Dissertations / Theses on the topic 'Recipient need'

The purpose of this study was to examine relationships among basic psychological need satisfaction, exercise motivation and health-enhancing physical activity as a test of self-determination theory with transplant recipients. Participants (N = 138; Mage= 48 years; 58% male), who were primarily heart, liver, lung, and kidney transplant recipients, completed scientifically-supported questionnaires. Controlling for transplant-specific factors (i.e., age at transplant, time waiting for transplant, and time since transplant), hierarchical regression analyses revealed that self-determined motivation was associated with physical activity and self-determined motivation partially mediated the relationship between psychological needs, specifically perceptions of competence, and physical activity (R2 = .25). Findings suggest basic psychological need satisfaction and exercise motivation have positive implications associated with health-enhancing physical activity among transplant recipients.<br>Le but de cette étude était de vérifier les relations entre la satisfaction des besoins psychologiques de base, la motivation à l'exercice et l'activité physique en tant que test de la théorie de l'autodétermination chez les receveurs de greffes. Les participants (N=138; Mâge=48 ans; 58% mâle), principalement des receveurs de greffes du cœur, du foie, du poumon et du rein, ont remplis des questionnaires appuyés par la littérature scientifique. Sous le contrôle de facteurs spécifiques à la transplantation (c.-à.-d. : l'âge au moment de la transplantation, le temps d'attente pour la transplantation et le temps écoulé depuis la transplantation), l'analyse de régression hiérarchique a démontré que la motivation autodéterminée est associée à l'activité physique et qu'elle module partiellement la relation entre les besoins psychologiques, particulièrement les perceptions des compétences, et l'activité physique (R2=.25). Les résultats suggèrent que la satisfaction des besoins psychologiques de base et la motivation pour l'activité physique entraînent des répercutions positives en ce qui a trait aux activités physiques favorables à la santé chez les receveurs de greffes.

The study concerns the needs assessment processes that older persons undergo to gain access to home care. The participation of older persons, their relatives and municipal care managers was studied from a communicative perspective. The assessment meetings functions as formal problem-solving events. The older persons´ accounts are negotiated discursively in interaction. Various storylines are used by the older persons and their relatives whether they view home care as an intrusion, as a complement or as a right. In case of divergent opinions the older person has the final say as prescribed by the Swedish social service act. One conclusion is that the role of relatives is not defined and a family perspective is not present. In the study the institutional structure of the assessment process was also analyzed. Older persons are processed into clients; their needs are fitted within the framework of documentation and institutional categories. In the transfer of talk to text all the particulars are not reflected and two types of documentation was identified; a fact-oriented objective language or an event-oriented personal language. Care management models and a managerialist thinking has influenced the assessment process by bureaucratisation of older people trough people processing, which is in contradiction to the individual-centric perspective prescribed by the law. The introduction of care management models in gerontological social work has lead to an embedded contradiction and constitutes a welfare political dilemma. Improved communicative methods are needed in order to achieve a holistic assessment situation.<br>Studien tar sin utgångspunkt i de bedömningsprocesser äldre personer genomgår för att få tillgång till hjälp i hemmet. Bedömningsprocessen där äldre, deras anhö-riga och kommunala behovsbedömare deltog studerades ur ett kommunikativt perspektiv. Interaktionen vid behovsbedömningssamtalet fungerar som en pro-blemlösningsprocess. Den äldre personens redogörelse för behov förhandlas diskursivt i interaktionen och tre olika berättelselinjer identifierades, baserade på om de sökande betraktar hemtjänsten som ett intrång, som ett komplement och stöd eller som en rättighet. När olika åsikter uttrycks har de äldre sista ordet i enlighet med Socialtjänstlagens föreskrifter. En slutsats är att de anhörigas roll i behovsbedömningsprocessen inte är definierad och att ett familjeperspektiv sak-nas. I studien analyserades också bedömningsprocessens institutionella struktur. De äldre behovssökande processas till att bli klienter, deras behov anpassas till dokumentationens ramverk och kategoriseras i enlighet med institutionella kate-gorier. I transfereringen av tal till text redovisas inte samtliga element i samtalet. Två typer av utredningstext identifierades, den faktaorienterade och den händelse-orienterade. I studien diskuteras det marknadsekonomiska tänkande som kommit att påverka bedömningsprocessen genom byråkratisering vilket står i motsatsställ-ning till det individcentrerade perspektiv som lagen förespråkar. Introduktionen av marknadsmodeller i det gerontologiska sociala arbetet har medfört en inbyggd motsättning och utgör ett välfärdspolitiskt dilemma. Förbättrade kommunikativa metoder behövs för att uppnå en holistisk bedömningsprocess.

This case study examines the educational needs of students attending two social affairs schools in Quebec. The aim was to determine why these youths continue to do poorly academically and why they fail to thrive once they leave the child welfare system, as described in the literature. Individual and environmental factors that hinder academic progress were investigated ethnographically. The chronic under-achievement characteristic of youths attending the social affairs schools appears to be due to a number of individual factors such as frequent school changes as well as to the mental health model that guides the social affairs schools. This model views educational difficulties to be secondary to psycho-social familial problems. As a result, appropriate educational assessments are not conducted and little attention is given to remediating learning difficulties that may prevent successful reintegration of students into regular schools and often exacerbate family dysfunction.

