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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
541

The self-concept and interpersonal relationships of student teachers

Mampa, Lemohang Lerato 11 1900 (has links)
The aim of the research was to determine the relationship between the self-concept of student teachers and their interpersonal relationships. A literature survey focused on these two variables. This was followed by an empirical investigation involving 300 students. Findings include: A significant, positive correlation was found between selfconcept and interpersonal relationships for males and females and for all three year groups involved. Significant, positive correlations were also found between: cognitive self-concept and relationships with lecturers; self-concepts of male students and relationships with parents; self-concepts of female students and relationships with lecturers. For all three year groups the relationships with lecturers contributed most to their self-concepts. For males, the emotional self-concept; and for females, the cognitive self-concept contributed significantly towards their interpersonal relationships. For first and second-year students, the social self-concept contributed most towards their interpersonal relationships; while for third-year students, the cognitive self-concept contributed significantly towards interpersonal relationships. / Psychology of Education / M. Ed. (Psychology of Education)
542

An investigation into the risk factors and management of rugby injuries in the greater Durban area

Tuck, Andrew Murray January 2010 (has links)
Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2010. / Objective: Majority of studies to date have focused on injury profiles and types of injuries in rugby, without looking at the risk factors associated and the management of these injuries. It was thus the aim of this study to determine the risk factors and management of rugby injuries in the greater Durban area. Methods: This was a prospective, cross-sectional based study, using a self-administered questionnaire, developed specifically for this research utilizing a focus group and pilot study. The questionnaire details a patient injury history, rugby history, resources, management, coaching and training parameters. Letters of informed consent and the questionnaire were distributed to 300 players / coaches for completion and data was analysed using Pearson’s correlation and t-tests. Results: A response rate of 70% (n=210) was achieved. Selected risk factors were found to be significantly related to current and / or previous injury. New risk factors which did significantly impact injury, were also determined. Conclusion: It is advised that coaches and players take note of significant injury risk factors and management protocols in order to improve player health and decrease injury risk. Further research may look into the factors identified in order to set up better structures in order to prevent further injuries.
543

A revision of a maternal interview questionnaire used in fetal alcohol spectrum disorder prevention programmes in South Africa

