| 1. |
- Bengtsson, Staffan, 1970-
(författare)
-
Varför får jag icke följa med dit fram? : Medborgarskapet och den offentliga debatten om dövstumma och blinda 1860–1914
- 2005
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Different kinds of cultural studies can be used in order to learn more about disability, social policies, attitudes and citizenship. The purpose of this study is to outline some aspects of disability and Swedish society during the 19th century. The ambition is to analyse the issue of the integration of the deaf-mutes and the blind. How did politicians and educators motivate the establishment of compulsory schooling? How was the issue of correction of the body treated? How did they deal with the situation on the labour market? What kind of compensation was contemporary society willing to support? Social policies in the past are likely to be described in terms of control, repression and barriers. This study looks at disability from a more anthropological view which implies the use of hermeneutics, seeking to identify the agent’s own understanding of a problem in order to learn more about how social categorisation and citizenship are integrated and how they change. The use of original sources, such as records from the Swedish parliament and conferences held by experts as well as periodicals, makes this kind of approach possible.This thesis argues that disability must be understood as something that is constantly in the arena of a more dialectical struggle where a number of visions and interests have melted together. In the course of state interventionism and growing social justice, citizenship and disability to a greater extent became a question of honour. Being granted certain rights meant that the individual had passed the test and was now sanctioned as disabled, one who deserved the right to rights. This transition promoted a growing group consciousness. A more dialectical approach perforates the border between social control and humanity since they were not always mutually exclusive.
|
|
| 2. |
- 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.
|
|
| 3. |
- Dahlström, Örjan, 1973-
(författare)
-
Focus on Chronic Disease through Different Lenses of Expertise : Towards Implementation of Patient-Focused Decision Support Preventing Disability: The Example of Early Rheumatoid Arthritis
- 2009
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disease. Treatment strategies emphasize early multi-professional interventions to reduce disease activity and to prevent disability, but there is a lack of knowledge on how optimal treatment can be provided to each individual patient.Aim: To elucidate how clinical manifestations of early RA are associated to disease and disability outcomes, to strive for greater potential to establish prognosis in early RA, and to facilitate implementation of decision support through analyses of the decision-making environment in chronic care.Methods: Multivariate statistics and mathematical modelling, as well as field observations and focus group interviews.Results: Decision support: A prognostic tree that predicted patients with a poor prognosis (moderate or high levels of DAS-28) at one year after diagnosis had a performance of 25% sensitivity, 90% specificity and a positive predictive value of 76%. Implementation of a decision support application at a rheumatology unit should include taking into account incentive structures, workflow and awareness, as well as informal communication structures. Prognosis: A considerable part of the variance in disease activity at one year after diagnosis could be explained by disease progression during the first three months after diagnosis. Using different types of knowledge – different expertise – prior to standardized data mining methods was found to be a promising when mining (clinical) data for new patterns that elicit new knowledge. Disease and disability: Women report more fatigue than men in early RA, although the difference is not consistently significant. Fatigue in early RA is closely and rather consistently related to disease activity, pain and activity limitation, as well as to mental health and sleep disturbance.Conclusion: A decision tree was designed to identify patients at risk of poor prognosis at one year after the diagnosis of RA. When constructing prediction rules for good or poor prognosis, including more measures of disease and disability progressions showed promise. Using different types of knowledge – different lenses of expertise – prior to standardized data mining methods was also a promising method when mining (clinical) data for new patterns that elicit new knowledge.
