82 research outputs found

    Occupational Therapy Practitioners\u27 Views on Health and Wellness Promotion Programming: A Qualitative Study

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    Purpose: Explore the essence of occupational therapy (OT) practitionersโ€™ perceptions of their experiences with health and wellness programming; to further understand the lack of this type of programming by finding out what their needs are in order to provide it. Methods: A qualitative, phenomenological study was used to gather data to answer the research questions. Following IRB approval, convenience/snowball sampling was used to access participants and gather data. Five registered occupational therapists participated in this study. Results: OT practitioners have positive views for health and wellness promotion; however, in order to be successful to OT practitioner must have an internal drive to provide such programming Conclusion: There are many benefits for promoting health and wellness at the community level; however, OT practitioners find there are more barriers than supports, and there must be an internal drive from the OT practitioner in order to be successful

    RAISING INTERCULTURAL COMPETENCE OF AMERICAN STUDENTS: A PILOT STUDY

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    International students and study abroad programs are major components of internationalization efforts for institutions (Beelen & Jones, 2015). Domestic students however do not have any established practice of intercultural training or orientation, even though most universities in America accept international students and promote internationalization which is the increase of intergroup contact as part of globalization (Sakurauchi, 2014). It is crucial to raise the intercultural communication competence (ICC) of American students so they can benefit from the internationalization efforts of universities (Sakurauchi, 2014). This study attempted see if the ICC can be raised by implementing an IPM training in a treatment and control group in a basic communication course (BCC). The questionnaire revealed that students mostly improved only in two dimensions of the IPM: positioning and framing. The reflective question revealed empathy as a major theme of the ICC success. This pilot study shows that the IPM training is a promising training to include in the BCC

