The health care setting and available health resources impact the health seeking behavior of people. The transnational migrants from Bangladesh find the health care system of the U.S. fundamentally different from that of their place of origin. This study aims to explore the health seeking behavior of Bangladeshi transnational migrants living in Atlanta, USA. Through analyzing data obtained from interviews, participant observation, and autoethnography, this research explains how their transnational status impacts their perception of health and health seeking behavior.

The general objectives of the study were to evaluate a social work support group programme with informal caregivers that aimed to enhance the quality of care provided to older persons in an urban and rural community setting in Namibia. In order to achieve the general objectives of the study, the following specific objectives were formulated: * To explore how informal caregiving situations in urban and rural communities lead to elder abuse and neglect. * To describe existing literature on the various factors that contribute to elder abuse and neglect within community settings. * To develop a support group programme for informal caregivers of older persons in urban and rural community settings that aimed at preventing elder abuse and neglect. * To implement and evaluate the effectiveness of the support group programme for informal caregivers that aimed at preventing elder abuse and neglect. The thesis consists of 5 sections: Section A consists of the problem statement, research objectives, central theoretical argument and the theoretical approaches that underpin the study. Furthermore, the research methodology, the definition of key concepts and the limitation of the study are presented. Section B contains four articles that together formed part of the research outcomes. Each article can function independently with it’s own objectives and distinctive content. However, each article is also a sub-project of the umbrella research study. Therefore, some of the data have to be repeated in different sections. The four articles are: Article 1: Informal caregiving, elder abuse and neglect in urban and rural areas of the Khomas region in Namibia: A needs assessment A needs assessment on informal caregiving situations and how it may lead to elder abuse and neglect of older persons from an urban and rural constituency in the Khomas region was explored. Data was collected through in-depth interviews with professional and community leaders. In addition, focus group discussions were held with older persons and informal caregivers in the urban and rural constituency. Article 2: Factors contributing to elder abuse and neglect in community settings In this article, a comprehensive review of the literature pertaining to the risk and protective factors to elder abuse and neglect was done. The ecological theory was worthwhile to describe the risk factors to elder abuse and neglect. Article 3: Designing a social work support group programme with informal caregivers of older people in Namibia A social work support group programme was developed for informal caregivers of older persons in community settings. The eight-week support group programme was developed based on a needs assessment and a comprehensive literature review, and included the following topics; the normal processes of aging, handling of difficult caregiving situations, caregiver stress, self-care of the caregiver, elder abuse and neglect and caregiver grief and loss. The planning model for group work was also utilised to design the group. Article 4: Evaluation of the effectiveness of a support group programme with informal caregivers to prevent elder abuse and neglect An eight-week support group programme with ten female informal caregivers from an urban group and twelve informal caregivers from a rural group setting was implemented and evaluated. Standardized measuring instruments that assessed the outcome of the group at pre-test, post-test and postponed post-test were the Zarit Burden Interview (ZBI), Potentially Harmful Behaviour (PHB) scale and the Caregiver Abuse Screen (CASE). The Group Engagement Measure (GEM) assessed the group processes at the fourth, sixth and eight group sessions. In addition, open-ended questions were used to collect qualitative data. The quantitative and qualitative evaluations indicated that both the urban and rural groups gained knowledge on aging and caregiving, and caregivers acquired vital qualities such as patience, compassion and communication skills. The process evaluation showed that caregivers from the urban group were more engaged in the group process than the rural group. Elder abuse was underreported in the study, while personal stress of caregivers reduced significantly because of the intervention. Section C consists of the summary of the most important findings and conclusions to the research study. In addition recommendations are provided. Section D consists of the annexures to the research report, such as the measuring instruments and interview schedules used for data collection. Section E contains a consolidated list of references. / PhD (Social Work), North-West University, Potchefstroom Campus, 2014

