Made available in DSpace on 2016-08-03T16:34:26Z (GMT). No. of bitstreams: 1 LUANA YEHIA DE LA BARRA.pdf: 647369 bytes, checksum: 5ed787f9c3f80662f9156a0374495f95 (MD5) Previous issue date: 2006-02-08 / The biopsychosocial approach is very important for physical therapists to enabling them to act with human beings, in a global way, not only focusing their attention only on the pathology, but also on the ill person as a whole. The comprehension of the profession and the concepts of health illness, and patient, are also needed for the physical therapists to consider their intervention on a more extended basis than only on the rehabilitation one. The purpose of this study is to investigate the comprehension of the last year´s Physical therapy students from a private University in São Paulo about health illness, patient, Physical therapy and the relationship between physical therapist and their patients, associating the understanding to the existent health models. In order to achieve these objectives it uses authors of the Health Psychology who defend the biopsychosocial approach, and also authors of Physical therapy and Medicine who write about the models for graduation curriculae of health professionals. Ten semi-structured interviews were led with students, asking about the subjects of the study. The results were analyzed qualitatively, using the construction of analysis categories to answer the objectives of the research. In conclusion, the students noticed some phsychological and social aspects of patients, but not in a clear way and in most of the students, this knowledge was adquired outside the University. Eventhough, the topics on humanities are included in their course, but at the time of the graduation, students don´t reach the objectives of a human comprehension of patient, and oscillate between the biomedical and biopsychosocial model / A visão biopsicossocial de homem é de fundamental importância para que os fisioterapeutas sejam capazes de atuar com seus pacientes, de forma global, sem focar a atenção apenas à doença, mas sim à pessoa doente. A compreensão acerca da profissão e dos conceitos de saúde-doença e paciente, também se faz necessária para que esses profissionais possam considerar sua intervenção num âmbito mais amplo do que a reabilitação. O objetivo deste trabalho é investigar a compreensão que os alunos do último ano de Fisioterapia de uma Universidade privada de São Paulo têm sobre saúde-doença, paciente, Fisioterapia e relacionamento fisioterapeuta-paciente e como associam estas compreensões aos modelos de saúde existentes. Para isso toma por base autores da Psicologia da Saúde que defendem uma visão biopsicossocial de homem, assim como autores da Fisioterapia e Medicina que escrevem sobre os modelos adotados nos currículos de formação dos profissionais da saúde. Foram realizadas 10 entrevistas semi-dirigidas com os alunos, apresentando questões a respeito dos temas em questão. Os resultados foram analisados de forma qualitativa através da construção de categorias de análise visando responder aos objetivos da pesquisa. Conclui-se que os alunos percebem alguns aspectos psicológicos e sociais do paciente, mas não de forma clara e, na maioria dos casos, este conhecimento se dá através de conhecimentos que não foram adquiridos na Universidade. Esta, apesar de fornecer os conteúdos para a formação mais humana do fisioterapeuta, não alcança os objetivos ao final do curso, já que os alunos oscilam entre os modelos biomédico e biopsicossocial

CARVALHO, Wirla Risany Lima. Da alvorada ao ocaso: estudo de caso sobre a avaliação da aprendizagem em Cursos de Pedagogia diurno e noturno em uma instituição de ensino superior da rede pública. 2012. 148 f. Dissertação (Mestrado em Educação) – Universidade Federal do Ceará. Faculdade de Educação, Programa de Pós-Graduação em Educação Brasileira, Fortaleza-CE, 2012. / Submitted by Raul Oliveira (raulcmo@hotmail.com) on 2012-07-05T16:54:38Z No. of bitstreams: 1 2012_Dis_WRLCarvalho.pdf: 1284711 bytes, checksum: 2ab25322a8b88026b91ac57d4db123ff (MD5) / Approved for entry into archive by Maria Josineide Góis(josineide@ufc.br) on 2012-07-06T13:59:08Z (GMT) No. of bitstreams: 1 2012_Dis_WRLCarvalho.pdf: 1284711 bytes, checksum: 2ab25322a8b88026b91ac57d4db123ff (MD5) / Made available in DSpace on 2012-07-06T13:59:08Z (GMT). No. of bitstreams: 1 2012_Dis_WRLCarvalho.pdf: 1284711 bytes, checksum: 2ab25322a8b88026b91ac57d4db123ff (MD5) Previous issue date: 2012 / O presente estudo intencionou investigar a prática de avaliação da aprendizagem realizada junto aos alunos de turnos diurno e noturno do curso de Pedagogia de uma Instituição de Ensino