Introduction: When enrolled nurses upgrade to newly-qualified professional nurses, they are considered more prepared to adapt to professional nurse roles and are expected to "hit the floor running". However, transitioning from enrolled nurse to newly-qualified professional nurse has been found difficult and stressful due to the shift from enrolled nurses' familiar dependent practitioner role to the less known professional nurses' independent practitioner role. Currently there is no official programme to address the transition support needs of newly-qualified professional nurses who upgrade from enrolled nurses in Mpumalanga private hospitals. In the Mpumalanga private hospitals, for the period 2012-2013, the estimated average turnover rate for newly-qualified professional nurses was 33-47%. Aim: The aim of this study was to explore and describe how newly-qualified professional nurses who upgraded from enrolled nurses experienced transition support during the transition period in private hospitals in the Mpumalanga Province. Research design: A qualitative holistic multiple case study research design was utilised to explore and describe how newly-qualified professional nurses who upgraded from enrolled nurses experienced transition support during the transition period in private hospitals in Mpumalanga Province. Method: Ten newly-qualified professional nurses, who graduated in 2012-2015 with a minimum of six months' and a maximum of four years' work experience in two private hospitals in Mpumalanga Province, participated in this study. In-depth semi-structured interviews were conducted and an inductive approach was utilised for content analysis of verbatim transcripts and field notes. Findings: The study found that at the private health care level, there is minimal understanding and recognition of the transition support needs of the newly-qualified professional nurse making the transition to clinical healthcare practice in private hospitals as professional nurses. Consequently, there is no newly-qualified professional nurse transition support programme during the transition period. Moreover, the newly-qualified professional nurse needs transition support mostly during the first two stages of the transition period. / Dissertation (MCur)--University of Pretoria, 2016. / Nursing Science / MCur / Unrestricted

This thesis discusses dignity of aging and elderly citizens and the ways in which it is supported within a village community. Dignity is seen as the most important and universal human need, and not only for elderly people. Its significance and protection is anchored in international and national legal documents which are also binding at lower levels of state administration including the community and municipality level. Municipalities are public institutions obliged to create social policies. Citizens need to be involved and to participate in constructing these policies that touch upon the needs of specific groups of them, including that of the elderly. Using several methods, the analytical part describes the situation in a particular village community. The method of social-demographic analysis is based on statistical data and literature. Participant observation and close study of documents provide additional information to the analysis of secondary data. The results show up-to-date age structure and the present state of coexistence of different people in the community. Judging from ways of participation in political life of the community we can infer that close relationships among citizens are the driving force of the development of the area as far as meeting the needs of the elderly are...

Bakgrund: Närstående i palliativ hemjukvård ökar förutsättningarna och möjliggör för patienten att vårdas och avlida i hemmet. Detta medför ett stort ansvar för närstående och kan påverka närståendes psykiska hälsa negativt. Interventioner syftar till att underlätta och stödja närstående. Sjuksköterskan har en ansvarsfull roll att fokusera på närståendes behov av stöd och förmågan varierar mellan sjuksköterskor. Att utföra strukturerade interventioner är ett sätt att systematisera. Syfte: Att beskriva interventioner och dess effekter med fokus på behov av stöd hos närstående som vårdar inom palliativ hemsjukvård. Metod: En allmän litteraturöversikt utfördes genom systematiskt tillvägagångssätt med induktiv ansats. Artiklarna analyserades och sammanställdes med tematisk analys avsedd för vetenskapliga artiklar med kvantitativ metod. Resultat: Resultatet presenteras i två teman med sex underteman, utifrån interventionernas utvärderade effekter. Samtliga interventioner fokuserar på behov av stöd hos närstående som vårdar inom palliativ hemsjukvård. Interventionseffekter som framkom gav närstående ökad kompetens, strategier och ökade förberedelser för att vårda. Effekter av interventionerna visade även minskad psykisk stress, ångest och depression, samt ökad livskvalitet. Slutsats: Resultatet indikerar att fokus på närståendes behov underlättar och ger stöd, vilket främjar närståendes psykiska hälsa. För att möta närståendes behov behövs strukturerade interventioner utföras systematiskt. Att implementera strukturerade interventioner är en roll för specialistsjuksköterska, som ska leda och utveckla den palliativa vården. / Background: In palliative home care, family caregivers enable and increase the chances of the patient being cared for and dying at home. This places a great responsibility on family caregivers and can have a negative impact on their mental health. The purpose of the interventions is to promote support needs of the family caregivers and facilate nursing care. The nurse has a responsible role in addressing the support needs of family members. The ability to address the needs varies between nurses and structured interventions are a way of systematizing. Aim: To describe interventions and their effects that focus on the need for support in family caregivers in palliative home care. Method: A general literature review was conducted systematically with an inductive approach. The articles were analyzed and synthesized using thematic analysis designed for a quantitative method. Result: The results are presented in two themes with six sub-themes, based on the evaluated effects of the interventions. All interventions focus on the support needs of family caregivers in palliative home care. Intervention effects shown provide family caregivers with increased skills, strategies, and preparation for caregiving. Intervention effects show reduced psychological stress, anxiety and depression, and increased quality of life. Conclusion: The results indicate that that support needs of family caregivers should be addressed in order to facilitate and provide support, which promotes family caregivers mental health. To meet the needs of family caregivers, structured interventions need to be carried out systematically. Implementing structured interventions is a role for the specialist nurse, who should lead and develop palliative care.

