Experiencing a traumatic event during childhood or adolescence is not a rare event, yet there is little written that examines the impact that trauma and the resulting stress have in the school context, from the perspective of the youth. Traumatic stress manifests itself in internalizing and externalizing behaviours that can significantly impact academic and social functioning, and the psychosocial well-being of youth. In the absence of disclosure, teachers are often unaware that trauma may be at the root of emotional and behavioural needs seen in the classroom and may be the reason for more subtle shifts in behaviour, achievement, appearance, and demeanour. The protective nature of school connectedness, and specifically student-teacher relationships and caring, positive school climates, in increasing engagement and decreasing at-risk behaviours and emotional distress (Blum, 2005, Bond et al., 2007; Klem, & Connell, 2004) holds promise for these students. School and teachers can play an important role in improving well-being and in mitigating long term negative outcomes. Research in this area is essential as students with trauma histories and subsequent mental health needs are at greater risk for delinquency, substance abuse, suicide, chronic health problems, and diminished educational and employment success than their peers (Bardone, 1998; Edwards, Anda, Felitti, & Dube, 2004; Fergusson, 2007). This qualitative study describes the experience of four young adults who had each experienced varying traumatic life events during childhood and adolescence. The interviews sought to understand how trauma impacted the high school experience for the participants, perceptions of teacher support, and to hear their advice on how teachers can best support their learning and well-being. Results of the cross-case analysis showed the importance of noticing and validating subtle signs of student distress, of connections with caring teachers, and of teacher initiated offers of support. The youth also emphasized the importance of being seen and related to as a person and not solely as a student, highlighting the need for schools to focus on student well-being as well as academic functioning. These findings emphasize the importance that caring connections with teachers can have in supporting the well-being of students who have experienced trauma. / Thesis (Master, Education) -- Queen's University, 2010-04-14 19:57:15.425

Bakgrund: Vårdmiljöns fysiska omgivningar med sin arkitektur, natur, ljud och belysning inverkar välbefinnandet subjektivt. Vårdmiljön har även betydelse i medvärlden, där relationer och mötet har sitt samspel mellan sjuksköterskor, patienter och deras anhöriga. Problemformulering: Sjuksköterskor upplever att patienten behöver en adekvat miljö för att främja välbefinnandet. Kunskap om hur vårdmiljön inverkar patientens återhämtning är avgörande för att sträva framåt för en bättre vård. Syfte: Syftet med detta examensarbete var att beskriva vårdmiljöns betydelse för patientens återhämtning. Metod: Allmän litteraturöversikt med tolv valda artiklar där nio hade kvalitativ ansats, två med kvantitativansats och en med blandad ansats. Resultat: Samtliga studier beskrev patienternas återhämtningsprocess i relation till vårdmiljön. Den fysiska vårdmiljön bidrog till att patienterna kunde distansera sig från sin sjukdom, integritet som bevarades ansågs positiv till återhämtningen, likaså en närvaro till natur. Sömnens betydelse för återhämtningen ansågs viktig för patienterna i deras återhämtningsprocess, störningar under natten förlängde vårdtiden. Den sociala aspekten mellan patienter, sjuksköterskor och anhöriga ansågs betona ett tydligt samband till god återhämtning. Slutsats: Vårdmiljön bidrar till att kunna både stödja och hindra återhämtningsprocessen, som i sin tur har betydelse för patientens välbefinnande. / Background: The care environments physical surroundings, with its architecture, nature, sounds and lighting subjectively affects well-being. Care environment also takes place in the relational world, where relationships and meetings between nurses, patients and their next of kin takes shape. Problem: Nurses feel that the patient needs a suitable environment to promote well-being. Knowledge of how the care environment affects the patient's recovery is essential for striving towards better care. Aim: The aim of this essay was to describe the importance of the care environment for the patient’s recovery. Method: A general literature review with twelve selected articles where nine with a qualitative approach, two with a quantitative approach and one with a mixed approach. Results: All studies described the patients' recovery process in relation to care environment. The physical care environment could have helped distancing from illness, preserved integrity was considered positive for recovery. Patients sleep emphasized importance for recovery, disturbances extended the care duration. The social activities in the care environment considered a connection for recovery. Conclusion: The care environment contributes to being able to support or hinder the recovery process, which in turn is important for patient’s well-being.

