Bakgrund: Hälsan hos barn med funktionsnedsättning är sämre än hos andra barn. Tillståndet påverkas av den familj som barnet lever i samt den omgivande miljön. Familjerna har många samarbetspartners i vård och omsorg och barnet kräver mer stöd och omvårdnad än barn i allmänhet behöver av sina föräldrar. Det är viktigt att hitta metoder som sänker påfrestningarna samt förebygger ohälsa i familjen. Syfte: Syftet med denna uppsats har varit att beskriva föräldrars, barns och vårdgivares upplevelse av familjecentrerad omvårdnad, FCC, som riktar sig till familjer som har barn med funktionsnedsättning. Metod: Litteraturöversikt valdes som metod och baseras på 13 vetenskapliga artiklar med både kvalitativ och kvantitativ ansats som analyserats. Resultat: FCC definieras i artiklarna i termer av kvalitét och tillgänglighet men även som att som förälder bli lyssnad på, få tillräckligt med tid, bli bemött med respekt, ha ett gemensamt beslutsfattande mellan föräldrar och professionella och att få information, vid behov anpassad. Genom flexibla arbetssätt som är anpassade efter barnet och familjens behov både inom sluten och öppen vård och inom habilitering, kan stress minska både i familj och hos vårdpersonal. Det finns dock grupper med funktionsnedsättning som uppfattar vården som lägre familjecentrerad än andra familjer. Slutsats: Hörnstenen i familjecentrerad omvårdnad är samarbete mellan vårdgivare och familj vilket främjas av att vårdgivare tar hänsyn till och respekterar familjens kultur och bakgrund. Artiklarna i studien visar på att familjecentrerad omvårdnad ger stöd för att vara en framgångsfaktor inom vården. FCC främjar barnets och familjens hälsa vilket gynnar samhällsekonomin på sikt. / Background: The health of children with disabilities is worse than other children. The state is influenced by the family that the child live in and the surrounding environment. The families have many partners in health care and the child needs more support and care than children in general need of their parents. It is important to find ways to reduce stress and prevent illness in the family. Purpose: The purpose of this study was to describe parents, children and healthcare experience of family-centered care, the FCC, which is aimed at families who have children with disabilities. Method: Literature review was elected as a method and is based on 16 scientific articles with both qualitative and quantitative approach analyzed. Results: The FCC defined in the Articles in terms of quality and availability, but also as a parent to be listened to, given enough time, be treated with respect, have a joint decision between parents and professionals and to get information, if necessary, adapted. Through flexible approaches that are tailored to the child and family's needs both in inpatient and outpatient care, and in rehabilitation, stress can reduce both the family and the health professionals. However, there are groups with disabilities who perceive health care as a less family-centered than other families. Conclusion: The cornerstone of family-centered care is the collaboration between caregivers and family, which is promoted by the health care provider will take into account and respect the family's culture and background. Articles in the study shows that family-centered care provides support to be a success factor in health care. FCC promotes child and family health, which benefits the economy in the long term.

<p>To address the U.S. labor shortage in the fields of agriculture and STEM, higher education needs to recruit, retain, and prepare more underrepresented minority students into agricultural and STEM disciplines. Teachers play important roles in student learning, which can lead to student academic and professional success. With university classrooms becoming more diverse, faculty need to adopt inclusive teaching methods in order to accommodate the needs and expectations of diverse students. Culturally responsive teaching embraces and integrates students’ culture into the teaching and learning process. As a result, culturally responsive teaching can offer a more engaging learning experience for all students; however, in the context of higher education, there is a lack of understanding and application of culturally responsive teaching by faculty. This study examined students’ perceptions of culturally responsive teaching practices in their first college mathematics course through a developed and modified instrument for higher education. Further, this study used a structural equation model to predict the relationships among students’ perceptions of culturally responsive teaching, sense of belonging and academic self-efficacy. Data were collected through the anonymous questionnaire administrated through Qualtrics. Participants of this study were undergraduate students enrolled in the college of agriculture, college of science and college of liberal arts at a predominately white institution (PWI) and an Historically Black College and University (HBCU). Five conclusions were generated from the study. First, the scale developed to measure students’ perceptions of culturally responsive teaching in higher education was a valid instrument. Second, college students observed and sensed different types of culturally responsive teaching differently. Third, students’ perceptions of culturally responsive teaching predicted students’ academic self-efficacy and sense of belonging. Fourth, students who had a higher sense of belonging were more confident as college students. Finally, African American students at an HBCU had higher perceptions of culturally responsive teaching. Implications for practice were provided to help promote the application of culturally responsive teaching in higher education. Recommendations for future research were also discussed to inform future studies regarding culturally responsive teaching in university settings.</p>

