Orientador: Francisco Hashimoto / Banca: Manoel Antonio dos Santos / Banca: Cristina Amélia Luzio / Resumo: O objetivo dessa pesquisa constitui em analisar as concepções do trabalhador de saúde mental em sua relação com o trabalho e a instituição e como concebe a produção de saúde mental no contexto psicossocial. Considera-se como campo social o contexto da reforma psiquiátrica e da proposta psicossocial, como sujeito da ação de mudança o trabalhador de saúde mental de um CAPS e como intermediário as forças antagônicas de desejo, motivação e sofrimento nas relações de trabalho. Levou-se em consideração como as escolhas profissionais e seus determinantes articulam-se com a relação que o sujeito estabelece com o exercício profissional e seu significado, com a concepção de saúde mental e as práticas desenvolvidas na atenção psicossocial. O referencial teórico fundamentou-se na Psicossociologia, com autores como Dejours (1992, 1994), Enriquez (2000) e Gaulejac (2001), na psicanálise com Freud (1913, 1930), Birman (1977) e Costa (2004) e na Saúde Coletiva com Amarante (1996, 1997, 1998, 1999, 2007), Rotelli (1990) e Costa Rosa, Luzio, Yasui (2001, 2003). Em termos metodológicos, foram coletados os dados por meio de entrevistas semidirigidas, com os técnicos do CAPS do interior do estado de São Paulo. Os resultados apontaram que os indícios de sofrimento dos trabalhadores não assumem um caráter patogênico, imobilizador de ações e impeditivos na realização de desejos. Os trabalhadores que tiveram uma livre escolha, considerando sua constituição subjetiva, sua historia pessoal e seus desejos, demonstram uma maior integração, afinidade, motivação e prazer nas relações de trabalho, bem como uma melhor adesão à proposta psicossocial... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This research aims to study the mental health professional.s conceptions related to his work as well as the institution and how this professional conceives the mental health production in the social context. The psychiatric reform context and the psycho-social proposal are taken as the social field; a mental health professional of a CAPS is the change action subject; and the desire, motivation and suffering adverse strength in the work relations are considered the means through which these changes are promoted. It was studied how the professional choices and their determining factors are articulated in the relation that the subject has with his work activity, and how its meaning is articulated with the mental health conception and the practices developed for psycho-social attention. The theoretical references were based on Psycho-sociology, with authors like Dejours (1992, 1994), Enriquez (2000) e Gaulejac (2001); on Psychoanalysis, with Freud (1913,1930, Birman (1977) e Costa (2204); and on the Collect Health, with Amarante (1996, 1997, 1999, 2007), Rotelli (1990) e Costa Rosa, Luzio, Yassui (2001, 2003). Method: data were collected up from semi-conducted interviews with technicians who work for CAPS in the countryside of São Paulo State. The results showed the professional.s suffering signs do not have a pathogenic character which can immobilize actions or avoid this professional to realize his own desire. The professionals who had a free choice, considering its subjective constitution, his personal life course and his own desire demonstrated a better integration, identification, motivation and pleasure to work, and it is better and easier for them to accept... (Complete abstract click electronic access below) / Mestre

Made available in DSpace on 2014-08-20T13:49:45Z (GMT). No. of bitstreams: 1 Dissertacao Carmen Argiles.pdf: 1323003 bytes, checksum: a96417125949261fe89f4b2da06e2050 (MD5) Previous issue date: 2012-12-10 / Significant paradigmatic changes have been proposed to reform psychiatric methods for relating with mental illness and conducting the work of Psycho-Social Care Centers in Brazil. The form of psycho-social care involves changes in the concept of care, with a focus on the person who suffers and his or her subjectivity. Services are spaces where care is provided and for the restoration of people and their reinsertion in their relational and social world. In this context, this study seeks to analyze the potential for production of subjectivity in the dynamic of work at the Psycho-social Care Center in the municipality of Alegrete-RS. This is a case study, with a qualitative research approach. As theoretical references, it uses concepts from Guattari and those from Foucault concerning power relations and the micropolitics of the dynamic of work. The data used