Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

<p>According to the World Health Organization(WHO) the most efficient and cost-effective strategies in the global fight of malaria are the Indoor Residual Spraying (IRS) and the Insecticide Treated Nets ITNs). However, since the strategies include the use of synthetic insecticides, WHO reports that they sometimes meet opposition in the society. In a Global Malaria Programme report from 20061, WHO describes that concerns in the community regarding the safety of the IRS hinder its effective implementation. WHO states that the social acceptability of ITNs2 has to increase. This study aims at investigating if and where in the Ugandan society the antimalarial strategies meet opposition. The study analyzes whether authorities, non-governmental organizations and caretakers in one region in Uganda reject the antimalarial strategies recommended by WHO. The aim is further to investigate where focus should be put in order to meet the</p><p>opposition (if any) to current strategies and thus facilitate the implementation of the strategies. The methodology used is an empirical approach based on interviews with officials at authorities, representatives of non-governmental organizations (NGOs) and caretakers in the slum areas in Kawempe Division, which is an area highly exposed to malaria, in Uganda. The results show that the authorities and the NGOs in this study accept the current strategies but believe that they are not fully accepted by caretakers. Further, the authorities and the NGOs point out that current strategies, mainly IRS, meet great resistance among politicians and within the agricultural and environmental sector. Nevertheless, the majority of the caretakers in the interviews does accept the strategies and give other reasons for not having them implemented in their houses. Many of the households do not have the money neither to buy the ITNs nor to have the IRS implemented in their houses. Thus, this study implies that the opposition to the current strategies is not among authorities, NGOs or caretakers but in the political, environmental and agricultural</p><p>sphere. In order to fight malaria in the study area, WHO and stakeholders have to work with the change of attitudes among politicians and stakeholders within the environmental and agricultural sector in Uganda. They also have to provide poor households with ITNs or IRS for free, since lack of money is the reason for the studied group of caretakers not having the recommended strategies implemented in their houses.</p>

According to the World Health Organization(WHO) the most efficient and cost-effective strategies in the global fight of malaria are the Indoor Residual Spraying (IRS) and the Insecticide Treated Nets ITNs). However, since the strategies include the use of synthetic insecticides, WHO reports that they sometimes meet opposition in the society. In a Global Malaria Programme report from 20061, WHO describes that concerns in the community regarding the safety of the IRS hinder its effective implementation. WHO states that the social acceptability of ITNs2 has to increase. This study aims at investigating if and where in the Ugandan society the antimalarial strategies meet opposition. The study analyzes whether authorities, non-governmental organizations and caretakers in one region in Uganda reject the antimalarial strategies recommended by WHO. The aim is further to investigate where focus should be put in order to meet the opposition (if any) to current strategies and thus facilitate the implementation of the strategies. The methodology used is an empirical approach based on interviews with officials at authorities, representatives of non-governmental organizations (NGOs) and caretakers in the slum areas in Kawempe Division, which is an area highly exposed to malaria, in Uganda. The results show that the authorities and the NGOs in this study accept the current strategies but believe that they are not fully accepted by caretakers. Further, the authorities and the NGOs point out that current strategies, mainly IRS, meet great resistance among politicians and within the agricultural and environmental sector. Nevertheless, the majority of the caretakers in the interviews does accept the strategies and give other reasons for not having them implemented in their houses. Many of the households do not have the money neither to buy the ITNs nor to have the IRS implemented in their houses. Thus, this study implies that the opposition to the current strategies is not among authorities, NGOs or caretakers but in the political, environmental and agricultural sphere. In order to fight malaria in the study area, WHO and stakeholders have to work with the change of attitudes among politicians and stakeholders within the environmental and agricultural sector in Uganda. They also have to provide poor households with ITNs or IRS for free, since lack of money is the reason for the studied group of caretakers not having the recommended strategies implemented in their houses.

