Bone marrow transplantation (BMT) is the treatment of choice for many malignancies and other childhood disorders. Acknowledging that the entire family is affected when a child undergoes a BMT, increasing research attention has been given to understanding this experience from the perspectives of recipients, parents and the family as a whole. Yet, minimal attention has been directed at understanding the experience of healthy siblings as they transition through the BMT experience. Before intervention studies can be undertaken that will help healthy siblings transition through the BMT experience, knowledge about the impact of the experience on siblings is needed. Accordingly, a qualitative study guided by the philosophy of hermeneutic phenomenology was conducted to elicit detailed descriptions of the lived experience of siblings. Participants were children, adolescents and young adults with a sibling who had undergone a BMT during childhood. Participants were recruited from a pediatric BMT clinic in Western Canada. Semi-structured, open-ended interviews that explored siblings’ memories about what it is like to be a sibling of a child who has had a BMT were conducted with each participant. Demographic data and field notes were recorded. All interviews and field notes were transcribed. The transcripts were reviewed repeatedly for significant statements in an attempt to find meaning and understanding through themes. The data analysis revealed the essence of siblings’ lived experience of transitioning through the BMT trajectory as an interruption in family life. Four themes communicated the essence of siblings’ lived experience: (1) life goes on, (2) feeling more or less a part of a family, (3) faith in God that things will be okay, and (4) feelings around families. Differences between donor and non-donor siblings are highlighted. Siblings’ recommendations for health care professionals are also provided. Results from this study will help health professionals better anticipate the diverse and shifting needs and demands of siblings of pediatric BMT patients. Recommendations for future research and innovations in nursing interventions are provided. / October 2005