Bakgrund: När en patient får en diagnos eller sjukdom kan vården vara inriktad på kurativ eller palliativ vård eller både och. Vård med kurativ inriktning syftar till att bota sjukdom medan palliativ vård syftar till att lindra den. Att vårda i transitionen kan vara komplext för sjuksköterskan vars uppgift är att stödja patienten genom hälsorelaterade transitioner. För att kunna göra det krävs en förtroendefull relation mellan patient och sjuksköterska samt tydliga riktlinjer för sjuksköterskan att förhålla sig till. Syfte: Syftet var att beskriva sjuksköterskors upplevelse av att vårda patienter i övergången från kurativ till palliativ vård. Metod: Metoden som använts är en litteraturöversikt som syftar till att skapa en överblick över det valda kunskapsområdet. Resultatet har författarna baserat på elva vetenskapliga artiklar varav 10 var kvalitativa och en var kvantitativ. Artiklarna söktes fram i databaserna Cinahl Complete, Pubmed och Medline. Resultat: Resultatet presenteras utifrån tre huvudteman med tillkommande subteman. Huvudteman; Sjuksköterskan i transitionen, Sjuksköterskans förutsättningar att vårda i transitionen och Vårdmiljöns betydelse i transitionen. Diskussion: Utifrån Meleis transitionsteori diskuterade författarna resultatet som var relaterat till sjuksköterskors upplevelser av att vårda patienter i övergången från kurativ till palliativ vård på vårdavdelningar. Konsensusbegreppet miljö diskuteras även av författarna i resultatdiskussionen utifrån inre och yttre miljöomständigheter. / Background: When a patient's gets a diagnosis or a disease healthcare can be orientedon palliative or curative care. Curative aims to to cure disease, whilstpalliative care aims to alleviate. To care in the transition can be complexfor the nurse who’s aim is to support the patient through health relatedtransitions. That requires a trustful relationship between the patient andthe nurse and that the nurse has clear guidelines during the transition torelate to. To do so requires a relationship of trust between the patient andthe nurse, as well as clear guidelines for the nurse to relate to during thetransition. Aim: The aim was to highlight nurses´ experiences trough the transition fromcurative to palliative care. Method: The method was a literature review that aims to create an overview of thechosen field of knowledge. The authors created the result based on elevenscientific articles, ten were qualitative and one of them were qualitative.The articles were sought out in the databases Cinahl Complete, Pubmedand Medline. Results: The results were presented in three main themes with four additionalsubthemes. The main themes; The nurse in the transition, The nurseability to care in the transition and The meaning of the caringenvironment in the transition. Discussion: The authors have discussed the result from Meleis transitions theorywhich is related to nurse’s experiences from caring for patients in thetransition from curative to palliative care. The consensus definition ofenvironment is discussed in the result from internal and external carecircumstances.

