Magister Scientiae (Physiotherapy) - MSc(Physio) / Palliative care is a vague and often confusing term used to describe a type of treatment model for chronic and life-threatening illnesses. WHO describes palliative care as an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness by: early identification, impeccable assessment, and treatment of pain, physical, psychosocial and spiritual. The aim of this study is to explore the perceptions of physiotherapists on palliative care in order to contribute to the understanding of the role of physiotherapists to the care of stroke patient in Zambia. The objectives of this study are to explore physiotherapists’ knowledge on palliative care, their perceptions on management of palliative care as well as explore its application in the rehabilitation of stroke patients; and lastly to make recommendations on guidelines based on the outcomes of this study. Method: an exploratory study, using qualitative design was used. Data collection techniques were in-depth individual interviews and FGDs that consisted of purposively sampling of physiotherapists working; at four selected hospitals and a rehabilitation centre in Lusaka. Audio recording from the interviews was transcribed verbatim for each session by an independent person. The study employed thematic content analysis for data analysis. The data was classified systematically by means of coding to identify key factors or issues such as concepts, categories, themes and the relationship between them. Results indicated that all participants in the current study perceived palliative care as a medical care for the chronic and terminal ill patient in whom stroke patient and family will benefit if it is applied in the early stages of the disease trajectory; as well as it does improve the patient and family quality of life. Furthermore they emphasized on multidisciplinary team and holistic approaches in order to achieve all its tenets. Conclusion: the study had succeeded in exploring the physiotherapists’ perceptions on palliative care and contributed to the understanding of the role of physiotherapy to the care of stroke patients in general.

A Rehabilitation centre for children with cerebral palsy is the proposed project undertaken in this dissertation. This theme was chosen after the author had been involved with New Hope School in fundraising projects for the past 3 years. The author recognized the need of a dedicated rehabilitation facility for children with cerebral palsy as well as better accommodation for rehabilitation purposes. Spending time with cerebral palsied children, the need for basic education becomes evident. Over protectiveness from parents could prevent these children from sensory experiences, which can only be evolved through touching, smelling, seeing hearing and tasting. This early childhood experience of sensory development usually involves play. Play is the ultimate form of exploration for any child and when disabled, free play is usually non-associative with everyday activities. Without free play, children will have a handicap in natural development of social, mental, physical and sensory skills. Through harmless play, even a lion cub learns to become a hunter. The aim of this project would be to create a center where play would be used to rehabilitate children with cerebral palsy. New Hope School is situated in the Menlopark area, Pretoria. The proposed site for the rehabilitation centre would be consolidated to the north western corner of the existing school grounds and thus engaging this project as an addition to the existing New Hope School. The architecture used, should be of simplistic nature which merges the interiors of the building with nature. By achieving this, the children would get a basic form of sensory development while rehabilitating in the building. Copyright / Dissertation (MArch(Prof))--University of Pretoria, 2010. / Architecture / unrestricted

Because of the importance of medical and psychiatric information in diagnosis, there is a tendency to neglect or under-emphasize socio-economic information. This is partly an Issue of recording; but it may have vital bearing on rehabilitation, and perhaps on treatment, in the broadest sense of the term, related to prognosis and rehabilitation plans. This study undertakes an exploration of this area, for a sample group of male patients receiving residential treatment in an arthritis treatment centre (Canadian Arthritis and Rheumatism Society, Vancouver) from 1952-1955. The socio-economic factors examined were in three groups, (a) age (b) family and marital factors (c) employment and occupational status. The material used was obtained from medical and social service records of the agency. Statistical data were taken from admission forms and social service face sheets. Social service records provided the material concerning the attitudes and adjustments of the patients. Two broad categories of treatment goal used by the agency in planning treatment, (1) employ-ability, and (2) improved self-care were followed in the present study in assessing the patients’ adjustment following treatment. Judged from these results the team estimate of the rehabilitation potential of the patients was 72% accurate in spite of the many unknowns in the handling of rheumatoid arthritis. The duration of the illness before treatment, and the length of treatment, appeared less important in relation to degree of improvement than might have been expected. Chronological age is clearly important: there was marked difference in the response of the patients under 50 years of age, compared with the response of the older patients, whether the treatment goal was "employability” or "improved self-care”. The patient's general attitude toward employment seemed more influential than the type of work he was accustomed to do. The men whose inter-personal relationships were adjudged within normal range were best able to adjust to the trauma of illness, and to make best use of the rehabilitation service. The concept of team treatment is again demonstrated by this kind of study. The Social Worker as a member of the treatment team is shown to have responsibility in three areas: (a) direct treatment of the patients (b) inter-professional planning for the patients, and (c) the use of community resources. The study leads to some recommendations for the improvement of community and agency services, and suggests that study of social and economic needs of older men demands attention. / Arts, Faculty of / Social Work, School of / Graduate