Bakgrund: När palliativ vård ges i hemmet är närståendes engagemang och insatser ofta omfattande. Närståendestöd ses som en av hörnstenarna inom den palliativa vården. Under sjukdomen och efter dödsfallet bör de närstående erbjudas att delta i vården och samtidigt själva få stöd. Begreppsutveckling är nödvändig inom sjukvården för att vårdpersonalen ska kunna arbeta utifrån en teoretisk grund som vilar på vårdvetenskapliga begrepp. Dessa begrepp kan uppmärksamma företeelser i vården och vara vägledande i sättet att agera. En förståelse och kännedom om begreppet nätståendestöd kan bidra med ett mer enhetligt arbetssätt avseende närståendestöd inom palliativ hemsjukvård. Syfte: Syftet var att definiera begreppet närståendestöd och belysa begreppets innebörd inom palliativ hemsjukvårdskontext. Metod: För ändamålet gjordes en begreppsanalys av begreppet närståendestöd enligt en metod i åtta steg utvecklad av Walker och Avant. Resultat: En lexikal och en litterär analys av 12 vetenskapliga artiklar resulterade i tre definierade attribut för begreppet närståendestöd inom en palliativ hemsjukvårdskontext: samverkan i nära relationer; individanpassad information och delaktighet i vården och livskvalitétshöjande åtgärder för de som står patienten närmast. Tre förutsättningar för begreppet närståendestöd framkom: förmedla en varaktig trygg och tillgänglig närvaro; tillgodose individuella behov över tid och lyhörd och öppen kommunikation mellan givare och mottagare. Tre konsekvenser för begreppet närståendestöd framkom: ökat välbefinnande hos inblandade parter; förberedelse inför det okända samt bearbetning av upplevelser och känsla av att bli sedd och bekräftad i situationen. Slutsats: Trots att närståendestöd som begrepp speglas i olika kulturella kontexter tycks likheterna dem emellan väga tyngre än skillnaderna när ett brett och ingående analysförfarande har iakttagits.

Bakgrund: När palliativ vård ges i hemmet är närståendes engagemang och insatser ofta omfattande. Närståendestöd ses som en av hörnstenarna inom den palliativa vården. Under sjukdomen och efter dödsfallet bör de närstående erbjudas att delta i vården och samtidigt själva få stöd. Begreppsutveckling är nödvändig inom sjukvården för att vårdpersonalen ska kunna arbeta utifrån en teoretisk grund som vilar på vårdvetenskapliga begrepp. Dessa begrepp kan uppmärksamma företeelser i vården och vara vägledande i sättet att agera. En förståelse och kännedom om begreppet nätståendestöd kan bidra med ett mer enhetligt arbetssätt avseende närståendestöd inom palliativ hemsjukvård. Syfte: Syftet var att definiera begreppet närståendestöd och belysa begreppets innebörd inom palliativ hemsjukvårdskontext. Metod: För ändamålet gjordes en begreppsanalys av begreppet närståendestöd enligt en metod i åtta steg utvecklad av Walker och Avant. Resultat: En lexikal och en litterär analys av 12 vetenskapliga artiklar resulterade i tre definierade attribut för begreppet närståendestöd inom en palliativ hemsjukvårdskontext: samverkan i nära relationer; individanpassad information och delaktighet i vården och livskvalitétshöjande åtgärder för de som står patienten närmast. Tre förutsättningar för begreppet närståendestöd framkom: förmedla en varaktig trygg och tillgänglig närvaro; tillgodose individuella behov över tid och lyhörd och öppen kommunikation mellan givare och mottagare. Tre konsekvenser för begreppet närståendestöd framkom: ökat välbefinnande hos inblandade parter; förberedelse inför det okända samt bearbetning av upplevelser och känsla av att bli sedd och bekräftad i situationen. Slutsats: Trots att närståendestöd som begrepp speglas i olika kulturella kontexter tycks likheterna dem emellan väga tyngre än skillnaderna när ett brett och ingående analysförfarande har iakttagits.

