The self-management approach of health education in the treatment of chronic illnesses

Health education is essential to the successful treatment of individuals with chronic illnesses. Self-management is a philosophical model of health education that has been shown to be effective in teaching individuals with chronic arthritis to manage their illness as part of their daily lives. Despite the proven results of arthritis self-management programs, some limitations of this form of health education were apparent in the literature. The present study attempted to address the problems of the self-management approach of health education such as reasons for lack of participation in programs and poor course outcomes. In addition, the study served to investigate the relationship between course outcomes and participation in programs with the theory upon which arthritis self-management programs are based, known as self-efficacy theory. Through a combination of qualitative and quantitative methodologies, data collection, and analysis, a deeper understanding of the self-management phenomenon in the treatment of chronic arthritic conditions was established. Findings of the study confirm findings of previous studies that suggest that arthritis self-management programs result in enhanced levels of self-efficacy and are effective in teaching individuals with arthritis to self-manage their health and health care. Findings of the study suggest that there are many factors that determine the choice of participants to participate in programs and the outcomes for the individuals who do choose to participate in programs. Some of the major determinants of enrollment and outcomes of programs include: the participant's personality, beliefs, attitudes and abilities, and the degree of emotional acceptance of the illness. Other determinants of course enrollment and outcomes included class size and length of time, timing of participation, and ongoing support after the program. The results of the study are consistent with the self-management literature and confirm the relationship between the underlying philosophies of adult education and Freire's model of education and self-management.

The transformation of teachers: an adult learning approach

The study focused on the teacher as an adult learner rather than an instructor. A sample of three hundred and three elementary school teachers completed a two-part Likert survey questionnaire. The instrument was developed by the researcher in an attempt to operationalize Mezirow's Theory of Perspective Transformation. The four sub-scales collected information about teachers as they perceived themselves as adult learners and the way they conceptualize critical SelfReflection, Meaning perspectives and New Insights (Mezirow, 1978, 1981, 1989, 1990) within a framework of Mezirow's concept of Transformative Learning. Survey research methodology was used. Frequency distributions, means, and standard deviation were calculated. Reliability analysis and Pearson 'r' correlations established the internal consistency of items It Cross tabulations to describe differences in responses across demographic valuables were computed. The survey results indicated that teachers perceived themselves as self-directed learners. The findings support the need for a better understanding of the teacher as an adult learner so that teacher inservice programs and teacher supervision and evaluation can provide a viable learning alternative to the existing models used in practice.

Verbal ability, previous practice and load on short-term memory as determiners of differences in a complex learning task: an experimental study

