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This research explores the subjective experiences of women with mental health challenges residing in a supportive housing building in Southern Ontario. Drawing on principles of Feminist Participatory Action Research (FPAR), five women were brought together to engage in an arts-based workshop meant to provide the opportunity to reflect on their experiences, express themselves through alternative means, and connect with peers over shared experiences. Over six meetings, participants have been invited to contribute to group discussions by taking and analyzing photos that represent their journey while living in supportive housing. Drawing on a critical feminist and Mad Study scholarship, this project used intersectionality as its theoretical lens. This choice intends to emphasize the interconnected and compounded system of oppression that women experience when their identity intersects across various dimensions such as gender, gender expression, race, mental health status, class, and more. This research is essential because of the pervasiveness of discrimination, disempowerment and oppression of people diagnosed with a ‘serious mental illness’ and how these infiltrate relationships and social systems. However, little empirical data exists to explore the in-depth perspective of these individuals, who lack power and voice in society. In particular, women with a psychiatric diagnosis live at the intersection of multiple oppressive factors. Thus, to counterbalance oppression, it is essential to recognize these women as the experts in their lives. Moreover, women’s active participation in research and their photographs and stories offered a nuanced understanding of issues affecting them. From the photographs (visual data) and the meaning given by participants through their stories (narrative data), issues emerged related to stigmatization, gender-based violence, economic limitations, inadequate support, and various forms of discrimination. Furthermore, participants expressed their insights into desired changes within and beyond the supportive housing program. The relevance of this research is threefold: 1) it gave agency to women living in supportive housing to outline their unique needs and wants; 2) it contributed to the paucity of qualitative research situated at the intersection of gender and ‘mental illness’; 3) through KTE activities, it has the potential to inform housing and helping professionals on ways to improve housing projects, design activities, and foster residents’ engagement for this population group. / Thesis / Master of Social Work (MSW)

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Appropriate housing for the aging American population is a timely topic of research in both housing and gerontology. Universal design is an innovation in housing design that is gaining interest from both industries. This research examines the effectiveness of universal design features that have been identified by experts in the field of aging, housing, and universal design as important to resident and caregiver participants of the ECHO demonstration housing program. A national survey was conducted that included all available current residents of the HUD ECHO houses and their caregivers. The relationships between age, effectiveness of universal design features, health and dependency were investigated. Quantitative results include some confounding relationships, and plausible explanations. A qualitative analysis, based on on-site and telephone interviews, and tape recordings of those interviews with residents and their caregivers, as well as architectural drawings, observation, and photographs of the ECHO houses provided additional details. The qualitative approach indicated that many of the universal design features recommended by the experts consulted satisfactorily met the needs of residents and/or their caregivers. It also revealed, however that some features were not considered important by residents and caregivers, some were not reported as present (when they were documented by the researcher as present), and at least one HUD-specified universal design feature was not provided by ECHO houses. Another aspect of the qualitative perspective addressed the health of the residents. Health characteristics are presented in the context of their effect on dependency. Phase II dependency task information was compared to that reported in phase I, and improvement and decline was noted. Conclusions, and Implications that elaborate on findings, and future research is recommended for taking this research to the next level. / Ph. D.