Thesis (MEdPsych)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: The researcher wished to ascertain what challenges mature, part-time, postgraduate Masters students faced. The research project focussed on the challenges faced by mature, part-time, postgraduate Masters students, in particular those challenges concerning their higher education institution. The interview schedule questions were based on the main challenging domains as revealed in the literature review. The researcher also gave the students the opportunity to voice any other challenges/support that was not covered in the interview schedule. The interview schedule was used at the face-to-face interviews and e-mailed to students that were unable to have interviews. The researcher used Qualitative Research Design so she could elicit verbal/written, descriptive accounts of students' experiences of challenges and support at their higher education institution. The focus points allowed the researcher to gather much information with regard to the support the students got in the challenging domains namely; Home, Family, Work, Colleagues, Social, Financial, Institution and any Other Challenges/Support. The mature, part-time, postgraduate Masters students felt they needed more support in various areas as well as from their institution of higher education. The researcher's aim is to bring the challenging domains and findings to the attention of those concerned with student support and recommend some support measures that could be adopted. Further research topics were also put forward. / AFRIKAANSE OPSOMMING: Dit was die navorser se wens om te bepaal watter uitdagings volwasse, deeltydse, nagraadse Meestersgraad studente in die gesig staar. Die navorsingsprojek het gefokus op die uitdagings wat ondervind word deur volwasse, deeltydse, nagraadse Meestersgraad studente veral uitdagings aangaande hoër opvoedkundige instellings. Die onderhoud skedule vrae is gebaseer op die hoof uitdagende areas soos getoon in die Literatuur Oorsig. Die navorser het ook die studente 'n geleentheid gegee om enige ander uitdagings of vorme van ondersteuning te noem wat nie in die onderhoud skedule gedek is nie. Die onderhoud skedule is gebruik in persoonlike onderhoude wat ook ge-epos is aan studente wat nie die onderhoude kon bywoon nie. Daar is gebruik gemaak van Kwalitatiewe Navorsing sodat die navorser die nodige verbale/geskrewe, beskrywings van die studente se ervarings, uitdagings en ondersteuning by die hoër opvoedkundige instellings kon bestudeer. Die fokuspunte het die navorser toegelaat om baie informasie met betrekking tot die ondersteuning wat studente gekry het in uitdagende areas bv. Huis, Familie, Werk, Kollegas, Sosiale, Finansiële, Instelling en enige ander uitdagings/ondersteuning te verkry. Die volwasse, deeltydse, nagraadse Meestergraad studente het gevoel dat hul meer ondersteuning benodig in verskeie areas sowel as van hul hoër opvoedkundige instelling. Die navorser se doel is om uitdagende areas en bevindings onder die aandag van diegene betrokke in die ondersteuning van studente te bring, en sommige meganismes wat as ondersteuning kan bied aan te beveel. Verdere navorsingsonderwerpe is ook na vore gebring.

