Doctor of Philosophy / School of Family Studies and Human Services / Karen S. Myers-Bowman / Every year more than 100,000 high school students around the world embark on a journey to study abroad for a few weeks up to a full year (CSEIT, n.d.). Most studies of international exchange programs address the university level, while very few researchers have examined high school study abroad. Of those who have, the focus has been almost exclusively on individual exchange students. For example, researchers have identified that some of the benefits for exchange students include developing a broader global perspective (Gu, Schweisfurth, & Day, 2010), increasing their intercultural competence, maturity, and sensitivity (Shiri, 2015), an increase in their personal development and growth (Geeraert & Demoulin, 2013), and increases in self-confidence (Hadis, 2005). While exchange students are in a unique position of being members of two families, the literature focusing on sending parents is currently nonexistent. The current applied qualitative study focused on investigating and giving voice to 26 sending parents’ living experiences. The participants in this study were in four participating countries – Denmark, Hungary, Norway, and Turkey. Using the lenses of family systems theory, these individual cases generated general patterns and common themes through collaborative, inductive, cross-case analysis. The results suggested that the experience of sending parents offers them some benefits at the micro and the macro levels (for themselves, their families, and for the world community). The analysis also revealed several challenges they faced and the coping strategies they utilized before, during, and after their teenagers studied abroad. This project begins to build a body of knowledge about the sending parents’ experiences, needs and strategies that can help guide the development of evidence-informed best practices as well as open a body of knowledge that can be essential to preparedness and understanding of exchange programs, to family professionals, host families, sending families, international students, our local communities and schools, and to assist them in their collaboration with each other to make these important, life-changing, world-changing experiences even better.

Background: Multiple Sclerosis (MS) is a chronic degenerative condition. It presents with highly varied physical and psychological symptoms and an unpredictable prognosis, causing difficulties for both professionals and patients. A high prevalence of comorbid psychological symptoms are reported in MS research, yet these may be underreported and underdiagnosed clinically in people with MS. Previous research has taken a dualistic approach, focussing on physical and psychological symptoms separately, resulting in a lack of knowledge on how MS is managed holistically. The aim of this research was to explore the experiences of both people with MS and professionals in the management of physical and psychological symptoms throughout the care pathway for people with MS.Methods: A qualitative approach was used. A systematic review was conducted to investigate existing qualitative literature exploring United Kingdom (UK) health care experiences of people with MS. A qualitative study using semi-structured interviews to explore the experiences of receiving or providing care for people with MS (n =24), general practitioners (n = 13), practice nurses (n = 13) and MS specialist nurses (n = 9). People with MS were purposively sampled from primary care and community settings in North West England. Primary care professionals were purposively sampled from across the North West. Specialist Nurses were purposively sampled from four NHS Foundation Trusts across the North of England. Transcripts formed the data and these were analysed using constant comparison analysis. Once themes had been derived from the data, this data was then interrogated using the concepts of candidacy and recursivity as a theoretical framework (Dixon Woods et al., 2006; Rogers, Hassell & Nicolaas, 1999).Results: Five studies meeting the review criteria were identified from the systematic review. The findings showed that previous UK research had focussed on the beginning (diagnosis) and the end (palliative care) of the care pathway for MS, resulting in a paucity of information regarding experiences of care between these points, for both people with MS and professionals. The subsequent qualitative study addressed this and identified central themes for people with MS: experiences of MS, managing self-care, access to services, interactions with health care professionals and continuity of care. For professionals the central themes identified were: the role of primary care for MS, patient-centred care for MS, access for MS care and management of people with MS. Conclusion: This study provides a unique contribution to the literature on the health care experiences of both people with MS and health care professionals responsible for their care. It has addressed the gaps in knowledge regarding the ongoing health care experiences of people with MS and the holistic management of psychological and physical symptoms. This study showed that candidacy is an appropriate theoretical framework to explain help-seeking and access to health care for MS: use of health services is based on both patient and professionals' interpretation of symptoms, perceptions of services and previous experiences. To improve identification of candidacy there is a need for greater education for patients and professionals on symptoms of MS and information on availability of local services.