Breytenbach, Elizabeth 04 1900 (has links)
Thesis (M Speech Path)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: This study was done in collaboration with the Foundation for Alcohol Related Research (FARR), a non-governmental organization whose primary objective is to develop and maintain Fetal Alcohol Spectrum Disorder (FASD) prevention programmes across South Africa. Research has shown the occurrence of FASD in South Africa to be much higher than in other parts of the world. As part of their prevention programmes, FARR uses a three part diagnostic process, including a maternal interview, a dysmorphological examination, as well as a general developmental assessment. The maternal interview questionnaire that FARR currently uses takes an average of two hours per interviewee to complete. Even though a recent study indicates that FASD prevention programmes administered by FARR can potentially reduce FASD prevalence, shorter maternal interviews could improve the use of FARR resources and the ability of FASD research studies to gather meaningful information and inform future prevention efforts. The main purpose of this study was to adjust the maternal interview questionnaire used by FARR in order to make interviews with mothers shorter while delivering the information needed for successful FASD prevention programmes. Data related to the adequacy of the adjusted maternal interview questionnaire was collected and analysed according to an action research approach in four consecutive phases. The research procedures consisted of two separate focus group interviews with five key role players from FARR. During the first focus group interview the main problems with the questionnaire was identified as being (i) the length of the questionnaire, (ii) the unsuitability of the questionnaire to interview someone other than the biological mother, and (iii) inconsistency between interviewers when using the questionnaire. During the second phase of the study the questionnaire was adjusted and revised as part of a second focus group interview. The interviewers, data capturer and data analyst who used the adjusted questionnaire as part of a larger FASD prevention programme made several suggestions on how the questionnaire could be further adjusted to suit the needs of FARR. These suggestions were addressed during the final phase of the study, after which the adjusted questionnaire was finalized. Findings from the study suggest that identified problems with FARR’s original maternal interview questionnaire were successfully addressed by the adjusted questionnaire, while simultaneously satisfying the objectives of a maternal interview as identified by participants during the first focus group interview. Results confirmed that more maternal interviews could be conducted in the same time period using the adjusted interview questionnaire compared to when the original questionnaire was used, due to the fact that the questionnaire was shorter and took less time to administer. As part of this study an additional questionnaire was developed specifically for caregiver interviews. According to FARR role players, inconsistency between interviewers was for the most past successfully addressed by the development of this additional questionnaire and the development of an interviewer guideline. Recommendations for future research include the further development and evaluation of the caregiver questionnaire and interviewer guideline. / AFRIKAANSE OPSOMMING: Hierdie studie is uitgevoer in samewerking met die “Foundation for Alcohol Related Research” (FARR), ‘n