According to research applying a social constructionist perspective, the sense of self is not lost in people with Alzheimer’s disease (AD). It is, however, greatly influenced by the symptoms and by how they are treated by other people. Without support, it is difficult to preserve a positive sense of self, when living with progressing cognitive impairments. The stigma associated with cognitive impairment also threatens their sense of self. Harré’s social constructionist theories of self and positioning have been used to study how people with AD express their sense of self. As there is a need to expand the previous research by involving additional participants and research contexts, the aim of the present thesis was to describe, in accordance with Harré’s theories of self and positioning, how people with AD expressed their sense of self in personal interviews and in support groups with other people with AD. The research consists of four substudies (I–IV), and has a qualitative, descriptive, and theory-testing approach. Thirteen people with mild and moderate AD were included, 11 of whom had the early onset form of the disease. Two support groups were formed, led by facilitators who supported the communication and the participants’ expressions of self. Each group met 10 times during an eight-month period. Topics were not predetermined, and introduced by both facilitators and participants. Semistructured interviews were conducted before the groups started and after they ended. The interviews and support group conversations were audio-recoded and analysed with qualitative content analysis, guided by Harré’s theories. In substudy I, the initial interviews were deductively analysed. The findings showed that Self 1 (the sense of being a singular, embodied person) was expressed by the participants without difficulties. Self 2 (the perception of one’s personal attributes and life history) was expressed as feeling mainly the same person. While some abilities had been lost, other had been developed. Self 3 (the socially constructed self) was described as mostly supported, but sometimes threatened in interactions with other people (I). In substudy II, support group conversations were analysed abductively with respect to expressions of Self 2. It was found that participants expressed Self 2 in terms of agency and communion, and a lack of agency and communion (II).In substudy III, a secondary analysis of the data from substudy II was performed inductively with the aim of describing how Self 3 was constructed in the interaction of the support group. Five first-order positions, generating lively interaction, were described: the project manager, the storyteller, the moral agent, the person burdened with AD, and the coping person (III). In substudy IV, all the collected data were reanalysed inductively, focusing on how participants expressed the experience of being research participants. Three themes were constructed: contributing to an important cause, gaining from participating, and experiencing risks and drawbacks (IV). In conclusion, it was found that participants constructed positive social selves through the support from each other, the facilitator, and researchers in the support group (III), and as research participants (IV). Agency and communion were central to Self 2, and decreased with the progression of AD (II). In spite of change, participants perceived themselves as basically the same people, with a potential to learn and develop as persons (I).

The purpose of this study was to describe and analyze how Homecourt, a nondirective support group at a public high school in the Dallas/Fort Worth area, operates and how it affects students.

