<p>Disclosure of HIV positive status to male partners is well established as a key element in the success of prevention of mother to child transmission of HIV programmes, as it helps improve adherence to ARVs by the women within these programme. However, partner notification rates remain low in the urban areas of Lusaka, Zambia against a high HIV prevalence of 25%. The purpose of this study was to explore the timing of disclosure as part of the process of disclosure amongst women who were part of the PMTCT services at Kaulu health centre in Lusaka. An exploratory descriptive study using qualitative research methods was conducted. 15 women, who were attending the Kaulu health centre PMTCT programme, were requested to participate in a semi-structured interview. The women, who were purposively selected with the aid of the health centre‟s PMTCT focal point nurse, had to have disclosed their HIV positive status to their partner, either before or during the course of their pregnancy or after delivery. To increase rigour,&nbsp / individual interviews were conducted with 5 health workers associated with the PMTCT programme so as to obtain their perspective and experiences on the issue of HIV disclosure amongst their PMTCT patients. Participation in the study was voluntary and all information obtained during the course of the interviews remained confidential and secure. Potential participants were each provided with an explanation of the purpose and process of the study and their informed written consent obtained before the researcher embarked on the interviews. Content analysis of the transcripts was done so as to develop coding categories and identify emerging themes. Disclosure to male partners is an important step in PMTCT and facilitates adherence to HIV care for the family and should be done as early as possible after the woman receives her HIV test result, though there exists a range of alternative times when it can be done. The relationship existing between a couple is very important in determining the timing of when a woman chooses to disclose. PMTCT services need to provide ongoing counselling for HIV positive women during pregnancy and after giving birth that supports, informs and equips them with the necessary skills to make an informed and timely decision about disclosure to a partner. In addition, the PMTCT service providers need to be encouraged to implement couple counselling as a strategy to facilitate disclosure as well as establishment of a peer support network for HIV positive pregnant women. The study findings will be used to contribute to health workers‟ capacity to support women manage the disclosure process to their male partners, thus helping to increase the disclosure rate and also contributing to improving the positive effect of the PMTCT services, in Lusaka, Zambia</p>

<p>Disclosure of HIV positive status to male partners is well established as a key element in the success of prevention of mother to child transmission of HIV programmes, as it helps improve adherence to ARVs by the women within these programme. However, partner notification rates remain low in the urban areas of Lusaka, Zambia against a high HIV prevalence of 25%. The purpose of this study was to explore the timing of disclosure as part of the process of disclosure amongst women who were part of the PMTCT services at Kaulu health centre in Lusaka. An exploratory descriptive study using qualitative research methods was conducted. 15 women, who were attending the Kaulu health centre PMTCT programme, were requested to participate in a semi-structured interview. The women, who were purposively selected with the aid of the health centre‟s PMTCT focal point nurse, had to have disclosed their HIV positive status to their partner, either before or during the course of their pregnancy or after delivery. To increase rigour,&nbsp / individual interviews were conducted with 5 health workers associated with the PMTCT programme so as to obtain their perspective and experiences on the issue of HIV disclosure amongst their PMTCT patients. Participation in the study was voluntary and all information obtained during the course of the interviews remained confidential and secure. Potential participants were each provided with an explanation of the purpose and process of the study and their informed written consent obtained before the researcher embarked on the interviews. Content analysis of the transcripts was done so as to develop coding categories and identify emerging themes. Disclosure to male partners is an important step in PMTCT and facilitates adherence to HIV care for the family and should be done as early as possible after the woman receives her HIV test result, though there exists a range of alternative times when it can be done. The relationship existing between a couple is very important in determining the timing of when a woman chooses to disclose. PMTCT services need to provide ongoing counselling for HIV positive women during pregnancy and after giving birth that supports, informs and equips them with the necessary skills to make an informed and timely decision about disclosure to a partner. In addition, the PMTCT service providers need to be encouraged to implement couple counselling as a strategy to facilitate disclosure as well as establishment of a peer support network for HIV positive pregnant women. The study findings will be used to contribute to health workers‟ capacity to support women manage the disclosure process to their male partners, thus helping to increase the disclosure rate and also contributing to improving the positive effect of the PMTCT services, in Lusaka, Zambia</p>

