This study explored community-based Palliative Care nurses’ experiences of their work. The aim of this study was to explore the positive aspects of working in palliative care, as well as the challenges that community-based nurses experience in their work. The coping strategies that are employed by these nurses to deal with the difficulties of their work were understood, and the participants provided recommendations to their organisations to improve their working experiences. The research was conducted in two research settings, St Luke’s Combined Hospices and Tygerberg Hospice, which are both non-profit organisations providing Palliative Care in the community. Permission was gained to conduct research by the St Luke’s Combined Hospices Research Ethics Committee, and the Palliative Care Manager at Tygerberg Hospice. A qualitative research design was used to conduct this study, and purposive sampling was used to select the sample. Fourteen nurses were interviewed using a semi-structured interview schedule, and a digital recorder was used so that interviews could be recorded accurately. Qualitative data analysis was used to arrange the data into themes, categories and subcategories. Findings from the study indicate that there is a great sense of satisfaction from working in Palliative Care and positive aspects include feelings of honour and privilege, making a difference, appreciation from patients and families, life lessons learnt, having a role in the community and working in a team. The perceived challenges were emotional challenges such as persistent rumination about work, feelings of helplessness and dealing with challenging families. Organisational challenges pertained to demanding workloads and a lack of organisational support. Personal challenges were seen as having a negative impact on the physical health and family lives of participants. Lastly, environmental challenges included issues around safety and driving to communities. Coping strategies were the support from family and friends, avoidance coping and self-care as well as group support and debriefing and support from colleagues. Lastly, recommendations include an open-door policy within the organisation, improved training and education, a better understanding of community Palliative Care, improved interaction with staff and staff reward and recognition.

Includes abstract. / Includes bibliographical references (leaves 64-69). / This study explored Cotlands Hospice staff's perceptions of challenges and stressors which they experience in the workplace, in caring for HIV infants. This aim of this study was to highlight some of the key struggles that healthcare workers are faced with in the HIV workplace in caring for HIV positive infants. The study also explored the participants' current coping strategies used to cope with stressors from within the workplace and supportive resources available to aid the participants were identified. Lastly unmet needs identified by participants were explored and discussed.

Includes bibliographical references (leaves 70-75). / The research investigated the perceptions of the challenges faced by grandmothers caring for AIDS orphans in Khayelitsha, a township on the outskirts of Cape Town. The aim of this study was to make a contribution to an understanding of the challenges faced by grandmothers who are performing a surrogate parent role. The research focused on the grandmothers? perceptions of the types of challenges they faced in caring for AIDS orphans as well as their perceptions of the causes of these challenges. Lastly the research aimed to investigate the strategies employed by the grandmothers in dealing with these challenges and to ascertain whether or not grandmothers are aware of existing resources that are available to assist them with their challenges.

Includes abstract. / Includes bibliographical references (leaves 82-86). / In this study the researcher aims to explore the child right violations and psychosocial risks experienced by children orphaned primarily as a result of HIV/AIDS in Lesotho. Lesotho ranks in at number three in the world of countries most ravaged by the HIV/AIDS pandemic. Of its 2.2million citizens, 17% are orphans, and half of them have been orphaned as a result of HIV/AIDS (United Nations Program on HIV/AIDS, 2004) (UNAIDS). According to the Non-Governmental Coalition on the Rights of the child, (2000), the number of orphans in Lesotho continues to increase on daily basis resulting in the country being under enormous strain and these vulnerable children at increased risk. The research design used in this study is the qualitative research design and research was conducted using face to face in depth interviews. A semi structured interview schedule was constructed and the researcher also used a tape recorder. Purposive sampling technique was used to obtain a sample size of 12 adolescent orphans at a High School in Maseru Lesotho. Data analysis is done according to Tesche’s steps of interview analysis, in which the main themes and categories are drawn from the interviews and discussed. The main findings were that most of the orphans who participated in the study had a poor quality of life but maintained a positive outlook in terms of the future. Most of the orphans were living in child headed households that had no electricity. There was no evidence of physical abuse amongst the respondents. In terms of psycho social risks, most orphans did not suffer from depression or severe anxiety. A small percentage of orphans did experience suicidal ideation in response to the death of their parents and their current circumstances. The main conclusions were that orphans in Lesotho are experiencing child right violations especially poor quality of life and that orphans in this study did not experience severe psycho social risks. From these findings, it is recommended that there is a need for more non-profit organizations that address the child right violations and psycho social risks experienced by orphans in Lesotho as well as a need for awareness campaigns on the plight of orphans to be generated. It is also recommended that the Lesotho government continue to fund the education costs of orphans as well as offer transportation to school.

