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Early conceptualisations of Attachment Theory placed considerable emphasis on the importance of early experiences of relationships on development throughout life. Central to the theory is the notion that early experiences determine internalised representations of relationships and experience which subsequently affect the way individuals perceive themselves in relation to others. However, the evidence suggests that development is not so deterministic and that the impact of early adversity can be overcome through reparative experiences. The current study is part of a larger longitudinal investigation concerned with the impact of pure non attachment on development. The study reported in this thesis aims to consider the impact of early non attachment in adulthood, by exploring the sense that adults have made of their lives having been placed in institutionalised care in early childhood, with no opportunity to develop attachment, and who were then adopted or restored to biological parents. The meanings given to these experiences were explored by conducting a Interpretative Phenomenological Analysis of the accounts given by 15 participants using the Adult Attachment Interview. The results of the study suggest that the over all experience of non attachment did not prevent or severely inhibit development. However, six themes were identified in the study which highlight difficulties in people's ability to make sense of the pastJUld how they function in the present. The findings provide further insight into the impact of early non-attachment in adulthood and suggest that internalised representations of relationships may have a lasting influence, although alternative experience can ameliorate their impact.

This thesis is a study of the residential care for elderly people in Beijing, China. First, a set of statistical indicators are developed for mapping the spatial distribution of the elderly population and residential care facilities (RCFs). Secondly, in-depth, semi-structured interviews are used to understand the socio-cultural meanings of access, the decision making process in relocation, the well-being of elderly residents, as well as the challenges of residential care and social welfare reform. In total, 27 elderly residents, 16 family members, and five RCF managers were interviewed in six RCFs in Beijing. The constant comparative method is used to analyze all the transcribed interview materials. There are several major findings resulting from the research: the distribution of the elderly population and residential care resources is geographically uneven across the districts of Beijing and the supply of resources does not match the potential need. Elderly people and their family members choose residential care because of the shortage of community and home care resources and/or the advantages of residential care. The decision making process is a process of balancing geographical factors, quality of services, and financial affordability. Access to residential care is an interactive process influenced by geographical, economic, and social-cultural factors. The physical and socio-cultural environments of RCFs and individual’s sense of place play important roles in their adaptation and well-being after the relocation from the home to a RCF. Building up the active aging model with joint efforts from governments, society, RCFs, and individuals is helpful and effective for promoting the well-being of elderly residents in RCFs. At the end, the study also provides suggestions for the government, organizations, and RCFs on aspects such as administration, policy making, planning, volunteering, and management of RCFs to meet the challenges of residential care in China. The study confirms the importance of healthy living environments to the well-being of elderly residents. It also provides knowledge for understanding the reconfiguration of filial piety in decision making processes and utilization of residential care in current Chinese society. From a health geography perspective, this thesis is one of the first studies on residential care in China. / Thesis (Ph.D, Geography) -- Queen's University, 2010-04-30 12:15:57.972

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Research suggests that for many older people with dementia living in residential care, communication with staff often provides the most significant element of their day. It seems likely that the quality of the interactions provided by staff during their care of people with dementia will be an essential factor in affecting the person's quality of life. Research also suggests that the attitudes of nursing and care staff towards people with dementia is a central component in the quality of care they deliver, however, to date, there has been no empirically established evidence that staff attitudes have a direct effect on the quality of life of the people cared for. This study aims to examine the impact of staff attitudes on both the quality of care delivered and on the quality of life of residents and to examine whether there are any changes in any of these areas as a result of training and development interventions. The research includes a review of existing attitude measurements and the development of a new attitude scale for use with dementia care professionals, offering evidence for its reliability and validity. In order to evaluate quality of care, a new observational technique is developed, which draws on previous observational methodologies, with a focus on the behaviour of staff during their care of people with dementia. Results suggest that staff with more 'hopeful' attitudes about people with dementia are more likely to engage in social interactions and activities with residents and use more quality indicators (such as giving choice and information) during physical care tasks. The study also showed improvements in staff attitudes, the quality of care provided and in resident well-being following a number of training and development inputs. The implications of the results are discussed in relation to the limitations of the research.

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