Hepatitis C is a fast growing infectious disease in Australia and is often associated with related psycho-social and mental health problems. The conventional treatment process for hepatitis C is challenging due to a number of reasons. This study explored social workers’ perceptions of the contribution of their role in hepatitis C treatment centres in relation to the treatment experience of patients. The roles that social workers fulfill, their contribution to the multidisciplinary team and towards a culturally competent service, were explored. Furthermore the knowledge, skills and values required for providing a competent service in a hepatitis C treatment setting was explored. The broad theoretical frameworks that inform social work practice were considered, especially the biopsycho-social model, the strengths perspective, the critically reflexive approach and communications theory. This qualitative study used a semi-structured interview method for data collection. Ten social workers in hepatitis C treatment clinics participated in the study. The findings highlight the needs of patients and how social worker participants described helping to address and meet these needs by employing their knowledge, skills and values through their social work roles and interventions in a team context in a multicultural and multi-faceted work environment. A major challenge that social workers described was to keep patients on treatment despite debilitating side effects that diminish patients' motivation to complete treatment. A shortcoming in the service was described to be the limited psychiatric support available at many treatment centres. The findings lead to a number of recommendations to improve social work services in hepatitis C treatment settings. More research was recommended in areas such as motivational techniques, psychiatric support, and effective group work strategies. The need for increased funding for social work positions in the hepatitis C field was also highlighted. It is anticipated that findings of this study can be applied to hepatitis C treatment in broader settings such as prisons, drug and alcohol settings and general practice. This research will contribute to literature in the field of hepatitis C treatment models and in the field of social work practice in hepatitis C contexts.

Hepatitis C is a fast growing infectious disease in Australia and is often associated with related psycho-social and mental health problems. The conventional treatment process for hepatitis C is challenging due to a number of reasons. This study explored social workers’ perceptions of the contribution of their role in hepatitis C treatment centres in relation to the treatment experience of patients. The roles that social workers fulfill, their contribution to the multidisciplinary team and towards a culturally competent service, were explored. Furthermore the knowledge, skills and values required for providing a competent service in a hepatitis C treatment setting was explored. The broad theoretical frameworks that inform social work practice were considered, especially the biopsycho-social model, the strengths perspective, the critically reflexive approach and communications theory. This qualitative study used a semi-structured interview method for data collection. Ten social workers in hepatitis C treatment clinics participated in the study. The findings highlight the needs of patients and how social worker participants described helping to address and meet these needs by employing their knowledge, skills and values through their social work roles and interventions in a team context in a multicultural and multi-faceted work environment. A major challenge that social workers described was to keep patients on treatment despite debilitating side effects that diminish patients' motivation to complete treatment. A shortcoming in the service was described to be the limited psychiatric support available at many treatment centres. The findings lead to a number of recommendations to improve social work services in hepatitis C treatment settings. More research was recommended in areas such as motivational techniques, psychiatric support, and effective group work strategies. The need for increased funding for social work positions in the hepatitis C field was also highlighted. It is anticipated that findings of this study can be applied to hepatitis C treatment in broader settings such as prisons, drug and alcohol settings and general practice. This research will contribute to literature in the field of hepatitis C treatment models and in the field of social work practice in hepatitis C contexts.

<p>This study aims to examine how adolescents with diabetes describe and value their experience of participating in a support group and how they describe the issues of being a teenager with diabetes. This is a qualitative study and we have interviewed three young women who have been participating in a support group. The results of the interviews were analyzed through a phenomenological method and then compared to earlier research and interpreted through symbolic interactionism and Erikson's development-theory, which were our theories of choice. Our findings support earlier research when stating that support groups are important and necessary for adolescents with chronic illnesses. Our interviewees stated that they think that one of the most important benefits of support groups is to meet other people in their situation; same age and same chronic illness.</p>

