• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 2
  • 2
  • 1
  • Tagged with
  • 7
  • 7
  • 5
  • 5
  • 4
  • 4
  • 3
  • 3
  • 3
  • 3
  • 3
  • 3
  • 3
  • 3
  • 3
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Experiences of secondary school management teams in the implementation of continuous assessment

Fanseka, Gezani Samuel 13 February 2013 (has links)
The 1994 democratic elections marked a great turning point in the history the of the South African education system. A call from many politicians and academics for dismantling apartheid education which was racially biased was subsequently made. This was supported by theorists and educational reformers such as Darling-Hammond (1996) and Sizer (1984) who suggested that an educational transformation that would provide South African learners with the necessary knowledge and skills to think critically was required. Following this call, in 1997, a National Curriculum Statement (NCS), with its accompanying assessment policy in a form of continuous assessment (CASS), was introduced in South African schools. This study focuses on the experiences of secondary schools management teams (SMT) in the implementation of continuous assessment. This study is informed by the findings of Chisholm (2001) and Jansen&Christie (1995) who contend that the hasty implementation of CASS was extremely problematic for school managers. The objective was to explore the role of principals, deputy principals, and heads of departments (as managers of schools) in the implementation of the continuous assessment policy. Furthermore, the study aimed to investigate the kind of support the Limpopo Department of Education provides to the SMT for the successful implementation of CASS. The study was conducted in six secondary schools in the Malamulele East Circuit, Vhembe District in Limpopo Province in the following schools: Deliwe, Dlayani, Falaza Gembani, Ndhengeza, and Yollisa and it employed a qualitative research approach. Semi-structured individual interviews were used to collect data from principals, deputy principals and heads of departments. In addition, semi-structured focus-group interviews were conducted with heads of departments in order to get in-depth understanding with regard to their experiences when implementing a continuous assessment policy. This study found that members of the SMT in many secondary schools in the Malamulele East Circuit did not receive training for the implementation of continuous assessment and as a result, they lack clarity in many critical aspects of this assess1nent policy. It has further been found that the majority of the members of the SMT lack a conceptual understanding of what CASS is and also the role they are supposed to play in its implementation. Consequently, educators are still relying much on tests to judge the performance of the learners. In the light of this, it is therefore recommended that principals, deputy principals and heads of departments be provided with extensive training which would generate a deeper conceptual understanding of this assessment policy. Copyright / Dissertation (MEd)--University of Pretoria, 2012. / Education Management and Policy Studies / unrestricted
2

Évaluation de la mise en œuvre du programme d’activités parascolaires musicales La classe enchantée

Milette, Marie-Catherine 07 1900 (has links)
Les activités parascolaires sont de plus en plus reconnues comme un contexte favorisant le développement positif des jeunes, et ce, particulièrement pour les jeunes en milieu défavorisé. Toutefois, l’efficacité de ces interventions varie selon les programmes, leur contexte d’implantation, ainsi que les caractéristiques et l’engagement des jeunes. La présente étude se situe dans l’évaluation du programme La classe enchantée (CE), un programme d’activités parascolaires musicales offert depuis 2017 aux élèves de 4e année d’une école primaire montréalaise pluriethnique en milieu défavorisé. La CE vise spécifiquement à influencer positivement l’épanouissement des jeunes par l’apprentissage collectif de la musique ainsi que par un accès démocratique à ce programme. De façon à mieux comprendre le fonctionnement et les conditions optimales d’implantation de cette initiative novatrice, la présente étude a comme objectif général d’évaluer la mise en œuvre du programme. De façon plus précise, le premier objectif est de décrire le programme et d’identifier les obstacles et facilitateurs en lien avec son implantation. Le deuxième objectif vise ensuite à relever les composantes essentielles de la mise en œuvre favorisant l’engagement des jeunes, et plus largement, leur développement positif. Les données ont été recueillies sur un peu plus de deux ans auprès de quatre groupes d’acteurs, soit les participants, leurs parents, les enseignants de musique ainsi que l’équipe de direction du programme, et ce, principalement à partir d’entrevues. Dans une visée formative, les analyses descriptives et thématiques