|
|
| 4. |
- Danielsson, Henrik, 1974-
(författare)
-
Facing the Illusion Piece by Piece : Face Recognition for Persons with Learning Disability
- 2006
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Avhandlingens övergripande syfte var att undersöka ansiktsigenkänning för personer med och utan utvecklingsstörning. Tre specifika forskningsfrågor undersöktes:1. Hur ser interaktionen ut mellan familjaritet med ansikten och familjaritet med miljöer när det gäller bildigenkänning för personer med utvecklingsstörning?2. Kan någon av de 2 teoretiska ansatserna till förklaring av falska minnen (sammanblandning av olika minnen), bindingsansatsen och dubbelprocessansatsen, förklara prestationen för både personer med och utan utvecklingsstörning?3. Hur förhåller sig arbetsminnesförmåga till prestation i studier av falska minnen?Resultaten i de 4 artiklarna som ingår i avhandlingen gav svar på frågorna:1. Interaktionen mellan familjaritet med personer och miljöer kan förklaras med förhållandet mellan personen och miljön, som antingen kan vara frånvarande, närvarande eller osannolikt. Dessa semantiska relationer bestämmer prestationen och en ”lat” semantisk strategi föreslogs.2. Beroende på uppgiftens svårighetsgrad framkom olika interaktionsmönster mellan grupp och typ av igenkänningsbild, och då särskilt olika antal sammanblandade bilder. Dessa mönster kunde inte förklaras av någon av de 2 teoretisk ansatserna. Därför föreslås ett nytt sätt att tolka resultaten som inkluderar arbetsminne.3. Hög arbetsminneskapacitet gav 2 effekter: för det första, igenkänning av fler ansiktsdelar, och för det andra, igenkänning av fler ansiktskonfigurationer. Vid höga arbetsminneskrav så används den första effekten mer på bekostnad av den andra.Det visade sig också att prestationen för personer med utvecklingsstörning på uppgifter med låga arbetsminneskrav liknade prestationen för åldermatchade kontrollpersoner utan utvecklingsstörning på uppgifter med höga arbetsminneskrav. Detta indikerar att utvecklingsstörning kan ”simuleras” genom högre arbetsminneskrav, åtminstone på denna typ av igenkänningsuppgifter. Resultatens implikationer för vittnespsykologi och användandet av fotografier som kognitivt stöd diskuteras.
|
|
| 5. |
- Edvardsson, Tanja
(författare)
-
Consequences of brain tumours from the perspective of the patients and of their next of kin
- 2008
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A disease has consequences not only for the afflicted person but also for those who interact with him or her. A low-grade glioma is a brain tumour whose regarding its psychosocial implications for adult patients and their next of kin has received little attention in the literature. In the light of this the overall aim of the present thesis was to provide increased knowledge about how patients with low-grade glioma and their next of kin experience and deal with everyday life.The methods of the studies were mainly qualitative. Thirty-nine patients and 28 next of kin were interviewed and all except one next of kin completed a quality of life questionnaire.The onset of low-grade glioma was described from the patients’ perspective as a process, either rapid (up to a few months) or prolonged over several years. This phase of low-grade glioma encompassed repeated visits to physicians and care institutions. The onset of low-grade glioma was accompanied by stress, anxiety and uncertainty in the case of both the patients and those nearest. The symptoms and problems the patients experienced covered a broad range of consequences, physical, psychological and social. The patients presented a wide range of ways to cope with illness-related problems.The next of kin were often deeply involved in the patients’ situation and many of them experienced extremely stressful emotions mainly in the early period of the illness. They had experience of positive encounters in health care but more often they had had a sense both of powerlessness and of being invisible and neglected. Relations and roles changed in ways that mostly were experienced as negative. Enabling strength in everyday life had to do with alleviation of strain and having a positive outlook upon life. By means of the questionnaire Subjective estimation of Quality of Life (SQoL) the patients and those nearest estimated their quality of life as being comparatively high. Only one variable, among the patients the absence of work/meaningful occupation and among the next of kin the absence of own children, being estimated at below 60% of the maximum score.
|
|
| 6. |
- Ferreira, Janna, 1973-
(författare)
-
Sounds of silence : Phonological awareness and written language in children with and without speech
- 2007
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Avhandlingens övergripande syfte var att undersöka fonologisk medvetenhet och skriftspråklig förmåga hos talande eller icke-talande barn, med lässvårigheter eller motoriska talsvårigheter. De huvudsakliga fynden i denna avhandling var: (1) För barn med lässvårigheter som befinner sig på en tidig nivå i sin läsutveckling bör intervention kring läs- och skrivförmågor fokusera på barnets svaghet snarare än styrkan vad gäller ordavkodning. (2) För barn med lässvårigheter hade såväl fonologisk som ortografisk intervention effekt på förmågan att läsa och skriva. Fonologisk intervention hade effekt även på barnen med lägst läsförmåga. (3) För barn med motoriska talsvårigheter var det signifikanta skillnader mellan de bästa och de sämsta läsarna vad gäller auditiv fonemdiskrimination och generella språkförmågor. (4) För barn med motoriska talsvårigheter hade fonologisk intervention effekt på förmågan att stava ord men inte på läsförmågan. (5) I en analys av nonsensord undersöktes stavfel hos en flicka med anartri. Fler stavfel återfanns i längre ord och en högre grad av fel återfanns i mitten av ord, vilket tyder på svårigheter med arbetsminne och med att segmentera ord.Fynden diskuteras i relation till fonologisk informationsbearbetning inom fyra delområden: fonologiska representationer, fonologisk produktion, fonologiskt minne och fonologisk medvetenhet. Talets betydelse för läs- och skrivförmågan är komplex. Även ett gravt avvikande tal kan ge fonologisk återkoppling och för barn med anartri tycks bristen på tal spela en viss roll.Denna avhandling har ett handikappvetenskapligt synsätt och bidrar till den övergripande förståelsen av fonologisk medvetenhet och skriftspråklig förmåga. Flera av fynden är direkt applicerbara i kliniska sammanhang.
