Dissertations / Theses on the topic 'Suffering related to helthcare'

Bakgrund: Vårdskador är vanligt förekommande i både svensk och utländsk sjukvård. Överlag bidrar vårdskadorna med flera dygns förlängda vårdtider och upptar ett stort antal vårdplatser. Detta upptar resurser och kostar samhället många miljarder kronor varje år. Hälso- och sjukvårdspersonal ansvarar för patientsäkerheten i vården, vilket i Sverige är reglerat i lagar och föreskrifter. Dessa finns till för att skydda patienter mot vårdskador och innebär en skyldighet för hälso- och sjukvården att ständigt jobba för att utveckla kvalitet och säkerhet i vården. Syfte: Syftet med litteraturöversikten var att beskriva patienters upplevelser av att drabbas av vårdskada. Metod: En litteraturöversikt enligt Friberg har genomförts. Sökning efter resultatartiklar till översikten gjordes i CINAHL Complete och PubMed. Elva originalartiklar hittades, vilka utgör underlag för resultatet i översikten. Resultat: Med stöd i Katie Erikssons vårdteori identifierades tre huvudkategorier av upplevelser, vilka var vårdlidande, sjukdomslidande och livslidande. Varje kategori hade tillhörande underkategorier där patienternas upplevelser beskrivs. Diskussion: Huvudfynd i resultatet har diskuterats utifrån bakgrund, annan forskning och Katie Erikssons vårdteori. Kommunikation och information från vårdpersonalen efter en vårdskada upplevs av patienter bristfällig. I de fall då kommunikation och information upplevs tillfredställande minskar också vårdlidandet. Patienters upplevelser visar att vårdpersonal inte följer sitt ansvar och befintliga lagar, vilket tycks utgöra ett problem som hämmar kvalitet och säkerhet i vården. I kontrast till de negativa upplevelserna förekommer också positiva upplevelser vilka relateras till god vård innan och efter vårdskadan.
Background: Adverse events are common in Swedish and foreign healthcare. These events overall contribute to several days of prolonged hospital stay and occupies a large number of hospital beds. It occupies resources and costs the society billions of Swedish crowns (SEK) every year. Healthcare professionals are responsible for the patients’ safety in the healthcare, which in Sweden is regulated by laws and regulations. These are designed to protect patients against adverse events and injuries in the healthcare and entail obligations for healthcare professionals to constantly work to develop the quality and safety for the patients in the healthcare.  Aim: The aim of this literature review was to describe patients´ experiences of being affected by an adverse event. Method: A literature review has been performed according to Friberg’s method. The databases CINAHL Complete and PubMed were used for searching articles for this literature review. Eleven original articles were found, which are used to form the results of this review. Results: With support in Katie Eriksson´s theory of caring, three main categories of patients experiences were found, these categories were suffering related to healthcare, suffering from illness, suffering of life. Each category had related subcategories where patients' experiences are described. Discussion: Main findings has been discussed on the basis of the background, other research and Katie Eriksson’s theory of caring. A lack of communication and information from the healthcare professionals after an adverse event was experienced. In cases when the communication and information perceived satisfactorily the suffer were reduced. Patients’ experiences show that healthcare professionals do not follow their responsibilities and the existing laws, which inhibits the quality and safety of the healthcare. In contrast to the negative experiences there were also positive experiences, which are related to good care before and after the adverse event.

Humanism is a worldview emphasizing interpersonal warmth, emotional expression, imagination, and humanity’s inherent goodness. Normativism is a worldview emphasizing discipline, emotional restraint, empiricism, and humanity’s inherent badness. We reasoned that worldviews could influence how people construe suffering. Prior research suggests there are two prominent suffering construals in contemporary U.S. culture. A Redemptive construal posits that suffering’s purpose is to lead to greater awareness and self-development, while a Biomedical construal sees biological frameworks as the standard for understanding suffering. In two studies, we examined how these worldviews and construals shape how people interpret suffering arising from depression. In Study 1, we predicted correlations between Humanism and a Redemptive construal, and Normativism and a Biomedical construal of depression. Results confirmed the hypothesis. In Study 2, we hypothesized that priming participants with Humanism or Normativism would increase endorsement of Redemptive and Biomedical construals, respectively. We discovered that exposure to Humanism (compared to Normativism) induced more support for a Redemptive construal, and less for a Biomedical construal, of depression. However, Normativism exposure did not result in an increased preference for a Biomedical, compared to a Redemptive, construal. We propose that the worldviews people encounter and endorse can shape their interpretations of depression.