Eltern zu früh geborener Kinder erhalten in neonatologischen Kliniken heute vielfältige Unterstüt-zungsangebote. Vertreter verschiedener Berufsgruppen informieren, beraten und begleiten die Eltern während des stationären Aufenthalts und zum Teil darüber hinaus. Elternorientierte Unterstützungskonzepte für einen Bedarf zu entwerfen, der theoretisch und empirisch begründet werden kann und sowohl interdisziplinär kommunizierbar ist als auch in Beziehung zu den von den Eltern selbst geäußerten Bedürfnissen steht, ist eine aktuelle Herausforderung. Studien zum elterlichen Bedarf beziehen sich bislang meist auf nur eine der relevanten Perspektiven und/oder nicht auf die hier fokussierte Untersuchungsgruppe, lassen jedoch eine Vielfalt möglicher Bedarfsarten erkennen. Der elterliche Unterstützungsbedarf bei Frühgeburt wurde daher im Rahmen eines explorativ und multiperspektivisch angelegten Forschungsprojekts mit dem Ziel einer fallübergreifenden Bedarfsanalyse untersucht. Bedarfsbezogene Selbst- und Fremdeinschätzungen während des Klinikaufenthalts der Kinder wurden innerhalb eines qualitativen Studiendesigns mittels leitfadengestützter Interviews erfasst. Datenerhebung und -auswertung fanden in mehreren, flexibel aufeinander bezogenen Phasen statt. Anhand der Gesprächsprotokolle erfolgte eine materialgestützte Kategorienbildung. Geeignete Auswertungskategorien wurden für eine nachfolgende qualitative Bedarfsbeschreibung unter Berücksichtigung unterschiedlicher Wahrnehmungsperspektiven herangezogen. Fallübergreifende Erkenntnisse zum Bedarf sind für die weitere Ausarbeitung professioneller "Elternbetreuungskonzepte" dringend erforderlich. Klar strukturierte und begründete Konzepte stecken den professionellen Handlungsrahmen ab, können Hinweise auf notwendige Kompetenzen des Klinikpersonals geben und sind ein wichtiger Beitrag zur Qualitätssicherung professioneller Routinehandlungen. / Today parents of preterm infants receive various forms of support in neonatal (intensive) care units. Health care providers inform, advise and accompany parents while their infants are hospitalized and beyond. The development of parent centered support concepts which have a strong theoretical as well as an empirical foundation constitutes a challenge, since such concepts have to be communicated across disciplines and also meet the needs of parents. Research on parents’ needs has often focused on one perspective only and/or not on this specific sample group. Even so, a variety of needs types can be identified. In this study, an exploratory and multi-perspective investigation was designed and conducted to examine the support needs of parents of preterm infants as perceived by parents themselves and by professional health care providers. In order to investigate and identify parents'' support needs during their infants'' hospitalization time a qualitative approach was chosen (guided interviews). Data was collected and analyzed in repeated, flexible interrelated phases. The transcribed interviews were used to analyze inherent ideas and to generate codes. Proven categories of analysis were used for the qualitative description of parents'' needs while different perspectives were considered. Research findings about parental needs which can be generalized are increasingly necessary for future development of professional parent-support concepts. Highly structured und well-justified concepts may outline the scope of professional responsibility and competencies and thus contribute to high-quality professional health care in neonatology.

Sedan behovet av att skaffa sig konkurrensfördelar uppstod har organisationer utvecklat mer flexibla organisationsformer. Projektkontor är ett sådant exempel. De är komplexa så till vida att de kan organiseras på olika sätt, på olika organisatoriska nivåer och inrymma ett spektrum av funktioner. Projektkontor har historiskt etablerats utan att inventera organisationens behov. Syftet med uppsatsen har varit att undersöka medarbetares upplevelser av behov av stöd i sin projektledarroll. Detta för att göra det möjligt att ta fram förslag på funktioner som bör inkluderas vid etablering av ett stödjande projektkontor inom den undersökta organisationen. Åtta semi-strukturerade intervjuer har genomförts och data har bearbetats genom tematisk analys. Detta resulterade i fyra teman som beskriver projektledarnas upplevelser av behov av stöd: förankring från början till slut, ökad projektmognad inom organisationen, bollplank som är tillgängligt efter projektledarens behov samt initialt stöd via personliga möten. Studiens fyra teman diskuterades sedan utifrån Hobbs och Aubrys modell från 2007, med 27 projektkontorsfunktioner indelade i fem funktionsgrupper. Detta ledde fram till ett antal konkreta förslag kring stödfunktioner som bör inkluderas vid etablering av projektkontor inom den studerade organisationen. / Since the need to gain competitive advantage, organizations have developed more flexible organizational forms. Project management offices are such an example. They are complex to the extent that they can be organized in different ways, at different organizational levels and contain a spectrum of functions. Project management offices have, historically, been established without inventing the organization’s needs. The purpose of this thesis has been to investigate employee perceived needs for support in their project management role. This is to enable proposals for functions that should be included when establishing a supporting project management office within the studied organization. Eight semi-structured interviews have been conducted and data has been processed through thematic analysis. This resulted in four themes that describe the perceived needs of project managers: anchoring from start to finish, increased project maturity within the organization, coach available according to project manager’s needs and initial support through personal meetings. The four themes of the study were then discussed based on the model of Hobbs and Aubry from 2007, containing 27 project office functions, divided into five groups of functions. This lead to a number of concrete suggestions on support functions that should be included when establishing a project management office within the studied organization.