nie-regeringsorganisasie met die primêre objektief om Fetale Alkohol Spektrum Afwyking (FASA) voorkomingsprogramme in Suid-Afrika te ontwikkel en te handhaaf. Volgens navorsing is die voorkoms van FASA in Suid-Afrika beduidend hoër as in ander dele van die wêreld. ‘n Drie-delige diagnostiese proses word as deel van FARR se voorkomingsprogramme gebruik, insluitend ‘n onderhoud gefokus op moeders, ‘n dismorfologiese ondersoek, asook ‘n evaluasie van die kind se algehele ontwikkeling. Die moeder-onderhoudsvraelys wat tans deur FARR gebruik word neem gemiddeld twee ure om te voltooi. Alhoewel ‘n onlangse studie aandui dat die voorkomingsprogramme deur FARR oor die potensiaal beskik om die prevalensie van FASA te verlaag, kan korter moeder-onderhoude potensieël daartoe lei dat bronne beter benut word, asook dat FASA voorkomingstudies betekenisvolle inligting versamel vir die ontwikkeling van toekomstige voorkomingsprogramme. Die hoofdoel van die huidge studie was om die moeder-onderhoudsvraelys wat tans deur FARR gebruik word aan te pas, om sodoende die onderhoude met moeders korter te maak terwyl die nodige inligting vir suksesvolle FASA voorkomingsprogramme steeds verkry word. Gedurende hierdie studie is data rakende die toereikendheid van die aangepaste moederonderhousdvraelys versamel en geanaliseer volgens ‘n aksie-navorsingsbenadering in vier opeenvolgende fases. Die navorsingsprosedures het bestaan uit twee afsonderlike fokusgroeponderhoude met vyf van die sleutelrolspelers van FARR. Gedurende die eerste fokusgroeponderhoud is die hoofprobleme met die vraelys geïdentifiseer as (i) die lengte van die vraelys, (ii) die ongeskiktheid van die vraelys om ‘n onderhoud met iemand anders as die biologiese moeder te voer, en (iii) die inkonsekwentheid tussen onderhoudvoerders met die gebruik van die vraelys. Gedurende die tweede fase van die studie is die vraelys aangepas en hersien as deel van ‘n tweede fokusgroeponderhoud. Die onderhoudvoerders, data verwerker en data analis wat die aangepaste vraelys gebruik het as deel van ‘n groter FASA voorkomingsprogram het verskeie aanbevelings gemaak rakende hoe die vraelys verder aangepas kan word om te voldoen aan FARR se behoeftes. Laasgenoemde aanbevelings is aangespreek gedurende die laaste fase van die studie, waarna die aangepaste vraelys gefinaliseer is. Die bevindinge van die studie dui aan dat die geïdentifiseerde probleme met FARR se oorspronklike moeder-onderhoudsvraelys suksesvol deur die aangepaste vraelys aangespreek is, terwyl die objektiewe van ‘n moeder-onderhoud (soos geïdentifiseer deur die deelnemers aan die eerste fokusgroeponderhoud) steeds vervul is. Resultate het bevestig dat meer moeder-onderhoude in dieselfde tydsperiode met behulp van die aangepaste vraelys gevoer kon word as met die oorspronklike vraelys, as gevolg van die feit dat dit korter was en minder tyd geneem het om te voltooi. As deel van die studie is ‘n bykomstige vraelys spesifiek vir sorggewer-onderhoude ontwikkel. Volgens die FARR rolspelers is inkonsekwentheid tussen die onderhoudvoerders grootliks suksesvol aangespreek deur middel van die ontwikkeling van hierdie bykomstige vraelys asook die ontwikkeling van ‘n riglyn vir onderhoudvoerders. Aanbevelings vir verdere navorsing sluit die verdere ontwikkeling en evaluasie van die sorggewer-vraelys en onderhoudvoerder riglyn in.
544

Η παραγοντική ανάλυση των αντιστοιχιών (Correspondence analysis) και εφαρμογή της, με χρήση του Spss, σε δεδομένα έρευνας για την αξιοποίηση Τεχνολογιών Πληροφορίας και Επικοινωνίας (ΤΠΕ) στην πρωτοβάθμια εκπαίδευση

