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- Eriksson, Lilly
(författare)
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Participation and disability : a study of participation in school for children and youth with disabilities
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Participation in everyday life is vital to a child's development and well-being and is a basic human right. One definition of participation is engagement in life areas. The objective of this study is to investigate participation in school activities of children and adolescents with disabilities; the study focus on personal factors and factors in the environment, which are closely related to participation. Data were collected in a large survey and a smaller observational study. In the survey, students, parents, teachers, and special education consultants responded to statements about participation and factors related to participation such as autonomy, interaction, availability, support, and environment. In the observational study, participation was observed during various school activities during an entire school day and after school. Children were interviewed about their school day, friendships, and autonomy. The results revealed that participation is multidimensional, with an emphasis on personal experiences, interactions, and context. The theoretical assumption of the International Classification of Functioning, Disability, and Health (ICF) states that the body, participation, and the environment are related. The research results proved this assumption and support the multidimensionality of the participation construct. As indicated in previous research, children and adolescents with disabilities show a lower degree of participation in school than their peers. Participation seems to be more related to autonomy and interactions with significant others than to disability type and general environment. A closer look at various school activities reveals that children with disabilities primarily have a lower degree of participation in math, practical subjects, and science. Being included and having many friends, who provide emotional support, facilitate participation. While, frequently receiving support from teachers and assistants lowered participation. This indicates that there is a relation between support and participation: providing too much support during class can be detrimental to class participation, whereas a good social support network of other children is vital. In this thesis, participation is measured in two ways: by participation frequency and by participation intensity. By counting the number of activities that children participate in, and how often they participate in these activities, a measure of an individual's average participation is obtained, that is, participation frequency. This measure depends more on internal rather than contextual factors, and it changes more often because of internal rather than contextual changes. Intensity measures of participation refer to the amount of involvement within a specific situation, and are contextually dependent. Involvement change based on the situation and the individual's present state. Participation is personal - it is about feeling good about what you are doing and feeling competent in using available opportunities. Participation is dependent on interaction with significant others. Participation for children with disabilities also depends on being provided with necessary support. Participation frequency seems to be less dependent on support than participation intensity. The fact that intensity seem to be more dependent on support and context, short-term interventions facilitating participation within situations are probably the most fruitful way to enhance participation.
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| 2. |
- Erlandsson, Kerstin
(författare)
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Care of the newborn infant during maternal-infant separation
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of the thesis was to describe care of the newborn infant immediately after birth, during maternal-infant separation; the father as primary caregiver and the mother’s experiences of separation and later reunion with the infant, in order to enhance development of care for the newborn infant during maternal-infant separation. In study I, II and III a phenomenological approach was used to gain access to mothers’ and fathers’ lived experiences (I, III) and lifeworld (II). Six interviews with mothers with experiences of separation and later reunion with their infants (study I) and interviews with 15 fathers taking care of their infants as primary caregivers during maternal-infant separation (study III) were included in the analyses. Study II was an observation study through videotape recording of 15 fathers taking care of their infants during the first two hours after birth. For the purpose of study IV and V, a quantitative design with naturalistic observations, audiotape recordings and respiratory monitoring was used. The infants in study IV and V were randomly assigned two groups: being cared for skin-to-skin with their father who was seated comfortably in an armchair or being placed in a cot, with their father seated beside them. Data was collected from 29 (study IV) and 13 infants (study V) respectively. The essence of the mothers’ experiences (study I) was their strong desire to be close to their babies during maternal-infant separation. Mothers wanted to be close to their babies whatever the circumstances, and to be kept fully informed at all times. It was the mothers’ experience that the organization, staff and other circumstances prolonged the separation. The essence of fathers lived experiences while taking care of their infant while mother and child were apart (study III) yielded a meaning of alterability towards togetherness between father and child. This movement meant immediate and gradual alterability within the father himself that made him gradually undertake the responsibility, as he got to know his child. The essence of the father’s observed lifeworld in study II yields the very first experience of the father coming increasingly closer to the newborn infant and revealing an ebb and flow variation in the father’s involvement with the child. There was an ebb and flow between becoming a father and a physical withdrawal, rather than immediately taking the practical approach of becoming a resource for the infant. In study IV the infants in the skin-to-skin group cried less than the infants in the cot group (p<0.001). Rooting activity was more frequent in the cot group than in the skin-to-skin group (p<0.01), as were sucking activities (p≤0.001). The pattern for wakefulness showed a lower level for the skin-to-skin group when compared with the cot group (p<0.01). The infants in the skin-to-skin group of study V showed higher inspiratory and expiratory air flows, larger breath volume (all (p<0.001) and minute ventilation when compared with the cot group. A caregiving model, where fathers hold their infants skin-to-skin in an upright position on their chest, seemed to have a positive impact on the infant’s wellbeing. At the same time, the father took the child to himself. The mothers, separated from their child, had a strong desire to be close to the baby.