Superior (IES) da rede pública, na cidade de Fortaleza-CE, refletindo sobre um modo de construção avaliativa que considere os fatores biopsicossociais dos discentes. Especificamente, intencionou-se: identificar um perfil dos alunos dos turnos diurno e noturno do curso de Pedagogia da IES investigada; descrever os problemas relacionados aos fatores biológicos, psicológicos e sociais mais apontados pelos discentes, vivenciados por eles como empecilhos a um bom rendimento acadêmico; elencar os tipos de avaliações realizados atualmente no curso de Pedagogia da IES pesquisada; analisar a visão dos docentes e discentes sobre o processo de construção das avaliações realizadas com os alunos desse curso, assim como seus resultados para o desenvolvimento e autonomia discente. O campo teórico da Avaliação Educacional atualmente desenvolvido promove uma avaliação de natureza formativa, a fim de minimizar os efeitos da cultura do exame, ainda identificada no ensino brasileiro. Nesse contexto, é necessário aliar-se à didática para melhor desenvolver a aprendizagem do educando, tornando-o mais autônomo e seguro de sua formação. Enfatizase, pois, o importante papel do professor para uma mediação pedagógica eficiente no contexto universitário. Para esse propósito, realizou-se uma investigação de natureza qualiquantitativa, na forma de um estudo de caso, perfazendo um total de 350 sujeitos investigados, sendo 340 alunos e 10 professores do curso de Pedagogia da IES estudada. Os dados foram coletados no período de novembro de 2010 a janeiro de 2011, na cidade de Fortaleza-Ceará. A análise dos dados confirmou a validação da pesquisa e dos depoimentos dos professores e alunos sobre a avaliação da aprendizagem no Ensino Superior, como previstos nas hipóteses propostas pelo estudo. Os modelos de avaliação da aprendizagem, realizados atualmente no curso de Pedagogia da IES, consideram os fatores biopsicossociais como elementos importantes na construção do processo avaliativo dos alunos como um todo, principalmente os do curso noturno, mesmo ainda não apresentando índices ideais. Conclui-se que, apesar de ainda existirem alguns indícios de prática, por parte de alguns docentes, da utilização de um método didático tradicional expositivo e de uma avaliação baseada na cultura do exame, já se observa a presença de métodos mais formativos e participativos, que consideram os fatores biopsicossociais dos discentes, visando a um desenvolvimento integral do estudante.

Diagnosis of Alzheimer’s disease is encouraged as a first step towards people planning for their future with the condition. Despite the proposed benefits of diagnosis, it is also widely recognised that Alzheimer’s disease can expose people to stigma. Therefore, this thesis explores the relationship between stigma and future outlook, from the perspective of people affected by early and late-onset Alzheimer’s disease. In order to recognise the physicality of the condition and how psychological and social factors influence experiences, a biopsychosocial perspective is employed throughout. People with Alzheimer’s disease (n=15 people with late-onset, 7 people with early-onset) and their supporters (n=22) completed questionnaires about perceived stigma. This was followed by 14 interviews with a subsample of participants, which explored stigma and future outlook in more depth. Perceived stigma reporting across participants was low in the questionnaires; whereas interviews revealed higher levels of stigma with people discussing mixed, unpredictable reactions from a range of sources. Participants expressed awareness of the unpredictable nature of their futures with the condition. The subsequent lack of control was managed through focusing on ‘one day at a time’ and avoiding looking too far ahead. Across reflections on stigma and future outlook there was a deliberate focus on positive experiences for people affected by early and late-onset Alzheimer’s disease. The similar management of experiences across participants minimised possible age-based differences. These findings are supported by socioemotional selectivity theory, which suggests people are motivated to maintain positive emotional states when facing ‘time-limiting’ conditions irrespective of age. The research suggests people’s experiences of stigma and future outlook interact, with stigma-driven assumptions about the future affecting how people manage their daily lives. The avoidance of looking ahead suggests that policy which encourages future planning should consider its utility and explore ways of helping people to manage both exposure to stigma, and planning for the future, whilst focusing on daily living.

