A theory of the coaching process based on the lived experience of coached executives in South Africa

Thesis (Ph.D.)--University of the Witwatersrand, Faculty of Commerce, Law and Management, Graduate School of Business Administration, 2017.Coaching is a young, growing professional practice with its origins in many older established fields of knowledge. There is considerable research into what coaches think about their work and the theories and methods underlining these approaches. However, there is a great deal less research on how the executives or coaching clients experienced the coaching. This research answered the questions from the coached executive perspective by first wanting to know (1) what the lived experience of the coaching executive was; and (2) based on that lived experience, what theory about the coaching process would emerge. This emerged theory would be grounded in evidence from the coachee. A total of 17 clients were involved in the research. While the research had a strong phenomenological underpinning, the method used was that of constructivist grounded theory. There were five key findings with theoretical propositions behind each of the findings. The findings are: (1) Coaching is a response to an unmet need in an individual who lives in a volatile, ever changing world with great complexity. Coaching provided a wellness model that is collaborative, client driven, and adaptable. A primary need in people is to have a sense of well-being and personal meaning in this world. (2) Even though the coaching is a response to a need, the coaching client still needs to be ready to be coached. A client readiness theory with integrated components was developed based on the clients’ lived experience. The interrelationships based on the client’s perceptions were a new contribution. (3) There are several processes in coaching but the key focus of the processes is that they are active and present. The processes also understand the relationship between the ‘being’ and ‘knowing’ of the coach and the ‘doing’ of the coach. The doing covers the active processes but it is the way in which the coach does these processes (the being) that influences their efficacy. (4) The coach needs to be authentic, credible and present. (5) Brain integration leads to deeper self-awareness, well-being and personal meaning. This theory of brain integration is based in Interpersonal Neurobiology, and the nine domains of integration assist in providing an overarching framework in which to position the outcomes of coaching. The contribution was broad in that it looked at all aspects of the coaching process: the coach, the coachee, the process, the outcomes and the context and provided an integrated framework.MT201

Provision of inpatient rehabilitation and challenges experienced with participation post discharge: quantitative and qualitative inquiry of African stroke patients

BACKGROUND: The provision of rehabilitation differs between developed and developing countries, this could impact on the outcomes of post stroke rehabilitation. The aim of this paper is to present provision of in-patient stroke rehabilitation. In addition the challenges experienced by the individuals with participation post discharge are also presented. METHODS: Qualitative and quantitative research methods were used to collect data. The quantitative data was collected using a retrospective survey of stroke patients admitted to hospitals over a three- to five-year period. Quantitative data was captured on a validated data capture sheet and analysed descriptively. The qualitative data was collected using interviews from a purposively and conveniently selected sample, audio-taped and analysed thematically. The qualitative data was presented within the participation model. RESULTS: A total of 168 medical folders were reviewed for a South African sample, 139 for a Rwandan sample and 145 for a Tanzanian sample. The mean age ranged from 62.6 (13.78) years in the South African sample to 56.0 (17.4) in the Rwandan sample. While a total of 98 % of South African stroke patients received physiotherapy, only 39.4 % of Rwandan patients received physiotherapy. From the qualitative interviews, it became clear that the stroke patients had participation restrictions. When conceptualised within the Participation Model participation restrictions experienced by the stroke patients were a lack of accomplishment, inability to engage in previous roles and a perception of having health problems. DISCUSSION: With the exception of Rwanda, stroke patients in the countries studied are admitted to settings early post stroke allowing for implementation of effective acute interventions. The participants were experiencing challenges which included a lack of transport and the physical geographic surroundings in the rural settings not being conducive to wheelchair use. CONCLUSION: Stroke patients admitted to hospitals in certain African countries could receive limited in-patient therapeutic interventions. With the exception of barriers in the physical environment, stroke patients in developing countries where resources are limited experience the same participation restrictions as their counterparts in developed countries where resources are more freely available. Rehabilitation interventions in these developing countries should therefore be community-based focussing on intervening in the physical environment.IS

The profile and outcomes of stroke patients discharged from a hospital In the Eastern Cape

