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Gaps, traps, bridges and props: a mixed-methods study of resilience in the medicines management system for heart failure patients at hospital dischargeFylan, Beth, Marques, Iuri, Ismail, Hanif, Breen, Liz, Gardner, Peter, Armitage, Gerry R., Blenkinsopp, Alison 2018 October 1924 (has links)
Yes / Poor medicines management places patients at risk, particularly during care transitions. For
patients with heart failure (HF), optimal medicines management is crucial to control
symptoms and prevent hospital readmission. This study explored the concept of resilience
using HF as an example condition to understand how the system compensates for known
and unknown weaknesses.
We explored resilience using a mixed-methods approach in four healthcare economies in the
north of England. Data from hospital site observations, healthcare staff and patient
interviews, and documentary analysis were collected between June 2016 and March 2017.
Data were synthesised and analysed using framework analysis.
Interviews were conducted with 45 healthcare professionals, with 20 patients at three timepoints
and 189 hours of observation were undertaken. We identified four primary inter-related themes concerning organisational resilience. These were named as gaps, traps,
bridges and props. Gaps were discontinuities in processes that had the potential to result in
poorly optimised medicines. Traps were features of the system that could produce errors or
unintended adverse medication events. ‘Bridges’ were features of the medicines
management system that promoted safety and continuity which ensured that, despite
varying conditions, care could be delivered successfully. ‘Props’ were informal, temporary or
impromptu actions taken by patients or healthcare staff to avoid potential adverse events.
The numerous opportunities for HF patient safety to be compromised and sub-optimal
medicines management during this common care transition are mitigated by system
resilience. Cross-organisational bridges and temporary fixes or ‘props’ put in place by
patients and carers, healthcare teams and organisations are critical for safe and optimal care
to be delivered in the face of continued system pressures.
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Seizing the Circumstances: Adult Reflections on Parental DeportationTaschman, Katrina Margarita 20 June 2018 (has links)
Currently there are 4.5 million U.S.-born children with at least one undocumented parent who are at risk of being deported (Passel and Cohn, 2011). The sudden loss caused by parental deportation destabilizes families and causes emotional distress, conduct issues, and academic decline in children (Dreby, 2012). Given the negative impact that deportation has on children and the recent increase of immigration efforts under the current administration (Cervantes, Ullrich, and Matthews, 2018), this study aimed to explore the long-term impacts of deportation on Latino children. This study used an interpretive phenomenological approach and retrospective interviews to gain understanding of how adults who experienced parental deportation as children made meaning of their experiences over time. Ten Latino adults who had a parent deported when they were between the ages of 7 and 17 were interviewed in depth about their parent's deportation, the long-term impact on their families and childhood, and how they made sense of those experiences as adults. Findings suggest that adults who have had a parent deported during childhood experienced long-term loss throughout their childhood, noticed their parent's absence more as they got older, and felt a lack of guidance while growing up. While some participants reported depression, anxiety or misconduct in childhood, positive beliefs about the experience emerged from the data that demonstrated resiliency. Implications for clinical practice and intervention are discussed. Researchers also make recommendations for future research. / Master of Science / Currently there are 4.5 million U.S.-born children with at least one undocumented parent who are at risk of being deported back to their country of origin (Passel & Cohn, 2011). The sudden loss caused by parental deportation destabilizes families and causes emotional distress, conduct issues, and academic decline in children (Dreby, 2012). Given the negative impact that deportation has on children and the recent increase of immigration efforts under the current administration (Cervantes, Ullrich, & Matthews, 2018), this study aimed to explore the long-term impacts of deportation on Latino children. Ten Latino adults who had a parent deported when they were between the ages of 7 and 17 were interviewed in depth about their parent’s deportation, the long-term impact on their families and childhood, and how they made sense of those experiences as adults. Adults in the study experienced long-term loss throughout their childhood, noticed their parent’s absence more as they got older, and felt a lack of guidance while growing up. Participants who were misinformed about what happened to their parents reported having more difficulty coping with the situation. While some participants reported depression, anxiety or misconduct in childhood, many developed beliefs about the experience that helped them find meaning and move forward after the loss. The findings of this study contribute to current literature by focusing on the long-term impact of parental deportation and the impact of family dynamics on children’s perceptions.
