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1.	Bergmark, Magnus, 1975- (författare) Integrerade psykosociala insatser : Policy, implementering och praktik i ett komplext verksamhetsfält 2017 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract InledningAlltsedan psykiatrins avinstitutionalisering tog fart under 1980- och 1990-talen har en utveckling av samhällsbaserade psykosociala insatser förespråkats för att erbjuda vård och stöd till personer med psykisk funktionsnedsättning. Insatserna förväntas bidra till att brukarna får tillgång till effektiv vård och stöd, samtidigt som de inkluderas i samhället. Vidare förutsätts insatserna baseras på kunskap och evidens, samt bygga på brukarens delaktighet och stödja dennes återhämtning. En annan målsättning är att vissa insatser ges i form av integrerade modeller, så att personer ur målgruppen får tillgång till sammanhållet stöd från inblandade myndigheter. Även om Sverige räknas som ett resursstarkt land som har kommit långt på området, så förekommer kritik mot utvecklingen. Kritiken har berört både planering och styrning på politisk nivå, men även utförandet av de insatser som erbjuds till brukarna. Kritiken har bland annat handlat om bristande samverkan mellan landsting och kommuner, och om stora lokala variationer i den erbjudna servicens kvalitet. I den här avhandlingen studeras dels utformningen av policy på området, dels implementering av specifika insatser. Syftet med avhandlingen är att undersöka hur svenska policymakare på nationell nivå har hanterat utvecklingen av psykosociala insatser för personer med psykisk funktionsnedsättning, samt att analysera möjligheter och svårigheter för organisationer och personal när det gäller att implementera de insatser som förespråkas av beslutsfattare. De frågeställningar som avhandlingen söker besvara är följande:Hur formuleras policy som syftar till att införa samhällsbaserade psykosociala insatser, och vad kan policyns egenskaper innebära för genomförandet av den?Vilka styrstrategier uttrycks i statliga policydokument?Vad hämmar respektive underlättar implementeringen av föreslagna integrerade psykosociala insatser?Hur kan vi förstå vad som påverkar möjligheten att erbjuda integrerade psykosociala insatser, i termer av lokala förutsättningar och strategier för implementering?MetodPolicy på området studerades genom en studie av tre av de övergripande dokument som beslutats på regeringsnivå de senaste 20 åren. Riktade kvalitativa innehållsanalyser baserade på relevant litteratur genomfördes. Implementering av insatser studerades genom att 15 program följdes under 3 års tid. 14 av dessa arbetade med att implementera arbetsrehabiliteringsprogram utifrån modellen Individual Placement and Support (IPS). Under samma tidsperiod följdes ett team som implementerade den intensiva samordnings-, vård- och stödmodellen Assertive Community Treatment (ACT). För att bedöma verksamheternas följsamhet till modellerna genomfördes programtrohetsskattningar av samtliga program. Data avseende programmens målgrupp samlades också in. Tre IPS-program deltog i en fördjupningsstudie där kvalitativa intervjuer genomfördes med ledare, personal och samverkanspartners. Implementeringen av dessa program analyserades utifrån implementeringsramverket the Consolidated Framework for Implementation Research. Implementeringen av samtliga 14 IPS-program studerades med hjälp av skattningsskalan the Sustainable Implementation Scale (SIS). När det gäller ACT-teamet genomfördes dels kvalitativa innehållsanalyser av djupintervjuer, och dels skattningar av implementeringskomponenter med hjälp av SIS.ResultatPolicy på området har innehållit stora mått av otydlighet och konflikt, både gällande de mål och medel som har formulerats. Regeringen har främst förespråkat så kallade mjuka styrstrategier, vanligen i form av statliga stimulansbidrag. Vissa förtydliganden och konkretioner har skett under tid, vilka ibland går i linje med de internationella rörelserna New Public Management och evidensbaserad praktik. Exempel på försök att strama upp styrningen är målformuleringar som förespråkar riktade och prestationsbaserade stimulansbidrag, samt nationella riktlinjer för att styra utvecklingen mot utvalda specificerade insatser. Trots detta är det fortfarande de berörda myndigheterna som är ansvariga för att välja ut, utforma och implementera psykosociala insatser. På verksamhetsnivå leder detta till att många otydligheter består, vilka ibland är relaterade till svårigheter att avgränsa ansvarsområden och att förändra hindrande regelverk och traditioner. Dessutom förekommer konflikter, exempelvis i form av konkurrerande målsättningar och ojämn resurstilldelning.Studierna av de integrerade modellerna IPS och ACT visar att implementering av dessa är möjlig, även i en sektoriserad välfärdskontext som den svenska. Det finns dock en rad faktorer på såväl organisationsnivå som teamnivå, som försvårar implementeringen. Exempel på dessa är de involverade organisationernas varierande målsättningar och traditioner, regelverkens utformning, samt svårigheter att erhålla långsiktig finansiering. I en del fall beskrivs de arbetssätt som modellerna förespråkar som försvårande, då de upplevs som annorlunda och utmanande för existerande rutiner och uppfattningar om stöd till målgruppen. Ett stort hinder för effektiv implementering är svårigheter att samverka, främst mellan, men även inom inblandade organisationer. De flesta program som lyckades genomföra en hållbar implementering hade personal som var duktiga på att navigera förbi de hinder som orsakades av ogynnsamma regler, och de lyckades även hitta vägar för att etablera samverkan, både horisontellt (med samarbetspartners på samma hierarkiska nivå) och vertikalt (mellan ledning och personal). En verksamhetsledare som har möjlighet att påverka samverkansrelationer i både horisontell och vertikal riktning är gynnande för implementeringen. Andra betydelsefulla komponenter som underlättar implementering är en noggrann planering innan ett program startas, medveten rekrytering av personal, formering av ändamålsenliga styrgrupper, samt att tidigt i processen arbeta strategiskt för att lösa finansieringsfrågan. Även programtrohetsskattningar var betydelsefulla, då de både fungerade som instrument för att identifiera förbättringsområden för programmen, men också hade en legitimerande funktion vid återkoppling till ledningen.SlutsatserDet råder en samstämmighet i övergripande målsättningar som syftar till att utveckla området integrerade psykosociala insatser. På en mer konkret nivå är läget betydligt oklarare, både gällande målsättningar i policy och av vem och hur insatserna ska implementeras. Även om vissa förändringar skett, står regeringen fortsatt för en mjuk styrning vilken lämnar ett stort ansvar till de myndigheter som ska implementera valda insatser. Detta innebär en rad svårigheter för frontlinjepersonalen, vilket leder till att de ofta behöver lägga mycket tid och energi på att hitta vägar för att överkomma dessa svårigheter.I många fall har ledare och personal goda möjligheter att uppnå en hög programtrohet på teamnivå, men för en hållbar implementering krävs det att ett program är väl förankrat både vertikalt och horisontellt. Därför finns ett behov av att forskare och beslutsfattare tar ett tydligare helhetsgrepp, både på området policy och implementering av specifika insatser. Skattningar av programtrohet och implementering kan vara ett stöd i att identifiera vad som fungerar samt vad som behöver förändras i och mellan organisationer. Men för att programmen ska lyckas med en effektiv implementering på organisationsnivå behöver deras legitimitet stärkas vertikalt, och planering för långsiktig lokal finansiering behöver göras i ett tidigt skede.