Magister Scientiae (Physiotherapy) - MSc(Physio)Stroke is the third leading cause of death and disability worldwide. The Uitenhage Provincial Hospital admits many stroke patients. To date, no in-depth study has been conducted on stroke patients admitted to the Hospital. This study identified the profile of stroke patients admitted to the Uitenhage Provincial Hospital and explored the challenges that these patients experienced post stroke. A concurrent mixed model design was used to collect the data. Firstly retrospective data was obtained by means of a quantitative data gathering instrument designed by the researcher. The information obtained, included data relating to demographic characteristics, reported risk factors relating to stroke, stroke onset-admission interval and length of hospital stay, as well as information relating to the process of physiotherapy. Secondly quantitative prospective information was collected by means of the Barthel Index, the Modified Rankin Scale and the Facilitators And Barriers Survey. The sample for the quantitative phase was drawn from medical records of 168 stroke patients admitted to the Uitenhage Provincial Hospital from the 1 of January 2008 up to and including the 31 of December 2009. For the second prospective quantitative part of the study, participants were selected conveniently from the admitted patients. In the qualitative phase, nine participants taken of the sampled participants were selected. The Microsoft Excel 2007 Package and the SPSS 18 for social sciences were used to analyse the quantitative data. Means, standard deviations, frequencies and percentages were calculated for descriptive purposes and the Chi-square test was used to test for associations between variables. Qualitative analysis began with the transcription of voice recordings and the translation of relevant Afrikaans transcription into English. Emerging categories were identified within the pre-determined themes. Permission and ethical clearance was obtained from the Higher Degrees Committee and the Senate Research and Grants and Study Leave Committee of the University of the Western Cape and permission to conduct this study was also obtained from the Medical Superintendent of the Uitenhage Provincial Hospital. Altogether 461 patients had been admitted with stroke during the relevant period, but only 168 could be included in the retrospective quantitative study. The mean age of the participants was 61,54 years; 59% were females and 41% males. The majority of the participants (86,9%) were admitted on the same day of stroke onset, and the mean length of hospital stay was 7,38 days. Hypertension was the most common reported risk factor, at 79%. Only 165 of the participants received physiotherapy while hospitalised, with the mean total physiotherapy sessions being 2,56 sessions. In 90% of the cases, physiotherapy sessions were discontinued due to the patient being discharged from the Hospital. The mean Barthel Index score was 81,46 and the family care domain of the Modified Rankin Scale was the most affected. Participants experienced participation restrictions and activity limitations due to stairs, gravel surfaces and kerb cuts. During the qualitative interviews participants reported activity limitations related to walking and activities of daily living. The participants also experienced participation restrictions, which included dependency on others, decreased social support and an array of emotions experienced post stroke. The current study’s findings suggest that the discharge of patients from the hospital post stroke should follow a mulitidisciplinary approach. Rehabilitation professionals should play an active role in the discharge process in providing patient and caregiver education

Do Scapular Kinematics Alter during the Performance of the Scapular Assistance Test and Scapular Retraction Test: A Pilot Study

Objective: To describe to what degree and in what plane biomechanical alterations occur during the performance of the Scapular Retraction test (SRT) and Scapular Assistance Test (SAT). Design: Laboratory Pilot Study Participants: Eight symptomatic and 7 asymptomatic subjects were instrumented with electromagnetic sensors. Main Outcome Measures: The SRT and SAT were performed with the scapula stabilized and unstabilized. The scapular kinematic variables of posterior tilt, internal rotation, upward rotation, protraction, and elevation were measured during both tests. Results: Descriptive analysis of scapular kinematics suggested that posterior tilt was primarily increased during both clinical tests in both groups. Both groups decreased in scapular elevation, indicating that the scapula was being depressed during the SRT. There was no meaningful change in force during the SRT. Conclusion: These findings indicate that both the SRT and SAT appear to alter scapular motion in both groups. The interpretations of these results are limited due to the small sample size and large confidence intervals, but suggest that these tests change specific positions of the scapula. Further research into these tests is needed to confirm these biomechanical alterations, and to determine the value of these tests when developing rehabilitation protocols in patients with shoulder pain

The cost of social influence:own-gender and gender-stereotype social learning biases in adolescents and adults

Pervasive gender gaps in academic subject and career choices are likely to be underpinned by social influences, including gender stereotypes of competence in academic and career domains (e.g., men excel at engineering, women excel at care), and model-based social learning biases (i.e., selective copying of particular individuals). Here, we explore the influence of gender stereotypes on social learning decisions in adolescent and adult males and females. Participants (Exp 1: N = 69 adolescents; Exp 2: N = 265 adults) were presented with 16 difficult multiple-choice questions from stereotypically feminine (e.g., care) and masculine (e.g., engineering) domains. The answer choices included the correct response and three incorrect responses paired with a male model, a female model, or no model. Participants’ gender stereotype knowledge and endorsement were measured, and adolescents (Exp. 1) listed their academic subject choices. As predicted, there was a bias towards copying answers paired with a model (Exp.1: 74%, Exp. 2: 65% ps < .001). This resulted in less success than would be expected by chance (Exp. 1: 12%, Exp. 2: 16% ps < .001), demonstrating a negative consequence of social information. Adults (Exp 2) showed gender stereotyped social learning biases; they were more likely to copy a male model in masculine questions and a female model in feminine questions (p = .012). However, adolescents (Exp 1) showed no evidence of this stereotype bias; rather, there was a tendency for male adolescents to copy male models regardless of domain (p = .004). This own-gender bias was not apparent in female adolescents. In Exp 1, endorsement of masculine stereotypes was positively associated with selecting more own-gender typical academic subjects at school and copying significantly more male models in the male questions. The current study provides evidence for the first time that decision-making in both adolescence and adulthood is impacted by gender biases