UA Open Access Publishing Fund
It is increasingly argued that social and economic inequities poorly affect overall health. One of the means through which these inequities are translated to the body is via negative emotions, which carry known psychological and physiological responses. This paper examines migration-related psychosocial stressors impacting first-generation Mexican immigrants in southern Arizona, and reports on the primary emotional experiences immigrants associate with these stressors. Data were drawn from a qualitative, ethnographic study conducted over the course of 14 months during 2013–2014 with first-generation Mexican immigrants (N = 40) residing in Tucson Arizona and service providers working directly in the immigrant community (N = 32). Results indicate that the primary structural vulnerabilities that cause emotional hardship among immigrants are pre-migration stressors and adversity, dangerous border crossings, detention and deportation, undocumented citizenship status, family separation, and extreme poverty. Many of these factors have intensified over the past decade due to increased border security and state level anti-immigrant legislation in Arizona. Immigrants connected these hardships to the emotions of trauma (50%), fear (65%), depression (75%), loneliness (75%), sadness (80%), and stress (85%), and most respondents reported suffering from three or more of these emotions. Given the heavy emotional toll of migration and the direct impact that regional legislation and border security had on well-being, this paper argues that emotion be considered an important mechanism for health declines in the immigrant community. In order to stem the frequency and intensity of emotional stress in the Mexican immigrant community in Tucson, it is imperative to support organizations and policies that promote community building and support networks and also expand access to and availability of mental health services for immigrants regardless of documentation status.

This study investigates the role that the notions of trauma and culture play in relation to the alleviation of distress within an war-affected population. It analyses how local, cultural conceptions of distress and those held by psychological service providers relate to one another, and how they contribute to improving the well-being of the displaced. Fieldwork was conducted with urban and rural displaced populations in the south-eastern province of Huila in Angola. Ethnographic, psychometric and participatory methods were used to examine issues of health, illness and distress amongst the displaced. Local idioms of distress in the form of pensamentos, mutima, madness and high and low blood pressure are common ways of expressing suffering related to war. The different explanatory models held about these illnesses and the various resources available in the popular, folk and professionals sectors of the health care system were explored. The religious and spiritual domains were found to be influential in the treatment of distress-related illnesses. The psychological services available in the war-displaced communities were examined in terms of their common theoretical and practical elements. These were then analysed in relation to the conceptualisations held by local populations, and points of similarity and difference were noted. Specifically, the conceptualisation of suffering as trauma and the cultural misunderstandings that arise as a result of this, and the representation of the displaced as traumatised and therefore dependent and passive people, are discussed. A particular subgroup in the community, the adolescents, was identified and participatory methods were employed to investigate the strategies and resources this group uses for coping with war-related distress. The youths predominantly make use of distraction, conselho, religious and cultural resources. The application of a PTSD scale, the EARAT, suggests that 71% of the adolescents had symptoms of trauma consistent with a diagnosis of PTSD. It is argued that for the vast majority such a conceptualisation does not reflect the adolescents' abilities to function on social, vocational, educational and physical levels. The implications of these findings for research and practice in the field of psychosocial work are discussed.

Adult day care rehabilitation centers represent options for the elderly population that long-term care professionals have long been seeking. Chapter One represents the statement of the problem, historical overview of adult day care/rehabilitation centers in general and in Georgia, conceptual framework and theoretical grounding and research method. Chapter Two discusses the problem in contextual review, services, access, quality in adult day care and rehabililitation, the federal government and adult day care programs. Further discussions focus on centers and their relationship of variables from the instrument in the participation of persons suffering from Alzheimer's diseasae and related disorders in Georgia. This chapter seeks also to utilize secondary data on previous studies relating to adult day care/rehabilitation centers to supplement the study. Primary emphasis was to determine the extent to which those adult day care/rehabilitation centers studied provide for Alzheimer's disease and related disorders patients through their services. Chapter three will cover presentation of data and discussion in the area of analyzing and examining the centers having Alzheimer's disease and related disorders patients. Presentation of data and interpretation of findings, sampling frame characteristics, key variables and utility and limitation of the study will all be included in this chapter. Included also, will be a comparison of participation of the Alzheimer's disease and related disorders patients between adult day care and rehabilitation centers, a breakdown of adult day care, adult day rehabilitation and combination centers, and the relationship between adult day care and selected variables from the instrument. Finally, in Chapter Four, a summary of findings, conclusions and study recommendations if need be as to how the adult day care and rehabilitation centers can or should be operated in order to accommodate a greater number of Alzheimer's disease and related disorders cases in Georgia will be addressed.