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| 3. |
- Gustafsson, Christine, 1967-
(författare)
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Närhet på distans : Nattsjuksköterskors vårdande i kommunal äldreomsorg
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Registered nurses’ [RNs] experiences of caring in nursing, working conditions for caring and reflection in municipal night care was explored to create expanded knowledge and understanding of care for older people. As a consequence of the Ädelreform and development in hospital health care a displacement from clinical health care to municipal care of older people has taken place. Night RNs’ work in the complex municipal care of older people implies single handed work in a consultative function. The RNs are distanced from the care receivers; it is care staff who mainly perform bed side caring. Municipal RNs’ care for older people during nights means trusting their own knowledge and reflective ability, in having nursing responsibility for large groups of old care recipients. This thesis takes point of departure in a qualitative research approach, with four empirical studies. These have been accomplished in a medium sized municipality in the middle parts of Sweden. The aims of the part studies were: to elucidate municipal night nurses’ experiences of the meaning of caring in nursing (I), to explore Swedish municipal night nurses’ experiences of their working conditions for caring in nursing (II), to examine the caring for care staff offered by municipal night nurses, in the setting of old care recipients people enrolled in the municipal social care system (III) and to describe nurses’ conception of reflection in their working situation (IV). Data were collected with interviews (I, II, IV), diary notes (II) and participative observations (III). The data were analyzed with phenomenological hermeneutics (I), thematic content analysis (II, III) and phenomenography (IV). The results reveal that night RNs caring in nursing means the paradoxes: being close at a distance, being responsible without control and being independently dependent. Caring in nursing means a caring stance in prioritizing and taking responsibility for care recipients and care of care staff (I). Night RNs’ caring is dependent on the organization and care staff, and is complex by the fact that the RNs are not care staff leaders. The RNs’ autonomy prerequisite the ability to handle their work, which mainly means mediated caring communicated by telephone (II). The night RNs’ care of care staff means an informal nursing leadership. With their medical competence and authority the RNs occupy a superior caring leader function in nursing (III). Reflection is conceptualized as an instrument to handle the working situation and requires capacity of presence, flexibility and courage. To reflect is experienced to use knowledge, ethics and also personal values, in considering, estimating and assessing caring situations and actions (IV). The conclusion of the studies (I-V) is that the night RNs’ caring is dependent on the prerequisites described in the dimensions of the organization, self-understanding and vocational and professional relations. The RNs must be able to reflect and handle the situation of caring at a distance, without loosing the vocational fundamental condition of caring, though the consultant function implies that they seldom encounter the care recipients. Increased quality, development and creating possibilities for dignity in care for older people means the RNs must participate more in bed side caring. The RNs should also be caring leaders and be given the opportunity for adequate specialist training in gerontology nursing.
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| 4. |
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| 5. |
- Nordgren, Lena, et al.