Thesis advisor: Dorothy A. Jones / Purpose: The purpose of this study was to define, develop, and psychometrically evaluate a scale designed to measure Nurse’s Perception of the Relationship Based Care Environment. Background: Relationship is a complex multidimensional concept. It is a critical component of professional practice and core to the interaction between nurse and patient. While there are a number of scales available to measure different dimensions of relationships between nurses and other groups there is no one scale that captures multiple dimensions. Methods: Based on a review of the literature and an earlier qualitative study, a theoretical representation was developed. This representation became the framework for development of elements and items for the NPRBCE scale. The content validity of the NPRBCE scale was determined by an expert panel of Registered Nurses. Four hundred and seventy three Registered Nurse participants completed the survey. Analysis: Data were subjected to Principal Components Analysis and Cronbach’s alpha was computed to determine reliability of the scale as a whole and each of the components of the scale. Results: The final solution was a five component 56-item scale. The five components include: nurse/ other discipline; nurse/organization; nurse/ nurse; nurse/ patient- knowing the patient; and nurse/patient-respecting the patient. The scale as a whole and each of the resulting components were found to be reliable. The components were parsimonious and interpretable. Keywords: relationship based care, relationship centered care, nurse practice environment / Thesis (PhD) — Boston College, 2016. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Thesis advisor: Marilyn Cochran-Smith / The purpose of this study was to understand beginning teachers’ experiences with learning to teach in an educational system that puts intense pressure on teachers to prepare students for standardized tests. The situation is common in many developed and developing countries whose educational systems are run by policies grounded in neoliberal and human capital ideologies. Using a phenomenological research design, I explored teachers’ experiences in two very different educational systems, the United States and South Korea, and focused on the commonalities and differences of their experiences of learning to teach. I recruited four secondary-school teachers (two English and two mathematics) who had been teaching fewer than three years from each country. I conducted a series of three phenomenological interviews with each teacher in his or her native language, following the guidelines set out by Irving Seidman (2012). My analysis suggested that, although there were many differences between US and Korean teachers’ lived experiences in the context of test-based accountability, the groups were primarily similar. Both novice teachers in the United States and Korea faced significant conflicts between their prior beliefs about good teaching and the educational system that demanded them to teach to tests. All teachers in this study described experiencing various levels of frustration with having to teach to the tests, which was not their preferred approach to teaching. While struggling to meet the demands of their test-based accountability systems, the beginning teachers in this study established firm student-centered beliefs and strived to integrate practices that were consistent with their beliefs. The findings suggest that support in the form of policies and teacher education is necessary to promote teachers’ constant learning and growth in the challenging context of test-based accountability. / Thesis (PhD) — Boston College, 2016. / Submitted to: Boston College. Lynch School of Education. / Discipline: Teacher Education, Special Education, Curriculum and Instruction.

This study investigates health care providers’ perceptions and practice in culturally sensitive care. 8 in-depth interviews were conducted with health care providers that lasted an average of 25 minutes. The findings revealed that health care providers tend to understand culturally sensitive care within the patient-centered care perspective. Their practice of culturally sensitive care is partially limited by language barriers, cultural barriers, and limited trainings in cultural sensitivity, while interpreting services, verbal and nonverbal communication strategies, collaborations with colleagues and self-education promote their practice of it. These findings underscore the importance of acknowledging health care providers’ influences in promoting culturally sensitive care, and the necessity of offering adequate amount of teachings and trainings in cultural sensitivity at health care programs and hospitals.

