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published_or_final_version / Architecture / Master / Master of Architecture

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

The present study aims to explore the experiences of caregivers working with children living with HIV/AIDS in the context of a children's home. While there has been research conducted on family members as well as community based caregivers of people living with HIV/AIDS, there has been a paucity of research on caregivers of children living with HIV/AIDS in Children's homes. There is a strong need to address this area of deficit in order to identify and tackle areas of difficulty as well as rewarding aspects to enhance the caregiving experience This pilot study adopted the interpretive research paradigm, is qualitative in nature and utilized in depth interviews as a means of data collection. Four women working as caregivers at the children's home were interviewed and the data obtained was analysed using thematic content analysis. The present study highlights the positive as well as the negative aspects of caregiving from the perspective of the caregivers. While caregivers identify the difficulties that they face as a result of caregiving, they also acknowledge the rewards that they attain from their line of work. Furthermore the present study emphasises the coping strategies employed by the caregivers on a personal and an organisational level as well as the resources that aid coping and the constraints against utilising the coping resources. In addition issues of attachment and detachment associated with caring for children, that are particularly pertinent to these non -familial caregivers have been explored. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2005.

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This dissertation looks at old age homes in British Columbia between 1920 and 1960. It describes and explains how changes in institutional care for aging men and women intersected with professional ideals, welfare state economics and political imperatives. It also considers how broader developments altered the physical and cultural world of the institution and the strategies employed by the elderly. / Facilities for the elderly changed significantly during the period. In 1920 provision of residential care for older British Columbians was extremely limited, and existing institutions operated under a poorhouse model, providing only custodial care. By 1960 a sizeable network of provincially regulated facilities had developed. Medical professionals urged that these establishments be medical facilities and that the elderly receive compassionate, therapeutic care. / However, circumstances inside these facilities limited change. While some institutions were run along medical lines, new policy initiatives were modified by strong historical links with older systems of custodial care and punitive poorhouse ethics.

The aim of the present study was to investigate all long-term institutions in the county of Västerbotten, Northern Sweden, to give a detailed description of the institutionalized population with respect to motor functions, vision, hearing, speech, ADL-functions, prevalence of psychiatric symptoms and behavioral disturbances, staff work load, use of psychoactive drugs and prevalence of dementia. Another aim was to select some specific 'problem areas' in the nursing care of demented patients for further descriptive and interventional studies. For this reason, morning care procedure (hygiene, dressing), meal behavior (eating, communication), nutrition, constipation and relocation between institutions were selected. The results of the study have been reported in six papers summarized below: I.The study has shown that the proportion of demented patients is increasing in longterm institutions in Sweden. Furthermore, demented patients were shown to be more impaired in all rated functioning abilities and exhibited more psychiatric symptoms and behavioral symptoms. A high proportion of the demented probands were also prescribed psychoactive drugs, i.e. neuroleptics. II. Five patients with Alzheimer-type dementia were monitored during morning care. A 12-step classification system was developed to be used as a guide to understand and determine abilities essential for performance of morning care for demented patients. The quantitative assessment showed that none of the patients were able to manage morning care independently, but there was a wide variation in their highest level of performance. III. Five patients with Alzheimer-type dementia were observed (video taped) during their meals in a changed meal milieu and with new meal routines. When the patients ate without staff participation, the two least demented patients became 'caregivers'. When two mental nurses joined the group, first in civil clothes and then in white uniforms, the patients dropped their roles as helpers. The patients were able to compose complete meals in 0-79 per cent of the meals. The conversation during the meals could be characterized as incomplete, with short sentences and a lot of breaks. Sixty-three per cent of all utterances were about food and eating and almost all conversation concerned the present time. IV. Thirty-three psychogeriatric patients, with severe constipation were given a high- bran bread instead of their accustomed laxatives. During the high-bran treatment period, the number of bowel evacuations and the volume of faeces increased. The total laxative consumption decreased by 93 per cent. V. Nutritional status and dietary intake were studied in a sample of severely demented, institutionalized patients. Energy and /or protein malnutrition was found in 50 per cent of the patients. The mean energy intake was 2059 kcal. Malnourished patients had had four times as many infectious periods during their hospital stay as patients without malnutrition. Thirty-nine of 44 patients lost weight during their hospital stay. VI. Thirty-three psychogeriatric patients were followed for 36 weeks after relocation from a mental hospital to two newly built nursing homes. An intensive pre-relocation program was performed. No negative effects of the relocation were found. On the contrary, the relocated group improved their ADL-functions after the transfer. Based upon the above cited studies, a model for nursing care of demented patients is presented. / <p>S. 1-45: sammanfattning, s. 46-192: 6 uppsatser</p> / digitalisering@umu