O presente estudo tem por finalidade apreender a construção dos sentidos que são produzidos e negociados no processo de um grupo de apoio a familiares de pessoas diagnosticadas com Anorexia Nervosa e Bulimia Nervosa atendidos em contexto ambulatorial. Mais especificamente, objetiva delinear os sentidos construídos pelos familiares sobre a sua participação no grupo. Acreditamos que o grupo de apoio oferece um contexto fecundo para investigar (e desconstruir) a maneira como as idéias e os valores são constituídos pela tradição da comunidade discursiva e que adquirem uma aparência de ?realidade? para as pessoas que pertencem àquela comunidade. Espera-se que, além de permitir a sistematização de conhecimento na área, os dados oriundos do presente estudo possam trazer benefícios para os usuários desse e de outros serviços com características semelhantes. Nosso objeto de estudo, o grupo de apoio psicológico aos familiares, da maneira como se configura hoje tem cerca de cinco anos de funcionamento. Desde o início é um grupo de ?portas abertas?, isto é, aberto aos parentes e acompanhantes dos pacientes atendidos. Não tem número definido de vagas e todos os familiares dos pacientes atualmente atendidos estão convidados a participar dos encontros. A freqüência é semanal, com uma hora de duração. Foram audio-gravadas e transcritas 10 sessões consecutivas do grupo, no qual 37 familiares estiveram presentes. Após a leitura exaustiva das sessões foram realçadas as falas dos participantes relacionadas à temática da participação grupal. Percebendo-se a pregnância dessa temática e a riqueza na presença de múltiplos sentidos para a participação grupal nas 3 primeiras sessões consecutivas gravadas, optou-se pelo seu recorte para a análise, sendo que a primeira sessão foi analisada em toda sua extensão e as outras 2 sessões foram recortadas em seus trechos mais significativos. A análise dessas sessões foi empreendida dentro do referencial téorico do construcionismo social e utilizando-se do recurso metodológico de delimitações temático-seqüenciais. Os diferentes momentos da sessão delimitados tematicamente foram: os diferentes sentidos para o estar no grupo; a construção da diferença no grupo; o reconhecimento das semelhanças e desigualdades entre os participantes; a construção dos diferentes lugares no grupo; a compreensão dos sentidos para o espaço grupal; a construção da possibilidade de continuarem juntos; as indicações para a participação grupal e a possibilidade de um novo sentido para a diferença. Ao negociarem esses sentidos, os participantes constroem a si-mesmos, a doença e o grupo. Os julgamentos construídos no grupo podem ser tomados como verdades, cristalizando determinadas maneiras descrições e valores, que podem promover movimentos de segregação e afastamento no grupo. Todavia, esses sentidos podem ser revisitados e reconfigurados, em uma constante teia que enlaça novos significados a cada nova interação (CAPES). / The aim of this study is the comprehension of the meanings produced and negotiated in the process of a familiar support group of people that has been diagnosed with anorexia nervosa and bulimia nervosa taken care in an ambulatory context. More specifically, this study aims to delineate the meanings that these familiars give about their participation at the group. We believe that the support group offers a valorous context for the investigation (deconstruction) of the ways that the discursive traditional communities construct its ideas and values and how those ideas gain the status of reality for the people in those communities. We hope that the results of this study can help the users of this and others services with similar characteristics. Our study object, the familiar support group, in its actual configuration, has five years of functioning. Since its beginning the group is open to the familiars and companions of the people taken care of at the service. It does not have a definitive number of participants that can be in, and all the families are invited to participate. We taped and transcript 10 sessions of this group. 37 participants were present in those sessions. After the exhaustive reading of this material, we enlighten the participant\'s sayings that were referred to the familiar participation. Once we realized the presence of this thematic in the first tree sessions, those were chosen to constitute the corpus of our analysis. The analysis was based in the social constructionist perspective and in the use of the methodological and theoretical recourse of analysis called sequential and thematic delimitations. The different moments of these session delimited by these themes were: the different meanings for the group participation; the construction of the difference in the group; the recognition of the similarities and differences between the participants; the different places taken in the group; the comprehension for the different group\'s meanings; the construction of the possibilities for being together; the indications for the group\'s participation; and the possibilities for the appearance of a new meaning for the difference. When negotiating these meanings, the participants construct themselves, the disease and the group. The judges that emerge at the group can be taken as true, being crystallized and promoting segregation movements in the group. However, these meanings can be revisited and be reconfigured in a constant art of enlacing new meanings as new relation and interaction begins (CAPES).

