Gauti rezultatai parodė, kad slaugomų sunkai sergančių asmenų ir jų artimųjų gyvenimo kokybė pasižymi tam tikromis ypatybėmis, tačiau slaugymo procesas, kaip veikla, nėra pagrindinis veiksnys, keičiantis gyvenimo kokybę. / Quality of live is individual evaluation of the status of very persons based on the ground of system of culture influenced by physical, psychological health, level of its independence and by communication between the persons and environment.

Due to the profound impact that aphasia has on both the person with aphasia and their close family members, aphasia is a family problem. Aphasia is a communication disorder, most commonly caused by stroke. It is associated with impairments in spoken language, understanding, reading, and writing that impact upon daily activities, participation in society, and the quality of life of those with the condition and their family members. However, family-centred rehabilitation programs, policy, and funding are not well established. In the International Classification of Functioning, Disability and Health (ICF), the World Health Organization introduced the term “third-party disability” and identified the need for further investigation into family members’ functioning and disability in relation to a significant other’s health condition. In this thesis, the term “third-party functioning” is used to describe positive and/or neutral changes to a family member’s functioning as a consequence of a significant other’s health condition; “third-party disability” describes negative changes. The overall aims of this thesis are to: i) describe third-party functioning and disability in family members of people with aphasia post-stroke, and ii) develop the Significant other Scale for family members of people with Aphasia (SOS-Aphasia), a scale for measuring third-party functioning and third-party disability in this population. Two systematic reviews were conducted to provide a summary of the current literature related to family members’ third-party functioning and third-party disability secondary to aphasia. Positive/neutral and negative findings were extracted from included articles, then synthesized and mapped to the ICF. These reviews showed that family members experienced third-party functioning and third-party disability secondary to aphasia in the Body Functions and Activities and Participation components of the ICF, in addition to the development and exacerbation of health conditions. The results laid the groundwork for the qualitative-quantitative sequential mixed methods study that followed. In the first phase of the study, qualitative methods were used to explore the positive and negative effects of aphasia on family members, thus expanding and confirming our existing understanding of third-party functioning and third-party vii  disability. Twenty family members participated in individual in-depth semi-structured interviews, which were analysed using qualitative content analysis with research codes subsequently mapped to the ICF. The results revealed five categories of positive/neutral aphasia-related changes, including: (1) emotions (e.g., focusing on the positive); (2) communication (e.g., talking to the person with aphasia more); (3) relationships (e.g., making new friends); (4) recreational activities and social life (e.g., taking up new hobbies); and (5) paid/volunteer work or education (e.g., volunteering to help people with aphasia). In addition, seven categories that described the negative effects of aphasia on family members were revealed: (1) physical, mental, and emotional health (e.g., tired); (2) communication (e.g., difficulty communicating with the person with aphasia); (3) relationships (e.g., lack of physical intimacy between spouses); (4) recreational activities and social life (e.g., restricted social activities); (5) paid/volunteer work or education (e.g., took extended time off work); (6) domestic and caregiving responsibilities (e.g., transporting the person with aphasia places); and (7) finances (e.g., loss of person with aphasia’s income). Research codes were mapped to two domains within the Body Functions component (i.e., Mental functions and Functions of the digestive, metabolic and endocrine systems) and eight domains within Activities and Participation components of the ICF (i.e., Learning and applying knowledge, General tasks and demands, Communication, Self-care, Domestic life, Interpersonal interactions and relationships, Major life areas, and Community, social and civic life). Health conditions (e.g., depression and anxiety) associated with the aphasia of a significant other were also identified in family members. Mapping of the qualitative research codes to the ICF demonstrated how the ICF framework could be applied to family members. The second phase of the study involved the development and validation of the SOS-Aphasia. The SOS-Aphasia items were derived from the constructs of third- party functioning and third-party disability identified in the qualitative study and the response scale format was based on the ICF. Following the development of the SOS- Aphasia, 104 family members completed the original 34-item version. Factor analysis and Rasch analysis were used to examine the underlying structure and internal construct validity of the SOS-Aphasia. Test-retest reliability and feasibility were also investigated. Based on the analysis, five SOS-Aphasia subscales were identified and viii 10 items marked for deletion. The revised 24-item SOS-Aphasia demonstrated preliminary evidence of good psychometric properties. In summary, this series of studies demonstrates that family members experience third-party functioning and third-party disability, as well as changes to their health, secondary to a significant other’s aphasia. In addition, the SOS-Aphasia shows validity and reliability in measuring third-party functioning and third-party disability. Together, these findings provide the motivation for the inclusion of family members of people with aphasia in a family-centred care model with implications for research, practice, and policy.

