Background: Using technology requires nurses to capture, retrieve and organize digital data within virtual environments. Nurses often integrate digital data with other data sources when providing patient care with telehealth technologies and conducting research. Little is understood of how nurses navigate technology and process digital data in professional practice. Purpose: The overall aim of this dissertation was to explore how nurses navigate virtual environments and integrate digital data in professional practice through a grounded theory study of how nurses know the person using telehealth technology. The goals of the dissertation were to: a) Describe how knowing the person occurs with use of telehealth technology; b) Create a theoretical conceptualization of how the nurse comes to know the person in a virtual environment; and, c) Explicate data collection and analytical processes in Charmaz’s constructivist grounded theory. Methods Charmaz’s constructivist grounded theory (ConGT) was used for the research study. Findings: The process of conducting this study yielded two outcomes: 1. A grounded theory and conceptualization for Getting a Picture, which illuminates an integrated and iterative interplay of seven processes and 21 sub-processes that nurses described when forming a mental image of the person being cared for. Twenty-two registered nurses from five telehealth programs in two different provincial health systems participated. Primary data sources included 22 first interviews and 11 second interviews with the participants, and five observational experiences. 2. The approach for conducting ConGT involved operationalizing a series of five steps in the analytic process to visualize and conceptualize Getting a Picture. These steps included Initial Data Collection, Initial Coding, Focused Coding, Theoretical Coding and Theory Building. Conclusion: Visualization played an instrumental role when technology was used for both knowing the person in a virtual environment and operationalizing the methodological processes for this ConGT research study. Three main themes related to this overall finding in this dissertation were: (a) visualization and conceptualization to create a mental image is evident in both clinical and research domains of nursing practice; (b) interoperability of technology can impact visualization; and (c) competencies are required to support mental imaging and use of technology in visualizing a whole and accurate picture.

D.Litt. et Phil. / The aim of this research was to examine the nature of the western self, using a grounded theory approach. The life narratives of a group of mid-life women were analysed utilising the method outlined by Strauss and Corbin (1990) and the data provided fertile ground for the development of a substantive theory of the self. In the past, midlife was considered a part of old age. Changes in western society have meant that midlife has become a significant life period. An examination of the nature of selfhood in historical periods as well as in Prehistory constituted the literature review. Modern and Postmodern approaches to the self were also examined. For the participants, the self occupied the area between identity and soul. The participants considered the soul to be the core of the individual. Identity was described in terms of gender, physical appearance as well as date and place of birth. Closely allied to the soul is said to be the individual value system. The participants regarded the self as having certain features including cognitive, affective, spiritual and physical components as well as unconscious elements. Moreover, the self is dynamic and has an inherent directorial capacity based particularly on individual thinking and feeling components. The substantive theory of the self suggests that the self constitutes a sense of existence resulting from conscious awareness of inherent personal capacity and awareness of the immediate present, personal past and projected future. The purpose of the self is to promote the survival of the individual. The core of the self is represented by the need to survive and is experienced as a feeling of continuity contained within the personal narrative. Survival is furthered by purposeful activity and the creation and development of meaning structures. The self rests on inter-related physical, cognitive, emotional-affective pillars, and responds to environmental currents. Thus the self is essentially a process and is given the feeling of form through the narrative capacity inherent in the individual. The self is situated in a self-space created by the interrelationship of the physical, cognitive and affective components in relation to the environment. Today, mainly through technological developments, the self-space has increased in size, and greater demands are placed on the individual self.

The focus of this study is on how counselling psychologists and other therapists interpret psychodynamic ideas. There is a dearth of qualitative work addressing this issue, particularly from the practitioner perspective. This study adopted a social constructionist version of Grounded Theory. Twelve volunteer therapist participants were interviewed (six counselling psychologists and six therapists accredited by the British Association of Counsellors and Psychotherapists (BACP) and the United Kingdom Council for Psychotherapy (UKCP)). Therapists had a wide range of experience but all had at least one year of training in psychodynamic theory. The analysis produced a grounded theory that suggests a tension between realist and social constructionist epistemological stances to psychodynamic theories. An unquestioning use of psychodynamic ideas persisted whereby these theories remained uncontested and were spoken about as if they were indicative of reality. This alternated with a reflective use of psychodynamic ideas where a theory was seen as one explanation among many. A tension was apparent as therapists spoke from these epistemologically opposed stances. This tension was expressed through the demonstration of being drawn to use psychodynamic ideas unquestioningly as they seem to abate anxiety and provide a sense of professionalism and expertise. The benefits of thinking objectively about psychodynamic ideas draw therapists into speaking of them in this way, even when this approach was not in line with the their epistemological stance at other points in time. The tension seems to result from societal demands and contextual pressures as well as the inter-relational discourse with the researcher. It is suggested that practitioners in the field of counselling psychology as well as by practitioners accredited with the UKCP and BACP experience this phenomenon. Length of experience in practice did not play a significant factor in how therapists conceptualise psychodynamic ideas. A discussion of the implication of these findings and the potential for future research is also explored.