Magister Public Health - MPH / Disclosure of HIV positive status to male partners is well established as a key element in the success of prevention of mother to child transmission of HIV programmes, as it helps improve adherence to ARVs by the women within these programme. However, partner notification rates remain low in the urban areas of Lusaka, Zambia against a high HIV prevalence of 25%. The purpose of this study was to explore the timing of disclosure as part of the process of disclosure amongst women who were part of the PMTCT services at Kaulu health centre in Lusaka. An exploratory descriptive study using qualitative research methods was conducted. 15 women, who were attending the Kaulu health centre PMTCT programme, were requested to participate in a semi-structured interview. The women, who were purposively selected with the aid of the health centre‟s PMTCT focal point nurse, had to have disclosed their HIV positive status to their partner, either before or during the course of their pregnancy or after delivery. To increase rigour, individual interviews were conducted with 5 health workers associated with the PMTCT programme so as to obtain their perspective and experiences on the issue of HIV disclosure amongst their PMTCT patients. Participation in the study was voluntary and all information obtained during the course of the interviews remained confidential and secure. Potential participants were each provided with an explanation of the purpose and process of the study and their informed written consent obtained before the researcher embarked on the interviews. Content analysis of the transcripts was done so as to develop coding categories and identify emerging themes. Disclosure to male partners is an important step in PMTCT and facilitates adherence to HIV care for the family and should be done as early as possible after the woman receives her HIV test result, though there exists a range of alternative times when it can be done. The relationship existing between a couple is very important in determining the timing of when a woman chooses to disclose. PMTCT services need to provide ongoing counselling for HIV positive women during pregnancy and after giving birth that supports, informs and equips them with the necessary skills to make an informed and timely decision about disclosure to a partner. In addition, the PMTCT service providers need to be encouraged to implement couple counselling as a strategy to facilitate disclosure as well as establishment of a peer support network for HIV positive pregnant women. The study findings will be used to contribute to health workers‟ capacity to support women manage the disclosure process to their male partners, thus helping to increase the disclosure rate and also contributing to improving the positive effect of the PMTCT services, in Lusaka, Zambia. / South Africa

Syftet med denna uppsats var att undersöka hur arbetet med unga vuxna som utövar våld i parrelationer hanteras inom socialtjänsten. Uppsatsen syftade även till att undersöka socialarbetares upplevelser av implementeringsprocesser, hinder och möjligheter. För att studera detta användes en kvalitativ ansats i form av sju intervjuer med socialarbetare. Datamaterialet analyserades med en kvalitativ innehållsanalys. Ur innehållsanalysenframträdde tre huvudteman med tillhörande två underteman vardera. Resultatet analyserades med teorin Normalization Process Theory samt teorin kring gräsrotsbyråkraters handlingsutrymme. Av resultatet framkom att individens behov och ett gott bemötande spelaren viktig roll i behandlingen. Vidare framkom det av resultatet att lagkravet hade uppmärksammats på olika sätt i verksamheterna samt att ledningen hade en viktig betydelse i implementeringsprocessen. Avslutningsvis framkom det av resultatet att det var svårt att nå unga som utövar våld i parrelationer. Det beskrevs handla om upplevda skamkänslor hos berörd målgrupp, att de hade svårt att formulera sina behov och att det rådde brist på forskning och beprövade metoder. När det gällde möjligheter i arbetet beskrevs detta handla om marknadsföring, samverkan och snabb hjälp. Studiens slutsatser var att det krävs mer forskning för att utveckla anpassade metoder för unga vuxna som utför våld. En central roll i en implementeringsprocess ansågs ledningen ha, likaså en förtroendefull relation till medarbetare.Marknadsföring är av vikt för att bättre kunna nå målgruppen. / The purpose of this essay was to investigate how the work with young adults who practice violence in couple relationships is handled within social services. The essay also aimed to investigate social workers' experiences of implementation processes, obstacles and opportunities. A qualitative approach was used in form of seven interviews with social workers. The data was analyzed using a qualitative content analysis. From content analysis, three main themes emerged and were presented based on two sub-themes each. The result was analyzed with the Normalization Process Theory and the theory about street-level bureaucrats' room for action. The results showed that the individual's needs and good treatment played an important role in the treatment. The results showed that the legal requirement had been noticed in different ways and that management had an important role in the implementation process. It emerged from the results that it was difficult to reach young people who practiced violence in couple relationships. It was described as perceived feelings of shame among the target group, they had difficulty articulating their needs and there was a lack of research and proven methods. Opportunities in the work was described as marketing, collaboration and quick help. The study's conclusions were that more research is needed to develop adapted methods for young adult perpetrators of violence. Management was a central role in an implementation process, as was a relationship of trust to employees. Marketing is important to better reach the target group.