No description available.

Since the introduction of the deinstitutionalisation policy in 1997 in South Africa, many families have agreed or have felt forced to take full responsibility of the care of their mentally ill family members. This impacted the lives of families because they were not well prepared for caring for their mentally ill family members. As a result of this, families were burdened, mentally ill family members defaulted treatment and ultimately revolving door admissions occurred. In spite of these concerns, some families do seem to cope with supporting their mentally ill family members. This makes it vital to explore and describe the strengths of families who take care of mentally ill family members in Potchefstroom, in the North West Province in order to formulate guidelines to support these families. A qualitative, explorative, descriptive and contextual design was employed to understand what strengths families have to support their mentally ill family members. Purposive sampling was used to select potential participants. Unstructured individual interviews with an open-ended question were conducted with nine participants after ethical approval was granted under the RISE study (Strengthening the Resilience of Health Caregivers and Risk Groups), and the permission of the North-West Provincial Department of Health, the psychiatric hospital where the data was collected and the family members of the mentally ill family members were obtained. Data were audio-recorded and transcribed verbatim. A consensus meeting was held between the researcher and the co-coder after they had analysed data independently to identify themes that emerged from the data. Twelve themes emerged from the data namely the strengths of getting the necessary treatment for the mentally ill family member, utilizing external resources, spirituality or faith, social support, supervising the mentally ill family member, finding ways to calm the mentally ill family member, explaining the importance of treatment to the mentally ill family member, finding ways to keep the mentally ill family member busy, trying to keep the mentally ill family member away from negative outside influences, trying creative ways to communicate with or understand the mentally ill family member, giving the mentally ill family member praise for doing something good or right and accepting the situation. From the findings, it is clear that the families do have strengths to support their mentally ill family members, although they seem to rely more on external than on internal strengths. From the findings, literature and conclusions of this study, recommendations were made for nursing practice, nursing research and nursing education, including guidelines to support families in their support of a mentally ill family member. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

Since the introduction of the deinstitutionalisation policy in 1997 in South Africa, many families have agreed or have felt forced to take full responsibility of the care of their mentally ill family members. This impacted the lives of families because they were not well prepared for caring for their mentally ill family members. As a result of this, families were burdened, mentally ill family members defaulted treatment and ultimately revolving door admissions occurred. In spite of these concerns, some families do seem to cope with supporting their mentally ill family members. This makes it vital to explore and describe the strengths of families who take care of mentally ill family members in Potchefstroom, in the North West Province in order to formulate guidelines to support these families. A qualitative, explorative, descriptive and contextual design was employed to understand what strengths families have to support their mentally ill family members. Purposive sampling was used to select potential participants. Unstructured individual interviews with an open-ended question were conducted with nine participants after ethical approval was granted under the RISE study (Strengthening the Resilience of Health Caregivers and Risk Groups), and the permission of the North-West Provincial Department of Health, the psychiatric hospital where the data was collected and the family members of the mentally ill family members were obtained. Data were audio-recorded and transcribed verbatim. A consensus meeting was held between the researcher and the co-coder after they had analysed data independently to identify themes that emerged from the data. Twelve themes emerged from the data namely the strengths of getting the necessary treatment for the mentally ill family member, utilizing external resources, spirituality or faith, social support, supervising the mentally ill family member, finding ways to calm the mentally ill family member, explaining the importance of treatment to the mentally ill family member, finding ways to keep the mentally ill family member busy, trying to keep the mentally ill family member away from negative outside influences, trying creative ways to communicate with or understand the mentally ill family member, giving the mentally ill family member praise for doing something good or right and accepting the situation. From the findings, it is clear that the families do have strengths to support their mentally ill family members, although they seem to rely more on external than on internal strengths. From the findings, literature and conclusions of this study, recommendations were made for nursing practice, nursing research and nursing education, including guidelines to support families in their support of a mentally ill family member. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