The aim of this research was to determine the way in which informal caregivers of HIV/AIDS patients experience their task as caregivers as well as to identify factors, or general resistance resources, which exercise an influence on their psychological well-being, and more specifically on their sense of coherence. The stressors encountered by informal caregivers of HIVIAIDS patients have previously been investigated thoroughly in a number of studies. The tasks of informal caregivers very often encompass much more than what would be, for example, included in the nursing context and therefore exceed the limits applying to the formal sector. Stressors to which caregivers are exposed include physical, financial and emotional aspects. It has been proved that this state of affairs has a negative impact on their physical health conditions as well as their psychological well-being. Caregivers do, however, at times report a certain extent of growth experienced by them which can be related to the care giving situation. The salutogenic perspective allows for a study of the origin of health and has, for the purposes of this study, been applied to obtain an alternative description of the caregivers' experiences. According to this perspective health does not merely mean the absence of disease, but also refers to health being influenced by an individual's management of stressful events. When an individual, even if confronted with stressful circumstances, has adequate general resistance resources at his/her disposal, a strong sense of coherence can develop and this will have a positive influence on his/her psychological well-being. In the South African context little if any literature can be found on the salutogenic factors that may affect informal caregivers of HIV/AIDS patients. The investigation of this study was based on an availability sample consisting of 8 informal caregivers of HIVIAIDS patients. A one shot cross sectional design with triangulation of data assessment techniques was used. The researcher obtained data with regard to the caregivers' sense of coherence by means of the Sense of Coherence Scale (SOC) (Antonovsky, 1987). Semistructured interviews were conducted with all the caregivers involved and a qualitative analysis followed. The results revealed that informal caregivers' sense of coherence was much lower than- that of a group of nurses (formal caregivers) as described by Cilliers (2003). One of the reasons for this significant difference could be the lack of a structured setting or environment in which caregivers still have to perform their duties and responsibilities. According to the results a variety of factors exercising a negative impact on informal caregivers' sense of coherence could be identified. These included (a) stress, (b) exposure to unfamiliar situations, and (c) a lack of counselling skills. Within the framework of the salutogenic perspective there were, however, different factors also known as general resistance resources, that exercised a positive impact on the caregivers' sense of coherence. Among these the following could be counted: (a) spirituality, (b) insight into interpersonal situations, (c) utilisation of social support systems, and (d) multi-disciplinary cooperation. It would therefore seem that informal caregivers do possess general resistance resources which enable them to persevere with their tasks as caregivers in spite of the stressors they encounter on a daily basis. One of the recommendations that can be posed after having carried out this study and after having analysed the results, is the compilation as well as the evaluation and implementation, of a psycho-education training programme for informal caregivers, with special emphasis on such general resistance resources. / Thesis (M.A. (Psychology))--North-West University, Potchefstroom Campus, 2006.

The aim of this research was to determine the way in which informal caregivers of HIV/AIDS patients experience their task as caregivers as well as to identify factors, or general resistance resources, which exercise an influence on their psychological well-being, and more specifically on their sense of coherence. The stressors encountered by informal caregivers of HIVIAIDS patients have previously been investigated thoroughly in a number of studies. The tasks of informal caregivers very often encompass much more than what would be, for example, included in the nursing context and therefore exceed the limits applying to the formal sector. Stressors to which caregivers are exposed include physical, financial and emotional aspects. It has been proved that this state of affairs has a negative impact on their physical health conditions as well as their psychological well-being. Caregivers do, however, at times report a certain extent of growth experienced by them which can be related to the care giving situation. The salutogenic perspective allows for a study of the origin of health and has, for the purposes of this study, been applied to obtain an alternative description of the caregivers' experiences. According to this perspective health does not merely mean the absence of disease, but also refers to health being influenced by an individual's management of stressful events. When an individual, even if confronted with stressful circumstances, has adequate general resistance resources at his/her disposal, a strong sense of coherence can develop and this will have a positive influence on his/her psychological well-being. In the South African context little if any literature can be found on the salutogenic factors that may affect informal caregivers of HIV/AIDS patients. The investigation of this study was based on an availability sample consisting of 8 informal caregivers of HIVIAIDS patients. A one shot cross sectional design with triangulation of data assessment techniques was used. The researcher obtained data with regard to the caregivers' sense of coherence by means of the Sense of Coherence Scale (SOC) (Antonovsky, 1987). Semistructured interviews were conducted with all the caregivers involved and a qualitative analysis followed. The results revealed that informal caregivers' sense of coherence was much lower than- that of a group of nurses (formal caregivers) as described by Cilliers (2003). One of the reasons for this significant difference could be the lack of a structured setting or environment in which caregivers still have to perform their duties and responsibilities. According to the results a variety of factors exercising a negative impact on informal caregivers' sense of coherence could be identified. These included (a) stress, (b) exposure to unfamiliar situations, and (c) a lack of counselling skills. Within the framework of the salutogenic perspective there were, however, different factors also known as general resistance resources, that exercised a positive impact on the caregivers' sense of coherence. Among these the following could be counted: (a) spirituality, (b) insight into interpersonal situations, (c) utilisation of social support systems, and (d) multi-disciplinary cooperation. It would therefore seem that informal caregivers do possess general resistance resources which enable them to persevere with their tasks as caregivers in spite of the stressors they encounter on a daily basis. One of the recommendations that can be posed after having carried out this study and after having analysed the results, is the compilation as well as the evaluation and implementation, of a psycho-education training programme for informal caregivers, with special emphasis on such general resistance resources. / Thesis (M.A. (Psychology))--North-West University, Potchefstroom Campus, 2006.