The impulse to develop an effective method of intervention for conduct disorder arose through practice experience. As a social worker based in a special school for children with severe emotional and behavioural problems between 1986 and 1995, I had responsibility for working with the child in the famiIy context. My clinical impression was that behavioural gains in the school setting were not transferred to the home setting, where parents of conduct-problem children reported that they continued to find the child’s behaviour unmanageable. This was confirmed by Fitzgerald, Butler, and Kinsella (1990) who found that parents having a child who was placed in a special school reported with frustration that they were not taught how to manage their child in the home setting. I shared their frustration, because it was evident that these children were usually manageable in the school setting. Generic social work training and post-qualifying training in family therapy did not however, provide the means to intervene effectively with the child’s behaviour in the home setting. I hope that this research will encourage the introduction of behavioural social work practice in Ireland, and that by doing so, it will broaden the practice options which are currently available to social workers. I also hope that the introduction of behavioural methods will lead, not to further paradigm wars, but to the necessary respect for diversity which emerges when social work is considered in a European context: The diversity of social work approaches which, despite all efforts at international harmonisation has not been levelled to one standard norm, might turn out to be one of the professions greatest assets in facing up to the diversity of the newly emerging welfare scenario (Lorenz, 1994, p. 181).

This thesis is a record of research exploring the limitations to successful policy implementation. Using Community Care as the illustrative example, it asks what these limitations might be, casting a particular light on the part played by care managers, the front-line policy implementers responsible for "needs assessments" which is a key activity in the implementation of Community Care. There is a tension in care management between the influence of procedures and the degree of discretion necessary for needs assessment to be completed effectively. In what ways, then, are policy intentions affected by the activities of care managers? Community Care is an illustration of a public policy imposed by central government through a top-down process of implementation in what is argued as a rationalist endeavour to simplify the complexities of community care and reduce it to questions of technique and structure. This attempt to present a unified conceptualisation of community care is backed by managerial procedures referred to in the public management and policy literature as "managerialism". Social work practice theory provides a third example of the rationalist attempt to simplify processes involving complex social interactions. The limitations to rationalist explanations of community care implementation and the necessity for a different kind of analysis are explored. There is a parallel with the research methodologies employed for this research. The initial interviews were helpful in revealing the degree to which policy implementation was being thwarted by care managers, but this resistance was mirrored in their rejection of my interpretation of their practice. The common thread running through the normative approach to policy implementation, management, social work practice and research methodology is an adherence to positivist forms of knowledge. The implementation of Community Care raises questions of epistemology and ontology that undermine these powerful forms of knowledge. The claim is that a different epistemology suggests practices more likely to lead to effective outcomes. An organisational orientation to effectiveness is revealed in the degree to which outcome has become wedded to techniques of scientific rationalism. A service orientation would define outcome by the degree to which the needs of vulnerable adults were met through reflection upon key relationships. The first of these is an exercise in objectivity which is not well equipped to take account of the subjective experiences of practitioners exploring needs in relationship with vulnerable adults. The service orientation suggests an experiential and participative epistemology in which people engage in the process of learning and understanding most successfully when it is collaborative rather than imposed. The second phase of fieldwork was an experiment using a method built upon a participatory epistemology and gives the reader a glimpse of what might be possible in direct contrast to rationalist approaches. Work with two co-operative inquiry groups has led me to new understandings about the nature of learning for individuals and organisations. The thesis concludes that an effective learning environment facilitating positive and reflective use of discretion can be created through co-operative inquiry, although any approach would need to include other important participants, notably managers and service users, if it is to maximise its effectiveness in the long term.

This study began in 1989 and is about leaving care and youth homelessness among young women. Little was known about young women leaving care, the early transitions of finding and maintaining independent housing, becoming a parent and managing an independent income. The research was exploratory and conducted in two parts. The first part was an 18 month longitudinal study of a cohort of female care leavers in two local authority areas, following their progress from the age of 17 until almost 19. The outcome of the first part was a typology of care leavers. The second part of the PhD consisted of a test of the typology on a larger sample by surveying a group of professionals through a mailed questionnaire. There were differences in the way the sample managed the transition to adulthood. Those who coped with the transition to adulthood more successfully, moved into independence later and in a planned way. They had good personal skills and resilience which was not adversely affected by the framework of existing social policies. Those who struggled with the transition to adulthood experienced homelessness, debts and problems in caring for their children. They had fewer personal skills, less stable support and were affected by existing social policies. Broadly, the typology was confirmed by the questionnaire sample. The study makes recommendations which affect social policies in housing, social security and employment and training and suggests ways in which the typology may assist social work practice in working with young women in care and leaving care.

No description available.

This thesis was conducted in order to explore the views and perception of social workers from Gävleborg on animal-assisted interventions. This study examines the attitudes of social workers towards the phenomenon of animal-assisted interventions and the importance of the animal-human bond. During the investigation process semi-structured e-mail interviews and one face-to-face interview were used as a method to collect empirical data. The results showed that social workers have a positive attitude towards animal-assisted interventions, as well as whether social workers have any knowledge regarding animal-assisted interventions. The final conclusion of this thesis presents the social workers’ desire to gain more knowledge and training on animal-assisted interventions within the social work practice in Gävleborg.

This study explores the levels of beliefs about practice and practice behaviors with lesbian and gay clients among social work practitioners in a medical setting. The Gay Affirmative Practice scale was utilized to measure the levels of gay affirmative practice beliefs and practice behaviors among the sample surveyed. The relationship of practice beliefs and practice behaviors is explored and reveals that practice beliefs are significant to practice behaviors with lesbian and gay individuals. The results identify variables that contribute to practice beliefs and practice behaviors.