Dissertations / Theses on the topic 'Peer Helper'

ABSTRACT DEVELOPING A PEER HELPING PROGRAM AND TESTING ITS EFFECTIVENESS Aladag, Mine Ph. D., Educational Sciences Supervisor: Prof. Dr. Esin Tezer 2005, 290 pages The main purpose of this three-phase study was to develop a peer helping program. The purpose of the first phase was to plan a peer helping program with its goal and content. The purpose of the second phase was to develop a peer helping training program and to investigate its effectiveness on improving the helping skills and self-growth of the peer helpers. The purpose of the third phase was to understand the peer helpers&rsquo<br>and helpees&rsquo<br>evaluations of the peer helping program. In the first phase of the study, a need assessment study was carried out with a sample of 316 (168 females, 148 males) students from Faculty of Education of Ege University. Results indicated that students preferred peer helpers among other helping agents<br>they preferred both non-directive helping styles (empathic responses) and directive helping styles (instrumental responses)<br>they seemed to believe the helpfulness of the program<br>they tended to apply to the program<br>and they wanted the program to concentrate on their career, academic, and interpersonal relationships concerns. In the second phase of the study, in order to investigate the effect of peer helping training program on improving peer helpers&rsquo<br>helping skills and the self-growth, a pre-test post-test control group experimental design study was carried out with a sample of 31 participants (15 experimental group and 16 control group). The participants were also administered six-month follow-up test. The data were gathered by administering five instruments: Communication Skills Evaluation Scale (CSES), Empathic Skill Scale-B Form (ESS-B), Reflection Skills Evaluation Form (RSEF), Rosenberg Self-Esteem Scale (RSS) and Self-Acceptance Inventory (SAI). After testing the equivalence of the pre-test scores of CSES, ESS-B, RSS, and SAI of the experimental and the control group participants, a series of 2 (experimental-control groups) X 3 (pre-post-follow up tests) repeated measure of analysis of variance (ANOVA) was employed to the CSES, ESS-B, RSS, and SAI scores of the participants. An analysis of covariance (ANCOVA) using pre-test as covariate was employed to the post-test and follow-up test scores of the RSEF of the participants. The results indicated that a peer helping training program was more effective on improving both the empathic and the reflection skills of the experimental group participants as compared to the control group participants. The results also indicated that there was a significant increase in the experimental group participants&rsquo<br>self-esteem scores from the pre-test to the follow-up test and also a significant increase in the experimental group participants&rsquo<br>self-acceptance scores from the pretest to the posttest. In the third phase of the research, a study, mainly based on qualitative data, was carried out with 15 peer helpers and 33 volunteered students/peer helpees (17 females, 16 males) who received peer helping services. All peer helpees were administered Peer Helping Service Evaluation Form and 15 peer helpers were also administered Peer Helping Program Evaluation Form. The analysis of the qualitative data indicated that most of the above mentioned areas were positively evaluated by both peer helpers and peer helpees.

In South African secondary schools there are learners who undergo a daily struggle with social and emotional problems. The problems learners struggle with include problems like drug and alcohol abuse, suicide, domestic violence, peer pressure, anorexia, bulimia, stress, bullying, and many more. These problems often result in learners experiencing a great deal of pressure. They sometimes feel hopeless as they fail to find suitable solutions for their problems. They often feel alone and as though there is no one whom they can share their problems with and who truly understands. A Peer Helper Programme is a programme that focuses on training a selective group of learners to be peer helpers. A peer helper is someone who understands or someone of more or less the same age as the person seeking for help, has empathy, good listening and communication skills, and offers help and understanding in times of need. A literature study has been undertaken to give the precise description of the concept of peer help, to determine the task and function of a peer helper and to establish what exactly the training of a peer helper should encompass. The results obtained from this information allowed the setting of guidelines for the implementing of a peer helper programme for the effective training of peer helpers. An empirical study was executed to establish the nature and scope of the problems learners in secondary schools in the Klerksdorp school district experience and their needs concerning peer helping. From this study it was concluded that a need exists for peer helping programmes as well as guidelines for the design and implementation of a peer helper programme. Questionnaires were used and the following can be concluded from the investigation: There is an existing need for a peer helper programme as learners who experience problems will rather share this with a peer before telling an older person. A set of guidelines need to be put into place for the implementation of a peer helper programme. To conclude the recommendation is made at the end of this study that a peer helper programme needs to be implemented in every school in the various school districts and that it should stand under the management of the school principle and the assistance of the guidance teacher.<br>Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2006.

This study was designed to determine the effectiveness of a filial/play therapy training model with high school juniors and seniors enrolled in a Peer Assistance and Leadership program (PALs). Filial/play therapy is an intervention that focuses on strengthening and enhancing adult-child relationships. The high students are trained to be a therapeutic change agent for primary school children identified as having adjustment difficulties by utilizing basic child-centered play therapy skills in weekly play sessions with young children. Specifically, this study is designed to determine the effectiveness of filial therapy in increasing: 1) the high school students' observed empathic behavior with young children, 2) the high school students' observed attitude of acceptance toward young children, 3) the high school students' observed ability to allow self-direction in young children, and 4) the high school students' observed level of involvement with young children. The experimental group, consisting of 16 volunteer high school students enrolled in a PALs class for high school credit, received a total of 24 weeks of filial/play therapy didactic training, application, and supervision for the playtimes they conducted with pre-kindergarten/kindergarten students identified with adjustment difficulties. The comparison group consisted of 15 volunteer high school students enrolled in a PALs class for high school credit. The comparison group received the standard PALs class curriculum. All students were videotaped playing with a young child 4 to 6 years of age before and after the training as a means of measuring empathic behavior with young children. An Analysis of Covariance revealed statistically significant findings in all four hypotheses. Specifically, the experimental group of high school students exhibited statistically significant increases in empathic interactions with young children when compared to the comparison group. The experimental group also exhibited statistically significant increases in communication of acceptance of young children's feelings and behaviors, acceptance and behavioral willingness to follow young children's lead rather than attempt to control their behavior, and attention to and participation in young children's play. This study supports the use of filial/play therapy as an effective training model for increasing high school students' empathic behavior with young children. Filial/play therapy offers significant possibilities for training high school students in a developmentally appropriate model for working with young children identified with school adjustment difficulties, in order to prevent future problems.