Children diagnosed and treated for cancer experience a profound life-transformation as they are confronted with unprecedented physical, psychosocial and emotional challenges. Children’s experience of diagnosis and treatment is often accompanied by a lack of participation and reduced control. Extensive research has been conducted on a variety of supportive interventions. Only a limited amount of research, however, has investigated the potential of animal-assisted activities (AAAs) to afford specialised support for the child hospitalised with cancer. Moreover, of this limited research, few studies explore AAAs in relation to participation and control. The purpose of this study was to explore and describe how participation and control are experienced during animal-assisted activities by children hospitalised with cancer. Paediatric oncology patients between the ages of 8 and 14 with any type of cancer were offered the opportunity to participate in the study, which comprised of animal-assisted activities at the facility where patients received their medical care. Five children were included in the final sample. Data were gathered by means of non-participant observations, participant interviews, graphic questionnaires and field notes. Data were then analysed in accordance with steps proposed by Tesch (1990: 142-145), which involved coding according to categories and related themes. Five major themes emerged, including (1) approach to animals, (2) body awareness, (3) level of engagement, (4) level of dependence and (5) communication. Nine sub-themes were derived from data analysis. Under “approach to animals”, the sub-themes were (i) taking the lead, (ii) grooming and affection and (iii) laughter and spontaneity. The sub-themes of “body awareness” were (iv) protection of body and (v) comfort. The sub-themes of “level of engagement” were (vi) initiative and (vii) choice. Finally, the sub-themes of “communication” were (viii) verbal communication and (ix) non-verbal communication. The study provides insight into the participation and control experienced during animal-assisted activities by children hospitalised with cancer. When the initial and final AAA sessions were compared, changes were noted in terms of the children’s approaches to the dog, their body awareness, their level of engagement, their level of dependence and their communication. These changes are associated with an enhanced sense of participation and control, aspects that are often reported to be diminished in children who are diagnosed, treated and hospitalised with cancer. AAAs should therefore be considered an effective means of supporting children hospitalised with cancer. / MA (Psychology), North-West University, Potchefstroom Campus, 2015

Children diagnosed and treated for cancer experience a profound life-transformation as they are confronted with unprecedented physical, psychosocial and emotional challenges. Children’s experience of diagnosis and treatment is often accompanied by a lack of participation and reduced control. Extensive research has been conducted on a variety of supportive interventions. Only a limited amount of research, however, has investigated the potential of animal-assisted activities (AAAs) to afford specialised support for the child hospitalised with cancer. Moreover, of this limited research, few studies explore AAAs in relation to participation and control. The purpose of this study was to explore and describe how participation and control are experienced during animal-assisted activities by children hospitalised with cancer. Paediatric oncology patients between the ages of 8 and 14 with any type of cancer were offered the opportunity to participate in the study, which comprised of animal-assisted activities at the facility where patients received their medical care. Five children were included in the final sample. Data were gathered by means of non-participant observations, participant interviews, graphic questionnaires and field notes. Data were then analysed in accordance with steps proposed by Tesch (1990: 142-145), which involved coding according to categories and related themes. Five major themes emerged, including (1) approach to animals, (2) body awareness, (3) level of engagement, (4) level of dependence and (5) communication. Nine sub-themes were derived from data analysis. Under “approach to animals”, the sub-themes were (i) taking the lead, (ii) grooming and affection and (iii) laughter and spontaneity. The sub-themes of “body awareness” were (iv) protection of body and (v) comfort. The sub-themes of “level of engagement” were (vi) initiative and (vii) choice. Finally, the sub-themes of “communication” were (viii) verbal communication and (ix) non-verbal communication. The study provides insight into the participation and control experienced during animal-assisted activities by children hospitalised with cancer. When the initial and final AAA sessions were compared, changes were noted in terms of the children’s approaches to the dog, their body awareness, their level of engagement, their level of dependence and their communication. These changes are associated with an enhanced sense of participation and control, aspects that are often reported to be diminished in children who are diagnosed, treated and hospitalised with cancer. AAAs should therefore be considered an effective means of supporting children hospitalised with cancer. / MA (Psychology), North-West University, Potchefstroom Campus, 2015