The purpose of the present study was to gain insight on the real and perceived needs of food stamp recipients for use in developing nutrition education programs. Six focus group interviews with 26 food stamp recipients were conducted in six Virginia counties. Transcripts of the meetings were analyzed to identify themes prevalent in all of the focus group interviews. Ninety-two 24-hour food recalls from a different sub-group of food stamp recipients were also analyzed for food consumption frequencies, trends in food preparation, and common food purchasing locations. A key finding was that most focus group participants made food-related decisions while in the grocery store. Explanations for incidences of food resource scarcities included beliefs that the amount of food stamps was insufficient and that poor food purchasing decisions were made. Predominant food behavior changes that had been previously attempted were decreasing consumption of fat and fried foods and reducing portion sizes. Most of the reasons for attempting those behavior changes involved a desire for weight loss. Prevalent nutrition education interests were low-fat cooking and child nutrition. Results of the 24-hour food recall analysis indicated an inadequate consumption of fruits, vegetables, whole grain cereals, and dairy products. Seventy-five percent of the subjects purchased food in a grocery store and prepared meals at home.<br>Master of Science

Thesis (MPhil (Rehabilitation))--University of Stellenbosch, 2000.<br>ENGLISH ABSTRACT: The South African National Census (1996) reports a disability prevalence of 6,6% in South Africa. In November 1999 the government paid out 635 881 temporary or permanent disability grants. Legislation is in place to allow the Department of Social Services to administer the grants. For this study demographic information of disability grant recipients in a semi-rural area was sought in order to improve understanding of disability and to assist in service delivery. The study was executed in Kleinmond, a coastal town in the Western Cape with a population of 3 918, where 189 people reported a disability during the 1996 census. Objective The objective of this study was to determine the disability profile, caregiver utilization and needs of disability grant recipients in Kleinmond, Western Cape, South Africa. METHODS A descriptive survey was the study design of choice. The study population consisted of recipients of a permanent disability grant who collected their grants at the Kleinmond Post Office in June 1999. In order to capture the necessary information, a questionnaire was developed based on the disability catalogue of the International Classification of Impairment, Disability and Handicap (ICIDH) of the World Health Organisation. Pilot studies were conducted and the researcher interviewed 29 grantees during the main study in Kleinmond in June/July 1999. Repeatability of the questionnaire was tested. Ninety six percent of the responses were the same on the second visit to four randomly selected grantees. Data was analysed with the statistical software package STATISTICA. RESULTS The response rate was 90% (29/32). The mean age of the mainly male grantees was 42 years (range: 18 - 64). Most grantees were single, but the majority stayed with someone else. Ninety three percent (27/29) were unemployed while 69% (20/29) felt they were able to work. Most grantees took regular medication and the majority accessed health services at the primary level local clinic. Twenty five grantees (86%or 25/29) reported multiple disabilities, while one person did not fit into any of the categories. The most common disability category was situational disability (82% or 24/29). Nineteen persons with disabilities (66% or 19/29) relied on help which was mainly given by the parents. Assistance was needed with activities such as collecting the disability grant, shopping and managing money. With regard to needs of grantees, most found it important to have the clinic closer to their homes (52% or 15/29), to increase the amount of the disability grant (76% or 22/29) and to raise awareness of disability in the community (69% or 20/29). CONCLUSION Most disability grant recipients in this study reported problems in many of the seven disability categories of the ICIDH, i.e. multiple disabilities. This is consistent with the assumption that only severely disabled people qualify for a permanent disability grant in South Africa. This might explain why the majority of the grantees utilized a caregiver for some tasks. Needs with regard to health and social services of this defined group of persons with disabilities in Kleinmond will be brought to the attention of the authorities, who are planning a new community centre and clinic.<br>AFRIKAANSE OPSOMMING: Volgens die Nasionale Sensus opname van 1996 is die prevalensie van ongeskiktheid in Suid- Afrika 6.6%. Bevindinge dui aan dat 635881 individue 'n ongskiktheidstoelaag ontvang. Hierdie toelae word volgens wetgewing deur die Departement van Maatskaplike Dienste ge-administreer. In hierdie studie is demografiese inligting van individue wat 'n ongeskiktheidstoelaag ontvang ingesamel in 'n poging om insig in gestremdheid en dienslewering aan gestremdes te verbeter. Die studiepopulasie het bestaan uit individue wat 'n ongeskiktheidstoelaag in die Wes-Kaapse kusdorp Kleinmond ontvang. Kleinmond het 'n populasie van 3 918 waarvan 189 individue ongeskik is volgens die 1996 sensus. DOEL Die doel van die studie was om 'n ongesiktheidsprofiel van individue in Kleinmond te bepaal, asook te evalueer of hulle versorgers benodig het en om hulle behoeftes te bepaal. METODOLOGIE Daar is gebruik gemaak van 'n beskrywende studie. Die studiepopulasie het bestaan uit aile individue woonagtig in Kleinmond wat 'n permanente ongeskiktheidstoelaag ontvang het en dit by die poskantoor afgehaal het. Data is deur middel van 'n vraelys ingesamel. Die vraelys is gebaseer op die ongeskiktheids katalogus van die Internasionale Klassifikasie van Gebrek, Ongeskiktheid en Gestremdheid (ICIDH) van die Wereld Gesondheidsorganisasie. Die vraelys is getoets deur middel van loodsstudies. Die betroubaarheid van die vraelys is ook getoets deur tydens die navorsing dieselfde vrae tydens 'n tweede besoek aan vier kandidate te stel. Hierdie vier individue is ewekansig geselekteer en 96% van die response het ooreen gestem met die van die eerste besoek. Data is verkry van 29 individue gedurende Junie/Julie 1999. Data analise is met behulp van STATISTICA, 'n statistiese sagteware pakket, gedoen.RESULTATE Die responskoers was 90% (29/32). Die meerderheid van die studiepopulasie was manlik met 'n gemiddelde ouderdom van 42 jaar (rykwydte: 18 - 64). Individue was meerendeels ongetroud en het wonings met ander persone gedeel. Uit die studiepopulasie was 93% (27/29) individue werkloos. Van hierdie groep het 69% (20/29) egter gevoel dat hulle wei een of ander vorm van arbeid kan verrig. Bykans aile individue uit die studiepopulasie het gereeld medikasie gebruik. Die plaaslike prirnere gesondheids kliniek is deur die meeste individue benut vir gesondheidssorg. Meeste individue (86% of 25/29) het meer as een ongeskiktheid gehad en een persoon het nie in enige van die kateqoriee ingepas nie. Die ongeskiktheid wat die mees algemeenste voorgekom het was situasie-gebonde ongeskiktheid (82% of 24/29). Hulp is hoofsaaklik deur ouers verskaf en 66% individue (19/29) het van hulp gebruik gemaak. Hierdie hulp was meestal nodig met aktiwiteite soos die afhaal van die ongeskiktheidtoelaag, die doen van inkopies en die bestuur van persoonlike finansies. Die studiepopulasie het 3 groot behoeftes uitgespreek naamlik 'n kliniek nader aan hulle wonings (52% of 15/29), 'n verhoging in die ongeskiktheidstoelaag (76% of 22/29) en .n groter bewustheid van ongeskiktheid in die gemeenskap (69% of 20/29). Samevatting Baie van die individue uit die studiepopulasie het ongeskikthede in meer as een van die ongeskiktheidskategoriee aangedui. Hierdie bevinding is in ooreenstemming met die aanname dat in Suid-Afrika slegs individue met erge ongeskiktheid n ongeskiktheidstoelaag ontvang. Dit kan moontlik ook verklaar waarom die meerderheid van die populasie versorgers benodig het vir die uitvoer van sekere take. Die behoeftes van hierdie studiepopulasie sal onder die aandag van die plaaslike owerheid, wat tans besig is met die beplanning van 'n nuwe gemeensskapssentrum en kliniek, gebring word.