The purpose of this study is to provide a comprehensive description of what a peer helper programme is and to set guidelines for the design and implementation of a peer helping programme for university residence students. In order to achieve these objectives a literature study was firstly conducted to attain a good understanding of the problems that students of tertiary institutions are currently experiencing. The conclusion was made that students are today faced with a lot of frustrations, problems and challenges resulting in a need for care, support and effective help. Secondly the terms "peer helping", "peer helper" and "peer helper programmes" were defined and peer helping was consequently identified as an effective way of addressing the need for help in the student community. This was followed by a description of guidelines for the design and implementation of a peer helper programme for students in university residences. Plomp's general educational design model was used as a point of reference in the setting of these guidelines. An empirical study was done in the form of a case study as it was exercised only at the Potchefstroom Campus of the North-West University. The aims of the empirical research were to determine firstly if there was a real need for the implementation of a peer helper programme among students in university residences; secondly, to look into and examine the guidelines set for the design and implementation of a peer helpers' programme in university residences, and finally to evaluate the efficacy of the training of peer helpers for university residences. Questionnaires, observations and semi structured interviews were used in the empirical study in order to come to the following general conclusions: Students tend to confide in friends when they experience problems of a more serious nature. In other words they share their problems and concerns with people whom they are in a close relationship with. There is a definite need for a peer helpers' programme in university residence environments. Students are willing to take part and make use of such a programme and students want to take the lead in organising and managing such a programme. In order to design and implement a peer helpers' programme successfully in a university residence, the set guidelines for the effective designing and implementation of such a programme should be followed. Finally it is recommended that a peer helpers' programme should be implemented in every residence or on the campus of every university or tertiary institution in South Africa in order to address the growing need for help among students, effectively. Various recommendations for further research were made.<br>Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2005.

Adolescent peer counselling as a social support strategy to assist adolescents to cope with stress in their peer group provides the focus for the present thesis. The prosocial behaviour of providing emotional and psychological support through the use of helping conversations by young people is examined. Current programs for training adolescent peer counsellors have failed to discover what skills adolescents bring to the helping conversation. They ignore, actively discourage, and censor, some typical adolescent conversational helping behaviours and idiosyncratic communication processes. Current programs for training adolescent peer counsellors rely on teaching microcounselling skills from adult counselling models. When using this approach, the adolescent peer helper training literature reports skill implementation, role attribution and status differences as being problematic for trained adolescent peer counsellors (Carr, 1984; de Rosenroll, 1988; Morey & Miller, 1993). For example Carr (1984) recognised that once core counselling skills have been reasonably mastered that young people " may feel awkward, mechanical or phoney" (p. 11) when trying to implement the new skills. Problematic issues with regard to role attribution and status differences appear to relate to the term 'peer counsellor' and its professional expectations, including training and duties (Anderson, 1976; Jacobs, Masson & Vass, 1976; Myrick, 1976). A particular concern of Peavy (1977) was that for too many people counselling was an acceptable label for advice giving and that the role of counsellor could imply professional status. De Rosenroll (1988) cautioned against creating miniature mirror images of counselling and therapeutic professionals in young people. However, he described a process whereby status difference is implied when a group of adolescent peer counsellors is trained and invited to participate in activities that require appropriate ethical guidelines including competencies, training, confidentiality and supervision. While Carr and Saunders (1981) suggest, "student resentment of the peer counsellor is not a problem" they go on to say, "this is not to say that the problem does not exist" (p. 21). The authors suggest that as a concern the problem can be minimised by making sure the peer counsellors are not 'forced' on the student body and by providing opportunities for peer counsellors to develop ways of managing resentment. De Rosenroll (1988) acknowledges that the adolescent peer counsellor relationship may fall within a paraprofessional framework in that a difference in status may be inferred from the differing life experiences of the peer counsellor when compared with their student peers. The current project aimed to discover whether the issues of skill implementation, role attribution and status differences could be addressed so that adolescent peer counselling, a valuable social support resource, could be made more attractive to, and useful for adolescents. The researcher's goal was to discover what young people typically do when they help each other conversationally, what they want to learn that would enhance their conversational helping behaviour, and how they experience and respond to their role as peer counsellor, and then to use the information obtained in the development of an adolescent-friendly peer counsellor training program. By doing this, the expectation was that the problematic issues cited in the literature could be addressed. Guided by an ethnographic framework the project also examined the influence of an adolescent-friendly peer counsellor training program on the non-peer counsellor students in the wider adolescent community of the high school. Three sequential studies were undertaken. In Study 1, the typical adolescent conversational and communications skills that young people use when helping each other were identified. In addition, those microcounselling skills that young people found useful and compatible with their typical communication processes were identified. In Study 2, an intervention research process was used to develop, deliver, and evaluate an adolescent-friendly peer counsellor training program which combined typical adolescent helping behaviours with preferred counselling microskills selected by participants in Study 1. The intervention research paradigm was selected as the most appropriate methodology for this study because it is designed to provide an integrated perspective for understanding, developing, and examining the feasibility and effectiveness of innovative human services interventions (Bailey-Dempsey & Reid, 1996; Rothman & Thomas, 1994). Intervention research is typically conducted in a field setting in which researchers and practitioners work together to design and assess interventions. When applying intervention research methodology researchers and practitioners begin by selecting the problem they want to remedy, reviewing the literature, identifying criteria for appropriate and effective intervention, integrating the information into plans for the intervention and then testing the intervention to reveal the intervention's strengths and flaws. Researchers then suggest modifications to make the intervention more effective, and satisfying for participants. In the final stage of intervention research, researchers disseminate information about the intervention and make available manuals and other training materials developed along the way (Comer, Meier, & Galinsky, 2004). In Study 2 an adolescent-friendly peer counsellor training manual was developed. Study 3 evaluated the impact of the peer counsellor training longitudinally on the wider school community. In particular, the project was interested in whether exposure to trained peer counsellors influenced students who were not peer counsellors with regard to their perceptions of self-concept, the degree of use of specific coping strategies and on their perceptions of the school climate. Study three included the development of A School Climate Survey which focused on the psychosocial aspects of school climate from the student's perspective. Two factors which were significantly correlated (p<.01) were identified. Factor 1 measured students' perceptions of student relationships, and Factor 2 measured students' perceptions of teachers' relationships with students. The present project provides confirmation of a number of findings that other studies have identified regarding the idiosyncratic nature of adolescent communication, and the conversational and relational behaviours of young people (Chan, 2001; Noller, Feeney, & Peterson, 2001; Papini & Farmer, 1990; Rafaelli & Duckett, 1989; Readdick & Mullis, 1997; Rotenberg, 1995; Turkstra, 2001; Worcel et al., 1999; Young et al., 1999). It extends this research by identifying the specific conversational characteristics that young people use in helping conversations. The project confirmed the researcher's expectation that some counselling microskills currently used in training adolescent peer counsellors are not easy to use by adolescents and are considered by adolescents to be unhelpful. It also confirmed that some typical adolescent conversational helping behaviours which have been proscribed for use in other adolescent peer counsellor training programs are useful in adolescent peer counselling. The project conclusively demonstrated that the adolescent-friendly peer counsellor training program developed in the project overcame the difficulties of skill implementation identified in the adolescent peer counselling literature (Carr, 1984). The project identified for the first time the process used by adolescent peer counsellors to deal with issues related to role attribution and status difference. The current project contributes new information to the peer counselling literature through the discovery of important differences between early adolescent and late adolescent peer counsellors with regard to acquiring and mastering counselling skills, and their response to role attribution and status difference issues among their peers following counsellor training. As a result of the substantive findings the current project makes a significant contribution to social support theory and prosocial theory and to the adolescent peer counselling literature. It extends the range of prosocial behaviours addressed in published research by specifically examining the conversational helping behaviour of adolescents from a relational perspective. The current project provides new information that contributes to knowledge of social support in the form of conversational behaviour among adolescents identifying the interactive, collaborative, reciprocal and idiosyncratic nature of helping conversations in adolescents. Tindall (1989) suggests that peer counsellor trainers explore a variety of ways to approach a single training model that can augment and supplement the training process to meet specific group needs. The current project responded to this suggestion by investigating which counselling skills and behaviours adolescent peer counsellor trainees preferred, were easy to use by them, and were familiar to them, and then by using an intervention research process, devised a training program which incorporated these skills and behaviours into a typical adolescent helping conversation. A mixed method longitudinal design was used in an ecologically valid setting. The longitudinal nature of the design enabled statements about the process of the peer counsellors' experience to be made. The project combined qualitative and quantitative methods of data gathering. Qualitative data reflects the phenomenological experience of the adolescent peer counsellor and the researcher and quantitative data provides an additional platform from which to view the findings. The intervention research paradigm provided a developmental research method that is appropriate for practice research. The intervention research model is more flexible than conventional experimental designs, capitalises on the availability of small samples, accommodates the dynamism and variation in practice conditions and diverse populations, and explicitly values the insights of the researcher as a practitioner. The project combines intervention research with involvement of the researcher in the project thus enabling the researcher to view and report the findings through her own professional and practice lens.