ont permis de dresser un portrait détaillé de la mise en œuvre de la CE et de ses facteurs d’influence à partir de la structure d’ensemble du modèle psychoéducatif. Parmi ceux-ci, l’instabilité du financement est ressortie comme étant un obstacle constant avec lequel la direction doit composer. Les résultats mettent également en valeur l’importance des enseignants, de la relation qu’ils créent avec les jeunes, mais également de leur expérience avec la clientèle qui est déterminante pour l’instauration d’un climat propice aux apprentissages. Enfin, certaines aptitudes de la direction ainsi que l’ajout d’une coordination à l’interne ressortent comme étant particulièrement importants au sein du programme pour que les acteurs de sa mise en œuvre s’ajustent efficacement aux obstacles rencontrés et répondent aux besoins des jeunes. L’étude dégage également des réflexions quant à l’utilisation de la structure d’ensemble du modèle psychoéducatif comme outil d’évaluation de la mise en œuvre. / Extracurricular activities are increasingly recognized as a context that promotes youth positive development, especially for those living in disadvantaged areas. However, the effectiveness of these interventions varies from one program to another, based on their implementation context, and according to youth characteristics and commitment. This study is part of the evaluation of the La classe enchantée (EC), an extracurricular music program offered since 2017 to 4th graders attending a multi-ethnic Montreal school located in a disadvantaged area. The EC specifically aims to positively influence youth development through collective music learning as well as through a democratic access to the program. In order to better understand the functioning and optimal conditions for implementing this innovative initiative, the present study aimed as a general objective to evaluate the implementation of the program. More specifically, our objectives were to describe the program and identify the obstacles and facilitators related to its implementation, as to identify the essential implementation components promoting youth engagement and positive development. Data were collected over two years among four groups of actors, namely the participants, their parents, the music teachers, and the program management team. Data were mainly collected from interviews. We relied on the psychoeducational model to draw a detailed portrait of the implementation of EC using descriptive and thematic analysis. Among the main factors associated with the program implementation, funding instability has emerged as a constant barrier for the management team. Our results also highlight the importance of the teachers and the relationship they create with their students, but also their experience with the clientele, which was decisive for the creation of an efficient learning climate. Finally, the management team skills as well as the addition of internal coordination stand out as being particularly important to allow program promoter to effectively adjust to obstacles and better meet student needs. The study also highlights important insight regarding the relevance of the psychoeducation model as an implementation tool as well as broader recommendations on the implementation of extracurricular activity programs.
3

Avaliação da implantação do Programa de Saúde Bucal da Estratégia Saúde da Familia, na zona leste do município de São Paulo,2008 / Evaluation of the implementation of the Program of oral healthcare of the Family Health Strategy, in the eastern region of the city of Sao Paulo, 2008

Abreu, Silvio Carlos Coelho de 12 February 2009 (has links)
A Estratégia Saúde da Família, caracterizada inicialmente como Projeto QUALIS no município de São Paulo, iniciou as suas atividades em 1996 na zona leste da cidade, através da Casa de Saúde Santa Marcelina. O Programa de Saúde Bucal da estratégia Saúde da Família Santa Marcelina está atuando no território desde 1998, tendo como principal ponto de reivindicações dos gestores a ampliação do número de equipes para garantir a ampliação do acesso à população. Atualmente, a preocupação está focada nos resultados das ações do programa na saúde bucal da população assistida. Porém, avaliar os resultados das ações de saúde de um programa sem conhecer as bases e o contexto em que foi implantado, torna-se uma tarefa muito complicada. O objetivo geral do estudo é avaliar a implantação do Programa de Saúde Bucal da Estratégia Saúde da Família da Casa de Saúde Santa Marcelina/Organização Social Santa Marcelina, na zona leste do município de São Paulo e os objetivos específicos são: verificar o conhecimento dos profissionais do programa sobre as leis, normas e diretrizes estabelecidas para a saúde bucal na Atenção Básica; verificar a adequação dos processos de trabalho às leis, normas e diretrizes propostas pelo Ministério da Saúde e Secretaria Municipal de Saúde; e, verificar se a estrutura estabelecida, nos