Detta är en kvalitativ studie med syftet att undersöka föräldrars upplevelser och erfarenheter av sitt föräldraskap, sin parrelation, sin intimitet och sitt sexliv när man har barn med autism och ADHD. Syftet är även att undersöka om det finns något samband mellan föräldraskapet, parrelationen, intimiteten och sexlivet hos dessa föräldrar. Om det finns något sådant samband så är syftet även att försöka förstå detta samband. Empirin bygger på semi-strukturerade intervjuer av 10 föräldrar, 7 kvinnor och 3 män, som har levt eller lever med en partner och som är föräldrar till barn 4–20 år med autismdiagnos eller barn med autismdiagnos och ADHD. Analysen bygger på systemteori (Johnsen &amp; Torsteinsson, 2015, Lundsbye, 2010 med flera), den interpersonella metoden för intimitet (Reis och Shaver, 1988) samt begreppet intimitet (Moss &amp; Schwebel, 1993). Analysen visar, tolkat med hjälp av systemteorin, att föräldrarna sitter fast i samma omvårdnadsbehov som föräldrar har till små barn samt har svårt att vara i partnerrollen då de tvingas vara i föräldrarollen hela tiden. Analysen visar även, tolkat med hjälp av den interpersonella modellen för intimitet (IPM) samt begreppet intimitet, att föräldrarna har svårt att få till en intimitet i sin parrelation, känna sexlust samt få till ett aktivt sexliv. / This qualitative study aims to investigate parents' experiences with parenting, marital relationships, intimacy and sex life when they have children with autism and children with autism and ADHD. The study also aims to investigate whether there is any connection between parenthood, the marital relationship, intimacy and the sex life of these parents. If there is any such connection, the purpose is also to try to understand this connection. The empirical data is based on semi-structured interviews of ten parents, seven women and three men, who live with or have  lived with a partner and who are parents of children 4-20 years old who have autism or children with an autism diagnosis and ADHD. The analysis is based on systems theory (Johnsen &amp; Torsteinsson, 2015, Lundsbye, 2010 et al.), the interpersonal method of intimacy (Reis and Shaver, 1988) and the concept of intimacy (Moss &amp; Schwebel, 1993). The analysis shows, interpreted with the help of systems theory, that the parents are stuck in the same care needs as parents have for young children and have difficulty being in the partner role as they are forced to be in the parental role all the time. The analysis also shows, interpreted with the help of the interpersonal model of intimacy (IPM) and the concept of intimacy, that the parents have difficulty achieving intimacy in their relationship, feeling sex drive and achieving an active sex life.