come from the study entitled Evaluation of Psycho-Social Care Centers in Southern Brazil II, which is a quantitative and qualitative study for the evaluation of services. This masters dissertation is a qualitative study based on field data from Alegrete, Rio Grande do Sul State. Data collection tools included semi-structured interviews with a pre-defined questionnaire conducted with 11 users and 21 workers and records in field diaries from 253 hours of field observations. The data were collected in July and August 2011, at a service of the Psycho-social care center of Alegrete. A thematic analysis was used for reading the data. Important movements were observed in the construction of practices and the working dynamics in the perspective of the psycho-social paradigm, as well as micropolitical factors that allow processes of subjective implication for users and workers based on the dynamic established in the operationalization of the work. These relations also present factors that restrict protagonism, autonomy and independence because of rigid, hierarchized and protective procedures. The presence of specialties and of power/knowledge prevent the establishment of horizontal relations in the context of service. The resistance produced by movements taken to confront prejudice toward mental illness and to create other options to promote a subjective repositioning for all the actors both users and workers - involved, indicates processes of production of singularized subjectivity. It is hoped that this study contributes to the development of processes of mobilization, innovation and differences in the psycho-social form of care, stimulating diversity, multiplicity and heterogeneity among the collective involved in this field. / A reforma psiquiátrica brasileira propõe mudanças paradigmáticas significativas no seu modo de relacionar-se com a loucura e operacionalizar o trabalho nos Centros de Atenção Psicossocial. O modo de atenção psicossocial envolve mudanças de concepção sobre o cuidado, com o foco na pessoa que sofre e sua subjetividade. Os serviços constituem-se em espaços de cuidado, resgate e reinserção das pessoas em seu mundo relacional e social. Neste contexto, o presente estudo procura analisar a potencialidade de produção de subjetividade, na dinâmica de trabalho no Centro de Atenção Psicossocial da cidade de Alegrete-RS. Caracteriza-se como um estudo de caso, com abordagem de pesquisa qualitativa, que utiliza como referencial teórico o paradigma do modo psicossocial, as concepções de subjetividade de Deleuze e Guattari, e os conceitos de Foucault sobre as relações de poder e a micropolítica da dinâmica de trabalho. Os dados utilizados fazem parte de um recorte da pesquisa intitulada Avaliação dos Centros de Atenção psicossocial da região sul do Brasil II, o qual se constitui de um estudo quantitativo e qualitativo de avaliação de serviços. Esta dissertação de mestrado é um estudo qualitativo a partir dos dados do campo de Alegrete Rio Grande do Sul. Como instrumentos de coleta de dados utilizou-se a entrevista semiestruturada realizada com 11 usuários e 21 trabalhadores, a observação de campo, com um roteiro pré-definido e registro em diário de campo num total de 253 horas. Os dados foram coletados em julho e agosto de 2011, em um serviço de Centro de Atenção Psicossocial do município de Alegrete. Utilizou-se a análise temática, para a leitura dos dados. Observou-se movimentos importantes de construção de práticas e dinâmicas de trabalho na perspectiva do paradigma psicossocial, bem como aspectos micropolíticos que possibilitam processos de implicação subjetiva para usuários e trabalhadores partindo da dinâmica estabelecida na operacionalização do trabalho. Estas relações apresentam ainda aspectos limitadores para o protagonismo, autonomia e independização, com a manutenção de procedimentos rígidos, hierarquizados e tutelares. A presença de especialismos e do saber-poder, colocam-se de forma a interromper os processos de horizontalização das relações no contexto do serviço. As resistências produzidas pelos diversos movimentos criados para o enfrentamento do preconceito em relação à loucura, na criação de outras possibilidades existenciais, de forma a promover um reposicionamento subjetivo para todos os atores envolvidos, usuários e trabalhadores, indicam processos de produção de subjetividade singularizada. Espera-se com este estudo contribuir para o desenvolvimento de processos de mobilização, inovação e diferenças no modo psicossocial de cuidar, estimulando a diversidade, multiplicidade e heterogeneidade nos coletivos implicados neste campo.