O trabalho tem como proposta entrar em contato com o câncer infantil e suas conseqüências do ponto de vista da própria criança com câncer, investigando o que significa para ela estar doente e buscando conhecer o sentido de sua vivência neste momento particular de sua vida. O trabalho fundamenta-se no método de pesquisa qualitativa de inspiração fenomenológica em Psicologia. Partindo de uma questão orientadora - Como é para a criança com câncer conviver com sua doença e seu tratamento? - a fonte de investigação utilizada foram as vivências de crianças com câncer no grupo de apoio psicológico, atividade que faz parte da rotina do Serviço de Psicologia do GACC-Grupo de Apoio à Criança com Câncer. O grupo reuniu-se semanalmente durante 01 hora, em local e horário fixos, no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto-USP. Foram utilizados materiais gráfico e lúdicos. As crianças participantes, em média 05 em cada sessão, tinham diferentes diagnósticos de câncer e encontravam-se em diferentes fases de seus tratamentos. Suas idades variaram de 03 a 16 anos. A construção dos resultados compreendeu duas etapas. Na primeira etapa, foram analisadas 30 sessões do grupo de apoio psicológico realizadas no período de abril a dezembro de 1999. Nesta etapa, o objetivo do grupo era propiciar e facilitar a livre expressão de preocupações, dúvidas e sentimentos das crianças participantes, além de proporcionar um momento no qual pudessem compartilhar suas experiências. Desta primeira etapa emergiram três dimensões de análise: os temas das sessões, o próprio grupo enquanto intervenção psicoterapêutica e a gestação da idéia de elaborar o livro das crianças. Na segunda etapa, foram analisadas 15 sessões do grupo de apoio psicológico, realizadas no período de janeiro a junho de 2000. Nesta etapa, o objetivo do grupo era a criação do livro das criança, material informativo sobre o câncer infantil elaborado coletivamente. Desta segunda etapa emergiram os temas das sessões, organizados posteriormente sob a forma do livro das crianças. Após estas duas etapas de análise, foi realizada uma síntese compreensiva da construção dos resultados sob a luz da Psicologia Fenomenológica. Nas considerações finais, foram discutidos os desdobramentos práticos dos aspectos estudados, assim como o papel da Psicologia nestes contextos assistenciais. (FAPESP) / This paper proposes to come into contact with childhood cancer and its consequences from the cancer-stricken child’s own viewpoint, and investigate what it means for the child to be ill, seeking to find out the meaning of its experience at this particular juncture of its life. This paper is based on the qualitative research method of phenomenological inspiration in Psychology. With a leading question as the starting point – What is it like for a child who has cancer to live with this illness and its treatment? – the source used for investigation were the experiences of children suffering from cancer in a psychological support group, a routine activity that is a part of the Psychology Service of the GACC – Support Group for Children with Cancer. This group met weekly for one hour, at a fixed time and place, at the Children’s Hospital of the Ribeirão Preto Medical School of the University of São Paulo (USP). Graphic and playtime materials were used. The participating children, five per session on the average, had different cancer diagnoses, and were at different stages of their treatment. Their ages ranged from 3 to16 years. Construction of results comprised two stages. In the first stage, 30 psychological support group sessions held during the period from April through December 1999 were analyzed. In this stage, the group’s objective was fostering and facilitating the free expression of concerns, doubts and feelings by the participating children, in addition to providing a time for them to share their experiences. In the second stage, 15 psychological support group sessions held during the period from January to June 2000 were analyzed. In this stage, the group’s objective was creating the Children’s Book – collectively prepared informative material on childhood cancer. Subsequently, a synthesis comprising both stages of such construction of results was carried out under the light of Phenomenological Psychology. Practical developments of the aspects studied, as well as the role of Psychology in such care contexts, were discussed in closing remarks.