Närstående betraktas tillsammans med patienten att vara experter i patienternas livsomständigheter. Ett gott samarbete mellan psykiatrisjuksköterskan och närstående kan innebära flera fördelar för patienters mående. För att uppnå förbättrad samarbete med närstående är det av betydelse att få ta del av psykiatrisjuksköterskors erfarenheter av samarbete med närstående. Syfte: Syftet med pilotstudien var att belysa psykiatrisjuksköterskors erfarenheter av samarbete med närstående i psykiatrisk vård. Metod: Studien har en kvalitativ ansats. Data baseras på fyra intervjuer med psykiatrisjuksköterskor utifrån öppna frågor. Data har analyserats med kvalitativ innehållsanalys. Resultat: Studien resulterade i kategorierna: Möjligheter till samarbete, Ett väl fungerande samarbete och Utmaning till samarbete. Konklusion: Psykiatrisjuksköterskorna hade intresse för samarbete med närstående i psykiatrisk vård. Samarbete sågs som positivt i patientarbetet men var inte alltid möjligt att praktisera. Samarbete upplevdes underlätta patientarbetet och leda till förbättrad relation mellan närstående och patienten. Det fanns flera svårigheter som utgjordes som hinder till samarbete. För kvalitétsbättring krävs att verksamheten ger stöd i kompetenshöjning och har ett förhållningssätt som är riktad till samarbete med närstående. Resultatet kan ha betydelse i förbättringssyfte för att utveckla ett fungerande samarbete med närstående till patienter i den psykiatriska vården. / Family members and next of kin are a central and natural partner who, together with the patient, constitutes the most important experts in their life circumstances. Collaboration with family members may include prevention of illness, acceleration of recovery, shorter care time and fewer incisions for the relative with mental illness. Only a few studies describe the professionals´ perspective on collaboration with family members. Aim: The aim of the pilot study was to describe the psychiatric nurse's experiences of collaboration with family members in psychiatric care. Method: The study has a qualitative approach and data was based on four interviews with psychiatric nurses based on open questions. Data has been analyzed with qualitative content analysis. Result: The study resulted in the categories: Opportunities for collaboration, Experiences of working collaboration and Experiences of challenge for collaboration. Conclusion: Psychiatric nurses had an interest in collaboration with family members in psychiatric care. Collaboration was considered positive in patient work but was not always possible to practice. Collaboration was found to facilitate patient work and lead to improved relationships between family members and patient. There were several difficulties that constituted interference to collaboration. It requires that the psychiatric care unit provide support in raising competence and has an attitude aimed at collaboration with family members for quality improvement. The result may be important for improvement purposes in order to develop effective collaborative relationships with family members in psychiatric care.