The purpose of this study was to investigate two underlying questions related to welfare reform and its impact on participants in the Cumberland Plateau Region: (1) What are the training and other noneducational needs of the participants in the VIEW program? and (2) What is the projected success of the impact of the training on the lives of the participants? The research study included 47 interviews with four distinct groups of individuals--VIEW participants, case managers, administrators, and trainers. Three focus group interviews were conducted with individuals who were participants in the VIEW program or professionals actively involved in the administration and implementation of the program. All the individuals interviewed in the study identified four difficulties to the successful implementation of the VIEW program: (1) the lack of economic development in the region, (2) the abbreviated time frame for the implementation of VIEW, (3) an excessive amount of paperwork, and (4) the lack of transportation. The participants cited the following difficulties: (1) child care, (2) inappropriate dress for interviews, (3) attitudes and busyness of case worker, (4) penalties associated with securing employment, and (5) limited opportunities for training. The training personnel identified three areas posing difficulties for participants: (1) motivation, (2) attitudes of the participants, and (3) leadership development. In summarizing the responses of all the individuals interviewed in this study, the two viable remedies emerged as options available to assist participants: (1) seeking additional help from family members or friends, and (2) taking the initiative to investigate other avenues of assistance outside the scope of the Departments of Social Services. The training component of the VIEW program was considered the most favorable among all the individuals interviewed in this study. The-proposed outcome of the training received for all participants in the VIEW program was the attainment of full-time or part-time employment. All the interviewees felt to varying degrees that the VIEW program would assist participants in securing employment. The administrators and case managers ultimately viewed the employment as the measure of success of the training. However, most of the participants were very unsure if they would secure employment in the Cumberland Plateau Region.