Made available in DSpace on 2017-07-21T14:42:40Z (GMT). No. of bitstreams: 1 Aparecida Garcia dos Santos.pdf: 2778641 bytes, checksum: 3f546ca886d40061c014cd904b8a5766 (MD5) Previous issue date: 2016-07-21 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Leprosy is a sickness that has been around for thousands of years, and since the biblical times has always been a focus of various discussions. For a long time, a person infected with leprosy was isolated from society, excluded, as well as called leper, unclean, dirty, and a sinner. In this sense, Leprosy became a sickness marked with stigma and discrimination, and those inflicted suffered from such. The objective study is to comprehend the structure of the Support Group of Patients with Leprosy (GAPHAN) while group action gives support to the public politics of health for lepers in the process of being attended. Developed in the City of Ponta Grossa – PR, in the Specialized Assistance Service (SAE), with professionals and participants of GAPHAN. This research is a descriptive and explorative work. Quality study was utilized, accomplished through semi-structured interviews with oral testimonies and non-participant observation, together with the participants of the research. The research was founded in bibliographical and documental study. The results of this research give evidence that the action of the support group strengthen the attendance and treatment of those with leprosy, in the city of study. This study made possible the understanding of the universe of meanings understood by the word leper, and gave evidence of the stigma, as explained by Goffman. The activities and happenings of GAPHAN aid in the attendance and precocious detection of leprous cases of relatives. Group co-living aids in the elevation of self-confidence, cognitive development, self-care and contributes to the reintegration of lepers into society, giving support to the public politics of health for lepers. In this sense, the group becomes a support for the control program and elimination of leprosy in the city of Ponta Grossa – PR. / A hanseníase é uma doença milenar, que desde os tempos bíblicos vem sendo foco de várias discussões. Por muito tempo, a pessoa doente era isolada da sociedade, excluída, bem como, nomeadas de termos como: leproso, imundo, sujo, pecador. Nesse sentido, a hanseníase tornou-se uma doença marcada por estigma e discriminação, os quais são vivenciados por aqueles que por ela são alcançados. A pesquisa objetiva compreender a estrutura do Grupo de Apoio a Pacientes com Hanseníase (GAPHAN) enquanto ação de grupo para dar suporte às políticas públicas de saúde voltadas aos hansenianos no processo de atendimento.Desenvolvida no Município de Ponta Grossa – PR, no Serviço de Assistência Especializada (SAE), com profissionais e participantes do GAPHAN. Trata-se de pesquisa descritiva e exploratória. Utilizou-se a pesquisa qualitativa, realizada por meio de entrevistas semiestruturadas, com depoimentos orais e observação não participante, junto aos participantes da pesquisa. Fundamentou-se em pesquisa bibliográfica e documental. Os resultados evidenciam que o grupo de apoio enquanto ação no SAE fortalece o atendimento e tratamento voltado à hanseníase,no Município de estudo. Esse estudo possibilitou compreender o universo de significados dos cometidos pela hanseníase, o qual ficou evidenciado o estigma, que é explicado por Goffman. As atividades e encontros ocorridos no GAPHAN auxiliam no atendimento e na detecção precoce dos casos de hanseníase dos familiares. A convivência grupal auxilia na elevação da autoestima, no desenvolvimento cognitivo, no autocuidado e contribui para a reintegração do hanseniano a sociedade, e dá suporte à política pública de saúde voltada à hanseníase. Nesse sentido, o grupo torna-se um apoio para o programa de controle e eliminação da hanseníase no município de Ponta Grossa – PR.

O trabalho tem como proposta entrar em contato com o câncer infantil e suas conseqüências do ponto de vista da própria criança com câncer, investigando o que significa para ela estar doente e buscando conhecer o sentido de sua vivência neste momento particular de sua vida. O trabalho fundamenta-se no método de pesquisa qualitativa de inspiração fenomenológica em Psicologia. Partindo de uma questão orientadora - Como é para a criança com câncer conviver com sua doença e seu tratamento? - a fonte de investigação utilizada foram as vivências de crianças com câncer no grupo de apoio psicológico, atividade que faz parte da rotina do Serviço de Psicologia do GACC-Grupo de Apoio à Criança com Câncer. O grupo reuniu-se semanalmente durante 01 hora, em local e horário fixos, no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto-USP. Foram utilizados materiais gráfico e lúdicos. As crianças participantes, em média 05 em cada sessão, tinham diferentes diagnósticos de câncer e encontravam-se em diferentes fases de seus tratamentos. Suas idades variaram de 03 