Μαντζούνη, Αικατερίνη 06 December 2013 (has links)
Η παρούσα διπλωματική εργασία ασχολείται με πολυδιάστατα κατηγορικά δεδομένα όπως αυτά προκύπτουν από συλλογή μέσω ερωτηματολογίων. Για να αναλυθεί όμως ένα ερωτηματολόγιο το οποίο περιλαμβάνει πλήθος ερωτήσεων-μεταβλητών και να εξάγουμε ορισμένα χρήσιμα συμπεράσματα θα πρέπει, πρώτα από όλα να γίνει η κατάλληλη κωδικοποίηση των δεδομένων. Χρησιμοποιώντας στατιστικές τεχνικές και μεθόδους κατάλληλες για κατηγορικά δεδομένα μπορούμε πιο εύκολα να μελετήσουμε τις σχέσεις μεταξύ των μεταβλητών. Για τον σκοπό αυτό, παρουσιάζουμε και αναλύουμε τη θεωρία της Παραγοντικής Ανάλυσης των Αντιστοιχιών και της Πολλαπλής Παραγοντικής Ανάλυσης των Αντιστοιχιών. Ύστερα, αναλύουμε τα αποτελέσματα που δίνουν οι μέθοδοι όταν τις χρησιμοποιήσουμε για την ανάλυση του ερωτηματολογίου. Τα συμπεράσματα που προκύπτουν έχουν ιδιαίτερο ενδιαφέρον. Η δυναμικότητα των μοντέλων αυτών παρουσιάζεται μέσα από μία εφαρμογή από τον χώρο των κοινωνικών επιστημών σε θέματα που αφορούν τα σχολεία και τους μαθητές της Πρωτοβάθμιας εκπαίδευσης. Στις μεθόδους αυτές δίνεται έμφαση κυρίως στα γραφικά αποτελέσματα αλλά και στις εκτιμήσεις των σκορ των κατηγοριών των μεταβλητών. Όλα τα παραπάνω τα συγκρίνουμε κριτικά μεταξύ τους στη θεωρία και στη πράξη έτσι ώστε ο ενδιαφερόμενος αναγνώστης να κατανοήσει περισσότερο τις μεθόδους αυτές και να αποκομίσει όσο το δυνατόν περισσότερες πληροφορίες που θα τον βοηθήσουν για την εφαρμογή τους. / This dissertation deals with multivariate categorical data of a raw data set produced by a questionnaire designed for a research purpose. However, in order to analyze a questionnaire and extract some fruitful results, that includes a great number of questions-variables, we must first impose a structure on it especially on situations this specific structure is missing. Whenever the structure is imposed, by using statistical techniques and methods designed for categorical data, we can then study more efficiently the relations among the variables in concern for further analyses. The capacity of these models is presented through an application from the social sciences on issues concerning schools and pupils in primary education. The analysis on a smaller subset is further explored by describing the issues of Correspondence Analysis, and Multiple Correspondence Analysis. With these methods, we focus on the interpretation of the results on the graphical displays of the data but also on the estimated category scores of the variables. The above methods described in this dissertation and the results after implementing them are all critically compared with each other at each chapter. This gives to the interesting reader the possibility to fully understand them and to obtain additional information on their implementation.
545

An evaluation of the Amblyopia and Strabismus Questionnaire using Rasch analysis

Vianya-Estopa, M., Elliott, D. B., Barrett, B. T. January 2010 (has links)
PURPOSE: To evaluate whether the Amblyopia and Strabismus Questionnaire (A&SQ) is a suitable instrument for the assessment of vision-related quality-of life (VR-QoL) in individuals with strabismus and/or amblyopia. METHODS: The A&SQ was completed by 102 individuals, all of whom had amblyopia, strabismus, or both. Rasch analysis was used to evaluate the usefulness of individual questionnaire items (i.e., questions); the response-scale performance; how well the items targeted VR-QoL; whether individual items showed response bias, depending on factors such as whether strabismus was present; and dimensionality. RESULTS: Items relating to concerns about the appearance of the eyes were applicable only to those with strabismus, and many items showed large ceiling effects. The response scale showed disordered responses and underused response options, which improved after the number of response options was reduced from five to three. This change improved the discriminative ability of the questionnaire (person separation index increased from 1.98 to 2.11). Significant bias was found between strabismic and nonstrabismic respondents. Separate Rasch analyses conducted for subjects with and without strabismus indicated that all A&SQ items seemed appropriate for individuals with strabismus (Rasch infit values between 0.60 and 1.40), but several items fitted the model poorly in amblyopes without strabismus. The AS&Q was not found to be unidimensional. CONCLUSIONS: The findings highlight the limitations of the A&SQ instrument in the assessment of VR-QoL in subjects with strabismus and especially in those with amblyopia alone. The results suggest that separate instruments are needed to quantify VR-QoL in amblyopes with and without strabismus.
546