A systematic review identified limited studies exploring oral formulation-related barriers to medicines administration in children. Owing to the lack of licensed medicines suitable for use in children, manipulation is often required to deliver a specific dose or to facilitate medicines administration. Little is known regarding the prevalence and nature of issues encountered when administering medicines to children in the domiciliary setting. This study adopted a pragmatic approach to determine the nature and prevalence of oral formulation-related barriers to medicines administration in children suffering from a range of chronic conditions. Problems reported by healthcare professionals, patients and their parents/carers were identified to inform future pharmaceutical development and improve children’s medicines. Focus groups (n=4) were conducted with healthcare professionals in the West Midlands and semi-structured face-to-face interviews (n=278) were conducted with parents/carers/young people at University Hospitals Coventry and Warwickshire. Questions explored barriers to medicines administration, refusal and manipulation. In total, 31% of interview respondents reported medicines refusal. Taste was the most commonly reported barrier to medicines administration. Almost one fifth (19%) of medicines administered to children were reported to require manipulation. Findings indicate that age-appropriate medicines are required to provide both suitable dose units and acceptable taste for paediatric patients.

Bakgrund: Alzheimers sjukdom (AS) kallas ofta för den anhöriges sjukdom med anledning av att sjukdomen även påverkar de närstående. Det är därför av vikt att sjuksköterskan arbetar utifrån ett helhetsperspektiv för att på så sätt få en förståelse för vilken inverkan AS har på familj och närstående. Syfte: Syftet med studien var att beskriva upplevelsen av hur livskvalitén påverkas av att vara närstående till en person med AS. Metod: En kvalitativ innehållsanalys, där självbiografiska verk har analyserats Resultat: Resultatet presenteras med tre kategorier ”En ny vardag”, ”Leva med ett lidande” och ”Ett tungt ansvar”. Varje kategori har två underkategorier vardera. . Det liv och den vardag som tidigare var känd för den närstående blev till ett minne. Nya utmaningar i vardagen och ett tungt ansvar väntade som resulterade att livskvalitén blev påverkad. Psykisk och fysisk ohälsa blev ett faktum. Slutsats: Det fanns flera faktorer till att livskvalitén blev försämrad. En faktor var att den närstående fick ta hela ansvaret för att vardagen skulle fungera i hemmet och spelade därför en viktig roll för personen med AS. Med anledning av detta måste sjuksköterskan kunna stödja den närstående så att denne orkar med sin vårdande roll och minimera risken för psykisk ohälsa.
Background: Alzheimer´s disease is often called the relative's illness on the grounds that the disease also affects the relatives. It is therefore important that the nurse working with a holistic approach and obtain an understanding of the impact of Alzheimer´s disease on family and relatives. Purpose: The purpose of this study is to describe the experience of how quality of life is affected by being related to a person with Alzheimer's disease. Method: This is an qualitative content analysis, where autobiographical works have been analyzed. Results: The results are presented in three categories: "A new day", "Living with suffering" and "A heavy responsibility." Each category has two subcategories. The life that was previously known to the relatives became a memory. New challenges in everyday life and a heavy responsibility that resulted in that the quality of life was affected. Mental and physical health became a fact. Conclusion: There were several factors that led to impaired quality of life. One factor was that the relatives had to take full responsibility for everyday life and played an important role for the person with Alzheimer´s disease. For this reason, the nurse must be able to support the relatives so that they can cope with their caring role and minimize the risk of mental illness.

Bakgrund: Självskadebeteende har tidigare uppfattats som ett tecken på allvarlig psykisk sjukdom och det ansågs enbart vara mycket förvirrade människor som skadade sig själva. Studier visar att självskadebeteende oftast är något människor begår i ensamhet och majoriteten väljer heller inte att uppsöka sjukvård. Kunskap om självskadebeteende och attityder till patienter som skadar sig kan bidra till en ökad förståelse hos sjuksköterskor för fenomenet.  Syfte: Syftet med denna litteraturstudie är att beskriva sjuksköterskors attityder till patienter med självskadebeteende. Metod: Uppsatsen är baserad på en litteraturstudie där nio artiklar analyserats med vägledning av Fribergs kriterier för analys av vetenskapliga studier. Resultat: Resultatet presenteras utifrån fyra huvudteman med 16 tillhörande subteman. De fyra huvudtemana är; sjuksköterskors föreställningar, sjuksköterskors känslor, sjuksköterskors värderingar samt sjuksköterskors handlingar. Resultatet visar att sjuksköterskors attityder till patienter med självskadebeteende är mångskiftande. Diskussion: Författarna skapade sex teman utifrån det i resultatet som kunde vara av intresse att lyfta fram. En diskussion kring dessa sex teman fördes sedan mot bakgrundsinformationen och Katie Erikssons teori om lidandet. Med hänsyn till vetskapen om att tankar och känslor inte alltid styr vårt handlande, valde författarna att inte dra slutsatsen att sjuksköterskor endera har positiva eller negativa attityder till patienter med självskadebeteende.