The Canadian Arthritis and Rheumatism Society, British Columbia Division has envisaged research as an important and integral part of its objectives and in February 1951 embarked upon an intensive study of the usefulness of cortisone in long-term medical treatment of the rheumatic diseases, including a series on Rheumatoid Arthritis. A comprehensive program of medical treatment has been put into effect, including the services of social workers. It is essentially a team approach to the aim of physical rehabilitation and a return to gainful employment. The present study is directed to the evaluation of the case work treatment offered to those patients selected to participate in the Rheumatic Diseases Project, Rheumatoid Arthritis Series on Cortisone Therapy. Within a predominantly medical setting the function of the case worker has been considered from the viewpoint of what is expected of her by the medical profession and what might be expected from her as a professional social worker. Two methods of assessment were employed both based on evaluation of each case according to selected case work criteria and the premise that effectiveness of treatment depends upon the appropriate use of skills in relation to the degree of treatability of the patient. The first approach made use of the available case records as far as possible. The second was the device of a Rating Scale devised for the purpose and completed by a group of social workers for each patient worked with. The goals aimed at by the Medical Committee responsible for the project were stated as "physical rehabilitation and a return to gainful employment". Medically the cortisone therapy was successful in effecting enough physical improvement for a patient to become potentially employable. Socially results were discouraging because emotional difficulties and the non-availability of suitable positions prevented the actual return of many patients to gainful employment. The Long-standing personality problems, characterizing this group of patients, precluded the use of intensive case work techniques in roughly 75% of the cases. The evidence is that face-to-face interviewing involving the skilled use of relationship is not appropriate and that supportive technigues designed to prevent further deterioration, alone are relevant for the majority. Sound social diagnostic evaluations with the use of appropriate treatment methods are essential. It is suggested the reality of the team approach should he made available, and that more use should be made of social work skills in the selective screening of applicants for rehabilitation, and that the contributions of social work in the total team plan merits deeper exploration. / Arts, Faculty of / Social Work, School of / Graduate

Team members in medical rehabilitation centres are focusing more attention on devising new means for the establishment of a more precise evaluation of the patient's total functioning. The evaluation of the patient's social functioning is critical to team planning and treatment. It is also critical for the assessment of the success of the rehabilitation program. This experimental study was carried out under the joint auspices of the Vancouver branch of the Canadian Arthritis and Rheumatism Society and the School of Social Work at the University of British Columbia, in order to devise specific criteria for the assessment of the patient's social functioning. This in turn, would enable a more accurate assessment of the patient's total functioning. The study is limited to a small group of married female patients who received residential treatment at the Vancouver C.A.R.S. medical centre during the period between January 1962-May 1964. Role theory was used as the main frame of reference for this study and social functioning was equated to the sum total of roles performed. A three-point rating scale and scoring was created to represent the assessed performance of each role. An experimental approximation represented by a percentage figure was obtained of the subjects' social functioning levels at four specific points in time. Three sets of ratings were collected from (a) data found In the C.A.R.S. social service recordings, (b) data obtained from the subjects and (c) data collected by the writer from the subjects. The findings point out that although the research model demonstrated changes in levels of social functioning, these results were not conclusively established. The results were at best tentative, since the C.A.R.S. social service records could not meet the demands of the research instrument and the study involved only a small number of subjects. However, there was strong Indication that application of role theory to social functioning assessment formulations does provide a meaningful and systematic method for evaluating the patient's total functioning. In future sequential research, it has been recommended that social service records be utilized which employ role theory as the basis for social assessment formulations. Further, it has been suggested that one way to overcome the crudeness of the present research model, is to expand this study's three-point rating scale to a five-point rating scale, which would then reflect more accurately the patient’s social functioning. / Arts, Faculty of / Social Work, School of / Graduate