2.	Bohlin, Margareta, 1970- (författare) Music and risk in an existential and gendered world 2011 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Adolescents in Western society often expose themselves to high levels of sound at gyms, rock concerts, discotheques etc. These behaviours are as threatening to young people’s health as more traditional risk behaviours. Testing boundaries and risk taking are fundamental aspects of young people’s lives and the processes of developing their identities. There is, however, a need to balance reasonable risk taking and risks that can damage health. The aim of Study I was to analyze the relationship between self-exposure to noise, risk behaviours and risk judgements among 310 Swedish adolescents aged 15-20 (167 men/143 women). The adolescents’ behaviour in different traditional risk situations correlated with behaviour in noisy environments, and judgements about traditional risks correlated with judgement regarding noise exposure. Another finding was that young women judge risk situations as generally more dangerous than young men, although they behave in the same way as the men. We suggest that this difference is a social and culture based phenomenon which underlines the importance of adopting a gender perspective in the analysis of risk factors. Adolescents reporting permanent tinnitus judged loud music as more risky than adolescents with no symptoms and they did not listen to loud music as often as those with occasional tinnitus. The aims of study II were to illuminate the complexity of risk behaviour, the meaning and purpose of adolescent risk-taking in both a traditional sense (e.g. smoking and drug use) and in noisy environments (e.g. discotheques and rock concerts), in relation to norms and gender roles in contemporary society. In total, 16 adolescents (8 men/8 women, aged 15-19) were interviewed individually and in focus groups. The interviewees’ responses revealed social reproduction of gender and class. Main themes of the phenomena for both genders emerged: Social identity and Existential identity of risk taking. The descriptive sub themes, however, which together formed the general structure, were rather diverse for men and women. The incorporation of social and existential theories on gender as basic factors in the analysis of attitudes towards risk-taking behaviours is considered to be of utmost importance. Likewise, research on hearing prevention for young people needs to acknowledge and make use of theories on risk behaviour and similarly, the theories on risk behaviour should acknowledge noise as a risk factor. Study III aims to increase the knowledge about young women’s and men’s risk judgement and behaviour by investigating patterns in adolescent risk activities among 310 adolescents aged 15-20 (143 women; 167 men). The Australian instrument ARQ, developed by Gullone et al, was used with additional questions on hearing risks [1] and a factor analysis was conducted. The main results showed that the factor structure in the judgement and behaviour scale for Swedish adolescents was rather different from the factor structure in the Australian sample. The factor structure was not similar to the Australian sample split on gender and there were differences in factor structures between genders among Swedish adolescents. The results are discussed from a gender and existential perspective on risk taking, and it is emphasized that research on risk behaviour needs to reconceptualize stereotypical ideas about gender and the existential period in adolescence. The aim of Study IV was to investigate possible gender differences regarding psychometric scales measuring risk perception in noisy situations, attitudes towards loud music, perceived susceptibility to noise, and individual norms and ideals related to activities where loud music is played. In addition, the purpose was to analyze whether these variables are associated with protective behaviour, e.g. the use of hearing protection. A questionnaire was administered to a Swedish sample including 543 adolescents aged 16 to 20. The result revealed significant gender differences for all the psychometric scales. Furthermore, all psychometric measures were associated with hearing protection use in musical settings. Contrary to previous studies, gender did not solely contribute to any explanation of protective behaviour in the analysis. One conclusion is that although gender does not contribute solely to the explanation of protective behaviour, gender may affect psychological variables such as risk perception, attitudes and perceived susceptibility and these variables may in turn be valuable for decision-making and protective behaviour in noisy situations. Although women tend to be more ’careful’ psychologically, they nevertheless tend to behave in the same way as men regarding actual noise-related risk-taking.
3.	Ehn, Mattias, 1972- (författare) Life Strategies, Work and Health in People with Usher Syndrome 2020 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Introduction: People with Usher syndrome (USH) have an inherited disorder causing congenital deafness or hearing loss combined with progressive vision loss and, in some cases, balance problems. Previous research has shown that people with USH have poor physical and psychological health. Research has, however, demonstrated that there are in-group health differences that have not yet been explored and that there is a lack of studies on life strategies as well as health in relation to working life.Aim: The aim was to explore the relationship between work and health in people with USH1 and 2 and to explore the experiences of life strategies in people with USH 2.Methods: A quantitative and a qualitative explorative design was employed comprising two cross-sectional studies of the relationship between work and health in people with USH2 (n=67) and USH1 (n=47). The third study, of life strategies, comprised focus group interviews with people with USH2a (n=14) analyzed by content analysis. The fourth study explored the lived experiences of working life by interviewing people with USH2 (n=7) using an interpretative phenomenological approach.Results: Study 1 and 2 demonstrated significant differences in health between working and nonworking people. Nonworking people showed significantly poorer health. In study 3, a variety of strategies to prevent and resolve challenges in life, as well as to comfort oneself was identified. The lived experiences of working life in people with USH2 (study 4) disclosed feelings of satisfaction, striving towards a work life balance. Work also disclosed feelings of limitations and uncertainty about the future.Conclusion: The results, which are discussed in relation to the Meikirsh model of health, demonstrated a complexity. Individual life strategies, psychological flexibility and environmental aspects, such as social determinants have to be considered to receive a comprehensive picture of the relationship between work and health in people with USH. This thesis provides new insights into the health of people with USH.
4.	Germundsson, Per, 1956- (författare) Lärare, socialsekreterare och barn som far illa : om sociala representationer och interprofessionell samverkan 2011 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract The aim of the thesis is, through use of the theory of social representations, to increase knowledge about the meeting between social workers and teachers, as professional groups, during collaboration with regard to the target group, children at risk. The thesis intends to capture the parties’ perceptions of one another and of that about which they are cooperating, as well as to discuss possible consequences of these perceptions in the context of interprofessional collaboration on children at risk. Empirical data was collected through an association study. The informants consisted of 200 teachers and social workers who had participated in various collaborative projects concerning the target group of children at risk. The study shows that the two professional groups have similar representations of children at risk. The social workers’ representations of the teachers are mostly positive, but the teachers are perceived, in many cases, to lack knowledge about social workers and their field of expertise. Teachers’ representations of social workers are colored to a much greater extent by negative associations. The negative image is primarily related to social services as an organization, not to social workers as individuals. In relation to the specific area of interprofessional collaboration on children at risk, the study indicates that the involved parties’ social representations play a significant role in the collaboration process. The research of this thesis has shown that the theory of social representations provides an effective framework for the study of the collaborating professionals’ group perceptions of one another and of children at risk. A preliminary model that seeks to illuminate the role of social representations, trust, and communication in the collaborative process has been presented.
5.	Granberg, Sarah, 1973- (författare) Functioning and disability in adults with hearing loss : the preparatory studies in the ICF Core sets for hearing loss project 2015 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Hearing loss (HL) is a health condition that affects more than 360 million people worldwide. The findings from previous research point at the adverse relationship between adults with hearing loss and important aspects of everyday life such as social relations, communication and work-related tasks. However, the overall picture concerning the functional and disabling aspects of adults with HL re- mains incomplete. To identify the functional and disabling aspects, a conceptual and/or theoretical framework is required. The International Classification of Functioning, Disability and Health (ICF) offer a multidimensional framework based on bio-psycho-social assumptions about health. In previous research inves- tigations in which the ICF has been used, some utility problems in the linking (relating) of data to the classification have been highlighted.The aims of the present thesis were to explore the areas of functioning and disability of relevance for adults with HL and to explore how audiological data can be linked to ICF. The aims were explored by applying the methodology of the ‘interdisciplinary evidence-based approach to functioning and disability in adults with HL’, acknowledging the merging of three perspectives designated the Researcher, the Patient and the Professional perspective. Four studies that focus on the three perspectives were conducted. All results were linked to the ICF classification. The results were merged into a model designated ‘the integrative model of functioning and disability in adults with HL’.When the three perspectives were linked, the results revealed several aspects of relevance for the target group. Bodily (individual) dimensions, such as hear- ing, auditory perception, memory, attention, energy, and emotions, were acknowledged. Aspects of everyday life such as conversations, the usage of communication strategies, family relationships and work, were highlighted. Influential environmental factors, such as noise, assistive technical devices, the design of public buildings, social support and the attitudes of people in the envi- ronment, were also identified. In conclusion, interactions seemed to be vital as almost all identified aspects highlighted or were tied to this dimension of human functioning. Further, concerning the linking of the data it was acknowledged that the ICF and the research area of adult HL do not fully comply. Suggestions for improvements in future revisions of the ICF were highlighted and discussed.
