The purpose of this cross-sectional correlational study was to examine the effects of patient and nursing unit characteristics on nursing-sensitive patient outcomes. The conceptual framework for this study is generated from the Quality Health Outcomes Model. The patient characteristics were patient age, gender, education, duration of illness, severity of illness, and illness representation. The nursing unit characteristics were nurse experience, nurse staffing, nursing unit competency, and group cohesion. Nursing-sensitive patient outcomes were patient’s confidence in self-care and patient’s perception of being well-cared for. Stratified sampling was employed to recruit a sample of 130 hospitalized chronically ill patients in 8 medical care units of 4 hospitals in Thailand. A face-to-face questionnaire interview was used to collect data from patients. A self-administered questionnaire was used to collect data from 90. Nurse staffing data were obtained from nursing administrative data for each unit. Multiple regression analyses were used to examine the relationships, test a mediator, and analyze the contextual effect of the study variables. Severity of illness (β = -.315, p <.01) and illness representation (β = -.234, p < .05) were significant predictors of patient’s confidence in self-care, when controlling for nursing unit characteristics. Illness representation partially mediated the relationship between severity of illness and patient’s confidence in self-care. Nursing unit characteristics were not significant predictors of patient’s confidence in self-care, when controlling for patient characteristics. There was a significant individual effect on patient’s confidence in self-care. Severity of illness (r = -.199, p < .05) and group cohesion (r = -.195, p < .05) were correlated with patient’s perception of being well-cared for. The findings of this study reinforce the need for acute care nurses to be aware of how chronically ill patients perceive health threats since illness representation directly affects patient’s confidence in self-care. Through understanding the role of illness representation as a mediator between severity of illness and confidence in self-care, it is suggested that nurses can improve patient’s confidence in self-care in severely ill patients by providing nursing interventions that promote positive illness representation.

It has long been recognised that cared for children can be at a disadvantage in terms of their educational experiences and outcomes (Comfort, 2007). The Care Matters Green Paper (DfES, 2006) suggested that although educational outcomes for cared for children had improved, there was still a gap between the outcomes for cared for children and those of the wider school population. A number of suggestions to narrow this gap were proposed, including the introduction of a virtual school head who would be responsible for driving up the performance of schools in relation to cared for children (DfES, 2006). In 2009 the role of the designated teacher of cared for children became statutory (DCSF, 2009a) with the aim of promoting the educational achievement of cared for children.This thesis aimed to explore the current and future role of the virtual school for cared for children in one local authority, using a mixed methods research design. The current role was established through semi-structured interviews with members of the virtual school team and surveying designated teachers using a questionnaire. The future role was explored through an appreciative inquiry session involving three members of the virtual school and one designated teacher. Appreciative inquiry seeks out what is already working in an organisation and builds on this success (Carter, 2006). There are limited examples of the use of appreciative inquiry in educational research regarding vulnerable groups (Woollam, 2010a; Woollam, 2010b), particularly within a mixed methods approach.Data was analysed using descriptive statistics and thematic analysis. The majority of designated teachers suggested that they were confident in their role. Existing support from the virtual school included individual casework, funding, training, support during placement breakdowns and emotional support for the designated teacher. Additional support was requested for post-16 cared for children and adopted children. Virtual school staff reported increased funding, the virtual school head position and virtual school branding, the raised profile of cared for children and relationships as facilitative to their work. Barriers included cared for children’s experiences, staff knowledge and experience and low expectations for cared for children. It was perceived the virtual school model was “working”; advantages over previous models included “sitting” in education, access to senior meetings to raise the profile of cared for children’s needs and being a “bridge” between social care and education. Priorities for the future role of this virtual school included “being bold”, developing early years and post-16 provision, increased enrichment opportunities and widening the remit of the virtual school to include other vulnerable groups such as adopted children, child protection cases and children in need. Implications for educational psychology practice and future research are considered.

Bibliography: leaves 273-284. This thesis examines the autobiographical texts of the Aboriginal women writers, Oodgeroo, Margaret Tusker and Monica Clare, in light of the 'community of commitment' which supported their publications. It considers how and why the Aboriginal women elicted outside support and how the ideology of the group informed the epistemology of the text.The role of collaborating white editors and professional editors are examined as crucial in influencing the style and content of the finished piece. The original manuscripts are compared against the published editions and the changes implemented by the editor are described. Following Frantz Fanon and Homi Bhaba, the adoption of the white ideological lattice by the Aboriginal author is characterised as the white mask of colonial mimicry. The outcomes of cross-cultural impersonation of the white editor are discussed, with the editorial collaboration viewed as the imposition of stereotyped representations of Aboriginality.