Nearly 80% of children treated for cancer are expected to survive, but not without cost. Survivors face unprecedented challenges associated with long-term consequences of treatment, also called late effects. Approximately half of children treated for cancer are at risk for experiencing cognitive late effects, which typically emerge several years post diagnosis. The nature and extent of cognitive late effects appear to be developmental and related to patient, disease, and treatment variables. However, the relationships between these variables is not well understood because there have been few prospective and longitudinal studies that report on the contributions of these variables over time. This dissertation examined the effects of patient, disease, and treatment variables, as well as their interactions over time on neurocognitive functioning in childhood cancer survivors. It comprises part of a large prospective, randomized clinical trial designed to examine changes in cognitive function over three years as a function of different levels of monitoring of school-based intervention based on individual educational plans (IEPs). This dissertation uniquely contributed a new measure (the Treatment Intensity Rating Scale) that was used to systematically classify treatment severity across different types of cancer and cancer treatments. Participants included 61 children ages 7 to 12 years at enrollment who were two to five years from completion of treatment for a brain tumor, leukemia, or lymphoma. Participants received yearly neuropsychological evaluations for a follow-up period of 3 years. Results of these evaluations were used to develop IEPs. Participants were randomized to have their IEPs monitored on a quarterly or annual basis for the duration of the study. Contrary to the progressive decline in neurocognitive functioning that is typically anticipated in pediatric cancer survivors, analyses revealed relative stability of performance on neurocognitive measures over time. Higher neurocognitive performance was noted in children whose IEPs were monitored more frequently versus less frequently. Results also supported gender-specific risk for late effects, with lower performance on select neurocognitive measures in females compared to males. Results of this study provide encouraging evidence of the positive effects of school-based interventions and their close monitoring. This has important implications for quality of life as these children survive well beyond childhood into adulthood.

This study aims to examine how adolescents with diabetes describe and value their experience of participating in a support group and how they describe the issues of being a teenager with diabetes. This is a qualitative study and we have interviewed three young women who have been participating in a support group. The results of the interviews were analyzed through a phenomenological method and then compared to earlier research and interpreted through symbolic interactionism and Erikson's development-theory, which were our theories of choice. Our findings support earlier research when stating that support groups are important and necessary for adolescents with chronic illnesses. Our interviewees stated that they think that one of the most important benefits of support groups is to meet other people in their situation; same age and same chronic illness.

To explore attributions about chronically ill peers, 545 older adolescents ages 17-26 read a short vignette describing a brief social encounter with a hypothetical peer suffering from a medical condition, and then responded to a series of questionnaires to assess their perceptions of that peer. Nine measures intended to assess perceptions of ill peers were developed and empirically validated. Test-retest reliability and internal consistency was moderate to good for all measures. Component structure of the Peer Acceptance Questionnaire (PAQ), Peer Acceptance Questionnaire ?? 3rd Person (PAQ-F), and Perceived Similarity Questionnaire (PSQ) were also evaluated. Principal components analysis yielded a 2-factor structure of Openness and Egalitarianism for both the PAQ and PAQ-F. A 6-factor structure of (a) Familial/Spiritual, (b) General Health, (c) Social, (d) Behavioral, (e) Physical, and (f) Educational was suggested for the PSQ. Results indicated an interaction between illness type and behavior on acceptance ratings, such that behavior potentiated the effect of illness type on acceptance. In addition, vignette characters with contagious illnesses were rated less favorably than those with noncontagious illnesses, and vignette characters displaying typical behavior were rated more favorably than either withdrawn or aggressive vignette characters. Illness-specific knowledge, ratings of perceived similarity, and ratings of assigned blame predicted acceptance ratings, whereas illness-specific knowledge and acceptance ratings predicted ratings of assigned blame. Finally, significant differences were observed between first- and third-person ratings of both acceptance and assigned blame.