Due to projected growth of the 65-and-older population and concerns of an impending care gap, reliance on informal caregivers is expected to increase. Improving support for informal caregivers is viewed as a national priority, yet research related to the unmet support needs of informal caregivers is limited. The purpose of this cross-sectional correlational study was to examine predictive relationships between contextual factors (caregiving relationship and type of illness) and environmental factors (rurality) and the unmet support needs (classes, service access, support groups, counseling, and respite) of informal caregivers of older adults. The theoretical framework was Bronfenbrenner's ecological systems theory. Archival data were drawn from the 2015 Behavioral Risk Factor Surveillance System optional caregiver module dataset provided by the Centers for Disease Control and Prevention. Findings from multiple logistic regression analysis revealed that spousal caregivers had 42.7% lower odds than adult child caregivers of reporting unmet support needs related to service access. Dementia caregivers had 2.05 times higher odds of reporting unmet support needs of counseling, 1.31 times higher odds of reporting unmet support needs related to service access, and 1.91 times higher odds of reporting unmet support needs for respite care, relative to other caregivers. Caregivers residing in a suburban county had 28.7% lower odds and caregivers not residing in a metropolitan statistical area (MSA) had 30.5% lower odds of reporting unmet support needs related to service access, relative to caregivers residing in the center city of an MSA. Health care leaders and policymakers may use the findings to distribute resources and tailor interventions to better meet the needs of informal caregivers of older adults.

Over the last 30 years there has been a paradigmatic shift in the field of disabilities towards assessing individual support needs in relation to social and environmental context rather than individual deficits. The capacity of existing assessment instruments to assess support needs is limited because most were designed to assess individual deficits and thereby determine eligibility for funding and/or services. Some instruments have been designed to assess support needs but there are several problems associated with these instruments including, suitability for use in only one disability type, susceptibility to rater bias, and failure to account for variations in support needs over time. This thesis attempted to contribute to addressing these deficiencies by examining the characteristics that are most predictive of support needs for people with psychiatric and intellectual disabilities and the methods by which changes in such support needs could be predicted. Two studies were used to address these aims. The first considered samples of people with primary psychiatric disabilities (N= 561) and intellectual disabilities (N =168), who lived in Supported Residential Facilities. These participants were assessed in regards not only to standard demographic and disability characteristics, and also personal characteristics, including functional abilities, and support needs. The data were analysed using ordinal logistic regression to determine which better predicted support needs and, accordingly, which characteristics were most important to include in the assessment of support needs. Analysis showed that personal characteristics, such as functional abilities such as showering/bathing and budgeting explained much more variance in support needs than either demographics or disability characteristics. This suggests that, for support needs assessments to be accurately assessed, they should include evaluations of these personal characteristics even though they may require more time and resources to obtain than demographic and disability data. The second study in this thesis aimed to investigate whether caregivers could predict changes in support needs over six-month periods accurately. Residents in supported accommodation with a primary psychiatric disability (N = 60; although some attrition among those with psychiatric disabilities), or primary intellectual disability (N = 57) and their caregivers were involved in this study. Caregivers were interviewed on three occasions at six-monthly intervals and asked to estimate any changes that they expected to occur in the next six months or that they believed had occurred in the preceding six months. Caregivers were also asked to complete two functional assessments for each resident at the three points in time. The functional assessments were used as the benchmark against which the accuracy of caregivers’ estimates was examined. Analysis found that caregivers were unable to predict accurately prospective changes in overall or specific support needs, nor were they able to report accurately such changes retrospectively. The results of this thesis contribute to the body of knowledge in the relatively new area of support needs assessment in terms of possible predictors of support needs and the assessment of changes in support needs. Recommendations for further research include; investigating some of the personal characteristics found to be predictors of support needs in greater detail and among other disability types, replication of these findings in other samples, and investigating ways to improve caregivers’ capacity to predict changes in support needs accurately. / Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2008