Abstract Unemployed are known to be in poorer health and to use less health care services compared to those employed. However, evidence on the work ability of the unemployed remains scarce. The methods of assessing work ability are very divergent, not least because a shared understanding on the concept of work ability is lacking. Furthermore, the aspect of marginalization gives rise to further challenges when assessing work ability among the unemployed. This study explored the work ability of long-term unemployed, their needs for medical care and rehabilitation as well as the methods of assessing work ability. The aims were to find out to which amount and how the work ability was restricted among the unemployed and to clarify the needs for medical care and rehabilitation among them. Additionally, differences between the methods for assessing the disease-oriented and multidimensional work ability, as well as the need for rehabilitation were analysed. Both qualitative and quantitative methods were used in this multi-method research in three different studies. The multidimensional work ability assessments were conducted among long term unemployed individuals in three Labour Force Service Centres (Oulu, Raahe region and Kainuu) and in one municipality (Paltamo). Furthermore, an illustrated case study was conducted to compare the materials and background theories of disease-oriented and multidimensional work ability assessment methods. The work ability was significantly decreased for a great proportion of long term unemployed, mostly because of mental disorders. In one municipality, 27% of the long term unemployed were found disabled for open labour market, in addition 20% of them were considered to need medical care and rehabilitation to enable return to work. By using multidimensional work ability assessment method, restrictions in work ability as well as the needs for rehabilitation appeared to get identified more accurately than by using the disease-oriented method. The latter had missed potential rehabilitation avenues and had led to under-rehabilitation, misrehabilitation and over-rehabilitation. The results indicate that the practices of assessing work ability should be based on biopsychosocial and not only on biomedical approach of health and therefore existing information from the multidisciplinary network concerning the clients’ functioning should be routinely collected and used. The health care services as well as the work ability assessment procedures should be tailored to meet the special needs of the long term unemployed to support their work ability and potential of returning to work. / Tiivistelmä Työttömien terveydentila on heikompi ja he käyttävät vähemmän terveyspalveluja kuin muu samanikäinen väestö. Sen sijaan työttömien työkyvystä ei ole olemassa kattavaa tutkimustietoa. Toisaalta työkyvyn arvioinnin menetelmät ovat epäyhtenäiset, koska työkyvyn käsitteestäkään ei ole yhtenäistä ymmärrystä. Syrjäytymiseen liittyvät ilmiöt aiheuttavat työttömien työkyvyn arviointiin omat erityishaasteensa. Tämän tutkimuksen kohteena olivat pitkäaikaistyöttömien työkyky, sairauksien hoitoon ja kuntoutukseen liittyvät tarpeet sekä työkyvyn arvioinnin menetelmät. Tavoitteena oli selvittää, kuinka suurella osalla ja millä tavoin pitkäaikaistyöttömien työkyky on heikentynyt sekä minkälaista hoidon ja kuntoutuksen tarvetta heillä on. Lisäksi selvitettiin sairauslähtöisen ja monialaisen työkyvyn ja kuntoutustarpeen arvioinnin eroja. Monimenetelmätutkimuksen kolmessa osatutkimuksessa käytettiin sekä laadullisia että määrällisiä menetelmiä. Aineistoina olivat kolmen työvoiman palvelukeskuksen (Oulu, Raahen seutukunta ja Kainuu) ja yhden kunnan (Paltamo) alueella asuville vaikeasti työllistyville henkilöille monialaisesti toteutetut työkyvyn arvioinnit. Lisäksi aineistona analysoitiin sairauslähtöisessä ja monialaisessa työkyvyn arvioinnissa käytettävät tietoaineistot ja tulokset yhdellä esimerkkiasiakkaalla havainnollistaen. Suurella osalla pitkäaikaistyöttömistä työkyky oli merkittävästi heikentynyt, sairausluokista eniten mielenterveyden häiriöiden takia. Yhden kunnan kaikista pitkäaikaistyöttömistä todettiin avoimille työmarkkinoille työkyvyttömiksi 27 % ja näiden lisäksi 20 %:lla todettiin työkykyä kohentavan hoidon ja kuntoutuksen tarvetta. Monialaisen arviointimallin avulla tunnistettiin työkyvyn heikkeneminen ja kuntoutustarve osuvammin kuin perinteisellä sairauslähtöisellä toimintatavalla, joka hukkaa kuntoutuksen potentiaalia ja johtaa alikuntoutukseen, väärinkuntoutukseen tai ylikuntoutukseen. Tulosten perusteella työkyvyn arvioinnin käytännöt tulisi perustaa biopsykososiaaliseen eikä vain biomedikaaliseen terveyskäsitykseen ja niissä tulisi nykyistä enemmän hyödyntää monialaisessa verkostossa olevaa informaatiota tutkittavan toimintakyvystä. Työkyvyn tukemiseksi työttömien terveyspalvelut sekä työkyvyn ja kuntoutustarpeen arvioinnit tulisi aiempaa enemmän suunnitella ja kohdentaa pitkäaikaistyöttömien erityistarpeet huomioiden.

