Philosophiae Doctor - PhD / The Wellness Leadership White Paper states that leadership is needed in a supportive environment with the purpose of guiding clients to lasting wellness. Wellness can be defined as an active process that enables an individual to become aware of all aspects of the self and to make choices in terms of a more healthy existence by means of balancing and integrating various life dimensions. Health care professionals are leaders who play an important role in creating an environment that contributes to wellness. Their leadership is, therefore, viewed as a wellness strategy. Leadership has been identified as an essential role of health care professionals with a responsibility to attend to the needs of their clients, such as youth victims of violence, with the aim of leading them towards wellness. The Provincial Nursing Strategy of the Western Cape in South Africa emphasises the need for health care professionals to demonstrate their leadership capacity in practice. In the communities of the Western Cape Province of South Africa, many youth victims of violence report for treatment at the health care facilities; it places a high burden on the health care system. Even though health care professionals provide treatment to this group of youth, it is not clear how health care professionals lead them towards wellness after an incidence of violence. The purpose of this study was to develop a conceptual framework that can be implemented by health care professionals to gain a better understanding about the important role they play in leading youth victims of violence towards wellness in a rural community in the Western Cape Province of South Africa. This research study applied a qualitative, exploratory, descriptive and contextual design. The study population who were selected by means of a purposive sampling technique consisted of youth attending a high school and who had been victims of violence and of health care professionals (professional nurses, medical doctors and social workers) working at the health care facilities in the community where the study was conducted. The study was conducted in four phases. Phase 1 of the study focused on the exploration and description of the expectations of the youth victims of violence about how health care professionals should lead them towards wellness. Focus group discussions (FGDs) were conducted at a high school at the study site. Phase 2 explored and described the experiences of health care professionals who were supporting youth victims of violence at the health care facilities in the community of study. The execution of this phase comprised of unstructured individual interviews. The total number of the FGDs and unstructured individual interviews conducted in this study was determined by data saturation. Data analysis of the data collected involved transcription of the voice recordings of the all the interviews and writing up of field notes. The steps of Tesch’s coding technique were used at the end of Phases 1 and 2. To ensure trustworthiness of the collected data, Guba and Lincoln’s strategies of credibility, transferability, dependability, confirmability and authenticity were applied. Phase 3 of this study entailed the development of a conceptual framework for health care professionals to lead youth victims of violence towards wellness. It was based on the findings from Phases 1 and 2 of the study; Phase 4 of the study involved peer debriefing and validation of the developed conceptual framework. In Phase 1 of the study, a total of nine (n = 9) FGDs were conducted among fifty eight (n = 58) youth participants between the ages of 15 and 19 years. Each group consisted of 6 to 8 participants and the interviews did not last more than an hour per session. The data analysis in this phase showed that the youth victims of violence did have expectations from the health care professionals in guiding them towards wellness. They shared their interpretation of the term wellness and were also quite aware of the challenges in their community. Four categories emerged from the data in Phase 1: Category 1 - Dimensions of wellness as it related to healthy body, mind, spirit and positive interactions: The findings of this category revealed that youth participants described wellness as a holistic concept that comprised healthy living, self-care and a healthy personality and mind (emotional, psychological) as well as spiritual well-being. They did not necessarily consider wellness as the absence of sickness or illness, Category 2 - Common problems among youth in the context of the community: They articulated that drug abuse, teenage pregnancy and violent behaviour were important issues of concern to them in their community. Category 3 – Building a sound and trusting relationship: They expressed their need for health care professionals to have a positive attitude towards them, to be respectful and to provide them with accurate information, as well as confidential and supportive services. Category 4 - Guidance of youth to wellness: The youth also proposed strategies that they believe could be used by the health care professionals while guiding them towards wellness. These strategies were: Provision of information / health education, school and community outreach programmes, provision of counselling services and role modelling. For the second phase, seven (n = 7) health care professionals were interviewed. Two (n = 2) were professional nurses, three (n = 3) medical doctors and two (n = 2) social workers. The findings of the individual interviews indicated that the health care professionals recognised the fact that wellness is very important. However, they felt that guiding youth victims of violence toward wellness was a challenging process. Three categories emerged from the data in Phase 2: Category 1 - Different points of view about the concept of wellness: The health care professionals described wellness as the holistic wellbeing of a person, an absence of illness or disease and living a healthy lifestyle. Category 2 - Barriers to leading youth victims of violence towards wellness: The health care professionals reported challenges while attempting to lead youth victims of violence towards wellness which included low socioeconomic status of families, unsupervised youth, violent behaviour, drug and substance abuse, a lack of resources in the community, negative staff attitudes, inadequate physical infrastructure and human resources as well as the absence of a process of guiding youth victims to wellness. Category 3 - Guidance to leading youth victims to wellness: The health care workers proposed strategies for guiding youth victims towards wellness. Those strategies included the provision of support in the form of counselling services, use of support groups, family and community support; recreational activities, dedicated staff to work with youth victims of violence and a multidisciplinary team approach. The findings from the first two phases were triangulated during the third phase of this study with the purpose of developing a conceptual framework. The survey list of Dickoff, James and Wiedenbach formed the foundation of the reasoning map for the development of the framework. The unique contribution of this study is the development of an original, participative leadership framework that provides health care professionals with information for leading youth victims of violence towards wellness in a rural community in the Western Cape. This study was conducted in a single rural community of the Western Cape Province of South Africa. Despite this limitation, the framework could be evaluated for use in similar settings. Finally, guidelines to implement the framework and recommendations for improving community health care practice, nursing education and nursing research were suggested based on the findings from the study.