6.	Gustafsson, Johanna, 1975- (författare) Supported employment i en svensk kontext : förutsättningarnär personer med funktionsnedsättning når,får och behåller ett arbete 2014 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract The overall aim of this thesis is to discover, to value and to explain, if and why Supported Employment functions in a Swedish context and to also highlight those mechanisms which provide meaningful conditions within that context, when a person with a disability reaches, procures and retains employment. The empirical part consists of four studies that examine (1) whether SE has an effect on the employment rate, disposable income and sum of allowances, (2) the employer´s perspective of employing people with disabilities, (3) how employers perceive support from SE in the employment process and (4) how employees with disabilities perceive their work situation and social inclusion in the workplace. The studies within the thesis show that in a Swedish context, SE is encompassed by norm structures, production structures and economical structures which affect conditions for people with disabilities to reach, procure and retain employment. Supported Employment’s mode of practice and the ability to meet, co-exist and co-operate with these social structures has, in many ways, affected the prerequisites for people with disabilities to reach employment. These structures do not in themselves however, constitute a sufficient frame of ideas to enable an understanding of how SE works in a Swedish context, or how to explain the factors that affect conditions when people with disabilities reach, procure and retain employment. In the qualitative studies, trust features prominently and is considered an important mechanism in holding the process together.
7.	Möller, Kerstin, 1950- (författare) Impact on participation and service for persons with deafblindness 2008 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Persons with deafblindness experience difficulties in daily life and they experience service to sometimes barrier. The overall aim of this thesis is therefore to discover, evaluate and explain: 1. mechanisms that might have impact on participation restrictions for people who have visual and hearing impairment i.e. deafblindness and 2. mechanisms that might barrier service to these people. Service is used as an umbrella term for health care, education and certain service for persons with disabilities. Materials from multiple sources have been used: literature (Study I No 96 papers). Interviews (Study I and V) with 32 and 3 adults with deafblindness respectively. Questionnaires (Study II and III): answered by 33 and 34 adults and youth with deafblindness. Patient records (Study IV and V): records from 9 and 3 adult females with USH I respectively. Materials mostly retrospectively cover the period from 2005 and about 40–50 years. Both quantitative and qualitative methods were used. International Classification of Functioning, Disability and Health (ICF) were consequently used as a framework to describe as well as a tool to analyze mechanisms. Further, the Ecological approach, Disability as a laminated system and Life course approach were used in order to evaluate and explain mechanisms. The conclusions that can be drawn from an ecological, laminated and life course approach are: Participation restrictions for people with deafblindness are far-reaching and are embedded in a complex process of interaction between the person with deafblindness and the environment. Services entail systematical barriers. In order to improve service it is extremely important to understand the role of participation restrictions in deafblindness. Primary activity limitation is to not see and hear enough for comprehension. Hence, not taking part in the visible and audible world is primary participation restriction. Performing activities without basic information includes risk. One important aspect of deafblindness is exposure. Persons with deafblindness require rehabilitation in a life perspective. In order to increase people’s participation and protection requirement of individually adapted support and assistive devices is necessary. ICF and the UN convention support service alterations.
8.	Simmeborn Fleischer, Ann, 1956- (författare) ”Man vill ju klara sig själv” : Studievardagen för studenter med Asperger syndrom i högre utbildning 2013 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract SammanfattningSedan början av 2000-talet har det skett en markant ökning av studier gällande barn och ungdomar och Autism. Dock är det så att den mesta forskningen fortfarande är inom det medicinska området. Endast ett fåtal av studierna rör vuxna med Asperger syndrom (AS) som studerar på högskola/universitet. Samtidigt sker en ökning av personer med AS som söker högre utbildning såsom högskola/universitet, vilket gör forskning gällande personer med diagnosen AS högaktuell. Antalet studenter med kognitiva funktionshinder, dit AS räknas, som sökt pedagogiskt stöd på högskola/universitet i Sverige, har ökat från 1 427 studenter 2010 till 1 943 studenter 2012. När man studerar på högskola/universitet så finns det pedagogiska stöd att tillgå, och till vardagen finns Lagen om stöd och service till vissa funktionshindrade (LSS) och Socialtjänstlagen (SoL) som personer med AS har möjligheter att söka stöd genom. Personer med AS kan ibland ha svårt att utnyttja stödsystem som kräver att man själv identifierar och uttalar sina behov av stöd. Denna avhandling fokuserar på personer med AS i högre utbildning och stöd.I doktorsavhandlingen ingår två studier: Studie I som är en fallstudie och Studie II, som är en enkätstudie. Bindningspunkten för studierna är studenter med AS som fått pedagogiskt stöd i sin utbildning vid högskola/universitet.Studie IStudie I består av en fallstudie (Merriam, 1994, 2009; Patton, 2002) som innefattade tre fall. Studien redovisas i artikel I och II, där artikel I bygger på studenternas berättelser och artikel II på anhörigas och samordnares berättelser. Insamlandet av data har byggt på berättelser genom samtal (Doecke, Brown, & Loughran, 2000; Hydén & Brockmeier, 2008; Johansson, 2005; Skott, 2004). Valet av berättelser som metod, innebär att man som forskare fokuserar på att få möjligheter att lära känna en annan person, få kunskap om denna persons erfarenheter, känslor och förväntningar. För att säkerhetsställa undersökningens validitet, användes triangulering mellan tre olika källor: intervjuer med studenter, anhöriga och samordnare. Urvalet av högskola/universitet gjordes med avsikten att inkludera högskolor/universitet från olika delar av Sverige, olika stora högskolor/universitet med olika studieinriktningar.Syfte med Studie I är att undersöka hur studenter med AS i högre utbildning beskriver och förstår sin livshistoria och sin studievardag, vilket redovisas i artikel I och i kappans resultat. Anhöriga är en central resurs för personer med AS. Därför undersöks i den andra artikeln hur anhöriga uppfattar sina barns eller syskons studier och det stöd de tidigare fått i skolan och på högskola/universitet. I artikeln redovisas även hur man upplever det pedagogiska stöd som högskola/universitet erbjuder. Samordnare för studenter med funktionshinder har en central roll i vilka pedagogiska stöd som beslutas att students ska få, därför är det också av vikt att undersöka hur samordnare beskriver den stödverksamhet som finns på högskola/universitet. Även detta redovisas i andra artikeln samt i kappans resultat.Vid insamling av data var fokus på studenternas berättelser om sin studievardag och hur de beskrev sina skolerfarenheter, från förskola fram till högskola/universitet samt hur de såg på sin framtid (Hydén & Brockmeier, 2008). Vid samtalen med anhöriga och samordnare använde forskaren sina yrkeserfarenheter som berör AS, diagnossättande, mediciner, lagar och forskning samt personliga erfarenheter. De anhöriga som intervjuades bestämdes av studenterna och bestod av en mamma, en pappa och en syster. Samordnarna bestod av de som arbetade på den högskola/universitet som studenten studerade på.Samtalsmanual har använts som stöd vid varje samtal. Totalt har tolv samtalsmanualer använts. Samtalens längd för studenterna varierade mellan 1 timma och 4 minuter till 4 timmar och 50 minuter. Samtalens längd varierade mellan 1 timma och 10 minuter till 3 timmar och 23 minuter för de anhöriga. Samtalens längd varierade mellan 1 timma och 13 minuter till 3 timmar och 40 minuter för samordnare. Varje samtal anpassades helt efter varje anhörigs och samordnares intresse av att vilja samtala. De tre fallbeskrivningarna omfattade femton transkriberade samtal: tre vardera för varje student, en för vardera anhörig och en för vardera samordnare. Första steget i analysen var att forskaren läste igenom det transkriberade materialet kring varje student upprepade gånger så att en känsla för helheten uppstod. Vid tredje genomläsningen gjordes noteringar i form av nyckelord som beskrev innehållet. Därefter plockades de meningar ut som innehöll information som byggde på nyckelorden och var relevanta för frågeställningarna. Den omgivande texten togs med så att sammanhanget kvarstod, det bildade meningsbärande enheter. De meningsbärande enheterna i samtalstexterna kondenserades i syfte att korta ner texten men ändå behålla innehållet. De kodades därefter och grupperades i kategorier som återspeglade det centrala budskapet i samtalen i relation till studenterna. Samma process gjordes med de anhörigas och samordnarnas transkriberade material.I Studie I framkom det att studenter med AS ofta behöver stöd i sin studievardag, det vill säga både i studierna och i vardagslivet, för att klara sina studier. Personer med AS har en kognitiv funktionsnedsättning som kan ge svårigheter i deras studievardag, och de har ofta en nedsatt förmåga att beskriva sina svårigheter och kan därför inte alltid redogöra för vilka behov de har. När man söker stöd bygger ansökan på att man själv kan beskriva sina behov av stöd och framför allt välja bland de stöd som finns utifrån det behov och de svårigheter man har, det