The purpose of this study was to explore the incentives and barriers perceived by low-income women of child-bearing age related to their participation in nutrition education programs. The specific programs of concern in this study are the Expanded Food and Nutrition Education Program (EFNEP) and the Food Stamp Nutrition Education (FSNE) program. This qualitative study sought to hear the voices of the women so that nutrition programs can be made more successful in reaching this population. Personal interviews were conducted with 23 women in their homes or appropriate local sites, and transcripts were analyzed to identify categories and themes. People of low socioeconomic status and those with the least education have higher rates of obesity and overweight and suffer disproportionately from poor health. Women receiving Temporary Assistance to Needy Families (TANF) also receive Medicaid. Medicaid costs have escalated due to the obesity rate, which is currently estimated at 64% of the adult population. In addition, 30% of American children are experiencing obesity or are overweight. It is important for parents to understand the causes of obesity and the effects of the chronic diseases related to obesity. Prevention programs are more cost effective than medical treatment of the diseases associated with obesity, and proper nutrition can reduce the incidence of chronic diseases. Findings of this study suggest that isolation is the main impediment to participating in nutrition education programs. Missing from the interviewed women's circumstances are social capital, human capital, and economic capital. Social capital relates to the connections and relationships that are important in life. Human capital involves the knowledge and skills acquired through life experiences. Economic capital refers to individual wealth or economic resources available to an individual or community. Nutrition education programs should be refined to incorporate opportunities for socialization that will develop trust and reciprocity, as well as nutrition knowledge. Based on the results of this study, Virginia Cooperative Extension programs will be adapted to incorporate weight control and cooking classes with nutritious recipes. The learning environment will be safe, learner-centered, and fun. New marketing tools that are more appealing to the prospective clients will be developed.<br>Ed. D.

O transplante de fígado é considerado um dos procedimentos mais complexos da medicina moderna. O ensino do paciente é relevante no contexto da saúde e pode contribuir para o sucesso do tratamento. Dentre as atividades do enfermeiro, ressalta-se o papel de educador. No período pós-operatório de transplante de fígado, este profissional deve implementar intervenções educativas direcionadas para o preparo do paciente no enfrentamento das mudanças no estilo de vida, decorrentes de procedimento cirúrgico complexo. Para tal, o primeiro passo consiste no conhecimento das necessidades de informação indicadas pelos receptores de transplante de fígado. O objetivo geral do estudo foi avaliar as necessidades de informação de receptores de transplante de fígado em atendimento ambulatorial em hospital público. A amostra foi composta por 92 receptores de transplante de fígado atendidos em ambulatório de hospital público do interior do Estado de São Paulo. A coleta de dados ocorreu no período de fevereiro a junho de 2014, por meio da aplicação de instrumento adaptado. Os principais resultados da pesquisa indicaram que a maioria dos receptores de transplante de fígado era do sexo masculino (77,17%) e casada (76,09%). A idade média foi de 54,48 anos, a média de anos de estudo foi de 9,02 anos, sendo 70,65% dos receptores moradores na zona urbana. Dos 92 participantes, 46,74% estavam aposentados e 26,09%, afastados de suas atividades laborais e 36,96%, com renda familiar entre dois e três salários-mínimos. Em relação às características clínicas, observou-se que 47,83% dos receptores eram do grupo sanguíneo tipo O, 72,83% tinham escore MELD entre 20 e 29 pontos, 41,30% estavam com cirrose de etiologia viral (B ou C). Dos 92 pacientes, 45,65% tinham IMC entre 18,50 e 24,99 Kg/m2 (peso normal) e 33,70% estavam acima de 25 Kg/m2 (sobrepeso). A média de dias após o transplante foi de 1.508,85 dias, o tacrolimus era empregado como terapia medicamentosa de imunossupressão principal em 36,96% dos receptores e era associado ao micofenolato sódico em 38,04% dos pacientes. As necessidades de informação que obtiveram as médias maiores foram: sugestão de assunto no 3 (média 5,35) refere- se aos sinais e sintomas de complicações (rejeição, infecção, diabetes, hipertensão arterial, entre outras) agrupada na categoria manejo das potenciais complicações; sugestão no 2 (média 5,29) relativa aos efeitos colaterais e cuidados sobre medicamentos (categoria manejo dos medicamentos) e sugestão no 14, alimentação segura após o transplante (média 4,53), também agrupada na categoria manejo das potenciais complicações. Os resultados evidenciados oferecem subsídios sobre o perfil sociodemográfico e clínico de receptores de transplante de fígado na realidade nacional, bem como das necessidades de informação, as quais podem auxiliar o planejamento de intervenções educativas direcionadas para o processo de transplante de fígado, para principalmente melhorar a qualidade da assistência, a adesão ao tratamento e a prevenção de complicações após o transplante<br>Liver transplantation is considered one of the most complex procedures in modern medicine. The patient education is relevant in the context of health and may contribute to the success of treatment. Among the activities of nurses, the role of educator is highlighted. In the postoperative period of liver transplantation, this professional must implement educational interventions directed to the preparation of the patient in coping with changes in lifestyle resulting from complex surgical procedure. For this, the first step consists in the identification of information needs indicated by liver transplant recipients. This study aimed to assess the information needs of liver transplant recipients in outpatient treatment at a public hospital. The sample consisted of 92 liver transplant recipients assisted in outpatient clinic at a public hospital in the state of São Paulo. Data collection was performed from February to June 2014, through the application of the adapted instrument. The main results indicated that most liver transplant recipients were male (77.17%) and married (76.09%). The average age was 54.48 years, the average years of schooling was 9.02; and 70.65% of recipients lived in the urban area. Of the 92 participants, 46.74% were retired, 26.09% were on leave from work and 36.96% had incomes between two and three minimum wages. Regarding clinical characteristics, 47.83% of recipients were type O blood group, 72.83% had MELD scores between 20 and 29 score points, and 41.30% had cirrhosis of viral etiology (B or C). Of the 92 patients, 45.65% had a BMI between 18.50 to 24.99 Kg/m2 (normal weight) and 33.70% greater than 25 Kg/m2 (overweight). Average days after the transplantation was 1508.85 days, the tacrolimus was used as the primary immunosuppression drug therapy in 36.96% of the recipients, and associated with mycophenolate sodium in 38.04% of the patients. Information needs with the highest averages were: suggestion of topic no 3 (5.35) which refers to the signs and symptoms of complications (rejection, infection, diabetes, hypertension, etc.), grouped in the category management of potential complications; suggestion no 2 (5.29) related to the side effects and care of medicines (category management of medicines); and suggestion no 14, safe food after transplantation (4.53), also grouped in the category management of potential complications. The results show subsidies on the sociodemographic and clinical profile of liver transplant recipients in the national reality and the information needs which may assist the planning of educational interventions directed to the process of liver transplantation, mainly aiming to improve quality of care, adherence to treatment and prevention of complications after transplantation