This paper has two objectives. First: the humanistic idea of knowledge, philosophically formulated by Rudolf Steiner (1861-1925), should be presented in relation to history of ideas. In the meeting with different kinds of cultural and social needs in Central Europe during the decades of the turn of the 20th century, Steiner developed his idea of knowledge into a singular Thought Style (Ge. Denkstil). A Thought Style can be described as a selective and aimed cognitive preparedness. The idea of knowledge and the Thought Style are here described as anthroposophical humanism. The second objective is to show how the Thought Style, in a historical way, was established in Sweden, and how it, until the mid 1980s, changed and was adapted to Swedish culture, i.e. how the style in various ways became Swedish. Organisations and movements that were influenced by the anthroposophical humanism were The Anthroposophical Society, the biodynamic movement, the movement for anthroposophic medicine, the medical pedagogical movement with special pedagogical institutions and social therapeutic homes for treatment, the Waldorf movement, the Christian Society, anthroposophic architecture and art practice etc. Since they co-operated with a common background, they formed a Thought Collective (Ge. Denkkollektiv). The anthroposophical humanism has its roots relating to history of ideas far back in the Central European Middle Ages. During the new humanism era, the idea of knowledge had a renaissance in German culture life. Rudolf Steiner remodelled the idea at the end of the 19th century and developed it into the singular Thought Style. When Steiner was a theosophical teacher he gave it an esoteric design. After the First World War, when Steiner was working as a social reformer, he gave it a humanistic design. Within The Anthroposophical Society, the double image of the anthroposophical movement, internationally and in Sweden, led to severe opposition and conflicts. Right until the mid 1980s, reorganisations were common in order to handle the two directions of the Thought Style when it came to differences in traditions, ideology and sociology. In Sweden, the anthroposophical movement has undergone four stages of development: the reception period 1890-1935, the conversion period 1935-55, the expansion period 1955-1985 and the integration period as from 1985. As from 1913, when The Anthroposophical Society was established, until 1985, the development of ideas in the anthroposophical Thought Style and the Thought Collective can be described as a wandering from Christian esotericism to an anthroposophical humanistic idea of knowledge, with a cultural education in the ideological focus of the Thought Style. The traditional development of ideas can also be described as an anthroposophical process of secularisation. There are mainly four things that have contributed to the expansion of the anthroposophical movement in Sweden during the phase of expansion: the post-war period economic expansion, the development of the educational system, the renaissance of esotericism in the late 1960s, as well as the need for an alternative to the post-war abundance consumerism and waste of resources. The Swedish development indicates similarities with the international development within those areas where different activities have been adapted to Swedish legislation, traditions and views, mainly through care and education.

La place primordiale accordée à l’apparence physique dans la société actuelle, qui est une société de «l’image», a fait de la chirurgie esthétique la pratique chirurgicale la plus répandue et réclamée. Cette pratique, d’abord considérée illicite, puis exclusivement liée à des fins thérapeutiques, fut reconnue par la jurisprudence française à la suite d’une évolution prétorienne en 1936. Les raisons d’un tel retard de reconnaissance résident dans la spécificité qui distingue la chirurgie esthétique des autres branches de la médecine chirurgicale : en effet, la chirurgie esthétique se caractérise d’une part par sa nature qui est dépourvue de toute finalité curative et qui est réalisée sur une personne jouissant d’une bonne santé et, d’autre part, par sa finalité puisqu’elle vise à réaliser une amélioration de l’apparence physique et de la morphologie de la personne concernée. Cette double spécificité distingue également la chirurgie esthétique de la chirurgie reconstructrice et réparatrice. Ces caractéristiques mêmes de la chirurgie esthétique ont exigé, de la jurisprudence, mais également du législateur français, un traitement juridique spécial du chirurgien esthétique en vue d’éviter que ce dernier ne profite de la fragilité, aussi bien physique que psychique, de la personne ayant une obsession de beauté et de perfectionnement physique dans un domaine non curatif. C’est ainsi que nous avons abordé, dans la présente étude, les points spécifiques du traitement juridique du chirurgien esthétique, tant au regard de ses obligations que de sa responsabilité. Relativement aux obligations, la spécificité de la chirurgie esthétique exige tout d’abord un devoir d’information rigoureuse de la part du praticien afin d’aboutir à un consentement préalable éclairé du patient, ce