consultórios odontológicos das unidades de saúde, permite a operacionalização do trabalho de acordo com as leis, normas e diretrizes. Metodologia: Estudo descritivo/analítico através de pesquisa documental e do arcabouço legal que estabelece as bases para a Saúde Bucal na Atenção Básica e de dados primários coletados em instrumento apropriado, aplicado para o levantamento de informações sobre o conhecimento dos profissionais em relação às normas, diretrizes e a legislação específica, e, em relação ao desenvolvimento dos processos de trabalho. O universo de estudo é composto por 14 UBS que desenvolvem a estratégia Saúde da Família na região, assim como todas as ESB habilitadas no Ministério da Saúde pela instituição. A avaliação dos dados foi feita considerando as variáveis em três Eixos de Análises, que correspondem aos objetivos específicos da proposta. Assim foram criados os eixos: 1 Conhecimento dos profissionais; 2 Adequação dos processos de trabalho; e, 3 Estrutura. A hipótese a ser verificada foi, que o Programa de Saúde Bucal está implantado satisfatoriamente considerando os eixos de avaliação propostos. Resultados: o eixo Conhecimento dos profissionais teve um percentual de implantação de 87,7%, o eixo Adequação dos processos de trabalho teve um percentual de implantação de 82,0% e o eixo Estrutura teve um percentual de implantação de 80,5%. Conclusão: O Programa de Saúde Bucal da estratégia Saúde da Família está Satisfatoriamente Implantado (83,4%) na zona leste do município de São Paulo, considerando o conhecimento dos profissionais envolvidos sobre as leis, normas e diretrizes para a Saúde Bucal na Atenção Básica, a adequação do processo de trabalho às leis, normas e diretrizes, e a estrutura oferecida nos consultórios odontológicos para o desenvolvimento das ações. / The Family Healthcare Strategy, characterized initially as Project QUALIS in the municipality of São Paulo, started its activities in 1996 in the eastern area of the city, through the Casa de Saúde Santa Marcelina. The Program of oral healthcare of the Family Health strategy Santa Marcelina is acting in the territory since 1998, the main point of claims of managers the enlargement of the number of teams to ensure the expansion of access to the population. Currently, the concern is focused on the results of the actions of the program in oral health of the population assisted. However, to assess the results of health actions of a program without knowing the bases and the context in which was implemented, becomes a difficult task. The general objective of the study is to assess the implementation of the Program of oral healthcare of the Family Health Strategy of Casa de Saúde Santa Marcelina/Social Organization Santa Marcelina, in the eastern region of the municipality of S Paulo and specific objectives are: to verify the knowledge of professionals of the program about the laws, rules and guidelines established for oral healthcare in primary health; to verify the adequacy of work processes to the laws, rules and guidelines proposed by the Ministry of Health and Municipal Department of Health; and, to verify whether the structure established in dental clinics of public health units allows the structuring of the work in accordance with the laws, rules and guidelines. Methodology: descriptive study/analytical through documental research and the legal framework which lays the foundations for the Oral Health Care in Primary Health and primary data collected in appropriate instrument, applied for setting up information on the knowledge of professionals in relation to standards, guidelines and specific legislation, and, in relation to the development of work processes. The universe of study is composed by 14 public health primary care units which develop the family health strategy in the region as well as all oral health teams empowered in the Health Ministry by the institution. Data evaluation was performed considering the variables in three axles of analyzes, which correspond to specific objectives of the proposal. So were created the axles: 1-Knowledge of professionals; 2- Adequacy of work processes; and, 3- Structure. The hypothesis to be verified was that the Program of Oral healthcare is implemented satisfactorily whereas the axles of evaluation proposed. Results: the axis of knowledge of professionals had a percentage of implementing of 87.7%, the axis Adequacy of the processes of work had a percentage of implementing of 82.0% and the axis Structure had a percentage of implementing of 80.5%. Conclusion: Concerning knowledge of involved professionals about laws, rules and guidelines for the Oral Health in basic care, the adequacy of work processes to the laws, rules and guidelines and structure offered in public dental clinics for clinical procedures it is legitimate that the Program of oral healthcare of the Family Health strategy is satisfactorily implemented (83.4%) in the eastern region of the city of São Paulo.