Syftet är att undersöka hur personal arbetar med samverkan och hur vårdnadshavare i förskolans verksamhet  beskriver samverkan mellan hem och förskola i mångkulturella verksamheter. I förskolans läroplan (Lpfö98/2010) står det att förskolan ska ge vårdnadshavare delaktighet och inflytande i samspel med den individuella familjens behov. Vi har genomfört en kvalitativ undersökning där vi har intervjuat personal och vårdnadshavare vad de tycker är betydelsefullt för en god samverkan. Undersökningen har genomförts med hjälp av medvetna öppna frågor följt av följdfrågor. Resultaten har jämförts mellan personal och vårdnadshavare för att undersöka respektives perspektiv på samverkan. Resultatet av undersökningen visar att majoriteten av personal och vårdnadshavare har en klar bild av vad samverkan är för dem och gav under intervjuerna intressanta förslag på olika samverkansformer. I resultatet framkom det att den övergripande samverkansformen var den dagliga kontakten som verkade vara den mest uppskattade samverkansformen mellan hem och förskola. Undersökningen syftar till att kunna bidra till en praktisk kunskapsproduktion för personer som arbetar och vistas i en mångkulturell verksamhet. / The purpose of the study is to investigate how staff works with collaboration and how the caretakers describe the interaction between home and preschool on three multicultural activities. The purpose and research question is to find out how staff and caretakers relate to collaboration work in preschool. According to the revised curriculum (Lpfö98/2010) the pre-school should provide caretakers involvement and influence in interaction with the individual family needs. We have through qualitative interviews asked staff and caretakers what they think is important for a good collaboration. The survey was conducted by means of conscious open-ended questions followed by supplementary questions. The results between staff and caretakers have been compared to take part of both staff and caretakers perspectives on collaboration. The results of the survey show that the majority of staff and caretakers have a clear picture of what collaboration is for them and gave during the interviews interesting proposals on forms of collaboration and what it means for them. The result showed that the overall form of cooperation was the daily contact that proved to be the most valued form of cooperation between home and preschool. Participants in the survey said that the daily contact was the most important because it was seen as a quick and easy way to be able to both give and receive information on the individual child's stay in preschool. The study aims to contribute to a practical knowledge production for people who work and participate in the multicultural activities. / <p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p>