Competencies needed for virtual workers / by Theresa A. Botha

Botha, Theresa Adrian January 2005 (has links)
The changing world of work that we live in is characterised by forming part of globalisation and virtualness. The previous era managers focused on how to make money and how this money can work for them. The changing world of work is characterised by global competitiveness in delivering quality products quicker and cheaper. Globalisation presents continuous advancements in technology, which requires a new mindset. These technological advancements have a profound effect on culture, training and management of staff. This brings about change in flexible working arrangements and the traditional office made space within certain organisations for virtual offices. The move towards virtualness causes companies to work more closely with their customers to be able to coordinate rapid changes in products (Schuh, Millarg & Gorannson, 1998; Weissenfeld, Fisscher, Pearson & Brockhoff, 200 1). The financial institution referred to in this study was also driven by globalisation and technological advancements to re-engineer the current way in which they do business. It became evidently clear that there was a need for a shift towards virtualness, which called for the identifying of relevant competencies; needed by employees for working in a virtual environment. These competencies will enable the organisation to select the right employees and provide them with information that could be utilised in training the current virtual employees according to the competencies identified. The objectives of this research were firstly to conduct a job analysis to determine the important competencies needed by virtual workers, in a specific job at a financial institution in South Africa. Secondly to compare the current competencies of the virtual workers (who took part in the research) with the competencies identified by the job analysis to be important for this specific job. Thirdly to determine the skills required for virtual workers and compare these skills with the skills ranked by the current virtual workers to be important. Fourthly to identify how these virtual workers experienced the effect of virtualness on their performance. Lastly to make recommendations regarding future training and selection purposes. A survey design (cross-sectional) was used to determine competencies needed by virtual workers for a specific job at a financial institution in South Africa. The study population consisted of (N= 71) employees in a virtual job at a financial institution in South Africa. The Work Profile Systems (WPS), Occupational Personality Questionnaire (OPQ), Performance Assessment Questionnaire (PAQ) and a Skills Audit (SA) were administered. Results of the research indicated that 44% of the study population exhibits the competencies needed by virtual workers as indicated by the Inventory of Management Competencies (IMC) Profile of the WPS. The results of the Performance Assessment Questionnaire (PAQ) indicated that the current virtual workers experienced the greatest impact of virtualness on improving the attainment of personal goals, as well as improving the achievement of organisational goals. The results from the Skills Audit (SA) identified skills that were essential for virtual workers in a specific job within a virtual environment, according to the feedback received from the current virtual workers. They compared favourably with the skills identified by literature as being important. Recommendations to the organisation and for future research have been made and limitations were also discussed. / Thesis (M.A. (Industrial Psychology))--North-West University, Vaal Triangle Campus, 2005.
547

Qualidade de vida na pessoa com deficiência intelectual: percepção do indivíduo / Quality of life in the people with intellectual disability: individual´s perception