AN ABSTRACT OF THE DISSERTATION OF GREGORY STEINSDOERFER, for the Doctor of Philosophy degree in PSYCHOLOGY, presented on December, 12, 2014, at Southern Illinois University Carbondale. TITLE: BURNED OUT FROM HEALING THE BROKEN HEARTED: THE EXPERIENCES OF CARDIAC NURSES MAJOR PROFESSOR: Kathleen Chwalisz, Ph.D. It has been well documented that prevalence of cardiovascular disease has become a major global healthcare problem. In the United States, healthcare expenditures have dramatically increased as more and more people are requiring cardiovascular treatment. Treatment outcomes (e.g., mortality rates, readmission rates) for cardiovascular disease related illnesses can vary drastically from one hospital to another. Researchers have recently attempted to understand why these drastic differences in performance exist from hospital to hospital. It has been suggested, that one important avenue for improving cardiovascular care is to improve hospital staff performance. Of all hospital staff, nurses spend the most time working directly with cardiac patients and their families. Nurses also frequently report high levels of occupational stress, burnout, and turnover rates. This study was a qualitative investigation of the lived work experiences of cardiac nurses. Qualitative research methodology was utilized as it provided the best opportunity to understand the individual experiences of nurses working with cardiac patients. In-person, semi-structured individual interviews were conducted with seven cardiac nurses. Through the analysis process, seven major categories and 24 sub-level categories emerged. More specifically, grounded theory methodology (Strauss & Corbin, 1998) was used to analyze the interview data. Participants described their experience working with cardiac patients as complex and multidimensional. The core theme of this study, revolved around the concept of cardiac nurses serving as bridges for their patients. Participants described feeling stuck in the middle between having a strong desire to help their patients improve their health, but also working with a high percentage of unmotivated patients who were not accepting of this help. This study also identified the unique stressors of working in a cardiac environment, and the resources that were utilized to help decrease or prevent symptoms of burnout.

Made available in DSpace on 2015-07-22T20:49:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-02-27 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Associação Fundo de Incentivo à Psicofarmacologia (AFIP) / Objetivo: Analisar entre usuários diários de cannabis, os sinais e sintomas da Síndrome de Dependência de Substância, tendo como referência os critérios diagnósticos do DSM-IV. Métodos: Foi utilizado o referencial qualitativo de pesquisa. A amostra intencional, de usuários diários de maconha da omunidade, foi composta por “bola de neve”. Foram realizadas entrevistas semi-estruturadas, individuais e anônimas, com base nos critérios do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-IV). As entrevistas foram gravadas, para posterior transcrição e análise de conteúdo categorial. Resultados: Participaram deste estudo 24 pessoas (15 homens), com idades entre 18 a 49 anos. Apenas um entrevistado relatou compulsão para o uso. Os demais mencionaram planejamento do uso em suas rotinas diárias,sem identificar redução de atividades consideradas importantes. Prejuízo de memória foi citada por 17 entrevistados.Não foi relatada tolerância para a sensação de relaxamento, principal motivação para a continuidade do uso. Sintomas nos períodos de abstinência (irritação, insîonia e redução do apetite) se aproximaram mais de sentimentos de frustração e/ou dos conceitos de efeito rebote ou off-set. Apesar de apenas quatro terem preenchido diagnóstico de dependência, 16 se consideravam dependentes. Conclusões: Os critérios diagnósticos do DSM-IV podem não identificar usuários diários de cannabis como dependentes, ainda que eles se considerem. As especificidades em relação à tolerância e controle/compulsão parecem diminuir a probabilidade de preenchimento de critérios diagnósticos. / Aim: To study the DSM-IV criteria for substance dependence among daily cannabis users. Methods: A qualitative method and an intentional sample of daily cannabis users in the community were adopted in this investigation, which was conducted in Sao Paulo, Brazil. In-depth, semi-structured interviews based on the DSM-IV criteria for substance dependence were held individually. The interviews were recorded and transcribed for posterior content analyses. Results: 24 people (15 men) aged 18-49 years participated in this study. Only one participant reported compulsive use, while the others planned cannabis use through their daily routine without reducing the frequency in which engaged in important activities. Impairments on the short-term memory were reported by 17 participants. There was no report of tolerance towards the sensation of relaxation, which was claimed to be the main motivation for continued use. Symptoms during the abstinence periods (irritation, insomnia and appetite reduction) were more likely to be some frustration feeling for not being able to smoke marijuana and/or rebound or off-set effects. Despite the fact only four participants were diagnosed dependent (DSM-IV), 16 considered themselves dependent. Conclusions: The DSM-IV diagnoses criteria might not identify cannabis daily users as dependents, despite the fat that they considered themselves dependents. The specificities regarding tolerance and control/compulsion seem to reduce the probability of establishing diagnoses of dependence. / FAPESP: 06/58658-8 / FAPESP: 07/50783-0 / TEDE / BV UNIFESP: Teses e dissertações