vill säga man ges en stor valfrihet. För studenter med AS kan detta bli till en stor svårighet då de ofta inte själva vet vilka stöd de har behov av och vad de olika stöden skulle innebära för de studiesvårigheter de har. Studenterna i studierna angav att när de fick stöd hade de svårt att förstå hur stödet skulle fungera och hur det skulle kunna förbättra deras studier, och att det pedagogiska stödet i stället blev till ytterligare ett hinder, som tog tid och fokus från studierna. Stödinsatsen med vidhängande valfrihet kan ses som ett uttryck för en ekvifinalitet: stödsystemet har designats för att ge olika funktionshindrade samma möjlighet, och utgångspunkten är att valfrihet är bra för alla. Många av studenterna har beskrivit att de känner sig socialt begränsade och har kommunikationssvårigheter och de upplever att de är stigmatiserade och känner sig alienerade.I analysen av studenternas beskrivning av sin livshistoria och studievardag framstod två teman, Kamp och Utanförskap. Anhöriga beskrev att kraven på fokusering, både på vardags- och studentaktiviteter, blev övermäktiga för deras barn eller syskon. De kunde se att deras barn eller syskon hade svårigheter med att planera inköp av exempelvis mat, att laga mat, att tvätta och sköta andra vardagsrutiner i hemmet. Samordnare för studenter med funktionshinder utryckte att även om de kunde se att studenter hade problem med vardagsrutiner i hemmet, kunde de inte ge något stöd för detta. De hade också svårt att erbjuda stöd i vissa studietekniska frågor. Samordnarna beskrev att det är svårt att ställa frågor om en students funktionshinder, diagnos och livssituation och att det är svårt att få grepp om vilket stöd som skulle kunna bli bra för varje enskild student.Sammantaget så har det framkommit att studenter med AS har behov av både pedagogiskt stöd och stöd i vardagsrutiner och det framkom också i studierna att de olika stöden behöver samordnas så att studenter med AS erhåller stöd i hela studievardagen. Det framkom också att det finns behov av ett kunskaps- och kommunikationsverktyg för framför allt samordnare och studenter. Detta verktyg skulle kunna användas av samordnare och student så att en tydlig agenda upprättas och följs vid samtalen och beslut om vad eller vilka pedagogiska stöd som studenten skulle kunna få som stöd i studierna.Studie IIStudie II består av en enkätstudie, bestående av 55 frågor med både öppna och slutna svarsalternativ, riktat till studenter med AS, studenter med rörelsehinder (RH) och studenter med hörselnedsättning (HN). Även i denna studie står studenter med AS i fokus, men med mer generell frågeställningar: Hur beskriver studenter med AS, RH och HN upplevda problem, erhållet stöd och upplevt stöd? Finns det skillnader och likheter mellan dessa tre grupper av studenter? Resultatet redovisas i artikel III samt kappans resultat.Syftet med studie II är också att undersöka vilka karaktäristika för studenter med AS som kan identifieras och bedömas som så viktiga att de med stöd av Internationella klassifikation för funktionstillstånd, funktionshinder och hälsa kan behöva ingå i ett code set. Resultatet redovisas i artikel IV samt i kappans resultat. Under arbetet med Studie I uppkom funderingar på om det fanns studentgrupper med andra funktionshinder som har samma erfarenheter som studenter med AS. Därför utökades urvalet till studenter RH och HN. Studie II var beskrivande med en mixed methods design. Den första delen hade en huvudsakligen kvantitativ ansats med data insamlade via en enkät. Till enkätstudien tillfrågades alla högskolor/universitet om de var intresserade att delta i undersökningen. Det var 14 samordnare på 12 högskolor/universitet som tackade ja till att medverka och de tillfrågade sedan de studenter som kunde vara aktuella att medverka i undersökningen. Respondenter blev 34 studenter som studerade vid 12 svenska högskolor/universitet, 16 studenter med AS, 11 med RH och 7 med HN. Eftersom endast 34 stu
9.	Strindlund, Lena, 1973- (författare) The Social Dynamics of Labor Market Inclusion 2020 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Labor market inclusion is a complex assignment that takes place through a dynamic interaction between unemployed individuals from vulnerable groups, several authority actors and employers.The overall aim of this thesis was to explore the social dynamics of labor market inclusion, with a particular focus on integration, from the perspectives of employers and authority actors. Three empirical studies have been conducted focusing on different perspectives and integration challenges, using various forms of qualitative methods and theoretical approaches.Study I was a qualitative phenomenographic interview study of employers’ perspectives on labor market inclusion and intersectoral integration. The study showed that employers’ views are multifaceted and can be categorized as constrained, independent, and conditional, and can be understood through a complex internal relationship between conceived individual-, workplace- and authority-related aspects in relation to the themes of trust, contribution, and support (paper I).Study II was a two-year longitudinal case study of an interorganizational integration project, focusing on the authority actors’ perspectives. Through ethnographic fieldwork and a practice-theory approach, two divergent rationalities (an empowerment rationality and a coordinating rationality) were identified within the project organization, and four central concepts were highlighted – communication, trust, structure, and steering – contributing to a collapse in integration (paper II). The dysfunctional group processes were further analyzed with the theory of negative effects of social capital and shadow organizing, summarized as three social dynamics: insulation, homogenization, and escalating commitment (paper III).Study III was a one-year longitudinal case study of a municipal intraorganizational integration project focusing on the perspectives of both authority actors and municipal employers. This study combined ethnographic field work with the theory of social representations, which visualized three different representations among the different professional groups – individual-, employer-, and political-oriented – which contributed to creating tensions within the project, identified as incomprehension, power struggles, expectation gaps, and distrust (paper IV).By studying two labor market inclusion projects through shadow organizing, the thesis has revealed a complex and dynamic interplay between the various views of the actors involved, as well as social processes within the project organizations and organizational aspects, referred to as social dynamics. These social dynamics constitute the key concepts in this thesis, contributing understanding about how integration and organization work within labor market inclusion projects, or rather, what makes them fail. Three social dynamics were identified: multiple and conflicting views, grouping processes, and power struggles.Greater knowledge and awareness of these complex and social dynamics of labor market inclusion may contribute to better preparedness when organizing integration projects. The results suggest that by identifying and addressing the multiple views characterizing integration projects and not letting incomprehension dominate, the destructive social dynamics may not be given as much space, or may even be avoided, which may stimulate a willingness to integrate rather than the opposite.
10.	Boström, Katrin, 1955- (författare) Living with deteriorating and hereditary disease : experiences over ten years of persons with muscular dystrophy and their next of kin 2005 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract The overall aim of this thesis was to elucidate haw persona with muscular dystrophy (MD) and their next of kin experience and describe their daily lives over the last ten years. MD is a group of inherited disorders characterised by muscular weakness caused by muscle wasting. Both qualitative and quantitative methods were used. Forty-isx individuals with MD and 36 next of kin were interviewed (Studies I, III, IV). Both groups completed the questionnaire Subjective Quality of Life (SQoL), (Study V). Persons with MD also completed the questionnaires Sickness Impact Profile and Self-report ADL (Study II). The interviews were subjected to qualitative content analysis. The persons with MD described the change from being independent to being an individual in need of assistive devices and/or personal support to manage activities of every day life (StudyI). Besides muscular weakness persons with MD have hte strain it means to have a hereditary disease, which also affects the family (Study III). The deterioration during a decennium was primarily with regard to ambulation. The number of persons walking without assistive devices has decreased from 40 to 23 and that of those working has almost been halved, from 21 to 11 (Study II). Next of kin have a special vulnerability in form of an emotional and practical lonliness in addition to actual and anticipatory losses. The relationship was described as related to obligation and/or love. To have an orientation towards tasks (obligation) was linked to a feeling of being weighed down by demands, while having an orientation towards relationship (love) was linked to a feeling of quality in life (Study IV). The persons with MD scored lower on most items in the SQoL than the next of kin (Study V). Patients without a partner scored lower on QoL as a whole than those with a partner. Those with an early onset of disease scored lower on personal economy. Next of kin who gave daily help assessed their relationships to friends lower than those who gave weekly help (Study V). This thesis provides knowledge of the trajectory with MD over time on the basis of a ten-year follow up. It also broadens the knowledge of how the hereditary aspect is experienced both by those with MD and their next of kin. How the next of kin of adult persons with MD experience their situation is an issue that has been overlooked in previous research.