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Building Spiritual Capital: The Effects of Kundalini Yoga on Adolescent Stress, Emotional Affect, and ResilienceSarkissian, Meliné 18 March 2016 (has links) (PDF)
In order to integrate a mind, body, spirit approach in school settings, yoga programming such as Y.O.G.A. for Youth was introduced to one public and two charter schools in Los Angeles area urban neighborhoods. The study examined the effectiveness of the overall program and its effect on adolescent stress, emotional affect, and resilience. A survey was administered to measure the three dependent variables and informal interviews were conducted to determine the overall effectiveness of the program. The results of the mixed method approach indicated that the overall program was effective in creating a general sense of well-being and statistically significant in alleviating stress (p < .05), increasing positive affect (p < .05), and resilience (p < .001), in the participants (N=30).
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Using the resilience assessment approach to evaluate social-ecological systems at the North-West University (Vaal Campus) / Irene MullerMuller, Irene January 2015 (has links)
This research reports on the use of the resilience assessment approach to evaluate the social-ecological systems (SES) at the NWU (Vaal) for a nine month period from March 2013 to November 2013. The research aims to determine the merits of the use of a resilience assessment approach to determine the resilience of the NWU (Vaal) in respect of social-ecological systems.
Objectives of the research include the identification of disturbing events to environmental resilience, to construct a conceptual social-ecological systems model of the NWU (Vaal) in order to determine thresholds relevant to resilience and to determine if the resilience assessment approach can be applied at the NWU (Vaal).
Data was collected in the form of a literature review, which aided with the construction of a time line for the focal social-ecological system; document reviews, interviews with relevant role players, observation by the researcher and the use of the assessment approach to construct the social-ecological system model.
The research findings include identification of possible disturbances and thresholds relevant to resilience of the social-ecological system of the NWU (Vaal). The construction of a social-ecological system model of the NWU (Vaal) aids with proposals to incorporate a stewardship approach which enhance resilience of the focal social-ecological system. / M (Environmental Management), North-West University, Potchefstroom Campus, 2015
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Using the resilience assessment approach to evaluate social-ecological systems at the North-West University (Vaal Campus) / Irene MullerMuller, Irene January 2015 (has links)
This research reports on the use of the resilience assessment approach to evaluate the social-ecological systems (SES) at the NWU (Vaal) for a nine month period from March 2013 to November 2013. The research aims to determine the merits of the use of a resilience assessment approach to determine the resilience of the NWU (Vaal) in respect of social-ecological systems.
Objectives of the research include the identification of disturbing events to environmental resilience, to construct a conceptual social-ecological systems model of the NWU (Vaal) in order to determine thresholds relevant to resilience and to determine if the resilience assessment approach can be applied at the NWU (Vaal).
Data was collected in the form of a literature review, which aided with the construction of a time line for the focal social-ecological system; document reviews, interviews with relevant role players, observation by the researcher and the use of the assessment approach to construct the social-ecological system model.
The research findings include identification of possible disturbances and thresholds relevant to resilience of the social-ecological system of the NWU (Vaal). The construction of a social-ecological system model of the NWU (Vaal) aids with proposals to incorporate a stewardship approach which enhance resilience of the focal social-ecological system. / M (Environmental Management), North-West University, Potchefstroom Campus, 2015
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The development and assessment of a family resilience-enhancement programmeHoltzkamp, Joanita 12 1900 (has links)
Thesis (DPhil (Psychology))--University of Stelenbosch, 2010. / ENGLISH ABSTRACT: A probe into resilience research has revealed that psychologists have taken on the
role of “keepers of the crypt”, where our attained knowledge has been “entombed” by
virtue of our reluctance to allow it to bear practical fruition. Consequently, the impetus
of the research is a response to the aforementioned gap and is explicated in four
phases: Phase 1: A detailed literature review consisting of the review and integration