This study explores the impact of an overnight camp experience for impoverished South African youth. I worked as a Youth Development Worker with the Ukulapha Community Outreach Project for six months in 2016. My research looks at one non-formal education (NFE) program in KwaZulu-Natal, South Africa through the lenses of critical theory and critical pedagogy. Emancipatory learning, social justice, and empowerment were the particular themes that framed my research. I used a qualitative design including an autoethnographic element to conduct my research. The study included six in-person semi-structured interviews with camp participants, one year after the conclusion of the camp. Additionally, four students provided participant journals where they wrote about their experience at the camp. I wove into the study my own participation, observations, journaling, and a blog. Findings show that the camp provided diverse skills development for personal empowerment, a new possibility to learn with and through nature, leadership development, and important intergenerational learning. Issues of gender were also highly prevalent, however. The five recommendations for future research that come from the study include the need for a more in depth follow up study with the same and more participants, involvement of a South African researcher who can conduct interviews in isi-Zulu, a longer camp, and outreach to different aged youth and youth from other South African provinces. / Graduate

Previous research has focused on measuring awareness in dementia with few attempts to define or clarify this concept, nor explore its meaning to the individual. The present study is preceded by a review of the concepts of insight and awareness, and the different approaches to understanding these drawn from the psychological, neurological and psychiatric literatures. The strengths and limitations of the different and models are discussed and the case for further research in this area is presented. This is followed by a research study that explores the experiences of seven people in the early to moderate stages of dementia. Interpretative phenomenological analysis illuminates some of the psychological factors that contribute to awareness and how these factors impact upon selfconcept. It is suggested that clinicians and services need to pay greater attention to the phenomenological experiences of individuals with dementia. Four superordinate themes emerged which were labelled 1. Relationship with memory 2. Relationship with professionals 3. Emotional experience of memory loss 4. Coping and maximising resources. Each category compares and contrasts individual experiences and suggests that insight may be a complex concept that would be better understood by taking into account the psychological processes that contribute to individual awareness, and their subsequent impact on self-concept. The research paper is followed by a critical review that outlines the strengths and weaknesses of this study, as well as the process issues that arose during the course of the research and the clinical implications.