Ethical hurdles in the prioritization of oncology care

With finite resources, healthcare payers must make difficult choices regarding spending and the ethical distribution of funds. Here, we describe some of the ethical issues surrounding inequity in healthcare in nine major European countries, using cancer care as an example. To identify relevant studies, we conducted a systematic literature search. The results of the literature review suggest that although prevention, access to early diagnosis, and radiotherapy are key factors associated with good outcomes in oncology, public and political attention often focusses on the availability of pharmacological treatments. In some countries this focus may divert funding towards cancer drugs, for example through specific cancer drugs funds, leading to reduced expenditure on other areas of cancer care, including prevention, and potentially on other diseases. In addition, as highly effective, expensive agents are developed, the use of value-based approaches may lead to unacceptable impacts on health budgets, leading to a potential need to re-evaluate current cost-effectiveness thresholds. We anticipate that the question of how to fund new therapies equitably will become even more challenging in the future, with the advent of expensive, innovative, breakthrough treatments in other therapeutic areas

A qualitative exploration of chronic pain management of older adults in remote and rural settings.

The World Health Organization predicts that the number of older adults will nearly double between 2015 and 2050. Older adults are at a higher risk of developing medical conditions such as chronic pain. However, there is little information about chronic pain and its management in older adults especially those residing in remote and rural areas. To explore views, experiences, and behavioural determinants of older adults regarding chronic pain management in remote and rural settings in Scottish Highlands. Qualitative one-to-one telephone interviews were conducted with older adults with chronic pain residing in remote and rural areas in the Scottish Highlands. The interview schedule was developed by the researchers, validated, and piloted prior to use. All interviews were audio-recorded, transcribed, and independently thematically-analysed by two researchers. Interviews continued until data saturation. Fourteen interviews were conducted with three key themes emerging: views and experiences with chronic pain, need to enhance pain management, and perceived barriers to pain management. Overall, pain was reported as severe and negatively impacted lives. Majority of interviewees used medicines for pain relief but noted that their pain was still poorly controlled. Interviewees had limited expectation for improvement since they considered their condition a normal consequence of ageing. Residing in remote and rural areas was perceived to complicate access to services with many having to travel long distances to see a health professional. Chronic pain management in remote and rural areas remains a significant issue among older adults interviewed. Thus, there is a need to develop approaches to improve access to related information and services. [Abstract copyright: © 2023. The Author(s).

The Community of Inquiry in Writing Studies Survey: Interpreting Social Presence in Disciplinary Contexts

This article applies the Community of Inquiry (CoI) framework to a particular disciplinary context: first-year writing (FYW). Students enrolled in online FYW courses across three institutions (n = 272) completed a version of the CoI survey that was slightly modified to fit the disciplinary context of writing studies. A factor analysis was conducted to determine how well the CoI in Writing Studies data aligned with typical CoI survey research; teaching presence and cognitive presence loaded onto single factors, but the social presence items divided into multiple factors. The authors put their findings in conversation with other scholarship about social presence, especially Carlon et al. (2012) and Kreijns et al. (2014), and advocate for differentiating between survey items that relate to “social presence,” “social comfort,” “attitude,” and “social learning.” They also recommend that future disciplinary uses of the CoI Survey include survey items that ask students to report on the extent to which they engaged in the types of social learning that the discipline values

Busy Streets Theory: The Effects of Communityâ engaged Greening on Violence

Lack of maintenance on vacant neighborhood lots is associated with higher levels of depression, anxiety, and stress for nearby residents. Overgrown grasses and dense brush provide hiding spots for criminals and space to conduct illicit activities. This study builds upon previous research by investigating greening programs that engage community members to conduct routine maintenance on vacant lots within their neighborhoods. The Clean & Green program is a communityâ based solution that facilitates residentâ driven routine maintenance of vacant lots in a midsized, Midwestern city. We use mixed effects regression to compare assault and violent crime counts on streets where vacant lot(s) are maintained by community members (N = 216) versus streets where vacant lots were left alone (N = 446) over a 5â year timeframe (2009â 2013). Street segments with vacant lots maintained through the Clean & Green program had nearly 40% fewer assaults and violent crimes than street segments with vacant, abandoned lots, which held across 4 years with a large sample and efforts to test counterfactual explanations. Communityâ engaged greening programs may not only provide a solution to vacant lot maintenance, but also work as a crime prevention or reduction strategy. Engaging the community to maintain vacant lots in their neighborhood reduces costs and may increase the sustainability of the program.HighlightsBlighted and abandoned properties generate substantial costs and risk for postindustrial cities.Communityâ engaged maintenance of properties can reduce blight and increase social cohesion.We compare levels of crime on streets with â greenedâ versus unmaintained vacant lots.Community greened lots may reduce blight and crime at lower cost to cities and build social capital.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146412/1/ajcp12270_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146412/2/ajcp12270.pd