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Psychological adjustment to chronic pain has been recently explored within three separate frameworks: a behaviour-focused account of chronic pain acceptance within the broader remit of Acceptance and Commitment Therapy; an emotion-focused approach with various research programs investigating the role of anger, fear, depression and also shame and positive emotions in chronic pain; and a cognitionfocused perspective more recently reframed in terms of illness perceptions as part of a wider model of response to health threats, the Self-Regulatory Model. Although these frameworks have broad areas of overlap, limited research has been directed at integrating acceptance, emotions and illness perceptions into a common, comprehensive account of psychological adjustment to chronic pain. Such an account would be beneficial both for providing a parsimonious approach that would guide further research and for developing pain management interventions that would take advantage of existing research from all three domains. The aim of the present thesis was to explore the possibility of integrating these separate areas by studying the relationships between the main concepts (acceptance, emotions, and illness perceptions) in the context of chronic pain. Based on a review of the relevant conceptual and methodological issues of each domain, a theoretical analysis of the similarities and differences between them was developed, with particular emphasis on the potential of existing models to support an integrative account. This analysis provided specific hypotheses regarding each domain and the interrelationships between them, which were investigated in a longitudinal study on a heterogeneous sample of 265 chronic pain patients using the services of the NHS Lothian Pain Clinic and several patient support organisations. Data were collected via postal and online questionnaires at 3 time points, at 41/2-month intervals (21% attrition rate). Validated questionnaires were used to measure the relevant constructs, with additional questions obtaining information regarding health status, medical history and demographics. The confirmatory analysis (employing a variety of statistical procedures, from correlation to multiple regression, factor analysis, cluster analysis and structural equation modeling) largely confirmed the expected relations within and between domains and was also informative regarding the most suitable data reduction methods. A detailed psychometric analysis of the questionnaires used offered a complementary view on the theoretical and methodological issues involved. An additional exploratory analysis focused on identifying the comparative characteristics of acceptance, emotions, and illness perceptions in predicting health status indicators, controlling for contextual factors such as medical history and demographics. Although no significant longitudinal changes were identified in most parameters (confirming the clinical observation of chronic pain as a stable condition), the longitudinal data allowed an analysis of the stability of the concepts and of the magnitude of their relationships in this patient sample. The analysis of intra- and interpersonal variation via hierarchical longitudinal modeling confirmed the stability of the data, highlighted the necessity of studying variation at both levels, and revealed interesting moderation effects, explained via the proposed concept of ‘discrimination ability’ and several alternative mechanisms. These results can be considered as first steps towards an integrative model of psychological adjustment to chronic pain. It is proposed that the behavioural, cognitive and emotional aspects need further conceptual clarification and these future efforts can be supported by the Cognitive-Affective Model of the Interruptive Function of Pain, within the wider framework of the Self-Regulatory Model.

It is expected that tourism industry is one of the fields that can boost female employment and therefore, can help redress the balance and empower women in Iran. Equal opportunities in employment assist them for empowerment. Being a tour guide is one of these opportunities, although most jobs are created elsewhere, e.g. hotels and restaurants. But for this thesis, tour guides are important from two aspects: first, it is a challenging condition that you find out what you are capable of and second; it is not an extension of traditional domestic roles, and it is a new role for women in a male-dominated job market.This study aims to investigate how female tour guides perceive their roles in the tourism industry and the elements of these perceptions among their family, colleagues, and tourists who could serve empowering or disempowering.

A relevant subject in our globalized world concerns the relationship between language and identity, specifically amongst migrant youngsters’ experience of group belonging. This study therefore focused on how adolescents born to foreign parents in Sweden, perceived their multilingualism as part of their identity formation. I also aimed to include how socio-economic aspects could affect the process of identity construction. Thus, the investigation was performed with seventh grade students at a primary school located in the Stockholm suburb Bredäng. The methods consisted of a questionnaire, which was completed by the entire class and a group interview where six students participated. The results revealed that students adapted their language use based on the context, but Swedish was used most habitually. The informants viewed their multilingualism as beneficial but yet fully aware of the linguistic ideologies functioning in society. By combining their minority and majority language, the students were left with different ethnic identities and had diverse interpretations of what it meant to be Swedish. Even though all of them perceived themselves to have multiple ethnic identities, this was not solely seen positively. The issue of belonging was raised and the students claimed to be outcasts everywhere. However, the results differed depending on whether the students were born in Sweden or not. Also, most of them struggled with the process of assumed and ascribed identities, since they perceived themselves to be Swedish but experienced that society valued them as immigrants. Lastly, the study revealed that there were connections between their multilingualism and social mobility as the relationship towards the motherland was highly prioritized even with low levels of economic capital.