Master of Science / Family Studies and Human Services / Joyce Baptist / This qualitative study explored 65 rural adolescents' perceptions of health issues and needs. Focus groups were conducted with adolescents in six rural communities in Kansas. Analysis of transcripts suggested that the adolescents’ face numerous health issues that strongly influence their behaviors and expressed need for assistance. Adolescent health issues stemmed across biological, psychological, and social factors. Major themes evolved around challenges pertaining to healthy choices in food and nutrition, physical activity, stress management, sexual health, perceptions of invincibility, and poor role-modeling. To improve well-being adolescents need privacy, effective conversations, accessible health services, reliable education, and prioritization of healthy lifestyles. Implications for clinical and research are discussed.

abstract: This study is an in-depth examination of thirty-one commercial marijuana growers in four states in the United States. Presently, federal law prohibits marijuana production, but twenty-five states and the District of Columbia allow some provision for marijuana production. Despite massive federal campaigns against marijuana growth, the growers themselves have received comparatively little attention. This study investigates three questions: 1) to what extent do commercial marijuana growers meet life-course criminology’s expectations of offenders; 2) how do growers learn the requisite norms, knowledge, and skills to be successful; and 3) to what extent do growers comply with state laws, and why? The results find little-support for life-course variables. While social learning theory is supported, the results also indicate that independent learning through trial and error and learning through various media are relevant to knowledge and skill acquisition. Respondents adopted a variety of strategies regarding state laws, with partial-compliance in order to minimize risk being the most common. Implications for both theory and policy are discussed. / Dissertation/Thesis / Doctoral Dissertation Criminology and Criminal Justice 2016

Purpose: A diagnosis of cancer can be disabling in many ways. Most notably, cancer treatments are toxic and harmful to the body and threaten a person’s ability to care for themselves. In addition, cancer and its treatments can affect many dimensions of quality of life, including peoples’ abilities to engage in meaningful occupations. However, there are many gaps in the literature surrounding rehabilitation and the ways in which the psychosocial effects of cancer may be addressed by individuals. Empowerment is a concept used to articulate processes of rehabilitation that involves addressing both functional concerns as well as quality of life issues. Yet, empowerment remains a phenomenon not well understood. It is most often defined as a process and outcome of regaining a sense of control and autonomy that is lost due to an illness, but much of the empowerment literature in the context of cancer is written from the perspective of the health care provider. This perspective fails to recognize the processes through which survivors address functional and quality of life concerns leaving a gap in theory and evidence based practice in cancer rehabilitation. The purpose of this dissertation was to develop a grounded theory of empowerment to illuminate its associated processes from the perspective of cancer survivors to answer the following questions: 1) In what ways do cancer survivors define, describe and/or experience the processes of empowerment?; 2) How do cancer survivors describe the emergence of empowerment within various contexts and relationships related to their illness; 3) What are the connections and relationships between processes of empowerment and the commonly held assumptions about this phenomenon? Methods: Data collection consisted of 22 semi-structured interviews with cancer survivors (cancer of the head or neck and/or breast). Interviews explored participants’ illness experiences and views of empowerment. I used the social constructivist grounded theory method to analyze and map the processes of empowerment. Summary of Results: Empowerment reflects multiple complex processes. Broadly, empowerment occurred in two dynamic and paradoxical ways. First, empowerment was associated with establishing control over the treatment, management and impact of the illness on participants’ daily lives as a means to circumvent a sense of self that was eroding and changing. Secondly, empowerment was described as processes associated with relinquishing control over aspects of the illness deemed irrepressible and incorporating those aspects into a new identity. Conclusion: These two processes illustrate the paradox embedded within experiences of empowerment. The first process is comparable to current evidence-based practice in cancer rehabilitation that has a dominant focus on symptom control to reduce the impact of the illness on daily life. Gaps are more significant in relation to the empowerment processes associated with relinquishing control. These processes enabled survivors to acknowledge and accept the impact of illness as another way to address functional and quality of life concerns. Thus, my findings suggest that there is a need to design a variety of interventions that help cancer survivors live with and adapt to the effects of illness into daily living.

Made available in DSpace on 2014-10-09T12:29:49Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:00:04Z (GMT). No. of bitstreams: 1 01354.pdf: 3623322 bytes, checksum: c718d54b73549c12892db727707c35bb (MD5) / Tese (Doutoramento) / IEA/T / University of Illinois Urbana - Champaign, Illinois