4

Avaliação da implantação do Programa de Saúde Bucal da Estratégia Saúde da Familia, na zona leste do município de São Paulo,2008 / Evaluation of the implementation of the Program of oral healthcare of the Family Health Strategy, in the eastern region of the city of Sao Paulo, 2008

Silvio Carlos Coelho de Abreu 12 February 2009 (has links)
A Estratégia Saúde da Família, caracterizada inicialmente como Projeto QUALIS no município de São Paulo, iniciou as suas atividades em 1996 na zona leste da cidade, através da Casa de Saúde Santa Marcelina. O Programa de Saúde Bucal da estratégia Saúde da Família Santa Marcelina está atuando no território desde 1998, tendo como principal ponto de reivindicações dos gestores a ampliação do número de equipes para garantir a ampliação do acesso à população. Atualmente, a preocupação está focada nos resultados das ações do programa na saúde bucal da população assistida. Porém, avaliar os resultados das ações de saúde de um programa sem conhecer as bases e o contexto em que foi implantado, torna-se uma tarefa muito complicada. O objetivo geral do estudo é avaliar a implantação do Programa de Saúde Bucal da Estratégia Saúde da Família da Casa de Saúde Santa Marcelina/Organização Social Santa Marcelina, na zona leste do município de São Paulo e os objetivos específicos são: verificar o conhecimento dos profissionais do programa sobre as leis, normas e diretrizes estabelecidas para a saúde bucal na Atenção Básica; verificar a adequação dos processos de trabalho às leis, normas e diretrizes propostas pelo Ministério da Saúde e Secretaria Municipal de Saúde; e, verificar se a estrutura estabelecida, nos consultórios odontológicos das unidades de saúde, permite a operacionalização do trabalho de acordo com as leis, normas e diretrizes. Metodologia: Estudo descritivo/analítico através de pesquisa documental e do arcabouço legal que estabelece as bases para a Saúde Bucal na Atenção Básica e de dados primários coletados em instrumento apropriado, aplicado para o levantamento de informações sobre o conhecimento dos profissionais em relação às normas, diretrizes e a legislação específica, e, em relação ao desenvolvimento dos processos de trabalho. O universo de estudo é composto por 14 UBS que desenvolvem a estratégia Saúde da Família na região, assim como todas as ESB habilitadas no Ministério da Saúde pela instituição. A avaliação dos dados foi feita considerando as variáveis em três Eixos de Análises, que correspondem aos objetivos específicos da proposta. Assim foram criados os eixos: 1 Conhecimento dos profissionais; 2 Adequação dos processos de trabalho; e, 3 Estrutura. A hipótese a ser verificada foi, que o Programa de Saúde Bucal está implantado satisfatoriamente considerando os eixos de avaliação propostos. Resultados: o eixo Conhecimento dos profissionais teve um percentual de implantação de 87,7%, o eixo Adequação dos processos de trabalho teve um percentual de implantação de 82,0% e o eixo Estrutura teve um percentual de implantação de 80,5%. Conclusão: O Programa de Saúde Bucal da estratégia Saúde da Família está Satisfatoriamente Implantado (83,4%) na zona leste do município de São Paulo, considerando o conhecimento dos profissionais envolvidos sobre as leis, normas e diretrizes para a Saúde Bucal na Atenção Básica, a adequação do processo de trabalho às leis, normas e diretrizes, e a estrutura oferecida nos consultórios odontológicos para o desenvolvimento das ações. / The Family Healthcare Strategy, characterized initially as Project QUALIS in the municipality of São Paulo, started its activities in 1996 in the eastern area of the city, through the Casa de Saúde Santa Marcelina. The Program of oral healthcare of the Family Health strategy Santa Marcelina is acting in the territory since 1998, the main point of claims of managers the enlargement of the number of teams to ensure the expansion of access to the population. Currently, the concern is focused on the results of the actions of the program in oral health of the population assisted. However, to assess the results of health actions of a program without knowing the bases and the context in which was implemented, becomes a difficult task. The general objective of the study is to assess the implementation of the Program of oral healthcare of the Family Health Strategy of Casa de Saúde Santa Marcelina/Social Organization Santa Marcelina, in the eastern region of the municipality of S Paulo and specific objectives are: to verify the knowledge of professionals of the program about the laws, rules and guidelines established for oral healthcare in primary health; to verify the adequacy of work processes to the