Bibliography: leaves 273-284. / 284 leaves : ill. (some col.) ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / This thesis examines the autobiographical texts of the Aboriginal women writers, Oodgeroo, Margaret Tusker and Monica Clare, in light of the 'community of commitment' which supported their publications. It considers how and why the Aboriginal women elicted outside support and how the ideology of the group informed the epistemology of the text.The role of collaborating white editors and professional editors are examined as crucial in influencing the style and content of the finished piece. The original manuscripts are compared against the published editions and the changes implemented by the editor are described. Following Frantz Fanon and Homi Bhaba, the adoption of the white ideological lattice by the Aboriginal author is characterised as the white mask of colonial mimicry. The outcomes of cross-cultural impersonation of the white editor are discussed, with the editorial collaboration viewed as the imposition of stereotyped representations of Aboriginality. / Thesis (Ph.D.)--University of Adelaide, Dept. of Social Inquiry, 2001

Varje dag väljer minst tre personer i Sverige att avsluta sina liv. Antalet personer som överlever ett suicidförsök är desto fler. Dessa personer kommer i kontakt med hälso- och sjukvård på olika sätt och möts ofta av stigmatisering och tystnad. Forskning visar att sjuksköterskan upplever en osäkerhet i mötet med patienten efter ett suicidförsök. För att bidra till en värdig vård behöver vi förstå vad patienten kan uppleva i vården. Syftet med litteraturstudien är därför att belysa upplevelsen av att vårdas efter ett suicidförsök ur ett patientperspektiv. Flera artikelsökningar resulterade i åtta kvalitativa artiklar vilka analyserades och sammanställdes i denna litteraturstudies resultat. Att vårdas efter ett suicidförsök förklaras i resultatet utifrån fem huvudteman där vårdarens bemötande ses som en central del. Patienten är också i behov av att få befinna sig på en trygg plats, där hen kan finna balans då patienten ofta tappat tilltron till sig själv. Det finns också en längtan efter att få dela sina tankar och planer på suicid med vårdpersonal. För att patienten ska få dessa behov tillgodosedda krävs en professionell och kompetent vårdare. Tyvärr visar forskning att vårdaren inte alltid lyckas tillgodose patientens basala behov. / At least three people commit suicide in Sweden every day. The numbers of the people who survive a suicide attempt are way more. These people get in touch with professional healthcare in different ways. Sadly they are often met with stigmatization and silence. Research shows that nurses often feel insecure when caring for these patients. To contribute to a meaningful care professional caregivers have to understand what these patients might experience. The purpose of this study is therefore to highlight the experiences of patients being cared for after a suicide attempt. Eight qualitative studies was selected and analysed. The result suggests how care after a suicide attempt can be understood throughout five themes: To be met in the right way, to feel safe, to find balance, to talk about suicide and to not trust in yourself. To be met by a professional caregiver was seen as the most important part of being cared for. There is also a longing to talk about the suicide attempt and the patient is in need of a safe place where he or she gets the opportunity to find balance. Lack of self-trust is also seen as a result of the suicide attempt. To be able to provide what the patient is in need of the caregiver has to be professional and competent. Unfortunately caregivers don’t always succeed in providing the care that the patient is in need of.

