Magister Public Health - MPH / HRQOL of HAART recipients at the Kagera region hospital was generally lower than that of the general population. However, their general health perceptions and mental health status were comparable to those of the general population, suggesting effectiveness of HAART in improving some subjective experiences of HIV morbidity. Chronic diseases were the main factor negatively affecting HRQOL of recipients.

Title from PDF of title page (University of Missouri--Columbia, viewed on Feb 25, 2010). The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Dissertation advisor: Dr. Debra Oliver. Vita. Includes bibliographical references.

This is a Straussian grounded theory study about the impact of nurses’ values on pressure ulcer prevention. Semi-structured interviews were used to gather data from participants (n=16) who were recruited from the non-acute adult medical wards of 14 hospitals in one NHS Trust and a local university. The participants were asked to talk about their experiences of preventing and managing pressure ulcers and their values were elicited from their accounts. The data were analysed and interpreted with Straussian grounded theory. Nurses were found to work according to the value that they placed on pressure ulcer prevention, as this value influenced the manner in which they prioritised and delivered skin care to their patients. Similar links between nurses’ values and their delivery of care with regards to other aspects of nursing were also identified. The delivery of care to prevent pressure ulcers was found to be subject to clinical priorities and other factors. As a result, the majority of care to maintain skin integrity was delivered by nursing auxiliaries and students because nurses were busy doing other things. Despite this, nurses who place a high value on pressure ulcer prevention appear to be more proactive and determined to deliver care that protects the integrity of their patients’ skin than their peers. This is highlighted by the participants’ accounts of how their prioritisation and delivery of care to prevent pressure ulcers changed when the value that they placed on pressure ulcer prevention increased from low to high. This study also identified the manner in which the value that nurses place on pressure ulcer prevention is formed and evolves. The recommendations that arise from this study are: further testing of this grounded theory in other settings to increase its generalisability and a greater awareness of the impact that the value that nurses place on different aspects of patient care has on their delivery of care to patients, especially with regards to pressure ulcer prevention. Nurse education and training must also take into account some of the factors that help to form and change the value that nurses place on pressure ulcer prevention. Greater attention needs to be paid to the value that nurses place on different aspects of nursing in view of the relationship between nurses’ values and care delivery, if patients are to receive the best possible care.

Föreliggande studie syftar till att öka förståelsen för sociala mediers (Facebook, Twitter, bloggar, forum) roll bland ungdomar i vård och behandling genom intervjuer med yrkesverksamma personer som arbetar på HVB-hem (hem för vård eller boende). Vidare är syftet att undersöka om de sociala mediernas användning inverkar på arbetssituationen och arbetsmetoder bland de yrkesverksamma. Undersökningen byggde på en kvalitativ forskningsansats med en tematisk analysmetod. Resultatet bygger på semistrukturerade intervjuer med fem informanter vars yrkesprofession är behandlingsassistent. I resultaten framkom att informanterna upplevde sociala medier som en frizon som skapar både problem men också en känsla av gemenskap. Sociala medier ses som en negativ trend som kan orsaka hälsorisker. Yrkesrollen har påverkats i och med tillgången av sociala medier, där personalen anser att ungdomarna kan bli utsatta för mobbing och få tillgång till droger. Enligt behandlingsassisterna kunde man utifrån studiens resultat även se att ungdomarna försökte höja sin självkänsla genom hur de framställer sig på de sociala medierna. Förslag på framtida forskning är en fördjupning i hur social medier används av ungdomar vid organisering och mobilisering i olika kontext exempelvis idrottssammanhang, demonstrationer m.m. Detta ur ungdomarnas synvinkel eller andra yrkesverksamma personer som kommer i kontakt med ungdomar så som lärare, fritidsledare m.m. / This study purposed to increase the understanding of social media’s (Facebook, Twitter, blogs, forums) role of young people in care and treatment through interviews with professionals who work at HVB-homes (homes for care or residence). An additional purpose was to investigate whether the use of social media affects the work situation and work methods among the professionals. The study was based on a qualitative research approach with a thematic analysis. The result is based on semi structured interviews with five informants whose profession is care assistants.  The results showed that the informants experienced social media as a free zone, which creates problems, but also a sense of community. Social media is seen as a negative trend that is believed to lead to health risks and access to crime, but still gives them a sense of participation. By the results of the study we can see that young people are trying to increase their self-esteem and status by how they’re presenting themselves through social media. Suggestions for future research are a continuation of how social media are used by young people in the organization and mobilization in different contexts such as sports, demonstrations, and others; this from the young people’s point of view or other professionals who are in contact with young people.