Traditional psychometric theory and practice classify people according to broad ability dimensions but do not examine how these mental processes occur. Hunt and Lansman (1975) proposed a 'distributed memory' model of cognitive processes with emphasis on how to describe individual differences based on the assumption that each individual possesses the same components. It is in the quality of these components ~hat individual differences arise. Carroll (1974) expands Hunt's model to include a production system (after Newell and Simon, 1973) and a response system. He developed a framework of factor analytic (FA) factors for : the purpose of describing how individual differences may arise from them. This scheme is to be used in the analysis of psychometric tes ts . Recent advances in the field of information processing are examined and include. 1) Hunt's development of differences between subjects designated as high or low verbal , 2) Miller's pursuit of the magic number seven, plus or minus two, 3) Ferguson's examination of transfer and abilities and, 4) Brown's discoveries concerning strategy teaching and retardates . In order to examine possible sources of individual differences arising from cognitive tasks, traditional psychometric tests were searched for a suitable perceptual task which could be varied slightly and administered to gauge learning effects produced by controlling independent variables. It also had to be suitable for analysis using Carroll's f ramework . The Coding Task (a symbol substitution test) found i n the Performance Scale of the WISe was chosen. Two experiments were devised to test the following hypotheses. 1) High verbals should be able to complete significantly more items on the Symbol Substitution Task than low verbals (Hunt, Lansman, 1975). 2) Having previous practice on a task, where strategies involved in the task may be identified, increases the amount of output on a similar task (Carroll, 1974). J) There should be a sUbstantial decrease in the amount of output as the load on STM is increased (Miller, 1956) . 4) Repeated measures should produce an increase in output over trials and where individual differences in previously acquired abilities are involved, these should differentiate individuals over trials (Ferguson, 1956). S) Teaching slow learners a rehearsal strategy would improve their learning such that their learning would resemble that of normals on the ,:same task. (Brown, 1974). In the first experiment 60 subjects were d.ivided·into high and low verbal, further divided randomly into a practice group and nonpractice group. Five subjects in each group were assigned randomly to work on a five, seven and nine digit code throughout the experiment. The practice group was given three trials of two minutes each on the practice code (designed to eliminate transfer effects due to symbol similarity) and then three trials of two minutes each on the actual SST task . The nonpractice group was given three trials of two minutes each on the same actual SST task . Results were analyzed using a four-way analysis of variance . In the second experiment 18 slow learners were divided randomly into two groups. one group receiving a planned strategy practioe, the other receiving random practice. Both groups worked on the actual code to be used later in the actual task. Within each group subjects were randomly assigned to work on a five, seven or nine digit code throughout. Both practice and actual tests consisted on three trials of two minutes each. Results were analyzed using a three-way analysis of variance . It was found in t he first experiment that 1) high or low verbal ability by itself did not produce significantly different results. However, when in interaction with the other independent variables, a difference in performance was noted . 2) The previous practice variable was significant over all segments of the experiment. Those who received previo.us practice were able to score significantly higher than those without it. J) Increasing the size of the load on STM severely restricts performance. 4) The effect of repeated trials proved to be beneficial. Generally, gains were made on each successive trial within each group. S) In the second experiment, slow learners who were allowed to practice randomly performed better on the actual task than subjeots who were taught the code by means of a planned strategy. Upon analysis using the Carroll scheme, individual differences were noted in the ability to develop strategies of storing, searching and retrieving items from STM, and in adopting necessary rehearsals for retention in STM. While these strategies may benef it some it was found that for others they may be harmful . Temporal aspects and perceptual speed were also found to be sources of variance within individuals . Generally it was found that the largest single factor i nfluencing learning on this task was the repeated measures . What e~ables gains to be made, varies with individuals . There are environmental factors, specific abilities, strategy development, previous learning, amount of load on STM , perceptual and temporal parameters which influence learning and these have serious implications for educational programs .

What motivates registered nurses to participate in continuing education activities?

The study was undertaken to identify what motivates registered nurses to participate in continuing education activities. The primary questions were whether basic nursing education, employment status, clinical area, and position, as well as readiness for selfdirected learning influenced Canadian nurses' motivational orientations when deciding to participate in continuing education activities. Other individual differences (e.g., age) were also examined. The sample included 142 registered nurses employed at an urban community hospital. Three instruments were used for data collection: the Education Participation Scale, the Self-Directed Learning Readiness Scale, and a nursing survey consisting of demographic questions. Basic nursing education and employment status did not effect motivational orientation or self-directed learning readiness. Clinical area and level of position significantly influenced nurses' decisions to participate in continuing education activities. Motivational orientation had a significant relationship with selfdirected learning readiness. Implications for practice as a result of this study involves program planning and delivery. The identification of the motivational orientations of participants may assist in the development and delivery of continuing education programs that are beneficial, relevant, and address the identified learning needs of participants. Implications for future research also exist in relation to studying different groups of nurses, for example, registered nursing assistants, and investigating related issues, for example, what are the deterrents to participation in continuing education?

Continuing education learning preferences and styles of legal clinic lawyers /

The purpose of this qualitative research was to study the learning preferences and styles of management lawyers who work in Ontario's legal aid clinics. Data were gathered from two sources and analyzed using the constant comparison method. A preand postconference survey provided the principal data on clinic lawyers' learning preferences. Follow-up interviews were then conducted with 3 purposefully selected survey participants to explore their personal learning styles. Kolb's experiential learning theory provided the theoretical framework for discussing personal learning styles. The findings showed a general consistency among the lawyers to learn by listening to lectures and experts. This preference may suggest a lingering influence from law school training. The lawyers' more informal learning associated with daily practice, however, appeared to be guided by various learning styles. The learning style discussions provided some support for Kolb's model but also confirmed some shortcomings noted by other authors. Educators who design continuing education programs for lawyers may benefit from some insights gained from this exploratory research. This study adds to a limited but growing body of work on the learning preferences and styles of lawyers and suggests new questions for future research.