This randomized, controlled study examined the effectiveness of two mentoring programs, child mentor relationship training (CMRT) and peer assistance and leadership (PAL®), on high school mentor empathic behaviors and child mentee behavior problems. Participants were 60 young, at-risk students (61.7% male; 38.3% Hispanic/Latino/a, 31.7% Caucasian, 21.7% African American, 8.3% biracial) and 30 high school students (53.3% male; 66.7% Caucasian, 26.7% Hispanic/Latino/a, 0.03% African American, 0.03% Asian). Mentors and mentees were randomly assigned to CMRT or PAL®, which was treatment as usual in the participating school district. Results from 2 (group) by 2 (time) repeated measures ANOVAs indicated compared to the PAL® treatment group over time, mentors in the CMRT group demonstrated statistically significant improvement in empathic behaviors with a large treatment effect, as rated by independent observers. Analysis revealed a moderate treatment effect with CMRT group mentee behavior problems, but the difference was not statistically significant between treatment groups over time. Further analysis revealed the CMRT group demonstrated statistically significant reductions in behavior problems from pre- to post-test with a very large treatment effect. Overall, findings support CMRT as a promising school-based intervention for at-risk young children that potentially increases school counselor efficiency.

This essay concerns on how my novel The Teacher was influenced by the Masters course I completed in Creative Writing at Linnaeus University (2012 – 2014). Basically, The Teacher is about a love affair between a teacher and a student. With an intertextual, comparative and structurally inspired method I examine the process of writing my text. I also examine how my work relates to the great changes of the Swedish school system in the early 1990:s: deregulation, decentralisation and management by objectives. These changes are satirised in the novel. The essay also deals the role of the city in its time, the school in its town, contemporary literary texts with corresponding thematic, the moral values in their time and overall existential questions about responsibility, guilt, acceptance, non-judgmental attitudes, forgiveness and being in the present moment. The examining part of the essay shows how these premises get a concrete expression in the main conflict, main theme, characterization, narrative and stylistic choices. The essay clarifies the satirical point of view that turns The Teacher into an ironical reflection on the Swedish school system after the so-called “kommunaliseringen” (communities taking over from the state). The essay also clarifies how grown ups abdicate from responsibility in the Swedish society and how people judge each other and cling to roles. For that reason The Teacher is relevant within its time but also and even more since it is about recurring existential questions about responsibility and non-judgmental attitudes.

The role of peer gatekeepers is crucial in connecting individuals at risk for suicide related behaviors to mental health service providers. However, limited research has focused on the role of peers as potential helpers for those at-risk. The current study utilized a mixed experimental and correlational design to examine predictors of female college students’ referral intentions following hypothetical interactions with peers at-risk for suicide related behavior. More specifically, the current project examined the utility of an extended Theory of Planned Behavior (TPB) model of peer-referral intentions. In addition to the original TPB constructs of attitudes, subjective norms, and perceived behavioral control associated with referring a peer to a mental health professional, attitudes towards seeking professional help, perceived stigma associated with receiving professional psychological help, emotional competence, and symptom severity were incorporated into an extended TPB model. The sample included 284 female college students. Participants completed computer-based questionnaires both before and after the presentation of a theoretically and empirically informed vignette describing a peer who was characterized as low, moderate, or high risk for suicide related behavior. The results of this study suggest the utility of applying an extended TPB model to intentions to refer at-risk peers for mental health services. The final trimmed model, which included all of the aforementioned constructs except symptom severity, accounted for 78.9% of the variance in referral intentions. The findings indicate that, in particular, preventative interventions would likely benefit from emphasizing the role of attitudes towards receiving mental health services, attitudes towards peer referral, and subjective norms regarding peer referral, in order to maximize the role of peers as gatekeepers for college students in distress. Incorporating the findings from this study with findings from future research will hopefully lead to more informed, empirically-based interventions for enhancing peer referrals.

Disproportionately high numbers of Black people use mental health services and experience involuntary treatment in the UK. There is no simple explanation, but research and policy suggest that groups run by and for Black people with mental health problems provide valued support. This study asks how community development (CD) practice can help these groups to develop and thrive. The research adopted an action research framework to develop four cycles of research, each informing the next, within a social constructivist paradigm. Methods were mainly qualitative: interviews, group discussions and observation, with a questionnaire survey in cycle one. This asked CD practitioners about their activities and helped to identify two groups for case studies in cycles two and three. During the case studies, groups received development support on their chosen topic while participating in qualitative research; activities were clearly demarcated. Reflective field notes added to the data. In the fourth cycle reflective conversations with eminent ‘critical friends’ refined and affirmed the learning. Thematic analysis was continuous and progressive. Findings suggest that CD practitioners can inspire and help Black people with mental health problems to come together in member-led, mutually supportive groups, justifying Black-only membership. Effective practitioners, especially Black role models, helped groups to generate self-belief and self-efficacy through collective action, enabling members to change their status, services and community. Those practitioners who demonstrated critical humility, commitment and competence broke the pattern of racial and psychiatric dominance. Others inadvertently reinforced societal oppression. A new concept is introduced to encapsulate the learning: the ‘liberation approach’ to CD which synthesises four perspectives: radical CD, mental health recovery, Black self-help and liberation theories. This approach helps groups to challenge oppressive processes, breaking the mould in which they feel constrained. The study contributes new theory, evidence and research methodology about CD and self-organising groups within this context.