(författare)
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Support as experienced by men living with heart failure in middle age : A phenomenological study
- 2008
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 45:9, s. 1344-1354
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- BACKGROUND: Men living with heart failure (HF) in middle-age experience restrictions limiting their work capacity and/or social activities. To adjust to the life-situation they need support. The meaning of the phenomenon of support is not well known. Thus, formal carers may find it problematic to know how to support patients. AIM: The aim of the current study was to uncover and describe the meaning of the phenomenon of support as experienced by men living with HF in middle age. DESIGN: The study used a caring science perspective and a reflective lifeworld approach based on phenomenological philosophy. PARTICIPANTS AND SETTINGS: Nine men, aged 49-64 years and diagnosed with HF, were recruited from two outpatient HF clinics in Sweden. METHODS: Interviews were used for data gathering. Data were analyzed by means of reflective lifeworld research. FINDINGS: The essence of support as experienced by men living with HF in middle age can be understood as security, and a sense of having control over body and situation. Support is realized in the men's relations to other people; there is however tension between what is supportive and what is not, meaning that even though intentions are good, intended support involves limitations, uncertainties or insecurity. The essence is illuminated by the following meaning constitutes: Support-a tenuous security; Medications-a support for life; Conditional support within the context of formal care; and, Information and knowledge. CONCLUSIONS: The meaning of support as experienced by men living with HF in middle age is multi-dimensional, qualitative and contextual. When the men are supported they gain a sense of security and control, giving them strength to handle their life-situation. A lifeworld-led approach in the context of formal care can help formal carers support men living with HF in middle age.
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| 6. |
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| 7. |
- Rayman, M. P., et al.
(författare)
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Do functional selenoprotein SNPs predict the risk of prostate cancer?
- 2006
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Ingår i: Proceedings of the Nutrition Society. - Univ Surrey, Sch Biomed & Mol Sci, Guildford GU2 7XH, Surrey, England. Umea Univ, Dept Oncol, Umea, Sweden. Karolinska Inst, Dept Med Epidemiol, S-10401 Stockholm, Sweden. : CAMBRIDGE UNIV PRESS. - 0029-6651 .- 1475-2719. ; 65, s. 100A-100A
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 8. |
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| 9. |
- Weman, Karin
(författare)
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Co-operation with family members : A challenge for registrated nurses in community elder care
- 2005
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to gain knowledge of how Registered Nurses (RN) are able to work together with family members of older people living in community elder care facilities.A questionnaire was distributed to all RNs (N= 314) with permanent appointments in community elder care in one province, and 67 percent (n = 210) answered after two reminders (I, II). The age of the participants was from 23 to 64 years and half of the participants worked in urban areas. About half of the participants had experience of work in elder care of five years or more.Study I focused on the RNs view of co-operation with family members of the old person and what influenced that co-operation. The working situation for RNs in community elder care showed that nearly half, 46 % of the RNs were not satisfied with their working situation. It was the nurses with more than five years of working experience that were unhappy with their working situation. The limited organisational and personnel resources influenced their ability to co-operate with the family members. The RNs expressed dissatisfaction and frustration when they could not spend enough time caring for the old people or communicating with their family members. The RNs believed that it was important for family members to show their involvement in the care of the old person. The results showed that cooperation would be more complicated if there was a conflict of interest between the RN and the family member. Furthermore, the RN pointed out the importance of family members taking care of the older person’s interest.Study II focused on what the RNs described as positive, negative or problematic in their cooperation with family members of old people. Content analysis was used in the analysis of the three open-ended questions. Three themes emerged from the answers of the three open-ended questions, namely Problems within the system, Interaction with families and Caring in nursing work. The co-operation between the RN and the family member was especially important when the old person was suffering from dementia. An exchange of information about the person before illness was especially important as it was then possible to provide better care and understanding for the old person.The development of community elder care will put increasing demands on the RNs in community elder care in the future and there is a need for further support and guidance. Her working situation involves both working alone and being a part of a team. Informal care giving is also expected to increase as the elder population increases and by that the registered nurse will be even more important in community elder care as more persons are dependent on her competence. Conclusions drawn imply that the RN in community elder care is dependent on the organization of elder care and the organization is dependent on RNs competence.
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