|
|
| 7. |
- Hällgren, Mathias, 1972-
(författare)
-
Hearing and cognition in speech comprehension. Methods and applications
- 2005
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Central auditory processing is complex and can not be evaluated by a single method. This thesis focuses on assessment of some aspects of central auditory functions by the use of dichotic speech tests and cognitive tests that tax functions important for speech processing.Paper A deals with the cognitive effects in dichotic speech testing in elderly hearing-impaired subjects. It was found that different listening tasks in the dichotic tests put different demands on cognitive ability, shown by a varying degree of correlation between cognitive functions and dichotic test parameters. Age-related cognitive decline was strongly connected with problems to perceive stimuli presented to the left ear.Paper B presents a new cognitive test battery sensitive for functions important for speech processing and understanding, performed in text, auditory and audiovisual modalities. The test battery was evaluated in four groups, differing in age and hearing status, and has proven to be useful in assessing the relative contribution of different input-modalities and the effect of age, hearingimpairment and visual contribution on functions important for speech processing.In Paper C the test battery developed in Paper B was used to study listening situations with different kinds of background noise. Interfering noise at +10 dB signal-to-noise ratio has significant negative effects on performance in speech processing tasks and on the effort perceived. Hearing-impaired subjects showed poorer results in noise with temporal variations, and elderly subjects were more distracted by noise with temporal variations, especially by noise with meaningful content. In noise, all subjects, particularly those with impaired hearing, were more dependent upon visual cues than in the quiet condition.Hearing aid benefit in speech processing with and without background noise was studied in Paper D. The test battery developed in Paper B was used together with a standard measure of speech recognition. With hearing aids, speech recognition was improved in the background condition without noise and in the background condition of ordinary speech. Significantly less effort was perceived in the cognitive tests when hearing aids were used, although only minor benefits of hearing aid amplification were seen. This underlines the importance of considering perceived effort as a dimension when evaluating hearing aid benefit, in further research as well as in clinical practice.The results from the studies contribute to the knowledge about speech processing but also to the search for more specific evaluation of speech understanding, incorporating both sensory and cognitive factors.
|
|
| 8. |
|
|
| 9. |
- 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.