Introdução: Os transtornos mentais, além de seus sinais e sintomas, por possuírem uma história de preconceito e descrédito, ainda hoje geram tanto nos doentes quanto nos que os cercam, dificuldades que interferem no seu cotidiano. Com o advento da Reforma Psiquiátrica, novos modelos de atenção foram criados estimulando a reinserção do doente na família e na sociedade. O CAPS surge então como um serviço que acolhe indivíduos com transtornos mentais, oferecendo atendimento terapêutico individual e em grupo, consulta médica e outras atividades. Os projetos terapêuticos individuais são voltados para o tratamento e para a reabilitação psicossocial, com iniciativas que incluem a família. Esperando contribuir para a atenção implementada pelos profissionais do serviço com elementos que possam orientar as intervenções, buscando maior eficácia e adesão aos tratamentos, este estudo teve por Objetivo caracterizar o perfil da população atendida no CAPS e as suas percepções da doença, tratamento e implicações psicossociais além de compreender como encaram sua convivência com a doença mental. Metodologia: Optou-se pela pesquisa descritiva, através da qual os dados foram coletados, analisados, classificados e interpretados. Foram entrevistados 65 pacientes e 53 familiares de pacientes em tratamento no CAPS de Pindamonhangaba, nos meses de setembro e outubro de 2008. Os instrumentos utilizados foram dois questionários com perguntas fechadas elaborados um para o paciente e outro para a família. A cada entrevistado eram explicados os objetivos da pesquisa, a forma como ela participaria do estudo, bem como o uso das informações por ela cedidas. Os dados coletados foram tabulados e os resultados foram submetidos à análise estatística comparando-se as posições dos usuários e de seus familiares frente ao cuidado relacionado aos aspectos clínicos, demográficos e do ambiente. Foram aplicados os Testes do Qui-quadrado (x2) e o de Fisher. A discussão teve por base a literatura sobre o tema. Dos pacientes, 80% tinham entre 31 e 60 anos e dos familiares, 75% apresentaram idade superior a 46 anos. Dois grupos de diagnóstico se destacaram: os esquizofrênicos e os portadores de transtorno bipolar. Um terço dos pacientes não souberam informar o próprio diagnóstico. Os familiares são constituídos em sua maioria por pais e irmãos de pacientes. Apesar de apresentarem bom nível escolar apenas 4 trabalham o que representa uma frustração para o paciente. Menos de um terço dos familiares trabalham e, mesmo assim, somente a metade participa de atividades do CAPS, especialmente reuniões de família e consultas médicas. As oficinas terapêuticas além de ajudar o paciente no processo de ressocialização e conhecimento da própria doença, servem para estabelecer vínculos e parcerias entre equipe, usuários e familiares. Mesmo a família considerando grande sua sobrecarga, sente-se otimista com relação ao futuro e satisfeita com a vida. O paciente mesmo tendo consciência de que a doença transformou seu cotidiano, também se sente otimista e satisfeito com a vida. Conclusões: Os transtornos mentais geram dificuldades nas relações pessoais e sociais, entretanto, observa-se nestas pessoas uma capacidade especial para enfrentar as adversidades, ser transformados por elas, e superá-las. / Introduction: Mental diseases, due to its symptoms, have a long history of prejudice and disbelief, and even today it brings difficulties to patients and people around them, interfering in their everyday life. With The Psychiatrist Reform, new approaches were created to stimulate the re-insertion of the patient into his family and society. So CAPS (a psychosocial care center) surges as a service that gathers individuals with mental diseases, offering them group and individual therapy assistance, medical help and etc. The individual therapeutic projects are about psychosocial treatment and rehabilitation, and it includes their family members. Hoping to contribute to this areas professionals with elements that may direct their interventions, and then result in a higher efficacy and acceptance to treatments, this study had the Objective of tracing the profile of people helped by CAPS and its psychosocial implications, treatment and perception of the disease, and also obtain an understanding of how they face and handle with their mental disease. Methodology Descriptive research was chosen, and so through this method data was collected, analyzed, classified and interpreted. 65 patients and 53 patients relatives being treated at CAPS in Pindamonhangaba were interviewed, during the months of September and October in 2008. Two questionnaires with closed questions were used as instruments for the research, being one formulated for the family and the other for the patient. For each interviewed person, the objective and the way the research would participate into the study was explained, as well as the use of the information obtained by it. The collected data was tabulated and the results were submitted to statistical analysis, observing the patients position and their relatives about clinical, environmental and demographic care. Fischer and chi-squared tests were applied, and the discussion had the literature of the theme as its basis. 80% of the patients were between 31 and 60 years old, and about the family members, 75% were older than 46 years old. Two groups were outlined: schizophrenic and bipolar. One third of the patients couldnt tell about their own diagnosis. The family members are mostly made of patients parents and siblings. Although they had good educational level, only four of them work, which is frustrating for them. Less than one third of the family members work, but only half participate in CAPS activities, especially family reunions and medical appointments. Therapeutic workshops not only help patients to get to know their illness and in their rehabilitation process but also make bonds and partnerships among the staff, patients and family members. Although the family feels the difficulties, looks at future in an optimistic way and is satisfied with life. Moreover patients are conscious about the big changes the disease brought into their lives; they also feel optimistic and satisfied. Conclusions: Mental diseases bring difficulties in social and individuals relationships. However, we could see in these people an extraordinary ability of facing and overcoming their adversities.

