The UK currently has the highest number of premature births (babies born before 37 weeks gestation age and below 2.5kg) in Europe affecting around 70,000 babies and their caregivers each year. Consequently many interventions have been created to support the development of the preterm newborn and minimise the complications of prematurity. Many of the interventions developed have been predominantly tactile and have almost exclusively focused upon their effect upon the baby and not, for example considered the effect that this type of intervention might have upon the parents; specifically the mother, when they are the ones who perform the therapy. In fact there is a severe lack of systematic studies investigating the latter. Hence, the aim of this thesis was to search for research-based evidence on the benefits of environmental support to both babies (e.g. increased weight gain or awake periods) and their mothers (e.g. higher perceptions of themselves as a mother) during hospital confinement and within the context of Neonatal Health Psychology (NNHP). For this reason, the main hypothesis investigated whether mothers’ cognitions and emotions; specifically Maternal Self-Efficacy, Self-Esteem and Attachment, would be affected by environmental mediators in the form of structured or non-structured tactile sensory nurturing interventions. The empirical work reported in this thesis is divided into 3 distinct phases. Firstly, as their was no appropriate measure of maternal Self-Efficacy for mothers of hospitalised preterm neonates the main aim of Phase-1 was to develop and validate an appropriate measure. Using a prospective survey method and a mixed design (between/within and correlational) a total of 160 mother-preterm dyads (pooled from 2 cohorts; cohort 1, N=100; cohort 2, N=60) were recruited. The results demonstrated that the Perceived Maternal Parenting Self-Efficacy (PMPS-E) tool had good initial psychometric properties (including internal/external reliability and construct validity) for its use with mothers of relatively healthy hospitalised preterm neonates. Secondly, in order to investigate mothers’ perceived maternal parenting self-efficacy beliefs further Phase-2 examined whether the type of feeding a mother chose to give to her baby mediated her self-efficacy beliefs. The results suggested that breastfeeding a preterm neonate during hospital confinement may adversely affect mothers’ perceptions of their efficacy in all aspects of parenting. Finally, using an experimental method Phase-3 tested the main hypothesis of this thesis and used a randomised cluster control trial (RCCT) design to allocate 60 mothers and their preterms equally to one of three cluster groups; consisting of either structured (e.g. TAC-TIC therapy or Using a Toy) or non-structured (Placebo/Control) tactile sensory nurturing interventions. The main findings illustrate that tactile sensory nurturing interventions do mediate maternal cognitions and emotions, preterm weight gain and behavioural state. In particular, mothers who performed TAC-TIC demonstrated significantly higher self-reported perceptions in their self-efficacy, self-esteem and attachment, which was attributed to the fact that these babies spent increased amounts of time in an alert and responsive behavioural state, and gained more weight throughout the study period. Thus, the work presented throughout this thesis has implications for Neonatal Health Psychologists and other Health Care professionals’ practice within neonatal units, the use of Neonatal Health Psychology as a framework to study the preterm neonate and their family, and also the way in which both mothers and their hospitalised preterm neonates are supported during hospital confinement.

published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Education / Doctoral / Doctor of Philosophy

published_or_final_version / Mental Health / Master / Master of Social Sciences

Bakgrund: Omkring 25000 individer i Sverige lever idag med en stomi. Stomin kan ha en påverkan på den sexuella hälsan då den kan orsaka problem vid sexuella aktiviteter. Den kan också hota vuxenrollen på grund av förlusten av att inte kunna konrollera tarmen. Sjuksköterskans uppgift är att ge vägledning, utbildning och information om sjukdomsförloppet och den sexuella hälsan. Att prata om sexualitet inom sjukvården kan dock vara problematiskt då det är ett känsligt ämne för både patient och sjuksköterska. Syfte: Att beskriva individers upplevelser av sexualitet i samband med stomi. Metod: Litteraturöversikten baserades på tio vårdvetenskapliga artiklar som hämtats från databaserna CINAHL Complete, PubMed, Medline, Academic Search Complete och DOAJ. Resultat: I resultatet framkom fem stycken teman. Rädsla och oro vid sex som visar på att många var rädda för att stomin skulle lukta, läcka eller låta vid sexuella aktiviteter. Upplevelser av smärta vid sex som visar att många upplevde smärtor vid samlag på grund av de nervskadebildningar som stomoperationen medförde i underlivet. Partners betydelse för sexualiteten som visar att partnern utgjorde en stor del för återupptagandet av sex. Känslor kring sexualitet som visar att många kände sig osexiga och ville dölja stomipåsen. Stöd från sjukvården som visar på att många sakande information från sjukvården om hur stomin skulle påverka deras sexuella liv. Diskussion: Resultatet diskuterades utifrån begreppet hälsa och med hjälp av andra vetenskapliga artiklar. Områden som berördes i resultatdiskussionen var känslor och informationens betydelse. / Background: Around 25000 individuals are living with an ostomy in Sweden today. An ostomy can affect sexual health and cause difficulties during sexual activities. The status as an adult may also be threatened by the loss of bowel control. The nurse's role is to guide, give instruction and educate about the course of the disease and sexual health. To talk about sexuality can be problematic in healthcare because of the sensitive nature of the subject for both the patient and nurse. Aim: The aim of this study is to describe the individual’s experiences of sexuality in connection with an ostomy.  Method: This literature overview was based on ten scientific articles retrieved from the databases CINAHL Complete, PubMed, Medline, Academic Search Complete. Results: The results are presented in five themes. Fear and anxiety during sex indicates that many were afraid that an ostomy would make noises, leak or smell during sexual activities. Experience of pain during sex indicates that many experienced pain during intercourse because of the nerve damage caused by the creation of an ostomy which caused pain in both male and female sexual reproductive organs. The Partners significance to sexuality indicates that partners constituted a large part of the resumption of sex. Feelings about sexuality indicate that many felt sexually unattractive with a pouch on the stomach and wanted to hide it. Support from the healthcare workers- many were not informed by healthcare workers about how an ostomy would affect their sexual life.   Discussions: The results were discussed from the concept of health and with the support other scientific articles. The areas of greatest influence were the Emotional aspect and The significance of educating of the patient.

