The purpose of the study was to describe the personal experience of individuals undergoing cancer treatment in an outpatient clinic by examining their perceived supportive care needs. The theoretical basis of the study lies in Alfred Adler's holistic view of human beings as unique and indivisible (1927/1954). Six individuals recently diagnosed with cancer were recruited from the same regional outpatient cancer clinic located at a major university medical center. A semi-structured interview process with open-ended questions was utilized to understand how people individually and collectively experience cancer and cancer treatment. The 17 factors of the wellness model (Witmer, Sweeney, & Myers, 1998) were used to assess the perceived supportive care needs of the study's participants. Data were analyzed using Interpretative Phenomenological Analysis (Smith, 1998) to ascertain emergent themes and interpret the meanings of the perceptions patients have of their cancer experience. The data resulted in eight major themes being present including facing mortality; uncertainty about the future; understanding cancer diagnosis and treatment; reliance on faith; maintaining control; love and support from family; physical impact of cancer; and importance of self-care. These themes provide insight into the perceived supportive care needs that patients experience during cancer treatment. With the exception of cultural and gender domains, the holistic assessment process identified patients' needs. The factors of wellness appear to capture the experience of individuals during cancer treatment. As an approach to assessing the coping skills of cancer patients, the wellness model seems appropriate for use by clinical mental health counselors. Implications for counselor theory, training, and practice with this unique client population are discussed.

A research report submitted to the Faculty of Commerce, Law and Management, University of the Witwatersrand, in partial fulfilment of the requirement for the degree of Master of Management of Business Executive Coaching Wits Business School Johannesburg February 2017 / Coaching has been growing in popularity, application and understanding (Passmore, 2014), yet enough is not known about how the use of assessments within the coaching process is structured. This exploratory study looked at how coaches choose and how coaches use assessments. The research methodology of this study was qualitative. Semi-structured interviews were undertaken in order to understand the lived experience of the coaches (Ponterotto, 2005) The key findings of the research was that coaches choose assessments based on three sets of criteria; the first being that they are clear about the outcome they want to achieve, they are clear and intentional about their choice. A second criteria of choice includes choosing assessments based on a particular paradigm or approach. The paradigm can be based on theory it may be based on a belief system, a methodology or a philosophy or personal bias. A third criteria was made up of a group who were unintentional about their choice or, in some instances, the choice was being made for them. Although coaches choose along these three criteria, it was clear that they were not choosing dogmatically, but instead there was an eclectic approach to choosing. The way coaches use of assessment was overwhelmingly in a practical way for the benefit of the coachee and for the benefit of the coach. The provision of well-crafted and thoughtful feedback and the guarantee of the coach having the required competence were some of the aspects identified as critical in the use of assessments.The success of the assessment process was dependent upon the skillset of the coach. The amount of care dedicated to feedback of the assessment report confirmed its importance in the assessment and coaching process A further key insight was the complexity of working with assessments in corporate environments, assessments that sometimes boxed people and coaches negative experiences amongst others meant that this surfaced a number of critiques, cautions and conundrums. / MT2017

Significance: This study provides the first systematic needs assessment of a U.S. business region to determine if businesses want international skills taught in community college technical and occupational programs. Without this assessment, community college leaders and faculty are not able to determine whether they are adequately preparing students in these skills to be successful in tomorrow's fast paced, mobile and integrated global workforce. Research Aims: 1. Conduct a needs assessment to determine whether international skills were considered important for employment entry or movement 2. Determine where businesses obtain international skills training. 3. Garner business recommendations for the improvement of international skills education in community college technical and occupational programs. Research Questions: 1. What international skills do surveyed U.S. business and industry executives believe are important for the sub-baccalaureate technical/occupational employees that they hire and promote? 2. How do surveyed U.S. business and industry executives engage their companies' sub-baccalaureate technical/occupational employees in international skills training programs? 3. How do surveyed business and industry executives think U.S. community college technical/occupational degree programs should change with respect to their international skills objectives? Methods: This study utilized a researcher created and empirically validated survey and two focus groups. The survey was sent to 1,920 businesses randomly sampled from Tampa Bay's 64,000 businesses. Response data from 145 returned questionnaires were analyzed and then discussed by business and community college focus groups. Findings: 1. Appreciation of Cross Cultural Differences and Foreign Language Skills were rated significantly (p< [or] = .05) higher higher in importance than other international skills. 2. Businesses utilize in-house trainers more often than any other type of training resource for international training. Community Colleges are rarely used as a training resource for international skills. 3. Community colleges should investigate whether to increase their academic outreach to businesses, mandate foreign language training in programs, and emphasize learning about other world areas in the curriculum. 4. Nation-wide surveys of Fortune 500 firms to determine international business practices and training needs may not translate to regional business communities.

