Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2010. / Full text also available online. Scroll down for electronic link.

Thesis (Ph.D.)--Virginia Commonwealth University, 2010. / Prepared for: Dept. of Health Administration. Title from title-page of electronic thesis. Bibliography: leaves 200-217.

Thesis (M.S.)--University of Michigan, 1991.

Thesis (M.S.)--University of Wisconsin--Madison. School of Nursing, 1968. / Typewritten. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 42-43).

Thesis (Ph. D.)--University of Texas at Austin, 2004. / Supervisors: Edmund Emmer and Guy Manaster. Vita. Includes bibliographical references.

Thesis (Ph. D.)--University of Missouri-Columbia, 2000. / Typescript. Vita. Includes bibliographical references (leaves 321-333). Also available on the Internet.

Introduction Patients with intestinal failure (IF) develop problems of malabsorption and malnutrition associated with short bowel syndrome (SBS). Home parenteral nutrition (HPN) became available to treat these patients since the 1970s. There is a paucity of qualitative research on patients’ experiences in the UK. The study aim was to generate theory that explains the experiences of adults living with HPN and complex medication regimens. Method The grounded theory methodology was used to explore the experiences and to generate theory about this health intervention. Twelve participants were interviewed. The interviews were recorded and transcribed verbatim. The joint process of data collection and analysis followed the principles of constant comparative approach. Results The core categories of stoma care and HPN treatment were supported by the subcategories of maintaining stoma output, access to toilets, maintaining HPN infusion routine, access to technical help to set up HPN infusion, and general health changes. Strategy used to manage living with loss was demonstrated by the subcategory of maintaining daily activities and social interactions. Discussion The theory of living with loss suggests that patients with a stoma receiving HPN experience the sense of loss at home and in social situations. Opportunities for professional practice development are detailed along with implications for future research. Conclusions The findings resonate with the Kubler-Ross Model of the five stages of grief (Kubler-Ross, 1970). The theory of living with loss was generated by the use of the grounded theory methodology. This study identified opportunities for changes and improvement in clinical practice.

The research study was aimed at exploring the narratives of motivations and challenges that home-based health care workers experience in their voluntary service provision. It was conducted in East London in Buffalo City Metropolitan Municipality. A total of seven participants who volunteer in home based care programmes were interviewed and their mean age was 30 years; all were females, two married, one a widow, one divorced and two single females. The narrative framework was used to explore the volunteers' interpretation of volunteering experiences, highlighting themes that emerged on what encourages them to volunteer as home based health care workers, and how they deal with challenges that arise during the provision of services. The research was also aimed at exploring the social factors supporting the volunteers' decision to continue volunteering. Narratives from the interviewed community health workers [CHWs] indicate that the motives for participating in CHW programmes are mainly altruistic although people are sometimes motivated by self-interest. Self-interest seems to be particularly relevant in the case of the younger volunteers as they expressed their hope that providing voluntary service may help to enhance their skills so as to facilitate future learning and employment prospects. The recurring themes within the CHWs' narrative indicate that they identify with the helping role and feel it empowers them as they participate in meaningful ways in their communities, and they gain strength to cope with challenges that come with community health work. This study highlighted the complex nature of home based care roles, which inevitably reflect the intervention approach, the mode of working, professional roles and relationships with communities.