Magister Artium - MA / Background: Healthcare workers are the human face of health systems, serving to connect knowledge and service delivery to improve patient care. The development of core competencies in the education of health professionals is fundamental for health improvement. Interprofessional collaboration amongst healthcare workers has been linked to improved patient outcomes as no single professional can address all healthcare issues. Aim: The aim of this research was to determine how UWC undergraduate physiotherapy students were being prepared for collaborative work as part of their professional development. Educational experiences of the third- and final-year physiotherapy cohort, physiotherapy educators’ perspectives on the development of competency for collaboration and a review of physiotherapy module outlines were explored. Research Method: A descriptive qualitative research design utilizing focus groups, semi-structured interviews and document analysis was employed. A pedagogical framework was used for instrument development and data analysis. The pedagogical framework was adapted from the CanMEDS physician competency framework, the core competency framework by the Medical and Dental Board of the Health Professions Council of South Africa and the Essential Competency Profile for physiotherapists in Canada. Research was conducted at the Department of Physiotherapy at the University of the Western Cape. Purposive sampling was undertaken with the sample population having consisted of six third- and six final-year physiotherapy students for the focus group discussions and seven lecturers formed the sample for the semi-structured interviews as well as sixteen physiotherapy module outlines. Data was collected and focus group discussion and interviews were transcribed verbatim. An inductive content analysis of the transcribed data was conducted and compared to the Pedagogical framework. Content analyses of module outlines were conducted drawing on Biggs work on constructive alignment and compared to the Pedagogical framework. Ethical clearance was received from the Senate Research Committee of the University of the Western Cape. Results: Participants showed a keen knowledge on the importance of collaboration in the teaching and clinical environment. It had relevance for personal development and learning as well as for interprofessional collaboration. Interprofessional education and group work were thought to be instrumental in collaborative learning but a lack of congruency of learning activities could be a barrier to learning. The clinical environment was highlighted as beneficial to developing collaboration through interprofessional observation and interaction but high patient loads and a lack of understanding of the roles and responsibilities of all healthcare professionals were identified as barriers. To a lesser degree, communication, conflict management and confidence were identifiable skills physiotherapy students should have to be effective collaborators. Conclusion: Students are well-positioned to participate within interprofessional team but have inadequately developed collaborative competencies. These include interprofessional role understanding and skills in conflict management, confidence and communication. Constructive alignment of curriculum by aligning learning outcomes and learning activities to develop collaboration including interprofessional learning activities would better prepare students for interprofessional collaboration.