There is a practice gap in the self-management education of patients with chronic low back pain. Insufficient self-management leads to increased frequency of flare-ups of low back pain, disability, loss of productivity, and increased cost of health care. The guiding practice-focused question was focused on the unmet self-management support needs of the chronic low back pain patients in a Midwestern state local pain clinic. The purpose of this descriptive cross-sectional study was to ascertain the unmet needs of patients' self-management support by analyzing the results of a patient study performed by this clinic. The theoretical principles of the model for evidence-based practice change, the chronic care model, and the middle-range theory of self-care of chronic illness were used. The evidence included the analysis of the Patient Assessment of Chronic Illness Care Survey (PACIC) data from 100 patients treated in this pain clinic. The clinic used the PACIC questionnaire to collect data from its 100 chronic low back pain patients, selected by simple random sampling method. The average weighted scores of these patients' responses were below the norm on all PACIC subscales and summary scores. According to study results, this pain clinic did not meet the self-management support needs of its chronic low back pain patients. Evidence-based recommendations were made for the improvement in the medical model of patient care by including nurse-led patient education and support. The positive social change is the improvement in the health status of this growing health population by meeting their identified education and support needs. Positive results from this nurse-led intervention could lead to the dissemination and widespread implementation of these recommendations in other pain clinics.

<p>The general aim of the present thesis is to investigate needs of support and service in clients with long-term mental disabilities living in the community. A further aim is to study changes in these client needs during a 3.5-year follow-up. </p><p>A questionnaire, The Need of Support and Service Questionnaire (NSSQ), was developed to provide staffs in psychiatric care and social services with a brief instrument to assess how their clients live in the community and to identify their needs. </p><p>The results are based on 1,759 clients. The prevalence of clients in urban and rural areas was 6.4/1,000 and 4.5/1,000 inhabitants, respectively. The clients living in the urban setting were more frequently male, older, with a diagnosis of schizophrenia and needed more support in activities of daily living than rural clients. </p><p>Clients identified by staff in psychiatric care only were more often living with a partner, with children living at home and more often had a rehabilitation allowance than clients identified by social services staff. In clients assessed by both organizations similar needs at a group level were identified. However, agreements were lower at the individual level. </p><p>Although clients reported fewer needs than staff in psychiatric care, the reported needs were in the same areas.</p><p>A majority of the clients with unmet needs of service at baseline had their needs met at the 3.5-year follow-up. New unmet needs were also identified at the follow-up, however. The results demonstrate less improvement in clients with schizophrenia as compared with non-schizophrenic clients.</p><p>In conclusion, needs of support and service present a dynamic process and both psychiatric care and social services should critically evaluate assessments of these needs.</p>

Enrollments of international students have increased dramatically in the last several decades. The delivery of health care to these students has become a topic of study for college health care providers and medical researchers across the country. The purpose of this study was to explore how Asian international students cope with illness while in school at Oregon State University. Interviews were held with international students from Japan, Korea, China and selected health care providers from the Oregon State University health center. Information was sought describing health care issues, and perspectives on medical care. The interplay between the student's perspectives and experiences and those of health care providers was explored as they revealed the role of culture in the cross-cultural medical situation. In contrast to other findings I maintain that it is the effects of culture, that is, the envisioning of different realities, in similar situations, that affect both patients and practitioners in the cross-cultural medical encounter. American core cultural values, in conjunction with a biomedical paradigm, formulate a base from which university health care providers interpret their clinical reality. Asian international students bring with them to the medical encounter a different paradigm that, for them, provides a definitive view of illness and health care. It also is grounded in meanings learned from cultural experiences. The anthropological views presented here are powerful and of considerable value in clinical settings because they assist individuals in moving beyond culture-bound realities in order develop a pluralistic perspective that validates the existence of different illness realities in the cross-cultural medical encounter. / Graduation date: 1994

The purpose of this descriptive study was to conduct a state-wide needs assessment of Tennessee 4-H Youth Development Extension Agents to determine the perception in working with 4-H Volunteer Leaders and the knowledge level of volunteer management. This study also determined the need for a formalized 4-H Volunteer Leader management system. Targeted participants were University of Tennessee (UT) Extension Agents and Tennessee State University (TSU) Extension Agents with 4-H job responsibility. Participants were asked to complete a four part questionnaire instrument. Components one through three of the instrument were used to determine the need for a formalized 4-H Volunteer Leader management system, the knowledge level in managing and the perception of working with 4-H Volunteer Leaders. The final component was used to collect demographic information. After completion of a pilot study, 161 Extension Agents were targeted to participate in the study. The questionnaire was administered on web-based data collection system known as Survey Monkey. Results indicated 90% of Extension Agents agreed there is a need for readily available, web-based materials. Results also indicated a need (66% agreeing) for a comprehensive 4-H Volunteer Leader management system. Also, results found high proficiencies, up to 97%, in both knowledge levels of managing 4-H Volunteer Leaders and perceptions of working with 4-H Volunteer Leaders. Demographic information was correlated among measures of knowledge, perception and the need for a formalized 4-H Volunteer Leader management system. Significant correlations were found between risk management of 4-H Volunteer Leaders and Extension tenure, also between Extension tenure and the perception of 4-H Volunteer Leaders being welcome within the school system. Significant correlations were also between recruiting volunteers and outside of Extension volunteer/employee management; between outside of Extension volunteer/employee management and removing 4-H Volunteer Leaders. Implications indicate a need for additional resources to provide training and information for both agents and 4-H Volunteer Leaders. Findings also indicate materials should be web-based for easy access for both agent and 4-H Volunteer Leader use. Data responses show there is a need for a formalized 4-H Volunteer Leader management system that would encompass all aspects from recruitment to retention of 4-H Volunteer Leaders.