|
|
| 10. |
- Keselman, Olga
(författare)
-
Restricting participation : Unaccompanied children in interpreter-mediated asylum hearings in Sweden
- 2009
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall goal of this thesis was to highlight different communicative aspects of participation in interpreter-mediated asylum hearings with unaccompanied Russianspeaking children who had applied for asylum in Sweden between 2001 and 2005. Participation in the asylum process is guaranteed to these children by the Swedish Administrative Law and the Convention on the Rights of the Child (CRC), which are incorporated in the Swedish Aliens Act. The Migration authorities in their work with asylum seeking minors have integrated principles of the best interests of the child and the principle of respecting the children’s views on matters concerning them.In this thesis, we have studied the conditions of participation in a highly complex, hybrid activity type, where participants face contradictory demands. Hybridity can be traced in communicative dilemmas which are difficult to solve and handle for all the participants involved, including the caseworkers, interpreters and children. The caseworkers are expected to control an interview in which whole of the communicative exchange is rendered by interpreters who influence the progress of the encounter. Contradiction lies in the fact that the caseworkers are expected to treat all asylum seekers equally both as a group and individually, by relating to general legal regulations and at the same time, take into account the interests and individual needs of an individual child. It might be difficult for these caseworkers to stay neutral and meet underage clients whose life stories and experiences, conduct and needs differ considerably from what is usually ascribed to children.Asylum seeking children come to Sweden to stay. Our results have shown that they take an active role in their attempts to lead to a positive outcome in their cases. In this respect, children’s testimonies and the impression they make as informants play a salient role. The communicative tasks faced by the adolescents are, however, difficult to achieve. Previous life conditions, vulnerability, psychosomatic problems, and memory and concentration difficulties may affect their performance. Other factors which might further impede these children from achieving their task is the pragmatic and linguistic deficiency, which they experience in a context where they lack communicative means and are not fully aware of the norms and regulations relevant for the encounter. Despite hese limitations, it seems that these minors try hard to shoulder their role as asylum seekers and informants actively and strategically. One strategy chosen by the children was to disclose information selectively. They tried to avoid answering questions which could reveal their age, origin or the whereabouts of their caregivers and thereby enable authorities to establish their identity and send them back. To compensate for their uncooperativeness in this area, the adolescents tended to provide information which had not been asked for.Our studies have shown that children could have been prevented by both the caseworkers and interpreters from expressing their views and opinions in a free and self-chosen way. In this respect, interpreters’ contributions were salient for what information was forwarded to the caseworkers. In some cases, they changed both the language and the format of the responses provided by the children. Some of the communicative strategies which were initiated by the interpreters could be linked to both their professional skills and to the hybridity and the complexity of the situation. Interpreters had difficulties staying neutral in relation to the children and orient them in the encounters. Age differences between the participants could also have an impact on how the children were treated and the respect and importance attributed to their voices. We have identified sequences where interpreters initiated monolingual exchanges with one of the interlocutors where they actively tried to exclude and discredit the children’s voices, something which often happened with the tacit approval of the caseworkers.Thus, it can be seen that communicative premises which are inherent in the asylum hearings influence the participant statuses of the children and their possibilities to express their asylum claims.
|
|
| 11. |
- Käcker, Pia, 1952-
(författare)
-
Nycklar till Kommunikation : Kommunikation mellan vuxna personer med grav förvärvad hjärnskada och personernas närstående, anhöriga och personal
- 2007
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Studien fokuserar kommunikation mellan vuxna personer med grav förvärvad hjärnskada och deras närstående. Syftet är att med utgångspunkt från de närståendes berättelser beskriva hur kommunikationen manifesteras, samt att ge en teoretisk beskrivning av vilka faktorer som understödjer respektive motverkar kommunikationen. Elva gravt hjärnskadade personer ingår i studien. Orsaken till hjärnskadan är stroke, traumatisk hjärnskada eller syrebristskada. Personernas ålder varierar från 16 till 64 år vid skadetillfället. Samtliga har som en följd av hjärnskadan grava språkstörningar och kognitiva funktionshinder. Datamaterialet baseras på intervjuer och videofilm. Den teoretiska utgångspunkten är symbolisk interaktionism och den metod som används är grundad teori.Resultatet presenteras i en empiriskt grundad teoretisk modell för hur kommunikation hos studiens aktörer manifesteras. Kommunikationsmodellen innehåller kärnprocessen, kommunikationsnycklar. De öppnande nycklarna består av inledande och vidmakthållande faktorer, samt av den betryggande faktorn. Den senare får stor betydelse, utan den kommer inte kommunikationen till stånd. Resultatet diskuteras i förhållande till sociala kommunikationsteorier och begreppet kommunikativ kompetens. Teorin förväntas ge de närstående stöd i hur de förhåller sig i mötet med en person som har ett kommunikativt funktionshinder.
