Adverse childhood experiences (ACEs) are linked to increased mental health problems in children, but their association with mental health services utilization is not well known. This secondary analysis used 2016 National Survey of Children’s Health data from two samples: children aged 6-17-years-old with a mental or behavioral condition in need of treatment or counseling (N = 5,723); and a subsample of children who experienced at least one ACE (n = 3,812). Multiple logistic regression and latent class analysis (LCA) were performed to examine the association between ACEs and mental health services utilization. Multiple logistic regressions also examined the associations of parent/caretaker vulnerability, school-system, and medical-system factors on mental health services utilization for children with ACEs using the Gelberg-Andersen Behavioral Model for Vulnerable Populations and a Systems of Care approach as the framework for model building. Children with increased ACE scores did not have higher odds of utilizing mental health services compared to children at lower levels of or no ACEs. For children who experienced adversity, increased parent/caretaker vulnerability was associated with lower odds and the current receipt of special education services with increased odds of mental health services utilization in adjusted models. Strengths of this study included the large dataset and generalizability to the U.S. population. There were limitations to the measurement of ACEs and other key variables. The current study identified children who experienced adversity as an underserviced population for mental health services.

The 2014-2016 Ebola pandemic in Sierra Leone significantly increased the orphan population and the need for social support programs, especially for student-orphans in higher education. Poorly prepared disaster response managers have little knowledge about how college student-orphans experience social services. The purpose of this transcendental phenomenological study was to explore how post-Ebola student-orphans enrolled in an agricultural university in rural Sierra Leone experienced post disaster specialized case management to enhance student performance. Criterion sampling techniques including specific inclusion and exclusion criteria guided the recruitment, that included 10 research participants taking part in the semi structured interviews. Ecological system theory and postpositivist ontology informed this transcendental phenomenological research. The modified van Kaam transcendental phenomenological data analysis enabled the development of themes from lived experiences of post-Ebola case management for student-orphans. The findings of the research showed that student-orphans experienced specialized case management with three characterizations: (a) sadness, (b) happiness, and (c) anger which included information helpful for crisis and disaster case management administration and staff across similar circumstances. The social change implication for the study results include information useful for human service administrators and staff in designing and employing post disaster programs for college student-orphans.

This qualitative study examined the phenomenology of advanced breast cancer (ABC) among 7 female participants between the ages of 20 and 45. Oral data were collected to extract participants' interpretations of their spiritual and psychosocial experiences of living with ABC. Findings suggest that these women experienced a dichotomous relationship with regard to their bodies and their relationships with others; this served as a means of making sense of their experiences and as a coping mechanism. Positive psychology and the theory of reasoned action and planned behavior provided the theoretical framework for examining the role of social reinforcements, beliefs, and attitudes and intentions on the health behavior of pre-menopausal African American women with ABC in Northern and Southern Delaware. Additionally, the theoretical framework provided answers to the overarching questions of how pre-menopausal African American women with advanced breast cancer applied meaning-making and spirituality to find purpose in their diagnosis. Inductive analysis of their narrative data suggested a set of themes: the body as a medical object, the body as a feminine object, honesty in relationships, missed opportunities from healthcare professionals, from wounded to mended, and the joy of purposeful living. The participants reported that an intimate relationship with God helped them feel supported in a way that family and friends could not. The findings in this study support potential spiritual and meaning-making interventions as well as promote a more positive quality of life for pre-menopausal women living with advanced breast cancer.-¬-¬-¬

Religion and spirituality have been found to contribute to the well-being of American university students. Although practiced by a small minority, Islam is the fastest growing faith in the United States, indicating a growing campus presence. The purpose of this study was to identify campus experiences that influenced the identity perception of traditional age Muslim American women. The conceptual framework included theories of identity negotiation, intergroup contact, and religious identity as well as campus climate structures developed to improve diversity. This phenomenological study took place at 2 public 4-year universities in California and included interviews with 6 participants. Interview protocol was framed by 4 research questions and focused on classroom and campus experiences that affected the choice to wear or refrain from wearing the hijab, campus satisfaction, and how student services might support a positive religious climate. Data were analyzed through continuous comparison of codes developed from organization of significant student statements into units of meaning, context, and synthesis of significance of events experienced. Themes that emerged were harassment, stereotyping based on media portrayals, and student and faculty ignorance of Islam. The participants expressed a deep personal and spiritual identification with their faith and requested campus spaces for this expression. This study may contribute to positive social change through the initiation of education and training programs for campus policymakers, student affairs personnel, faculty, and staff regarding the unique needs of religious minority groups, including Muslim American women.