Objetivos: Utilizando-se o referencial Teórico do autocuidado de Dorothea Orem o estudo tem como objetivo: avaliar a capacidade de autocuidado do agente de autocuidado (AAC) de lactentes com Seqüência de Robin isolada (SRI), quanto à manipulação e o tempo que o AAC levou para adquirir a capacidade de cuidados com a intubação nasofaríngea (INF); sonda nasogastrica (SNG) e técnicas facilitadoras da alimentação (TFA). Modelo: Estudo prospectivo. Método: A pesquisa foi desenvolvida na Seção de Terapia Semi-Intensiva denominada Unidade de Cuidados Especiais (UCE) do Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo USP/Bauru. A amostra constituiu-se de 31 agentes de autocuidado (mães) com seus lactentes com SRI internados na UCE. Após elaboração e validação de um instrumento de coleta de dados, baseado na Teoria de Autocuidado de Dorothea Orem, o instrumento foi aplicado ao agente de autocuidado (AAC), em dois momentos distintos. O primeiro durante o período de internação após treinamento oferecido pelo enfermeiro quanto às ações de cuidados com o lactente e, o segundo, antes do lactente receber alta hospitalar a fim de verificar a capacidade do AAC para realizar os cuidados em seu domicilio. Resultados: Com relação às variáveis básicas do agente de autocuidado tais como: idade do agente de autocuidado obtivemos um total de (70,95%) de adultos jovens entre 15 a 30 anos; predominou que (77,41%) dos AAC mantinham um estado civil sem união consensual; baixo nível de escolaridade (58%); (56,11%) dos AAC possuíam mais de 1 filho; apresentavam classe social baixa (87,09%) e a maioria dos lactentes tinham menos de 30 dias (67,72%). Os AAC sem união consensual apresentaram escores mais elevados para o autocuidado. Pudemos evidenciar que os AAC com menos de 21 anos apresentavam um melhor desempenho para as habilidades de autocuidado para manipulação da INF e SNG. Assim como os AAC com classificação sócio-econômica mais elevada (classe baixa superior e média inferior) apresentaram uma pontuação maior para as habilidades do cuidar quando comparadas ao AAC de classe baixa inferior (p = 0,006). A maioria dos AAC (53%) adquiriu a capacidade para o autocuidado com INF e SNG em menos de 3 dias, enquanto que o tempo para adquirir o autocuidado com as TFA foi mais demorado. Os agentes de autocuidado que apresentaram os maiores escores na avaliação geral para o autocuidado apresentaram menos tempo para adquisição do autocuidado com a manipulação da INF. O nível sócio-econômico, escolaridade, no. de filhos, estado civil e o tempo de internação não interferiram na aquisição da capacidade de autocuidado pelo AAC, para os 3 procedimentos ensinados pelo enfermeiro: INF, SNG e TFA. Conclusão: O referencial Teórico do Autocuidado de Dorothea Orem permitiu a avaliação das capacidades de autocuidado dos agentes de autocuidado por meio do ensinoaprendizagem, preparando-os para a alta hospitalar contribuindo para uma melhor assistência do cuidar, favorecendo a melhora da vida desses lactentes com SRI. / Objectives: Using Dorothea Orem\'s theoretical reference for self-care, the objective of this study is to: assess self-care agents self-care capacity (AAC) for infants with isolated Robin Sequence (SRI), with regard to manipulation and the time the AAC needed to acquire the capacity to handle nasopharyngeal intubation (NPI); nasogastric probes (NG) and feedingfacilitating techniques (FFT). Model: Prospective study. Method: The study was carried out at the Semi-intensive Care Unit called the Special Care Unit (UCE) at the Hospital de Reabilitação de Anomalias Craniofaciais of the University of São Paulo USP/Bauru. The sample was comprised of 31 self-care agents (mothers) with their infants with SRI admitted in the UCE. A data collection instrument was elaborated and validated based on Dorothea Odems Self-Care Theory. The instrument was applied to the self-care agent (AAC) at two different moments. The first during the hospital stay period after training offered by the nurse with regard to infant care and the second after the infant had been released from the hospital in order to verify AAC capacity to perform the care at home. Results: With regard to the self-care agents basic variables, such as: the self-care agents age, we had a total of (70.95%) young adults between 15 and 30 years of age; a predominant percentage (77.41%) of the AACs marital status was without consensual union; low levels of education (58%); (56.11%) of the AAC had more than 1 child; low-income social class (87,09%) and the majority of the infants was under 30 days of age (67.72%). The AAC without consensual unions revealed higher scores for self-care. We can see that the AAC under 21 years of age had a better performance in terms of self-care skills for handling NPI and NG. The AAC with higher social-economic classifications (upper low class and low middle class) received a higher score for care skills when compared to AAC from lower low classes (p = 0.006). Most of the AAC (53%) acquired self-care capacity with NPI and NG in less than 3 days, whereas the time to acquire self-care with FFT was longer. The self-care agents that presented the highest scores in the general assessment for self-care needed less time to acquire self-care skills with INF manipulation. The social-economic level, education, number of children, marital status and hospital stay time did not interfere in selfcare capacity acquisition by the AAC for the 3 procedures taught by the nurse: NPI, NG and FFT. Conclusion: The Dorothea Orem Self-Care Theoretical Reference allows the assessment of self-care capacities for self-care agents by means of teaching-learning, preparing them for release from the hospital and contributing towards better care assistance, favoring improvement in life for these infants with SRI.

<p>Purpose: Our aim is to get an insight on how home care workers experience, handle and looks upon their work. We also want to form an opinion of how home care workers experience the relationship to the clients they meet.</p><p>Questions: How does home care workers experience their daily work with their clients? Home care workers daily meet many different sorts of clients with different needs, how do they handle this? What kind of support does home care workers get in their work?</p><p>Method: A qualitative design with semistructured interviews.</p><p>Conclusion: The most central conclusion from all of our interviews were: that home care service workers has a very stressful and demanding occupation, that the work has a low status, that the personnel has a big responsibility for the wellbeing of other people and that they often find their work satisfying and fun. To have someone to talk to and exchange ideas with was also mentioned by the informants as a vital part of feeling support in their work. From the Antonovskys theory, a sense of coherence, and Goffmans views of the society, we also find that the larger part of our informants feel a high sense of coherence and that when they have to adjust to their different caretakers they play different roles.</p>

