Thesis (M.S.W.)--University of Hong Kong, 1995. / Includes bibliographical references.

Thesis (Ph. D.)--University of Washington, 2002. / Vita. Includes bibliographical references (leaves 177-192).

No description available.

Background and Objectives: In a previous randomized study, we reported the benefits of providing integrated care by the Joint Asia Diabetes Evaluation (JADE) Program consisting of comprehensive assessment (CA) and 3-4 monthly follow up (FU) assessments with personalized feedback reports and decision support on control of cardio-metabolic risk factors through reduced clinical inertia and improved self-care. Further, provision of additional peer support improved psychological well-being and all-cause hospitalization especially in those with negative emotions who tended to have co-morbidities. However, given the multicomponent nature of the program, the differential effects of peer support in different patient subgroups and independent effect of personalized FU reports had not been systematically evaluated.. In this thesis, I used a randomized and case-control design to examine the effects of providing regular FU reports and peer support on metabolic control, psychological health, and all-cause hospitalization in patients with diabetes. / Methods: Between February and December 2013, 1488 Chinese patients with diabetes aged 18-75 years underwent CA using the JADE portal and returned in 4 weeks in groups to receive their personalized CA report with explanation by nurses about their complications, risk factors and treatment targets. Amongst them, I selected 288 high risk patients defined as 1) HbA1c≥8%, 2) obesity (body mass index≥27.5 kg/m² and/or waist≥80cm (women) or ≥90cm (men), and/or 3) chronic kidney disease (CKD, eGFR<60ml/min/1.73m²) and offered them a telephone-based peer support program, to which 144 (50%) agreed (P+ group) and 144 (50%) refused (P- group). Within each group, they were also randomized to receive 2 JADE FU reports by mail after their clinic visits. These FU reports displayed their trends of ABC (HbA1c, BP, LDL-C) control and body weight with individualized reminders for self-care during a 12-month period. In the remaining patients (n=1200), half were randomized to receive 2 FU reports by mail (R+ group: n=600) while half received usual care (R- group: n=600). Amongst patients not offered peer support, 425 patients (50% received FU report) were matched to the P+ group (52% received FU report) on a 3:1 basis by age, gender, diabetes duration, and baseline HbA1c as a control group. The outcome measures were reduction in HbA1c and all-cause hospitalization at month 12. / Results: Amongst patients not offered peer support, after a median (IQR) follow-up period of 575 (519-646) days, the R+ group had greater reduction in HbA1c (mean [95% CI]: -0.24[-0.35,-0.14]% versus -0.15[-0.24,-0.06]%, p=0.030) with similar hospitalization rate and frequency compared with the R- group. Amongst patients offered peer support, the P+ group and P- group had similar baseline clinical and psychological-behavioral parameters. After 530 (463-575) days, the P+ group (n=138) tended to have greater reduction in HbA1c (-0.75[-0.97,-0.52]% versus -0.42[-0.68,-0.15]%, p=0.106) with significant improvements in mental health and quality of life than the P- group (n=131). In the case-control cohort for peer support,the P+ group tended to have greater reduction in HbA1c than the control group (n=425) (-0.75[-0.97,-0.52]% versus -0.49[-0.64, -0.35]%, p=0.119) with lower rate, frequency and length of hospitalization. On multivariable analysis of the entire cohort (n=1488), peer support (β coefficient [95% CI] -0.31[-0.56, -0.06], p=0.015) and receiving FU reports (-0.14[-0.25, -0.04], p=0.009) were independent predictors for reduction in HbA1c. Peer support (OR [95% CI] 0.36[0.16, 0.79], p=0.011) and CKD with FU reports (0.40[0.18, 0.88], p=0.022) were also associated with reduced hospitalization. / Conclusion: In this real-world quality improvement program, both peer support and regular personalized feedback report by mail were associated with reduced HbA1c in patients with diabetes. Peer support was associated with lower risk of hospitalization, while feedback report was associated with reduced hospitalization only in patients with diabetes and comorbid CKD. / 背景及目的：在一項隨機對照研究中，我們發現通過亞洲糖尿病評估計劃JADE提供整合了全面糖尿病併發症篩查（CA）、定期隨訪（FU）評估、個體化回饋報告及決策支持的綜合護理可通过降低臨床惰性，促進自我管理從而改善糖尿病風險因素的控制。在此基礎上，同伴支持可進一步改善患者的心理健康，降低住院率， 并且在有負面情緒的人群中作用尤其明顯。然而，由於綜合護理由多部分組成，個體的作用並未被系統評估。本文分別採用隨機對照和病例對照研究，評估個體化隨訪報告和同伴支持對糖尿病患者代謝控制、心理健康及住院率的作用。 / 研究方法：2013 年2 月至12 月，1488 位年齡18 至75 歲的糖尿病患者進行了CA，並于4 周後領取個體化CA 報告，由護士說明其併發症和危險因子的控制以及治療有無達標。其中，我邀請了288 位有以下高危因素的患者參加一項基於電話的同伴支持計劃：1）糖化血紅蛋白（HbA1c）≥8%；2）肥胖（體重指數≥27.5 kg/m² 和/或女性腰圍≥80cm/男性腰圍≥90cm；和/或3）慢性腎臟病（CKD，腎小球濾過率<60 ml/min/1.73m²）。其中，144 位（50%）同意（P+ 組）參與，144 位（50%）（P- 組）拒絕參與。每組再隨機抽取一半患者郵寄2 份JADEFU 報告。該報告顯示了患者HbA1c、血壓、低密度膽固醇和體重的控制情況，並附有針對自我管理的個體化建議。餘下的1200 位患者中，隨機抽取一半患者（R+ 組，n=600）郵寄2 份JADE FU 報告，另外一半患者常規護理（R- 組，n=600）。未被邀請參加同伴支持計劃的1200 位患者中，425 位（50%有FU 報告）按年齡、性別、病程和基礎HbA1c 與P+組（52%有FU 報告）匹配成為對照組。研究指標為12 個月後HbA1c 和住院率的改變。 / 研究結果：未提供同伴支援的患者中，經過575（519-646）日的隨訪，R+組HbA1c 降低更多（ 均值[95% 置信區間]: -0.24[-0.35,-0.14]% versus-0.15[-0.24,-0.06]%, p=0.030），但住院率與R-組相同。提供同伴支持的患者中，P+組和P-組研究開始時臨床、心理和行為指標皆相似。530（463-575）日後，與P-組比較，P+組有HbA1c 降低更多的趨勢（-0.75[-0.97,-0.52] % versus-0.42[-0.68,-0.15]%, p=0.106），住院率相似，但心理健康和生活品質均有明顯改善。在病例對照研究中，與對照組比較（n=425），P+組（n=142） HbA1c降低更多（-0.92[-1.25, -0.59]% versus -0.39[-0.58, -0.21], p=0.004），且住院率、住院次數和時間皆有明顯降低。採用多變量回歸分析，同伴支持（β 係數[95% 置信區間] -0.31[-0.56, -0.06], p=0.015）和FU 報告（-0.14[-0.25, -0.04], p=0.009）均是降低HbA1c 的獨立預測因子。同伴支持（0.36[0.16, 0.79], p=0.011） 和CKD伴FU 報告（0.40[0.18, 0.88], p=0.022）與住院风险降低明顯相關。 / 結論：在此項品質改進計畫中，同伴支持和定期郵寄個體化隨訪報告均与糖尿病患者的糖化血紅蛋白降低相關。同伴支持伴隨住院风险降低，但個體化隨訪報告僅在糖尿病伴慢性腎臟病患者中与住院风险降低相關。 / Yin, Junmei. / Thesis Ph.D. Chinese University of Hong Kong 2015. / Includes bibliographical references (leaves 209-235). / Abstracts also in Chinese; appendix 4 in Chinese. / Title from PDF title page (viewed on 06, October, 2016). / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.

