D.Litt. et Phil. / In this phenomenological study, art therapy is explored and described for its mediating effect on the grieving process of parents who have been traumatically bereaved by the loss of a child. The focus is on the ‘inner world’ of the bereaved parents and their subjective experience of being part of a psychotherapy group that uses artworks, as well as language, to explore and express feelings and to clarify existential meaning systems. Traumatic bereavement can result in detrimental long-term psychological consequences. The therapeutic value of existing grief therapies is currently under debate in the literature. To evaluate art therapy as an alternative therapeutic approach, art therapy sessions were held and a ‘text’, consisting of the participants’ artworks and reflections, established. From this text themes were drawn, which facilitated an in-depth understanding of the participants’ lived experience of traumatic bereavement and elucidated their perceptions of the usefulness of art therapy. Art therapy appears to offer a viable alternative to mainstream, language-based therapies. It provides a context in which creative play can facilitate healing and angry feelings sublimated. It assists the participants to rebuild their fragmented sense of ‘self’ through an exploration of their ‘inner world’ via the symbolic function of the artwork. It facilitates the revisiting of the traumatic event and encourages the reconstruction of new meaning. It promotes adaptive grieving through the expression of emotions and cognitions too painful and/or threatening to be verbalised.

M.Cur. / The story of loss, after the experience of spontaneous abortion affects the women’s being as a whole. It impacts her emotional, physical, intellectual, social and spiritual dimensions. The woman finds herself robbed of her voice by her social network. She stands isolated in her new reality of loss and bereavement. This research tells the story of the women’s loss after the experience of spontaneous abortion. The objectives of the research are to • explore and describe the women’s experience after a spontaneous abortion, and • describe guidelines for the advanced psychiatric nurse practitioner according to which he/she can provide support to women after the experience of spontaneous abortion and facilitate mental health through the mobilisation of resources. The paradigmatic perspective of this study is guided by the Theory for Health Promotion in Nursing (Rand Afrikaans University, Department of Nursing Science, 2002: 2-8). A functional approach was followed, based on Botes’s model for nursing research (Botes in Rand Afrikaans University: Department of Nursing, 2002: 9-15). A qualitative, descriptive, exploratory and contextual design was used. In-depth, semi-structured, phenomenological interviews were held with seven women who fitted the sample criteria. Consent for the research was obtained from the Rand Afrikaans University as well as informed consent from the women volunteering to participate in the research. Trustworthiness was maintained by using strategies of credibility, applicability, dependability and confirmability, as described by Lincoln and Guba (1985: 289-331). Recorded interviews were transcribed and analysed using Tesch’s data analysis techniques (in Creswell, 1994: 155-136). An independent coder was utilised in coding the data, and a consensus discussion was held between the researcher and the independent coder. A central storyline was identified and themes highlighted. A literature control was undertaken to highlight similarities and differences between this and other research. The results were described in a narrative manner, which included the content as well as the processes of the women’s emotional experiences after the experience of spontaneous abortion. The impact of the loss affected her social dimension in terms of emotional processes as well as emotional expression. Participants experienced a strong need for acknowledgment of their loss and understanding of their reality of loss and bereavement. The spontaneous abortion has an impact on the women’s physical dimension. She experiences physical discomfort. The impact also effects her spiritual dimension by influencing her relationship with herself and God. The impact also touches her social dimension by robbing her of her voice through her social network’s response to the spontaneous abortion. There is also an impact on her relationship with her partner, as men and women experience and express loss differently. In the reality of loss and bereavement, the participants identified hope givers and hope stealers. Hope givers include • a strong connection with women who experienced spontaneous abortion themselves, • strengthening their relationship with God, • time as a healing faktor, • the value of sharing their stories, • the ability to find meaning after spontaneous abortion, and • the need for emotional growth. Hope stealers include • the response from people in her social network with regard to the spontaneous abortion, • experience of loss of control, • insufficient support in their interpersonal relationships and social network, • confronting the finality of the loss, and • being confronted with pregnant women en babies. Guidelines for the advanced psychiatric nurse practitioner to provide support to women after the experience of spontaneous abortion will be described to assist them in mobilising their resources to facilitate the promotion of their mental health.

Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 2001. / Includes bibliographical references.

Thesis (Ph. D.)--University of Hong Kong, 2001. / Includes bibliographical references (p. 451-462).

Thesis (Ph. D.)--University of Texas at Austin, 2000. / Vita. Includes bibliographical references (leaves 128-133). Available also in a digital version from Dissertation Abstracts.