Nursing is uniquely demanding work and occupational stress in the nursing profession has been well-documented. Many theories of stress-related disruptions among helping professionals have been proposed. Although these theories differ slightly in their origin of stress, they share similarities in nurses’ response to the patient relationship. Depersonalization, withdrawal, and avoidance all serve to create relational distance between the nurse and the patient. Despite the prevalence of these responses, there are not any theories on the nurses’ process of disengagement from patient relationships. Using Strauss and Corbin’s (1990) grounded theory method, this study explored acute care nurses’ experience of disengagement in patient relationships. The purpose of the study was to develop a mid-range theory of nurses’ process of disengagement from patient relationships as it occurred in acute care. Through purposive and theoretical sampling, 12 acute care nurses participated in open-ended individual interviews. The process of open, axial and selective coding discovered seven categories related to nurses’ experience of disengagement from patient relationships. These categories were emotional experience, behavioural expression, environmental influences, relational distance, professional identity and work spillover. Although these categories were exclusive, conceptual elements were interwoven into more than one category. The categories were interrelated around the core category, ‘Doing and Being’, and the process of nurses’ disengagement from patient relationships was delineated. Participants in the study experienced dissonance when they were unable to act in accordance to their caring beliefs. Conditions in the work environment, such as the lack of time, the culture of productivity and patient characteristics influenced and promoted their process of disengagement. Disengagement was manifested in the nurse-patient relationship by decreased eye contact, increased physical distance and increased task focused behaviour. These behaviours increased relational distance between the nurse and the patient. Nurses’ experience of dissonance had the potential to foster feelings of professional dissatisfaction and alienation from self, leading to increased turnover behaviour and depression. Implications and recommendations for practice and future research are discussed. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Due to increasing emergence of social needs and problems throughout the world, accompanied by reduced government ability to provide the funding necessary to effectively combat these problems, it is expected that social enterprises will grow in number and importance. Because of this growing importance and the lack of research concerning marketing practices in such organizations, the purpose of this thesis is to develop a deeper understanding of both marketing in social enterprises and the context in social enterprises that has the potential to affect the marketing strategies employed in such organizations. Based upon this enhanced understanding, I develop and propose a model of marketing strategy in social enterprises. To develop this enhanced understanding and model, I conducted empirical qualitative research consisting of a comparative study of fifteen cases of social enterprises. Results show that four major dualities represent the critical context of social enterprises that influence the marketing strategies employed. Marketing is viewed as important by these enterprises and the strategies employed are quite well developed in the areas of market research, product quality, branding, and promotion.

Cancer incidence is increasing and so are survival rates. The aftermath of cancer includes multi-dimensional and long-lasting effects that prevent individuals from recovering and re-integrating into their daily routines. Cancer systems attend to patients during diagnosis and treatment, but often fall short in providing continuity of care afterward. This results in a considerable number of individuals living with the effects of cancer, with little support care. While there are evidence-based recommendations to improve follow-up cancer care, the extent to which they have been implemented remains unknown. To support the needs of cancer survivors The Ottawa Regional Cancer Foundation developed a Cancer Coaching Program (CCP). As life and health coaching interventions have been shown to benefit this population, this study aimed to explore the impacts of the CCP on the lives of cancer survivors. Using a grounded theory approach, the experiences of (n=12) cancer survivors who had previously participated in the program were explored, to create an explanatory model. Descriptive results depicted various beneficial outcomes to participating in the CCP. The dominant role of the CCP is to support survivors by “bridging the gap” to survivorship, through tailored coaching services. This study provides insight into the mechanisms that work for this cancer coaching program, which may be helpful for other programs exploring strategies to assist this population.

Orientador: Silvia Cristina Mangini Bocchi / Banca: Tania Ruiz / Banca: Edilson Iglesias de Oliveira Vidal / Banca: Luis Roberto Ramos / Resumo: Dados da literatura têm associado o estilo de vida com o aparecimento de patologias crônicas, com o grau de autonomia e o tempo de sobrevivência dos seres humanos. Estudo realizado na cidade de Botucatu - SP em 2003 com pessoas de 60 anos e mais, mostrou que estes constituíam 3 grupos classificados segundo sua definição de qualidade de vida e como viviam a vida, situações coincidentes. O objetivo deste trabalho foi compreender como a vida do idoso, a partir do seu relato, o levou a ter valores, crenças, conceitos e referências morais na velhice e que terminaram por determinar o estilo de vida que levam. Foram realizadas entrevistas domiciliares com idosos participantes do inquérito de 2003 norteadas pela frase "Fale sobre sua vida". Através de metodologia qualitativa se buscou reproduzir a experiência de vida desses idosos e reconhecer ações que o encorajaram ou não a mudanças durante a vida. Os dados foram analisados segundo a Grounded Theory que possibilitou compreender o conjunto das experiências dos idosos. Foi possível compreender não apenas o movimento da vida desta geração de brasileiros, mas explicar a alocação destes nos três grupos ao mostrar as semelhanças de suas vidas dentro de cada grupo / Abstract: Data from the literature have associated the lifestyle with the onset of chronic diseases, with the degree of autonomy and the survival time of humans. A study conducted in Botucatu - SP in 2003 with people 60 years and older showed that they constituted three groups classified according to their definition of quality of life and how they lived their lives, coincide situations. The aim of this study was to understand how elderly life, from his account, took him to have values, beliefs, moral concepts and references in old age and that ultimately determine the lifestyle they lead. Home interviews were conducted with individuals participating in the 2003 survey guided by the phrase "Tell me about your life. Through qualitative methodology was sought to reproduce the experience of these elderly individuals and to recognize actions that encouraged or not to change throughout life. The data were analyzed according to Grounded Theory enabled us to understand that all the experiences of older people. It was possible to understand not only the movement of life of this generation of Brazilians, but to explain the allocation of these three groups to show the similarities of their lives within each group / Mestre

Many teachers of international students in the United States are challenged to address cultural differences in a classroom. International students often experience psychological, physical and cultural stress when they study abroad, due mainly to unfamiliar environments and a diverse culture. The question this study asks is: Are there any strategies that can be used to benefit these students? This grounded theory study will examine a purposefully-selected group of subjects from China and Taiwan who are currently studying at a large metropolitan university in the Southeastern United States. After data collection and analysis procedure, I hoped there are some things valued for international student who just arrived at the new environment and provides the reference to those students and college with the similar situation as UCF all over the world.

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