laws, rules and guidelines proposed by the Ministry of Health and Municipal Department of Health; and, to verify whether the structure established in dental clinics of public health units allows the structuring of the work in accordance with the laws, rules and guidelines. Methodology: descriptive study/analytical through documental research and the legal framework which lays the foundations for the Oral Health Care in Primary Health and primary data collected in appropriate instrument, applied for setting up information on the knowledge of professionals in relation to standards, guidelines and specific legislation, and, in relation to the development of work processes. The universe of study is composed by 14 public health primary care units which develop the family health strategy in the region as well as all oral health teams empowered in the Health Ministry by the institution. Data evaluation was performed considering the variables in three axles of analyzes, which correspond to specific objectives of the proposal. So were created the axles: 1-Knowledge of professionals; 2- Adequacy of work processes; and, 3- Structure. The hypothesis to be verified was that the Program of Oral healthcare is implemented satisfactorily whereas the axles of evaluation proposed. Results: the axis of knowledge of professionals had a percentage of implementing of 87.7%, the axis Adequacy of the processes of work had a percentage of implementing of 82.0% and the axis Structure had a percentage of implementing of 80.5%. Conclusion: Concerning knowledge of involved professionals about laws, rules and guidelines for the Oral Health in basic care, the adequacy of work processes to the laws, rules and guidelines and structure offered in public dental clinics for clinical procedures it is legitimate that the Program of oral healthcare of the Family Health strategy is satisfactorily implemented (83.4%) in the eastern region of the city of São Paulo.
5

Évaluation d’un programme de réadaptation en communauté par les arts visuels pour les jeunes présentant un trouble psychiatrique stabilisé

De Broux-Leduc, Victor 08 1900 (has links)
No description available.
6

Évaluation d’un programme novateur de réadaptation par les arts de la scène pour des jeunes présentant un trouble psychiatrique stabilisé : le programme Espace de Transition

Archambault, Kim 04 1900 (has links)
L’objectif de cette thèse était d’évaluer Espace de Transition (ET), un programme novateur d’intervention par les arts de la scène visant à favoriser la réadaptation psychosociale d’adolescents et de jeunes adultes présentant des troubles mentaux stabilisés et à diminuer la stigmatisation des individus aux prises avec des problèmes de santé mentale. Ce programme a été conçu par une équipe de cliniciens du département de psychiatrie du Centre hospitalier universitaire Ste-Justine, en collaboration avec des artistes professionnels, et est livré depuis le printemps 2009. L’évaluation du programme ET a été conduite de manière indépendante, selon des approches collaborative et naturaliste et en usant de méthodes mixtes. Les données de recherche ont été recueillies avant pendant et après le programme auprès de l’ensemble des participants à deux sessions distinctes (N = 24), de même qu’auprès des deux artistes instructeurs, de la psychoéducatrice responsable du soutien clinique, ainsi que des psychiatres et autres intervenants ayant référé des participants (N=11). Des entrevues semi-structurées individuelles et de groupe, des observations directes et des questionnaires ont servi à recueillir les données nécessaires à l’évaluation. Des analyses quantitatives de variance, ainsi que des analyses qualitatives thématiques ont été réalisées et leurs résultats ont été interprétés de manière intégrée. Le premier chapitre empirique de la thèse relate l’évaluation de la mise en œuvre du programme ET. Cette étude a permis de constater que le programme avait rejoint des participants correspondant de près à la population visée et que ceux-ci présentaient globalement des niveaux élevés d’assiduité, d’engagement et d’appréciation du programme. L’évaluation de la mise en œuvre a en outre permis de conclure que la plupart des composantes du programme identifiées a priori comme ses paramètres essentiels ont été livrées tel que prévu par les concepteurs et que la plupart d’entre elles ont été largement appréciées et jugées pertinentes par les participants et les autres répondants consultés. Le second chapitre empirique consiste en un article portant sur l’évaluation des effets du programme ET relativement à l’atteinte de trois de ses objectifs intermédiaires, soient l’amélioration 1) du