Els diferents col·lectius de professionals, les experiències personals viscudes anteriorment, els valors i creences, l'edat, el sexe i la formació creen una diversitat de punts de vista i maneres d'actuar diferents davant d'un malalt terminal. Aquesta divergència comporta una falta de cohesió en la tasca professional i una manca de criteris d'actuació unànimes. La finalitat d'aquest projecte és conèixer quins són els criteris assistencials per a una mort digna. Per això, els objectius concrets que es persegueixen en aquest estudi són: analitzar les actituds del personal sanitari davant la mort dels malalts i fomentar els criteris de qualitat assistencial que haurà d'utilitzar l'equip interdisciplinari amb la finalitat d'abordar terapèuticament el procés de la mort del pacient pal·liatiu. L'estudi segueix un disseny que combina el mètode qualitatiu amb el quantitatiu. A nivell quantitatiu, la mostra ha estat formada per un total de 260 participants (17 homes i 243 dones), l'instrument utilitzat ha estat un qüestionari de 16 ítems que avalua com s'està realitzant actualment l'atenció al malalt terminal, competències del professional (coneixements, habilitats, actituds, sentiments, implicacions emocionals del professional) i com s'hauria de realitzar l'atenció al malalt terminal; posteriorment les dades s'han analitzat mitjançant el programa estadístic SPSS.V15. A nivell qualitatiu, van col·laborar en l'estudi 6 participants (2 homes i 4 dones) en els que s'ha aplicat una entrevista estructurada, semidirigida i individual que posteriorment s'ha analitzat mitjançant el programa Atlas.ti. Els resultats a nivell quantitatiu indiquen que dels 260 professionals sanitaris enquestats hi ha una actitud negativa davant la mort del 24.2%, aquest fet ens diu que existeix quasi una quarta part dels professionals que no tenen coneixement dels criteris per a una mort digna. Per altra banda, els resultats de les entrevistes indiquen una convergència de criteris alhora de definir una bona i una mala actitud professional. Així doncs, cal canviar les actituds o estils professionals en l'acompanyament a la mort; com més assertiva sigui la nostra actitud i quanta més capacitat tinguem per millorar l'estat d'ànim, major serà la qualitat de vida de les persones que ens deixen i ens han dipositat la seva confiança, una confiança que no podem transgredir, doncs es tracta d'un dret humà.<br>Los diferentes colectivos de profesionales, las experiencias personales vividas anteriormente, los valores y creencias, la edad, el sexo y la formación crean una diversidad de puntos de vista y maneras de actuar diferentes ante un enfermo Terminal. Esta divergencia comporta una falta de cohesión en la tarea profesional y una falta de criterios de actuación unánimes. La finalidad de este proyecto es conocer cuáles son los criterios asistenciales para una muerte digna. Por ello, los objetivos concretos que se persiguen en este estudio son: analizar las actitudes del personal sanitario ante la muerte de los enfermos y fomentar los criterios de calidad asistencial que tendrá que utilizar el equipo interdisciplinario con la finalidad de abordar terapéuticamente el proceso de la muerte del paciente paliativo. El estudio sigue un diseño que combina el método cualitativo con el cuantitativo. Según el método cuantitativo, la muestra ha sido formada por un total de 260 participantes (17 hombres y 243 mujeres), el instrumento utilizado ha sido un cuestionario de 16 ítems que baraja como se está realizando actualmente la atención al enfermo terminal, competencias del profesional (conocimientos, habilidades, actitudes, sentimientos, implicaciones emocionales del profesional) y como se debería realizar la atención al enfermo terminal; posteriormente los datos se han analizado mediante el programa estadístico SPSS.V15. Según el método cualitativo, colaboraron en el estudio 6 participantes (2 hombres y 4 mujeres) en los que se ha aplicado una entrevista estructurada, semidirigida e individual que posteriormente se ha analizado mediante el programa Atlas.ti. Los resultados cuantitativos indican que de los 260 profesionales sanitarios encuestados presentaron una actitud negativa ante la muerte del 24,2%, este hecho nos indica que hay casi una cuarta parte de los profesionales que no tienen información de los criterios asistenciales para una muerte digna. Por otra parte, los resultados de las entrevistas indican una convergencia de criterios al definir una buena y una mala actitud profesional. Así pues, es preciso cambiar las actitudes o estilos profesionales en el acompañamiento a la muerte; cuanto más asertiva sea nuestra actitud y cuanta más capacidad tengamos para mejorar el estado de ánimo, mayor será la calidad de vida de las personas que nos dejan y nos han depositado su confianza, una confianza que no podemos transgredir, pues se trata de un derecho humano.<br>The different professional groups, previous personal experiences, values and beliefs, age, gender and training bring about a wide range of points of view and ways of interacting with the terminally ill. This criteria divergence entails a lack of cohesion in the professional task and a lack of unanimous performance. The aim of this project is to get to know which are the welfare criteria for a dignified death. Hence, the specific objectives in this research are: to analyze the attitude of the public health staff towards the patient's death and promote the health care quality criteria to be used by the interdisciplinary team to tackle the death process in the palliative patient. The study is designed as to combine the qualitative and quantitative method. At a quantitative stage, the sample consisted of 260 participants (17 men and 243 women). The evaluation tool was a questionnaire consisting of 16 items which evaluated the attention on the terminally ill, the professional competence: knowledge, ability, attitude, feelings, emotional implications as well as how to assist the terminally ill. The data was then analyzed by SPSS.V15 statistic programme. Six participants took part at a qualitative level (2 men and 4 women) who underwent a structured , semi directed and individual interview which was subsequently analyzed by Atlas.ti programme. The results at a quantitative level indicate that 24.2% out of 260 health care workers surveyed have a negative attitude towards death. This fact shows that almost a fourth part of the professionals don't know the criteria to be applied for a dignified death. On the other hand, the interview results indicate a criteria convergence when defining a good and a bad professional attitude. Therefore, the professional attitudes or styles in supporting a dignified death must be changed. The more assertive our attitude is, and the more capacity to improve our mood we have, the better quality of life will the dying people have. This trust we cannot betray for it is a human right.