Cartolano, Fernanda Parsequian 10 May 2019 (has links)
Em sua maioria, as pesquisas que investigam a qualidade de vida de pessoas com deficiência intelectual (DI) apresentam a opinião dos atendentes pessoais e/ou familiares sobre a pessoa com deficiência ou sobre si mesmos, encontrando-se um número reduzido de estudos referentes à opinião das pessoas com DI a respeito de suas vidas. Sendo assim, o presente estudo teve como objetivos investigar a percepção de indivíduos com DI sobre sua qualidade de vida e comparar com a percepção de seus atendentes pessoais. Os participantes da pesquisa foram selecionados e incluídos no presente estudo a partir da indicação de equipamentos de saúde e assistência social, vinculados à Prefeitura do Município ou ao Estado de São Paulo, aos quais estão cadastrados. Foram incluídos no estudo 51 indivíduos com idade entre 19 e 59 anos, residentes na cidade de São Paulo com diagnóstico médico de deficiência intelectual, que não apresentaram como comorbidades deficiências físicas e/ou transtornos mentais, e 31 atendentes pessoais. Os participantes com deficiência responderam o questionário WHOQOL-bref-ID e seus atendentes pessoais responderam o questionário WHOQOL-bref-ID proxy e Questionário sobre Perfil Socioeconômico. Os dados obtidos foram analisados e relacionados com as variáveis: sexo, idade, raça, diagnóstico médico e perfil socioeconômico e percepção das famílias quanto à qualidade de vida destes indivíduos. Os indivíduos com DI apresentaram maior pontuação no domínio Psicológico e menor pontuação no domínio Discriminação do questionário, já os atendentes pessoais apresentaram maiores pontuações para o domínio Físico e menores para o domínio Autonomia. As variáveis sexo, raça e perfil socioeconômico apresentaram correlações significativas com o domínio Social do protocolo. Quanto à comparação entre a autoavaliação e a avaliação por representante foram observadas diferenças estatisticamente significativas em cinco dos sete domínios avaliados / There are few studies about how people with intellectual disability (ID) perceive their own quality of life, with research being focus, mainly, in the opinion of caregivers and/or family. For this reason, the aim of this study was to increase knowledge and understanding of how people with ID perceive their own quality of life. Participants were selected from the register of São Paulo city hall. Fifty-one participants, aged 19-59 years, living in São Paulo city with a diagnostic of ID, that did not present any comorbidities, as physical or mental disabilities, were included. Thirty-one caregivers were also included in this study. The participants with ID answered the WHOQOL-bref-ID and their caregivers answered WHOQOL-bref-ID proxy and the socio-economic profile questionnaire. Data was analyzed in relation to the following variables: gender, age, race, diagnostic, socio-economic profile and family\'s perception regard the quality of life of the participants with ID. The individuals with ID presented higher score on the psychologic domain and lower score in the discrimination domain of the questionnaire. The caregivers presented higher scores on the physical domain and lower scores in the autonomy domain. The variables gender, race and socio-economic profile presented significant correlations with the social domain of the questionnaire. Regard the comparison between self-perception and the perception of caregivers it was possible to observe significant differences in 5 of the 7 evaluated domains
548

Prejuízos da qualidade de vida em pacientes com transtornos alimentares / Impairment of quality of life in patients with eating disorders

Taragano, Rogeria Oliveira 22 May 2013 (has links)
Avaliar a Qualidade de Vida (QV) de pacientes com Transtornos Alimentares (TA), verificar diferenças entre os subtipos de TA e identificar dimensões de QV mais prejudicadas. Métodos: O instrumento de QV da Organização Mundial de Saúde (WHOQOL-100) foi respondido por 69 mulheres com TA (Anorexia Nervosa AN=34; Bulimia Nervosa BN=26 e Transtorno Alimentar Não Especificado TANE=9) e por 69 mulheres saudáveis. Utilizou-se a Entrevista Clínica Estruturada para Transtornos do Eixo I do DSM-IV (SCID) para a realização dos diagnósticos psiquiátricos. Resultados: Pacientes com TA apresentaram piores escores na QV geral e em todos os domínios (físico, psicológico, relações sociais, meio ambiente, nível de independência e espiritualidade), tendo sido o psicológico aquele com maior prejuízo. Não foram encontradas diferenças entre os subtipos de TA quanto aos prejuízos de QV. As comorbidades psiquiátricas encontradas com maiores prevalências foram os Transtornos do Humor, os Relacionados ao Uso de Álcool e Outras Substâncias e os de Ansiedade. Pacientes com AN e comorbidade com o Transtorno de Pânico apresentaram QV mais prejudicada que pacientes com AN sem Pânico. A maioria dos pacientes apresentava múltiplas comorbidades e histórico de diversas tentativas de suicídio. Conclusões: Pacientes com TA apresentam significativo prejuízo de QV em todos os domínios, em especial no psicológico, provavelmente em função das peculiaridades da psicopatologia alimentar, sem diferenças entre os subtipos de TA. Pacientes com AN e comorbidade com Pânico devem ser avaliados com mais critério / Purpose: To assess quality of life in patients with eating disorders, verify differences among eating disorder subtypes, and identify the domains of quality of life most affected by eating disorders. Methods: The World Health Organization quality-of-life assessment instrument (WHOQOL-100) was completed by 69 women with eating disorders (34 with anorexia nervosa, 26 with bulimia nervosa, and 9 with eating disorder not otherwise specified) and 69 healthy women. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used for the diagnosis of psychiatric disorders. Results: Patients with eating disorders reported lower (worse) total quality- of-life scores and lower scores on all quality-of-life domains (physical, psychological, social relationships, environment, level of independence, and spirituality) compared with healthy patients, with the psychological domain being the most impaired. No significant differences in impairment of quality of life were found among eating disorders subtypes. The most prevalent psychiatric comorbidities were mood disorders, alcohol or substance abuse- related disorders, and anxiety disorders. Patients with anorexia nervosa and comorbid panic disorder had greater impairment in quality of life than patients with anorexia nervosa but no panic disorder. Most patients had multiple comorbidities and history of suicide attempts. Conclusions: Patients with eating disorders experience significantly greater impairment in quality of life on all domains, especially on the psychological domain, compared with healthy patients, probably because of peculiarities in eating disorders psychopathology. No difference in quality of life impairment was observed among eating disorders subtypes. Patients with anorexia nervosa and comorbid panic disorder should be carefully evaluated
549