of appropriate preceding resilience research, thereby serving as a possible reference
guide for future studies; Phase 2: Provision of a succinct, comprehensive framework
for programme development within the field of psychology; Phase 3: Family
hardiness was selected as the resilience quality to be attended to via the
development of a universal, multidimensional resilience-enhancement programme;
Phase 4: An assessment of whether the resilience-enhancement programme is
successful in developing the selected resilience quality in families. Following the
salutogenic approach, the main theoretical foundation of the investigation resides in
the Resiliency Model of Stress, Adjustment and Adaptation (McCubbin & Thompson,
1991). The significant contribution of the research is its provision of a framework for
programme development within the field of psychology. Self-report questionnaires
and open-ended questions were completed by mothers as representatives of their
families. Therefore, the research amalgamated both qualitative and quantitative
measures in its quasi-experimental, pretest-posttest natural control-group research
design. A total of fifty families living in the Western Cape, South Africa participated in
the research. The statistical trends observed in the study hinted at the enhancement
potential of family hardiness. It became evident that gender, level of education,
income and occupation, emotional intelligence and the time frame of interventions
affected the enhancement potential of family hardiness. Age may also play a role, but
the conflicting research results render conclusions about the correlation between age
and hardiness questionable. Comparative studies would clarify this aspect. Future
studies attempting to develop these findings further, need to consider the influence of
factors such as gender, level of education, income and occupation, emotional
intelligence and the time frame of interventions. Family hardiness is but one of the
identified resilience qualities. An exploration of the enhancement potential of other
identified resilience qualities will provide a plethora of interventions for service
providers to choose from, enabling them to meet families and communities at their
point of need. / AFRIKAANSE OPSOMMING: Nadere ondersoek van veerkragtigheidsnavorsing het aangedui dat sielkundiges die
rol van “bewaarders” aangeneem het, waar ons versamelde kennis verberg word as
gevolg van ons onwilligheid om dit prakties toe te pas. Gevolglik is hierdie navorsing
gedoen in respons op bogenoemde gaping in die navorsing, en word dit in vier fases
gelewer: Fase 1: ’n literatuuroorsig wat die voorafgaande veerkragtigheidsnavorsing
integreer en hersien ten einde as verwysingsgids te dien vir toekomstige studies;
Fase 2: Die voorsiening van ‘n omvattende raamwerk vir programontwikkeling binne
die veld van die sielkunde; Fase 3: Gesinsgehardheid is gekies as die
veerkragtigheidsfaktor om deur middel van ’n universele, multidimensionele program
verryk te word; Fase 4: ‘n Bepaling om te ontdek of die
veerkragtigheidsverrykingsprogram suksesvol is om die geselekteerde
veerkragtigheidsfaktor in families te verryk. Die studie is gedoen vanuit die
salutogeniese benadering. McCubbin en Thompson (1991) se “Resiliency Model of
Family Stress, Adjustment and Adaptation” is as teoretiese basis benut. Die
navorsing se betekenisvolle bydrae lê in die voorsiening van ‘n raamwerk vir
programontwikkeling binne die veld van sielkunde. Selfbeskrywingsvraelyste en oop
vrae is deur moeders as verteenwoordigers van hulle gesinne voltooi. Die navorsing
het dus van beide kwalitatiewe en kwantitatiewe metings gebruik gemaak in die
kwasi-eksperimentele voortoets-natoets, natuurlike kontrolegroep
navorsingsontwerp. ’n Totaal van vyftig families wat in die Wes-Kaap van Suid Afrika
woonagtig is, het aan die navorsing deelgeneem. Die statistiese neigings wat in die
navorsing waargeneem is, sinspeel op die verrykingspotensiaal van
gesinsgehardheid. Dit het aan die lig gekom dat geslag, opvoedkundige vlak,
inkomste en beroep, emosionele intelligensie en die tydsduur van intervensies die
verrykingspotensiaal van gesinsgehardheid beïnvloed. Ouderdom kan ook ‘n invloed
hê, maar die teenstrydige navorsingsresultate in dié verband maak gevolgtrekkings
oor die korrelasie tussen ouderdom en gesinsgehardheid twyfelagtig. Vergelykende
studies sal die bogenoemde kan uitklaar. Toekomstige studies wat poog om die
bevindinge van hierdie navorsing verder te ontwikkel, moet die invloed van faktore
soos geslag, opvoedkundige vlak, inkomste en beroep, emosionele intelligensie en
die tydsduur van intervensies in ag neem. Gesinsgehardheid is maar een
geïdentifiseerde veerkragtigheidsfaktor. Verdere ondersoeke na die
verrykingspotensiaal van ander veerkragtigheidsfaktore sal ‘n oorvloed van
intervensies aan diensleweraars beskikbaar stel, ten einde in die behoeftes van
families en gemeenskappe te voorsien.