fonctionnement global, 2) du confort relationnel et des compétences sociales, ainsi que 3) de la perception de soi des participants présentant des troubles mentaux. Les résultats de cette étude ont révélé des changements significatifs et positifs dans le fonctionnement global des participants suite au programme, tel qu’évalué par les cliniciens référents et partiellement corroboré par les participants eux-mêmes. Des améliorations en ce qui concerne le confort relationnel, les compétences sociales et la perception de soi ont également été objectivées chez une proportion substantielle de participants, bien que celles-ci ne se soient pas traduites en des différences significatives décelées par les analyses quantitatives de groupe. Le troisième et dernier chapitre empirique de la thèse relate une étude exploratoire des mécanismes sous-tendant les effets du programme ET ayant conduit à l’élaboration inductive d’une théorie d’action de ce programme. Cette investigation qualitative a révélé quatre catégories de mécanismes, soient des processus de 1) gain d’expérience et de gratification sociales, 2) de désensibilisation par exposition graduelle, 3) de succès et de valorisation, et 4) de normalisation. Cette étude a également permis de suggérer les caractéristiques et composantes du programme qui favorisent la mise en place ou l’impact de ces mécanismes, tels l’environnement et l’animation non cliniques du programme, la composition hétérogène des groupes de participants, le recours aux arts de la scène, ainsi que la poursuite d’une réalisation collective et son partage avec un public extérieur au programme. Globalement, les études présentées dans la thèse appuient la pertinence et le caractère prometteur du programme ET, tout en suggérant des pistes d’amélioration potentielle pour ses versions ultérieures. Par extension, la thèse soutient l’efficacité potentielle d’interventions réadaptatives mettant en œuvre des composantes apparentées à celles du programme ET pour soutenir le rétablissement des jeunes aux prises avec des troubles mentaux. / The objective of this thesis was to evaluate Espace de Transition (ET), an innovative art-based program aimed at fostering the rehabilitation of adolescents and young adults with recently stabilized psychiatric disorders and diminishing the stigmatization experienced by individuals with mental health problems. This program was designed by a team of clinicians from Ste-Justine Hospital’s psychiatry unit, in collaboration with professional artists. It is delivered since the spring of 2009. The evaluation of program ET was conducted in an independent yet collaborative manner, using a naturalistic approach and mixed methods. Data were collected before, during, and after the program from all participants who took part in two distinct sessions (N = 24), as well as from the two artist instructors, the psychoeducator who provided clinical support during the workshops, and the clinicians who referred participants (N=11). Individual and group semi-structured interviews, direct observations, and questionnaires served to collect the necessary data. Quantitative analyses of variance and qualitative thematic analyses were conducted and their results were interpreted in an integrated manner. The first empirical chapter of the thesis reports on the evaluation of the implementation of program ET. This evaluation showed that the program reached participants closely corresponding to its targeted population and that these youths globally presented elevated levels of assiduity, engagement in, and appreciation of the program. This evaluation also allowed to conclude that most essential program components were delivered as intended by designers and were largely appreciated and judged pertinent by participants and other respondents. The second empirical chapter presents an article detailing the evaluation of the effects of the program ET. This evaluation focused on three of its intermediate objectives: the improvement of 1) global functioning, 2) social comfort and competence, and 3) self-perception in program participants suffering from mental disorders. Results of this study revealed significant and positive changes in the global functioning of participants following the program, as assessed by their referring clinicians and partially corroborated by participants themselves. Improvements in social comfort and competence and self-perception were also noted in a substantial proportion of participants, although they did not translate in significant differences detected by group-level quantitative analyses. The third and last empirical chapter of the thesis reports on a study which sought to