During recent decades, lumbar spinal stenosis (LSS) has become the most common indication for spine surgery, a change that coincides with a higher worldwide prevalence of overweight and obesity. Thus, surgical treatment of LSS in the overweight and obese population is common and increasing in scope. The overall aim of this thesis was to investigate whether body mass index (BMI) is related to the development of LSS, and whether BMI is linked to outcome after surgery for LSS. We further evaluated whether there are specific experiences of LSS from a patient perspective. Data were obtained for all patients registered in the Swedish Spine Register who had undergone surgery for LSS between January 1, 2006 and June 30, 2008. After adjusting for differences in baseline characteristics, patients with obesity showed both poorer results after surgery and a higher rate of dissatisfaction than patients with normal weight (odds ratio 1.73; 95% confidence interval, CI, 1.36-2.19). Furthermore, patients with obesity in the cohort reported modest weight loss at follow-up (2.0 kg; 95% CI, 1.5-2.4), and only 8% reported a clinical important weight loss 2 years after surgery. Our analysis of 389,132 construction workers, showed that overweight (incidence rate ratio, IRR 1.68; 95% CI, 1.54-1.83) and obesity (IRR 2.18; 95% CI, 1.87-2.53) were associated with an increased future risk in developing LSS when compared with patients with normal weight. To gain insight into the patients' perspective of LSS, we performed interviews with 18 patients who were on a waiting list for LSS surgery. The transcripts, analyzed with content analysis, revealed that living with LSS is a physical, mental and social challenge in which resources to cope with the condition are of major importance. In summary, obesity is associated with poorer results after surgery, and patients with obesity report modest weight loss during follow-up. In addition, obesity is associated with an increased risk to develop LSS. Our findings revealed that being a patient with LSS, naturally involves considerable suffering and pain, but it also implies being a person with his or her own resources who is able to cope with these adverse conditions.

Le concept de « risques psychosociaux au travail » rassemble plusieurs phénomènes de souffrance liés au travail. Ces risques se réfèrent à la fois aux actes porteurs de souffrance et aux expressions de cette souffrance sur la santé des salariés. Malgré sa formulation, ce concept renvoie à des événements qui portent atteinte tant à la santé psychique que physique des travailleurs. Ces atteintes d’origine professionnelle ont pour trait commun leur caractère avant tout social. En effet, les risques psychosociaux sont principalement causés par des organisations du travail, des méthodes de management ou des relations interpersonnelles néfastes. Si l’expression de risques psychosociaux a émergé hors du champ juridique, elle est désormais communément utilisée en droit pour traiter des questions de santé et de sécurité au travail. L’appréhension juridique de ces risques n’est pourtant pas évidente. Ceux-ci sont difficiles à délimiter, teintés de subjectivité et peu enclins à être appréhendés au vu de l’histoire du droit social. Toutefois, le droit est de plus en plus sensible à l’appréhension des différentes dimensions de la personne du salarié. En outre, si la consécration des risques psychosociaux en tant que catégorie juridique est marginale, les événements auxquels renvoie ce concept sont saisis par les textes de droit nationaux et extranationaux ainsi que par la jurisprudence. Dès lors, les dispositifs et solutions juridiques applicables aux relations de travail de droit privé sont en capacité de prévenir ces risques, de les sanctionner ou de les réparer. À ce titre, une multitude d’acteurs internes ou externes à l’entreprise sont en capacité d’agir face à ces risques
The concept of "psychosocial risks at work" gathers several work-related suffering risks. These risks are, at the same time, related to the generating acts of pain and to the expressions of suchpain on employees’ health. Despite its formulation, this concept refers to events affecting both mental and physical health of workers. Such affecting events share the same social ground. Indeed, psychosocial risks are mainly caused by the companies’ organization themselves, management methods or harmful relationships. Even though the expression of psychosocial risks was formerly developed out of the legal environment, it is now generally used in law to deal with issues of health and safety at work. However, the comprehensive understanding of such risks is not yet obvious from a legal perspective. These are complicated to define and delimit, tinged with subjectivity and unlikely to be understood in light of the employment law history. However, law is increasingly taking into account the different dimensions of the workers’ individuality. Also, if the psychosocial risks fail to be recognized, so far, as an independent and entire legal concept, both laws (domestic and international) and case law are more and more referring to it. Therefore, measures and legal solutions applicable to the working relationships in private companies enable to prevent such risks, punish or compensate them. As such, a wide range of people, whether related or not to the company, are able to duly face these factors