This study examines the extent to which the educational component of the 1996 Welfare Reform Act impacted African-American TANF recipients' access to postsecondary education in Jackson, Mississippi in 2011. This study was based on the premise that policies within the legislation restrict opportunities for welfare recipients to pursue postsecondary education as a pathway to self-sufficiency. For welfare recipients who often believe that college is inaccessible due to financial means, access is especially important for them. Participants in this study were thirty-two African-American women receiving TANF benefits from the State of Mississippi who were either enrolled in a college program or participated in the job readiness training supported by the Mississippi Department of Human Services. A qualitative research methodology was used to analyze the data. The data revealed that there is total consensus among the participants on the importance of postsecondaryeducation as a measure of future economic well-being for themselves and their families. Findings specifically revealed that many of the participants strongly believe that policies associated with welfare reform have prevented or denied them full access to education and that some of the policies should be changed. The conclusions drawn from the findings suggest that the 1996 Welfare Act impacted access to postsecondary education for TANF recipients in Jackson, Mississippi to some degree; and that after 15 years of stagnated welfare reform policies, specifically policies associated with work requirements, TANF recipients in Mississippi are longing for better educational opportunities that will allow them to enjoy a self-sustaining lifestyle.

Thesis (Ph. D.)--Georgia State University, 2006.<br>Title from title screen. Wendy Simonds, committee chair; Ralph LaRossa, Charles A. Gallagher, committee members. Electronic text (289 p.) : digital, PDF file. Description based on contents viewed June 19, 2007. Includes bibliographical references (p. 246-275).

Allt fler blir allt äldre i Sverige och äldreomsorgen står inför en stor utmaning när resurser i form av ekonomiska medel och rätt personal blir allt svårare att konkurrera om. I eHälsans tidsålder utvecklas det på många håll smarta tekniska lösningar för att effektivisera och kvalitetshöja omsorgsinsatser, något som allt fler aktörer får upp ögonen för. Denna uppsats utreder behovsbilden för att kunna skapa en ny kontaktyta mellan omsorgstagare, närstående och utförare inom äldreomsorg. Uppsatsens resultat är en del av det Vinnova-finansierade projektet BoNUS VO som undersöker förutsättningarna för en sådan kontaktyta. IKT-stödet ska underlätta delaktighet i den egna omsorgen såväl som stödja yrkesutövare i arbetsuppgifter. Data samlades in genom en observationsstudie av hemtjänstarbete, deltagande i gruppsamtal med närstående till omsorgstagare samt kvalitativa intervjuer med 13 informanter som hade erfarenhet av äldreomsorg. Resultatet av dataanalysen visar på att det i dagsläget finns problem som skulle kunna undvikas genom att underlätta kommunikation och informationsdelning mellan användargrupperna. Resultaten visar också på att det finns många diskussionspunkter vad gäller nytta, motsättningar i behov och avvägningen mellan ett översiktligt eller komplext system. Studien konstaterar att det finns utrymme för vidare forskning inom området.<br>Sweden’s population is steadily growing older and while the demand for care of senior citizens is increasing, care givers are forced to cope with diminishing resources in terms of money and qualified staff. Many put hope in new eHealth technology, as a means of raising efficiency and quality in the every day working situation. This thesis aims to study needs regarding communication, information and interaction between care takers, dependants and caregivers in geriatric care, in order to create a foundation upon which an ICT system may be built to fulfill those needs. The results presented are part of a research project focusing on future ICT systems in healthcare. Data was collected through an observational study, group discussions with informants related to care takers, and qualitative interviews with 13 informants who have extensive experience of geriatric care. The results imply there are existing problems that may be avoided by facilitating information sharing between the aforementioned groups. The study also presents some important points of discussion regarding usefulness, clashing needs of different users, and the balance between simplicity of use and system size.