Thesis (M.S.W.)--University of Hong Kong, 1998. / Includes bibliographical references.

M.Cur. / The role players participating within the support groups for patients with chronic diseases in Primary Health care services are facing a difficult task of managing support groups effectively. They are confronted by managerial challenges involved in the managing of support groups for patients with chronic diseases, such as careful planning, organising, leading and controlling the support groups. This is evidently confirmed by the disintegration of support groups and patients openly and deliberately rebelling and ignoring participation in support groups. The resistance and opposition is also displayed by other staff members within the clinic. The general dissatisfaction and frustration among the primary health care facilitators serves as proof of the poor management of support groups. The need to investigate and address this dilemma is important. It is therefore the reason why the researcher embarked on this studying order to explore the I experiences of the role players with regard to the management of the support groups for patients with chronic diseases within the clinic context, and then utilise the results ad basis for formulating guidelines for quality management of support groups within Primary Health Care clinics in Soweto. The following research questions are therefore relevant: ~ What are the experiences of the primary health care facilitators with regard to the management of support groups for the patients with chronic diseases with primary health care clinics in Soweto? ~ What are the experiences of the facility managers with regard to the management of support groups for patients with chronic diseases within primary health care clinics in Soweto? ~ What are the experiences of patients with chronic diseases with regard to the management of support groups? ~ What guidelines should be formulated to ensure quality management and sustainability of support groups for patients with chronic diseases within the primary health care clinics in Soweto? The following research objectives were formulated: ~ To explore and describe the experiences offacility managers with regard to the management of support groups for patients with chronic diseases within primary health care clinics in Soweto. ~ To explore and describe the experiences of the primary health care facilitators with regard to the management of support groups for patients with chronic diseases within primary health care clinics in Soweto. ~ To explore and describe the experiences of the patients with chronic diseases with regard to the management of support groups within primary health care clinics in Soweto. ~ To formulate guidelines for quality management and sustainability of support groups for patients with chronic diseases within the primary health care clinics in Soweto.