Proposta de modelo de indicadores de qualidade para o atendimento oferecido aos indivíduos autistas na cidade de São Paulo / A model of quality indicators for the service provided to subjects with autism in the city of São Paulo

Netrval, Danielle Azarias Defense 08 May 2014 (has links)
A prevalência do Transtorno do Espectro Autista (TEA) tem aumentado dramaticamente no mundo todo e, a partir disso, observa-se a ampliação das discussões sobre políticas públicas destinadas a essa população. No Estado de São Paulo essas discussões iniciaram-se em 2000 a partir de um movimento das famílias de crianças com TEA. Em 2012, o Brasil instituiu a Política Nacional de Proteção dos Direitos da Pessoa com TEA e, por meio desta, os indivíduos com TEA passaram a ser considerados portadores de deficiências, tendo todos os direitos atribuídos a estes. Ao considerar os questionamentos sobre o tratamento oferecido aos indivíduos com TEA, a presente pesquisa teve como objetivos traçar o perfil da população com TEA assistida e propor um modelo de indicadores de qualidade do tratamento fonoaudiológico oferecido a essa população no município de São Paulo. A pesquisa foi dividida em três momentos: elaboração do questionário intitulado \"Questionário de elaboração de indicadores de qualidade no tratamento de autistas\"; busca dos locais de estudo no município de São Paulo e coleta de dados. Para a elaboração do questionário, inicialmente houve a seleção dos indicadores de qualidade de processos e resultados, baseada no instrumento Balanced Scorecard (BSC). Após isso, foi criado um questionário com 23 perguntas objetivas, sendo apenas 13 obrigatórias e que permitia a coleta de dados sobre os indicadores de qualidade. A ideia inicial da pesquisa era que ela fosse longitudinal e realizada em parceria com a Secretaria de Saúde do Estado de São Paulo, porém houve o veto por parte do Gabinete do Secretário e a pesquisa limitou-se a apenas um momento de coleta de dados e a busca dos locais da amostra ocorreu por meio de trabalho de campo em redes. A amostra inicial teve 62 locais, porém apenas 25 destes concordaram em participar da pesquisa. A coleta de dados ocorreu por meio de entrevistas com coordenadores e/ou fonoaudiólogos responsáveis pelos locais estudados e isso ocorreu, em todas as situações, após uma reunião com a pesquisadora. Os dados obtidos foram tabulados e receberam análise estatística descritiva e de agrupamentos significativos. Os resultados demonstraram maior predominância de escolas particulares (escolas regulares com inclusão e escolas especiais) e maior oferta de locais de assistência a indivíduos da faixa etária infantil. O total de indivíduos assistidos foi de 854, sendo que a maioria é de crianças e diagnóstico de autismo puro. A maioria dos indivíduos é falante, mas isso não esteve relacionado à oferta da terapia fonoaudiológica. A oferta de terapia fonoaudiológica ocorre em 64% da amostra, sendo em média um fonoaudiólogo por local, que atende em média 18 pacientes com TEA, uma vez por semana. A maior parte dos locais informou que o tempo de tratamento no local, assim como a duração da terapia fonoaudiológica é indeterminada. Em relação à rotatividade dos indivíduos, a maior proporção foi de desligamentos e a menor de reinserções. Na análise de agrupamentos foram consideradas sete variáveis relevantes para o agrupamento dos dados, totalizando três grupos (1, 2 e não classificados) e em geral, o G1 apresentou maior proporção de sujeitos com indicação para acompanhamento fonoaudiológico, de número de fonoaudiólogos, diagnóstico de autismo puro e de autismo associado a outras patologias. Conclui-se que a presente pesquisa permitiu traçar um perfil dos locais de assistência e da população assistida e identificou informações importantes para as primeiras estratégias para o gerenciamento de serviço de Fonoaudiologia oferecidos a indivíduos com TEA / The prevalence of Autism Spectrum Disorders (ASD) increased dramatically in the whole world and it leaded to an increase in the discussions about the public policies regarding this population. In the State of São Paulo these discussions were started with a movement by families of children with ASD in 2000. In 2012 Brazil adopted the National Policy of Protection of the Rights of Persons with ASD and people with ASD were considered as having a disability and therefore with all the rights attributed to them. Considering the issues regarding the intervention services provided to persons with ASD, the present research aimed to determine the profile of the population with ASD receiving health and educational services and to propose a model of quality indicators regarding the speech-language pathology provided to this population in the city of São Paulo. The study was divided in three moments: construction of the questionnaire called \"Questionnaire to the identification of quality indicators of the intervention with persons with ASD\"; identification of the services to be studied and data gathering. Building the questionnaire started with the selection of the quality indicators for processes and results, based on the Balanced Scorecard (BSC). Following that, a questionnaire with 23 objective questions was proposed. Of these questions, just 13 were mandatory and allowed the identification of data about the quality indicators. The initial plan was to perform a longitudinal study in collaboration with the State Health Secretariat, but the chief office vetoed the research and therefore the study was limited to just one moment of data gathering using a net-web field-work. The initial study group included 62 services but just 25 of them agreed to participate in the study. Data was obtained during interviews with the chairs and/or speech-language pathologists (SLP) of each service, always conducted after an initial interview where the researcher informed the participants about the research\'s purpose and methods. Data obtained was organized on a spread-sheet and underwent statistical descriptive and cluster analysis. Results indicated a larger number of private schools (regular schools with inclusion policy and special schools) and larger availability of services destined to children. The total of persons with ASD involved in the study is 854 with a larger number of children with diagnosis of autism. Speech-language services are available in 64% of the sample with an average of 1 SLP in each service, providing one weekly therapy session to an average of 18 persons with ASD. Most of the services informed that the length of the SLP treatment undetermined. In what regards to the rotation of subjects, the largest proportion of them undergo some interruption on the treatment but the smallest one have some re-insertion in the intervention service. The cluster analysis considered 7 relevant variables, resulting in 3 groups (G1, G2 and not-classified). Generally, G1 presented largest proportions of subjects referred to speech-language therapy; of number of SLPs, of subjects with diagnosis of autism and of autism associated to other disorder. It can be concluded that the present research allowed the determination of the profile of the services provided to persons with ASD and of their clients. It also identified the first important issues to the management of speech-language therapy services provided to persons with ASD
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Perfil psicossocial de portadores de CDI: COMFORT-CDI / Psychosocial profile of patients: COMFORT-ICD