The problem that this study focused on was the difficulties and challenges experienced by daughters who had absent fathers. The purpose of this qualitative phenomenological study was to explore the lived experiences of daughters who grew up with absent fathers, and the effects on them as adults at home, in school, in their neighborhoods, and in their decision-making processes. The sample consisted of 20 daughters who grew up with absent fathers. Data were collected using face-to-face semi-structured interviews, and analyzed using 5 phases of Hycner's (1999) phenomenological research. Results indicated that participants' lived experiences of home life were characterized by financial and emotional hardships resulting from the loss of a father's earnings and care. The meanings or lessons that participants derived from having absent fathers included the importance of being independent, of appreciating the people who remained with them, and of making a better life for their own children, either by choosing a mate who would be a committed father or by helping their children to come to terms with the man's absence. Participants reported that the absence of their fathers shaped their decision-making patterns in romantic relationships, either by normalizing exploitative behavior in men (e.g., deception, abuse, or abandonment), or by predisposing them to distrust men. Participants were also affected in their decision-making patterns by the loss of a male perspective and a father's guidance. These results are of significance because by gaining understanding of the experiences of daughters with absent fathers, healthcare professionals may provide appropriate assistance to help these women cope better with their difficulties and struggles.

Implementation of federally mandated classroom inclusion of students with disabilities (SWDs) in the United States is inconsistent. Research has been limited on how teachers implement inclusion in classrooms, which has prevented systemwide improvements of inclusion practices. The purpose of this basic qualitative study was to describe the circumstances and experiences of regular and special education teachers in 3rd to 6th grade inclusion classes. The theory of organizational learning served as the conceptual framework for the study. Data were collected in interviews with 7 regular education teachers (RETs) and 5 special education teachers (SETs) from 3 public school districts in a south-central U.S. state. Data were analyzed using open coding to identify themes and patterns. Results indicated that SETs served SWDs from multiple classes and sometimes from multiple grades rather than following 1 student throughout the day. Further, RETs had students with and without disabilities from up to 7 different grade levels in their inclusion classrooms. Findings also revealed that none of the participants engaged in collaborative content planning. Almost all participants expressed the need for additional teachers to reduce the teacher-to-student ratio and for more training for RETs to support inclusion of SWDs in their classes. Findings may provide information to leaders at the building, district, regional, state, and legislative levels regarding how inclusion can be improved in classrooms, including how systemic change in public school systems may be implemented.

Thesis (MPH.) --University of Limpopo, 2013 / Setting: The study was undertaken in St Rita’s Hospital, a district hospital for healthin Makhuduthamaga Municipality, Sekhukhune District, Limpopo Province. The purpose of the study was to describe client experiences of HIV-positive post-disclosure tosexual partners at St Rita’s Hospital, Limpopo Province. Research design and methodology: A qualitative, descriptive and phenomenological design was used. Purposive sampling was used to select 15 HIV-positive clients to participate in the study. Semi-structured interviews were conducted for data collection until saturation was reached. Data analysis was done using Techs open-coding method. Research findings: The study found that most of the clients were shocked and worried after testing HIV-positive. Participants whose sexual partners were aware that they were sick, indicated their wish to test and to immediately disclose their HIV-positive status. The study identified that some women found it difficult to disclose their HIV-positive status to sexual partners and continued to have unprotected sex in spite of ongoing counselling and support provided at the clinic. Some women participants who disclosed to sexual partners were accepted and some were rejected by sexual partners. Some women who disclosed their HIV-positive status to sexual partners were unable to motivate sexual partners to be counselled together and have mutual disclosure. These participants therefore continued to have unprotected sex with sexual partners and some became pregnant as sexual partners indicated that they tested HIV-negative elsewhere and were not keen to use condoms. Female participants did not indicate the use of female condoms as part of their responsibility to prevent transmission of HIV. Implications, recommendations and conclusions: The barriers which female participants face to disclose their HIV-positive status to sexual partners and not being able to insist on the use condoms may contribute to a high rate of HIV transmission and disease incidence. There should be establishment of consortiums at community level to provide quality support and follow up to vii clients who face challenges or fear to disclose their HIV-positive status to sexual partners. KEYWORDS • Clients’ experiences • Disclosure • Experiences, • Sexual partner • HIV-positive

Thesis (M.Sc. (Curations)) --University of Limpopo, 2015 / The purpose of the study was to determine the experiences of professional nurses with ethical dilemmas at the Witbank hospital Nkangala district Mpumalanga province. The objectives of the study were to describe the experiences of professional nurses with ethical dilemmas in nursing practice and to determine supportive measures to help professional nurses to deal with ethical dilemmas encountered in nursing practice. The research question was: what are the ethical dilemmas that professional nurses experience in nursing practice? Kohlberg theory of moral development was used as a theoretical framework. A qualitative exploratory, descriptive and contextual research design was used to describe the experiences of professional nurses with ethical dilemmas in nursing practice. Purposive sampling was used to sample fourteen (14) professional nurses. Data was collected using semi-structured interviews. Open-coding method of data analysis was used and four themes and sub-themes emerged. The study found that professional nurses experience ethical dilemmas related to death and dying, distribution of both human and material resources, respect of patients’ autonomy and the nurses’ rights. The study recommends continuous ethics education and the inclusion of ethics in nursing curricula, creation of a supportive working environment, knowledge and understanding of the pledge of service, Inter- disciplinary teams to discuss ethical issues, availability of ethics experts and ethics mentors in the wards.