I slutet av femtiotalet var det ingen som kunde tro att de tre icke-socialistiska partierna Centern, Folkpartiet och Högern skulle kunna enas om något politiskt program och än mindre samsas i en regering. Med tiden förstod partierna ett efter ett att det enbart var genom en borgerlig samverkan som de skulle kunna bryta Socialdemokraternas makthegemoni. Några händelser var av yttersta vikt för att borgerligheten skulle kunna enas. Centern gick från att vara ett resultatfokuserat stödparti åt Socialdemokraterna med annat fokus än bara böndernas, vilket ledde till en mer marknadsekonomisk orientering. Folkpartiet däremot behöll sin profil och arbetade i många år för ett närmande till Centern, vilket var källan till både glädje och sorg för partiet. Högern å sin tur, som präglades av starka interna stridigheter, reformerades till ett modernare parti under sextiotalet men det var först under Bohman som partiet enades och därmed blev ett mer trovärdigt regeringsparti. Högern, sedermera Moderaterna, var det parti som under flera år arbetade hårdast för att borgerligheten skulle samla sig i ett gemensamt regeringsalternativ, emedan framförallt Centern under en lång period höll emot. Utöver partiernas egna utveckling kan också nämnas socialdemokratins radikalisering som en en för borgerligheten sammansvetsande faktor. Detta tillsammans med samhällsförändringarna gjorde att sextiotalets förarbete resulterade i en borgerlig regering 1976.

Our healthcare systems are facing sustainability challenges caused by a demographic shift with ageing, chronicity and disability growing in our society. A novel healthcare paradigm should be founded on 4P medicine: Preventive, Predictive, Personalized, and Participatory medicine needs new methodologies and tools enabled by Information and Communication Technologies (ICTs). One of the key technology enablers for 4P medicine is telemonitoring, i.e. ICTs to monitor the health status of a patient from a distance, which may trigger 4P decision making. A new generation of telemonitoring tools allow prescription and follow-up around the main chronic care strategies, namely, therapeutic adherence and healthy habits promotion. A broader and more ambitious challenge is Quality of Life (QoL) telemonitoring based on the knowledge of context. We are proposing a formal methodology to provide Context-aware QoL assessment, categorizing data inputs, defining outputs, and exploring data fusion techniques. A Telemonitoring and Home Support System (TMHSS) which implements that methodology has been designed, developed and integrated to the BackHome system for a particular Use Case, i.e. severely disabled people using Brain Computer Interfaces (BCI) as an assistive technology (AT) at home. We have applied User Centred Design throughout all development stages of a multi-functional BCI, in order to move BCIs from the lab towards independent home use. The BackHome system has achieved five key innovations: (i) an architecture able to meet the requirements of BCI multifunctionality and remote home support; (ii) a light, autonomous, comfortable and reliable BCI equipment; (iii) an easy-to-use software to control multiple purpose applications; (iv) a TMHSS for BCI independent home use; and (v) a Therapist station to manage and monitor BCI-based remote services. We have evaluated the BackHome system with end-users at home, also taking the therapists' and non-expert caregivers' perspective into account. The results show good acceptance, usability levels, user satisfaction and levels of control, which demonstrate that BCI can already be considered as an alternative AT. We used the TMHSS of BackHome to recognize activities and habits of users based on the analysis of sensors' data, in order to detect for example whether the user is at home or away or whether has received a visit at home or not. Similarly, and consequently from the previous analysis, results show good accuracies in assessing items of QoL such as Mobility, Sleep, or Mood, based on measures and fusion of detected activities from the user. The assessment of the overall wellbeing of an individual with a multidimensional perspective through processing of data gathered from environmental and personal sensors in a broad and non-intrusive way, will become of great interest to healthcare professionals, policy makers and also for citizens which are called to co-produce and lead the new paradigm of care.<br>Els nostres sistemes de salut estan veient qüestionada la seva sostenibilitat arran del canvi demogràfic d'una societat en la qual augmenta la prevalença de cronicitat i discapacitat. El nou model de salut es basa en la Medicina 4P. Una tecnologia clau per a la Medicina 4P és el telemonitoratge, és a dir, les TIC per conèixer l'estat de salut d'un pacient a distància i prendre decisions 4P. Un repte ambiciós és el telemonitoratge de la Qualitat de Vida (QoL) basat en el coneixement del context. Proposem una metodologia formal per avaluar la QoL mitjançant la categorització de dades d'entrada i sortida i tècniques de fusió de dades. Hem dissenyat i desenvolupat un Sistema de Telemonitoratge i Suport Domiciliari (TMHSS) que implementa aquesta metodologia, integrat al sistema BackHome per un Cas d'Ús concret, el de persones amb discapacitats severes que utilitzen Interfícies Cervell Ordinador (BCI) com a Tecnologia Assistencial (AT) en entorns reals. Hem aplicat Disseny Centrat en l'Usuari amb la finalitat de traslladar els BCIs des del laboratori fins a l'ús domèstic independent. El sistema BackHome ha assolit cinc innovacions fonamentals: (i) una arquitectura que satisfà els requisits d'un BCI multifuncional i amb suport remot; (ii) un dispositiu de BCI lleuger, autònom, còmode i fiable; (iii) un programari fàcil d'utilitzar per a manegar diverses aplicacions d'autonomia física i social; (iv) Un TMHSS per fer efectiu l'ús independent dels BCIs a la llar; i (v) una estació clínica per a la gestió remota de serveis terapèutics. Hem avaluat el sistema BackHome amb usuaris finals a casa seva, aprenent de la perspectiva de terapeutes i cuidadors no experts amb resultats que mostren bona acceptació i nivells d'usabilitat, satisfacció de l'usuari i nivells de control que demostren que el BCI pugui ja considerar-se una AT alternativa. Hem emprat el TMHSS de BackHome per reconèixer activitats i hàbits dels usuaris a partir de l'anàlisi de dades de sensors, per detectar per exemple si l'usuari està a casa o fora, o si ha rebut una visita. També hem avaluat a continuació amb bona precisió elements de la Qualitat de Vida, com ara mobilitat, son, o estat d'ànim, a partir de les activitats de l'usuari prèviament detectades.