qui suppose un devis écrit contenant tous les renseignements relatifs à l’intervention. Elle exige, d’autre part, un processus préalable en trois étapes […] Pour ce qui est de la responsabilité du chirurgien esthétique, elle est également spécifique, et ce sur les plans civil et pénal : Sur le plan civil, sa spécificité a poussé la jurisprudence française, qui a réalisé son approche du point de vue de la nature de l’obligation du chirurgien esthétique, à procéder à une démarche de « mutation » des règles applicables en droit commun dans une tentative de les adapter à la spécificité de l’intervention chirurgicale esthétique et de la responsabilité du praticien qui en découle. Cependant, la démarche jurisprudentielle était inadaptée à la spécificité de la chirurgie esthétique, et a entrainé une large confusion au sein de la jurisprudence et de la doctrine ; elle est donc critiquable. C’est ainsi que la présente étude propose un régime spécifique à la responsabilité civile du chirurgien esthétique à trois facettes : La détermination du cadre juridique de la responsabilité contractuelle du chirurgien esthétique liée à la spécificité du contrat de chirurgie esthétique ayant pour objet unique l’amélioration de morphologie et pour objectif la réalisation du résultat attendu qui a justifié l’intervention esthétique ; ainsi le chirurgien garantit le résultat esthétique de l’intervention. Le maintien de la responsabilité extracontractuelle en ce qui concerne les dommages qui surviennent à l’occasion de l’exécution de l’obligation contractuelle. L’institution d’un régime spécifique prenant en considération l’éventualité des dommages survenus en raison des aléas thérapeutiques et des risques exceptionnels, en envisageant un régime d’indemnisation automatique lié à des cas spécifiques qui se place en dehors du régime de la responsabilité civile. Quant à la responsabilité pénale du chirurgien esthétique, une incrimination spéciale et strictement adaptée à la nature de la chirurgie esthétique s’applique essentiellement dans trois circonstances : le remodelage sexuel, la publicité mensongère et l’expérimentation scientifique. / The prominent place given to physical appearance in the current society qualified as the society of the “image”, has made cosmetic surgery, the most common surgical practice and claimed. This practice which was deemed illegal at one time and was then linked to the only therapeutic purposes has been recognized by the French courts following a change praetorian in 1936. The reasons supporting such a delay of recognition result from the specificity that distinguishes cosmetic surgery of the other surgical branches, it’s characterized by its very nature which is devoid of any curative purposes and is performed on a healthy person and its purpose is to achieve an improvement in the physical appearance and the morphology of the person concerned. This dual specificity also distinguishes cosmetic surgery from reconstructive and restorative surgeries. The specifications of cosmetic surgery required a special legal treatment of the cosmetic surgeon so it does not take advantage of the physical and mental fragility that has an obsession with beauty and physical development. Thus, we approached in this study the specific features of the legal treatment of the cosmetic surgeon in terms of obligations and responsibility.Regarding obligations, the specificity of cosmetic surgery requires a rigorous information obligation of the cosmetic surgeon to lead to a prior informed consent of the patient contained also on a written quotation. It requires a three-step process prior […] As for the cosmetic surgeon’s responsibility, it is also specific regarding its civil and criminal responsibilities : Specificity of its liability has led the French courts which made its approach towards the nature of the cosmetic surgeon’s obligation to conduct a process of «changing» the rules of common law in an attempt to adapt to specificity of cosmetic surgery and the resulting liability. However, the judicial process was not adapted to the specificity of cosmetic surgery, it led to a significantly wider confusion in the jurisprudence and doctrine, it is therefore questionable. Thus, we propose in this paper a specific regime for civil liability cosmetic surgeon three-sided : The contractual liability of the cosmetic surgeon linked to the specific contract cosmetic surgery that aims to improve morphology and has the objective of achieving the expected result which has justified the intervention. Thus, the cosmetic surgeon provides the aesthetic result of the intervention. Maintaining liability regarding damages that occur during the execution of the contractual obligation. The establishment of a special regime taking into account the case of damage due to therapeutic hazards and exceptional risks considering a compensation scheme automatically linked to specific cases that are placed outside the regime of civil liability. As to the criminal responsibility of the cosmetic surgeon, a special incrimination is strictly adapted to the nature of the surgery mainly applies in three situations : sexual remodeling, false advertising and scientific experimentation.