碩士
國立成功大學
護理學系碩博士班
96
Domestic violence has been a universal phenomenon within the family since ancient times. The majority of domestic violence victims is female, and they are assaulted by their male intimate partners. In addition to physical trauma, domestic violence may also lead to psychiatric morbidity. Among these domestic violence -related psychiatric disorders, depression is not uncommon, and it may lead to disability, chronicity and increased risk of suicide, if untreated or inadequately treated. The aim of the present study was to explore the relationship between severity of physical violence, personality, childhood maltreatment experience and depression. This study also tried to determine possible predictors of depression within the context of an abusive relationship. Participants in this cross-sectional study were all from the Domestic Violence Prevention Center, Kaohsiung, Taiwan, under purposive sampling. A total of 66 participants completed questionnaires, including the Eysenck Personality Questionnaire (EPQ), the Brief Conflict Tactics Scale (CTS), the Center for Epidemiologic Studies-Depression (CES-D) scale, and socio-demographic data. All data were analyzed by descriptive statistics, t-test, chi-square test, stepwise regression and logistic regression. In this study, we found that (1) among all victims, 55 (83.4%) had depressive symptoms, which was significantly higher than the general population; (2) t-test andχ2-test analysis showed that domestic violence related depressive symptoms were negatively associated with age (t=3.240, p=0.002), extraverted personality (t=2.417, p=0.019), but positively associated with duration of marriage (t=2.362, p=0.021), childhood-witnessed domestic violence (χ2=0.903, p=0.015) and neurotic personality (t=-5.629, p=0.000); (3)multiple stepwise regression analysis showed that three factors, age, neurotic and extraverted personality can predict 55.7% of total variance in domestice violence-related depressive symptoms; (4) logistic regression analysis showed that the aused women with neuroticism have significantly higher risk to have depressive symptoms than those without neuroticism. Discussion: The results of this study may help in understanding the relationship between depressive symptoms and the personality of the abused women, and in providing more applicable assessment and intervention. These results also may provide the government and clinical nurses a deeper comprehension of domestic violence and can be used as reference for constructing health and social policies for abused women in the future.

碩士
中國醫藥大學
醫務管理學系碩士班
99
Objective: Taiwan belongs to the moderate prevalence of tuberculosis (TB) region, and research indicates that the incidence of dialysis patients with TB is 6.9 times higher than the general population. At present, most domestic and international research compared the TB infection rate between the general population and dialysis patients. In the past, few studies examined the TB infection rate for different dialysis modality, and thus the purpose of this study is to explore patients with the different dialysis modality suffering from tuberculosis infection and its related factors. Method: This study used a retrospective cohort study method, and obtained the data of patients treated by dialysis for more than three months from the National Health Insurance Research Database in 1997 to 2007. We used propensity score matching (PSM) method, and matched the patients with peritoneal dialysis (PD) and those with hemodialysis (HD) by 1:1. The number of PD patients and HD patients have 5,093 people, respectively. We used Cox proportional hazard regression models to examine the relative risk of dialysis patients with different modality suffering from TB and the associated factors. Results: There were 313 dialysis patients suffering from tuberculosis. The Cox model analysis results show that after controlling for other variables, patients with HD had 1.67 time higher risk of suffering from TB than those with PD. Other significant factors include the relative risk for men to women was 0.70 times; the relative risk is higher with the increased age; connective tissue diseases and hypertension in patients have low risk (HR:0.25 ; HR:0.56). Conclusions and recommendations: This study found that HD patients with the risk of suffering from TB were higher than the PD patients. Therefore, health authorities on the medical institutions of the dialysis unit should strengthen TB infection control measures; the hospital staff should be regularly screened for TB and enhance education and training; We also need to reduce the high risk of suffering from TB for the dialysis patients.

D.Diac. (Play Therapy)
Teachers in South Africa experience strain and tension, unique to their specific work description, which is evident in the career-related stress symptoms experienced by the individual teachers, the high rate of absenteeism amongst teachers, as well as the high attrition rate. Although factors causing teacher-stress, and the consequences thereof, have been extensively researched, a limited number of empirical evaluations of the effectiveness and accessibility of stress-management programmes have been conducted. Due to the holistic nature of Gestalt therapy, its emphasis on the here-and-now and the Gestalt principles of awareness, dialogue and process, a Gestalt therapeutic process model was developed to empower teachers to regain homeostasis. The aim and objectives of the research were the design, development, presentation and evaluation of a Gestalt therapeutic process model for teachers suffering from career-related stress, in their quest to regain homeostasis. The model was developed to be implemented within the school environment by a trained member of the school management team. The process of intervention research was used for the research study. A functional Gestalt therapeutic programme, based on the theoretical Gestalt therapeutic model, was developed and presented to ten teachers, selected through purposive sampling, and again to five different teachers, selected through theoretical sampling. The teachers identified were representative regarding age, gender, race and years in education. Triangulation was used and qualitative and quantitative data were collected simultaneously. The hypothesis stated for the research was that if teachers, suffering from career-related stress, were exposed to a Gestalt therapeutic model, they would regain homeostasis. Both the qualitative and quantitative data supported the hypothesis. The effect of the variables on each other was compared to confirm the reliability, applicability and neutrality of the research data. At the end of the three month research period the teachers who were exposed to the said model experienced less stress-related symptoms, as well as growth towards maturity and self-support, which would ultimately result in the regaining of homeostasis. A further objective of the research was to determine the feasibility of a trained school management team member implementing the Gestalt therapeutic process model at school. The qualitative data collected, indicated the feasibility thereof on condition that the school management team member did receive the necessary Gestalt therapeutic training.
Social Work