Aim: The aim of the study was to explore and describe the perceptions and experiences of rape survivors who were receiving Post Exposure Prophylaxis at a regional hospital. Methodology: A phenomenological approach was used to explore the phenomena, of rape survivors' perception and experiences concerning the Post Exposure Prophylaxis (PEP) they received. The study was conducted in R.K.Khan Hospital, in an Outpatient Department in a gynaecology clinic. This is the regional hospital located in Chatsworth, in the Inner Outer West of Ethekwini District. The sample comprised of ten female rape survivors who were receiving Post Exposure Prophylaxis. Data was collected by means of face-to-face interviews using an interview guide. Interviews were lasting thirty to forty minutes long per participant. The researcher applied the principle of theoretical saturation of data and a total of ten participants were included in the study. All interviews were tape recorded and transcribed verbatim. Data was analysed manually using the Editing Analysis Style. Findings: The results of this study indicated that PEP is the new service to rape survivors and this evoked that when you are being raped you face a risk of range of immediate, medium, and long term health problems; physical, and psychological problems. The rape survivors described a number of emotions and physical reactions that they experienced when they were receiving PEP after rape, which were negative and positive reactions. Most experiences they faced indicated that they benefited from the PEP program, because they gained knowledge, got support from care providers and major diseases and complications were prevented by offering the Post Exposure Prophylaxis A number of recommendations were suggested for the provision of PEP program to the community that is for nursing practice, management and education, the policy makers and for future research in an 'attempt to prevent major complications and health problems that occur in rape survivors. / Thesis (M.A.)-University of KwaZulu-Natal, 2005.

Cancer is emerging as a major problem globally and effective cancer care services are needed to lessen its burden on the community. In Greece, oncology health service provision is not located efficiently, resulting in only few patients receiving high quality care. Furthermore, shortages of health professionals and underdeveloped services such as primary care, home care and palliative care in the Greek NHS have aggravated the problem. The limited resources for healthcare have led to the absence of a national cancer registry, thus the extent of cancer incidence cannot be evaluated effectively. The dissatisfaction of the population regarding the Greek NHS is well established, despite the numerous reforms proposed by consecutive Greek governments. It remains that limited research exists in the area of oncology, especially on cancer services and cancer care. The aim of this study was to identify the key areas of cancer care and services that needed to be developed or improved in Greece and their prioritisation within the Greek healthcare system. Once identified, these areas of improvement could be used in a policy making context for the provision of effective services to cancer patients and might provide areas for further research A new Delphi technique (Q-Delphi) was introduced as an extension of the classical Delphi and implemented in two settings to collect data from a sample of 30 healthcare providers and 30 healthcare users. This was to reduce the potential subjectivity that may be introduced by the researcher in generating themes as an essential part of a successful Delphi outcome. The Q-Delphi of healthcare providers consisted of three rounds while that of the healthcare users was based on two rounds. The response rates for all rounds in both Q-Delphi studies were over 77%. The priorities for healthcare providers were focused on staff shortages, working conditions, pain management, home care, day units and communication. Healthcare users' highest priorities included the provision of and research on effective treatment, lessening the financial costs involved and the organisation of cancer services. Despite the separate Delphi studies, there were areas that both healthcare providers and users identified and prioritised. However, for the areas that both panels shared, there was a significant difference between their prioritisation. The World Health Organisation (WHO) suggestions for controlling cancer were used to triangulate, explain and discuss the results from this study (WHO 2002). The areas identified by healthcare providers and users were within those recommended by WHO. Based on the priorities provided by the participants and the suggestions by WHO, the establishment of a national cancer registry, the employment of nurses in order to develop primary care, home care, day care and palliative care services, education in communication skills and redistribution of the bio-medical technology are recommended in order to reduce the burden of cancer hi Greece. More research is needed to validate the actual level of cancer services provided in Greece. In addition, Q-Delphi is suggested as a valid and objective research method. For the benefit of Greek researchers, copies of documents used in conducting the research are also presented in Greek (Appendices 3 to 13 and 15).