This study investigated marital dissolution in the Tanzanian context. The study specifically focused on the potential effect of marital dissolution (both positive and negative) on early adolescents’ academic and psycho-social functioning. The primary research question directing the research is: ―How can insight into marital dissolution in Tanzania broaden our knowledge on its effect on children?‖ The conceptual framework for the study is based on attachment theory, crisis theory, family stress theory and life course theory. Epistemologically, the study utilised social constructivism as paradigm. A qualitative methodological approach was followed, implementing an instrumental case study as research design. I purposefully selected eight children from two children’s centres in Tanzania and four additional children from custodial homes. In addition, twelve parents, who had been separated from their partners, as well as twelve teachers and caregivers who have been involved with the child participants, participated in the study. For data collection I employed semi-structured interviews with the parents and children; focus group discussions with teachers and caregivers; interviews and narrations with children; and an analysis of existing documents. Field notes, a research diary and verbatim transcripts were utilised to document the data I collected. Following inductive thematic analysis four themes emerged, relating to the reasons for marital dissolution, the effect of marital dissolution on early adolescents’ functioning, trends following marital dissolution and managing marital dissolution in Tanzania. In terms of reasons for marital dissolution I identified the following subthemes: abuse, lack of commitment to the family, influence of others, and financial strain. In terms of the effect of marital dissolution on early adolescents’ functioning three subthemes emerged namely; effect on early adolescents’ academic performance, effect on early adolescents’ psycho-social well-being, and parents’ insight into the effect of marital dissolution on their children. With regard to trends following marital dissolution I identified the following three subthemes: positive effect of marital dissolution, change in living arrangements, and other related changes negatively affecting children. Finally, two subthemes emerged concerning the management of marital dissolution in Tanzania, namely minimising the effect of marital dissolution on children, and potential role of the Tanzanian government. The findings of this study indicate that the majority of Tanzanian couples merely separate, rather than following a legal divorce. Parents showed limited insight into the effect of marital dissolution on their children. Besides some children experiencing the separation of their parents as a relief, the majority of children were negatively affected in terms of their academic performance and psycho-social functioning. Children indicated the need to be involved in discussions preceding and during the separation process, yet Tanzanian parents did not value the involvement of their children during this process. Based on the findings I obtained I conclude that the effect of marital dissolution on children are not only continuous but that the effects in various areas of functioning are interrelated and cyclic in nature, and that children can experience the effects before, during and after marital dissolution. / Thesis (PhD)--University of Pretoria, 2014. / lk2014 / Educational Psychology / PhD / Unrestricted

According to the regulations contained in the Social Services Act (SFS 2001:453), Swedish social services have a legal responsibility to provide support, care, and treatment for individuals with substance use problems.  This law mandate those who are responsible to provide treatment to motivate drug users to actively seek treatment on a voluntary basis, ensuring an end to their dependence on drugs. Studies have shown that although the treatment system largely focuses on promoting abstinence, about two-thirds of client’s relapse into substance use within one year after completing treatment. This dissertation focuses broadly on clients who repeatedly enter and use treatment for substance use disorders in the Swedish addiction treatment system. The aim of this thesis is to examine and identify the population groups who are repeated treatment users of the Swedish treatment system for substance use disorder, including both the voluntary treatment and compulsory care. This thesis was based on three national level databases. The results showed that clients with a higher degree of problems and problems in different areas of life also had an increased risk of having treatment for substance use disorder repeatedly. Clients who were older, men, reported more years of polydrug and alcohol use to intoxication, reported more compulsory care episodes for substance use, had ever been charged with crime, had ever