자연주의적 탐구조사(Naturalistic Inquiry)

Basics of qualitative research: Grounded theory procedures and techniques

การวจยเชงคณภาพ เปนเครองมอสำคญอยางหนงสำหรบทำความเขาใจสงคมและพฤตกรรมมนษย การวจยแบบการสรางทฤษฎจากขอมล กเปนหนงในหลายระเบยบวธการวจยเชงคณภาพทกำลงไดรบความสนใจ และเปนทนยมเพมสงขนเรอยๆ จากนกวชาการ และนกวจยในสาขาสงคมศาสตร และศาสตรอนๆ เชน พฤตกรรมศาสตร สงคมวทยา สาธารณสขศาสตร พยาบาลศาสตร จตวทยาสงคม ศกษาศาสตร รฐศาสตร และสารสนเทศศกษา ดงนน หนงสอเรอง “ConstructingGrounded Theory: A Practical Guide through Qualitative Analysis” หรอ “การสรางทฤษฎจากขอมล:แนวทางการปฏบตผานการวเคราะหเชงคณภาพ” จะชวยใหผอานมความรความเขาใจถงพฒนาการของปฏบตการวจยแบบสรางทฤษฎจากขอมล ตลอดจนแนวทาง และกระบวนการปฏบตการวจยอยางเปนระบบ จงเปนหนงสอทควรคาแกการอานโดยเฉพาะนกวจยรนใหม เพอเปนแนวทางในการนำความรความเขาใจไประยกตในงานวจยของตน อกทงนกวจยผเชยวชาญสามารถอานเพอขยายมโนทศนดานวจยใหกวางขวางขน

Constructing Grounded Theory: A Practical Guide through Qualitative Analysis

A significant and core text in occupational therapy for more than 8 years, Dr Ann Wilcock's revolutionary "An Occupational Perspective of Health" has been updated and enhanced into a much-anticipated Second Edition This unique text that examines the relationship between occupation, health, and ill-health explores the occupational experience within populations and offers more information critical to the practice of occupational therapy Based on extensive studies of human history and occupation, Dr Wilcock takes a holistic approach of health in line with that of the World Health Organization, examining the necessity for occupational therapists and their role in promoting health and well-being for all people "An Occupational Perspective of Health" uncovers a different way to understand health by exploring the physical, social, mental, environmental, and spiritual dimensions that lead to or result from occupation Dr Wilcock takes a global perspective by approaching health from this angle, rather than just considering medical or social factors The text considers the growth, development, and enhancement potential of involvement This valuable resource supports and explains the historical and rational foundations of the advancing field of occupational therapy, by showing the link between occupation and existence Addressed in this edition are: a conceptualization of health in the past, present, and future; the role of occupation in human life, health, and survival; occupation as a positive or negative influence on well-being; the potential contribution of occupational therapy to current WHO public/population health objectives; and possible action for OTs to become recognized as health-promoting professionals at population levels Clinicians and students of occupational therapy, as well as other professionals working in public health, will benefit from and relate to this admired and essential text

An Occupational Perspective of Health

A meta-analytic study investigated the causal relationships among job satisfaction, behavioral intentions, and nurse turnover behavior. A theoretical model was proposed in which behavioral intentions were viewed as a direct antecedent to turnover behavior. Job satisfaction was expected to be indirectly related to turnover by virtue of the mediating role of behavioral intentions. Consistent with these expectations, a strong positive relationship was indicated between behavioral intentions and turnover; a strong negative relationship between job satisfaction and behavioral intentions; and a small negative relationship between job satisfaction and turnover. The results of the modifier analysis suggested that effect sizes are fairly robust to differences in study designs, response rates, and methods of measuring job satisfaction, but the manner in which behavioral intentions were operationalized appeared to moderate the relationship between behavioral intentions and turnover and job satisfaction. Of variables related to nursing job satisfaction, work content and work environment had a stronger relationship with job satisfaction than economic or individual difference variables.

Job Satisfaction and Turnover Among Nurses: Integrating Research Findings Across Studies

1* The contribution of work in the occurrence of mental health problems prompts us to question the conditions which favour a successful return to work. The goals of this study are to describe the profile of workers who have been absent due to a mental health problem and to compare those who returned to those who did not, and those for whom there was resolution or non resolution of their health problem. This study among public sector employees was cross-sectional. Data was collected using mailed questionnaires and analyses were performed for 1850 respondents. The results show a significant difference between those who were back at work and those who were not, based on the cause they reported for their absence from work. Improved working conditions accompanying return to work may be a major determinant of health recovery and successful return to work, and ensure job retention.

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Determinants of Return-to-Work among Employees Absent Due to Mental Health Problems

Le but de cette etude est de mieux comprendre les facteurs impliques dans le processus de reinsertion professionnelle a la suite d’une absence en raison d’un probleme de sante mentale. La methodologie est basee sur des donnees d’entrevues individuelles colligees aupres de travailleurs qui s’etaient absentes pour un probleme de sante mentale, certifie par un diagnostic medical. L’analyse de la trajectoire des personnes permet de saisir l’articulation entre les evenements qui ont precede l’arret de travail, le processus de restauration des capacites et les conditions qui favorisent ou empechent le retour au travail. Cette etude a permis de concevoir l’arret de travail et le processus de restauration des capacites comme etant une etape charniere entre le processus de desinsertion et de reinsertion professionnelle et de construire un modele qui rend compte de la dynamique de l’ensemble des facteurs impliques.