    ๋„์‹œ ๋…ธ์ธ์˜ ์ •์‹ ๊ฑด๊ฐ• ์˜ํ–ฅ์š”์ธ๊ณผ ๋„์‹œ์ˆฒ์˜ ์‹ฌ๋ฆฌ ์น˜์œ ์  ํ™œ์šฉ

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    ํ•™์œ„๋…ผ๋ฌธ(๋ฐ•์‚ฌ)--์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :ํ™˜๊ฒฝ๋Œ€ํ•™์› ํ˜‘๋™๊ณผ์ • ์กฐ๊ฒฝํ•™,2019. 8. ์ด๋™๊ทผ.In Korea, most of the population resides in cities owing to the increase in urbanization. Urban older adult population formed 76.6% of the total urban population in 2014, and it has been steadily increasing. People living in the urban environment are more vulnerable to mental health problems such as stress and depression, caused by lack of contact with green spaces, and social isolation, caused by fewer opportunities for communication. Older adults are vulnerable to mental health problems such as stress and depression due to a decrease in their social and economic status as well as an increase in their physical illnesses. Mental health is related to physical and social health, and consequently affects the burden of health care and the overall survival rate. Therefore, it is important to study the mental health problems of older adults in urban areas as social problems, and not merely as personal problems, to strengthen preventive measures and to identify the factors that affect mental health. In addition, it is necessary to identify the factors that affect mental health in older adults in relation to social, demographic, physiological, and psychological aspects of their lives. Further, urban parks and green areas are known to help improve mental health by promoting social contact and interaction among people and by reducing psychological stress. In recent years, national and local governments in Korea have recognized the importance of the health benefits of forest therapy (forest bathing), and the implementation of forest therapy programs using urban as well as other forests is increasing. However, most of them target the general public, and the urban forest therapy program targeting specific vulnerable groups such as low-income groups or older adults living alone is at the pilot stage. In addition, there is relatively insufficient study focusing on how urban forests affect mental health positively. The psychological healing effect of urban forests varies according to peoples age and life cycle stage and is reported to be the strongest in older adults as well as middle-aged people. Therefore, it is necessary to implement forest therapy programs utilizing urban forests separately to target older adults or middle-aged people. This is empirical case studies of an urban forest therapy program for mental health of older adults and middle-aged people. We found socio-demographic factors affecting mental health of older adults in Chapter 1. The predictive indicators of subjective stress level were female gender, younger age, belonging to a third-generation household, low income, comorbidity, being a smoker, and participation in manual labor. The predictive indicators of depressive experience were female