The objective of this thesis is to analyse the issues related to the legal status of family members of European Union citizens in light of European Union law, and to compare the rights of family members of EU citizens with the rights of the other third country nationals (further referred to as TCNs) and the EU citizens themselves. The first chapter deals with the institute of EU citizenship and especially stresses the importance of the right of EU citizens and their family members to move and reside freely within the territory of Member States which is connected with the status of an EU citizen. The second chapter is related to the different definitions of family members in EU secondary legislation. The third chapter examines in detail specific rights (e.g.: the right of entry and residence to the territory of the host Member State, protection against expulsion) which are connected with the status of the family member of EU citizens on the one hand and the status of the TCNs on the other hand. The thesis attempts to answer to the questions related to the legal status of family members and tries to suggest possible future adjustments of EU legislature.

Magister Artium (Social Work) - MA(SW) / The phenomenon juvenile delinquency is an enormous concern for communities in the ZFM district, Northern Cape, South Africa. Juvenile offences have increased since 2010 in this area. From existing theories, it is clear that the causes of this phenomenon are complex and interrelated. Some of these contributing factors are rooted in the character of the delinquent and his or her family. Other factors are peer, community or economic related. Against this background, it is clear that each community/area should be individually assessed concerning its contributing factors as these factors can differ from community to community, individual to individual and family to family. Thus, the research question: What are the psychosocial contributing factors of juvenile delinquency in the ZFM district, Northern Cape, South Africa? The research goal of this study was to determine the psychosocial factors contributing to juvenile delinquency in the ZFM region in the Northern Cape, South Africa. The objectives to arrive to the aim were to explore and describe the psychosocial factors contributing to juvenile delinquency in the ZFM region in the Northern Cape, South Africa and to make recommendations for interventions through probation services by probation officers and the Department of Social Development in the Northern Cape, South Africa. A qualitative approach was used, with an exploratory, descriptive design. Non- probability; purposive sampling was used to select probation officers from the Department of Social Development in the ZFM district in the Northern Cape. These Probation officers have each identified a parent of a juvenile in their caseloads. Because both parents of delinquents and probation officer’s perceptions are shaped by their own context, social constructivism was used as theoretical framework. Data was collected by semi-structured interviews with a checklist. The spiral for data analysis was used to analyse data, which was then clustered in themes, sub- themes and categories. Probation officers, participants identified a range of familial and community contributing factors to juvenile delinquency, and emphasises the interplay between these factors. Their also stressed the issue of parental control and guidance. Participants further indicated that harsh and ineffective parental discipline, lack of parental involvement, family conflict, child abuse and/or neglect and rejection by parents have also been identified as important factors related to delinquent behaviour. Another finding was that single parents, especially single mothers and the lack of a father figure are a great risk factor for juvenile delinquency. Parents also stressed the issue of their lack of control due to peer dependence and the juvenile’s involvement in alcohol and drugs. Probation officers also stressed the lack of parental involvement, continuous communication & parental guidance as some of the important contributing factors of delinquent behaviour amongst children. Parents also indicated a general lack of close relationship amongst family members, as well as emotional insecurity, and the inability to control their children. Both parents and probation officers agreed that peer pressure is a mayor risk factor concerning juvenile delinquency.

No description available.