Orientador: Ana Archangelo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação / Made available in DSpace on 2018-08-18T15:25:16Z (GMT). No. of bitstreams: 1 Gentini_MariaLigiaPompeu_M.pdf: 1091158 bytes, checksum: 0974b84bb6bdb2152ac2e737004e9da4 (MD5) Previous issue date: 2011 / Resumo: Esta pesquisa investiga os medos vividos e sentidos pelos profissionais que atuam na escola, analisando-os a partir de três dimensões interrelacionadas: o mundo interno do sujeito que sente medo, a dinâmica da instituição educacional e a lógica social atual, a qual modifica, de alguma maneira, os comportamentos e as formas de sentir. Foram entrevistados profissionais, entre professores e diretores, de uma escola pública do estado de São Paulo, com a finalidade de entender a origem de seus medos e dos medos vividos atualmente, que os colocam frente a situações de insegurança. Tendo como referenciais a psicanálise e a sociologia, a pesquisa mostra que os medos predominantes estão relacionados à perda de controle e a medos relacionados à crise de autoridade do professor. Além disso, a pesquisa aponta que, embora alguns medos sentidos sejam nomeáveis, definíveis, eles não são sinônimos de "fraquezas pessoais", e que a instituição escolar tem, não só alguma participação na produção dos medos do sujeito, mas também, fundamentalmente, uma responsabilidade institucional no seu acolhimento e elaboração. / Abstract: The main objective of this research project was to investigate the fears felt by professionals of the educational areas, analyzing them from three related dimensions: the subject's internal world, the dynamic of the educational institution and the current social logic, which modifies, in a certain way, the behavior and the way fear is felt. Professionals of public schools, such as teachers and principals, in the state of São Paulo, were interviewed in order to understand the origin of their fears and the current fears felt by them, which makes the person insecure when facing challenges. Thus, by having sociology and psychoanalyzes as references, this study shows that fears are predominantly related to the loss of control and to crisis of authority. Additionally, this research indicates that despite the fact that some fears are known and ascertainable, they are not "personal weaknesses"; and that educational institutions have, not only, some influence on the development of these fears, but mostly important, they have, as an institution, the responsibility of dealing with them. / Mestrado / Psicologia Educacional / Mestre em Educação

Society's attitude towards people with disabilities has changed over time. People with disabilities are a group that historically has been marginalized by society and treated differently. Many have been exposed to various assaults from society such as forced lock-ins, prohibition of marriage and sterilization. People with disabilities are a group of people who have historically been treated very badly in Swedish care, prior to the launch of the Swedish modern disability policy. Towards the end of the 1980s, an investigation was carried out into the treatment of disabled people in Sweden. This resulted in the Convention of the rights of people with disabilities reform of 1994, known as the LSS. The result was to create a fair and equal society for everyone. The LSS reform requires people with disabilities to have good living conditions, equality in living conditions, full participation in community life, an opportunity to live as other members of society, adaptation to individual needs, ease of access, opportunities for independence, good quality of life, respect for the individual's right to make their own decision and maintain their individual integrity and voluntariness.In LSS, the group housing associations meet users and staff and the idea is that the efforts made by the staff should compensate for the obstacles and difficulties that a disability may cause. Researchers describe the relationship between residents and staff as crucial for the success of the LSS goals. With correct implementation they help ensure good living conditions and high quality of life for the residents.In order to find out the reasoning and the principles about the approach to patients within the LSS-agency, the qualitative method was chosen as a course of action. The empirical material was based on semi-structured interviews with six employees within LSS-group homes. As the purpose was to examine the stories of employees regarding the work with the personal treatment of clients, the essay is built upon theories of empathy and communication.

Published in: SAMJ November 2016, Vol. 106, 1096-1102, DOI:10.7196/SAMJ.2016.v106i11.10689 / Background. Healthcare professionals (HCPs) produce various types of waste in the course of rendering healthcare services. Each classification of waste must be disposed of according to the prescribed guidelines. Incorrect disposal of waste may pose a danger to employees, patients and the environment. HCPs must have adequate knowledge of the disposal of medical waste. Objectives. To determine the knowledge and practices of HCPs with regard to medical waste disposal at a hospital in Mpumalanga Province, South Africa. Methods. A quantitative cross-sectional research approach was used. The study respondents included nurses, medical doctors, dental health staff and allied health staff. Data were collected through self-administered questionnaires and analysed using IBM SPSS version 22.0. Results. A high proportion of HCPs did not have adequate knowledge regarding the disposal of medical waste, but nevertheless disposed of medical waste appropriately. While the knowledge and practices of HCPs with regard to medical waste disposal were not associated with age, gender or years of experience, there was an association between professional category and knowledge and practices. Conclusions. Disposal of medical waste is the responsibility of all HCPs. All categories of HCPs should receive regular training to improve their knowledge regarding disposal of medical waste and to minimise the risks associated with improper waste management. This will further increase compliance with the guidelines on disposal of medical waste.