Purpose: Our aim is to get an insight on how home care workers experience, handle and looks upon their work. We also want to form an opinion of how home care workers experience the relationship to the clients they meet. Questions: How does home care workers experience their daily work with their clients? Home care workers daily meet many different sorts of clients with different needs, how do they handle this? What kind of support does home care workers get in their work? Method: A qualitative design with semistructured interviews. Conclusion: The most central conclusion from all of our interviews were: that home care service workers has a very stressful and demanding occupation, that the work has a low status, that the personnel has a big responsibility for the wellbeing of other people and that they often find their work satisfying and fun. To have someone to talk to and exchange ideas with was also mentioned by the informants as a vital part of feeling support in their work. From the Antonovskys theory, a sense of coherence, and Goffmans views of the society, we also find that the larger part of our informants feel a high sense of coherence and that when they have to adjust to their different caretakers they play different roles.

Resumo: A despeito da eficácia de vários programas de intervenção com cuidadoras ter sio divulgada na literatura, supõe-se que conhecer os procedimentos e resultados não seja suficiente para esclarecer quais comportamentos do terapeuta determinam as mudanças. Pesquisadores propõem que o entendimento do processo de mudança que ocorre em terapia, possa partir da análise da interação terapêutica. A presente pesquisa tem por objetivo, descrever a interação terapêutica estabelecida entre terapeuta e clientes, ou seja, investigar como terapeuta e clientes comportam-se em uma intervenção de grupo e analisar a influência exercida entre ambos. Participaram da pesquisa, uma Terapeuta Comportamental com experiência de três anos, duas mães e uma avó. Foram designadas para a análise, cinco de de treze sessões filmada, num total de 10 horas. Para a análise dos dados, foi utilizado o software The Observer XT, capaz de selecionar imagens, quantificar dados e realizar análises sequenciais. Os dados foram organizados em termos de frequencia e duração das categorias de comportamentos dos participantes e também foram realizadas análises de correlação e sequenciais. Resultados principais: a) as categorias do terapeuta apresentadas com percentuais de ocorrência e duração elevados foram: Aprovação, Recomendação, Interpretação, Informação e Solicitação de relato; b) constatou-se que as categorias Recomendação, Informação e Solicitação de reflexão foram apresentadas com frequencia maior em relação ao grupo de clientes, já as demais, Aprovação, Interpretação, Solicitação de relato, Reprovação e Empatia, foram apresentadas com frequencia maior às clientes individualmente; c) as categorias dos clientes: Relato, Concordância, Estabelece relações e Oposição, representaram as categorias com maiores percentuais de ocorrência e duração para as três clientes; d) as análises de correlação revelaram a existência. / Abstract: In spite of the efficiency of many interventional programs, it is believed that believed that knowing the procedures and results of such programs is not enough to clarify which attitudes performed by the therapist leaded to the actual results. Researchers propose that the understanding of the changing process originates from the analysis of the interaction established between therapist and client. The present study thus has the purpose of describing the therapeutic interaction established among therapist and clients, specifically to investigate how they behave in a group intervention analyzing therfore the influence that one has on the other. The participants were a Behavioral Therapist, two mothers and one grandmother. Five of thirteen taped sessions were randolmly designated for analysis. The software The Observer XT was designated for the data analysis. They were organized in categories classified by frequency and duration of the participants' behavior, as well as undergone to the correlational and sequential analyses. The duration and frequency were: Approval, Recommendation, Interpretation, Information and Report Solicitation; b) it was observed that the therapist's categories such as Recommendation, Information, and Thinking Request were presented in a higher frequency in relation to the clients group, yet the others such as Approval, Interpretation, Report Request, Criticism and Empathty were presented in a higher degree to the clients individually c) the categories of the clients such as Report, Concordance, Establish Relations and Opposition, represented the categories with higher percentages of requency and duration for the three clients that participated in the research; d) the correlation analysis revealed the existence of correlations among the therapist's categories, for example, Approval and Information; therapist and client's such as Interpretation... (Complete abstract click electronic access below) / Orientador: Alessandra Turini Bolsoni-Silva / Coorientador: Sonia Beatriz Meyer / Banca: Denis Roberto Zamignani / Banca: Olga Maria P. Rolim Rodrigues / Mestre