been in inpatient mental health treatment, and had a higher ASI mental health symptom composite score, were significantly more likely to report more voluntary addiction treatment episodes. The strongest significant association with the number of treatment episodes was the number of compulsory treatment episodes for alcohol and drugs. Individuals who experienced prior compulsory care including mandatory treatment through LVU (law (1990:52)), been in prison, and had children mandated to out-of-home care, were more likely to have two or more entries in the compulsory care system for substance use disorder. In addition, this analysis showed that 59% of clients mandated to compulsory care dropped-out during their compulsory care episode, and that younger clients were significantly more likely to drop-out. Those who drop-out were significantly more likely to experience negative outcomes, i.e. additional sentence to compulsory care and higher risk of mortality.  A hierarchal logistic regression model also identified that individuals with riskier childhood conditions were more likely to have had repeated entries to compulsory care for substance use disorder. The indirect effects showed that a family history of substance use disorder and psychiatric problems are both associated with higher probability of institutional care as a child i.e. LVU, and that in turn, mandated childhood institutional care is related to repeated compulsory care intakes as an adult. Individuals who use treatment for substance use disorder repeatedly have a higher degree of problems i.e. an exposed and problematic group of individuals characterized by problem in several different areas of life. Growing up in a home environment with unfavorable conditions, mandated care before the age of 18 (LVU), compulsory care for substance use disorder as an adult, children taken into out-of-home care, and crime are the factors that are primarily associated with repeated treatment for substance use. A change in the view of treatment for clients in need of repeated use of treatment seems important, and access to adapted continuous care efforts are crucial to counteract the risk of relapse after a treatment episode of voluntary or compulsory care. Further, it seems important to motivate the client to complete the compulsory care without any deviation, since this seems to have positive effects on their substance use disorder.

Introduction et problématiques: Les politiques et choix des produits plasmatiques (PP) ou recombinants (PR) en hémophilie divergent selon les pays en dépit de recommandations internationales consensuelles. A la différence d'autres pays, la politique française en ce sens ne fait aucune priorité de choix entre les PP versus les PR en dépit de l'avènement de variante (v) de la maladie de Creutzfeldt-Jakob (MCJ) dont le risque transfusionnel affecté à ces premiers est jugé être infinitésimal. L'adhésion des soignants et des patients à cette politique ainsi que les répercussions psychologiques des retraits de lots de PP pour le risque de vMCJ sur ces derniers, sont inconnues et suscitent des questions éthiques. Méthodologie: Des enquêtes mono et multicentriques ont été menées auprès de patients et médecins français afin d'évaluer leurs sentiments envers la politique de maintien sans restriction des PP et celle de leurs procédures de retrait de lots. Une discussion des problématiques éthiques inhérentes est conduite à partir des rapports des expertises scientifiques et de nos propres données. Résultats: L'analyse des politiques et choix des PP versus PR en hémophilie a permis d'identifier un modèle français aux côtés des trois modèles nord-américain, britannique et européen. Ce premier modèle apparaît être le moins astreignant alors que la France pointe à la haute deuxième place de la prévalence mondiale de la vMCJ après le Royaume Uni qui a tout simplement banni la prescription des PP pour les hémophiles, à la faveur des PR dénués de ce risque. Nous avons identifié nombre de tensions dans la prise en charge des patients et dans la gestion des risques de ces produits en France. Celles-ci sont principalement le fait de quatre problématiques qui correspondent à des paradoxes français de la politique de gestion de risque de ces produits, notamment: 1) multiplication injustifiée des procédures de retrait de lot de PP, essentiellement en rapport avec les formes sporadiques de la MCJ pourtant non transmissibles par ce biais. 2) absence de formalisation précise de l'organisation des procédures de retrait de lot dont les sources, les méthodes, les moyens et les délais de contact des médecins et leur relais aux patients sont divers et variés, ce qui témoigne d'une certaine improvisation et d'un cafouillage dans ce processus. 