Thesis advisor: Janet E. Helms / Historically, psychological theory and mental health researchers have viewed sex work as inherently harmful to sex workers and capable of producing negative mental and physical health effects (Sprankle et al., 2018). Moreover, research focused on clinicians’ expectations for sex workers in therapy has not specifically examined clinicians’ attitudes toward sex workers or sex work as separate concepts (Benoit et al., 2015; Koken, 2011; Ma et al., 2017). In addition, mental health professionals may not view sex work as legitimate work because of the virtual lack of evidence-based theoretical frameworks for guiding therapy for sex workers, and, therefore, may use prostitution stigma as a substitute for theory (Krumrei-Mancuso, 2017; Williamson & Cluse-Tolar, 2002). The present study investigated the extent to which mental health professionals’ expectations of sex work and sex workers were related to prostitution stigma and their perceptions of sex workers’ overall mental health and evaluations of sex work as decent work. In particular, the study investigated the extent to which mental health professionals stigmatized the work of sex workers. Mental health professionals (N = 201) read a clinical vignette and completed an online survey containing a demographic information sheet, the Attitudes Toward Prostitutes and Prostitution Scale (Levin & Peled, 2011); (c) the Decent Work Scale (Duffy et al., 2017), (d) the Hospital Anxiety and Depression Scale (Zigmond & Snaith, 1986), and (e) the PTSD-8 (Hansen et al., 2010). Results from multivariate multiple regression analyses supported that when mental health professionals held higher levels of stigma towards sex work and sex workers, they may diagnose the client with higher levels of PTSD symptoms. Further, the results supported that endorsement of a feminist orientation moderated the relationship between sex work stigma and diagnosis clients’ PTSD avoidance symptoms. The discussion included methodological limitations and implications for research and practice. / Thesis (PhD) — Boston College, 2020. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental and Educational Psychology.

Due to changes within the public library profession and a lack of previous research regarding its societal role, this essay explores this phenomenon. The objective of this empirical study is to explore the societal role of public library professionals in Canada through the analyzation of semi-structured interview transcripts and a guideline document for professionals. The results were analyzed and sensitized through the theoretical frameworks of Abbott’s professionalization theory (1988) and Bourdieu’s praxeology theory (1986; 1992). Through grounded theorization, the study found that the role of professionals has changed, and is changing, due to not only external but also internal factors in the form of a conflict. This conflict was conceptualized through sensitization of Bourdieu’s framework as challenging and enabling ideas of the doxa of the profession. This conceptualization was understood further through the lens of Abbott’s system of professions where claims of expertise, which is viewed as a crucial part of professionalization, was theorized as an important part of that conflict.