11.	Boström, Marianne, 1953- (författare) Vardagslivets aktiviteter. Handlingen som terapeutiskt redskap vid återhämtning för personer med svårare psykiska funktionshinder : En analys av arbetsterapeuters berättelser med utgångspunkt i G H Meads teori om social handling 2017 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract There is a need of community-based treatment methods with focus on everyday occupations, for persons with severe mental disabilities. The importance of occupation in achieving health has been highlighted in large mental hospitals and community-based service/support designed for people with severe mental disabilities who today live in society. Despite this support these people are in a vulnerable position, as they often have extensive difficulties in carrying out daily occupations which also leads to poorer well-being and health conditions. In the rehabilitation process, it is necessary to enable the person to use her own effort to perform activities. Occupational therapy has a unique role in community-based efforts for people with severe mental disabilities through their person-centered practices approaches and knowledge of daily occupations and how these can be used as therapeutic means of recovery and development of the self.The purpose of the study is to use theory about social action to contribute theoretical understanding about how everyday occupations are used as a therapeutic means for people with severe mental disabilities in occupational therapy, with the goal of contributing to their recovery and development of self. A qualitative, interpretative approach is used in the study to examine how everyday life can be used as a therapeutic tool. Empirical data of 11 events were generated from interviews with four occupational therapists. A theoretical tool developed by George Herbert Mead’s social psychological theory of the social act, were used as a frame for new-descriptions. Through abductive analyses reconstructed events are given new (theoretical) understanding.The result indicate that the social acts have met such difficulties that they have almost ceased and at the same time risk losing their meaning. The therapist adjusts the activity to find the level at which the person can participate with his/her own experience in the implementation of the everyday action. This gives the person with severe mental disabilities opportunities to use one self in the social process which eventually makes the person regain the ability to perform everyday activities
12.	Carlsson, Per-Inge, 1959- (författare) Hearing impairment and deafness : genetic and environmental factors - interactions - consequences : a clinical audiological approach 2005 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract OBJECTIVES - Hearing impairment (HI) can be due to genetic or environmental factors, e.g. noise. More than 50% of HI cases are thougt to be hereditary. HI can affect social participation in different ways. How serious these problems becomes depends on several factors, for example, the type of social environment the person lives in. The objective of the present study was to point out the importance of studying HI and deafness in a broad perspective, from the molecular - biological level to the psychological - social level and to evaluate how interactions of factors at several levels form the consequences, in a long-term perspective, to witch HI and deafness can lead. MATERIAL AND METHODS - Three different study populations have been used to study the four levels in this study: Papers I - III; 1200 noise-exposed workers (molecular and biological levels), Paper IV; 50 persons with HI since early childhood, with or without a family history of HI (FHHI)(biological, psychological and social level), and in Paper V; 600 persons with early onset of deafness in two counties with differently strong Deaf communities (psychological and social level). RESULTS - The molecular genetic studies (Papers I – III) showed that the combination of smoking and having a mutation in the protective antioxidant system revealed an additional risk for noise induced hearing loss. In Paper IV, only small differences was found between subjects with and without a FHHI. The results in Paper V indicated that differences in the social environment, in terms of the strength of the Deaf community, influence family factors such as marriages, divorces and the number of children born. CONCLUSIONS - Analysing complex issues such as HI and deafness from a medical audiological perspective requires a multi- level approach at several levels. The results indicate that interactions of factors at all four levels form the consequences, in a long-term perspective, to wich HI and deafness can lead. Furthermore, this multi-level approach - here called a clinical audiological approach - is essential when using the ICF framework in audiological rehabilitation/habilitation.
13.	Hillborg, Helene, 1968- (författare) Erfarenheter av rehabiliteringsprocessen mot ett arbetsliv : brukarens och de professionellas perspektiv 2010 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Erfarenheter av rehabiliteringsprocessen mot ett arbetsliv - brukarens och de professionellas perspektiv. Örebro, Studies from the Swedish Institute of Disability Research No 34, 107 pp.The overall aim of this dissertation is to (1) describe and analyse perceived barriers and opportunities from the perspective of the individual receiving vocational rehabilitation services as a result of unemployment and psychiatric disability (2) describe and analyse perceived barriers and opportunities in services for unemployed people with psychiatric disabilities from the perspective of professionals working in the area of vocational rehabilitation and (3) utilize empowerment theory to explore and develop a deeper understanding of the experiences and perceptions described by these individuals and professionals. The data consists of open-ended interviews with service users and professionals’ working in the area of vocational rehabilitation. A content analysis together with an interpretive approach was used to analyse the data. The results revealed that support and the psychosocial work environment are important factors that influence the rehabilitation process for the individual. These factors can facilitate opportunities to develop skills in contacts with fellow employees, increase belief in one’s own abilities, and can contribute to the achievement of specified goals. These factors are also seen as supporting empowerment and active participation in the rehabilitation process. However, the results also revealed that the rehabilitation process is negatively effected by environmental factors to which the professionals and their organizations contributed. Barriers related to interagency collaboration contributed to barriers to a successful rehabilitation for the individual. The professionals were consistent in what they viewed as enabling factors in the rehabilitation process but the results also showed how difficult it was for the service system to create a rehabilitation context in line with their knowledge and experience.Keywords: Psychiatric disabilities, vocational rehabilitation, empowerment, interagency collaboration, support system.
14.	Olsson, Lena (författare) Children with mild intellectual disability and their families – needs for support, service utilisation and experiences of support 2016 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract This thesis focuses on service utilisation among children with mild ID and their families, their needs for support and their experiences of support.AimsThe overall aim of the thesis was to explore and describe service utilisation patterns among families of children with mild ID from a systems perspective.MethodsA cross-sectional, descriptive and comparative quantitative design was used to describe the extent of service utilisation among 84 children with mild ID and their families (paper I and II). The types and number of services utilised were investigated in relation to the child’s age, gender and school setting. Data concerning the services utilised were collected from the organisational records of social services and paediatric habilitation units. In paper III, a descriptive questionnaire design was used to describe the support needs of families of 38 children with mild ID. A confirmatory design was used to examine the relation between family needs for support and (a) parental self-efficacy and (b) parents’ control over services. A confirmatory design was also used to examine the relation between parents’ experiences of the helpfulness of the support and (a) parental self-efficacy and (b) parents’ control over services. In paper IV a longitudinal, comparative and confirmatory design was used to investigate whether social service utilisation patterns differ over time when children with mild ID in self-contained classes are compared with those integrated into mainstream classes (n=405).ResultsIn total, 60% of the families utilised paediatric habilitation services, and 40% of the families used disability-related services provided by social services. The most commonly utilised services were services concerned support outside of the home, such as respite care and services to improve children’s participation in society. Approximately 25% of the families utilised social problems-related services provided by social services. The most commonly utilised services concerned those to support parents in their parenting roles and financial assistance. In contrast to older children, younger children were more likely to utilise paediatric habilitation services. Older children utilised a higher number of disability-related service types provided by social services. Few differences were found between males and females. The majority of families did not utilise such services that are provided by social services. It was rare for families to use both disability-related services and those that address social problems during the same year.Commonly reported family needs concerned information about what services are available for their child, their child's impairment, how to respond to their child's behaviour and how to teach their child skills. Other common needs included access to parent support networks, to find suitable leisure activities for the child, and more alone time for parents. In contrast to families with mothers who did not participate in paid work, families with mothers who were employed expressed a lower requirement for support such as counselling, contact with other parents of children with impairments, more friends and more alone time for parents. Similar results werefound for families with mothers with higher levels of education. Parents with higher levels of perceived self-efficacy reported a lower need for information, as did also parents with higher levels of control over services. Parents with higher levels of control over services experienced the support as being more helpful.Children with mild ID who attended self-contained classes were more likely to utilise paediatric habilitation services than children integrated in mainstream classes. The same pattern was found for utilisation of disability-related services provided by social services. Integrated children who changed school setting to attend self-contained classes were more likely to begin to utilise disability-related services in comparison with those children who continued to be integrated. The former also had a higher likelihood of increasing the number of disability-related service types utilised.ConclusionsIn addition to disability-related problems, families of children with mild ID may also be at a higher risk of experiencing social problems when compared with the general population. Furthermore, very few families utilised both disability-related services and services addressing social problems. This implies that collaboration flaws exist between those professionals concerned with child welfare services and those concerned with disability-related services. A strong predictor of service utilisation was the type of school setting: children attending self-contained classes had a higher rate of service utilisation than those attending mainstream classes. This indicates that service systems outside of school are designed to collaborate with groups of pupils in special classes rather than individual children in mainstream classes. The strong need for information by families indicates that an ecological framework should be used to identify those factors that affect information availability and effectiveness. To increase parents’ perceived level of control over services, HSO professionals need to work in a capacity building manner with the explicit goal to enhance parental self-efficacy.