The study aimed to explore and describe factors which impacted on the satisfaction of patients using the curative component of primary health care in the Ekurhuleni Metropolitan area. A qualitative, explorative and contextual design was followed in this study. Focus group interviews were used to collect data from clients, nurse clinicians and community health committee members. Findings indicated that there was lack of facilities, resources and supplies, lack of safety and security measures, negative attitudes of nurse clinicians, lack of community involvement and lack of clinic management involvement. Suggestions were made by the groups on how to improve the curative primary health care service and intervention strategies were identified from the suggestions made. The implementation of these strategies will help with the improvement of the service delivery at the clinic for primary health care. / Health Studies / (M.A. (Health Studies)

Submitted by Claudia Rocha (claudia.rocha@udesc.br) on 2018-02-26T14:34:34Z No. of bitstreams: 1 PGPV14MA199.pdf: 646661 bytes, checksum: d059bad8109ad64370d1387bc525b456 (MD5) / Made available in DSpace on 2018-02-26T14:34:34Z (GMT). No. of bitstreams: 1 PGPV14MA199.pdf: 646661 bytes, checksum: d059bad8109ad64370d1387bc525b456 (MD5) Previous issue date: 2014-08-11 / Tomato (Solanum lycopersicum L.) is the second major horticultural crop in the world and it is necessary a high technological level and intensive labor for develop it, which increase its economic and social values. Several plant pathogenic fungi affect this crop, which causes an excessive use of chemicals, thereby increasing the cost of production. Septoria lycopersici, causal agent of Septoria leaf spot, occur in all tomato-producing areas around the world and causes severe losses on high humidity conditions. Management techniques as crop rotation, chemical seed treatment, systemic and contact fungicides has been used to control the disease. The aims of this work were: a) to evaluate the protective and curative activity of the fungicides b) to determinate the effective dose (ED50);. Septoria strains were obtained from symptomatic tomato leaves of tomato cultivars located at several production areas. Active ingredients used in the assay of the curative effect were thiophanate-methyl, mancozebe, difenoconazol and metconazol, in commercial rates. The fungicides were applied to plant at 12; 24; 36; 48; 72 and 96 hours after inoculation. To evaluate the protective activity were used the fungicides azoxystrobin, chlorothalonil, mancozebe and captan, in commercial rates. Plants were sprayed with spore suspension at 12; 24; 36; 48; 72 and 96 hours after the application of fungicides. Germination index was evaluated in the in vitro assays, using different concentrations of thiophanate-methyl and mancozebe (0,1;1;10;100 e 1000 mg.L-1 active ingredient). Data were subjected to analysis of variance and differences assessed using the method of Tukey (p < 0,05). All analysis were performed using the software R. Difenoconazol and metconazol were the more effective curative treatments, while azoxystrobin and chlorothalonil showed the best protective activity / O tomate (Solanum lycopersicum L.) é a segunda hortaliça mais produzida no mundo e o seu cultivo exige alto nível tecnológico e intensa mão de obra, o que eleva a importância econômica e social da cultura. Essa hortaliça é afetada por doenças fúngicas, exigindo gastos adicionais com agrotóxico, elevando os custos de produção. A septoriose ou mancha-de-septoria causada pelo fungo Septoria lycopersici possui importância no tomateiro em locais de alta pluviosidade ocorrendo em quase todas as regiões produtoras do Brasil e do mundo. O presente trabalho teve como objetivos: a) avaliar a ação curativa preventiva e dos fungicidas testados a) avaliar a eficiência in vitro de fungicidas sobre a germinação de conídios de S. lycopersici, c) indicar a dose efetiva - ED50; para cada isolado;. Foram obtidos isolados de S. lycopersici a partir de folhas de tomate com sintomas de septoriose de diferentes cultivares na Região do Alto Vale do Rio do Peixe. Os princípios ativos utilizados para o ação curativa foram tiofanato metílico, mancozebe, difenoconazol e metconazol nas doses comerciais. As plantas foram tratadas com os fungicidas 12; 24; 36; 48; 72 e 96 horas após a inoculação. Para avaliar ao ação preventiva os tratamentos utilizados foram azoxistrobina, clorotalonil, captana e mancozebe nas doses comerciais. Pulverizou-se a suspensão de conídios sobre todas as folhas com 12; 24; 36; 48; 72 e 96 horas após o tratamento com os fungicidas. Para