Thesis (Ph. D.)--Florida State University, 2003. / Advisor: Dr. Thomas A. Cornille, Florida State University, College of Human Sciences, Program in Marriage and Family Therapy. Title and description from dissertation home page (viewed Mar. 2, 2004). Includes bibliographical references.

published_or_final_version / Public Health / Master / Master of Public Health

Background: Secondhand smoke exposure (SHS) causes many fatal diseases to children and there is no safe level of exposure. In Hong Kong, around 41%of infants are exposed to household SHS and leading to the additional hospital admissions of the infants. Objectives: To study the effectiveness of a theory-based family intervention delivered by the smoking cessation counselor (SCCs) which aims to reduce household SHS exposure to infants under 18-months, by helping fathers to quit smoking and motivating mothers to establish a smoke-free home . Methods: Families with a smoking father, non-smoking mother and an infant attended the Maternal and Child Health Centres (MCHCs) were invited to join this randomized controlled trial. The family (mother and father) was randomized after the completion of mother’s baseline questionnaire and the collection of saliva samples from mothers and infants. Father was then contacted for telephone baseline interview. Individual interventions were provided to both mothers and fathers at baseline, 1-week and 1-month, and a family session involving both parents was offered to the intervention group. The control group received information on the hazards of SHS and the benefits of smoking cessation. The intervention and control groups were followed-up at 6-and 12-monthsto assess father’s smoking behavior and the execution of a complete no-smoking policy at home. Chi-squares and independent t-tests were used to assess the group differences in father’s smoking behavior and the initiation of a smoke-free home. Generalized estimating equations were used to examine the group changes of mothers’ and infants’ saliva cotinine levels from baseline to 12-month. Logistic regressions were performed to identify the predictors on father’s smoking behavior and the initiation of a smoke-free home. Results: There were 1,158 families randomized. Significantly more fathers in the intervention groupattainedhigher7-day point prevalence quit rate at 6-(8.0% vs 4.1%, p= .007)and 12-months (13.7% vs 8.0%, p= .002)respectively, stopped smoking at home at 12-month (35.7% vs 28.8%, p= .023), higher continuous quit rates at 6-(3.3% vs 0.7%, p= .002) and 12-month (1.8% vs 0.2%, p= .006), reduction of daily cigarette consumption over 50% at 12-month (33.4% vs 23.9%, p= .006), improvement in the stage of readiness to quit smoking at 6-month (13.0% vs 8.9%, p= .04) and more quit attempts (30.9% vs 24.1%, p=.015). No group differences were found in the establishment of the smoke-free home and the changes of saliva cotinine levels of infants and mothers from baseline to follow-ups. Discussion: This theory-based family intervention is effective in reducing household SHS exposure to infants by helping fathers to quit and stopped them to smoking at home, but it is less effective in motivating the mothers to initiate a smoke-free home. Significance: This is the first study testing a theory-based family intervention in reducing household SHS exposure to healthy infants. The family intervention provides a new insight in using ‘family’ as a unit for the intervention to reduce household SHS exposure to healthy infants by improving fathers' household smoking behavior and helping them to quit smoking. / published_or_final_version / Nursing Studies / Doctoral / Doctor of Philosophy

No description available.

The purpose of the study was to explore the significance of the concept, differentiation of self (DOS), for understanding marital satisfaction. Also, the predictive validity of the Family Systems Personality Profile was explored. The sample was nonclinical in nature and was composed of 101 married couples from east central Indiana.Subjects responded to three questionnaires: Family Systems Personality Profile (FSPP), a psychometric instrument for measuring differentiation of self; the Dyadic Adjustment Scale (DAS), a psychometric instrument for measuring marital adjustment; and a demographic information sheet.A multiple regression analysis using marital adjustment as the criterion variable was conducted. The predictor variables were: Education level, income, age, years married, age at marriage, number of children, previous marriage, cohabitation, and FSPP total score. The .01 alpha level was necessary for statistical significance.Findings1. Contrary to the Bowen theory, there was not a significant relationship between spouses' levels of differentiation of self.2. Consistent with the Bowen theory, there was a statistically significant relationship between levels of DOS and marital satisfaction for males and females.3. As a predictor of marital quality, the FSPP contributed approximately 17% of the variability in DAS scores over and above that variance contributed by all of the demographic variables, for males and females.ConclusionsIn this nonclinical population of highly educated, middle class married couples, the FSPP was a useful predictor of marital quality. The mate selection hypothesis of the Bowen theory was not supported by this data. Thus, this study did not rule out the possibility that the FSPP could be measuring another psychological construct in addition to differentiation of self.