Guimarães, Tathiane Barbosa 08 August 2016 (has links)
Introdução: Ansiedade, depressão, personalidade Tipo D e terapias de choque do cardioversor-desfibrilador implantável (CDI) são fatores de risco para pior ajuste psicossocial. Além da maior parte dos estudos serem realizados em países desenvolvidos, pouca atenção é dada a estes e outros fatores, assim como à influência na percepção de portadores de CDI quanto à sua cardiopatia de base. Estratégias de enfrentamento, diferença entre percepção do CDI e da doença, assim como percepção dos familiares também têm sido negligenciadas. Os objetivos deste estudo foram descrever o perfil psicossocial de portadores de CDI em nosso meio, avaliar a relação entre os fatores de risco supracitados, percepções do paciente quanto à doença cardíaca e CDI, a relação entre ocorrência e frequência das terapias de choque do CDI e a compreensão e percepção de familiares em relação ao CDI. Método: 250 portadores de CDI foram avaliados (54.10 ±15.15 anos, 67% sexo masculino) quanto à percepção de doença (Questionário Breve de Percepção de Doença [B-IPQ]); ansiedade, depressão, distress (Escala Hospitalar de Ansiedade e Depressão [HADS]); personalidade Tipo D (DS-14); ocorrência e frequência de choques do CDI desde implante e estratégias de enfrentamento. Representações emocionais e compressão de familiares dos pacientes também foram medidas. A análise estatística utilizou os métodos de Mann-Whitney, Wilcoxon e X2. Resultados: Noventa e nove pacientes (39,6%) apresentaram ansiedade, 62 (24.8%) depressão; 85(34%) distress, 84(34%) personalidade Tipo D e 72(29%) perceberam a doença cardíaca como ameaça. Ansiedade, distress, depressão e personalidade Tipo D foram associadas à percepção de cardiopatia como ameaçadora, OR=11 (p= <. 0001); 7.4 (p= <. 0001); 5.3 p= <. 0001); e 2.9 (p= 0.0001), respectivamente. A percepção da doença cardíaca como ameaça também foi influenciada pela presença de choques do CDI desde o implante, com OR= 2.2 (p= 0.007), 2.1 para >=3 choques em 24 horas (p= 0.03) e 2.4 para >= 5 choques desde o implante (p= 0.008). Pacientes ansiosos e Tipo D foram associados a pior percepção de doença, considerando: 1 - fortes crenças sobre consequências mais graves da doença; 2 - não serem capazes de controlar a doença; 3 - atribuem maior número de sintomas à doença; 4 - são mais preocupados e apresentam mais emoções negativas. As percepções de pacientes com distress ou depressivos são mais negativas em todas as subescalas, exceto compreensão. A maioria dos pacientes (68%) utilizou estratégias de enfrentamento focadas na emoção. Vinte e cinco por cento dos pacientes reportaram limitação imposta pela doença, enquanto 75% se sentiram limitados pelo CDI. Pacientes perceberam mais consequências negativas da doença que do CDI. Familiares apresentaram desgaste emocional e baixa compreensão quanto o uso e funcionamento do CDI. Conclusões: Portadores de CDI assistidos em hospital terciário de atenção cardiológica apresentaram: Elevada taxa de ocorrência de ansiedade; depressão, distress, personalidade Tipo D e percepção de doença como ameaça; Limitação das atividades da vida diária como a maior demanda vivenciada; Cardiopatia de base afetando mais a vida que o CDI, mas a maioria considerando o choque do CDI aversivo. Implicação: Intervenções psicossociais específicas são essenciais para melhor ajustamento de portadores de CDI e seus familiares / Introduction: Anxiety, depression, Type D personality, and implantable cardioverter-defibrillator (ICD) shocks are well-known risk factors for psychosocial maladjustment. Despite the fact that most of the studies were conducted in well-developed countries, little attention has been given to these and others factors and their influence on ICD patients\' perceptions of their heart disease. Coping strategies, the differences between ICD patient and heart disease patient perceptions, and the perception of family members has also been neglected. This project was aimed at describing the psychosocial profile of Brazilian ICD patients and evaluating the relationship between the aforementioned risk factors and patient perceptions about their heart disease and ICD, the temporal relation between occurrence and frequency of ICD shocks, and the understanding and perception of family members regarding the ICD. Methods: 250 ICD patients were evaluated (54.10 ±15.15 years, 67% male) regarding illness perception (Brief Illness Perception Questionnaire [B-IPQ]); anxiety, depression, distress (Hospital Anxiety and Depression Scale [HADS]); Type D personality (DS-14); occurrence and frequency of ICD shocks since implantation; and coping. Family members\' comprehension and emotional representations of the ICD were also assessed. Mann-Whitney, Wilcoxon and X2 were used for statistical analysis. Results: Ninety-nine patients (40%) had anxiety, 62 (25%) depression; 85 (34%) distress, 84 (34%) Type D personality, and 72 (29%) perceived the heart disease as a threat. Anxiety, distress, depression, and Type D personality were associated with perceiving heart disease as a health threat with odds ratios of 11 (p= <.0001); 7.4 (p= <.0001); 5.3 (p= <.0001); and 2.9 (p= 0.0001), respectively. Patients\' perceptions of their heart disease as a threat were also influenced by ICD shocks since implantation with odds ratios of 2.1 (p= 0.007), of 2.1 for >=3 shocks in 24 hours (p= 0.045) and of 2.4 for >= 5 shocks since implantation (p= 0.043). Anxious and Type D patients were also associated with poorer illness perceptions regarding: 1 - strong beliefs about more serious consequences of the illness; 2 - not being capable of controlling the disease on their own; 3 - a greater number of symptoms attributed to the illness; 4 - more concerns and negative reactions. Distressed or depressive patients\' perceptions are more negative on every item of the scale except for understanding. The majority of patients (68%) used emotion focused coping mechanisms. Twenty-five percent of the patients reported feeling limited by heart disease, while 75% reported feeling limited by having the ICD in place. Patients perceived more negative consequences with heart disease than with ICD placement. Family members manifested distress about the ICD and misunderstanding regarding its purpose and function. Conclusions: ICD patients treated in a tertiary heart center presented with incresead frequency of anxiety, depression, distress, Type D personality, and perception of their illness as threat. Limitation of activities of daily living was the most common complaint. Heart disease was reported as more debilitating than the ICD itself, but most patients still considered the device\'s shock aversive. Implication: Specific psychosocial interventions are essential for better adjustment of ICD patients and their families after ICD placement

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