3) maintien sans restriction d'indication ni de source des PP. 4) information systématique traumatisante à posteriori des patients à l'occasion des retraits de lots pour ce risque très infime, au lieu d'une approche au cas par cas. Les problématiques éthiques induites sont: traumatisme psychologique rémanent des patients et leur famille à l'occasion de l'information, mal conduite et mal comprise, du risque de la vMCJ lors des procédures de retrait de lots de PP conduisant à leur switch massif pour des PR; inefficacité de ces procédures à éliminer les lots incriminés car souvent déjà consommés; diminution drastique, voire bannissement de la prescription des PP; vécu difficile et désapprobation majoritaire des médecins de la politique du maintien sans restriction des PP et des procédures de retrait de lot; faible respect des procédures de retrait de lots, appliquées de façon confuse et inégale; crise de confiance des patients et médecins envers cette politique; sentiments de conflits d'intérêts des autorités politiques en rapport avec un protectionnisme supposé de l'industrie nationale de fabrication des PP en l'absence de motifs solides à leur maintien sans restriction à des indications précises. Conclusion: Un recadrage institutionnel de procédures de retrait de PP en France apparait nécessaire, celles-ci étant majoritairement injustifiées car relatives aux formes sporadiques de la MCJ. La limitation de l'usage des PP à des indications spécifiques nécessite d'être discutée à l'heure de la grande disponibilité des PR. De larges enquêtes et réflexions aideraient aux futures orientations de la politique nationale. / Introduction and issues: The policy and local choices of plasmatic (PP) or recombinant products (RP) in hemophilia vary according to the country, despite consensus international recommendations. In contrast to other countries, French policy in this context gives no priority in the choice between plasmatic and recombinant ones, despite the appearance of variant Creutzeldt-Jakob disease (vCJD) involving risks in transfusions, albeit miniscule, in the former. Caregivers and patient adherence to this policy and its likely psychological impact on them, are unknown and raise ethical questions. Methodology: Single- and multi-site surveys of French doctors and patients were carried out to evaluate their feelings about the French policy of unrestricted continued use of plasmatic products and their procedures of batch recall. A discussion of inherent ethical problems is conducted, based on reports of scientific expertise and our own data. Results: This analysis allowed a French model to be defined and compared to the North American, British, and European ones. This French model seems to be the least strict in terms of the use of PP, while France is in second place in terms of the worldwide prevalence of vCJD, just after U.K who have simply banned the prescription of these first products for hemophiliacs in favor of RP, which are risk-free. We identified many ethical tensions in the management of patients and in risk management of these products in France. These are mainly due to four issues that correspond to the paradoxes of French policy of hemophilia product risk management, including: 1) unjustified multiplication of recall procedures concerning batches of PP, primarily those related to sporadic forms of CJD even though incommunicable through it; 2) lack of accurate formalization concerning the organization of batch removal procedures, the sources, methods, means and time of contact for physicians and their patients that are very varied, reflecting some improvisations and a mess in the process; 3) maintaining of unrestricted indication and source of PP; 4) systematic retrospectively traumatic information for patients, especially during the batch recalls for this very small risk, rather than a case-by-case basis. The induced ethical issues are : residual psychological trauma for patients and their families on the occasion of information, poorly managed and poorly understood, the risk of vMCJ during batches removal procedures of PP leading to their massive switch RP ; ineffectiveness of these procedures to remove incriminated batches since they are often consumed; drastic reduction or even banishment of the prescription of PP; difficult experience and majority disapproval of physicians maintaining unrestricted PP and batch removal procedures; low respect for batch removal procedures, applied unevenly; crisis of confidence of patients and physicians concerning this policy; feelings of conflict of interest from political authorities in connection with an alleged protectionism of the domestic industry manufacturing PP in the absence of strong reasons to their retention without restriction to specific indications. Conclusion: An institutional reframing of PP recall in France appears to be necessary, these being mainly unjustified since relative to sporadic CJD forms. Restrictions on the use of PP at specific directions need to be discussed at this time of high availability of RP. Extensive surveys would help the future direction of national policy.