Bakgrund: Förlossningen kan upplevas som en positiv livshändelse och har betydelse för framtida hälsa, välbefinnande och relation till partner. Förlossningsupplevelsen påverkas av de blivande föräldrarnas förberedelser inför förlossningen och föräldraskapet. Parrelationen är central under förlossningen där stöd från partnern är viktigt. I nuläget finns dock begränsad forskning kring hur förlossningsupplevelsen påverkas av kvinnors och partners kvalitet i parrelation samt deras tankar och känslor inför förlossningen och föräldraskapet i ett longitudinellt perspektiv, varför det finns behov av att studera detta. Syfte: Syftet med studien är att undersöka faktorer relaterade till förstföderskor och partners förlossningsupplevelse sex månader efter förlossning. Metod: Studien är en kvantitativ longitudinell kohortstudie. Datainsamlingen genomfördes via webbaserade enkäter vid tre tillfällen under graviditet och de första sex månaderna efter förlossning. Enkäterna innehöll frågor kring studiedeltagarnas bakgrund, förlossningsupplevelse (QPP), kvalitet i parrelation (QDR36) och känslor inför förlossning och föräldraskap. Analys av data har skett i SPSS där deskriptiv statistik och multipel logistisk regressionsanalys har genomförts. Resultat: Följande faktorer hade ett samband med en mer positivt skattad förlossningsupplevelse sex månader efter förlossning; Upplevelse av normal förlossning (QPP 5), förstföderska (p=0.001), partner (p=0.003); Upplevelse av kontroll vid förlossning (QPP9), förstföderska (p=0.024); Högre uppfattad kvalitet i parrelation (QDR36-index), partner (p=&lt;0.001). Konklusion: Förlossningsupplevelsen påverkas av upplevelsen av förlossningen som normal, upplevelsen av kontroll under förlossningen samt högre uppfattad kvalitet i parrelation. / Background: Childbirth can be perceived as a positive life event and has a significance for future health, well-being, and relationship with partner. The childbirth experience is influenced by the prospective parent´s preparations for childbirth and parenthood. The couple relationship is central during childbirth where support from the partner is important. At present, however, there is limited research on how the childbirth experience is affected by the quality of couple relationship, as well as thoughts and feelings about childbirth and parenthood, in a longitudinal perspective, why there is a need to study this further. Purpose: The aim of the study is to examine factors related to first-time mothers and partners' childbirth experience six months after childbirth. Method: The study is a quantitative longitudinal cohort study. Data collection was conducted via web-based surveys on three occasions during pregnancy and the first six months after childbirth. The questionnaires contained questions about the study participants' background, childbirth experience (QPP), quality of couple relationship (QDR36) and feelings about childbirth and parenting. Data has been analyzed in SPSS where descriptive statistics and multiple logistic regression analysis have been performed. Results: Following factors were associated with a more positive childbirth experience six months after childbirth; Experience of normal childbirth (QPP 5), first-time mother (p=0.001), partner (p=0.003); Experience of control during childbirth (QPP 9), first-time mother (p=0.024); Higher perceived quality of couple relationship (QDR36 index), partner (p=&lt;0.001). Conclusion: The childbirth experience is affected by the experience of a normal childbirth, feeling of control during childbirth and higher perceived quality of couple relationship.

This study replicated components from Babcock et al. (2013) by examining an Imago-based Safe Conversations (SC) workshop using Gottman's psychometrically established instruments for couple functioning. Participants were 28 married heterosexual couples (N = 56) with a mean age of 27.30 years (SD = 10.16), 89.3% non-Hispanic, 78.6% Black or African-American, 85.7% first time married, 75% with at least a bachelor's degree, and a median household income in the $100,000-150,000 range. Couples independently completed the online SC workshop, The Toolbox for Couples, within a 2-week timespan. For each of three variables regarding marital quality assessed at pre- and post-workshop—(a) marital friendship, (b) conflict management, and (c) marital adjustment—multilevel dyadic analysis was conducted for four outcomes: (a) overall Time*Gender interaction effect, (b) effect for women, (c) effect for men, and (d) interclass correlation between men and women. From pre- to post-test, participants improved on all three variables: Out of the 12 analyses, 11 yielded statistically significant improvement with one very large, six large, and five medium effects. Results suggested that women may benefit more or be more sensitive to the effect of marital friendship, conflict management may be more important to men, and whereas both distressed and non-distressed couples can benefit regarding marital friendship and conflict management, distressed couples may benefit more regarding marital adjustment.