/pdf/de-la-desinsertion-a-la-reinsertion-professionnelle-a-la-cab2mpo4s8.pdf

De la désinsertion à la réinsertion professionnelle à la suite d’un arrêt de travail pour un problème de santé mentale

Malgre une vaste litterature sur l’abandon de traitement en pedopsychiatrie, les connaissances sur cette problematique chez l’adolescent avec trouble de personnalite limite (TPL) demeurent peu developpees. Les consequences d’un arret premature du traitement sont serieuses considerant la recurrence de leurs conduites suicidaires. Afin de comprendre les processus associes a l’instabilite du mode de consultation de ces adolescents, une methode de theorisation ancree constructiviste avec un devis de cas multiples a ete utilisee. Trente-quatre entrevues aupres de trois groupes d’informateurs (adolescent, parent et clinicien) ont ete realisees. Un modele explicatif des facteurs de risque d’abandon, mais aussi des conditions susceptibles de favoriser la poursuite du traitement a ete elabore. Il identifie les determinants de l’abandon qui sont specifiques aux adolescents avec TPL et decrit les processus par lesquels ceux-ci interferent avec la poursuite du traitement. Deux moments critiques ont ete mis en evidence. Le premier survient au moment de l’offre de traitement. Il est determine par les capacites du dispositif de soins a profiter de l’impulsion de la demande d’aide pour engager l’adolescent et le parent en tenant compte de leurs vulnerabilites a l’abandon. Le deuxieme moment critique survient en cours de traitement. Il est marque par les capacites du dispositif de soins a adopter des mesures correctives lorsqu’apparaissent des complications d’engagement. Ces resultats mettent en evidence l’importance des reponses du dispositif de soins et suggerent que l’engagement des adolescents avec TPL devrait constituer un objectif therapeutique au meme titre que la reduction de la symptomatologie et des problemes de vie.

/pdf/modele-de-l-engagement-et-de-l-abandon-de-traitement-de-l-1rnvx3pwqg.pdf

Modèle de l’engagement et de l’abandon de traitement de l’adolescent avec trouble de personnalité limite

Objective
The aim of this study was to gain a broader appreciation of processes involved in treatment dropout in adolescents with borderline personality disorder (BPD).

Design
A constructivist grounded theory was chosen using a multiple-case research design with three embedded levels of analysis (adolescent, parent, and care setting).

Method
Theoretical sampling and the different stages of analysis specific to grounded theory were performed according to the iterative process of constant comparative analysis. Twelve cases were examined (nine dropouts among adolescents with BPD and for the purpose of falsification, one dropout of suicidal adolescent without BPD and two completed treatments among adolescents with BPD). To document the cases, three groups of informants were recruited (adolescents, parents, and therapists involved in the treatment) and 34 interviews were conducted.

Results
Psychological characteristics, perception of mental illness and mental health care, and help-seeking context were the specific treatment dropout vulnerabilities identified in adolescents with BPD and in their parents. However, their disengagement became an issue only when care-setting response – including mitigation of accessibility problems, adaptation of services to needs of adolescents with BPD, preparation for treatment, and concern for clinicians' disposition to treat – was ill-suited to these treatment dropout vulnerabilities. Treatment planning proves to be a key milestone to properly engage adolescents with BPD and their parent.

Conclusions
Systematic assessment of treatment dropout vulnerabilities before the intervention plan is laid out could foster better-suited responses of the care setting thus decreasing the incidence of treatment discontinuation in adolescents with BPD.

Practitioner points
Treatment dropout vulnerabilities specific to adolescents with BPD and their parents can be detected before the beginning of treatment.
Premature treatment termination may be prevented if the care setting considers these vulnerabilities at treatment planning.
Fears and negative reaction to treatment can be attenuated if the reasons behind the therapeutic orientation are explained and if the adolescent understand how the treatment will affect his condition.
Concerns for autonomy of the adolescent, parental help-seeking context as well as ensuring that the clinician has the skills, interest, and motivation to work with the family may have a positive effect on families' commitment to treatment.

Treatment planning: A key milestone to prevent treatment dropout in adolescents with borderline personality disorder.

This study measured the effects of a pre-vocational program on cognition, symptoms, and integration to work in schizophrenia. Twelve participants, receiving pharmacological treatment only, were compared to 14 participants, who were part of a pre-vocational program and who received pharmacological treatment on pre and post measures. The work skills training group was offered by an occupational therapist. Results showed statistically significant differences in negative and general symptoms, visual attention, learning, and integration to work when comparing the two groups in favor of the program. These results provide evidence of the positive effects of occupational therapy interventions in mental health.

Micheline Saint-Jean

Papers

Determinants of Return-to-Work among Employees Absent Due to Mental Health Problems

De la désinsertion à la réinsertion professionnelle à la suite d’un arrêt de travail pour un problème de santé mentale

Modèle de l’engagement et de l’abandon de traitement de l’adolescent avec trouble de personnalité limite

Treatment planning: A key milestone to prevent treatment dropout in adolescents with borderline personality disorder.

The Impact of a Pre-Vocational Program on Cognition, Symptoms, and Work Re-Integration in Schizophrenia