The general aim of the present thesis is to investigate needs of support and service in clients with long-term mental disabilities living in the community. A further aim is to study changes in these client needs during a 3.5-year follow-up. A questionnaire, The Need of Support and Service Questionnaire (NSSQ), was developed to provide staffs in psychiatric care and social services with a brief instrument to assess how their clients live in the community and to identify their needs. The results are based on 1,759 clients. The prevalence of clients in urban and rural areas was 6.4/1,000 and 4.5/1,000 inhabitants, respectively. The clients living in the urban setting were more frequently male, older, with a diagnosis of schizophrenia and needed more support in activities of daily living than rural clients. Clients identified by staff in psychiatric care only were more often living with a partner, with children living at home and more often had a rehabilitation allowance than clients identified by social services staff. In clients assessed by both organizations similar needs at a group level were identified. However, agreements were lower at the individual level. Although clients reported fewer needs than staff in psychiatric care, the reported needs were in the same areas. A majority of the clients with unmet needs of service at baseline had their needs met at the 3.5-year follow-up. New unmet needs were also identified at the follow-up, however. The results demonstrate less improvement in clients with schizophrenia as compared with non-schizophrenic clients. In conclusion, needs of support and service present a dynamic process and both psychiatric care and social services should critically evaluate assessments of these needs.

The Training for Health Renewal Program (THRP) is a multi-year CIDA-funded partnership between the Health Science Faculties at the University of Saskatchewan and the Ministry of Health of Mozambique. Participatory Teaching, Learning and Research: Core Facilitator Training was a curriculum offered to participant Trainers in THRP between August 1999 and November 2000, at the University of Saskakatchewan. The participants were seven Mozambican health care workers who have since returned to Mozambique to work as core facilitators of improved community health practice in Massinga, Mozambique. In January, 2001, I traveled to Mozambique to contribute to the overall THRP program evaluation through the completion of a needs assessment. The assessment examined the current practice experience of the Trainers, used that experience to assist the Trainers in identifying professional development needs, and examined the use of the Story-Dialogue method as used in this particular context. The participants were six of the original seven Trainers. Data were collected using one-on-one interviews, the Story-Dialogue method, a focus group debriefing session, and journaling. The current practice experience of the Trainers involved both challenges and successes. Challenges included bridging several gaps related to having studied in Canada in order to practice in Mozambique, working with local communities, working with colleagues and students, and a lack of support. Successes described included those found when working with local communities and working as a team. The Trainers identified a rich breadth of professional development needs. Content needs included learning related to planning, formalizing their practice of critical reflection, recognizing their own assets and limitations, and dealing with organization issues affecting their professional development. As well, the Trainers identified course-specific areas of interest. Methods for achieving development included relationship building, use of distance education and participatory methods, and formalizing access to continuing education. Finally, the Story-Dialogue method was found to be particularly useful in this context. The Trainers found the method fostered both personal and organizational change and was inclusive. Challenges of the method included the risk of disclosure, the need to formalize follow-up, and the potential need to adapt the method depending on the community using it.

The Training for Health Renewal Program (THRP) is a multi-year CIDA-funded partnership between the Health Science Faculties at the University of Saskatchewan and the Ministry of Health of Mozambique. Participatory Teaching, Learning and Research: Core Facilitator Training was a curriculum offered to participant Trainers in THRP between August 1999 and November 2000, at the University of Saskakatchewan. The participants were seven Mozambican health care workers who have since returned to Mozambique to work as core facilitators of improved community health practice in Massinga, Mozambique. In January, 2001, I traveled to Mozambique to contribute to the overall THRP program evaluation through the completion of a needs assessment. The assessment examined the current practice experience of the Trainers, used that experience to assist the Trainers in identifying professional development needs, and examined the use of the Story-Dialogue method as used in this particular context. The participants were six of the original seven Trainers. Data were collected using one-on-one interviews, the Story-Dialogue method, a focus group debriefing session, and journaling. The current practice experience of the Trainers involved both challenges and successes. Challenges included bridging several gaps related to having studied in Canada in order to practice in Mozambique, working with local communities, working with colleagues and students, and a lack of support. Successes described included those found when working with local communities and working as a team. The Trainers identified a rich breadth of professional development needs. Content needs included learning related to planning, formalizing their practice of critical reflection, recognizing their own assets and limitations, and dealing with organization issues affecting their professional development. As well, the Trainers identified course-specific areas of interest. Methods for achieving development included relationship building, use of distance education and participatory methods, and formalizing access to continuing education. Finally, the Story-Dialogue method was found to be particularly useful in this context. The Trainers found the method fostered both personal and organizational change and was inclusive. Challenges of the method included the risk of disclosure, the need to formalize follow-up, and the potential need to adapt the method depending on the community using it.