碩士
臺灣大學
哲學研究所
98
Abstract This dissertation is an inquiry into the observation of suffering and pleasure related to the mind-body. It is mainly a discussion of topics related to the mind-body such as the Buddhist interpretation of pleasure and suffering. Buddhism advocates the authentic observation as a reliable approach to understanding the principles of pratītya-samutpāda (dependent co-arising), anitya (impermanence); as well as developing the wisdom of śūnyatā (emptiness) and madhyama-pratipad (middle path). Unlike most worldly views, Buddhism does not adhere to the concept of self, thus avoiding any discussion of personal identity, subjectivity, ownership, and the entrapment of substantial entity in the mind-body. Instead, Buddhism reveals its theory of the truth by positing mind and body as being non-self, and an accumulation of the five aggregates. Confronted with daily suffering and pleasure through the activities of the mind-body , ordinary people are either driven to blindly sensual pursuit or caught in the essential recognition of each experience of suffering and pleasure, confused by various feelings.By contrast, Buddhism concludes that all feelings are basically dukkha (suffering), thereby highlighting the three marks of reality. First, all mental expectations and hopes of ownership will eventually fall into a suffering void under the dynamic flux of reality. Second, this suffering is a real portrayal of reality-blinded sentient beings in two facets: continuous, agitated, ignorant mental activity; and unceasing karma (action-reaction) in an endless chain of reincarnation. Third, only through correct observation of the reality of suffering will a person be further motivated to investigate the causes of suffering and the way to extinguish suffering, thus leading to cultivation on the path to liberation. In terms of epistemological perspectives, the Saṃyuktāgama-Sūtra inspires people to observe the true nature of suffering and pleasure arisen from the mind-body in order to spell out four significant points. First, the destruction of the view of self and elimination of blind faith towards the ontological essence of feelings is highlighted. Second, besides examining the worldly cognitive model, a dynamic observation is introduced with the inclusion of cognitive faculties, elements, and their mutually dependent process in the relational network. Third, instead of operating in the conventional, dualistically opposing mindset, development of the wisdom of non-dualism and middle path is stressed. Fourth, the coherent working of skandia, āyatana, and dhātu is incorporated into the understanding of feelings, thereby making a breakthrough in knowledge by way of detaching linguistic absolutism. In terms of practical implementation of such observation, progress is diligently made along the eight-fold path and the practices of being mindful of the four foundations. These efforts are the fundamental building blocks to attaining the great qualities of percepts, balanced-concentration, and wisdom. While transforming the suffering and pleasure arisen from the mind-body into the dharma (true nature of reality), the joy of nirvana is guaranteed .

碩士
國立高雄大學
運動健康與休閒學系碩士班
98
This study investigated quality of life (QOL), parental stress and related factors in parents with children suffering from cerebral palsy (PCCPs) and attempted to assess their relationship with regard to the severity of a child’s motor disability. Using a case-control study design, data were collected primarily through the use of survey questionnaires. In total, 147 PCCPs as well as 143 parents of healthy children participated in the study. Demographic data including children’s age, sex and the parents’ age, sex, residence and education were also compared with those of the study group. Measurement instruments for the study included the Quality of Life Scale (WHOQOL-BREF), Parental Stress Scales (PSI/SF). Also, Gross Motor Function Classification System (GMFCS) was used for the children with cerebral palsy. The basic information of the children and parents focused upon: severity of motor disability, related diseases, rehabilitation, and frequency of parents asking for related support system. The data were analyzed with the SPSS 14.0Windows statistical package. The results of the study indicated significantly worsened QOL and parental stress was more likely to be observed in PCCPs than in comparisons to the parents of healthy children. Specifically, a negative correlation between QOL and parental stress was noted in PCCPs. Also, QOL and parental stress were significantly correlated with the severity of a child’s motor disability. They were also reported physical problems, including tenderness over lower back, upper back and wrist sprain. The PCCPs’ important supporter is spouse, other families and therapists. The predictor of QOL and parental stress is the severity of a child’s motor disability, overall QOL, general health and household income. The QOL and parental stress of parents of children is different from those who have a healthy child. Different coping strategies and psychosocial programs must be designed and implemented to decrease the burden of care. Health professionals have a role to assist families with information needs to prepare for key periods in the lives of their children with children.