The purpose of this study was to test the relationships between and among the concepts of severity of illness, dependency, uncertainty, functional status and the mediators of self-esteem and mastery relative to the outcome of wellbeing. The conceptual framework was adapted from various sources in the literature which support the concept of wellbeing as an important outcome in arthritis. Evidence also supports self-esteem and mastery as mediators of the chronic illness experience. Dependency, uncertainty and functional status have been shown to be predictors of wellbeing but have never been tested as a complete paradigm. The sample for the study was 128 patients with either rheumatoid arthritis or osteoarthritis. Subjects completed 7 questionnaires which measured the 7 variables under study. Descriptive statistics were used to examine the demographic characteristics of the sample. Multiple regression technique was used to empirically test the predicted theoretical concepts and to estimate predictive validity for the theoretical concepts. The results demonstrated that when self-esteem was used in the causal model, 58% of the variance in wellbeing was explained by self-esteem and uncertainty. When mastery was included instead of self-esteem 52% of the variance of wellbeing was explained by mastery and uncertainty. When tested as mediators, both self-esteem and mastery emerged as significant mediators of dependency, uncertainty and functional status relative to wellbeing. These results are of clinical use to nurses who, by virtue of working with these patients on a daily basis, are in a position to intervene with actions which encourage positive self-esteem and maintain mastery over the environment. If these actions are successful, then wellbeing can be maintained for those patients diagnosed with arthritis.

Dual careers and mobility have become a way of life in this society. With moving often comes a loss of job for one of the spouse, usually the wife. This pilot study examined the effects of 'captivity' (the inability of a wife to pursue a career because of a mobile spouse) on self-esteem. Through the use of a demographic questionnaire and the Rosenberg Self-esteem Scale, data was collected and correlations between mobility and self-esteem were derived. Results indicated that the self-esteem of a wife is affected by 'captivity'.