explore the mechanisms underlying the effects of program ET and to inductively elaborate a theory of action of the program. This qualitative investigation revealed four categories of mechanisms: 1) social experience and gratification, 2) desensitization by gradual exposure, 3) success and valorization, and 4) normalization. This study also allowed to identify program characteristics and components that seemed to favor the onset or impact of these mechanisms, such as the non-clinical setting and conducting of the program, the heterogeneous composition of the groups, the use of performing arts, and the pursuit of a collectively achieved artistic product and its presentation to an external public. Globally, the studies presented in the thesis support the relevance and promising character of program ET, while suggesting potential improvements for future versions. By extension, the thesis supports the potential efficacy of rehabilitation strategies which include components analogous to those of ET in fostering the recovery of youths with mental disorders.
7

Évaluation d’un programme novateur de réadaptation par les arts de la scène pour des jeunes présentant un trouble psychiatrique stabilisé : le programme Espace de Transition

Archambault, Kim 04 1900 (has links)
L’objectif de cette thèse était d’évaluer Espace de Transition (ET), un programme novateur d’intervention par les arts de la scène visant à favoriser la réadaptation psychosociale d’adolescents et de jeunes adultes présentant des troubles mentaux stabilisés et à diminuer la stigmatisation des individus aux prises avec des problèmes de santé mentale. Ce programme a été conçu par une équipe de cliniciens du département de psychiatrie du Centre hospitalier universitaire Ste-Justine, en collaboration avec des artistes professionnels, et est livré depuis le printemps 2009. L’évaluation du programme ET a été conduite de manière indépendante, selon des approches collaborative et naturaliste et en usant de méthodes mixtes. Les données de recherche ont été recueillies avant pendant et après le programme auprès de l’ensemble des participants à deux sessions distinctes (N = 24), de même qu’auprès des deux artistes instructeurs, de la psychoéducatrice responsable du soutien clinique, ainsi que des psychiatres et autres intervenants ayant référé des participants (N=11). Des entrevues semi-structurées individuelles et de groupe, des observations directes et des questionnaires ont servi à recueillir les données nécessaires à l’évaluation. Des analyses quantitatives de variance, ainsi que des analyses qualitatives thématiques ont été réalisées et leurs résultats ont été interprétés de manière intégrée. Le premier chapitre empirique de la thèse relate l’évaluation de la mise en œuvre du programme ET. Cette étude a permis de constater que le programme avait rejoint des participants correspondant de près à la population visée et que ceux-ci présentaient globalement des niveaux élevés d’assiduité, d’engagement et d’appréciation du programme. L’évaluation de la mise en œuvre a en outre permis de conclure que la plupart des composantes du programme identifiées a priori comme ses paramètres essentiels ont été livrées tel que prévu par les concepteurs et que la plupart d’entre elles ont été largement appréciées et jugées pertinentes par les participants et les autres répondants consultés. Le second chapitre empirique consiste en un article portant sur l’évaluation des effets du programme ET relativement à l’atteinte de trois de ses objectifs intermédiaires, soient l’amélioration 1) du fonctionnement global, 2) du confort relationnel et des compétences sociales, ainsi que 3) de la perception de soi des participants présentant des troubles mentaux. Les résultats de cette étude ont révélé des changements significatifs et positifs dans le fonctionnement global des participants suite au programme, tel qu’évalué par les cliniciens référents et partiellement corroboré par les participants eux-mêmes. Des améliorations en ce qui concerne le confort relationnel, les compétences sociales et la perception de soi ont également été objectivées chez une proportion substantielle de participants, bien que celles-ci ne se soient pas traduites en des différences significatives décelées par les analyses quantitatives de groupe. Le troisième et dernier chapitre empirique de la thèse relate une étude exploratoire des mécanismes sous-tendant les effets du programme ET ayant conduit à l’élaboration inductive d’une théorie d’action de ce programme. Cette investigation qualitative a révélé quatre catégories de mécanismes, soient des processus de 1) gain d’expérience et de gratification