This study is aimed at exploring the impact of secondary trauma on the child. A shortcoming has been identified in practice because of the lack of trained social workers and therapists in the field of secondary trauma and children and applying effective therapeutic intervention. The goal of this study was to explore and determine the impact of trauma on the child as the secondary victim in the emergency room of the hospital. In order to reach the required goal, a number of objectives were set. By means of a literature study and consultation with experts in the field of trauma, a theoretical framework was set up with regard to the following: secondary trauma as phenomenon; the child in the middle childhood as part of life; trauma debriefing and the child. An empirical study where semi-structured interviews and participatory observation were used as the methods of data collection was undertaken, to assess the impact of trauma on the child, as the secondary victim in the emergency room of the hospital. The following aspects were handled specifically: 1. the experience of trauma by the child 2. fears and anxiety 3. re-experiencing the event through thoughts 4. sensation, communication and play 5. increase in sensitivity through sight, noises and smell 6. avoidance of memories, thoughts and feelings towards the trauma and then the search for closure Individual semi-structured interviews were used with ten respondents. Applied research was undertaken as the researcher aimed at establishing solutions for problems that occur in the emergency room of the hospital. The researcher used a qualitative research approach. Considering that in this study a relatively unknown field was researched, a phenomenological strategy within an exploratory study was used to explore, understand and interpret the research question, which is not well known. The research question formulated for this study was: “What is the effect of trauma on the child as the secondary victim?” Empirical data, which was obtained by using a semi-structured interview schedule and participatory observation, revealed the following: 1. The secondary traumatized child is the individual that’s been exposed to the trauma by either witnessing the event or through the relationship with the victim. 2. The following phases of trauma were identified through the study of the secondary traumatized child: i. PHASE 1 : Biological impact phase ii. PHASE 2 : Reaction phase iii. PHASE 3 : Avoidance phase iv. PHASE 4 : Reintegration and recovery of homeostasis 3. Role of social support systems for the adaptation of the psycho-social functioning of the victim. 4. External factors that might influence the traumatized child. The study revealed information on the child as the secondary traumatized victim in the emergency room of the hospital, which holds further research possibilities. The desired information was acquired and can be used in further studies and the development of a trauma-debriefing programme. / Dissertation (MSW (Social Health Care))--University of Pretoria, 2006. / Social Work and Criminology / MSW (Social Health Care) / Unrestricted

Although aggression as social phenomenon is widely researched, this research study aimed to illuminate the importance of early identification of excessively aggressive children specifically. The aim was to explore and gain an in-depth understanding of excessive aggressive behaviour during the preschool years. A qualitative research methodology was employed consisting of a parent interview, observations of the research participant and numerous play sessions consisting of various activities including free drawings; ‘Draw-a-Person ‘, a family drawing; the ‘Children’s Apperception Test’, and free play activities. The study explored various factors possibly leading to the onset and continuation of excessive aggressive behaviour. It seems clear that no single factor is responsible for the display of excessive aggression, but rather, multiple factors contribute to the problem of aggression as a whole. Play therapy is suggested as an effective method in the assessment and counselling of excessive aggressive behaviour in preschool children / Psychology / M.Sc. (Psychology)