Backround. Based of my personal observations when employed as a pharmacist in a Saudi hospital it was clear that there were problems with medicine supply to outpatients. This thesis was designed to scientifically investigate the types of shortages, the reason(s) for such problems and potential solutions to the problem. Methods . This study was undertaken using a variety of experimental techniques to determine the views and perceptions of patients, pharmacists, physicians and administrative staff of the hospital under examination. To establish the scale of the problem: focus groups (n=25), structured questionnaires, structured interviews/meetings for health care professionals and a national survey (n=650) were the research tools used to objectively determine the relevant data. The data were analyzed by appropriate statistical methods. Results and Discussion That there was a real problem was quickly established in the data obtained from patients. A similar finding was made for each of the 'professional groups'. The central problem was one of shortages of medicines for prescriptions presented by outpatients. It was not a case the medicines were simply not available because they were never stocked but rather a simple shortage in the dispensary stock. It was established the lack of medicines was not due to central budget arrangements but involved prescribing quantities outside of the hospital guidelines which no degree of planning could accommodate. There was also the very unexpected finding that a prescription could be filled in a variety of hospital dispensaries as individuals could access more than one hospital or they could consult more than one physician for the same condition and obtain effectively double the supplies. Communications between the hospital and patients and the health care professionals could all be improved by perhaps increasing the knowledge of the patient about the correct use of medicines. Recommendations. A series of recommendations for future work is provided

Hepatitis C is a fast growing infectious disease in Australia and is often associated with related psycho-social and mental health problems. The conventional treatment process for hepatitis C is challenging due to a number of reasons. This study explored social workers’ perceptions of the contribution of their role in hepatitis C treatment centres in relation to the treatment experience of patients. The roles that social workers fulfill, their contribution to the multidisciplinary team and towards a culturally competent service, were explored. Furthermore the knowledge, skills and values required for providing a competent service in a hepatitis C treatment setting was explored. The broad theoretical frameworks that inform social work practice were considered, especially the biopsycho-social model, the strengths perspective, the critically reflexive approach and communications theory. This qualitative study used a semi-structured interview method for data collection. Ten social workers in hepatitis C treatment clinics participated in the study. The findings highlight the needs of patients and how social worker participants described helping to address and meet these needs by employing their knowledge, skills and values through their social work roles and interventions in a team context in a multicultural and multi-faceted work environment. A major challenge that social workers described was to keep patients on treatment despite debilitating side effects that diminish patients' motivation to complete treatment. A shortcoming in the service was described to be the limited psychiatric support available at many treatment centres. The findings lead to a number of recommendations to improve social work services in hepatitis C treatment settings. More research was recommended in areas such as motivational techniques, psychiatric support, and effective group work strategies. The need for increased funding for social work positions in the hepatitis C field was also highlighted. It is anticipated that findings of this study can be applied to hepatitis C treatment in broader settings such as prisons, drug and alcohol settings and general practice. This research will contribute to literature in the field of hepatitis C treatment models and in the field of social work practice in hepatitis C contexts.

[Truncated abstract] In Australia, asthma is a common chronic illness, which often requires complex treatment regimens. This study used an anthropological perspective to explore the experience of people living with asthma, with the specific aim of contributing to the health care programs offered to people living with asthma. The study was conducted in an Australian city (Perth, Western Australia). The foci of the study were Australian lay people, from the general community, living with asthma, and a small number of non- English speaking Vietnamese-Australian migrants. Some spouses of the Australians and biomedical practitioners were also included. Questionnaires, and particularly indepth interviews, were used to explore the explanatory models of asthma for doctors and lay people with the condition. The explanatory models of the doctors focused primarily on assessing and treating the physiological dimension of asthma, and educating patients. The explanatory models for lay people with asthma reflected their everyday reality: in addition to its impact on their physical health, asthma affected their daily life, social roles and participation, and their personal identity. Placing the experience of asthma in this wider perspective showed that the Australians used practical reasoning to make a trade-off between using medication, such that they felt safe from `attacks? and could `do all they wanted to do?, and minimising their `dependence? on potentially harmful medications. Responding to acute episodes involved a risk assessment in which people weighing the health risk of waiting against the social risk of seeking help unnecessarily. For the Vietnamese- Australians, caring for asthma was strongly shaped by their social position as non- English speaking migrants. They lacked access to information about asthma and to specialist care. They had sufficient medication, but were ill-informed about how to use their medicines effectively and safely: in general, the Vietnamese people were overmedicated but under-serviced in the care of their asthma. Beyond explanatory models, the Australian participants (lay people and doctors) shared a cultural model of asthma as a chronic illness. This Australian cultural model shaped the experience and care of asthma. It included concepts such as framing the past as an adjustment process, and the present as `living normally? with asthma. Taking care of asthma was expressed as `taking control? of asthma, so a person could minimise the illness and still be healthy. The Vietnamese-Australians did not share this cultural model of asthma as a chronic illness, as reflected in their expression of the hardship asthma created in limiting their ability to work hard for their family, and how they expected a cure for their condition from biomedicine. The Australians also shared a cultural model of health that was derived, in part, from the health promotion messages that are targeted at lay people. These promotional messages were the basis of a morality in health: people shared an implicit understanding that a person deserved health, and assistance when ill, when he/she displayed the required self-discipline in performing health behaviours.