Thesis (M.Cur.) -- University of Limpopo, 2015 / The purpose of the study was to investigate the experiences of families towards psychiatric state patients during LOA. A qualitative, phenomenological, exploratory, descriptive and contextual design was used. Non-probability sampling of the purposive type was used to explore and describe the experiences of families towards psychiatric state patients during LOA. Data were collected from ten (10) families by using semi-structured face-to-face interviews. Data were audio recorded and field notes were also written. Trustworthiness was ensured by applying credibility, transferability, confirmability and dependability. Transferability was ensured by utilizing purposive sampling to include participants. Confirmability was ensured by collecting data from the participants who have experience on the problem studied. Data were analysed qualitatively by using Tech’s open coding method. Results from the study shows that families experiences uncontrolled and disruptive behaviour from the psychiatric state patients during LOA. Guidelines for the study include: Families of psychiatric state patients should receive counselling and be involved in family therapy prior and after the psychiatric state patient’s LOA. Family members of psychiatric state patient experience emotional pain, therefore they need support from multidisciplinary team members to assist them to facilitate promotion, maintenance and restoration of their mental health as an integral part of their health. Recommendations include improvement of aspects in nursing practice, nursing education and nursing research. Key words: Experiences, family, psychiatric state patients, Leave of absence. DEFINITION

Bakgrund: Alzheimers demens medför stora kognitiva förändringar i den sjukes liv och beteende och slutar med en grav försämring och förlust av alla kognitiva och motoriska funktioner. Detta betyder en stor påfrestning inte bara för den som lider av sjukdomen utan också för närstående som vårdar dessa patienter hemma. Sjuksköterskans ledande och hälsofrämjande roll är då väsentligt för att ge stöd till inte bara för den sjuke men också för dess närstående. Syfte: Syftet var att belysa närståendes upplevelser av att vårda personer med Alzheimers demens. Metod: En litteraturöversikt genomfördes med sökningar i databaserna Academic Search Complete, Cinahl Complete och Nursing & Alliades Health Database. Åtta artiklar valdes efter en kvalitetsgranskning och analysen baserat på likheter och skillnader som efteråt tematiserades. Resultat: Analysen resulterade i tre huvudteman: Vikten av familjerelationer, kultur och traditioner, vilket visade att närstående ger en stor vikt till familjen och ger en inblick av rollen som vårdare och hur de ser på sjukdomen från ett kulturellt perspektiv; bristande familjestöd, vilket visar att närstående kan känna sig övergivna av andra familjemedlemmar och att de inte alltid är villiga att vårda sin sjuke anhörig; strategier för att klara av vardagen, känslor av börda och svårigheter, vilket visar vilka strategier de vårdande närstående använder sig av för att kunna hantera den anhöriges sjukdom och sin egen roll som vårdare. Diskussion: Resultatet diskuterades utifrån Callista Roys teori. Diskussionen fokuserar på hur närstående som vårdar en anhörig med Alzheimers demens upplever en rollförändring och hur de kan återskapa balansen i livet genom att acceptera en föränderlig tillvaro och navigera genom den med hjälp av sjuksköterskans stödjande insatser. / Background: Alzheimer's dementia causes major cognitive changes in the sick's life and behavior and ends with a severe deterioration and loss of all cognitive and motor functions. This means a great stress not only for those who suffer from it but also for relatives who care for them at home. The nurse's leading and health-promoting role is essential for providing support not only for the patient but also for its relatives. Aim: The aim was to illuminate the experiences of relatives in caring for people with Alzheimer's dementia. Method: A literature review was conducted with searches from the databases Academic Search Complete, Cinahl Complete and Nursing & Alliades Health Database. Eight articles were selected after a quality review and the results were analyzed and categorized into main themes. Results: The analysis resulted in three main themes: The importance of family relationships, culture and traditions, which showed that relatives give great importance to the family and provide an insight into the role of caring and how they view the disease from a cultural angle; lack of family support, which shows that relatives sometimes feel abandoned by other family members and that they are not always willing to care for their sick relative; strategies to cope with everyday life, feelings of burden and difficulties, which shows strategies that relatives use to be able to handle their relatives' illness and their own caring role. Discussion: The result was discussed based on Callista Roy's theory of adaptation. The discussion focuses on how relatives who care for a family member with Alzheimer's dementia experience a role shift and how they can restore the balance in life by accepting this change and navigate through it with the help of the nurse's support.