Contexte. L’avènement de nouvelles technologies a pris de l’ampleur au cours des dernières années, jusqu’à ce que celles-ci deviennent partie intégrante de la réalité d’aujourd’hui. Les études antérieures démontrent qu’une exposition excessive aux écrans présente un risque important au niveau du développement physique et psychologique chez les enfants. L’identification des facteurs modifiables précoces afin de prédire les risques possibles relié aux habitudes télévisuelles des jeunes représente un défi important à ce jour, car leurs impacts néfastes peuvent avoir des conséquences importantes pendant la durée de l’enfance, l’adolescence, voir même la vie adulte. Toutefois, la littérature fournit peu d’informations sur de possibles facteurs de protection contre ces risques biopsychosociaux. La participation à des activités sportives a su démontrer, à travers les années, ses nombreux bienfaits sur la santé des jeunes ainsi que sur leur développement à long terme. À la lumière des nombreux bénéfices reliés au développement, il est tout à fait possible de croire que la participation à des activités sportives extrascolaires pourrait agir à titre de facteur de protection afin de contrer les risques biopsychosociaux reliés aux habitudes télévisuelles excessives en bas âge. / Background. The advent of new technologies in recent years has grown to be an integral part of today's reality. Previous studies show that excessive exposure to screens poses a significant risk to physical and psychological development of children. Identifying early factors that modify associated risks related to youth screen viewing habits is an important challenge to date. However, the literature shows little information on possible protective factors against such biopsychosocial risks. Over the years, participation in sporting activity has demonstrated its numerous benefits on the health of young people as well as for long-term development. Given the established benefits related to physical activity, it is quite plausible that participation in extracurricular sporting activity could act as a protective factor which counters the biopsychosocial risks related to excessive televiewing at a young age.

Individuals born with primary immune deficiency diseases (PIDD) have a dysfunctional immune system, and many are treated by lifelong injections of immunoglobulin therapy. Studies have shown that these patients have low health-related quality of life (HRQOL) and well-being (WB) and that these outcomes might be improved by the availability of therapy innovated according to preferences for fewer needle sticks or a shorter infusion time. Regulators at the U.S. Food and Drug Administration (FDA) have approved therapies innovated per these preferences. However, there is limited data demonstrating how these innovations impact HRQOL and WB. Using the biopsychosocial model, the purpose of this cross sectional quantitative study was to evaluate whether patients with PIDD using therapies innovated for fewer needle sticks or a shorter infusion time had a higher mean HRQOL and WB compared to those who were not. The study included 153 patients who completed the Patient Reported Outcomes Measurement Information System (PROMIS)-29 survey. The dependent variables were HRQOL and WB measured by PROMIS-29, and the independent variables were the medical product innovations. Independent samples t tests results showed mean PROMIS-29 scores were not statistically different (p > .05). This suggests patients were optimized according to their treatment preference. A subgroup of patients who had taken the PROMIS-29 survey more than once concurrent with switching to a therapy aligned with patient preferences showed improved HRQOL and WB. These findings have implications for positive social change in that seeking the patient's voice to inform medical product innovation and FDA regulatory decision-making has potential to improve biopsychosocial outcomes.