Intimate partner violence (IPV), including physical, psychological, and sexual violence towards a partner, is a human rights violation that is associated with the development of a multitude of short- and long-term physical and mental health problems (WHO, 2013). IPV survivors are at greater risk of developing mood, anxiety, and trauma- and stressor-related disorders (García-Moreno et al., 2005). Public health guidelines recommend screening for IPV in mental health settings (WHO, 2013). However, most mental health practitioners do not routinely assess for IPV in their practice (Howard et al., 2010). Lack of training in how to assess for and respond to IPV has been identified as an important barrier for IPV assessment in mental health settings (Trevillion et al., 2016). IPV-related training has been linked to positive outcomes for clinicians, including higher ratings of perceived knowledge and confidence in addressing IPV (Forsdike et al., 2019). Yet, studies suggest that approximately one quarter to one half of mental health professionals have never received IPV-related training (Murray et al., 2016; Nyame et al., 2013). To address this gap, the WHO advanced a series of evidence-based training recommendations (WHO, 2013). At present, there is a dearth of research exploring the degree to which global mental health providers’ experiences of training resemble WHO guidelines. Furthermore, few studies have investigated factors that contribute to clinicians’ likelihood of participating in IPV-related training, and reasons for obtaining training are not well understood. There has also been no previous research into the relationship between mental health professionals’ experiences of training and their accuracy in correctly identifying IPV. The present thesis, consisting of two studies, sought to assess global mental health providers’ IPV-related training experiences, including factors that influence the probability of participating in training and the relationship between training and diagnostic accuracy. In study 1, mental health professionals’ IPV-related training experiences were surveyed, and factors that may contribute to the likelihood of participating in training were explored (e.g., IPV prevalence, norms, and legislation, and professional experience with IPV). The relationship between IPV-related training and knowledge and experience of relationship problems was also examined; 321 specialized mental health professionals (psychologists and psychiatrists) from 24 countries participated in an online survey. Participants responded to a series of questions regarding the content, duration, and frequency of their IPV-related training based on WHO recommendations, and rated their level of knowledge and experience with relationship problems. Descriptive analyses showed that nearly half of participants (46.9%) had never received IPV-related training. Approximately half of those who received training (49.4%) indicated that their training followed WHO recommendations. Logistic regressions revealed that participants who were from countries with relatively better implemented laws addressing IPV and participants who encountered IPV more often in clinical practice were more likely to have received training. Furthermore, participants who received training were more likely than those without training to report higher knowledge and experience of relationship problems. Findings highlight global challenges with regards to IPV-related training. They suggest that clinicians’ likelihood of participating in training is related to their clinical contact with IPV and the institutional context in which they practice. Study 2 investigated the relationship between IPV-related training and clinicians’ diagnostic accuracy in the context of relationship problems, using the same sample as study 1. Chi-square analyses evaluated relationships between IPV-related training and clinicians’ performance while assessing for clinically significant relationship problems (RPM) in case-controlled vignettes across two study conditions: RPM present (i.e., when the task was to correctly identify RPM) and RPM absent (i.e., when the task was to correctly identify that there was no RPM; normative relationship problems were presented). Results showed that participants who received IPV-related training were more likely to perform better than those without training in the RPM present condition, but not in the RPM absent condition. In the RPM present condition, participants were more likely to respond correctly when their training was more recent and more closely resembled WHO recommendations for training. In the RPM absent condition, a similar percentage of participants with training (60-78%) and without training (45-76%) misclassified normative relationship problems as clinically significant RPM. Overall, findings suggest that IPV-related training is related to improved diagnostic accuracy in the context of relationship problems. WHO recommendations for training are supported.

My thesis examines the interprofessional collaboration between school-based educators and health professionals (HPs). Four research questions guided the study: 1) What is the current state of literature on interprofessional collaborations between school-based educators and HPs? 2) Based on the existing literature, how are school-based educators and HPs collaborating interprofessionally? 3) Based on the existing literature, what are the outcome(s) or impact(s) of interprofessional collaborations between school-based educators and HPs? and 4) Based on the current state of the literature, what areas are important to consider for future research on interprofessional collaborations between school-based educators and HPs? It is important for both school-based educators and HPs alike to consider answers to these questions as it can refine and strengthen their current and future practices in an effort to ultimately create a successful working and learning environment for themselves and for their students and patients. Systematic searches of four databases yielded 46 articles for inclusion, data extraction, and analysis. Through a thematic analysis of the literature, I found the following two overarching themes that govern the implementation of interprofessional collaboration: 1) time and 2) funding. In addition to these themes, I extracted two major themes and one minor theme from the literature that can guide current and future interprofessional collaborative practices. These themes included 1) pre-service training whereby a) everyone is involved, b) there is a mutual understanding between and of educators and HPs, c) both educators and HPs feel valued in their positions for their work, d) there is less sophisticated profession-specific jargon which can in turn open further dialogue between both teams of professionals, and e) a journal or frequent log can be kept to track the successes and challenges of and suggestions for the collaborative efforts as well as of student satisfaction; and 2) in-service training whereby a) educators and HPs are able to maintain consistency in their roles and responsibilities as well as for students educationally, and b) provide continued support for all. I discuss methods of how this interprofessional collaboration could be implemented, noting a) proximity (i.e., how closely, in what ways, and how frequently educators and HPs work together) and b) frequent meetings as essential to successful interprofessional collaboration. Finally, a minor theme emerged from the literature with suggestions for current and ongoing implementation of interprofessional collaboration which suggested a) increased and stronger liaison in schools and b) frequent meetings to establish and build upon a foundation that will foster further interprofessional collaboration. This review of the available literature on this topic, especially of the literature empirical in nature, worked to map key concepts, evidence, and main sources of information as well as synthesize a myriad of information (Arksey and O’Malley, 2005), fill a visible gap in the area of interprofessional collaboration among school-based educators and HPs specifically, and provide avenues for further study and practical application.

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