The analysis of pharmacotherapy by patients suffering with DM in Greece I Author: Georgios Kalaitzidis Tutor: Professor RNDr.Jiri Vlcek,CSc. Department of Social and Clinical Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Kralove. Introduction: The diabetes in developed countries concerns 11% of people over 70 years and is the cause of 3% of total deaths in general population. Aim: The aim of the study was to assess the Pharmacotherapy of Diabetes mellitus type II in a pharmacy of a small town of Greece, Veria. Methods: It is retrospective cross-sectional study, which was conducted in a pharmacy in a small town of Greece, Veria. The study population consists of 60 patients with known Type II diabetes Melitus. The data collection was performed by a self-reported questionnaire, which was created and developed by the researcher and filled by the respondents. Results: The mean age of the sample was 56.5±17.5 years. Most of them were females (n=40). Most of the patients knew their fasting glucose level (93.3%,n=56).Of the patients who knew their fasting glucose level, 36 (64.3%) patients had high fasting glucose level and 20 (35.7%) had physiological fasting glucose level. From all the patients(n=60), some of them visited their physician every 6 months (n=24), and every 3 months...

Sjuksköterskans ansvar är att lindra lidande. Vårdverksamheten och vårdforskningens största utmaningar är att förstå hur lidande bäst kan lindras. Lidande som orsakas av vården kallas vårdlidande. Den systematiska litteraturstudiens syfte var att pröva Katie Erikssons teori om vårdlidande inom omvårdnad. En deduktiv ansats användes vid genomförandet av studien. Studien genererade tolv resultatartiklar som analyserades enligt Erikssons följande kategorier om vårdlidande kränkning av värdighet, fördömelse och straff, maktutövning och utebliven vård. De mest förekommande kategorierna som identifierades utifrån resultatet var kränkning av värdighet och utebliven vård. En ytterligare kategori som framkom benämdes vårdens prioriteringar. Den kan ses som en utveckling av Erikssons kategori utebliven vård. Resultatet bekräftade Erikssons teori om vårdlidande. Rekommendationer för klinisk verksamhet är att patienten ska få möjlighet att utvärdera vården i efterhand, för att skapa en medvetenhet hos vårdpersonalen kring patientens upplevelse. Vidare rekommenderas forskning om vårdens prioriteringar.
Nurses’ responsibility is to alleviate suffering. The main challenge for healthcare organisation and the science of caring and nursing is to understand how suffering could be alleviated. Suffering caused by care is called suffering related to care. The aim of the study was to test and imply Katie Erikssons theory about suffering related to care in nursing. The systematic review was performed with a deductive research method. Twelve articles was analysed according to Erikssons theory about suffering related to care. The theory includes three themes: violating the patients dignity, condemnation and punishment, exert of power and absence of care. The themes that occurred the most in the results were violating the patients’ dignity and absence of care. Another theme was developed through the results was healthcare priorities. The theory can be interpreted as a subtheme to absence of care. Erikssons theory was validated by the results of the study. One implication for clinical practice is to give the patients ability to evaluate their received healthcare. The purpose of the evaluation is to make the health care professionals aware of the patients’ experience. Further research about healthcare priorities are suggested.