Problématique : L’autogestion est une approche à privilégier pour gérer la douleur chronique qui touche un Canadien sur cinq. L'ergothérapie joue un rôle important pour soutenir les personnes vivant avec de la douleur chronique (PVDC) dans la reprise de leurs activités et considère l’application de stratégies d’autogestion comme des activités en soi, à intégrer dans la routine. Bien que le rôle et les interventions des ergothérapeutes dans la gestion de la douleur soient bien documentés, l’équipe de recherche n'a trouvé aucune étude spécifique décrivant les pratiques actuelles en ergothérapie concernant l’accompagnement à l'autogestion de la douleur des PVDC. Objectifs : Le but de cette étude était de mieux comprendre les pratiques actuelles en ergothérapie pour accompagner les PVDC dans l'intégration de stratégies d'autogestion dans leur quotidien. Méthodologie : Trois groupes de discussion focalisés d'une durée de 120 minutes, chacun composé de cinq ergothérapeutes, ont été réalisés. Les enregistrements, transcrits en verbatim, et les réponses des participants recueillies sur la plateforme Mentimer ont été analysés par deux co-chercheurs à l’aide du logiciel NVivo, en utilisant les approches d’analyse thématique inductive et d’analyse de contenu. Résultats : L’ergothérapie privilégie l’ «empowerment» des PVDC à travers le développement de compétences d’autogestion de la douleur, adaptant ses interventions à leur profil et besoins spécifiques, selon leur stade de changement. Les ergothérapeutes exploitent une variété d'outils numériques pour appuyer l’éducation thérapeutique et promouvoir l’autogestion de la douleur. L’efficacité et la mise en œuvre de ces interventions de soutien dépendent de facteurs clés tels que l'accès à des ressources et à des formations favorisant le développement professionnel continu, la capacité de personnaliser le contenu et la durée des interventions en fonction des besoins uniques des PVDC, ainsi qu'une orientation appropriée vers l'ergothérapie. Conclusion : Cette recherche souligne le rôle crucial des ergothérapeutes dans l'accompagnement des PVDC vers une gestion autonome et efficace de leur douleur. Elle contribue de manière significative à la compréhension des pratiques québécoises en ergothérapie pour l’autogestion de la douleur chronique et offre des pistes pour améliorer la qualité et l'efficacité des interventions. / Problematic: Self-management is a preferred approach for managing chronic pain, which affects one in five Canadians. Occupational therapy plays a significant role in supporting people living with chronic pain (PLCP) in resuming their activities and considers the pain management strategies as daily activities the PLCP needs to adopt and integrate into its routine. Although the role and interventions of occupational therapists for pain management are well-documented, the research team found no specific study describing The ways in which occupational therapists’ current practices support PLCP using self-management strategies. Objectives: The aim of this study was to better understand current occupational therapy practices for assisting PLCP in integrating self-management strategies into their daily lives. Methodology: Three focus group discussions lasting 120 minutes each, composed of five occupational therapists, were conducted. The recordings, transcribed verbatim, and participants' responses collected on the Mentimer platform were analyzed by two co-researchers using NVivo software, employing inductive thematic analysis and content analysis approaches. Results: Occupational therapy prioritizes the empowerment of PLCP through the development of pain self-management skills, tailoring its interventions to their specific profile and needs, according to their stage of change. Occupational therapists utilize a variety of digital tools to support therapeutic education and promote pain self-management. The effectiveness and implementation of these support interventions depend on key factors such as access to resources and training that encourage continuous professional development, ability to customize the content and duration of interventions based on the unique needs of PLCP, and appropriate referral to occupational therapy. Conclusion: This research highlights the crucial role of occupational therapists in guiding PLCP towards autonomous and effective pain management. It significantly contributes to the understanding of Quebec occupational therapy practices for the self-management of chronic pain and offers avenues to improve the quality and effectiveness of interventions.

This study is an exploration, through ethnographic and auto-ethnographic inquiry, of the personal world, gambling experiences and underlying biopsychosocial vulnerabilities of three individual case studies - one male and two females - each representing a different sub-type of pathological gambler. It comprises the integration and implementation of a psycho-structural stage matching model to explore comorbidity and identify certain biopsychosocial manifestations in the respective stages of pathological gambling. Long term treatment strategies were identified and patient treatment matching was explored. Further, it comprises my personal relationship and therapeutic treatment of these sub-types of gamblers over a period of one year and longer. In this study it is hypothesized that formulating appropriate matching long term treatment strategies should be based on the stage of change, the phase in the psycho-structural model, as well as the gambler's underlying vulnerability. From this a comprehensive gambling disposition profile can be completed with proper intervention matching approaches. A number of other hypotheses emerged from this study that could provide valuable information and serve as a guideline to those working with pathological gamblers. / Psychology / D.Phil.