gender, living alone, low income, comorbidity, not working, being a smoker, being a non-drinker, and non-participation in periodic social activities. Additionally, the lower the urban green ratio in the administrative district, the higher the subjective stress levels and depression. In older adults, the presence or absence of periodic physical activity was not correlated with mental health, but the presence of social activity was significantly correlated with mental health. Based on the results of this study, we analyzed the effects of social capital on depression in Chapter 2. It was found that trust factor in social capital reduced depression through social capital satisfaction and self-esteem. In other words, we found that qualitative social capital is more effective in dealing with depression than quantitative social capital. It is necessary to identify and manage vulnerable groups through demographic and social characteristics and suggest such policies for improving trust factor in social capital that are effective in improving and promoting the mental health of older adults. In Chapter 3, we implemented a forest therapy program targeting older adults living alone on low income and receiving medical aid, using the urban forest near their living area as healing resources. As a result, the relationship between self, others (neighbors), and nature is formed through the process of awareness and flow in nature, and the sense of isolation is reduced, and self-coping, healthy lifestyle habits, were instilled. This implies that the utilization of urban forests contributed to the formation of social relations, and the formation of social capital results in not only mental health but also physical health improvement. In Chapter 4, we conducted the urban forest therapy program for middle-aged women preparing for the old age. We found that negative emotions are replaced by positive emotions through the recognition of inherent negative emotions in nature, recovering self-esteem through internal immersion process, and acquiring coping ability based on nature's providence. It is necessary to be careful while generalizing these results to other groups because each result is for a specific group. However, the results of this study will be helpful in establishing the policy direction of green welfare for the future through the understanding of mental health issues of older adults and middle-aged people in an aging society and in-depth analysis of the effects of therapy programs using urban forests.ํ•œ๊ตญ์€ ๋„์‹œํ™”์˜ ์ฆ๊ฐ€๋กœ ์ธ๊ตฌ์˜ ๋Œ€๋ถ€๋ถ„์ด ๋„์‹œ์— ๊ฑฐ์ฃผํ•˜๋ฉฐ, ๋„์‹œ ๋…ธ์ธ์€ 2014๋…„ 76.6%๋ฅผ ์ฐจ์ง€ํ•˜์˜€๊ณ  ๊พธ์ค€ํžˆ ์ฆ๊ฐ€ํ•˜๋Š” ์ถ”์„ธ์ด๋‹ค. ๋„์‹œํ™˜๊ฒฝ์€ ๋…น์ง€์˜ ์ ‘์ด‰์ด ๋ถ€์กฑํ•˜๊ณ  ์‚ฌํšŒ์  ๋‹จ์ ˆ๋กœ ์ธํ•œ ์†Œํ†ต์˜ ๊ธฐํšŒ๊ฐ€ ์ ์–ด ์ŠคํŠธ๋ ˆ์Šค ๋ฐ ์šฐ์šธ์ฆ๊ณผ ๊ฐ™์€ ์ •์‹ ๊ฑด๊ฐ• ๋ฌธ์ œ์— ๋”์šฑ ์ทจ์•ฝํ•œ ํ™˜๊ฒฝ์ด๋‹ค. ๋…ธ์ธ์€ ์‹ ์ฒด์  ์งˆ๋ณ‘์˜ ์ฆ๊ฐ€์™€ ํ•จ๊ป˜ ์‚ฌํšŒ, ๊ฒฝ์ œ์  ์ง€์œ„์˜ ๊ฐ์†Œ๋กœ ์ธํ•ด ์ŠคํŠธ๋ ˆ์Šค, ์šฐ์šธ์ฆ๊ณผ ๊ฐ™์€ ์ •์‹ ๊ฑด๊ฐ• ๋ฌธ์ œ์— ๋…ธ์ถœ๋˜๊ธฐ ์‰ฝ๋‹ค. ์ •์‹ ๊ฑด๊ฐ•์€ ์‹ ์ฒด์ , ์‚ฌํšŒ์  ๊ฑด๊ฐ•๊ณผ ๊ด€๋ จ๋˜์–ด ์žˆ์œผ๋ฉฐ ๊ฒฐ๊ณผ์ ์œผ๋กœ ๊ฑด๊ฐ•๊ด€๋ฆฌ์˜ ๋ถ€๋‹ด๊ณผ ์ „๋ฐ˜์ ์ธ ์ƒ์กด์œจ์—๋„ ์˜ํ–ฅ์„ ๋ฏธ์นœ๋‹ค. ๊ทธ๋Ÿฌ๋ฏ€๋กœ ๋„์‹œ ๋…ธ์ธ์˜ ์ •์‹ ๊ฑด๊ฐ• ๋ฌธ์ œ๋Š” ๊ฐœ์ธ์˜ ๋ฌธ์ œ๋ฅผ ๋„˜์–ด ์‚ฌํšŒ์  ๋ฌธ์ œ๋กœ ์ธ์ง€ํ•˜์—ฌ ์˜ˆ๋ฐฉ์„ ๊ฐ•ํ™”ํ•˜๊ณ  ์ •์‹ ๊ฑด๊ฐ•์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ํŠน์„ฑ์„ ํŒŒ์•…ํ•˜๋Š” ์—ฐ๊ตฌ๊ฐ€ ์ค‘์š”์‹œ ๋˜๊ณ  ์žˆ๋‹ค. ๋”ฐ๋ผ์„œ ์ •์‹ ๊ฑด๊ฐ•์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ์‚ฌํšŒ์ , ์ธ๊ตฌํ†ต๊ณ„ํ•™์ , ๋ฌผ๋ฆฌํ™˜๊ฒฝ์ , ์‹ฌ๋ฆฌ์  ํŠน์„ฑ๋“ค์„ ๊ณ ๋ คํ•˜์—ฌ ๋Œ€์ƒ์˜ ํŠน์„ฑ์„ ์ดํ•ดํ•  ํ•„์š”๊ฐ€ ์žˆ๋‹ค. ํ•œํŽธ ๋„์‹œ์˜ ๊ณต์›๊ณผ ๋…น์ง€๋Œ€๋Š” ์ธ๊ฐ„์—๊ฒŒ ์‚ฌํšŒ์  ์ ‘์ด‰๊ณผ ์ƒํ˜ธ์ž‘์šฉ์„ ์žฅ๋ คํ•˜๊ณ  ์‹ฌ๋ฆฌ์  ์ŠคํŠธ๋ ˆ์Šค๋ฅผ ์ €๊ฐ์‹œ์ผœ ์ •์‹ ๊ฑด๊ฐ•์„ ํ–ฅ์ƒ์‹œํ‚ค๋Š”๋ฐ ๋„์›€์„ ์ค€๋‹ค๊ณ  ์•Œ๋ ค์ ธ ์žˆ๋‹ค. ์ตœ๊ทผ์—๋Š” ๊ตญ๊ฐ€ ๋ฐ ์ง€๋ฐฉ์ž์น˜๋‹จ์ฒด์—์„œ ์ˆฒ์น˜์œ ์˜ ๊ฑด๊ฐ•ํšจ๊ณผ์— ๋Œ€ํ•œ ์ค‘์š”์„ฑ์„ ์ธ์ง€ํ•˜๊ณ  ์‚ฐ๋ฆผ ๋ฟ ์•„๋‹ˆ๋ผ ๋„์‹œ์ˆฒ์„ ํ™œ์šฉํ•œ ์น˜์œ  ํ”„๋กœ๊ทธ๋žจ์˜ ์‹œ๋ฒ”์  ์ ์šฉ ์‚ฌ๋ก€๊ฐ€ ์ฆ๊ฐ€ํ•˜๊ณ  ์žˆ๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ๋Œ€๋ถ€๋ถ„ ์ผ๋ฐ˜์ธ์„ ๋Œ€์ƒ์œผ๋กœ ์ ์šฉ๋˜๊ณ  ์žˆ์œผ๋ฉฐ, ์ €์†Œ๋“์ธต ๋˜๋Š” ๋…๊ฑฐ๋…ธ์ธ๊ณผ ๊ฐ™์€ ํŠน์ • ์ทจ์•ฝ๊ณ„์ธต์„ ๋Œ€์ƒ์œผ๋กœ ํ•œ ๋„์‹œ์ˆฒ ์น˜์œ  ํ”„๋กœ๊ทธ๋žจ์€ ์‹œ๋ฒ” ์šด์˜ ์ˆ˜์ค€์ด๋‹ค. ๋˜ํ•œ ๋„์‹œ์ˆฒ์˜ ํ™œ์šฉ์ด ์ •์‹ ๊ฑด๊ฐ• ๊ฐœ์„ ์˜ ํšจ๊ณผ๋กœ ๋‚˜ํƒ€๋‚˜๋Š” ๊ฒฝ๋กœ์— ๊ด€ํ•œ ์—ฐ๊ตฌ๋Š” ์ƒ๋Œ€์ ์œผ๋กœ ๋ถ€์กฑํ•œ ํŽธ์ด๋‹ค. ํ•œํŽธ, ๋„์‹œ์ˆฒ์˜ ์‹ฌ๋ฆฌ์  ์น˜์œ  ํšจ๊ณผ๋Š” ์—ฐ๋ น ๋ฐ ์ƒ์• ์ฃผ๊ธฐ์— ๋”ฐ๋ผ ์ฐจ์ด๊ฐ€ ์žˆ์œผ๋ฉฐ ๋…ธ์ธ ๋ฟ ์•„๋‹ˆ๋ผ ์ค‘์žฅ๋…„๊ธฐ์— ๊ฐ€์žฅ ํšจ๊ณผ์ ์œผ๋กœ ๋‚˜ํƒ€๋‚˜๋Š” ๊ฒƒ์œผ๋กœ ๋ณด๊ณ ๋œ๋‹ค. ๊ทธ๋Ÿฌ๋ฏ€๋กœ ๋„์‹œ์ˆฒ์„ ํ™œ์šฉํ•œ ์น˜์œ  ํ”„๋กœ๊ทธ๋žจ์˜ ์‹ค์ฆ์  ์‚ฌ๋ก€๋Š” ๋Œ€์ƒ์ธต์„ ๊ตฌ๋ถ„ํ•˜์—ฌ ์ ์šฉํ•  ํ•„์š”๊ฐ€ ์žˆ๋‹ค. ๋”ฐ๋ผ์„œ ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ๋…ธ๋…„๊ธฐ ์ทจ์•ฝ๊ณ„์ธต๊ณผ ์ค‘๋…„์ธต์˜ ์ •์‹ ๊ฑด๊ฐ•์„ ์œ„ํ•œ ๋„์‹œ์ˆฒ ์น˜์œ  ํ”„๋กœ๊ทธ๋žจ์— ๋Œ€ํ•œ ์‹ค์ฆ์  ์‚ฌ๋ก€๋ฅผ ์ ์šฉํ•˜์˜€๋‹ค. ์—ฐ๊ตฌ๊ฒฐ๊ณผ, chapter 1์—์„œ๋Š” ๋…ธ์ธ์˜ ์ •์‹ ๊ฑด๊ฐ•์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ์ธ๊ตฌ์‚ฌํšŒํ†ต๊ณ„ํ•™์  ํŠน์„ฑ๋“ค์ด ๋ฐœ๊ฒฌ๋˜์—ˆ๋‹ค. ์ฃผ๊ด€์  ์ŠคํŠธ๋ ˆ์Šค ์ˆ˜์ค€์˜ ์˜ˆ์ธก์ง€ํ‘œ๋Š” ์—ฌ์„ฑ, ์ดˆ๊ธฐ๋…ธ๋…„, 3์„ธ๋Œ€ ๊ฐ€๊ตฌ, ์ €์†Œ๋“์ธต, ์งˆ๋ณ‘์ดํ™˜์ž, ํก์—ฐ์ž, ๋…ธ๋™ํ™œ๋™ ์ฐธ์—ฌ์ž, ์ฃผ๊ธฐ์  ์‚ฌํšŒํ™œ๋™ ๋น„์ฐธ์—ฌ์ž๋กœ ๋‚˜ํƒ€๋‚ฌ์œผ๋ฉฐ, ์šฐ์šธ๊ฐ ๊ฒฝํ—˜์˜ ์˜ˆ์ธก์ง€ํ‘œ๋Š” ์—ฌ์„ฑ, 1์ธ๊ฐ€๊ตฌ, ์ €์†Œ๋“์ธต, ์งˆ๋ณ‘์ดํ™˜์ž, ๋…ธ๋™ํ™œ๋™ ๋น„์ฐธ์—ฌ์ž, ํก์—ฐ์ž, ๋น„์Œ์ฃผ์ž, ์ฃผ๊ธฐ์  ์‚ฌํšŒํ™œ๋™ ๋น„์ฐธ์—ฌ์ž๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ๋˜ํ•œ ํ–‰์ •๊ตฌ์—ญ ๊ตฌ๋‹จ์œ„์˜ ์ƒํ™œ๊ถŒ ๋„์‹œ๋ฆผ ๋ฉด์  ๋น„์œจ์ด ๋‚ฎ์„์ˆ˜๋ก ์ฃผ๊ด€์  ์ŠคํŠธ๋ ˆ์Šค์™€ ์šฐ์šธ๊ฐ์ด ๋†’์€ ๊ฒฝํ–ฅ์„ ๋‚˜ํƒ€๋ƒˆ๋‹ค. ๋…ธ์ธ์˜ ๊ฒฝ์šฐ ์ฃผ๊ธฐ์  ์‹ ์ฒด ํ™œ๋™์˜ ์œ ๋ฌด๋Š” ์ •์‹ ๊ฑด๊ฐ•๊ณผ ์ƒ๊ด€๊ด€๊ณ„๊ฐ€ ๋‚˜ํƒ€๋‚˜์ง€ ์•Š์€ ๋ฐ˜๋ฉด, ์‚ฌํšŒ ํ™œ๋™์˜ ์œ ๋ฌด๋Š” ์œ ์˜ํ•˜๊ฒŒ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ์ด๋Ÿฌํ•œ ์—ฐ๊ตฌ๊ฒฐ๊ณผ์— ๊ธฐ๋ฐ˜ํ•˜์—ฌ chapter 2์—์„œ๋Š” ์‚ฌํšŒ ํ™œ๋™๊ณผ ๊ด€๋ จํ•œ ์‚ฌํšŒ์  ์ž๋ณธ์ด ์šฐ์šธ์ฆ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ๊ฒฝ๋กœ๋ฅผ ๋ถ„์„ํ•˜์˜€๋‹ค. ๊ทธ ๊ฒฐ๊ณผ, ์‚ฌํšŒ์  ์ž๋ณธ ์ค‘ ์‹ ๋ขฐ ์š”์ธ์ด ์‚ฌํšŒ์  ์ž๋ณธ ๋งŒ์กฑ๋„์™€ ์ž์•„์กด์ค‘๊ฐ์„ ํ†ตํ•ด ์šฐ์šธ์ฆ์„ ๊ฐ์†Œ์‹œํ‚ค๋Š” ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ๋‹ค์‹œ๋งํ•ด, ์–‘์ ์ธ ์‚ฌํšŒ์  ์ž๋ณธ ๋ณด๋‹ค ์งˆ์ ์ธ ์‚ฌํšŒ์  ์ž๋ณธ์ด ์šฐ์šธ์ฆ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ์š”์ธ์ž„์„ ๋ฐœ๊ฒฌํ•˜์˜€๋‹ค. ์ด๋Š” ๋…ธ์ธ์˜ ์ •์‹ ๊ฑด๊ฐ• ๊ฐœ์„ ๊ณผ ์ฆ์ง„์„ ์œ„ํ•ด์„œ๋Š” ์ธ๊ตฌ์‚ฌํšŒ์  ํŠน์„ฑ์„ ํ†ตํ•ด ์ทจ์•ฝ๊ณ„์ธต์„ ํŒ๋ณ„ํ•˜์—ฌ ๊ด€๋ฆฌํ•  ํ•„์š”๊ฐ€ ์žˆ์œผ๋ฉฐ, ์‚ฌํšŒ์  ์ž๋ณธ ์ค‘ ์‹ ๋ขฐ ์š”์ธ์˜ ํ–ฅ์ƒ์„ ์œ„ํ•œ ์ •์ฑ…์ด ํšจ๊ณผ์ ์ž„์„ ์‹œ์‚ฌํ•œ๋‹ค. chapter 3์—์„œ๋Š” ์˜๋ฃŒ์ˆ˜๊ธ‰์„ ๋ฐ›๋Š” ์ €์†Œ๋“์ธต ๋…๊ฑฐ๋…ธ์ธ์„ ๋Œ€์ƒ์œผ๋กœ ์ƒํ™œ๊ถŒ ๋„์‹œ์ˆฒ์„ ์น˜์œ ์ž์›์œผ๋กœ ํ™œ์šฉํ•˜์—ฌ ์ˆฒ์น˜์œ  ํ”„๋กœ๊ทธ๋žจ์„ ์ ์šฉํ•œ ๊ฒฐ๊ณผ, ์ž์—ฐ ์†์—์„œ ์•Œ์•„์ฐจ๋ฆผ(awareness)๊ณผ ๋‚ด๋ฉด์  ๋ชฐ์ž…(flow) ๊ณผ์ •์„ ํ†ตํ•ด ์ž์•„, ํƒ€์ธ (์ด์›ƒ), ์ž์—ฐ๊ณผ์˜ ๊ด€๊ณ„๊ฐ€ ํ˜•์„ฑ๋˜์–ด ๊ณ ๋ฆฝ๊ฐ์ด ์ €๊ฐ๋˜๊ณ , ์ž๊ธฐ๋Œ๋ด„ ๋Œ€์ฒ˜๋Šฅ๋ ฅ(coping)์˜ ์ผํ™˜์ธ ๊ฑด๊ฐ•์ƒํ™œ์Šต๊ด€์˜ ๋™๊ธฐ๊ฐ€ ๋ถ€์—ฌ๋œ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ์ด๋Š” ๋„์‹œ์ˆฒ์˜ ํ™œ์šฉ์ด ์‚ฌํšŒ์  ๊ด€๊ณ„๋ฅผ ํ˜•์„ฑ๋˜๋Š” ๋ฐ์— ๊ธฐ์—ฌํ•˜์˜€์œผ๋ฉฐ, ์‚ฌํšŒ์  ์ž๋ณธ์˜ ํ˜•์„ฑ์€ ์ •์‹ ๊ฑด๊ฐ• ๊ฐœ์„  ๋ฟ ์•„๋‹ˆ๋ผ ์‹ ์ฒด์  ๊ฑด๊ฐ•์—๋„ ์˜ํ–ฅ์„ ๋ฏธ์นจ์„ ์‹œ์‚ฌํ•œ๋‹ค. ํ•œํŽธ, chapter 4์—์„œ๋Š” ๋…ธ๋…„๊ธฐ๋ฅผ ์ค€๋น„ํ•˜๋Š” ์ค‘๋…„๊ธฐ ์—ฌ์„ฑ์—๊ฒŒ ๋„์‹œ์ˆฒ ์น˜์œ  ํ”„๋กœ๊ทธ๋žจ์„ ์ ์šฉํ•œ ๊ฒฐ๊ณผ, ๋‚ด์žฌ๋œ ๋ถ€์ •์  ๊ฐ์ •์„ ์ž์—ฐ ์†์—์„œ ์•Œ์•„์ฐจ๋ฆฌ๊ณ , ๋‚ด๋ฉด์  ๋ชฐ์ž… ๊ณผ์ •์„ ํ†ตํ•ด ์ž์•„์กด์ค‘๊ฐ์˜ ํšŒ๋ณต๊ณผ ์ž์—ฐ์˜ ์„ญ๋ฆฌ์— ๊ธฐ๋ฐ˜ํ•œ ๋Œ€์ฒ˜๋Šฅ๋ ฅ์„ ๊ฐ–๊ฒŒ๋จ์œผ๋กœ์„œ ๋ถ€์ •์  ๊ฐ์ •์ด ๊ธ์ •์  ๊ฐ์ •์œผ๋กœ ๋ณ€ํ™”๋˜๋Š” ๊ฒฝ๋กœ๋ฅผ ๋ฐœ๊ฒฌํ•˜์˜€๋‹ค. ๊ฐ ์—ฐ๊ตฌ๊ฒฐ๊ณผ๋Š” ํŠน์ • ๊ทธ๋ฃน์„ ๋Œ€์ƒ์œผ๋กœ ํ•˜์˜€๊ธฐ์— ์ผ๋ฐ˜ํ™”์— ํ•œ๊ณ„๊ฐ€ ์žˆ์Œ์„ ๊ณ ๋ คํ•  ํ•„์š”๊ฐ€ ์žˆ๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ๋ณธ ์—ฐ๊ตฌ ๊ฒฐ๊ณผ๋Š” ๊ณ ๋ นํ™” ์‹œ๋Œ€๋ฅผ ๋Œ€๋น„ํ•œ ๋…ธ๋…„์ธต์˜ ์ •์‹ ๊ฑด๊ฐ•์— ๋Œ€ํ•œ ์ดํ•ด์™€ ๋„์‹œ์ˆฒ์„ ํ™œ์šฉํ•œ ์น˜์œ  ํ”„๋กœ๊ทธ๋žจ์˜ ํšจ๊ณผ์— ๋Œ€ํ•œ ์‹ฌ์ธต์  ๋ถ„์„์„ ํ†ตํ•ด ํ–ฅํ›„ ๋…น์ƒ‰ ๋ณต์ง€์˜ ์ •์ฑ…์  ๋ฐฉํ–ฅ์„ ์ˆ˜๋ฆฝํ•˜๋Š” ๋ฐ์— ๋„์›€์ด ๋  ๊ฒƒ์œผ๋กœ ์‚ฌ๋ฃŒ๋œ๋‹ค.1. INTRODUCTION 2. CHAPTER 1: Do Sociodemographic Factors and Urban Green Space Affect Mental Health Outcomes Among the Urban Elderly Population? 2.1. Introduction 2.2. Materials and Methods 2.3. Results 2.4. Discussion 2.5. Conclusions 2.6. References 3. CHAPTER 2: Relationships between Social Capital, Social Capital Satisfaction, Self-esteem, and Depression among Elderly Urban Residents: Analysis of Secondary Survey Data 3.1. Introduction 3.2. Materials and Methods 3.3. Results 3.4. Discussion 3.5. Conclusions 3.6. Appendix 3.7. References 4. CHAPTER 3: Qualitative Assessment of Experience on Urban Forest Therapy Program for Preventing Dementia of the Elderly Living Alone in Low-Income Class 4.1. Introduction 4.2. Research Methods 4.3. Results and Discussion 4.4. Conclusion 4.5. References 5. CHAPTER 4: Healing experiences of middle-aged women through an urban forest therapy program 5.1. Introduction 5.2. Materials and Methods 5.3. Results 5.4. Discussion 5.5. Conclusions 5.6. References 6. DISCUSSION AND CONCLUSION 7. REFERENCESDocto