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This research study explores the perceived impact of multiple sclerosis on “carepartners” in committed caring relationships as the spousal roles change over time. Both quantitative and qualitative methods were used in this study of persons with MS and their spousal carers residing in Australia during ten months of recruitment. Varied recruitment methods were used including the internet. 263 expressions of interest were received, and 203 survey packets were returned with usable data (77%). The demographic instrument and 4 scales measuring mood, reciprocity, life satisfaction and functional wellness were subjected to descriptive statistical analysis. Results from the quantitative phase of the study supported many international epidemiological findings related to gender, age of onset, difficulty in obtaining a diagnosis in the light of vague early symptoms of MS, and high levels of depression in the study sample. The preliminary analysis suggested that these data should be analysed further in dyadic terms (a person with MS and their identified carer). Further inferential statistical analysis examined the data sub-set of ‘pairs only’ which helped to inform formation of a pool of couples in caring relationships from which was selected a sub-sample of 12 spousal dyads residing in Victoria for interview in the second phase of the study. / Emerging themes from narrative analysis (n=24 persons) revealed pressing concerns, personal strengths and coping strategies of interviewees. Two themes of special interest relating to (1) differing perceptions by ‘carepartners’ of the importance of cognitive changes to the dyadic relationship, and (2) expectations of health professionals are explored. Most respondents agreed that their expectations left much to be desired, suggesting that improvements could be made in the area of health care delivery to persons with MS, their carers and their families. There are implications for the development of a multidisciplinary, ongoing assessment, educational and support program for these persons. Further research is needed to define and expand the proposed role of a specialized key contact person to be a valuable ‘advocate’ in the delivery of timely health care resources throughout the disease trajectory.

This research study explores the perceived impact of multiple sclerosis on “carepartners” in committed caring relationships as the spousal roles change over time. Both quantitative and qualitative methods were used in this study of persons with MS and their spousal carers residing in Australia during ten months of recruitment. Varied recruitment methods were used including the internet. 263 expressions of interest were received, and 203 survey packets were returned with usable data (77%). The demographic instrument and 4 scales measuring mood, reciprocity, life satisfaction and functional wellness were subjected to descriptive statistical analysis. Results from the quantitative phase of the study supported many international epidemiological findings related to gender, age of onset, difficulty in obtaining a diagnosis in the light of vague early symptoms of MS, and high levels of depression in the study sample. The preliminary analysis suggested that these data should be analysed further in dyadic terms (a person with MS and their identified carer). Further inferential statistical analysis examined the data sub-set of ‘pairs only’ which helped to inform formation of a pool of couples in caring relationships from which was selected a sub-sample of 12 spousal dyads residing in Victoria for interview in the second phase of the study. / Emerging themes from narrative analysis (n=24 persons) revealed pressing concerns, personal strengths and coping strategies of interviewees. Two themes of special interest relating to (1) differing perceptions by ‘carepartners’ of the importance of cognitive changes to the dyadic relationship, and (2) expectations of health professionals are explored. Most respondents agreed that their expectations left much to be desired, suggesting that improvements could be made in the area of health care delivery to persons with MS, their carers and their families. There are implications for the development of a multidisciplinary, ongoing assessment, educational and support program for these persons. Further research is needed to define and expand the proposed role of a specialized key contact person to be a valuable ‘advocate’ in the delivery of timely health care resources throughout the disease trajectory.

Indiana University-Purdue University Indianapolis (IUPUI) / Caring relationships established between nurse managers and staff nurses promote positive work environments. However, research about staff nurses' perceptions of nurse manager caring behaviors is limited. A 94-item Caring Assessment Tool-Administration (CAT-adm©) was developed to measure staff nurses' perceptions of nurse managers' caring behaviors; however, it lacked robust psychometric testing. This study was undertaken to establish the CAT-adm© survey as a reliable and valid tool to measure staff nurses' perceptions of nurse managers' caring behaviors. The Quality-Caring Model® (QCM®) served as the theoretical framework. Specific aims were to 1) evaluate construct validity of the CAT-adm© survey by describing factors that account for variance in staff nurses' perceptions of nurse manager caring, 2) estimate internal consistency, and 3) conduct item reduction analysis. Four research questions were: 1) Will the factor structure of observed data fit an 8-factor solution? 2) What is the internal consistency reliability of the CAT- adm©? 3) What items can be reduced while maintaining an acceptable factor structure? and 4) What are staff nurses' perceptions of nurse manager caring behaviors? A cross-sectional descriptive design was used. A sample of 703 staff nurses from Midwestern, Midatlantic and Southern Regions of the U.S. completed the CAT-adm© survey electronically. Analysis included Confirmatory Factor Analysis (CFA), Exploratory Factor Analysis (EFA), univariate analysis, and descriptive statistics. CFA did not support an 8-factor solution. EFA supported a two-factor solution and demonstrated significant shared variance between the two factors. This shared variance supported a one-factor solution that could conceptually be labeled Caring Behaviors. Random selection reduced the scale to 25-items while maintaining a Cronbach's Alpha of .98. Using the new 25-item scale, the composite score mean of staff nurses' perceptions of nurse manager caring behaviors indicated a moderately high level of caring. Suggestions for nursing administration, nurse manager practice, leadership, education and for future research were given. The new 25-item CAT-adm© survey has acceptable reliability and validity. The 25-item CAT-adm© survey provides hospital administrators, nurse managers, and researchers with an instrument to collect valuable information about the caring behaviors used by nurse managers in relationship with staff nurses.