The high crime rate in South Africa and the government’s apparent inability to deal with this problem is a reality. Even though no official statistics exist regarding the recidivism rate in South Africa it is estimated that it could be between 55% and 95%. The contributing role that recidivism plays towards the high crime rate can therefore not be ignored. In South Africa no classification system exists whereby a repeat offender can formally be classified as a recidivist. The crime prevention and management strategies currently utilised in South Africa furthermore does not recognise and address the role that recidivism plays as contributing factor towards the high crime rate. The aim of this study was to formulate a classification system for the South African recidivist in order to compile an inter-disciplinary action plan for the prevention and management of recidivism. The research design of this study was exploratory and both quantitative and qualitative data gathering methods were used in this study. The quantitative study involved the completion of the PFIR eco-metric scale by offenders falling within the classification criteria for recidivism. From the analyses of this data a proposed profile of the South African recidivist was compiled. During the qualitative phase of the research interviews were conducted with experts in the field of crime prevention and management. A semi-structured interview schedule was used for this purpose. Based on the key findings of the study an inter-disciplinary action plan for the prevention and management of recidivism was compiled. The purpose of this action plan is to propose an inter-disciplinary and inter-sectoral intervention and management strategy to address recidivism holistically. Within the action plan it is suggested that recidivism should be addressed on three levels, namely prevention, therapeutic and developmental intervention and reintegration. The primary recommendation of this study was that the proposed inter-disciplinary action plan should be adopted by policy makers and be included in the crime management and prevention strategies of South Africa. The study concluded with specific recommendations to help facilitate this process. / Thesis (DPhil)--University of Pretoria, 2002. / Social Work and Criminology / Unrestricted

Chronic pain in children and adolescents is common; approximately 5% of children and adolescents report chronic pain along with moderate to high pain-related disability. Chronic pain is a subjective experience and can best be explained by a bio-psycho-social approach, which suggests reciprocal relations between different levels of this multidimensional phenomenon. The different dimensions of chronic pain need to be considered for a comprehensive assessment. Due to the subjective nature of pain, the child’s self-report is usually considered the best available and most valid estimate of the pain experience. A reliable and multidimensional assessment is an indispensable requirement for treatment planning. To date, questionnaires in German language are available to assess a wide range of relevant parameters in pediatric chronic pain. However, so far, no validated self-report tool exists to assess sensory and affective pain perception in children. These two parameters are of relevance since they describe aspects of the biological as well as the psychological dimension of chronic pain. Furthermore, a comprehensive diagnostic approach combining parameters from the three dimensions of chronic pain does not yet exist for children and adolescents. Such a comprehensive approach could be used for sample descriptions and standardized comparisons across different populations; it could serve as an approach for treatment planning or to classify outcome. This doctoral thesis is aimed at further developing the available diagnostic measures for older children and adolescents with chronic pain based on the above mentioned gaps in pediatric pain assessment. Research was performed on three patient samples. Sample 1 includes data from a prospective assessment at the German Pediatric Pain Centre from August 2008 to March 2009 (N(1)=139). Sample 2 includes retrospective data from patients who were treated at the German Pediatric Pain Centre from July 2005 to June 2010 (N(2)=1242). Sample 3 consists of pediatric pain patients who started an intensive