    Transfers to residential aged care : health professionalsโ€™ lived experience of decision making in hospital

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    Understanding how health professionals make transfer decisions with older people from hospital to residential aged care is important as it sheds light on a previously unexplored phenomenon as well as identifies the barriers and enablers in making these decisions. The literature review revealed a dearth of studies that focused on this particular aspect of transfer decision making in hospitals, which indicated that further research was needed to better understand this complex phenomenon. My study explored the lived experience of doctors, occupational therapists, physiotherapists, registered nurses and social workers in making transfer decisions with older people from hospital to residential aged care. The significance of my study is that it is the first that has examined health professionalsโ€™ transfer decision making from a phenomenological perspective. The application of a phenomenological approach informed by Husserl supported an understanding of health professionalsโ€™ experiences in making transfer decisions. This included the use of two data collection methods of interviews and observations to explore not only the descriptions of their lived experience in making transfer decisions but also in observing how they made these decisions. My study was conducted in five hospitals in New South Wales, Australia. The findings revealed that health professionals made transfer decisions by exploring options through assessments as well as collaborating with the older patient, family, carers, and the multidisciplinary team. However, this sometimes led to conflict. Overall, the health professionals gathered information and tried to make collaborative, safe transfer decisions, with limited options, under significant time pressures. The implications that arose from these findings for policy makers, hospital administrators and clinicians include the lack of transfer decision assessment tools and education on how to make these decisions along with the difficulties of accessing alternatives to transfer to residential aged care. The recommendations for future practice, research and education that arose from this research include strategies that support older patientsโ€™ choice as well as registered nursesโ€™ participation in the transfer decision. Making quality transfer decisions requires both education and the development of comprehensive multidisciplinary transfer assessments which include access to supports

    Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke โ€“ A Prospective Cohort Study

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    Background: Due to a lack of prospective research in South Africa's Speech-Language Therapy (SLT) private healthcare sector, this prospective cohort study investigated associations between speech, language, and swallowing conditions (i.e. dysarthria, apraxia of speech, aphasia, dysphagia), risk factors, and outcomes post-stroke (i.e. length of hospital stay, degree of physical disability according to the Modified Rankin Scale [mRS], functional level of oral intake according to the Functional Oral Intake Scale [FOIS], dehydration, weight loss, aspiration pneumonia, mortality). Methods: Adults with a new incident of stroke without pre-existing speech, language or swallowing difficulties (N=68) were recruited. Convenience sampling was used to select participants. A prospective design was used to determine the incidence of speech, language, and swallowing conditions poststroke and association with outcomes from admission to discharge. Results: Co-occurring speech, language, and swallowing conditions frequently occurred post-stroke (88%). Participants who were referred to SLT greater than 24 hours post-admission (52.94%) stayed in hospital for a median of three days longer than those who were referred within 24 hours (p=.042). Dysphagia was significantly associated with moderate to severe physical disability. Dysphagia with aspiration was significantly associated with poor functional level of oral intake (i.e. altered consistency diets and enteral nutrition), at admission and at discharge (p<. 01). Dysphagia had a higher likelihood of mortality (OR=2.86) (p=.319). At discharge, aspiration pneumonia was significantly associated with severe physical disability (p< .01, r=0.70). Risk factors; poor oral hygiene (p=1.00), low level of consciousness (p=1.00), dependent for oral intake (p=.040), and enteral nutrition (p=.257); were not associated with aspiration pneumonia. Conclusion: In South Africa's private sector, cooccurring speech, language, and swallowing conditions commonly occurred post-stroke, and dysphagia was strongly associated with physical disability and poor functional level of oral intake. Length of hospital stay was increased by delayed SLT referrals

    Like lemmings over a cliff : a study of Alberta physician burnout

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    ix, 106 leaves : ill. ; 29 cm. --The prevalence and severity of physician burnout in Alberta was investigated. A total of 1161 out of 6584 (17.6%) practicing physicians, retired physicians, residents, and medical students responded to the survey either by fax, mail, or electronic version. The survey consisted of one demographic section and four burnout measures, one of which was the Modified Maslach Burnout Inventory (MMBI). More specifically, and relative to the Alberta physician population numbers provided by the Alberta Medical Association (AMA), 22 % were practicing physicians; 9.2 % retired; 7.5 % residents, and 1.3 % medical students. Based on the Phase Model, almost ha1f(i.e., 48.6%) of Alberta physicians are found to be in an advanced phase of burnout (i.e., phases VI, VII, & VIII). A comparison of these data with other occupations and countries is also offered

    Strategies for Real Estate Professionals to Compete With Internet Organizations

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    There has been slow growth among traditional residential real estate organization managers to communicate among the real estate industry successful e-commerce strategies. Grounded in diffusion of innovation theory, the purpose of this descriptive case study was to explore strategies traditional residential real estate managers use to compete with e-commerce real estate managers. The study population comprised traditional real estate office managers in western Nebraska who had at least 5 years\u27 experience in developing successful e-commerce strategies and had sold a home in the past 5 years. I conducted a thematic analysis on the data collected via semistructured interviews and company documents. Four themes emerged from the analysis, including establishing and maintaining multiple e-commerce websites, regularly monitoring websites, establishing a visible presence on multiple e-commerce websites, and preparation to evolve as technology evolves. The study\u27s implications for positive social change include the potential for traditional residential real estate organization managers\u27 to develop and use new and useful strategies for overcoming barriers and effectively competing with e-commerce real estate organizations to remain competitive in the local economy through job creation, innovation, and competitiveness to sustain their businesses

    Contextual Framework of Communications Functions Supporting Complex System Governance

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    The purpose of this research was to develop a systems theory-based contextual framework of communication functions supporting complex system governance using an inductive research design. Communication, as one aspect of Management Cybernetics (communication and control for effective system organization) constructed of channels of communication, provides for the movement of information internally and externally for a system. This flow reflecting new information, decisions, questions, and intelligence is critical for viability of a system. This research looked for communication mechanisms as developed in system theory, communication theory, management theory, and organizational theory. The literature indicates the importance of communications, but a systemic perspective of communication mechanisms and an effect on the viability of a system are not described. This gap in knowledge was addressed by this research. Specifically, the research looked at the description and system functions serviced by the development of content that flows through the channels of communication. The extensive use of grounded theory method enabled a rigorous inductive analysis of literature dealing with channels of communication. The research produced a construct of communication mechanisms that consists of an integrated grouping of the concepts; Direction, Mode, Product, and Technology (Conveyance). A communication design when developed and/or maintained suggests the communication mechanisms are subject to underlying influences; Identity (motive/intent), Variety Attenuation, Variety Amplification, and Transduction that must be recognized with respect to how Channels of Communication support the viability of the system of interest. While system emergence was not directly related to the Communication Mechanism, the role of Channels of Communication in system emergence is evident as the conduit for the emergence process. Identification of the communication functions means that communication mechanisms, beyond the identification provided by Beer (1979) and Shannon (1948) can be described based in systems theory, communication theory, management theory, knowledge management, and organizational theory. From this construct, a face validation in the form of a survey was conducted. The content of the questionnaire was aligned to the communication mechanisms with the intent to support triangulation. There was peer validation of the questions to the subject of communication, for ease of use and exclusion of private personal information. This was followed by a test run of the survey. The actual accomplishment of the survey was through a web service. This research provides a theoretical construct of communication mechanisms when viewing a system of interest to determining the state of the system channels of communication