sociales, 2) de désensibilisation par exposition graduelle, 3) de succès et de valorisation, et 4) de normalisation. Cette étude a également permis de suggérer les caractéristiques et composantes du programme qui favorisent la mise en place ou l’impact de ces mécanismes, tels l’environnement et l’animation non cliniques du programme, la composition hétérogène des groupes de participants, le recours aux arts de la scène, ainsi que la poursuite d’une réalisation collective et son partage avec un public extérieur au programme. Globalement, les études présentées dans la thèse appuient la pertinence et le caractère prometteur du programme ET, tout en suggérant des pistes d’amélioration potentielle pour ses versions ultérieures. Par extension, la thèse soutient l’efficacité potentielle d’interventions réadaptatives mettant en œuvre des composantes apparentées à celles du programme ET pour soutenir le rétablissement des jeunes aux prises avec des troubles mentaux. / The objective of this thesis was to evaluate Espace de Transition (ET), an innovative art-based program aimed at fostering the rehabilitation of adolescents and young adults with recently stabilized psychiatric disorders and diminishing the stigmatization experienced by individuals with mental health problems. This program was designed by a team of clinicians from Ste-Justine Hospital’s psychiatry unit, in collaboration with professional artists. It is delivered since the spring of 2009. The evaluation of program ET was conducted in an independent yet collaborative manner, using a naturalistic approach and mixed methods. Data were collected before, during, and after the program from all participants who took part in two distinct sessions (N = 24), as well as from the two artist instructors, the psychoeducator who provided clinical support during the workshops, and the clinicians who referred participants (N=11). Individual and group semi-structured interviews, direct observations, and questionnaires served to collect the necessary data. Quantitative analyses of variance and qualitative thematic analyses were conducted and their results were interpreted in an integrated manner. The first empirical chapter of the thesis reports on the evaluation of the implementation of program ET. This evaluation showed that the program reached participants closely corresponding to its targeted population and that these youths globally presented elevated levels of assiduity, engagement in, and appreciation of the program. This evaluation also allowed to conclude that most essential program components were delivered as intended by designers and were largely appreciated and judged pertinent by participants and other respondents. The second empirical chapter presents an article detailing the evaluation of the effects of the program ET. This evaluation focused on three of its intermediate objectives: the improvement of 1) global functioning, 2) social comfort and competence, and 3) self-perception in program participants suffering from mental disorders. Results of this study revealed significant and positive changes in the global functioning of participants following the program, as assessed by their referring clinicians and partially corroborated by participants themselves. Improvements in social comfort and competence and self-perception were also noted in a substantial proportion of participants, although they did not translate in significant differences detected by group-level quantitative analyses. The third and last empirical chapter of the thesis reports on a study which sought to explore the mechanisms underlying the effects of program ET and to inductively elaborate a theory of action of the program. This qualitative investigation revealed four categories of mechanisms: 1) social experience and gratification, 2) desensitization by gradual exposure, 3) success and valorization, and 4) normalization. This study also allowed to identify program characteristics and components that seemed to favor the onset or impact of these mechanisms, such as the non-clinical setting and conducting of the program, the heterogeneous composition of the groups, the use of performing arts, and the pursuit of a collectively achieved artistic product and its presentation to an external public. Globally, the studies presented in the thesis support the relevance and promising character of program ET, while suggesting potential improvements for future versions. By extension, the thesis supports the potential efficacy of rehabilitation strategies which include components analogous to those of ET in fostering the recovery of youths with mental disorders.

Page generated in 0.1449 seconds