碩士<br>國立彰化師範大學<br>輔導學系<br>82<br>The two purposes of this study are ：(1) to train peer helpers to improve their interpersonal relationship, basic helping skills, the skills of leading group discussion and understanding the role of the peer helper, (2) to understand the role of peer helper in the effects of classroom guidance. The subjects were sophomores of a public senior high school in Kauohsiung city. Pretest-posttest nonequivalent control group design and interrupted time- series design were applied into this research. Meanwhile, in order to collect qualitative data, sociometric test, in- person interview and vedio-taped observation were adopted into the research process, too. The research findings were:一 、Concerning the effects of the peer helpers'''' training program:（一）Peer helpers were willing to share feelings with their classmates more than ever during the research period.（二）Most of the peer helpers led discussion actively but a few of them led discussion nondirectly.（三） All of the peer helpers understood they were not counselors. But they didn''''t introduce enough infor- mations about the guidance center to their class- mates. 二、Concerning the effects of the classroom guidance:（一） Students understood each other, sharing experiences, geting along with classmates and identifing their classroom well than before through the activities of the classroom guidance.（二）The classroom cohesion wasn''''t significantly influenced by classroom guidance.（三）The reading atmosphere wasn''''t significantly influenced by classroom guidance.

The purpose of this study is to tell the story of how four peer helpers within the Unisa Peer Help Volunteer Programme managed their portfolio development processes to monitor their growth and development which took place as a result of their involvement in peer helper activities. The epistemological framework of this study is interpretive and involved in-depth interviews with four peer helpers who rendered volunteer services at the University of South Africa and have been developing their career portfolios over a period of time. Hermeneutics was the method used to analyse the data. The stories of the four participants were transcribed and retold by the researcher in the form of themes that emerged. This study contained the stories of how the participants initially struggled to understand the concept and purpose of portfolios; how they took charge of the process; and how their attitudes changed from uncertainty and confusion to viewing the process as worthwhile - thus enabling them to commit themselves, to varying degrees, to the development of their individual portfolios. Recurring themes present in all four stories were described in the researcher's story of the participants' stories. The information generated by this study could serve as guidelines for not only peer helpers interested in developing their own portfolios, but also for project leaders involved in the management of peer helper groups and who plan to implement portfolios in their programmes.<br>Psychology<br>M.A. (Psychology)

碩士<br>國立彰化師範大學<br>輔導系<br>87<br>This study is aimed at designing the training program for senior high school students as peer helpers, and assessing the effectiveness of the training program and the peer helpers. There are 57 students of Stella Matutina Girls’ High School attending this research. Self-attitude questionnaire, Group Scale, and Counselor Rating Form (CRF) are employed, and in order to collect qualitative data, in-person interview are adopted into the research process, too. The results of this research are as following: 1.There is no interaction effect between group and time variables in subjects’ self-concept. For the main effect of group variable, there is no significant difference. For the main effect of time variable, there is significant difference, and the posttest is higher than the pretest results. 2.The basic helping skills that the peer helpers learned from the training program are: nonverbal skills, listening skills, self-expression skills, and coping with value conflict. 3.The peer helpers think that the meaning of attending group training program are: increasing the realization, acceptance and growth of oneself, improving the interpersonal relationships and communication skills. 4.The assessment of peer helpers’ efficiency in expertness, attractiveness, and trustworthiness are positive regarded. Finally, discussions of the results are made and suggestions for teachers, counselors, and advanced studies are supplied.

Text in English<br>The primary aim of this study is to explore and describe experiences of peer helpers at an Open Distance Learning institution since the start of their joining the Unisa Peer Help Volunteer Programme. This study was conducted with the intention of granting the peer helpers an opportunity to reflect on their individual experiences and in so doing in laying the foundation for future studies, intended to steer the Unisa peer help volunteer programme to new frontiers, while simultaneously highlighting the contribution that has been made by the Unisa Peer Help Voluntary Programme. An intrinsic case study design has been utilised in order to gain comprehensive insight into peer helpers’ experiences. A sample of seven peer helpers were interviewed using the semi-structured interview technique. The main findings from this study can be categorised into four distinctive themes namely: (a) the peer helpers’ goals for joining the Unisa Peer Help Volunteer Programme; (b) construction of roles as peer helpers at an open distance learning institution; (c) positive experiences of participating in the Unisa peer help volunteer programme; and (d) the negative experiences of participating in the Unisa Peer Help Volunteer Programme. The findings have painted a positive picture of how the Unisa peer help volunteer programme has contributed in shaping the lives of the peer helpers.<br>Psychology<br>M.A. (Psychology (Research Consultation))

In South Africa the idea of a peer helping service has gained impetus and is viewed as a viable option given the fact that there is a shortage of professional school-counsellors and complementary care-givers in the public school environment. This research emanated from an awareness that there was a need to develop an objective assessment tool regarding the identification of peer-counsellors. This instigated an investigation of the essential criteria, predominant characteristics and requirements of effective peer-counsellors. The primary focus of this research has been to develop a self-assessment instrument that will assist in the identification and selection of potential peer-counsellors. The self-assessment instrument proved to be a valuable tool in discriminating between good, average and weak peer-counsellors. Findings indicate that the self-assessment instrument should be used in conjunction with other modes of assessment such as the self-report data, teacher ratings and peer ratings.<br>Psychology of Education<br>M. Ed. (Guidance and Counselling)