À medida que o ser humano envelhece as doenças crônicas tornam-se mais frequentes, o que faz com que os idosos necessitem de mais atenção à saúde. Paralelo a este cenário, a estrutura familiar brasileira vem passando por modificações e, atualmente, fica cada vez mais difícil que o cuidado fornecido ao idoso venha de membros da família. Muitas empresas privadas já contam com a oferta de cuidadores de idosos para atendimento domiciliar, outras poucas estão utilizando um novo formato de assistência à saúde do idoso, com a inclusão de gerontólogos na gestão do cuidado. Objetivo: compreender o significado do gerontólogo bacharel como gestor do cuidado formal domiciliar, através da perspectiva dos gerontólogos e cuidadores formais envolvidos diretamente no cuidado ao idoso. Método: A pesquisa foi qualitativa e teve como referencial metodológico a fenomenologia social. Foram entrevistados 20 participantes, que trabalhavam em empresas de atendimento domiciliar localizadas na cidade de São Paulo, sendo 15 cuidadores formais e cinco gerontólogos. Os depoimentos foram coletados por meio de perguntas norteadoras, gravados e transcritos. Para análise dos dados foi realizada a categorização dos significados a partir da redução fenomenológica. Resultados: a partir dos depoimentos foi possível verificar que os gerontólogos zelam pelo cuidado à saúde do idoso; capacitam e orientam os cuidadores de idosos; dão suporte integral e eficaz aos cuidadores; administram as informações; dão orientação e suporte aos familiares; unem a equipe interprofissional, familiares e cuidadores; gerenciam os conflitos familiares; auxiliam o cuidador no processo de adaptação com o paciente; entre outras categorias. Conclusão: A compreensão dos significados do gerontólogo como gestor do cuidado formal domiciliar mostra que este profissional, com sua formação generalista e interdisciplinar sobre o envelhecimento e a velhice, consegue desenvolver uma visão integral do idoso, compreender e atender suas necessidades biopsicossociais, trabalhar em equipe e atuar ativamente na assistência. Todos os cuidadores entrevistados apresentam uma visão definida e positiva em relação à atuação do gerontólogo. Enfatizaram que a falta de uma gestão gerontológica afeta diretamente na qualidade do cuidado prestado ao idoso / As the human being ages, chronic diseases become more frequent, which makes the elderly need more attention to health. In parallel to this scenario, the Brazilian family structure has been undergoing changes and, at present, it is increasingly difficult for the family members to provide the care needed by the elderly. Many private companies already have the supply of caregivers of elderly people for home care, others are using a new form of health care for the elderly, with the inclusion of gerontologists in the management of care. Objective: to understand the meaning of the bachelor gerontologist as manager of the formal home care, from the perspective of gerontologists and formal caregivers directly involved in care for the elderly. Method: The research is qualitative and had as methodological reference the social phenomenology. Twenty participants were interviewed, who work in home care companies located in the city of São Paulo, 15 formal caregivers and five gerontologists. The testimonies were collected through guiding questions, recorded and transcribed. For the analysis of the data the categorization of the meanings was carried out from the phenomenological reduction. Results: from the testimony it was possible to verify that the gerontologists: care for the health care of the elderly; train and mentor caregivers of the elderly; provide comprehensive and effective support to caregivers; manage the information; give guidance and support to family members; unite interprofessional staff, family members and caregivers; manage family conflicts; assist the caregiver in the process of adaptation with the patient; among other categories. Conclusion: The understanding of the gerontologist\'s meanings as a manager of formal home care shows that this professional, with his general and interdisciplinary training on aging and old age, is able to develop an integral view of the elderly, understand and respond to their biopsychosocial needs, work as a team and act actively in the care. All caregivers interviewed present a definite and positive view regarding the performance of the gerontologist. They emphasized that the lack of gerontological management directly affects the quality of care provided to the elderly

This thesis researches the need for increased social engagement among isolated elderly population receiving home care service in Sweden. The notion of ‘social engagement’ and how to stimulate it is a central point throughout the work. The author finds that the isolation issue is related to political factors, sustainability and Swedish culture and how they interact with the individual. The theoretical framework is comprised of the field of care science and theories regarding isolation and sense of community. Using such empirical research and more in-depth own research such as interviews, the author concludes that social isolation is, in fact, a problem. The answer or suggested solution to this problem takes the shape of a design proposal: Play, Share, Connect, Repeat. Play, Share, Connect, Repeat is a game introduced by home care service that aims to create bonds and stimulate social engagement between care receivers.