Made available in DSpace on 2016-04-28T20:39:50Z (GMT). No. of bitstreams: 1 Fernando Lourenco Maeda.pdf: 503002 bytes, checksum: 7aa342814a5c45db50d1356bb3f56ffc (MD5) Previous issue date: 2008-05-30 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / This study had as general goal investigate the perception of partner s support and the impact of the pain in the relationship as a couple of patients suffering of chronic lower back pain, of both gender, in ambulatory treatment in a big public hospital of São Paulo city. The study was made with 50 patients, where 25 were men and 25 were women, aged 35 to 65 years. The main used instruments were: social-demographic questionnaire, visual analogical scale of pain intensity, medical Outcomes study 36- item short form-health survey and semi directed interviews. The results demonstrated that all the participants of the study had the quality of their lives harmed, and that women showed intensity pain levels considered severe, whereas men obtained intensity pain levels considered moderate. 70% percent of the sample mentioned a negative impact on their sexual relations, due to their functional limitation and intensity of the pain, while the rest mentioned a marital adjustment when facing the symptoms of the pain. 86% of the sample mentioned perceiving their partners as supportive, being the helpful behavior considered the main way of support. The analysis of the results showed that the participants that had received partner s support, obtained better levels in the control of Vitality and Mental Health, when compared to the ones that had had no support. The conclusion of the results indicated that the chronic lower back pain causes a negative impact in the couple s relationship and that the partners support can work as a protection factor for depressive and anxiety symptoms, being this an important aspect to be considered in the health process of individual with chronic pain and in the planning of therapeutic procedures / Este estudo teve como objetivo geral investigar a percepção de apoio conjugal e o impacto da dor no relacionamento de casal de pacientes portadores de dor lombar crônica, de ambos os gêneros, em tratamento ambulatorial em um hospital de grande porte da rede pública da cidade de São Paulo. O trabalho foi realizado com 50 pacientes, sendo 25 homens e 25 mulheres, com faixa etária entre 35 e 65 anos. Os principais instrumentos utilizados foram: Questionário Sócio-demográfico, Escala VAS de intensidade da dor, Questionário de Qualidade de Vida SF 36 e Entrevista Semi-dirigida. Os resultados demonstraram que todos os participantes do estudo obtiveram qualidade de vida prejudicada, sendo que as mulheres apresentaram intensidade de dor considerada severa, enquanto os homens obtiveram intensidade de dor moderada. 70% da amostra relataram impacto negativo no relacionamento sexual, em decorrência da limitação funcional e gravidade da dor, enquanto que o restante referiu um reajustamento conjugal frente aos sintomas da dor. 86% da amostra relataram que percebem seus cônjuges como apoiadores, sendo que o comportamento solícito foi considerado o principal meio de apoio. A análise dos resultados demonstrou que os participantes que receberam apoio do cônjuge, obtiveram melhores índices nos domínios Vitalidade e Saúde Mental, quando comparados com aqueles que não receberam apoio. A conclusão dos resultados indicou que a dor lombar crônica causa impacto negativo no relacionamento de casal e o apoio conjugal pode funcionar como fator de proteção para sintomas depressivos e de ansiedade, sendo este um aspecto importante a ser considerado no processo da saúde dos indivíduos com dor crônica e no planejamento de condutas terapêuticas

El estudio buscó determinar la relación entre el perdón y los estilos de apego en universitarios que tienen una relación de pareja. Para tal fin, se desarrolló un estudio empírico cuantitativo de tipo asociativo con 260 estudiantes que tienen una relación una relación de pareja que reportaron algún tipo de transgresión en su relación. Los instrumentos que se utilizaron fueron la Escala del Perdón en la Relación de Pareja y Escala de Estilos de Apego Adulto. Los resultados evidencian que, existe una relación positiva, estadísticamente significativa y con tamaño del efecto bajo entre los factores afecto positivo y benevolencia y cognición positiva con el estilo de apego evitante. Por otra parte, se encontró una relación negativa, estadísticamente significativa y con tamaño del efecto bajo entre el comportamiento positivo y compasión con el apego ansioso (miedo a la distancia del afecto de la pareja). A su vez, se halló una relación negativa, estadísticamente significativa y con tamaño del efecto moderado entre el afecto positivo y el comportamiento positivo y compasión con el apego ansioso (miedo al abandono). Se concluye que, si uno de los integrantes de la pareja es transgredido posee un apego evitante lo que posibilitará su capacidad de perdonar. / The study sought to determine the relationship between forgiveness and attachment