South Africa has one of the highest HIV prevalence rates globally, with nearly 2.5 million people accessing antiretroviral treatment (ART) at the end of 2013. Retaining patients on ART has become a major problem in this country. When patients no longer show up for ART for unknown reasons, they are considered lost to follow-up (LTF). LTF is the highest contributor to ART attrition. This study, guided by the health belief model, evaluated the effectiveness of a technology-based, mobile health (mHealth) appointment reminder intervention on LTF among patients accessing ART services. The study ascertained differences in 6- and 12-month LTF rates between patients enrolled in the mHealth intervention (n = 832) and those in the standard of care comparison group (n = 918). A quantitative, retrospective cohort approach was used to answer the research questions using binary logistic regression analyses. The mHealth intervention was found to be significantly linked to lower likelihood of 6- and/or 12-month LTF among patients. There were 2 other key findings: a positive correlation between pregnancy and LTF, and a positive correlation between viral load increases and LTF. This study added evidence to the existing literature on the effectiveness of using mHealth-based interventions to improve HIV/AIDS care. Based on these findings, professionals should pay special attention to pregnant women and those clients with increasing viral loads to ensure they are not LTF. Positive social change that may result from this study is better health outcomes for patients on ART due to reduced risk of HIV related complications and other illnesses. This awareness would improve the lives of the patients, and positively impact their families, communities, and ultimately the global community, by reducing the overall impact of HIV disease.

Ng Sau Kwan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (leaves 107-127). / Abstracts in English and Chinese. / ABSTRACT --- p.ii / ACKNOWLEDGEMENTS --- p.vi / TABLE OF CONTENTS --- p.vii / LIST OF TABLES --- p.ix / LIST OF APPENDICES --- p.x / Chapter Chapter 1: --- INTRODUCTION / Background of the study --- p.1 / Significance of the study --- p.3 / Chapter Chapter 2: --- LITERATURE REVIEW / Introduction --- p.6 / Search Strategy --- p.6 / Overview of the Concepts of Pain --- p.7 / Types of Pain --- p.8 / Nature of Postoperative Pain --- p.9 / Effects of Pain --- p.9 / Factors Influencing Pain Management Outcomes / Undermanaged Postoperative Pain --- p.11 / Assessing Pain in Postoperative Patients --- p.14 / Pain Relief and Patient Satisfaction --- p.16 / Health Locus of Control --- p.20 / Health Care Professionals' Attitudes --- p.22 / Barriers to Postoperative Pain Relief --- p.24 / Psychosocial Factors Influencing Patient Satisfaction --- p.26 / Nursing and Quality Assurance of Pain Management --- p.29 / Pain Management Strategies / Organization of an Acute Pain Service --- p.32 / Pharmacological Pain Management --- p.35 / Nonpharmacological Pain Management --- p.37 / Summary of Literature Review --- p.38 / Chapter Chapter 3: --- METHOD / Introduction --- p.41 / Aim and objectives of the study --- p.41 / Research Questions --- p.42 / Research Hypotheses --- p.43 / Operational Definitions --- p.43 / Research Design --- p.44 / Settings --- p.45 / Sample --- p.46 / Instruments --- p.47 / The Modified American Pain Society Patient Outcome Questionnaire (APS-POQ-Modified) --- p.48 / The State Scale of State-Trait Anxiety Inventory (STAI) --- p.50 / The Multidimensional Health Locus of Control Form C Scale (MHLC) --- p.53 / The Modified Patient Satisfaction Questionnaire (PSQ-Modified) --- p.54 / Demographic Data Form --- p.55 / Translation and Content Validity of the Instruments --- p.55 / Pilot Study --- p.57 / Data Collection Procedures --- p.60 / Data Analysis / Effect Size and Power of the Study --- p.62 / Ethical Considerations --- p.64 / Conclusion --- p.65 / Chapter Chapter 4: --- RESULTS / Introduction --- p.66 / Reliability of the Instruments --- p.67 / Demographic Characteristics / Medical Characteristics --- p.70 / Physical and Psychosocial Characteristics of Pain / Pain intensity and pain interference --- p.72 / Beliefs about pain --- p.73 / State anxiety --- p.73 / Health locus of control --- p.73 / Patient satisfaction --- p.75 / Responses to Modified Patient Outcome Questionnaire --- p.75 / Comparisons of Patient Satisfaction Ratings with Demographic / Characteristics --- p.77 / Correlates of Patient Satisfaction --- p.78 / Predictors of Patient Satisfaction --- p.80 / Conclusion --- p.82 / Chapter Chapter 5: --- DISCUSSION / Introduction --- p.84 / Demographic Characteristics --- p.84 / Effect Size and Power of the Study --- p.85 / Patient Satisfaction with Pain Management and Pain Intensity --- p.86 / Multidimensional Health Locus of Control --- p.90 / Beliefs or Misconceptions about pain --- p.94 / Education on Pain Management --- p.98 / Conclusion --- p.101 / Chapter Chapter 6: --- "LIMITATIONS, IMPLICATIONS, RECOMMENDATIONS AND CONCLUSION" / Introduction --- p.102 / LIMITATIONS OF THE STUDY --- p.102 / IMPLICATIONS FOR NURSING PRACTICE --- p.106 / RECOMMENDATIONS FOR FUTURE PRACTICE / AND RESEARCH --- p.110 / CONCLUSION --- p.113 / REFERENCES --- p.115