De multiples auteurs de la discipline infirmière réclament la valeur inestimable de la relation de caring et de ses bienfaits pour la clientèle nécessitant des soins et services de réadaptation. En dépit de cette importance, la recherche concernant les bienfaits thérapeutiques de la relation de caring pour la clientèle de réadaptation demeure encore un domaine peu exploité. Actuellement, aucune étude scientifique québécoise, canadienne ou internationale, issue de la discipline infirmière, ne porte sur la compréhension de l’expérience d’« être avec » la personne soignée dans un contexte de réadaptation, aspect qui s’avère central à la relation de caring selon Watson. Au cœur même de la philosophie du Human Caring de Watson, la présente étude vise à explorer, par des entrevues qualitatives auprès de 17 infirmières oeuvrant en contexte de réadaptation, la signification de l’expérience d « être avec » la personne soignée, de même que leur perception de la contribution de cette expérience à la réadaptation de la personne soignée. Cinquante et une entrevues, c’est-à-dire trois entrevues réalisées pour chaque participant de recherche, ont été analysées à l’aide de la méthode phénoménologique intitulée « Relational Caring Inquiry » développée par Cara (1997). Le processus de recrutement des participants a impliqué la direction des soins infirmiers des deux centres de réadaptation ciblés par l’étude. Une attention particulière a été mise afin de favoriser une diversité de participants (par exemple : genre, niveau éducationnel, quart de travail, unité de soins). Le processus d’analyse des données a permis la découverte de cinq eidos-thèmes. Parmi ces eidos-thèmes, quatre se rapportent à la signification de l’expérience d’«être avec» la personne soignée (première question de recherche), à savoir : (a) l’importance des valeurs humanistes au centre du soin, (b) l’investissement de l’infirmière et de la personne soignée, (c) les dimensions réciproque et relationnelle du soin et, finalement, (d) l’expérience de soin irremplaçable d’une complexité contextuelle. De façon plus détaillée, le premier eidos-thème dévoile les fondements humanistes à la base de l’expérience d’« être avec » la personne soignée. Le deuxième manifeste l’implication substantielle de l’infirmière et de la personne soignée. Le troisième eidos-thème met en lumière la réciprocité et la dimension relationnelle comme étant des éléments centraux à l’expérience d’« être avec » la personne soignée. Le quatrième eidos-thème documente les natures fondamentale et complexe de cette expérience de soin unique, de même que les conditions contextuelles qui la facilitent et la contraignent. Le cinquième et dernier eidos-thème ayant émergé de la présente étude, « rehaussement de l’harmonie corps-âme-esprit chez la personne soignée et l’infirmière », illustre la perception des participantes quant à la contribution thérapeutique de l’expérience d’« être avec » la personne soignée à la réadaptation de cette dernière (deuxième question de recherche). Cette contribution se situe en termes de répondre aux besoins du patient, d’optimiser les progrès de réadaptation de la personne soignée, de promouvoir le niveau de bien-être de la personne soignée et de l’infirmière et, finalement, de hausser la croissance intérieure des personnes engagées dans cette expérience de soin extraordinaire. La reconnaissance des cinq eidos-thèmes a favorisé l’émergence de l’essence universelle du phénomène à l’étude qui s’intitule « la rencontre humaine profonde, thérapeutique et transformatrice ». La présente étude contribue de façon novatrice au développement des connaissances, notamment en permettant une meilleure compréhension de ce que signifie l’expérience d’« être avec » la personne soignée, pour des infirmières en réadaptation et en proposant une multitude de résultats probants pouvant servir de guide à la promulgation de soins infirmiers en contexte de réadaptation. En déterminant la signification ontologique de cette expérience de soin, la présente étude permet de préciser la place du phénomène d’« être avec » la personne soignée au centre de la théorie du caring. Ces résultats qui découlent de la deuxième question de recherche participent au développement initial d’un corpus de connaissances. Ces résultats probants serviront de guide au renouvellement de la pratique infirmière en contexte de réadaptation. De plus, en identifiant les bienfaits de cette expérience de soin, la présente étude reconnaît l’élément au cœur de la relation transpersonnelle de caring, qui contribue à rehausser l’harmonie corps-âme-esprit chez la personne soignée et l’infirmière. En plus de la clinique, des recommandations au niveau de la formation et de la recherche en sciences infirmières découlent de la présente étude. / Several nursing authors acknowledge the essential value of the caring relationship and its benefits for the rehabilitation clientele. In spite of this importance, the therapeutic benefits of the caring relationship for this clientele remain an unexamined area. Currently, no Quebec, Canadian or international scientific nursing study is concerned with understanding the experience to « be with » the person being cared for in a rehabilitation context, which is central to the caring relationship according to Watson. Inspired by Watson’s Human Caring philosophy, this study aims to investigate, by qualitative interviews with seventeen rehabilitation nurses, the meaning of the experience to « be with » the person being cared for, as well as their perception of the contribution of this experience to the person’s rehabilitation. Fifty one interviews, therefore three interviews for every research participant, were analyzed using the « phenomenological » method entitled « Relational Caring Inquiry » developed by Cara (1997). The process of participant recruitment involved the nursing management team of both rehabilitation centres targeted by the study. A variety of participants was favoured (e.g.: gender, educational level, shift worked, and patient care unit). The process of data analysis allowed the discovery of five eidos-themes. Among these eidos-themes, four refer to the meaning of the experience to « be with » the person cared for (first research question), namely: (a) the importance of humanistic values at the core of the care, (b) the investment of the nurse and the person cared for, (c) the reciprocal and relational care dimensions and finally, (d) the irreplaceable care experience of contextual complexity. In more detail, the first eidos-theme reveals the humanistic basis of the experience to « be with » the cared person. The second expresses the substantial implication of the nurse and the person cared for. The third eidos-theme clarifies the reciprocity and relational dimension as being central elements of the experience to « be with » the person cared for. The fourth eidos-theme documents fundamental and complex origins of this unique care experience, as well as the contextual conditions which facilitate and impede it. The fifth and last eidos-theme emerging from this study, « strengthening the mind-body-spirit harmony of the person cared for and the nurse », illustrates the participants’ perception regarding the therapeutic contribution of the experience to « be with » the person cared (second research question). This contribution meets the patient’s needs, optimizes the rehabilitation progress of the person cared for, promotes the level of well being of the person cared for and the nurse and finally, raises the inner growth of the people engaged in this extraordinary care experience. The recognition of these five eidos-themes supports the emergence of the universal essence of the phenomenon being studied which is entitled « the profound, therapeutic, and transformative human relationship ». The present study contributes, in an innovative way, to knowledge development, in particular by allowing a better understanding of the meaning of rehabilitation nurses’ experience to « be with » the patient, and advancing evidence-based results to be used as a guide for the development of nursing care in the context of rehabilitation. By determining the ontological meaning of this care experience, the present study makes it possible to specify the place of the phenomenon to « be with » the patient as being central to the caring theory. The results arising from the second research question contribute to the development of a body of knowledge. These evidence-based results will be used to guide the renewal of nursing practice in the context of rehabilitation. Moreover, by identifying the benefits of this care experience, the present study recognizes the element at the heart of transpersonal caring relationship, which contributes to mind-body-spirit harmony for both, the person cared for and the nurse. This study also proposes recommendations for education and research in nursing sciences.