15.	Pavli, Antonia, 1984- (författare) Creative Disability Classification Systems : The case of Greece, 1990-2015 2017 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Disability classification systems belong to the core of states’ social/disability policies through which persons with disabilities are classified as eligible or ineligible for having access to disability allowances. The study of disability classification systems has stimulated the interest of several scholars from the broader area of disability studies. Either by conducting comparative studies between different states and describing the similarities and differences of these systems around the world or by conducting studies focusing on the politics and semantics in the development of disability classification systems in specific states, all studies have shown a pluralism in the systems for assessing and certifying disability. In Greece, the development of disability classification systems for social welfare reasons emerged as a controversy that lasted for almost twenty years. One factor that strengthened the controversy was the outbreak of the economic crisis late in 2009 followed by the announcement by the governmental authorities of the enactment of a new system for assessing and certifying disability as part of the austeritydriven policies that the Greek state would enact for facing the consequences of the economic crisis. Drawing on an interdisciplinary approach, the overall aim of this study is to describe and analyze the enactment of disability classification systems in the context of Greek social policy from 1990 to 2015. For the collection of empirical material, a qualitative research method was employed, consisting of interviews, written material, and newspaper articles. The main findings of this thesis are: I) the involvement of the political parties in the development of the systems for certifying and assessing disability; II) the involvement of the disability movement in policymaking; III) the “creative” use of statistics by governmental authorities for the enactment of disability/social policies; IV) how the concept of “disability fraud” has been constructed as a “threat” to the society; and V) the vulnerability of disability classification systems in times of austerity.
16.	Rydberg, Emelie, 1978- (författare) Deaf people and the labour market in Sweden : education - employment - economy 2010 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract This thesis focuses on deaf people’s educational attainment, position on the labour market and sources of revenue. These issues are interrelated, for instance a higher level of educational attainment seems to be associated with a lower unemployment rate and higher levels of income. The national context is Sweden and the Swedish welfare state in 2005. All studies in the thesis compare a deaf population, consisting of 2,144 persons born between 1941 and 1980 who have attended a school for the deaf in Sweden, with a general reference population, consisting of 100,000 randomly chosen persons from the total Swedish population born between 1941 and 1980. Data for all studies consisted of registered information about the persons in the year 2005. The results show that there are differences between the deaf and the reference population regarding level of educational attainment, position on the labour market and sources of revenue and disposable income, with the deaf population having a poorer position than the reference population in all areas. There are also differences between the workplaces of the deaf and the people in the reference population, and it is twice as common for people in the deaf population than for people in the reference population to have a higher level of educational attainment than is required for their occupation. These differences between the deaf and the reference population cannot be associated with differences in the independent factors, as for instance sex, age and immigration background, for which the results have been adjusted. This thesis shows that being part of the deaf population appears to be of importance. Factors in conjunction with deafness that can increase our understanding of the differences between the deaf and the reference populations in an educational context, labour market context and economic context are discussed in the thesis.
17.	Strandberg, Thomas, 1965- (författare) Vuxna med förvärvad traumatisk hjärnskada - omställningsprocesser och konsekvenser i vardagslivet : en studie av femton personers upplevelser och erfarenheter av att leva med förvärvad traumatisk hjärnskada 2006 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract The overall purpose of this study is to illuminate the changeover process experienced by individuals who as adults acquired a traumatic brain injury (TBI), to increase the knowledge and the understanding of this process, and describe the meaning of support in every day life.Persons who acquired a TBI as adults were administered a semi-structured interview covering six areas: consequences of TBI, family and social networks, working life and occupation, life-changes, support from society and everyday life. The interviews were qualitative and in-depth. A total of 15 informants participated, aged between 19-53 years when injured. Data were structured and underwent two phases of analysis. In the first phase, data underwent latent content analysis, underpinned by a hermeneutic approach, and in the subsequent phase, reanalysed within a framework derived from the theory of social recognition.Findings from the first phase of inductive analysis elicited key themes: (i) the meaning of care, a question of formal and/or informal support; (ii) the meaning of action, a question of activity versus inactivity; (iii) autonomy, a question of dependence versus independence; (iv) social interaction, a question of encounter and/or treatment; (v) the theme of changes, a question of process versus stagnation; and (vi) emotions, an oscillation between hope versus hopelessness. After the construction of the six themes each of them were, through a discursive analysis, connected with theories, earlier studies in the field of brain injuries and important interview quotations from the empirical material. During this phase, an interest developed to study the material from a new theoretical point of view. The second phase of analysis therefore involved the development of a framework derived from Honneth’s (1995) theory of social recognition. The central construct of ‘recognition’ was analysed from three different dimensions proposed by Honneth: the individual dimension, the legal dimension, the value dimension. Using this framework, the data were reanalysed. The scientific term for this process of re-contextualisation and re-description of data is abduction inference.Reported consequences were negative as well as positive. Significant others (e.g. next of kin) had an important function as a driving force for training and preparation for life-situation after injury. A majority of the informants were satisfied with support from society, such as hospital-care, rehabilitation and community support. Such support, initially, proceeded without problems but as time passed, the responsibility shifted to the person with TBI to take the initiative in arranging longer-term services. Long-term support which addresses physical, cognitive as well as psychosocial consequences of the TBI is important for outcomes. The majority of the informants had difficulties in returning to working life after the injury. The outcomes and recovery seemed to be a prolonged process, probably never ending, but which gradually over time becomes integrated as a part of life. The informants gave varying accounts of the extent to which they experienced social recognition.
18.	Söderberg, Elisabet, 1975- (författare) Grynnor och farleder i karriärvalsprocessen : Unga med rörelsehinder och deras handlingsutrymme 2014 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract This thesis deals with the career choices of young adults (ages 18 through 40) with mobility impairments and the experiences they had throughout their career-selection process. The purpose of the study was: To find the inhibitory and furthering factors of the career choices of people with mobility impairments from their own perspective, with a special focus on how various factors affected the process over time. The method for collecting the results of this study was biographical interviews. The main theories of the study were Sense of Coherence, Self-efficacy, Learned Helplessness, Social Role Valorization and The Four Rooms of Change. The results show that mobility impairment affects career choices and that the effect is more often inhibitory than it is furthering. Structural factors, such as how the respondents are treated by other people, as well as rules and material barriers (stairs, mal-functioning elevators, etc.) are found to be more limiting than the body itself. Being over-protected is a main inhibitory factor which can contribute strongly to low self-efficacy and drainage of self-image for the respondents. The goal of the respondents is to obtain independence and a job based on their own terms, and not a social care career. This goal was found to form a vital resistance resource versus adversity and obstacles. The respondents consider themselves to be overprotected by society (by parents, teachers, career counsellors, employment officers, etc.) in relation to their career choices, and they would like not to be.