Submitted by admin tede (tede@pucgoias.edu.br) on 2017-02-23T17:48:27Z No. of bitstreams: 1 VANESSA DOS SANTOS PICÃO.pdf: 1451406 bytes, checksum: b3d821582fccdf2cf2fd9e4d0c796781 (MD5) / Made available in DSpace on 2017-02-23T17:48:27Z (GMT). No. of bitstreams: 1 VANESSA DOS SANTOS PICÃO.pdf: 1451406 bytes, checksum: b3d821582fccdf2cf2fd9e4d0c796781 (MD5) Previous issue date: 2016-02-26 / In Brazil, policies concerning women’s health are relatively new in Brazil, and in many states a program called Rede Cegonha is only gradually being realized. The present dissertation focuses the experience of obstetric intake at a service in hinterland of the state of Bahia. Objective: to investigate the experience of women in an obstetric unit during the moments immediately before childbirth. Method: Grounded Theory (GT) was chosen as theoretical and methodological reference for this study. Eleven women who had recently given birth were interviewed about their perception, feelings and experiences about the intake in the unit. Results: The analysis suggests three axes: Starting point, the Person in her context and e the Physical environment. These were constructed based on nine categories. The “Starting point” unites experiences and difficulties of transport to the unit. Many reported troubles in getting to the unit. The “Person in her context” describes vulnerabilities of the intake process, feeling cared for or not, valued or neglected. The recent mothers were sensitive to the interpersonal relation with the team, and to the rejection of their request to have a partner accompany them. However, most of them valued the service and the help they received. The axis “Physical environment” contains important ambient elements that positively or negatively influence the experience of the intake. Conclusion: Policies of personcentered care in obstetrics still have not been able to meet women’s real needs. Failure to meet the needs of women giving birth in the obstetric context leads to maladjustment in the process of delivery and birth. The perspectives analyzed in this study show that women are sensible to aspects like the personal relationship with the health professionals, care centered on the person with her vulnerabilities and the adequacy of the physical environment. Such factors can impact positively or negatively, depending on the experience of the woman giving birth. The same factors, when linked to the nursing practice, can also, aid or hinder adequate patient care. / As políticas de atenção à saúde da mulher no Brasil são relativamente novas e em muitos estados a Rede Cegonha ainda se encontra em fase de implantação. Esta dissertação enfoca a vivência do acolhimento à parturiente num serviço de obstetrícia no interior do estado de Bahia. Objetivo: investigar a vivência da parturiente em uma unidade obstétrica até os momentos que antecedem o parto. Método: a Grounded Theory (GT) ou Teoria Fundamentada nos Dados (TFD) foi escolhida como referencial teórico e metodológico para a realização deste estudo. Onze puérperas foram entrevistadas e as entrevistas concerniram à sua percepção, sentimentos e vivências acerca do acolhimento na unidade. Resultados: da análise das entrevistas surgiram três eixos norteadores, a saber: Ponto de partida, A pessoa no seu contexto e Ambiente físico; estes foram construídos a partir de nove categorias. O “Ponto de partida” abarcou vivências e complicações do deslocamento. Grande parte das parturientes apresentou dificuldade no transporte. “A pessoa no seu contexto” descreveu as fragilidades do processo, de sentir-se ou não assistida, valorizada ou negligenciada. As parturientes mostraram-se sensíveis à relação interpessoal com a equipe e à não permissão de acompanhante; contudo, quase todas valorizaram o serviço e o atendimento prestado, mesmo quando o percebiam de forma incompleta. O eixo “Ambiente físico” abarcou elementos importantes da ambiência que influenciam a vivência do acolhimento, positiva ou negativamente. Conclusão: as políticas e os programas de humanização na área obstétrica ainda não atendem às necessidades das parturientes. Falha em atender às necessidades das parturientes no contexto parto culmina em desajustes no processo de parto e nascimento. As perspectivas analisadas neste estudo mostram que as mulheres são sensíveis a aspectos como relacionamento com os profissionais, cuidados centrados na pessoa com suas fragilidades e adequação do ambiente físico. Tais fatores podem implicar positiva e/ou negativamente, a depender da vivência da parturiente. Essas mesmas vertentes, quando relacionadas à prática do enfermeiro, podem também, facilitar ou dificultar a assistência de enfermagem.

BACKGROUND: Rising rates of maternal morbidity and mortality and persistent disparities in care utilization and outcomes signal a need for new approaches to prenatal care delivery. This study uses perspectives of low-socioeconomic status (SES) pregnant women to generate features of a patient-centered intervention aimed at improving outcomes in high cost, high need pregnant individuals. METHODS: We performed a secondary analysis of qualitative interviews with Medicaid-insured pregnant high and low utilizers of unscheduled obstetric care. Using a grounded theory approach, we tightly mapped themes to generate intervention strategies with potential to improve prenatal care delivery. RESULTS: Three key themes translated into intervention features: social support, care delivery, and access. Unlike low utilizers, high utilizers had a desire for more social support, improved communication in care delivery, and access to timely and efficient appointments. For low utilizers, improved insurance access and the ability to opt out of support services that didn’t align with their priorities were essential. CONCLUSION: High and low utilizers of unscheduled obstetric care have unique ideas for improving their care. Targeted interventions to improve prenatal care can be tested to potentially address unmet needs of vulnerable subgroups of low-SES pregnant women at risk for poor outcomes. / 2019-10-31T00:00:00Z