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Resilience in the humanitarian sphere : stimulating resilience for recovery in HaitiKing, Katrice G. January 2015 (has links)
Severe recovery deficits after post-disaster interventions have become the landscape seen globally. Humanitarian operations have struggled to find coherence between relief and recovery activities, which has resulted in a perceived operational gap between relief, recovery and development. This current dynamic has caused significant deficiencies within humanitarian programming, such as weak strategy, a lack of transition mechanisms, exit plans and effective recovery. A situation that stems from the current paradigm the humanitarian system operates under and the framework that has evolved around it. Supporting the development of adaptive resilience of a disaster-affected population, within the humanitarian sphere, has been theoretically posed to be fundamental for recovery; a programmatic consideration that could ensure former weak resilience would not hinder post-disaster recovery. Therefore, could a resilience building approach offer much needed solutions to the challenge of recovery within post-disaster contexts? This research aimed to understand whether resilience building within post-disaster environments could increase potential recovery of disaster affected populations and whether it is feasible to build individual/household (HH) level resilience through emergency response operations? The research looked specifically at adaptive resilience at the individual/HH level, clarifying the concept and understanding its modality in order to operationalise it within humanitarian programming. The common barriers to recovery experienced by individuals/HH in a crisis event were gauged, and the relationship between adaptive resilience and recovery determined. A unique singular case study was used to collect quantitative and qualitative data required to answer the key objectives of this research. The case study chosen was the 2010 Haiti earthquake response. Primary data was collected over a 7 months period through 37 semi-structured interviews and 31 online questionnaires with donors, government, INGOs, LNGOs and the private sector, that were operating within the Haiti response, and 18 disaster affected community members within a community discussion forum. Bringing a total participation of 86 individuals and organisations. An in-depth case study was developed in order to offer an evidence base for the proposed theory, that supporting adaptive resilience through emergency response programming has the ability to stimulate recovery. A new data collection tool was trialed within the community discussion forum, namely the Sociogram. This tool looked to assess the main components of adaptive resilience. Methodological rigour was introduced through the use of methodological and data triangulation to ensure validity and reliability of the research. The research successfully identified the main barriers to recovery, pinpointed the key components for adaptive resilience and the influence of emergency programming on the development of adaptive resilience, establishing the relationship between them. The role emergency response operations can play in the development of adaptive resilience was then explored. It has been demonstrated that to ensure recovery and allow for a more resilient society to evolve, adaptive resilience needs to be and can be supported and developed within emergency response operations. The research has been able to demonstrate, through the analysis of the Shelter and WASH response undertaken in Haiti, that developing resilience in the post-disaster environment is possible and an approach that is able to improve strategy within emergency response operations. Improvements would be seen in the provision of essential services within the response, a substantial increase in transitional and exit options and an increased capacity to proactively stimulate rapid recovery. This strategic approach to emergency response programming has the ability to offer the coherence needed between relief, recovery and development. Determining that a resilience building approach within emergency response operations could be the missing link or resolution to the perceived operational gap between relief, recovery and development. Pursuing a resilience building approach has the potential to bring much needed cultural change within the humanitarian sector that will shape operations for a more strategic and successful future.
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Livelihoods on the edge: farming household income, food security and resilience in southwestern MadagascarHänke, Hendrik 02 May 2016 (has links)
No description available.
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Construction, social structure and policy response in Jamaica - A hurricane hit country : / Byggteknik, samhällsuppbyggnad och politiskt gensvar på Jamaica – Ett orkandrabbat landNilsson, Josephine January 2014 (has links)
The Jamaican hurricane history goes back a long time. The country has an average ratio of getting hit or brushed every 3.84 years and it is estimated to be hit directly every 9.47 years. This underscores the relevance of this paper since it seeks to investigate the construction, social structure and policy response of Jamaica. The impressions of the author combined with the interviews and literature study resulted in the conclusion of the constructions and social structure not being the main issue, but the policy response.
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Resilience, self-efficacy and burnout of employees in a chemical organisation / Louisa PretoriusPretorius, Louisa January 2007 (has links)
The objectives of this study were to investigate the relationship between positive psychological capacities (state ego-resilience and state self-efficacy) and burnout levels of employees (N = 164) in a chemical organisation and to determine whether state ego-resilience and state self-efficacy can be used to predict burnout levels of employees in a chemical organisation. A cross-sectional survey design was used. The Ego-Resiliency Scale (ER89), the State Self Efficacy
Scale (SSES) and the Oldenburg Burnout Inventory (OLBI) were administered to measure the constructs. The research method for this article consists of a brief literature review and an empirical study. Confirmatory factor analyses, Cronbach's alpha coefficients and the inter-item correlation coefficients were used to assess the reliability and validity of the measuring instruments. Descriptive statistics were used to describe data, and Pearson's product moment correlation coefficients, and regression analyses were used to examine the relationships between the constructs employed in this research.
Results obtained confirmed the internal consistency and one-dimensional factor structures of the state ego-resilience and state self-efficacy measuring instruments. Although the two - dimensional factor structure of the OLBI was confirmed, the two subscales were not consistent with the expected factor structure. Consequently, only the total burnout scale (which presented with adequate internal consistency) was used. A significant statistical and practical correlation was found between state ego-resilience and burnout. State self-efficacy and burnout demonstrated a significant statistical and practical correlation. Regression analyses indicated that both state ego-resilience and state self-efficacy hold predictive value with regard to burnout. Conclusions were made, limitations of the current research were discussed and recommendations for future research were put forward. / Thesis (M.Com. (Industrial Psychology))--North-West University, Vaal Triangle Campus, 2008.
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