Background and Objectives: In a previous randomized study, we reported the benefits of providing integrated care by the Joint Asia Diabetes Evaluation (JADE) Program consisting of comprehensive assessment (CA) and 3-4 monthly follow up (FU) assessments with personalized feedback reports and decision support on control of cardio-metabolic risk factors through reduced clinical inertia and improved self-care. Further, provision of additional peer support improved psychological well-being and all-cause hospitalization especially in those with negative emotions who tended to have co-morbidities. However, given the multicomponent nature of the program, the differential effects of peer support in different patient subgroups and independent effect of personalized FU reports had not been systematically evaluated.. In this thesis, I used a randomized and case-control design to examine the effects of providing regular FU reports and peer support on metabolic control, psychological health, and all-cause hospitalization in patients with diabetes.<br>Methods: Between February and December 2013, 1488 Chinese patients with diabetes aged 18-75 years underwent CA using the JADE portal and returned in 4 weeks in groups to receive their personalized CA report with explanation by nurses about their complications, risk factors and treatment targets. Amongst them, I selected 288 high risk patients defined as 1) HbA1c≥8%, 2) obesity (body mass index≥27.5 kg/m² and/or waist≥80cm (women) or ≥90cm (men), and/or 3) chronic kidney disease (CKD, eGFR<60ml/min/1.73m²) and offered them a telephone-based peer support program, to which 144 (50%) agreed (P+ group) and 144 (50%) refused (P- group). Within each group, they were also randomized to receive 2 JADE FU reports by mail after their clinic visits. These FU reports displayed their trends of ABC (HbA1c, BP, LDL-C) control and body weight with individualized reminders for self-care during a 12-month period. In the remaining patients (n=1200), half were randomized to receive 2 FU reports by mail (R+ group: n=600) while half received usual care (R- group: n=600). Amongst patients not offered peer support, 425 patients (50% received FU report) were matched to the P+ group (52% received FU report) on a 3:1 basis by age, gender, diabetes duration, and baseline HbA1c as a control group. The outcome measures were reduction in HbA1c and all-cause hospitalization at month 12.<br>Results: Amongst patients not offered peer support, after a median (IQR) follow-up period of 575 (519-646) days, the R+ group had greater reduction in HbA1c (mean [95% CI]: -0.24[-0.35,-0.14]% versus -0.15[-0.24,-0.06]%, p=0.030) with similar hospitalization rate and frequency compared with the R- group. Amongst patients offered peer support, the P+ group and P- group had similar baseline clinical and psychological-behavioral parameters. After 530 (463-575) days, the P+ group (n=138) tended to have greater reduction in HbA1c (-0.75[-0.97,-0.52]% versus -0.42[-0.68,-0.15]%, p=0.106) with significant improvements in mental health and quality of life than the P- group (n=131). In the case-control cohort for peer support,the P+ group tended to have greater reduction in HbA1c than the control group (n=425) (-0.75[-0.97,-0.52]% versus -0.49[-0.64, -0.35]%, p=0.119) with lower rate, frequency and length of hospitalization. On multivariable analysis of the entire cohort (n=1488), peer support (β coefficient [95% CI] -0.31[-0.56, -0.06], p=0.015) and receiving FU reports (-0.14[-0.25, -0.04], p=0.009) were independent predictors for reduction in HbA1c. Peer support (OR [95% CI] 0.36[0.16, 0.79], p=0.011) and CKD with FU reports (0.40[0.18, 0.88], p=0.022) were also associated with reduced hospitalization.<br>Conclusion: In this real-world quality improvement program, both peer support and regular personalized feedback report by mail were associated with reduced HbA1c in patients with diabetes. Peer support was associated with lower risk of hospitalization, while feedback report was associated with reduced hospitalization only in patients with diabetes and comorbid CKD.<br>背景及目的：在一項隨機對照研究中，我們發現通過亞洲糖尿病評估計劃JADE提供整合了全面糖尿病併發症篩查（CA）、定期隨訪（FU）評估、個體化回饋報告及決策支持的綜合護理可通过降低臨床惰性，促進自我管理從而改善糖尿病風險因素的控制。在此基礎上，同伴支持可進一步改善患者的心理健康，降低住院率， 并且在有負面情緒的人群中作用尤其明顯。然而，由於綜合護理由多部分組成，個體的作用並未被系統評估。本文分別採用隨機對照和病例對照研究，評估個體化隨訪報告和同伴支持對糖尿病患者代謝控制、心理健康及住院率的作用。<br>研究方法：2013 年2 月至12 月，1488 位年齡18 至75 歲的糖尿病患者進行了CA，並于4 周後領取個體化CA 報告，由護士說明其併發症和危險因子的控制以及治療有無達標。其中，我邀請了288 位有以下高危因素的患者參加一項基於電話的同伴支持計劃：1）糖化血紅蛋白（HbA1c）≥8%；2）肥胖（體重指數≥27.5 kg/m² 和/或女性腰圍≥80cm/男性腰圍≥90cm；和/或3）慢性腎臟病（CKD，腎小球濾過率<60 ml/min/1.73m²）。其中，144 位（50%）同意（P+ 組）參與，144 位（50%）（P- 組）拒絕參與。每組再隨機抽取一半患者郵寄2 份JADEFU 報告。該報告顯示了患者HbA1c、血壓、低密度膽固醇和體重的控制情況，並附有針對自我管理的個體化建議。餘下的1200 位患者中，隨機抽取一半患者（R+ 組，n=600）郵寄2 份JADE FU 報告，另外一半患者常規護理（R- 組，n=600）。未被邀請參加同伴支持計劃的1200 位患者中，425 位（50%有FU 報告）按年齡、性別、病程和基礎HbA1c 與P+組（52%有FU 報告）匹配成為對照組。研究指標為12 個月後HbA1c 和住院率的改變。<br>研究結果：未提供同伴支援的患者中，經過575（519-646）日的隨訪，R+組HbA1c 降低更多（ 均值[95% 置信區間]: -0.24[-0.35,-0.14]% versus-0.15[-0.24,-0.06]%, p=0.030），但住院率與R-組相同。提供同伴支持的患者中，P+組和P-組研究開始時臨床、心理和行為指標皆相似。530（463-575）日後，與P-組比較，P+組有HbA1c 降低更多的趨勢（-0.75[-0.97,-0.52] % versus-0.42[-0.68,-0.15]%, p=0.106），住院率相似，但心理健康和生活品質均有明顯改善。在病例對照研究中，與對照組比較（n=425），P+組（n=142） HbA1c降低更多（-0.92[-1.25, -0.59]% versus -0.39[-0.58, -0.21], p=0.004），且住院率、住院次數和時間皆有明顯降低。採用多變量回歸分析，同伴支持（β 係數[95% 置信區間] -0.31[-0.56, -0.06], p=0.015）和FU 報告（-0.14[-0.25, -0.04], p=0.009）均是降低HbA1c 的獨立預測因子。同伴支持（0.36[0.16, 0.79], p=0.011） 和CKD伴FU 報告（0.40[0.18, 0.88], p=0.022）與住院风险降低明顯相關。<br>結論：在此項品質改進計畫中，同伴支持和定期郵寄個體化隨訪報告均与糖尿病患者的糖化血紅蛋白降低相關。同伴支持伴隨住院风险降低，但個體化隨訪報告僅在糖尿病伴慢性腎臟病患者中与住院风险降低相關。<br>Yin, Junmei.<br>Thesis Ph.D. Chinese University of Hong Kong 2015.<br>Includes bibliographical references (leaves 209-235).<br>Abstracts also in Chinese; appendix 4 in Chinese.<br>Title from PDF title page (viewed on 06, October, 2016).<br>Detailed summary in vernacular field only.<br>Detailed summary in vernacular field only.<br>Detailed summary in vernacular field only.<br>Detailed summary in vernacular field only.