19.	Wahlqvist, Moa, 1979- (författare) Health and People with Usher syndrome 2015 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract The present thesis concerns people with Usher syndrome (USH) and their health. People with USH have a congenital hearing loss of various degrees and an eye disease with a progressive course; for some, the balance is also affected. Three clinical groups have been identified 1, 2 and 3, and 13 genes have currently been identified. USH is the most common cause of deafblindness. Clinical knowledge and the limited research that exists have shown that people with deafblindness can experience difficulties in everyday life. Depression, anxiety and social withdrawal have been described.The general aim of the present thesis was to describe the health of people with USH. The empirical material employed was based on an extensive survey in which people with USH answered two questionnaires concerning health, anxiety, depression, social trust, work, health-care, financial situation, and alcohol and drug use. The focus of the present thesis is on general health, physical health and psychological health, social trust and finance. Three studies in the present theses focus on USH1, 2 and 3, respectively; finally, the fourth study provides an in-group comparison of people with USH. The results of studies I and III are compared with a crosssection of the Swedish population. The results revealed poor physical and psychological health, a lack of social trust and a strained financial situation regardless of clinical diagnosis. The discussion stresses the importance of taking a biopsychosocial approach when describing the health of people with USH, in which previous research is lacking. Additional research should focus on the mechanisms at different levels that affect people with USH and their health from a life- course perspective. Furthermore, research should include a salutogenic perspective to explore the resources and strengths of people with USH.
20.	Warnicke, Camilla, 1971- (författare) Tolkning vid förmedlade samtal via Bildtelefoni.net : interaktion och gemensamt meningsskapande 2017 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract The Swedish Bildtelefoni.net is a service that people who use Swedish Sign Language (SSL) through a video phone can call in order to get in touch with people who speak through a telephone, or vice versa. In relayed calls via the Swedish video relay service (FBT), the interlocutors have different access to the visual arena and the auditive space. They are also physically separated from each other. An interpreter, working in a studio, enables the interaction across the different media, and the interpreter is the only person who has direct contact with both users of the service. FBT has been provided in Sweden since 1996, and is administrated by The Swedish Post and Telecom Authority (PTS).The overall aim of the dissertation is to describe, analyse and discuss participants’ interaction and their joint construction of meaning within FBT. The theoretical and methodological frameworks for the dissertation are dialogism and Conversation Analysis (CA). The dissertation is based on twenty-five authentic calls from FBT, recorded during two periods of time: in the years 2009–2010, and in 2013. One stimulated recall is also made with one interpreter, concerning a call from the second collection. The project has been ethically approved by the Swedish Ethical Review Board.The interaction within FBT is dynamic and dependent on different media, modalities, resources, and also related to several conventions specific for the setting. All this influences the interlocutors, their actions as well as the entire activity. This kind of complexity has not previously been studied in the regular service. Analysis of the recordings focuses on the actions and activities of the participants who interact in the FBT, on a moment-to-moment basis. As results of the research, four phenomena are addressed, and presented as papers: I: the organisation of turns; II: the headset as an interactional resource; III: positioning and bimodal mediation with a focus on the interpreter; IV: the co-creation of communicative projects among the interlocutors. A main conclusion of the results is that the interaction is a joint construction of meaning among all of the interlocutors, although, the interpreter has a key function.Further research of interaction within FBT needs to be conducted, since investigations on this institutional interaction are rare despite the fact that this kind of service is widespread all over the world.
21.	Boman, Tomas (författare) Situationen på den svenska arbetsmarknaden för personer med funktionsnedsättning : en sekundäranalys om sysselsättning, yrkesnivå, diskriminering, stöd och anpassning för personer med olika typer av funktionsnedsättning 2019 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract The overall aim of this thesis is to explore how the labour market situation appears to persons with different types of disabilities in Sweden. Study I (n=4 359) examined the importance of the person’s type of disability for the possibility of having a job. Study II (n=3 396) examined whether there were differences in occupational attainment between persons with different types of disabilities and between persons with and without a disability (n=19 004). Study III (n=4 359) examined perceived discrimination in the workplace among persons with different types of disabilities. Study IV (n=2 268) examined whatsupport and adaptation persons with different types of disabilities need in their actual workplace or to enter the labour market. In studies I–III the respondents were divided into six disability types, and in study IV the respondents were divided into four disability types.Overall, it can be concluded that a person’s type of disability is of importance for the situation in the labour market, where persons with psychological disabilities encounter barriers to a greater extent than other groups, both difficulties at the present workplace and difficulties entering the labour market. Further, they were subjected to discrimination and they expressed a great need for adaptations to acquire employment and at their actual workplace. It can also be concluded that there are discriminatory mechanisms against women, who have more difficulties than men in acquiring employment, and that men, despite lower education, can more easily progress in the labour market. It is suggested that, in order to achieve inclusion and recognition, factors in the environment, such as existing support systems, need to be changed and developed, and social prejudices vis-à-vis people with disabilities must also be addressed.
22.	Brunnberg, Elinor (författare) Vi bytte våra hörande skolkamrater mot döva! : Förändring av hörselskadade barns identitet och självförtroende vid byte av språklig skolmiljö 2003 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract This study is a comparative study with the aim of finding out whether the identity and self-confidence of hearing-impaired children changes when they attend schools with a different language base. The focus of the study was the interaction of hearing-impaired children with other children of the same age. The number of hearing-impaired children in this study was 29. The children were aged between 7 and 14 when the study began. In autumn 1994 special classes for hearing-impaired children in Örebro moved from a mainstream school to a special school for Deaf children. In the classroom, the hearing- impaired children in both the mainstream and the special schools were educated in spoken Swedish with signs as support. However, the dominant language outside the classroom changed from spoken Swedish to Swedish sign language. Two semi-structured interviews were conducted with the hearing-impaired children in 1994, before the move, and in 1996, after the move. At the same time the children's self-confidence was examined. In both the mainstream and the special school the children's play in the playground was video recorded. This study shows that several of the hearing-impaired children were socially isolated. Some even felt little solidarity with their classmates and were solitary. Most of the children were longing to meet more children in their spare time. The playground seemed to be the social arena where children with impaired hearing mainly met other children. The hearing-impaired children as a group were socially excluded and marginalized in the mainstream school. Most of the hearing-impaired children did not describe the same feeling of being outsiders in the special school as in the mainstream school. Most of the hearing-impaired children's confidence improved after the change of school. However, the hearing-impaired children's social situation was not perfect in the special school either. The playground is a central arena for hearing-impaired children in trying out their identity. In forming their identity children seem to look for other similarities. The hearing-impaired children experienced affiliation, equality and fellowship with other hearing-impaired children. They also expressed the opinion that Deaf children were "almost similar" to hearing-impaired children. The school situation that strengthens the identity of hearing-impaired children seems to be the school where they feel most at home with their schoolmates. That happened in the special school. However, some of the hearing-impaired children with multi-disabilities had difficulties in both the mainstream school and the special school and failed to find a secure identity as a hearing-impaired child. Unless school arrangements address their social needs, hearing-impaired youngsters could experience an identity crisis.
23.	Englund, Ulrika, 1976- (författare) Samverkansprojekt, och sen då? : en uppföljande studie av samverkansprocessen kring barn och unga som far illa eller riskerar att fara illa 2017 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Satisfactory collaboration regarding children and youth in need of a comprehensive support is particularly important. Despite extensive research on collaborative work, knowledge of long term development of the collaboration process is lacking. The present thesis concerns inter-organizational collaboration within the framework of a former Swedish policy effort – focusing collaboration between schools, social services, police and the child and youth psychiatry – for the benefit of children and young people in distress or at risk. Applying a critical realist perspective, the overall aim of the thesis is to describe how former collaboration projects develop over time, and to identify significant mechanisms within this development. Through three questionnaire studies, the collaborative process development within the same collaborative settings is described (n=66) over a period of close to seven years. Estimations of 58 collaboration quality indicators within three categories rules and regulations, structural aspects and *shared perspectives/ consensus were collected at baseline in 2008, after one year at the final project stage in 2009, as well as five years after the project period (and the policy effort) ended, in 2014 (n=38). Two developmental trends occur: I) an overall positive trend and II) a negative trend on a comprehensive level. I) Collaboration on the target group has increased over time, are mainly incorporated into permanent organizational structures and is judged to have worked well/very well over time. II) Overall deteriorations of high estimates of the 58 quality indicators for collaborations is seen over the five year period, following the project period. However, less dramatic changes is noted on quality indicators concerning shared perspectives/consensus than on matters regarding rules and regulations and structural aspects. Five mechanisms of particular importance for the collaboration development are identified: anchoring, holistic perspectives, engagement, knowledge and clarity.