styles in college students who are in a relationship. To this end, a quantitative empirical study of an associative type was developed with 260 students who are in a relationship with a partner who reported some type of transgression in their relationship. The instruments used were the Couple Relationship Forgiveness Scale and the Adult Attachment Styles Scale. The results show that there is a positive, statistically significant relationship with a low effect size between the factors positive affect and benevolence and positive cognition with the avoidant attachment style. On the other hand, a negative, statistically significant and low effect size relationship was found between positive behavior and compassion with anxious attachment (fear of distance from partner's affection). In turn, a negative, statistically significant and moderate effect size relationship was found between positive affect and positive behavior and compassion with anxious attachment (fear of abandonment). It is concluded that if one of the members of the couple is transgressed, they have an avoidant attachment, which will enable their ability to forgive. / Tesis

Die qualitative Studie befasst sich mit der Lebenslage von (Ehe-)Paaren, welche in ihrer gemeinsamen Zeit als Zweierbeziehung den Eintritt einer sogenannten „Spätbehinderung“ durch plötzliches Krankheits- oder Unfallgeschehen oder aufgrund einer chronischen Erkrankung erleben. Die inhaltliche Fragestellung richtet sich auf die soziale Handlungspraxis partnerschaftlicher Arbeitsorganisation im Zusammenhang mit dem Eintritt einer körperlichen „Behinderung“ sowie auf die partnerschaftliche Deutung von „Körperbehinderung“ im Rahmen der dyadischen Wirklichkeitskonstruktion. In Erweiterung des aktuellen Forschungsstands wird diesbezüglich nicht allein auf die individuelle Sichtweise des „betroffenen Partners“ oder des „angehörigen Partners“ fokussiert, sondern auch die gemeinsame Ebene dyadischer Wirklichkeitskonstruktion miteinbezogen. Die Datengrundlage dieser Studie im Stil der Grounded Theory Methodologie bilden fünfzehn Interviewreihen, bestehend aus einem Paarinterview (narratives Interview) und anschließenden Einzelinterviews (problemzentriertes Interview) mit jedem Partner. Im Ergebnisteil verdeutlichen sieben Fallbeschreibungen die komplexe paarspezifische Bearbeitung einer „Spätbehinderung“ im Rahmen von Biographie, Ressourcen und Körperlichkeit. Theoretisch verdichtet werden die Ergebnisse in einer Konzeption partnerschaftlicher Konstruktion von Behinderung im Kontext von Leiberfahrung und Körperbetrachtung. Die partnerschaftliche Alltagsverhandlung dreht sich im Zuge der Neukonstruktion von Alltag und „Normalität“ um die körperliche Funktionsfähigkeit des Partners mit Beeinträchtigung und verhandelt dessen Veränderung der Körperlichkeit dabei gleichzeitig mit, wobei körperliche, kulturelle, medizinische und sozialpolitische Aspekte in die partnerschaftliche Deutung mit hinein spielen. Zudem berühren derlei Aushandlungen zentrale Grunddefinitionen von Partnerschaft wie Individualitätsentfaltung, Intimität und Privatheit. / This study focusses on the circumstances of marriage and quasi-marital couples, which experience together diability in later couple lifetime by occurence of chronical illness or impairment of one of the couples members. The contentwise question is on one hand targeted at the social practice of work processes and tasks of couples related to the life change through the occurence of impairment. On the other hand the study demands on the couples interpretation of this experience. The data basis consists of fifteen narrative interview cycles each containing one interview with the couple plus one interview with each marriage partner. Here the situation of a suddenly interruption of everyday life through an event of accident or illness has been contrasted with the situation of chronic ailment with its progressing loss of physical power. The study approach of interviewing, analysing and interpretation founds on the principles of the Grounded Theory Methodology. The results are presented twofold. Firstly seven case reconstructions clarify the couple''s coping with physical body change in the context of biography, capabilities and resources, and physicality and illustrate similarities and differences of the couple’s topics. After this a conception of the couple''s construction of reality in the case of an impairment experience were tendered. It describes the couple’s experience of change, disability and normality as a experience of the physical and functional body, which cannot be extricated from cultural and socio-political framing. Specifically, the main topic of the couple’s negotation concern on the one hand the self-activity of the partner with impairment and on the other hand the availability of the other part and his / her duty to compensate for both the lack of paid work and the increasing amount of time spent for everyday life. Significant is the fact that in this process challenge central positions of the couple’s intimacy and privateness.