Research literature on foreign assistance suggests that the U.S. provides aid in order to serve both its own strategic interests as well as the development needs of aid recipient countries. Maintaining a focus on Africa, this report uses newly available data for official development assistance and attempts to verify whether prevailing hypotheses regarding the motivations behind U.S. aid giving still hold true. Specifically, the report analyzes whether aid giving patterns align with 1) the development needs of recipient countries as understood through the lens of internationally established priorities, or 2) with good political and economic policies within recipient countries vis-à-vis democratic institutions and open markets, or 3) with U.S. national strategic interests (be they political, military, or economic interests). A statistical analysis of U.S. Official Development Assistance (ODA) to 53 countries in Africa over the period of 1970 to 2010 was carried out for this purpose. The results suggest that, when it comes to aid that is specifically addressed towards development projects in Africa, the strategic considerations and political priorities of the U.S. are just as important, if not more important, than the development needs or economic performance of recipient countries. Political allies and countries that democratize receive more aid from the U.S., ceteris paribus. In addition, it was found that more aid is given to countries with larger populations - a result that contradicts earlier literature on aid's motivations. The report is organized as follows. I begin in Section 1 by providing a general overview of U.S. foreign aid. In Section 2, I detail why Africa is a significant continent for such an analysis of U.S. aid, and outline some of the trends in aid to Africa. The third section summarizes some of the most important existing hypotheses about why the U.S. gives development aid. Section 4 describes the data and methodology used for this study and provides a discussion of the results obtained from the statistical analysis. Finally, in Section 6, I conclude by offering broader policy implications and sketching out avenues for future research.<br>text

Client education is an important aspect in the provision of holistic care for those clients who have undergone liver transplantation. Yet there remains a paucity of research that identifies the learning needs of liver recipients. Research pertaining to transplantation addresses such issues as functional and psychosocial outcomes, stressors, information needs of the family, and quality of life following transplantation. The majority of the studies are quantitative in method and employ questionnaires to obtain data. As a result, liver recipients' perceptions of their learning needs during convalescence have not been explored. Grounded theory provides the research design for this qualitative study which explores the learning needs of clients who have undergone liver transplantation during convalescence. In utilizing this research design, common circumstances, experiences, meanings and behaviours were taken into consideration. Symbolic interactionism was the conceptual framework for this study which enabled common circumstances, experiences, meanings, and behaviours to be understood from the perspective of those who have actually experienced liver transplantation. There were 6 study participants who had undergone liver transplantation of whom 5 were interviewed twice and the other participant only once. Data analysis was simultaneously carried out with data collection utilizing the constant comparison methods as outlined by Corbin and Strauss (1990). The participants' learning needs were identified to entail "Crucial Learning Needs" and "Knowing What to Expect". Three main categories emerged from the latter area which include: mastering recovery, transition, and reflection. Each category had within it several subcategories. As a result of this study, health care professionals may anticipate and assess liver recipients' learning needs and have insight into the experience of convalescence following liver transplantation. Implications for nursing practice and research have emerged which are addressed.

碩士<br>國立臺灣大學<br>護理學研究所<br>99<br>Liver / renal transplantation is one of the important treatments for end-stage liver / renal disease and acute liver / renal failure. Although transplantation can prevent recipients from suffering with critical and fatal symptoms, patients may experience the complications with surgery and immunosuppressive drugs. Furthermore, they might have many unmet needs in daily life. The aims of this study were to explore the level of home care needs among the post liver or renal transplant recipients, and identify the significant factors for unmet care needs. Totally, 289 patients were recruited by purposive sampling with a cross-sectional correlated design from organ transplant outpatient departments at a medical center in northern Taiwan. Data were collected from December, 2010 to March, 2011. A set of structured questionnaires were used to collect data including patients’ demographic and disease characteristics, the Transplant Symptom Frequency and Symptom Distress Scale, the Hospital Anxiety and Depression Scale, and the Transplant Home Care Needs Scale. Data were analyzed with descriptive statistics, Spearman’s correlation and stepwise multiple regressions by SPSS 17.0 software. The main results included (1) The prevalence rate of diabetes mellitus, hyperlipidemia and gout significantly increased after transplantation. (2) The overall symptom experience occasionally occured with mild level of distress. Difficulty seeing well, concentration or memory problems, sleep difficulties, and tiredness were the most symptoms experienced by patients both in frequency and distress domains. (3) The level of anxiety and depression were mild. There were 4.8% of the patients identified as clinically anxious cases in our study, and 3.1% were clinically depressive cases. (4)The most unmet of home care needs was health system and information domain. Through stepwise multiple regression analysis, the significant predicting variables included symptom distress, anxiety, time after transplantation and education in years, and they could explain 36.8% of variances for unmet home care needs. The results of this study can help clinical nurses to understand more about liver or renal transplant recipients’ physical and mental distress, and the high risk population with unmet needs. Therefore, in order to increase the patients’ ability of self-care, health provider can offer the sufficient health system and information with the available health resources, and provide consultation when patients are in emergency.