24.	Jerlinder, Kajsa, 1976- (författare) Rättvis idrottsundervisning för elever med rörelsehinder : dilemma kring omfördelning och erkännande 2005 Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract Licentiate dissertation, written in Swedish with an English abstract.The educational goal of “a school for all” creates many challenges. Issues of socialjustice and equity are central tenets of the concept of inclusive education. Despitethe goal of comprehensive education for all children, for many pupils with physicaldisabilities in an inclusive school system PE (Physical Education) teaching canresult in experiences of injustice. In the struggle to achieve social equity and createeducational experiences where disability does not matter, it seams to matter verymuch.The aim of this study is to illustrate a dilemma and its potential outcomeswhere demands for justice for pupils with physical disabilities are raised in inclusivephysical education. In the study, based on theories of redistribution andrecognition, two empirical examples are presented.The first example, in the context of the decentralisation of Swedish compulsoryschools, illustrates degrees of awareness about numbers of pupils with physicaldisabilities attending compulsory schools located in a case municipality. Foursources, with varying responsibilities for disabled children, all reported differentnumbers of pupils. Thus, with no congruent data at municipality level, distribu-tion and redistribution of necessary resources becomes difficult.In the second example of a ten year old boy with a physical disability,experiences of participation in inclusive physical education are described, fromthe perspective of five different actors (the boy himself, his PE teachers (2), hisparents, classmates, and his personal assistant).Data for this case study was gathered through interviews and systematic ob-servation. In this particular case, the outcome of inclusive PE was judged to besuccessful. The example illustrates the importance of recognition needing to befulfilled at several distributive levels. The positive outcome is discussed in terms ofthe combination of identification of particular special needs, sensitive adaptation,and general respect for the child with physical disability.Dilemmas of justice for disabled pupils in physical education are best studiedwithin a multi-level context. Recognition and redistribution demands need to besimultaneously addressed in order to fulfil the goal of equitable education forpupils with physical disabilities attending PE within the compulsory school sys-tem. An attempt to combine these different ideological approaches is discussedfrom the perspective of social status.The outcome of the two empirical examples presented in this study illustrategeneral dilemmas reaching beyond the educational challenges facing pupils withphysical disabilities and the responses of the compulsory school system to them.
25.	Rehnman, Anna-Carin, 1955- (författare) Lära och Leva : Kunskapsutveckling hos personer med en ärftlig dövhet/hörselnedsättning 2013 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract The aim of this study is to explore the development of how people in different generations of a family with a hereditary hearing loss developed knowledge and to examine the role of the educational system and how it influenced this development.The research questions are:What is the prevalence of the deafness spoken of in the family chronicle?What different kinds of knowledge did the family members with deafness/hearing loss develop and how did they make use of them?In what ways may they have experienced their deafness/hearing loss as a suffering?What knowledge did they develop because the hearing loss recurred in several successive generations?The studied material includes answers from a questionnaire, different historical documents and sixteen interviews. Descendants of the first man born in the family in 1816 described as deaf. Among the descendants a total of 84 persons with a hereditary hearing loss have been found, at most in seven successive generations. The sixteen persons interviewed have spoken about themselves, their parent, mother or father-parent, with hearing loss. This has made it possible to explore the development of knowledge in different areas. The findings from the interviews are interpreted in four chapters where the development knowledge in the different generations has been related to each other and to the hearing loss.The study shows that the generations developed various forms of competence and knowledge and that this occurred mainly in the homes. The members of the family with hearing loss were educated by themselves. The role of public school was small. The last generation, however, has been able to carry out higher studies. The communicative practice at home was spoken Swedish, eye contact, a loud and clear voice and speechreading. The speech of children was read before the children themselves had to read the speech of others.
26.	Stålnacke, Helena, 1973- (författare) Fonologisk utveckling hos barn med otitbenägenhet : En longitudinell studie i åldrarna 3;6 – 5;6 år 2020 Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract Background: Hearing loss can act as a risk factor to poor linguistic development. One type of hearing loss is caused by fluid in the middle ear, a common consequence of acute otitis media (AOM). A number of children have ≥3 episodes of AOM within a 6-month period and are thus classifiedas otitis prones. Otitis proneness can result in fluctuation of the hearing experience that is believed to create inconsistency of the perceived speech signal and, thus, difficulties for the child to identify, categorize and produce speech sounds.Objective: The aims of the current study are to investigate, longitudinally the phonological development, concerning phonological production and phonological awareness, in children with otitis proneness and to compare their results with the results of the children without otitis proneness.Method: In total, 25 children with and 21 children without otitis proneness were involved in the study. Tests on phonological production (age 3;6 and 4;6) and phonological awareness (age 5;6) were performed onannual basis.Result: The comparisons between the study and the control group at the age 3;6, 4;6 and 5;6 years, reveal few significant results for either phonological production nor phonological development. For phonological production differences were seen at segmental level. The longitudinal development of phonological production indicate typical phonological development between age 3;6 and 4;6 for both test group and control group.Conclusion: Otitis proneness before 2;6 years of age does not appear to be an indicator of affected linguistic development at the ages 3;6 to 5;6 years, neither for phonological production nor concerning phonological awareness. However, there are great variations in the results, indicating that some children have greater difficulties than others do.
27.	Venizelos, Nikolaos, Professor, 1946-, et al. (redaktör/utgivare, creator_code:cre_t) Örebro University’s Nobel Day Festivities : Book of abstracts 2014 2014 Bok (övrigt vetenskapligt/konstnärligt)
28.	Yilmaz, Maria, 1961- (författare) Social interaction and participation in activities of everyday life among persons with schizophrenia 2009 Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract Difficulties in social interaction frequently accompany a diagnosis of schizophrenia and are an obstacle for participation in everyday life. The overall aim of this licentiate thesis was to develop knowledge about participation in everyday life among persons with schizophrenia. Four persons with schizophrenia, two men and two women, participated in the two studies in this thesis. Data were collected by participant observation (study I and II) and interviews (study II). The data collection took place in the participants’ personal environment and the activities and interactions under study were chosen out of their daily routines. The activities were performed together with one or more persons with a certain amount of regularity in the participant’s everyday life. Qualitative analysis methods were used in both studies. In the first study qualitative content analysis was used to analyse the data and resulted in two themes constituting the main result: Facilitating social interaction in activity performance and Hindering social interaction in activity performance. These two themes served as headings for sub-themes representing factors influencing social interaction in activity performance. A further analysis of the themes and sub-themes identified the following dichotomous contexts as influential: meaningful/not meaningful activity being performed; attitudes were trusting/lacking trust; and location, at home/outside the home. In the second study a narrative analysis was used to identify social processes of participation in performing activities of everyday life among person with schizophrenia by looking at what characterized the social processes that preceded or aggravated participation. Three plots constituted the main result in the second study: 1) To be met by respect, to receive attention from others and to have straightforward communication. 2) To take one’s own initiatives to perform meaningful activities together with others, to trust in one’s social environment and to mean something to others. 3) To take part in discussions and mutual decision-making facilitated by routines and structure. These results indicate several possibilities for supporting and promoting participation among persons with schizophrenia. To focus on the facilitating factors of social interaction and the social processes leading to participation in everyday life identified in this thesis could give health care professionals access to individual preferences and choices concerning meaningful activities, social environment and relationships, a knowledge that can be used to support the person with schizophrenia to gradually start or continue a process towards participation in everyday life.

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