    Challenges in the mental health care of older incarcerated persons

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    Background: The number of older incarcerated adults has exponentially risen within the past two decades. Even though they still represent a minority amongst the general prison population, they require vast amount of resources from prison mental health services. Their health needs are higher compared to the general population and to younger incarcerated adults. At the same time, we lack detailed knowledge on their needs and the applicability of current interventions to this particular subgroup. We therefore systematically explored their mental health needs profile with a specific focus on substance use issues. Moreover, a major limitation in the integration of literature on older incarcerated adults is the missing shared definition of this age group. For this reason, we assessed the problems of defining the older population and compared current understandings and arguments provided to support these choices. In addition, in the Swiss prison context, the number of older adults mandated to psychotherapeutic treatment has risen the most drastically. The overall goal of these court-mandated treatment orders is to reduce risk of recidivism by treating mental health disorders that stand in direct connection with the crime committed. Such interventions come with specific challenges due to aspects such as the coercive and restrictive nature of prison environment, the involuntary admission to psychotherapeutic treatment, as well as the therapistโ€™s dual role to care and control. To date, we lack research exploring these factors on psychotherapeutic interventions, which could support mental health professionals in integrating these challenges into their clinical practice. This thesis therefore investigated the experiences of older incarcerated adults and mental health professionals with court-mandated treatment orders to explore current challenges and shortcomings in the delivery of psychotherapeutic and psychiatric treatment. Methods: Systematic reviews of current literature were performed with the aim to investigate prevalence rates of mental health disorders with a specific focus on substance use issues as well as to shed light into current ways of defining this older age group, arguments used to support this choice, and the empirical evidence to back these definitions. This research project further used a mixed-methods approach, collecting qualitative and quantitative data from incarcerated persons as well as mental health professionals working in Swiss and Canadian correctional contexts. Quantitative data collection mainly encompassed data extraction from medical records. Additionally, pilot studies for the applicability of the routine outcome measure HoNOS-secure, the screening tool PHQ-9, and the structural diagnostic interview MINI were conducted. For qualitative data collection, semi-structured interviews were performed with older incarcerated adults receiving mental health care as well as mental health professionals working with patients who offended. Results: Systematic review methodology revealed that definitions of the older age group vary and hamper the integration of already limited research. Based on our findings, we suggest the use of age 50 as cut-off to define the older age group for research and health care planning on national levels. Additionally, we confirmed the high rates of mental health disorders amongst this subgroup with psychiatric diagnoses of cognitive issues, alcohol misuse, and affective disorders being relatively more common in comparison to younger incarcerated adults. Qualitative interviews showed that patients and mental health professionals likewise struggled with integrating the involvement of the justice system into their psychotherapeutic work. In particular, limits to confidentiality needed to be handled transparently. Patients accepted mental health professionals sharing information with judicial authorities, as long as their private details were protected that were of no relevance to authoritiesโ€™ decision-making. Additionally, when mental health professionals accomplished to emphasize their caring role over their controlling responsibilities, patients reported beneficial treatment experiences. This was achieved by a supportive and respectful attitude that aimed at promoting the patientโ€™s well-being and progress in life. Therapists needed to master the balancing act between responding to patientโ€™s individual needs within the predefined framework of mandated interventions. When therapist managed to respond to these personal needs, relief from psychological burden and therefore positive effects from treatment participation motivated them to remain and engage in therapy. This psychological burden frequently originated in their difficulties in dealing with deprivation of freedom, harshness of prison environments, as well as accepting and understanding their crimes committed and their psychiatric diagnoses. Last, external pressures imposed by judicial authorities strongly affect patientsโ€™ experiences with psychotherapeutic treatment. Predefined goals and authoritiesโ€™ decision-making currently lacks clarity and transparency. To augment patientsโ€™ motivation to participate in treatment, the application of these external motivators should be used more favorably. Discussion: This research project contributes to much-needed research on mental health of older incarcerated adults and their experiences with court-mandated interventions. We confirmed high prevalence rates of older incarcerated personsโ€™ mental health issues and outlined current definitions applied to this subgroup. This to advance a shared understanding of this population to facilitate the integration of available literature. Further, we showed that the involvement of the justice system substantially affects psychotherapeutic processes. We confirmed previous assumptions that the way MHPs integrate coercion and control in their clinical work, alters patients experiences with psychotherapy. We outline some pressing shortcomings of current treatment delivery and propose some strategies in alleviating the negative impact of external pressures. By this, we can potentially enhance patient motivation and alliance quality to improve clinical and criminal outcomes of incarcerated persons mandated to treatment. By increasing the effectiveness of such court-mandated treatments, we consequently not only enhance well-being of the individual patient but concurrently increase publicโ€™s safety
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