In this thesis it is proposed that the rehabilitation of existing buildings for family homes can make a substantial contribution toward reestablishing the central area of the city as an attractive place for a variety of people to live. A literature review summarizes the factors which influence inner city liveability, and those that influence the decision to rehabilitate or demolish a building. It is argued that the city needs a concentrated and varied residential population living in the inner city if the core is to retain its vitality, and that familiar structures provide a sense of place and continuity. Evidence suggests that housing supply shapes the inner city population, both of which have diminished in overall numbers. The exodus of families from the central city has been stimulated and encouraged, while equivalent support has not been available . for those who wish to remain. There is also evidence of a changing attitude, city support for inner city family housing and increasing numbers of families who want to live there. In an outline of requirements for the family environment, ways are suggested that can render the inner city a safe and stimulating place for children to learn the skills of an urban citizen. Three sets of goals are presented: those derived from statements regarding the aspirations for a livable and vital central city; those derived from the socially accepted basic needs; for family housing; and those derived from preferences beyond basic housing needs as expressed by people in Vancouver and Toronto. Rehabilitation is defined as the process that restores something to its former level of usefulness. Building rehabilitation is defined in relation to the physical properties and life cycles of the building components. Second, it is defined as an action that diminishes obsolescence, a process judged by various views of the buildings relative usefulness. A third definition describes the mutually supportive nature of housing rehabilitation and heritage conservation. The second part of the thesis presents a survey of 20 percent of the inner city area of Vancouver. A random sample included 54 small neighbourhood plots where data was taken covering 1556 building lots with 780 pre-1945 and 572 post-1945 buildings. Amongst the older buildings 64 percent were still the original houses, accounting for 37 percent of all buildings in the sample area. By contrast 46 percent of the newer buildings were commercial and only 4 percent were houses. Half the older buildings had been built by 1913, and 80 percent by 1921 when zoning was introduced in Vancouver. Only one third of the buildings' sites were zoned exclusively for residential use. Most of the sample were in fair or better condition, and half were unchanged from their original form. There were good indications that most of the 54 plots were suitable locations for family homes. In the third part of the thesis the sample plots, and 771 of the inventoried buildings, were evaluated to assess their relative suitability for rehabilitation. Three sets of criteria were established related to the three sets of goals from the first part of the study. Appropriate indicator variables were selected from the inventory and scaled according to their influence on the decision to rehabilitate or demolish. A simple additive weighting procedure was used, with separate weights assigned for each criterion set, derived from expert opinion. The results of the evaluation were normally distributed, showing a satisfactory differentiation among the sample. The findings suggested that rehabilitation was most promising in the Mt. Pleasant and Strathcona sample plots. The indication was that rezoning would considerably improve rehabilitation prospects for the older buildings. Gentrification appeared to be likely in the most favorable areas. Also the best chance for an advantageous linkage is where heritage buildings are found in good family neighbourhoods. The findings indicated that different rehabilitation programs would be needed for the various areas of the city. Suggestions are given regarding these programs, as well as recommendations for political, educational, and design activities to support efforts toward the rehabilitation of selected older buildings and heritage neighbourhoods. / Applied Science, Faculty of / Architecture and Landscape Architecture (SALA), School of / Graduate

M.A. (Clinical Psychology) / Please refer to full text to view abstract

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Domestic violence is a national concern that affects women of all ages and ethnicities, as well as women with disabilities. Although there is literature focusing on attitudes about domestic violence toward women, the literature review provided no studies that investigated attitudes about domestic violence toward women in relation to domestic violence knowledge, counselor competency, and counselor comfort level. Statistics reveal the increasing number of women who are in abusive relationships and the mental and health effects of domestic violence abuse. This study explored Rehabilitation Counseling master's students' attitudes and beliefs about domestic violence toward women. The participants were 113 Rehabilitation Counseling master's students enrolled in Rehabilitation Counseling master's programs in 30 universities in different geographical regions of the United States. The study consisted of a demographic questionnaire and five research instruments: the Attitudes Toward Women Scale, the Domestic Violence Blame Scale, the Perceived Counselor Comfort Scale, the Domestic Violence Knowledge Test, and the Marlowe-Crowne Social Desirability Scale. The results of the three hierarchical regression analyses are provided. First, there was significance based on domestic violence knowledge and race/ethnicity, and domestic violence and age: (a) Participants who identified as African American scored lower in domestic violence knowledge, and (b) participants in the age group 25 to 30 years scored lower in domestic violence knowledge. Second, there was no significant relationship between the criterion variables and perceived comfort. Third, there was a significant relationship between the criterion variables (domestic violence training and previous history of domestic violence) and competency level. Participants who indicated having training in domestic violence had a higher the level of competency than participants who indicated having no training in domestic violence. Participants who indicated having a previous history of domestic violence had a higher level of competency than participants who indicated not having a previous history of domestic violence. Implications for counselors, educators, and future research are discussed.

Traumatic brain injury (TBI) is a significant public health issue due to the incidence, complexity, and cost associated with treatment – emphasizing the need for effective rehabilitation programs. One mode of rehabilitation that has been demonstrated to improve health and reduce healthcare costs is health promotion programs (HPPs) that incorporate physical activity (PA). However, PA is not currently incorporated into the standard of care post-TBI. The purpose of this study was to conduct group interviews among individuals with a TBI undergoing outpatient rehabilitation to determine PA knowledge, attitudes, intentions, and barriers. Results will be used to develop a HPP that focuses on facilitating PA participation as part of the rehabilitation process. Seventeen participants completed a series of group interviews (2-3 people/group) regarding their PA needs. A qualitative research design was adopted and trustworthiness was established through triangulation of data (i.e., theoretical underpinning; multiple researchers and data-coders). A cross-case analysis was completed to identify themes and conceptual patterns. The main themes identified were (1) an inability to differentiate between PA and physical therapy, (2) a limited knowledge of PA health benefits and the relationship to rehabilitation, and (3) an interest in participating in a PA HPP as part of their rehabilitation. HPPs for outpatients with a TBI should educate individuals about PA, the associated health benefits, and the role PA plays in the rehabilitation process. A well designed HPP may increase the likelihood that individuals adopt and maintain PA as part of the rehabilitation process, thus reducing the risk of morbidity and mortality.