a 16 anos. A construção dos resultados compreendeu duas etapas. Na primeira etapa, foram analisadas 30 sessões do grupo de apoio psicológico realizadas no período de abril a dezembro de 1999. Nesta etapa, o objetivo do grupo era propiciar e facilitar a livre expressão de preocupações, dúvidas e sentimentos das crianças participantes, além de proporcionar um momento no qual pudessem compartilhar suas experiências. Desta primeira etapa emergiram três dimensões de análise: os temas das sessões, o próprio grupo enquanto intervenção psicoterapêutica e a gestação da idéia de elaborar o livro das crianças. Na segunda etapa, foram analisadas 15 sessões do grupo de apoio psicológico, realizadas no período de janeiro a junho de 2000. Nesta etapa, o objetivo do grupo era a criação do livro das criança, material informativo sobre o câncer infantil elaborado coletivamente. Desta segunda etapa emergiram os temas das sessões, organizados posteriormente sob a forma do livro das crianças. Após estas duas etapas de análise, foi realizada uma síntese compreensiva da construção dos resultados sob a luz da Psicologia Fenomenológica. Nas considerações finais, foram discutidos os desdobramentos práticos dos aspectos estudados, assim como o papel da Psicologia nestes contextos assistenciais. (FAPESP) / This paper proposes to come into contact with childhood cancer and its consequences from the cancer-stricken child’s own viewpoint, and investigate what it means for the child to be ill, seeking to find out the meaning of its experience at this particular juncture of its life. This paper is based on the qualitative research method of phenomenological inspiration in Psychology. With a leading question as the starting point – What is it like for a child who has cancer to live with this illness and its treatment? – the source used for investigation were the experiences of children suffering from cancer in a psychological support group, a routine activity that is a part of the Psychology Service of the GACC – Support Group for Children with Cancer. This group met weekly for one hour, at a fixed time and place, at the Children’s Hospital of the Ribeirão Preto Medical School of the University of São Paulo (USP). Graphic and playtime materials were used. The participating children, five per session on the average, had different cancer diagnoses, and were at different stages of their treatment. Their ages ranged from 3 to16 years. Construction of results comprised two stages. In the first stage, 30 psychological support group sessions held during the period from April through December 1999 were analyzed. In this stage, the group’s objective was fostering and facilitating the free expression of concerns, doubts and feelings by the participating children, in addition to providing a time for them to share their experiences. In the second stage, 15 psychological support group sessions held during the period from January to June 2000 were analyzed. In this stage, the group’s objective was creating the Children’s Book – collectively prepared informative material on childhood cancer. Subsequently, a synthesis comprising both stages of such construction of results was carried out under the light of Phenomenological Psychology. Practical developments of the aspects studied, as well as the role of Psychology in such care contexts, were discussed in closing remarks.

Trata-se de uma pesquisa de natureza qualitativa, do tipo descritivo exploratório, que teve como proposta descrever o processo de implantação e implementação de um grupo de pacientes portadores de estomas intestinais definitivos e identificar a percepção desses quanto à sexualidade como uma dimensão importante de suas vidas. Para a coleta de dados, foram utilizadas as falas dos sujeitos participantes do grupo durante os encontros realizados, transcritas na íntegra pela pesquisadora. As falas, posteriormente foram analisadas segundo a análise de prosa de André (1983). Foram realizados 14 encontros com 3 horas de duração cada, participaram do grupo 19 portadores de estomas definitivos de São José do Rio Preto e região, uma coordenadora (pesquisadora), um coloproctologista, uma psicóloga e uma observadora não-participante. Toda dinâmica do grupo obedeceu a uma programação feita previamente pela pesquisadora. Os dados obtidos permitiram concluir que essa atividade grupal proporcionou aos portadores um espaço no qual puderam trocar experiências, adquirir conhecimentos, criar vínculos, encontrar cumplicidade, companheirismo e aceitar a sua condição, pois ouviram as vivências dos outros e não se sentiram únicos a terem problemas, facilitando o sentimento de universalidade. Quanto à percepção da sexualidade como uma dimensão importante em suas vidas identificou-se ser esse um tema pouco abordado pelos profissionais de saúde e necessário para o reajustamento sexual satisfatório. Evidenciou-se que a saúde sexual não foi inibida pela doença, pois quanto mais orientados adequadamente, e mais