o experimento in vitro avaliou-se a germinação de conídios em relação aos princípios ativos tiofanato metílico e mancozebe nas concentrações de ingrediente ativo de 0,1;1;10;100 e 1000mg.L-1. Avaliou-se a germinação de conídios. Os dados foram submetidos à análise de variância (p <0,05), e quando significativos, á análise de regressão. Foram realizadas contrastes de médias por meio de teste de Tukey a 5% de significância para comparação das médias, utilizando o programa R. Os tratamentos curativos com eficiência foram difenoconazol e metconazol. Clorotalonil e azoxistrobina apresentaram controle como preventivo. Nos testes in vitro verifica-se que os isolados coletados na Região do Alto vale do Rio do Peixe são insensíveis ao princípio ativo mancozebe e tiofanato metílico, indicando uma possível resistência a esses fungicidas

Complex rehabilitative care for pre-school children undergoing c urative stays is the care of which the main task is to promote the health of a child as a whole or, if impaired, to bring it back to normal. A child sanatorium is a health care facility providing long-term preventive care for child patients through its complex therapeutic and rehabilitative methods during the child{\crq}s entire curative stay. It strives for reaching the optimum health condition of a child and for the elimination of possible fallouts. Curative stays are recommended by pediatricians. Generally, curative stays are designed for children between 3 and 15 years of age. They are covered by all health insurance companies. The aim of the thesis was to find out the current possibilities of the use of curative stay offers in the Czech Republic and how the offer of such stays is used, specifically in the mountainous climatic conditions. Also, the work aimed at the factors leading to the fact that some children use the curative stays repeatedly. In order to gather the necessary data to define the aim of the thesis, the method of questionnaire was used and the technique of written questionnaire was used to collect the data. The research used parents and other relatives of the pre-school children who at least once participated in the curative stay together with their child or children. The research was conducted at the Child Sanatorium of Javorník in Šumava during the months of January and February 2007. The hypothesis based on the presumption that the opportunity to use the offer of curative stays for pre-school children is influenced mostly by socio-economic factors was not confirmed. It has been detected that the physicians play an important role in this field. The second hypothesis concerning the repetitive use of the curative stays offer as not being directly linked to the curative effect of the previous stays was also not confirmed because the reasons leading the guardian escort to the decision to send the child or children for a repetitive curative stay are directly linked to the fact that the recently undergone stay has helped the health condition of their child or children.

Allians har i tidigare forskning visat sig vara betydelsefullt för utfallet i terapeutiska sammanhang. Emellertid har forskning som visar på betydelsen av allians i kurativa samtal inom hälso- och sjukvård vid efterforskning till denna studie inte kunnat påträffas. Metoder för att mäta allians har i huvudsak utgjorts av patientskattningsskalor för att utröna utfallet i det terapeutiska behandlingsarbetet utifrån patientens ståndpunkt. Att återge även kuratorernas perspektiv tror vi kan inbringa mer kunskap om kurativt arbete i jakten på förståelsen av den betydelse man anser allians utgör. Syftet med denna studie är således att genom en kvalitativ ansats undersöka hur kuratorer inom hälso- och sjukvård upplever samt arbetar med etablerandet av allians med sina patienter. Genom semistrukturerade intervjuer med åtta informanter (&lt;18 år) har denna studie bidragit till en nyanserad och djupgående beskrivning av fenomenet allians i mötet med patienten. Resultatet visar att hälso- och sjukvårdskuratorer definierar allians som något som är sprunget ur kuratorns förmåga att förmedla en trygg och förtroendefull relation. I etablerandet av allians är det initialt viktigaste att patienten upplever självbestämmande, att kuratorn tydliggör sitt uppdrag tidigt och att kuratorn skyndar långsamt. I det fortsatta kurativa arbetet är kuratorns förmåga att härbärgera patientens känslor en bidragande faktor till god allians. Andra faktorer som har visat sig bidra till en god allians är personlig kompatibilitet, individanpassad behandling och att skönja människan bakom sjukdomen för ett mellanmänskligt