Aims: Unmet needs have mainly been investigated with formal and informal adult caregivers and ill individuals within psycho-oncology; findings indicate unmet needs are associated with negative affective state and caregiver burden. Research relating to adolescent children’s experiences of unmet needs during parental illness has, in the main, been based upon parental reports or professional opinion, yet research suggests that parental reports can downplay the effects and it is important to ask the adolescent child for their opinion. Adolescence is a transitional time in development; this may make the illness experience and subsequent needs vary from those of formal and informal adult caregivers. This thesis pragmatically investigates adolescent children’s firsthand accounts of unmet psychosocial and supportive care needs when they have a parent with a non-communicable disease. Methods: Systematic Review: To inform the direction of the thesis and capture all relevant published literature, a comparative systematic review was carried on adolescent’s experiences of unmet needs when they have a parent with a NCD, cancer or psychological problem. The review was conducted using standardized procedures and guidance from the Cochrane collaboration. Interpretative Phenomenological Analysis: Qualitative methodology was used to investigate seven adolescent’s experiences of unmet psychosocial and supportive care needs in relation to having a parent with a NCD. Participants were recruited through institutions of further and higher education. Quantitative Research: Pearson’s correlation and multiple regressions were used to test associations between unmet needs, depression, stress, anxiety and quality of life, and to determine the applicability of the revised version of the Offspring Cancer Needs Inventory (OCNI) for individuals who have a parent with a NCD. One hundred and seven adolescent children completed the revised version of the OCNI, the DASS-21 (depression, anxiety, and stress) and AC-QoL (Adult carers’ quality of life) scales. Findings: Systematic Review: In the review 1479 papers were considered. Seven met the inclusion criteria, of these five papers related to cancer, one to chronic illness and one to psychological problems. Results suggest that adolescents had informational, supportive and recreational needs, and did not want to worry parents by asking them questions. The lack of hits and the disparity between illness groups is problematic in making comparisons and drawing definitive conclusions. Interpretative Phenomenological Analysis: Four interdependent themes emerged from the data, two relating to interpersonal needs (Information Needs and Support Needs), and two relating to intrapersonal needs (Need for 4 Acknowledgement and Need to be Them-Self), each had their own number of sub-themes. Adolescent’s had a variety of needs that could be partially met through honest and accurate information, interpersonal support and acknowledgment of their caring role within the family. The interdependence of the needs indicated that the fulfilment of one need has the potential of meeting other needs. Unmet needs were comparable to those of adolescent children who have a parent with cancer; as such it was deemed that the new version of the OCNI would be suitable for use with individuals who had a parent with a NCD. Quantitative Research: Ninety-Three percent of adolescents reported at least one unmet need. Analysis suggests that the unmet needs variables were co-dependent and correlated with depression, stress, anxiety, and quality of life. Certain unmet need variables predicted stress, anxiety, depression, and quality of life. Conclusion: The findings of this thesis indicate that adolescent children who have a parent with a NCD have a variety of unmet needs, and that these are associated with affective state and well-being. It is suggested that counselling psychologists are well placed to provide psychological and needs based interventions based upon the findings within this thesis. More research is required in this area to determine cause and effect; owing to counselling psychologists working with the lifespan they would be well placed to further the knowledge in this area.

Bakgrund: De medicinska insatser, omvårdnad och rehabilitering som erbjuds patienter i primärvård idag är vedertagna och vanligtvisevidensbaserade. Patienter kan få diagnos, behandling och ofta bot för många åkommor. En dimension som dock mindre ofta är tillvaratagen är effekterna av en genomtänkt fysisk miljö. Ett respektfullt bemötande i kombination med en genomtänkt vårdmiljö kan beskrivas som en god vårdatmosfär. Syftet med studien är att undersöka hur patienter upplever och uppfattar vårdatmosfären vid besök på en rehabiliteringsenhet i primärvård. Metod: Kvalitativaforskningsintervjuer och kvalitativ innehållsanalys Huvudresultat: En vårdatmosfär kan delas in i tre domäner: Fysisk miljö, Bemötande och Organisation. Inom domänerna finns ett antal kategoriermed variationer: Känsla av kontroll, Fysiska förutsättningar för att bli uppmärksammad, Subjektiva upplevelser av miljön, Kunskap om miljöns effekter, Uppmärksammar och bekräftar, Kommunicerar, Helhetssyn, Patienten i fokus, Delaktighet, Empati, Jämlikt möte, Att göradet ‖lilla extra‖, Innehåll och utbud, Tillgänglighet, Kontinuitet, Vårdkedjor och samverkan, Jämlik vård, Patientens rättigheter, Bemötandeandaoch förbättrings-och utvecklingsanda.Temat som framkommit är Att bli sedd, att vara värdefull. Slutsats: Till begreppet vårdatmosfär kan förutom vårdmiljö och bemötande, organisation läggastill. Organisationen ger förutsättningar eller