estimulados para a prática sexual, mais satisfeitos e interessados se mostraram para buscar caminhos, superando obstáculos como: a recusa do parceiro, disfunção erétil, alteração imagem e o próprio estoma. Alguns caminhos apontados para atingir a satisfação sexual foram a troca de parceiro, busca de profissionais especializados, criatividade no ato sexual e alguns cuidados com o dispositivo. Nesse espaço evidenciou-se que a prática sexual seja ela qual for, é importante e necessária para a vida de cada um. A experiência de vida de cada integrante permitiu o desenvolvimento da autonomia sexual e fez com que os portadores reconhecessem a necessidade de mantê-la ou buscar auxílio, para o alcance do prazer, satisfação e retorno à vida. / This is a descriptive exploratory qualitative research, with the goal to describe the creation and implementation process of a group of patients with definitive intestinal stomas and to identify their perceptions with respect to sexuality as an important dimension of their lives. In order to collect data, the author used the speech of the subjects who participated in the group during their meetings that were transcribed by the researcher. Their speeches were analyzed according to André’s prose analysis. The group met 14 times, with meetings of about 3 hours each. 19 patients from the city of São José do Rio Preto and region with definitive stomas participated in the meetings with the researcher, one physician, one psychologist and one non-participant observer. The dynamics of the group followed the researcher’s program. Data showed that this activity gave to patients a space to exchange experiences, to learn and create links, to find complicity and colleagues as well as to accept their condition as they listen the others experiences and feel that they are not the only ones who have problems, facilitating the feeling of “universality". With respect to their sexuality perception as an important dimension of their lives, author identified that this theme was not often mentioned by the health professionals and that this is necessary to a satisfactory sexual readjustment.. The author found out that when sexual health was not inhibited by the disease, they were adequately oriented and stimulated to sexual practice and were satisfied and interested to find ways and overcome some problems such as: the partner refusal, erectile dysfunction, image alteration and the stoma. Some ways used to have sexual satisfaction were to change partners, to search for the care of specialized professionals, creativity during sexual intercourse and to pay attention to the device. In this space, the author found that the sexual practice is important and necessary to their lives. The life experience of each one of the members enabled the development of sexual autonomy and the need to maintain it or to search for health in order to have pleasure, satisfaction and to feel alive.

Children with Sickle Cell Disease (SCD) face medical, psychosocial, and cognitive challenges, which may impede their social and academic functioning. These complications can be lessened through the implementation of comprehensive interventions. This study reviews one comprehensive intervention, a support group, for children with SCD and their families, and reviews the challenges faced by the children and family who participate in the support group as well as those who do not participate. The study has a mixed-method design because the families participated in focus groups, and they completed quantitative instruments, including a knowledge survey, a behavior rating scale, and an instrument to measure the degree that SCD affects one's life. Most children rated SCD as affecting their life a little bit and were knowledgeable in SCD. The children who did not participate in the support group reported less symptoms and a smaller impact on their lives than those who did participate. The results from the behavior rating scale did not reveal any significant behavior problems in these children; however, those who did not participate in the support group had higher ratings than those who did. These results imply that individuals with SCD who are less impacted by the disease may be less likely to attend a support group than those who are more impacted. Additionally, a theme analysis from the focus groups revealed key themes, such as keeping SCD a secret, getting made fun of, missing school, missing PE class, hospital visits, and experiences with pain crises. The findings from this study indicate that SCD does impact the life of children with the disease; however, the impact may be unknown to others and may differ among individuals. The results also imply that school personnel and other students in schools must be accurately informed about the manifestations of SCD to best promote healthy physical and psychosocial development in children with SCD. Finally, support groups can help to reduce symptoms and complications related to the disease.