Darbo tikslas – nustatyti paauglių ir jų tėvų savęs vertinimo ir jų požiūrio į auklėjimą šeimoje sąsajas. Tyrime dalyvavo 494 tiriamųjų šeimos – 77 tėvai (15,6%) ir 415 motinų (84,0%), auginančių 9-11 klasės moksleivius – 155 vaikinus (31,4%) ir 339 merginų (68,6%). Tiriamųjų tėvų amžius kinta nuo 32 iki 62 metų. Dauguma paauglių (57,5%) yra 10 klasės gimnazistai. Tyrime savęs vertinimui įvertinti buvo naudota T. Nugent „Savęs vertinimo skalė“ (angl. Self-Esteem Rating Scale – SERS). Tėvų ir paauglių požiūris į auklėjimą buvo vertinamas S.J. Bavolek „Tėvų-paauglių auklėjimo klausimynu“ (angl. Adult-Adolescent Parenting Innventory – AAPI-2A). Taip pat buvo pateikiami papildomi klausimai apie socialinius-demografinius veiksnius: tiriamų tėvų buvo prašoma pažymėti lytį, amžių, šeimos sudėtį, išsilavinimą, užimtumą, vaikų skaičių ir parašyti savo nuomonę, ar pakankamai laiko praleidžia su savo 9-11 klasę lankančiu paaugliu. Paauglių buvo prašoma pažymėti lytį, gimimo eiliškumą, mokyklos tipą, klasę bei pažangumą. Tyrimas atliktas Kauno miesto gimnazijose. Iš 1200 išdalintų šeimoms anketų sugrįžo 511 (42,58%), iš jų 494 (96,67%) tinkamos tyrimui. Savęs vertinimas šiame darbe – tai situacinis visą gyvenimą trunkantis procesas, kurio pagrindas susiformuoja vaikystėje, tačiau svarbus ir senatvėje, kuris priklauso nuo sėkmės ar nesėkmės išgyvenimo, įsisąmoninamas per jausmus ir emocijas, ką išgyvena ir jaučia savo atžvilgiu. Tai savosios vertės, savo svarbumo pažinimas, kuris kelia... [toliau žr. visą tekstą] / The purpose of the study was to measure self-esteem correlations with parenting attitudes of prospective parents and their adolescent in the family. 494 families participates in the study, 415 (84,0%) of them being mothers and 77 (15,6%) fathers, having 9-11 class schoolchildren: 155 (31,4%) boys and 339 (68,6%) girls. Most of adolescents are 10 class schoolchildren. Age of study parents varies from 32 to 62. For evaluation of self-esteem, the study employed T. Nugent Self-Esteem Rating Scale – SERS. Parenting altitudes employed by parents and their adolescents were assessed using S.J. Bavolek Adult-Adolescent Parenting Inventory – AAPI-2A. Additional questions on social-demographic factors were also asked: gender and age of study parents, family composition, education and employment of study parents, how many children are in family; also gender and class of study adolescents, birth order, and school type. On the basis of the results obtained, the following conclusions were made: 1. Higher self-esteem of parents can be related with higher self-esteem of adolescents. 2. Self-esteem of adolescents can be related with their formative parenting attitudes: higher self-esteem can be related with formative higher level of empathy and formative higher values alternatives to corporal punishment. 3. Self-esteem of parents can be related with their parenting attitudes: higher self-esteem can be related with more appropriate family roles and higher values alternatives to corporal... [to full text]

Tyrimo metodika. Tyrimas yra lokalus – momentinis, atliktas 2009 metais Pravieniškių I-uosiuose ir II – uosiuose pataisos namuose. Taikyti du tyrimo metodai – anketinė apklausa ir interviu. Tyrimas vyko tarp pilnamečių kalinių. Anketą (klausimyną) sudarė keturi klausimų/teiginių blokai: I – demografiniai klausimai; II – klausimai/teiginiai apie nuteistųjų asmenų fizinę (sportinę) veiklą ir tam sudarytas sąlygas; III – kalinčiųjų socialinių įgūdžių vertinimas pagal E. Gambrill (1995), IV – nuteistųjų savęs vertinimas. Naudota G. Rosenbergo sudaryta iš dešimties teiginių vertinimo skalė. Skirtumai laikyti statistiškai reikšmingais esant ne didesnei kaip 5 proc. paklaidai (p<0,05). Nuteistųjų apklausai pasirinktas struktūruotas interviu pagal iš anksto turimus klausimus ir numatant klausimų eiliškumą. Anketinėje apklausoje dalyvavo 320 nuteistųjų. Interviu metodu apklausta 17 minėtųjų pataisos namų gyventojų Rezultatai. Pakankami fiziškai aktyvūs nuteistieji sudarė 57,8 proc. visų tyrime dalyvavusių respondentų. Kaip parodė tyrimas, fizinis aktyvumas nuteistųjų tarpe yra statistiškai reikšmingai susijęs su jaunesniu amžiumi. Klausdami nuteistųjų: ,,Ar dalyvaujate sporto varžybose”? nustatėme, kad ir fiziškai pasyvūs kaliniai tokiose varžybose dalyvauja. Tačiau statistiškai reikšmingai jų nėra tiek daug kiek sportuojančių kalinių. Varžybose apskritai nedalyvauja trečdalis sportuojančių ir du trečdaliai nesportuojančių kalinių. Dominuojantis kalinių išsilavinimas sportuojančiųjų... [toliau žr. visą tekstą] / Aim of the study. To evaluate a physical activity as ability to develop for healthy lifestyle and social skills in prisons of Lithuania among the prisoners man. Methods. The research there are topical – instantaneous was done at 2009 in the first and second prisons of Pravieniskes. In the research were used two methods: the questionnaire and interview. Both at one and other of research participated only prisoners (men). The questionnaires consisted of three blocks of questions/propositions: I - demographics questions (age, education, duration of imprisonment, amount of previous convictions); II – questions about physical activity of prisoners. III – evaluation of social skills of prisoners according E.Gambrill (1995). For questioning of prisoners were chose structure interview according beforehand available a questions and predictable a questions succession. At questionnaire poll participated 320 prisoners. In interview were survey 17 already has mention occupant of prisons. Results. An enough physically active prisoners consist 57.8% of all in research to had participated respondents. As shown study, physical active among prisoners are statistics significant relate to more young age. To asked: ,,Do you participate in competition of sport”? to establish fact physically active prisoners participate in such competition. But statistics significant of them is not so much like physically active one. Overall in competition don’t participating third physically active and two third... [to full text]