碩士<br>國立陽明大學<br>臨床暨社區護理研究所<br>97<br>Background In caring for the organ transplant (OT) donors and recipients, critical care nurses (CCN) are always challenged to effectively manage complex caring situations related to organ donors, recipients, their families, nursing and interdisciplinary health team members. It is important to learn their perspectives of caring dilemmas, needed helps, coping strategies between young and senior nurses. Purpose The purposes of this study were to explore CCN’s perspective of their caring dilemma for organ transplant donors and recipients, their needed help, and coping strategies between young and senior nurses. Method A qualitative exploratory study was used. A purposive sample of CCN with experiences of OT was obtained from a leading medical center in Central Taiwan. With semi-structured interview guide, data were collected by in-depth face-to-face interviews, and analyzed by qualitative content analysis mode. Results A total of 30 CCN (29 females, 1 male) participated in this peoject. They were aged between 26 ~ 44 (M ± SD = 36.3 ± 4.5) years old. Twenty-one of them were married, and 9 were single. The majority graduated from university or college. Fourteen of them reported a belief of combination of Confucianism and Buddhism, 9 were Buddhists, 5 were non-believers, and others were Taoist or Christian. In terms of nursing professional status, 21 were occupational nurses, 5 were registered nurses, 2 were nurse practitioners, and others were head nurse or assistant head nurse. The years of nursing profession ranged between 3 ~ 22 (M = 13.8) years; the years of organ transplant nursing care ranged between 0.5 ~ 15 (M = 4.10) years. Finally, 26 received OT training programs, and the rest reported having no related training. Five caring dilemmas were reported as: (a) limitations in medical resources; (b) lacking of sound mental preparations; (c) insufficient OT professional care competence; (d) workload of caring; and (e) inefficient coordination and communication between OT team members. Several explicit needed help were identified as: (a) a functional OT center and long-term OT caring team; (b) improvement in medical equipments and materials; (c) holding periodical single/multiple OT case conference and forum; (d) bereavement care for the donors’ and recipient’s family; (e) OT nursing care standard operating procedure (SOP); (f) comprehensive humanistic training program; (g) comprehensive OT in-service training programs; (h) opportunities of national and/or overseas advanced OT training for senior CCN; (I) encouragement from peers, superiors, and medical team members; (j) stress-managing protocols for CCN; (k) sufficient nursing manpower in multi-organ transplant ICUs; (l) recruiting more young RNs to learn OT care; (m) reasonable work shifts; (n) reimbursement for overtime-work; (o) consensus among physician, CCN and other OT team members; (p) precise caring guidance and decision-making; and (q) coordination efforts from social workers. The coping strategies for needed help were: (a) arousing hospital administrators’ attentions to update OT policies; (b) asking hospitals to provide safe caring environment; (c) holding case conference for successful and failed cases; (d) developing clinical paths for multiple OT cases; (e) establishing long-term team for multiple OT cases; (f) implementing humanistic caring training program; (g) hosting systematical OT in-service training program; (h) offering professional certification for OT CCN; (i) asking hospital to offer reasonable payment systems for OT CCN; (j) asking hospital to offer reasonable manpower systems for OT CCN; (k) establishing coaching systems for OT CCN; (l) searching for available resources; and (m) inviting assistance from social workers. Finally, the perspectives between the young and senior CCN were further compared and discussed. Conclusions The project explored and compared Taiwan’s OT CCN’s perspectives of their caring dilemmas for OT clients, their needed help, and coping strategies for the difficulties. The findings between young and senior CCN’s groups are not identical. The nurse educators and administrators are suggested to develop related programs and administrative support to meet this particular group’s multiple needs. With the reasonable direct and indirect caring systems, and tangible as well as psychological support, OT CCN will be encouraged to devote them to OT care; the functional interdisciplinary OT team will also be established. Finally, the quality of OT care will then be ensured. Keywords: critical care nurses, young and senior nurse, organ transplant caring dilemmas, needed help, coping strategies, explorative qualitative study

Bone marrow transplantation (BMT) is the treatment of choice for many malignancies and other childhood disorders. Acknowledging that the entire family is affected when a child undergoes a BMT, increasing research attention has been given to understanding this experience from the perspectives of recipients, parents and the family as a whole. Yet, minimal attention has been directed at understanding the experience of healthy siblings as they transition through the BMT experience. Before intervention studies can be undertaken that will help healthy siblings transition through the BMT experience, knowledge about the impact of the experience on siblings is needed. Accordingly, a qualitative study guided by the philosophy of hermeneutic phenomenology was conducted to elicit detailed descriptions of the lived experience of siblings. Participants were children, adolescents and young adults with a sibling who had undergone a BMT during childhood. Participants were recruited from a pediatric BMT clinic in Western Canada. Semi-structured, open-ended interviews that explored siblings’ memories about what it is like to be a sibling of a child who has had a BMT were conducted with each participant. Demographic data and field notes were recorded. All interviews and field notes were transcribed. The transcripts were reviewed repeatedly for significant statements in an attempt to find meaning and understanding through themes. The data analysis revealed the essence of siblings’ lived experience of transitioning through the BMT trajectory as an interruption in family life. Four themes communicated the essence of siblings’ lived experience: (1) life goes on, (2) feeling more or less a part of a family, (3) faith in God that things will be okay, and (4) feelings around families. Differences between donor and non-donor siblings are highlighted. Siblings’ recommendations for health care professionals are also provided. Results from this study will help health professionals better anticipate the diverse and shifting needs and demands of siblings of pediatric BMT patients. Recommendations for future research and innovations in nursing interventions are provided.<br>October 2005