The purpose of this Heideggerian phenomenological study was to understand the meaning of the lived experience of seclusion in a psychiatric hospital. Five people with a long standing mental illness who had spent time in a locked seclusion room in a psychiatric hospital were asked to describe their experience in seclusion.Consistent with the method, purposive sampling was used in order to obtain an understanding from those who had lived the experience of seclusion and could articulate their experience. Interviews were audiotaped and the data were transcribed by the researcher. Audiotapes were destroyed when the study was completed. Transcribed data were shared with other researchers who were familiar with Heideggerian phenomenology and hermeneutics for the purpose ofgaining insight into the interpretations. When data were shared, names of participants and other identifying information were removed. Sharing of data for purpose of interpretation is inherent in the Heideggerian method as described by Diekelmann, Allen, and Tanner (1989). Data were analyzed using Diekelmann, Allen, and Tanner's (1989) seven stages. The following patterns emerged constituted pattern- Seclusion, A Paradox Being Powerless yet Hopeful with the supporting themes of 1.) Being Punished, 2) Being Abandoned, and 3) An Opportunity for Reflection and Self Growth. / School of Nursing

The purpose of the study was to validate the use of the Geriatric Functional Rating Scale (GFRS) in assessing cognitively impaired individuals 65 years of age and older to determine the need for institutionalization. The population of interest consisted of individuals 65 years of age and older exhibiting cognitive impairment and residing in Delaware County, Indiana. A nonrandomized two-group experimental design was utilized for the study. Eighty subjects were selected from two subpopulations consisting of 40 institutionalized and 40 noninstitutionalized elderly.Two geriatric assessment tools were used for the study, the Mental Status Questionnaire (MSQ) and the Geriatric Functional Rating Scale (GFRS). The hypothesis for the study stated that the mean GFRS score of the noninstitutionalized subjects, the control group, would be significantly greater than the mean score of the institutionalized subjects, the experimental group.The MSQ scores as well as the means and standard deviations for the seven subscales of the GFRS were reported for the two groups. A one-tailed t-test was used to test the hypothesis. A decision with regard to the hypothesis was made at the .05 level.Findings of the study included the following:1. The subjects ranged in age from 65 to 92 years, were 90 percent female, and predominantly Protestant, 88 percent.2. The MSQ scores for the combined groups ranged from minimal cognitive impairment, 71 percent, to severe cognitive impairment, four percent.3. The total mean score on the GFRS for the institutionalized group was 6.8 indicating a need for institutionalization.4. The total score on the GFRS of the noninstitutionalized was over 10 times higher at 70.7.5. The noninstitutionalized group scored significantly higher in the GFRS (p<.00) than the institutionalized counterparts.In conclusion, the research supports the use of the Geriatric Functional Rating Scale in assessing the need for institutionalization in cognitively impaired individuals, 65 years of age and older in Delaware County, Indiana. / Department of Educational Administration and Supervision

This thesis is a study of the experiences of young people living together in groups. It uses two children's homes in the north east of Scotland as its research sites. The ways in which data were collected were devised in consultation with the young people involved and required the researcher to 'live-in' th units for a year long period. This thesis concentrates on the ways in which the young people structured their resident groups and gained status and position within them. It argues that fixed roles or positions were not in play; rather there was constant change and fluidity. Young people, it is argued, gained position through a complex set of negotiations which required them to consider their skills and abilities as well as the social context in which they were operating. This inter-relationship supports some of the ideas put forward by Pierre Bourdieu and the conceptual analysis developed during the course of this thesis draws upon his work. The thesis as a whole contributes to the debates both within the study and practice of residential child care and broader sociological debates around children and young people. It illustrates the wide range of skills and knowledge used by the young people thus challenging bully/victim stereotypes and beliefs about the solely 'negative' influence of peers. Furthermore this thesis demonstrates the ways in which young people use their social agency to negotiate around 'adult' influences and controls.