The development, assessment, and implementation of an evaluation of the EMPOWER Program at shelters for abused women /

The development, assessment, and implementation of a program evaluation instrument was carried out to evaluate the impact and efficacy of the EMPOWER Program. This intervention was created to educate residents at a shelter for abused women with an anticipated outcome of prevention. Participants included the staff and residents at 2 shelters in Southern Ontario. Client pre, post and follow-up measures were obtained and analyzed statistically and using keyword content analysis. A single staff measure was obtained and summarized using keyword content analysis. Qualitative results were suggestive of important change in participants. All women in the post and follow-up measures believed their participation in the EMPOWER Program provided them with the knowledge, skills, and confidence to avoid abusive relationships in the fliture. This transformational impact was repeatedly expressed in both resident and staff feedback. Limitations of this research, as well as suggestions for future study were discussed.

What Matters? : the full-time graduate students' perceptions of teacher effectiveness

The purpose of this qualitative study was to explore the full-time graduate students' perceptions of teacher effectiveness at the graduate school level, to identify how graduate students perceive effective and ineffective teachers, and specifically to discover the main dimensions of teacher effectiveness that graduate students perceive as most significant. This topic was investigated because, although the teacher has been deemed as a crucial component in the teaching process, there is no common agreement on the definition and measure of teacher effectiveness. Graduate students' perceptions of teacher effectiveness have not been given much attention. The research design was based on a ground theory approach. It utilized qualitative data through interviews, field notes, andjournals. The findings ofthis study revealed that teacher effectiveness is markedly influential to graduate students. There is no universally consented definition or measure of teacher effectiveness due to the multidimensionality of teaching and learning. Nevertheless, several major dimensions ofteacher effectiveness were discovered and highlighted in this study. Such dimensions include good command of subject matter, presentation skills, challenging and motivating students, rapport with students, learning environment, course demands, as well as assessment and feedback. It was hoped that the study would move towards developing a theory that contributes to the knowledge base of graduate students' perceptions of teacher effectiveness. It was anticipated that the results would provide first-hand information for the instructor to improve teaching; for the administrator to promote the effective educational experiences and student achievements. It was intended that the findings would lay a theoretical and empirical groundwork for future research.

Examining the influence of family support on diabetes education behavioural outcomes

The purpose of this study was to examine the influence of family support on diabetes education behavioural outcomes, specifically in relation to diet, exercise, and blood glucose monitoring in adult individuals with Type 2 diabetes. Fifty-three individuals attending diabetes education for the first time were followed approximately 1 month. The findings for the influence of family support were mixed. Family attending diabetes class with participants had a positive influence with respect to diet. This is consistent with Carl Rogers (1969) who espouses setting a positive climate for learning and that learning new attitudes or information comes when external barriers are at a minimum. However family attending class with participants had no influence with respect to exercise or blood glucose monitoring. The family support action of encouraging with respect to diet overall did not influence healthy eating behaviours except for decreased skipped meals and scheduled snacks. In fact, in the areas of family willing to make healthy choices along with participant, the less the family was involved in encouraging, the better the participant did. Exercise on the other hand was influenced positively by family encouragement. This is consistent with Bandura's theory that enhancement of self-confidence and self-efficacy can lead to desired behaviour changes. Family encouragement however did not appear to influence blood glucose monitoring behaviours. This study has implications for practice in that diabetes education programs can encourage family to attend classes or get involved in encouraging the person with diabetes, so that it may help to increase healthy eating behaviours and exercise. As time is necessary to implement changes in behaviour, future research can look at the influence of family support over a 6-month, I-year, or greater period.