碩士
國立暨南國際大學
社會政策與社會工作學系
87
The Title of the Thesis: The Study of Caring Problems, Total page: 91Needs, and Expectation of the Supportive Programs of the Community Care Related PFC of the Elderly Suffering Chronic Disease at Home─The Case of Da Li City, Taichung CountyUniversity: National Chi Nan University Class Level: Graduate Class for MA degree, Dept. of Social Policy and Social WorkDate of Graduation: The 2nd Semester of 1998Candidate for MA degree: Lin Huey ChenDirector of the Thesis: Dr. YI-CHANG CHANThe Outline of the Thesis is as follows:Owing to the rapid growth of the aged in our society, the insufficiency of health care system devoted to the long term care of the elderly and the change of traditional family ways of living, the need for the long-term care of the elderly has become a critical issue. Based on important books in the West and East(China in particular), family centered private care system, instead of nursing homes, is always a preferable way to take care of the elderly and accordingly, the most commonly accepted way to take care of the elderly in our society. With the change of society, traditional family structure has not only disintegrated but also become more and more complicated. The rate of birth has significantly dropped and on the other hand, the rate of women labor participation is on the rise. These are the elements that inevitably affected the traditional way of taking care of the elderly at home. Because of the ‘deinstitutionalization’ and the ‘awareness of the welfare community care system of the elderly have become an essential part of a modern society. In other words, if it is possible, the elderly should stay in a place where they can be at ease, a place like home. Therefore, the program of taking care of the elderly, to the social welfare organizations and to the health care system.This thesis focuses on an analysis of family care of the elderly paying special attention to the family care-givers. The analysis includes four parts: 1. The current long term care facilities available in the community of Da Li City 2. The problems and concern of those Primary Family Care-givers (PFC) 3. The need of those PFC. 4. The expectation and viewpoints of the interviewers on the program of community care facility of the elderly.This thesis aims to take a closer look at the present condition of long term care of the elderly interviewing people who are the PFC. Based on the contents of the interview, the outlines include four aspects:1. The problems and concern of the PFC2. The need of the PFC3. Viewpoints of the interviewers concerning the community’s care facilities and the supportive programs. As to the interview, 11 samples of the PFC are interviewed and the interview is recorded accordingly. The analysis of the interview is as follows: Among the 11 samples, the role they play in the family can be classified as follows: 8 are females; 6 are in the role of daughter and son (4 daughters and 2 sons); 4 in the role of spouse (3 wives and 1 husband) and 1 in the role of daughter-in-law. The numbers of female roles of those who take care of the elderly at home exceed those of male roles. As to the need of those who take care of the elderly at home, financial support or economic condition of the family is the major concern that will eventually affect the quality and the way they choose to take care of the elderly. The 11 samples discuss widely on the service offered by nursing home. They wonder whether the price is reasonable and affordable. The distance of the nursing homes, they also show interest on a variety of alternative programs that offer service to take care of the elderly. The so-called ‘compensation program’ as a feasible way for the long term care of the elderly that combines family care and care offered by private nurses at the home of the elderly.Based on the result of the study and findings, my proposals are as follows:1. Policy:To promote the program of the community care of the elderly in compliance with the government policy. To unite the medical facilities available in Da Li City and encourage the social and government organizations to join together in order to plan the community care system. To regulate the administration standard of the nursing homes as well as the standard of the service charge. To have access to the organizations of nursing homes in the neighboring counties and villages, to establish networks to enable fast service and to develop alternative ways of community care of the elderly and make them available to the public.2. Pragmatic approaches: To allow the medical facilities in the region, the professionals of social and political spheres and the spheres and the specialists of the related fields to participate in the program of community care and to back up the plan as well as all the related matters such as, research, promotion and development. 3. Viewpoints for further study: There are several issues which can be further discussed such as, the issue of female roles in the long-term care of the elderly, the issue of filial piety with regard to the care of the elderly as well as a profound understanding of the inner world of those who take care of the elderly focusing on how they manage to adjust themselves to the daily work of taking care of the elderly. In addition, it is also worth discussing the suitability of the policy and how the policy-markers, the scholars and the specialistsevaluate the policy. Finally, from the macro-perspective, I expect that this program can be carried out in accordance with the government’s advocating of the spiritual reform of people and society and with the spreading of the philosophy of the Chapter Da Tong in the Book of Rites. From the ethical perspective, with the reinforcement of family function, the concept of filial piety and the perpetuity of family, the problems of taking care of the aged population can be gradually solved.

The thesis is concerned with two issues, modern messiahs and their appeal, namely the highly successful Rebbe M.M. Schneerson from Chabad; and hostile, modern day, militant messianists and their beliefs, namely the USA Christian evangelicals and their rapture belief. The study directs attention at the three successful (in the sense that their movements survived their deaths) Jewish Messiahs, the 1st century Jesus, the 17th century Sabbatai Sevi and the present day, but recently deceased (1994) Rebbe Schneerson. The focus in the study falls on the latter two Jewish Messiahs, especially Rebbe Schneerson and Chabad, from Crown Heights, New York, whose messianic beliefs and conduct the thesis has been able to follow in real time. The thesis argues that Rebbe Schneerson and Chabad‟s extreme messianic beliefs and praxis, and the marked similarities that exist between all three Jewish Messiahs and their followers indicate that Chabad will probably, over time, become another religion removed from Judaism. The thesis notes that the three Jewish Messiahs share a similar messiah template, the “„suffering servant‟ messiah” template. The thesis argues that this template is related to the wide appeal and success of these three Jewish messiahs, as it offers their followers the option of vicarious atonement which relieves people from dealing with their own transgressions and permits people to evade the demanding task of assuming personal accountability for all their actions, including their transgressions. The recommendations in this thesis are prompted by the “wall of deafening silence” which is the result of political correctness and the “hands off religion” position, that prevents debate or censure of hostile militant messianism, despite the inherent dangers and high cost attached to the praxis of hostile, militant messianism and militant messianists‟ belief in exclusive apocalyptic scenarios, in modern, multicultural and democratic societies. The thesis argues this situation is not tenable and that it needs to be addressed, especially where modern day, hostile, militant messianists, unlike their predecessors at Qumran, now have access to the military and to military hardware, including nuclear warheads, and are able to hasten the End Times should they simply choose to do so.
Old Testament and Ancient Near Eastern Studies
D. Litt. et Phil. (Biblical Archaeology)