bemötande. Därtill har patientens förväntningar samt inställning till kontakt med kurator visat sig vara avgörande omständigheter för att en allians ska komma till stånd. Sammanfattningsvis utgör allians en grundförutsättning för ett lyckat kurativt arbete. Behovet av forskning i socialt arbete inom hälso- och sjukvård har visat sig vara stort och vi för diskussioner kring det holistiska perspektivet i sjukvården. / Alliance has been shown in previous research to be significant for the outcome in therapeutic contexts. However, research showing the importance of alliance in curative conversations in health care during research for this study could not be found. Methods for measuring alliance have mainly consisted of patient rating scales to ascertain the outcome of the therapeutic treatment work based on the patient's point of view. We believe that depicting also the perspective of the counselors can bring more knowledge about curative work in the search for the understanding of the importance one considers alliance to be. Thus, the purpose of this study is to investigate, through a qualitative approach, how counselors in health care experience and work with the establishment of an alliance with their patients. Through semi-structured interviews with eight informants (&lt;18 years), this study has contributed with a nuanced and profound description of the phenomenon of alliance in the meeting with the patient. The results show that health care counselors define alliance as something that stems from the counselor's ability to mediate a safe and trusting relationship. In establishing an alliance, the most important thing initially is that the patient experiences self-determination, that the counselor clarifies the mission early and that the counselor proceeds slowly. In the continued curative work, the counselor's ability to contain the patient's feelings is a contributing factor to a good alliance. Other factors that have been shown to contribute to a good alliance are personal compatibility, individualizing the treatment and recognizing the person behind the illness for interpersonal treatment. In addition, the patient's expectations and attitude towards contact with the counselor have proven to be crucial circumstances for an alliance to come about. In summary, alliance is a basic prerequisite for successful curative work. The need for research in social work within healthcare has proven to be great and we are having discussions around the holistic perspective in healthcare. The need for research in social work within healthcare has proven to be great and thus we discuss the holistic perspective in healthcare.

Det existentiella lidandet återfinns i samband med frågor som rör människans frihet, tillvarons mening, känslor av ensamhet och isolering i livssituationen samt i mötet med döden. Dessa frågor är universellt mänskliga och uppträder därför oavsett människans bekännande till eller avståndstagande från andlighet eller religiositet. Syftet med denna litteraturstudie var dels att beskriva hur det existentiella lidandet tar sig uttryck hos cancerpatienter i kurativ vård men också att beskriva sjuksköterskors bemötanden gentemot dessa patienter och de möten som uppstår mellan patienter och sjuksköterskor. De resultat som framkom av studien visade på att det existentiella lidandet karaktäriseras av förändringar och är en stor del av det totala lidande som cancerpatienter utstår. Samtidigt är emellertid sjuksköterskor, till följd av rädsla och okunskap, i många fall oförmögna att möta de förväntningar och behov som patienterna har. Den teoretiska referensram som använts utgörs av valda delar av Katie Erikssons omvårdnadsteori. / The existential suffering is found in relation to questions about human freedom, meaning of existence, feelings of loneliness and isolation in life and encountering death. These questions are of a universal human character and are therefore to appear irrespective of human confession to or dissociation from spirituality or religiosity. The aim of this review was partly to describe the existential suffering in cancer patients in curative care, partly to describe nurses´ treatments to these patients and the encounters that arise between patients and nurses. The findings emerging in the study revealed that the existential suffering is characterized by changes and is a great part of the total suffering that cancer patients endure. At the same time are nurses, as a result of fear and ignorance, in many cases unable to encounter the patients´ experiences and needs. The theoretical framework used, consist of selected parts of Katie Eriksson´s nursing theory.