The thesis titled Biological Therapy in Patients with Inflammatory Bowel Diseases deals with the needs of clients with Crohn's disease and ulcerative colitis prior and after biological therapy. The role of nurses in biological therapy centres, including the application of this therapy, was also investigated. Crohn's disease and ulcerative colitis are inflammatory bowel diseases. They are chronic inflammatory diseases of the gastrointestinal tract, which are accompanied by ample extraintestinal symptoms. This thesis also deals with biological therapy that involves the administration of highly effective substances of biological nature that inhibit specific sites of inflammatory reactions. This therapy is provided in centres of biological therapy and is used not only in gastroenterology but also in rheumatology and oncology. Teams of experts work in biological therapy centres; the task of these teams is to provide a comprehensive holistic health care. The thesis is divided into a theoretical part and an empirical part. The theoretical part focuses mainly on Crohn's disease, ulcerative colitis and biological therapy that helps patients suffering from these diseases. The methodological section employed qualitative research using in-depth semi-structured interviews with patients suffering from idiopathic inflammatory bowel diseases and with nurses who deal with these patients when applying biological therapy. Since head nurses from gastroenterology departments did not wish to record the interviews with a recorder, they were recorded in writing and transcribed subsequently. The questions dealt with the issues of biological therapy in connection with inflammatory bowel diseases. All the acquired data was processed with the Atlas.ti programme, which is designed for encoding, processing and interpretation of large amounts of textual and graphic qualitative data. Based on the research, an educational brochure for patients suffering from inflammatory bowel diseases was complied as well as educational materials for nurses starting work in biological therapy centres. Furthermore, the results can be used by nurses in practice and nursing students too.

This study aims to examine the trajectory of sex offenders through the Lebanese criminal justice system while highlighting various human rights violations. It attempts to fill in the gaps within the literature through building on the existing research and by examining the processes and experiences of arrest, detention, court, prison and release. Recently, numerous scholars have argued that most criminal justice systems are following a popular punitive trend rather than focusing on rehabilitation. This study through its focus on human rights violations, participants attitudes and beliefs as well as issues of rehabilitation and treatment of prisoners firmly places Lebanon within the global trend of popular punitiveness. Seventy-three interviews were carried out with sex offenders, police officers, prison guards, judges and lawyers within Lebanon. These qualitative interviews captured criminal justice professionals and offenders experiences, attitudes and perceptions surrounding sex offending and the criminal justice system. The thematic analysis of the interviews specifically focused on uncovering how sex offenders moved through and were dealt with by the Lebanese criminal justice system. Human rights violations were found to be abundant at the various stages of the criminal justice system. Participants highlighted events such as the excessive use of torture within police stations as well as prisons, the use of forced confessions, and the lack of legal representation. Numerous factors were found to play a role in conceding the copious violations of sex offenders rights occurring at the various stages of the criminal justice system. These factors included corruption, the lack of accountability, police culture, the commonly held belief that offenders are undeserving of human rights, the lack of training, and religion. In investigating the structure and the functioning of the criminal justice system, it became evident that religion played a vital role. Religion dictated professionals positions within the criminal justice system and influenced participants beliefs and attitudes surrounding sex offenders. Because of its influence, religion played a vital role in paving the way for the re-occurrence of human right violations. For example, religion granted the criminalisation of homosexuality and the act of de-virginizing as well as legalising marital rape, all of which result in human rights violations. In order to move Lebanon, and other punitive countries, towards a more rehabilitative criminal justice approach, this study highlights the importance of training, change in legislation, as well as the separation of religion from law.