A Thesis Proposal Submitted to the Psychology Department School of Human and Community Development University of Witwatersrand in Partial Fulfilment of the Degree of Master of Arts Degree in Psychology by Dissertation. February 2016 / This study was aimed at an in-depth exploration of the recovery experiences of a group of 12 individuals who attended 12 step self-help groups situated in different regions in Johannesburg. 12-step self-help groups are presently the largest clinical supplements in the world. Ongoing discussions with the relevant representatives from the fellowships of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) were utilised in order to gain access to this population of people. These 12 individuals suffered from substance dependence and one or more co-occurring disorders (CODs) and were interviewed in semi-structured interviews about how their lives had changed since they had achieved a state of recovery and about some of the difficulties they had experienced since the point at which they had achieved remission from their substance-related disorder. The study also focused on the therapeutic aids that the participants had found useful during their time in recovery. In this study, CODs refers to the existence of at least one substance-related disorder and at least one psychiatric disorder in the same individual. The overarching methodological framework that was used in the study was phenomenological. It was evident from the study that the road to recovery is fraught with many challenges that the recovering individual needs to negotiate and that very often there is no information available on what the best course of action to follow is. In conclusion it is evident that recovering addicts, especially those that have been diagnosed with one or more CODs often require on going support and care if they are to continue on their journey of recovery

A research report submitted to the Faculty of Health Sciences (School of Public Health), The University of the Witwatersrand, in partial fulfillment of the requirements for the degree of Master of Public Health in the field of Social Behaviour Change and Communication. June , 2017 / Introduction Proper access to antenatal care services and skilled birth attendants during delivery is key to reducing maternal deaths. But studies show that women in rural communities in Nigeria, do not access Ante-Natal Care (ANC) and a lower proportion deliver in a health facility. An internationally funded maternal and child health program in Enugu State, Nigeria introduced the concept of using the support group to improve uptake of antenatal care services and health facility delivery services. The support group comprised of pregnant women who encouraged and supported each other from pregnancy through to delivery in a health facility. However there was no documented evidence to show that the support groups actually influenced women’s intention to deliver in a health facility. This research work is being carried out to address this gap – by providing evidence on whether the support groups influenced women’s intention to deliver in a health facility. Methods Following informed consent, a qualitative study was conducted. Data was collected from women aged between 18 years and 49 years who were in a support group in seven health facilities in Nkanu West Local Government Area (LGA) of Enugu State, Nigeria. Seven Focus Group Discussions (FGD) and In-depth Interviews (IDI) were conducted. The data analysis was done using NVIVO software. All field notes were checked against translated interviews to ensure completeness and correctness. Inter-coding agreement, triangulation of data was done to ensure consistency. A descriptive analysis of the findings against theoretical framework was done and all findings also linked to objectives of the study. ii Results The pregnant women support group is shown to influence pregnant women’s intention to deliver in a health facility. Reasons for joining the group included; increasing knowledge about pregnancy and the benefits of ANC attendance and health facility delivery, socio-economic and spiritual support. However, the intention to deliver in a health facility is influenced by other factors such as; good and caring attitude of health workers, availability of qualified health workers, and better health infrastructure to respond to complications and emergencies. Other influences such as mother-in-law and spouses were also identified. The members of the group enjoyed benefits such as; visitation and presentation of gifts by support group members upon delivery, post- natal care and sometimes financial support. Despite these benefits, the goal of having a safe delivery remained the ultimate benefit of being a member of the support group. The existence, management and survival of the group other than by its members were dependent on the health facility workers. Conclusion The study demonstrated that the support group intervention did influence pregnant women’s intention to deliver in a health facility. But, the intention to deliver in a health facility was also driven by other factors such as; availability of skilled health workers, improved infrastructure and the cost of health services. / MT2017

Thesis (Ed. D.)--West Virginia University, 2004. / Title from document title page. Document formatted into pages; contains vi, 166 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 102-116).

Thesis (DPysch) - Dept. of Psychology, Swinburne University of Technology, 2005. / Submitted in fulfilment of the requirements for the degree of Professional Doctorate Health Psychology, Department of Psychology, Swinburne University of Technology - 2005. Typescript. Includes bibliographical references (p. 151-159).