碩士<br>國立陽明大學<br>臨床暨社區護理研究所<br>97<br>Background End-stage-heart-failure is there terminal phase of heart disease with irreversibly multiple dysfunction, and heart transplantation (HT) has been long acknowledged as the only avenue for the patients’ survival and possibility of quality of life. Nevertheless, most of the recipients (HTR) and their care givers, primary family caregivers (PFC) in particular, continued to suffer from numerous discomforts/distress during the recipients’ recovery process of resuming their holistic well-being including physical, psychological, cognitive, social and spiritual optimal functions. Dark recovery stage (DRS) is referred to the post-HT stage when the HRT or their PFC reported having suffered from intolerable recovery experiences. Did the DRS exist in Taiwan’s HTR and their PFC groups? What are the contents and rationales for their DRS experiences? What are their coping strategies and needed help during DRS? All these questions deserve HT health professionals’ investigation. Aims The aims of this project were to explore: 1. the DRS experiences for Taiwan’s adult HTR and their PFC; 2. the coping strategies employed by Taiwan’s adult HTR and their PFC; 3. Taiwan’s adult HTR’s and their PFC’s needed help from others during DRS; and 4. Twain’s adult HTR’s appraisals for the discharge-planning provided by hospital. Design & Method An explorative descriptive qualitative design was used. A purposive sample of adult HTR and their PFC with DRS experiences in the most famous HT hospital in Taiwan was obtained. . Face-to-face depth interviews were and conducted with a semi-structured interview guide. Data were analyzed by qualitative content analysis mode. Results A total of 52 informants including 20 HTR and 13 of their PFC participated in this project. In the HTR group, 16 of them were male aging from 32 to 70 (M = 46.95) years old. Most of them are married. Their post-HT duration ranged from 3 months to 2 years and 10 months. In the PFC group, 11 of them were females aging from 28 to 67 (M = 47.53) years old; 12 were married, and 1 was single. The relationships of the PFC group were reported spousal (n =11), mother/son (n = 1), and boy/girlfriend (n = 1). Five of them reported suffering from various disease including hypertension (n = 2), duodenal ulcer (n = 1), cardiopalmus (n = 1), and breast cancer (post-operation) (n = 1). The DRS experienced by HTR were: (a) The physical and psychological discomforts caused by intrusive examinations and major changes of the health status（n = 8）; (b) the sense of uncertainty with future health condition（n = 15）; (c) the sense of uncertainty with future life（n = 13）; (d) the sense of becoming a burden for families（n = 2）; and (e) the unfamiliar medical treatment and environment（n = 2）. Their coping strategies were: (a) setting a goal for recovery and maintaining healthy status（n = 10）; (b) searching for spiritual support（n = 10）; (c) complying with the difficulties（n = 10）; (d) holding positive attitudes（n = 11）; and (e) searching for possible job opportunities（n = 1）. Their needs help included: (a) help from HT and other health professionals（n = 10）; (b) spiritual support（n = 11）; (c) assistance from HTR supporting groups（n = 1）; and (d) social welfare resources（n = 4）. The DRS experiences for PFC were: (a) worries about HTR’s physical discomforts caused by disease/treatment（n = 1）; (b) psychological turmoil caused by HTR’s unstable health condition（n = 6）; (c) worries about the loss of HTR’s healthy status（n = 5）; (d) psychological stress from HTR’s inadequate physical strength after HT（n = 2）; (e) worries about poor quality of care by PFC（n = 2）;. (f) being unable to take care of other families and HTR in the same time（n = 1）; (g) psychological suffering from the HTR’s suffers（n = 1）; and (h) difficulties in having part-time job to meet financial needs（n = 1）. The PFC’s needed help were identical to the HTR’s. In terms of HTR’s appraisals for discharge-planning, the benefits were systematical help from health professionals（n = 10）, exchanges of recovery tips with other HTR（n = 2）, and learning strategies of health information（n = 2）. The limitations were lacking of complete health teaching package（n = 5） and advertisement（n = 2）, as well as inadequate health care manpower such as case manager（n = 2）. Conclusions This project identified the contents, rationales, coping strategies and needed help of Taiwan’s adult HTR and their PFC during the most difficult recovery time from HT named as DRS. In order to facilitate the adult HTR’s post-HT recovery, their experiences of DRS need to be prevented, early detected and effectively managed. HT health professionals are encouraged to further develop related caring plans and systematically evaluate the effectiveness of the protocols. The findings of this project can also serve as innovative information for other organ transplant societies.