kan försvåra. Ett tema håller samman alla kategorier och det är betydelsen av att bli sedd som ger budskap om att vara värdeful / Background: Medical treatment, care, and rehabilitation offered to patients in primary care settings are established and mostly evidence-based. Patients can receive diagnose, treatment and, quite often, cure. A dimension that receives less attention involves the effects of a carefully planned physical environment. Combined with a carefully planned environment, respectful interaction between patients and health professionals enhancesthe atmosphere of care settings. Aim: This study aimed to investigate how patients experience the atmosphere they encounter when visiting a rehabilitation unit within a primary care unit. Method: Qualitative research interviews and qualitative content analysisResults: The atmosphere in care settings encompasses three domains: physical environment, interaction between patients and health professionals, and the organization. Within these domains, categories include sense of control, physical conditionsfor to attract attention, subjective experience, knowledge of the effects of the environment, attention to and confirmation of the patient, communication, holistic view of the patient, patient in focus, participation, empathy, equality in the meeting, To do ―the little more‖, healthcare content, accessibility, continuity, cooperation, equal care, patient rights, spirit of interaction between patient and health professional, and spirit of improvement and development. The major themes that emerged were the patient’s need to be noticed and valued. Conclusion: Our results suggest that the organization should be added to the concepts of atmosphere in care settings. The organization can create and obstruct careconditions. The overarching theme of these categories is the patient’s need to be noticed and valued / <p>ISBN 978-91-86739-27-0</p>

The question of agro/pastoral livelihoods adaptation is gaining attention in the rural development arena but little empirical evidence exists that has examined the performance and impact of diversified enterprises on agro/pastoral livelihoods and the environment in the ASAL, and on how to effectively support such initiatives. Additionally, there has been little evaluation of the type of behavioural patterns that agro/pastoral communities need to evolve in order to engage in such initiatives. This research study endeavours to bridge this knowledge-gap and assist the ASAL communities, NGOs, CBOs and government departments to understand the skills and resources required to develop climate-resilient, environmentally and economically sustainable bio-enterprises. This study examines the roles of bio-enterprise initiatives in enabling agro/pastoralists to develop more resilient livelihoods and incentivising positive community-led natural resource management and draws on different bio-enterprise initiatives located across the drylands of Kenya. In this study data was collected through interviews, focus group discussions and from secondary data. The analysis of four agro/pastoral bio-enterprise initiatives compares the level of success of specifically orientated development-funded support schemes. A more in-depth study was made of one of the initiatives, the BDP. Two surveys were made one year apart and secondary data was collected of the BDP impact. This highlighted the probable factors that influence the communities’ up-take of these bio-enterprises. Results show that this diversification requires stakeholders and support-actors to gain a greater understanding of business development approaches. Other factors such as capacity development to ensure production meets market standards, strong linkages with ethical commercial operators, access to trade-finance and ongoing mentoring proved to be the main drivers of success in these initiatives. The results show that the outputs of the BDP service-providing activities and the ethical trade facilities have been a major factor in the level of success achieved by the BDP. The main policy implications that this study has shown are: Agro/pastoralists realise that they can improve their resilience, food security and incomes by developing bio-enterprises. If conducted using conservation practices, this is an effective conservation and drought management tool. Communities do not possess the necessary skills and business acumen to diversify from traditional activities. Due to the lack of market knowledge, business acumen and technical skills many development and government instigated rural enterprise initiatives have failed. The commercial sector has strong transferable skills and will assist in developing bio-enterprises where commercial gains can be attained. This study has shown that where government, development and the private sector work in synergy projects are more socially, environmentally and economically successful. International standards and certification for sustainable harvesting of indigenous plant materials will effectively assist communities to manage their natural resource utilization and market their products more competitively. Women have shown that they have control over small-scale diversified activities and are able to choose how to use the revenue they have raised. Due to the orientation of agro/pastoralists to collective-action a wide ripple-effect can be seen from well-targeted business development assistance such as: mentoring, skills development, access to affordable trade finance/capital, improved market opportunities and value-addition.