This qualitative study aimed to investigate psychotherapy clients’ phenomenological experience of positive regard. Though positive regard is broadly accepted as a useful and effective clinical tool across orientations, it has been under-researched and overlooked in favor of more clearly conceptualized variables, such as empathy and working alliance. Designed as a follow-up to a quantitative study that yielded a tentative factor structure and inventory for measuring positive regard (Psychotherapist Expressions of Positive Regard, PEPR), the study also aimed to elucidate the extent to which those findings could be replicated in a qualitative format. Following Consensual Qualitative Research (CQR) methodology, 15 psychotherapy clients, primarily white women, participated in semi-structured interviews eliciting the factors that contribute to their experience of positive regard in therapy, the absence of positive regard in therapy, and the impact of positive regard on the course of psychotherapy. Nine domains and several key findings emerged from the analysis. While clients named a wide range of therapist behaviors and actions that served as markers of positive regard in the relationship, three constituent attitudes appeared repeatedly throughout the CQR categories, suggesting an underlying tripartite structure of positive regard – warm authenticity, flexible responsiveness, and empathic understanding. Clients viewed positive regard as a crucial ingredient of therapy, suggesting that it facilitates self-disclosure, risk-taking, personal growth, and rupture resolution. In relationships where positive regard was lacking, clients became disengaged from treatment, and terminating without explanation was not uncommon. Clinical implications and recommendations for optimizing the experience of positive regard are offered. The substantial overlap and interdependence of positive regard with the other Rogerian facilitative conditions of congruence and empathy is discussed. Convergence and divergence between the PEPR factor structure and the results of the current study are also highlighted, with future directions proposed.

This dissertation, presented in the form of a grant application, intends to deliver a technique for decreasing the pervasive achievement gap between White and Latino students. Specifically, the aim of the proposal is to identify and implement a school-embedded, family-centered intervention designed to address the local values and concerns of a southern Oregon Latino population. Latino students face unique acculturation stressors under the current U.S. system that create academic difficulties, place strain on familial relationships, and put students at greater risk for problem behavior. In addition, barriers in the U.S. school system present challenges for recently immigrated Latino parents to participate within the school. When embedded in schools, family-centered interventions addressing the needs of Latino students will strengthen the parent-child-teacher relationship and create support structures across family and school social systems to help decrease the achievement gap and produce positive academic and behavioral results. The research approach includes both qualitative and quantitative methods. Initially, a systematic process derived from a model of evidence-based practice will be used to determine a locally-appropriate family-centered intervention for implementation in an educational context with a southern Oregon Latino population. After the selection of an appropriate family-centered intervention, a pilot randomized control trial will be employed to gather data on preliminary outcome measures, including intervention feasibility, fidelity, and effects of the intervention on parents and students. Finally, project results will be disseminated to key stakeholders and funding options for larger efficacy studies will be explored. Three outcomes will result from this project: (1) identification and selection of a locally-appropriate, evidence-based, family-centered intervention for use in a southern Oregon educational context with the Latino population; (2) pilot research to determine the feasibility, implementation fidelity, and initial program effects on student and parenting outcomes; and (3) dissemination of project results and exploration of options for funding intervention efficacy research.

Aim of study Person-centered medicine (PCM) with its focus on humanistic-biographical-oriented medicine and integrated, positive-salutogenic health is a central aspect in the patient-physician relationship in general practice. The objective of this analysis is to assess the prevalence and type of research project in academic institutions of general practice in Germany (Ger) and Austria (At) and the thematic priorities of the projects in the areas PCM, health promotion (HP), prevention (PRE) and conventional medicine (CM). Methods A search was conducted (September–December 2015) on the websites of 30 institutes and divisions of general medicine for their current research projects. The retrieved projects were assigned to five categories: PCM, HP, PRE, CM and others. Subsequently, we identified the targeted patient groups of the projects as well as the thematic focus in the categories PCM, HP, PRE and CM with focus on PCM and HP. Results 541 research projects were identified, 452 in Germany and 89 in Austria. Research projects were only included if they were explicitly indicated as research-oriented. Seventy projects addressed PCM aspects, 15 projects HP aspects, 32 projects PRE aspects and 396 projects CM aspects. The most frequently target groups in the categories PCM (24 of 70) and HP (7 of 15) were chronically ill patients. The most common thematic focus in PCM was communication (13 of 70) and in HP, physical activity (6 of 15). Conclusion The vast majority of research projects focused on conventional medical topics. PCM (13%) or PCM including HP (16%) in Ger and At is below the European average of 20%. From our point of view, PCM and HP need to be considered in general practice.