Most health care providers lack the education or clinical training to adequately recognize delirium. and are distressed when caring for patients with delirium (Akechi et al., 2010; Brajtman, Higuchi, & McPherson, 2006; Griffiths, Knight, Harwood, & Gladman, 2014; McCrow, Sullivan, & Beattie, 2014). Early recognition of delirium can improve patient safety and decrease the use of hospital resources (National Institute for Health and Care Excellence, 2014). Although delirium knowledge and recognition are increased after implementation of education and the use of screening tools, more could be done to improve patient outcomes and increase sustainability of knowledge learned (Yanamadala et al., 2013; Soja et al., 2008; van den Boogaard et al., 2009; Pun et al., 2005). The purpose of this DNP project was to explore the perceptions, attitudes and behaviors of ICU nurses in a community hospital when caring for patients with delirium. Findings indicated that most nurses felt delirium is an underdiagnosed problem. Almost all agreed or strongly agreed that assessing ICU patients for delirium is a worthwhile intervention. Interestingly, 38.5% disagreed and 30.7% were neutral that delirium is largely preventative. Despite 69.2% of the participants agreeing that they felt heard by the provider when they suspect the patient is delirious, 76.9% are neutral that they are satisfied with the applied treatment. Despite agreeing that delirium is underdiagnosed, there is lack of knowledge regarding prevention and treatment of delirium. In this ICU, it would be beneficial to tailor the education prior to implementing any delirium screening tools. Results show that education should include: the types of delirium, delirium prevention strategies, RASS scales, importance of daily sedation vacations, and treatment. Education should be provided to both the nurses and the providers. In addition to this, "buy in" should be obtained from the providers to ensure that they will use data gathered from screening tools. Prior to implementing any screening tool, examples of screening tools should be provided to the staff, as well as a bedside demonstration to show ease of use. An additional study should be done to assess the sustainability after tailoring education based on perceptions, attitudes, and behaviors.

The purpose of the present study was to examine 1) the effect of achievement information on evaluations of males and females, 2) male and female expectations of discrepancies between their opposite sex and themselves in evaluating achievement.

The problem of this study was to compare concepts of the actual and ideal roles of school superintendents as they are perceived by superintendents and by classroom teacher presidents.

The purpose of this research design is to explore the meaning of death for the female adolescent. A qualitative design was used as the method of research. Twelve participants were selected from a snowball sample ten females and two males. Four participants reported witnessing the death of an individual, five reported a moderated death experience in which they were not present but were told after the fact and three reported no significant experience with death. The study indicated relationships and cause of death as among the pre-conditions towards meaning development for the adolescent female. The two main themes derived from the pre-conditions are an understanding of the inevitability of death for themselves and the experience of death as qualia. Consequences to the experience of death include increased emotional tolerance under stress and a perceived increased maturity suggesting resilience in the adolescent female following a loss. Future areas of research are also addressed.

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

This study investigates the perceptions surrounding the role Virginia elementary school principals play in supporting the induction of new teachers. Attention is given to the type of the principal’s support, the frequency of support, and the perceived importance assigned that support. Because the Virginia Department of Education has encouraged the use of one of three specific models of induction (the ETS Pathwise model, Fairfax Virginia’s Great Beginnings model, or the New Teacher Center “Santa Cruz” model) or a locally, research-based model, additional attention is placed on the impact training and experience in one of these models has and the degree to which varying levels of that training influences those perceptions. In this non-experimental, comparative study, a census of new teachers and principals throughout the Commonwealth of Virginia was conducted, using an adaptation of an instrument developed by Gurule-Gonzales (1995). Follow-up telephone interviews were conducted to confirm findings from the survey. Results indicate there are statistically significant differences in some principal and new teacher perceptions of the Virginia elementary principals’ role in supporting programs of induction. These are found more often in the perceptions regarding frequency than regarding importance. Statistically significant differences were found among principals’ perceptions of certain categories of support when considering the amount of training and the type of induction program utilized. While statistically significant differences in teachers’ perceptions could not be determined because of the small n, there appear to be practical differences based upon the type of induction program and the amount of new teacher program training. There are a number of implications resulting from this study. New teachers need to be integrated into the life of the school, and programs of induction should be certain to include the careful pairing of mentors with new teachers. Frequent observation and feedback by the principal are necessary to support new teachers. Principals must maintain a frequent presence throughout the work with the new teachers and must be more transparent regarding support efforts. The type of program and the amount of training provided principals and new teachers alike are also critical aspects of induction.