Motivational differences in science course enrolment shown by males and females in grades 9 through OAC

A sample of 1,345 students enrolled in advanced-level science courses from Grades 9 through OAe was surveyed in order to gain perspective into the existence of motivational differences attributing to science course enrolment by gender. Records of enrolment were examined in order to detect patterns and trends. A questionnaire was devised and piloted. It measured five motivational variables - demographics, science and science-related experiences, science ability and attitudes, impressions about women in science, and importance of science and science-related skills. The students also provided some impressions about the image of scientists. Results of the questionnaire were analyzed for frequency of responses and for significant gender differences using the chi-square. Differences were found to exist in the areas of science anxiety as it relates to testing and oral participation; in motivation generated by the performance of extra-curricular science and science-related activities, and by the classroom environment; in impressions of women in science; in the importance of science skills, and in the area of teacher influence. The study also showed a differential enrolment of females, with an emphasis on biology and chemistry. The males were enrolled in courses of physics and chemistry. The findings lead to numerous suggested strategies and programs for encouraging the participation of females in science education and careers.

Course/instructor evaluation : perspectives of part-time graduate students

This study explored 6 part-time graduate students' perspectives on course/instructor evaluation. The purpose was to explore whether a link exists between the evaluation for course and instructors as contained in the Faculty of Education courselinstructor evaluation form and the needs of part-time students enrolled in that program. The literature review provided contextual information concerning the 3 main subject areas based upon which the research questions were designed: learner needs in the context of part-time graduate students, courselinstructor eval~ation, and the potential lack of congruency between the 2. Using a semistructured interview process, participants identified criteria important or relevant to the evaluation process and incongruent with the course/instructor evaluation form. A qualitative research methodology using a grounded theory approach contributed to the theory on the nature of course evaluation instruments in a graduate program and addressed the notion of where power was situated within the evaluation process. Findings suggested that the concepts of relevance and the instructor's role that participants identified as important in their graduate learning experience were congruent with what they considered important components of the course/instructor evaluation form. Participants noted a lack of congruency between their expectations of a quality graduate learning experience and the format, content, intent, and timing of the evaluation process. The study confirmed that students did want a voice in the evaluation of their learning experience at both the course and program levels.

Advocating recognition and redistribution in poverty alleviation programs in Ghana : an examination of state and NGO programs and policies

Abstract This thesis argues that poverty alleviation strategies and programs carried out by the government and Non Governmental Organizations in Ghana provide affirmative solutions to poverty. This is because, these intervention strategies have been influenced by conventional discourses on poverty that fail to adequately address non-economic issues of poverty such as powerlessness, marginalization and tmder-representation. The study is carried out in a two-pronged manner; first, it analyses state policies and strategies, particularly the Ghana Poverty Reduction Strategy (GPRS), on poverty alleviation and compares these to NGO programs, implemented with funds and support from external donor organizations. Specifically, I focus on how NGOs and the governnlent of Ghana negotiate autonomy and financial dependency with their funding donor-partners and how these affect their policies and programs. Findings from this study reveal that while external influences dominate poverty alleviation policies and strategies, NGOs and the government of Ghana exercise varying degrees of agency in navigating these issues. In particular, NGOs have been able to adapt their programs to the changing needs of donor markets, and are also actively engaged in re-orienting poverty back to the political domain through advocacy campaigns. Overall, rural communities in Ghana depend on charitable NGOs for the provision of essential social services, while the Ghanaian government depends on international donor assistance for its development projects.

Show me, help me, let me : supporting teachers' changing conceptions of reading assessment and reading instruction

This qualitative inquiry used case study methodology to explore the change processes of 3 primary-grade teachers throughout their participation in 7 -month professional learning initiative focused on reading assessment and instruction. Participants took part in semimonthly inquiry-based professional learning community sessions, as well as concurrent individualized classroom-based literacy coaching. Each participant's experiences were first analyzed as a single case study, followed by cross-case analyses. While their patterns of professional growth differed, findings documented how all participants altered their understandings of the roles and relevancy of individual components of reading instruction (e.g., comprehension, decoding) and instructional approaches to scaffold students' growth (e.g., levelled text, strategy instruction), and experienced some form of conceptual change. Factors identified as affecting their change processes included; motivation, professional knowledge, professional beliefs (self-efficacy and theoretical orientation), resources (e.g., time, support), differentiated professional learning with associated goal-setting, and uncontrollable influences, with the affect of each factor compounded by interaction with the others. Comparison of participants' experiences to the Cognitive-Affective Model of Conceptual Change (CAMCC) and the Interconnected Model of Teacher Professional Growth (IMTPG) demonstrated the applicability of using both conceptual models, with the IMTPG providing macrolevel insights over time and the CAMCC microlevel insights at each change intervaL Recommendations include the provision of differentiated teacher professional learning opportunities, as well as research documenting the effects of teacher mentorship programs and the professional growth of teacher educators. ii