interdisciplinary inpatient treatment between November 2009 and July 2011 (N(3)=83). In a first study, a tool to assess sensory and affective pain perception, the Pain Perception Scale for Adolescents, was adapted and validated in an adolescent clinical sample (Sample 1). The Pain Perception Scale for Adolescents allows pain patients to provide a valid and reliable self-report of parameters for both the biological and psychological dimensions of pain. In a second study, this tool was applied to a further sample of adolescents with migraine and tension-type headache (subsample of Sample 2). It was demonstrated that, contrary to the official headache classification guidelines, the sensory pain perception in this sample did not differentiate between migraine and tension-type headache. To develop a multidimensional assessment approach, in a third study, an adult classification system (Chronic Pain Grading) was applied to a sample of pediatric pain patients (Sample 2). This approach proved useful as a valid measure for a brief operationalization of pain problem severity, including pain intensity and pain-related disability only, and as an outcome measure. However, it displayed major shortcomings with regards to treatment stratification. To further develop an approach for treatment stratification and treatment planning, a fourth study focused on developing a new multidimensional approach for subgroup classification (subsample of Sample 2). The stability of subgroups was demonstrated in a cross-validation with an independent sample (Sample 1). Furthermore, the identified subgroups displayed distinct treatment outcomes after a standardized treatment program (Sample 3). In conclusion, this doctoral thesis offers an addition to diagnostic measures for older children and adolescents with chronic pain by adding the Pain Perception Scale for Adolescents and by proving the validity of the Chronic Pain Grading for the application in this patient group. These tools allow a valid description of adolescents’ subjective pain experience. Results from this doctoral thesis also indicate that the findings from adults cannot be readily transferred to children and adolescents. The final output of this doctoral thesis is a bio-psycho-social classification approach that identifies subgroups of adolescents with chronic pain with treatment relevant differences. This is a first step toward the development of subgroup-specific treatment.

This review aimed to evaluate orthotic treatments for children and adolescents with pectus carinatum, primarily focusing on patient satisfaction with the treatment. Secondary outcomes of interest were adherence and psychological and social factors following the treatment period. A literature search was performed in the databases CINHAL, Medline, Web of Science and Scopus. Following predetermined eligibility criteria, articles were included and excluded. Next, criticala ppraisal was performed for the included articles. Following this, relevant data were extracted, analysed, and presented to aid in answering the research questions. Six articles with 402 patients were included in the final review. Patient satisfaction was good or improved following the treatment period, and the combined non-adherence rate for the included orthosis was 37.7 %. Patients adhering to the treatment protocol showed increased self-esteem and decreased interference with social activity following orthotic correction. Moreover, they displayed significantly higher patient satisfaction than patient's non-adherent to the treatment protocol. The findings were displayed and discussed in the Bio-Psycho-Social model. Due to their connection, patient satisfaction and adherence were placed together in the middle and surrounded bypsychological and social factors. The model displayed that a combination of many aspects determines patient satisfaction and adherence, demonstrating that treatment is complex and challenging. In conclusion, adherence was deemed one of the most important aspects to achieve high patient satisfaction. Moreover, due to psychological and social factors, a patient-centred approach with professional collaboration is necessary to achieve successful outcomes. To make reliable conclusions, research of higher quality with long follow-up periods including standardised patient satisfaction and adherence measures is needed.