Em consequência da complexidade e extensão da problemática do viver com uma doença crônica, é importante investigar o impacto da doença e da adesão ao tratamento sobre a qualidade de vida (QV), especialmente no período da adolescência. Assim, esta dissertação teve como objetivo investigar as relações entre adesão ao tratamento e qualidade de vida em adolescentes com Diabetes Mellitus Tipo 1 (DM1), e foi organizada em dois estudos empíricos. O primeiro estudo investiga os preditores da QV, enquanto o segundo estudo enfoca a adesão ao tratamento, verificando variáveis associadas. Participaram da pesquisa 122 adolescentes com diagnóstico de DM1, com idades entre 12 e 18 anos (M=14,71; ±1,77), sendo 56,6% do sexo masculino. Foram utilizados os seguintes instrumentos: ficha de dados sociodemográficos, CEAT-VIH adaptado para tratamento com insulina, Questionário de Atividades de Autocuidado com o Diabetes, Escala de Depressão, Ansiedade e Estresse (EDAE-A-21), além da consulta de prontuários para obter os valores da hemoglobina glicada (HbA1c). Foram observadas correlações significativas entre QV, autocuidado, adesão, sintomas de depressão, ansiedade e estresse, o número de internações e a média dos últimos dois valores mensurados de HbA1c. Além disso, quanto mais adesão ao tratamento prescrito e quanto maior o autocuidado relacionado às práticas de mudança de hábitos, como o cuidado com a alimentação e atividade física regular, melhor a QV dos adolescentes. Destaca-se a importância de compreender os fatores relacionados à adesão ao tratamento, especialmente na adolescência, e sua influência sobre a QV, a fim de minimizar os impactos negativos da doença na vida dos jovens, promover maior qualidade de vida e buscar melhorias no atendimento a populações com DM1. / Due to the complexity and problems of extension of living with a chronic illness, it is important to investigate the impact of disease and treatment adherence on the quality of life (QOL), especially during adolescence. Thus, this work aimed to investigate the relationship between treatment adherence and quality of life in adolescents with type 1 diabetes mellitus (T1DM), and it was organized in two empirical studies. The first study investigated the predictors of QOL, while the second study focused on treatment adherence, looking for associated variables. The study included 122 adolescents diagnosed with type 1 diabetes aged between 12 and 18 years (M= 14.71; ±1.77), and 56.6% were male. The instruments were used: sociodemographic data chart, CEAT -VIH adapted to insulin treatment, Self-Care Activities Questionnaire with Diabetes, Depression Scale, Anxiety and Stress (EDAE-A), and the records of query to get the values of glycated hemoglobin (HbA1c). There were significant correlations between quality of life, self-care, adherence, symptoms of depression, anxiety and stress, the number of hospitalizations and the average of the last two measured values of HbA1c. In addition, the more adherence to prescribed treatment and the higher the related self-care habits to change practices, such as attention to diet and regular physical activity, the better the adolescents’ quality of life . The study highlights the importance of understanding the factors related to adherence to treatment, especially in adolescence, and their impact on quality of life in order to minimize the negative impacts of the disease in the young people’ lives, thus promoting better quality of life and qualifying the assistance to T1DM population.