Certaines personnes peuvent être stigmatisées quand elles présentent un attribut relié à une identité sociale qui est dénigrée dans un contexte particulier. Il existe plusieurs stéréotypes au sujet des personnes qui ont une perte d'audition. Le grand public associe souvent la perte d'audition à des comportements indésirables, au vieillissement et à une capacité intellectuelle réduite. Ces stéréotypes affectent négativement la participation des personnes ayant une perte auditive à diverses activités. Malgré les impacts évidents et importants que la stigmatisation a sur la participation sociale des personnes ayant une perte auditive et leur propension à recourir aux services de réadaptation, on constate une pénurie relative de recherche sur le stigmate lié à la perte d'audition. Ces dernières années, les chercheurs en sciences sociales ont fait de grands pas pour conceptualiser le stigmate selon la perspective des personnes qui sont la cible des attitudes nuisibles. La plupart de ces concepts peuvent s'appliquer au stigmate social lié à la perte d'audition. Le premier article de cette thèse tente de placer le stigmate lié à la perte d'audition dans un modèle de menace à l’identité induite par le stigmate (stigma-induced identity threat model). Ce chapitre explore comment les services pourraient être modifiés pour mieux soutenir les individus qui montrent des signes que leur identité personnelle est compromise à cause de leur perte d'audition. De façon générale, les buts de ce manuscrit sont a) de dresser un bref résumé de la question du stigmate lié à la perte d'audition ; b) de présenter un modèle spécifique de menace d'identité induite par le stigmate et d’incorporer des notions propres au stigmate lié à la perte d'audition à cette conceptualisation générale du stigmate et c) de réfléchir sur la pertinence de ce modèle pour la réadaptation audiologique. L'intention de la deuxième étude est de mieux comprendre comment le stigmate affecte les comportements de recherche d’aide des adultes ayant une perte d'audition acquise. Dix personnes ayant une perte d'audition, et appartenant à des groupes de soutien par les pairs ont participé à des entrevues semi-structurées audio-enregistrées. Les transcriptions de ces entrevues ont été analysées au moyen d’analyses thématiques. Les analyses ont indiqué que les répondants montre une plus grande propension à chercher de l'aide à la suite d’étapes charnières, où l’équilibre entre le stress négatif et l'énergie positive était rompu : a) un moment où le stress était de loin supérieur à l'énergie positive (première étape charnière) et b) un moment où l'énergie positive était de loin supérieure au stress négatif (deuxième étape charnière). On propose une série de représentations graphiques qui dépeignent comment les influences positives et négatives présentes dans l'environnement social et physique du répondant influencent la recherche d'aide. Le but de la troisième étude est d'identifier les facteurs qui amènent des individus à cacher ou révéler leur perte d'audition dans leur lieu de travail. Des entrevues semi-structurées ont été menées en utilisant une technique d’élicitation par photographies pour susciter des informations liées à la révélation de la perte d'audition. Les thèmes dégagés des entrevues incluent : l'importance perçue de la situation, la perception du sentiment de contrôle, l'affiliation à la communauté, le fardeau de communication et la présence de problèmes connexes à la perte d'audition. Les résultats de cette étude offrent un aperçu du monde caché des travailleurs ayant une perte d'audition. Cette étude sert à documenter certaines stratégies que les travailleurs avec une perte d'audition utilisent pour contrôler leur identité professionnelle et, plus spécifiquement, comment certains gèrent le dévoilement de leur perte d'audition dans leur lieu de travail. Les résultats fournissent des informations utiles pour le développement de programmes d'intervention appropriés pour des travailleurs ayant une perte d'audition.<br>Individuals are stigmatized when they possess, or are thought to possess, an attribute or characteristic that conveys a social identity that is devalued in a particular social context. There are several stereotypes, or commonly held (often erroneous) beliefs about people who have hearing loss. The general public often associate people with hearing loss to undesirable behaviours, ageing, and reduced intellect. Stereotypes such as these negatively impact upon activities of daily living engaged in by people with hearing loss. In spite of the obvious and important impacts that stigma has on social participation and inclination to use rehabilitative strategies, there has been a relative dearth of research on the stigma associated with hearing loss. In recent years, researchers in the social sciences have made great strides to conceptualize “stigma” from the perspective of people who are the target of prejudicial attitudes. Most of these concepts are applicable to the social stigma associated with hearing loss. The first study presented in this dissertation attempts to position hearing loss stigma within a model of stigma-induced identity threat. Overall, the goals of this paper are to a) offer a brief summary of hearing loss stigma; b) present a specific stigma identity threat model and incorporate ideas about hearing loss stigma into this general conceptualization of stigma; and c) reflect on the appropriateness of this model for the domain of rehabilitative audiology. The intent of the second study was to better understand how stigma impacted upon the help-seeking activities of adults with an acquired hearing loss. Ten people who had hearing loss, and were members of peer-support groups participated in audio-recorded semi-structured interviews. Thematic analyses of verbatim transcripts revealed that respondents experienced a heightened propensity to seek help following Critical Junctures, when negative stress and positive energy were out of balance: 1) a time when negative stress far outweighed positive energy (i.e., Critical Juncture One); and 2) a time when positive energy far outweighed negative stress (i.e., Critical juncture Two). A series of graphic representations are proposed that depict how positive and negative influences found in the respondent’s social and physical environment influenced help seeking. The purpose of the third study was to identify the factors that lead individuals to conceal or disclose their hearing loss in the workplace. We conducted semi-structured interviews using a photo-elicitation technique to aid in probing issues related to disclosure of hearing loss. Emergent themes included: Perceived importance of the situation, Perceived sense of control, Community affiliation, Burden of Communication and Coexisting issues related to hearing loss. This study serves to document some of the ways that workers with hearing loss manage their workplace identity, and more specifically, how some people manage revealing their hearing loss in workplace settings. The findings also inform the development of pertinent intervention programs for workers with hearing loss.

During the past thirty years several models for lifelong education after retirement have been developed worldwide, one of them being the University of the Third Age (U3A). This study explored the contributions of the U3A to the educational needs of older adults and evaluated the benefits they perceived from their participation in U3A by means of a literature study and an empirical investigation. The latter used a survey to explore the experiences of U3A members of two U 3As and presidents of 68 U3As in Victoria, Australia by means of two different questionnaires. As only 1.47 percent of the over-55 population of Victoria are U3A members, the survey also investigated barriers to U3A participation in general and with special reference to the male population. The findings indicated that member respondents were very satisfied with their U3A experiences which had made substantial differences in their lives. Both male and female respondents saw personal, mental, social, and physical improvement as a result of U3A participation. The majority indicated that participation had improved their intellectual development. Significant differences in the perceptions of male and female participants emerged: female members outnumbered males by three to one. Both the presidents and the members expressed some programmatic concerns, primarily obtaining tutors and classroom availability. The subject areas covered by courses presented were extensive. There was a difference in the subjects desired by males and female respondents; very few courses are offered in science and economics. Some barriers to participation identified are a lack of awareness of U3A, the stereotypical attitudinal barrier of `I am too old' and negative past educational experiences. Moreover, U3As should increase marketing endeavours. Although most U3As advertise, almost a third of the respondents indicated that they would have joined earlier if aware of U3As. A contributing factor appears to be a virtual lack of research and information provided in educational academic journals and other media about lifelong education after retirement. Based on the findings, recommendations were made for future research and for improved practice in the U3A environment as a means to enhance the quality of life for older adults.<br>Educational Studies<br>D.Ed. (Comparative Education)