Актуальность темы исследования. Разные культурные традиции сказываются на рабочем процессе, общении между людьми, криминогенной обстановке и единстве общества. С 2010 года по 2018 наблюдается рост численности въезжающих Вьетнамских граждан более чем в полтора раза, часть из которых прибыли с целями трудоустройства (кроме трудовых мигрантов, есть школьники, студенты и аспиранты). Известно, что именно детский возраст – это тот период, когда возможно эффективно скорректировать, сформировать важные области детского развития, что будет влиять на их адаптацию в обществе в дальнейшем. Следовательно, исследования кросс-культурных различий развития человека, в частности младенца, являются актуальными в наше время. Объектом исследования является психо-социальное развитие младенцев. Предметом исследования является кросс-культурные различия в психо-социальном развитии младенцев Росии и Вьетнама. Цель и задачи исследования: выявить различия в психо-социальном развитии младенцев России и Вьетнама. Научно-информационная база исследования: Культурноисторическая теория Выготского, концепция онтогенетического развития психики в общении М.И. Лисиной, общепсихологическая теория деятельности А.Н. Леонтьева. Научная новизна исследования заключается в следующем: Данное исследование – это одна из первых попыток найти различия между Россией и Вьетнамом. Научно-практическая значимость исследования. В первую очередь, результаты данного исследования дают возможность родителю более экологично для ребенка взаимодействовать с ним. Помимо этого, результаты данного исследования позволят психологам, работающим с младенцами типично и атипично развивающимися, повысить качество работы с семьями, имеющими таких детей и разработать подходящие сопровождающие и коррекционные методики, основанные на кросс-культурных особенностях. Данное исследование является частью лонгитюдного исследовательского проекта при поддержке гранта Российского научного фонда РФФИ.№ 19-513-92001 \ 19. Содержание диссертации. Диссертация состоит из введения, трех глав, выводов, заключения, списка литературы в количестве 77 источников, 3 приложения. Объём работы — 68 страницы печатного текста, который содержит 1 таблицу. В рамках исследования имеется публикация: «Различие маркеров детско-родительского взаимодействия у детей с типичным и атипичным развитием» (2019). / Relevance of the research topic. Different cultural traditions affect the work process, communication between people, the criminal environment and the unity of society. From 2010 to 2018, there has been an increase in the number of incoming Vietnamese citizens by more than one and a half times, some of whom arrived for employment purposes (in addition to labor migrants, there are schoolchildren, students and postgraduates). It is known that children's age is the period when it is possible to effectively correct and form important areas of children's development, which will affect their adaptation in society in the future. Therefore, research on cross-cultural differences in human development, in particular in infants, is relevant in our time. The object of research is the psycho-social development of infants. The subject of the study is cross-cultural differences in the psycho-social development of infants in Russia and Vietnam. The purpose and objectives of the study: to identify differences in the psycho-social development of infants in Russia and Vietnam. Scientific and information base of the research: Vygotsky's cultural and Historical theory, the concept of ontogenetic development of the psyche in communication M. I. Lisina, the General psychological theory of activity A. N. Leontiev. The scientific novelty of the study is as follows: This study is one of the first attempts to find differences between Russia and Vietnam. Scientific and practical significance of the research. First of all, the results of this study allow the parent to interact with the child in a more environmentally friendly way. In addition, the results of this study will allow psychologists working with typically and atypically developing infants to improve the quality of work with families with such children and develop appropriate accompanying and corrective methods based on cross-cultural characteristics. This research is part of a longitudinal research project supported by a grant from the Russian science Foundation (RFBR) no. 19-513-92001 \ 19. Content of the dissertation. The dissertation consists of an introduction, three chapters, conclusions, conclusion, list of references in the number of 77 sources, 3 appendices. The volume of work is 68 pages of printed text, which contains 1 table. Within the framework of the study, there is a publication: "Differences in markers of child-parent interaction in children with typical and atypical development" (2019).

A qualitative study was undertaken in Pietermaritzburg to unveil the experiences and challenges of WLWHIV as perceived by social workers as well as to explore and describe the experiences of social workers in rendering services to these women. Explorative, descriptive and contextual research designs were employed for the research process. Purposive and snowball sampling techniques were utilised to recruit participants who met the set criteria. Face-to-face semi-structured interviews were conducted with thirteen participants. Data obtained were transcribed and analysed applying Tesch‘s eight steps (Creswell, 2009). Data verification was guided by Guba‘s model (Krefting, 1991). The findings revealed the existence of strained relationships between WLWHIV and their partners and ineffective delivery of social work services to WLWHIV. Based on the findings, it is recommended that specialised training for social workers on issues related to death and dying and services for children of WLWHIV be incorporated in the guidelines for social work practice / Social Work / M.A. (social Work)