The study investigated the extent of burnout condition among counsellors in Kenya. The sources of burnout were explored and personality style was positively correlated with burnout development. Impact of burnout on counsellor wellness and productivity was also established. It examined whether counsellor supervision was an appropriate strategy in the management of counsellor burnout. The study utilized a pluralistic design that combined both qualitative and quantitative methods (Howard, 1983). The qualitative design permitted collection of rich data from study subjects' experiential and perceptual fields. This ensured study findings would be relevant and applicable to specific counsellor situations. The study population comprised 20 counsellors and 9 Kenya Counselling Association (KCA) accredited counsellor supervisors. The counsellor sample was drawn from 2 Voluntary Counselling and Testing (VCT) centres, 2 rehabilitation centres and 2 educational institutions. This diverse population was a helpful representation in terms of generalizability of the study. Three data collection instruments utilized were: Questionnaires, focus group discussions and in-depth interviews. The study's validity and reliability were ensured through the two sample populations (counsellor and counsellor supervisors), test re-test and pre-test procedures for questionnaires and in-depth interviews. Tallying identified items checked content validity. The study findings showed that burnout seriously affected practitioner effectiveness and led to malpractice and client harm. The study predictably established that supervision is an appropriate strategy in the management of counsellor burnout. The metaphor of motor vehicle maintenance was utilized in the development of the Holistic Burnout Supervision Model (HBSM) that focussed on wellness maintenance of the counsellor in a lifecycle. HBSM identified two levels in wellness maintenance: Preventative (servicing) and curative (repair). The study recommended that counselor - training institutions should incorporate in their curriculum burnout and supervision modules. This would create awareness about burnout and appropriate prevention strategies at counsellor formation stages. People care agencies should also institutionalize the burnout supervision facility in order to ensure counsellor resiliency and vitality. / Psychology / D. Phil (Psychology)

The study investigated the extent of burnout condition among counsellors in Kenya. The sources of burnout were explored and personality style was positively correlated with burnout development. Impact of burnout on counsellor wellness and productivity was also established. It examined whether counsellor supervision was an appropriate strategy in the management of counsellor burnout. The study utilized a pluralistic design that combined both qualitative and quantitative methods (Howard, 1983). The qualitative design permitted collection of rich data from study subjects' experiential and perceptual fields. This ensured study findings would be relevant and applicable to specific counsellor situations. The study population comprised 20 counsellors and 9 Kenya Counselling Association (KCA) accredited counsellor supervisors. The counsellor sample was drawn from 2 Voluntary Counselling and Testing (VCT) centres, 2 rehabilitation centres and 2 educational institutions. This diverse population was a helpful representation in terms of generalizability of the study. Three data collection instruments utilized were: Questionnaires, focus group discussions and in-depth interviews. The study's validity and reliability were ensured through the two sample populations (counsellor and counsellor supervisors), test re-test and pre-test procedures for questionnaires and in-depth interviews. Tallying identified items checked content validity. The study findings showed that burnout seriously affected practitioner effectiveness and led to malpractice and client harm. The study predictably established that supervision is an appropriate strategy in the management of counsellor burnout. The metaphor of motor vehicle maintenance was utilized in the development of the Holistic Burnout Supervision Model (HBSM) that focussed on wellness maintenance of the counsellor in a lifecycle. HBSM identified two levels in wellness maintenance: Preventative (servicing) and curative (repair). The study recommended that counselor - training institutions should incorporate in their curriculum burnout and supervision modules. This would create awareness about burnout and appropriate prevention strategies at counsellor formation stages. People care agencies should also institutionalize the burnout supervision facility in order to ensure counsellor resiliency and vitality. / Psychology / D. Phil (Psychology)