Identifying language needs of ESL students in a Canadian university based intensive English language program

This study investigated the needs of adult ESL learners intending to pursue higher education in Canada. Its chief purpose was to enable educators and administrators to design ESL programs that would prepare students to function at optimal levels in academic and social settings during their university studies. The study adopted a mixed research method that was predominantly qualitative in its orientation and narrative in its implementation. It focused on an Intensive English Language Program (IELP) offered at an Ontario university. Using a holistic approach, the study sought to represent the various perspectives of all the participants in the program: the students, the instructors, and the administrators. Analysis of both qualitative and quantitative data gathered from 17 students, 6 instructors, and 1 administrator in the IELP showed that to a large extent the academic needs ofESL learners in the IELP were generally not being met. Most notably, the study found that learners were not receiving sufficient training in speaking and listening skills, a factor that contributed to their sense of insecurity and lack of confidence in their ability to communicate successfully in academic and social settings. The study also revealed that the solutions to many of the problems it identified lay not in the classroom but in the way the ESL program was structured administratively. One major recommendation to come out of the study is that programs like the IELP should be restructured so as to give them greater flexibility in meeting individual needs. While the study labored under certain limitations and did not achieve all of its goals, it did succeed in creating awareness ofthe problems and in establishing a methodological approach that can serve as a framework within which future research may be conducted in this somewhat neglected area.

The impact of a digital children's literature program on primary students' reading motivation

This qualitative study stemmed from a concern of the perceived decline in students' reading motivation after the early years of schooling, which has been attributed to the disconnect between the media students are accustomed to using outside the classroom and the media they predominantly use within the classroom. This research documented the effectiveness of a digital children's literature program and a postreading multimedia program on eight grade 1 students' reading motivation, word recognition, and comprehension abilities. Eight students were given ten 25-minute sessions with the software program over 15 weeks. Preprogram, interim-program, and postprogram qualitative data were collected from students, teachers, and parents through questionnaires, interviews, standardized reading assessment tools, classroom observations, field notes, and student behaviour observation checklists. Findings are summarized into 3 themes. The motivational aspects and constructivist styles of instruction in the digital reading programs may have contributed to 5 student participants' increased participation in online storybook reading at home. Qualitative data revealed that the digital children's literature program and multimedia postreading activities seemed to have a positive influence on the majority of grade 1 student participants' reading motivation, word recognition, and listening comprehension skills. These findings suggest the promise of multimedia and Internet-based reading software programs in supporting students with reading andlor behavioural difficulties. In keeping with current educational initiatives and efforts, increased use of media literacy practices in the grade 1 curriculum is suggested.

A case study investigation of the learning needs of the Niagara grape and wine community

The Niagara Grape and Wine Community (NGWC) is an industry that has undergone rapid change and expansion as a result of changes in governmental regulations and consumer preferences. As a result of these changes, the demands of the wine industry workforce have changed to reflect the need to implement new strategies and practices to remain viable and competitive. The influx of people into the community with little or no prior practical experience in grape growing (viticulture) or winemaking (oenology) has created a need for additional training and learning opportunities to meet workforce needs. This case study investigated the learning needs of the members of this community and how these needs are currently being met. The barriers to, and the opportunities for, members acquiring new knowledge and developing skills were also explored. Participants were those involved in all levels of the industry and sectors (viticulture, processing, and retail), and their views on needs and suggestions for programs of study were collected. Through cross analyses of sectors, areas of common and unique interest were identified as well as formats for delivery. A common fundamental component was identified by all sectors - any program must have a significant applied component or demonstration of proficiency and should utilize members as peer instructors, mentors, and collaborators to generate a larger shared collective of knowledge. Through the review of learning organizations, learning communities, communities of practices, and learning networks, the principles for the development of a Grape and Wine Learning Network to meet the learning needs of the NGWC outside of formal institutional or academic programs were developed. The roles and actions of members to make such a network successful are suggested.