|
|
| 12. |
- Larsson Abbad, Gunvor, 1970-
(författare)
-
Aspergern, det är jag : En intervjustudie om att leva med Asperger syndrom
- 2007
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall purpose of this interview-study is to increase the knowledge and understanding of persons with Asperger syndrome. For each participant has common and unique aspects been described. The ambition has been to illuminate their perspective of their situation in life and develop the understanding of their quality of life. The participants’ experiences of their diagnosis, and its consequences in their life has been studied. Several aspects of their everyday life have been reported, i.e. schooling, occupational problems, spare time and interests. The results show that the participants may experience their life as hard, as seemingly uncomplicated chores prove to be exhausting. Not fitting with the norms they believe other people in society have, is one aspect of experienced difference.The diagnostic process has proved to be an important event in the life of the participants. It has been described as a way of taking control over one’s life. Their experienced difference may be acceptable to them, if it is in the form of an Asperger diagnosis. Experiences of chock, denial and ambivalence after receiving their Asperger diagnosis were also reported. However, all participants have accepted their diagnosis.The participants’ biologically different way of being has given them consequences. Both psychological and social consequences have been illustrated, as well as interpersonal and societal. Disability research theory (Danermark, 2005; Rönnberg & Melinder, 2007) and Bronfenbrenner’s ecological systems theory (1979) have been used to illustrate the outcome of a diagnosis like Asperger syndrome. The study shows the participants’ experiences of their different way of being.
|
|
| 13. |
- Levén, Anna, 1976-
(författare)
-
Postponed Plans : Prospective Memory and Intellectual Disability
- 2007
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Avhandlingen handlar om prospektivt minne (PM) hos personer med utvecklingsstörning. PM syftar på att formulera intentioner och genomföra dessa någon gång i framtiden, antingen inom en definierad tidsram eller i samband med en specifik händelse.Frågeställningar:1. Finns det en kvalitativ och kvantitativ skillnad mellan prospektivt minne hos personer med utvecklingsstörning och en kontrollgrupp? (Artikel I – II)2. Hur ser sambandet mellan prospektivt minne, arbetsminne och episodiskt minne ut hos personer med utvecklingsstörning och, skiljer sig detta åt jämfört med kontrollgruppen? (Artikel II)3. Vilka förutsättningar vid inkodning och hågkomst är kompatibla? (Artikel III)4. På vilket sätt kan svag association mellan olika delar av information bidra till prospektiva minnesfel? (Artikel IV)5. Går det att särskilja en hög- respektive lågpresterande grupp personer med utvecklingsstörning med avseende på prospektiv minnesprestation? (Artikel II)Personer med utvecklingsstörning begår fler prospektiva minnesfel än personer i kontrollgruppen. Motsvarande gruppskillnad finns inte för självskattat minne. Prospektiv minnesprestation är bättre med bilder jämfört med ord som prospektiva ledtrådar, mest tydligt för personer med utvecklingsstörning. Arbetsminneskapacitet visade ett samband med både prospektivt minne och antalet falska minnen i kognitivt krävande situationer, till exempel, situationer med flera parallella prospektiva minnesuppgifter. Falska minnen och prospektivt minne hade ett samband hos personer med utvecklingsstörning. Att felaktigt känna igen bilder med bara delvis bekanta delar och att känna igen prospektiva ledtrådar utan att komma ihåg själva intentionen hade ett samband hos personer med utvecklingsstörning. Personer med utvecklingsstörning var också sämre än kontrollgruppen på att upprepa tidsintervall. Detta kan till exempel bero på bristande episodiskt minne och begränsade strategier för att lösa den här typen av uppgifter. Resultaten diskuteras i relation till träning av prospektivt minne och val av hjälpmedel.
|
|
| 14. |
- 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.
|
|
| 15. |
- Rudner, Mary, 1958-
(författare)
-
Modalities of Mind : Modality-specific and nonmodality-specific aspects of working memory for sign and speech
- 2005
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Language processing is underpinned by working memory and while working memory for signed languages has been shown to display some of the characteristics of working memory for speech-based languages, there are a range of anomalous effects related to the inherently visuospatial modality of signed languages. On the basis of these effects, four research questions were addressed in a series of studies:1. Are differences in working memory storage for sign and speech reflected in neural representation?2. Do the neural networks supporting speech-sign switching during a working memory task reflect executive or semantic processes?3. Is working memory for sign language enhanced by a spatial style of information presentation?4. Do the neural networks supporting word reversal indicate tongue-twisting or mind-twisting?The results of the studies showed that:1. Working memory for sign and speech is supported by a combination of modality-specific and nonmodality-specific neural networks.2. Switching between sign and speech during a working memory task is supported by semantic rather than executive processes.3. Working memory performance in educationally promoted native deaf signers is enhanced by a spatial style of presentation.4. Word reversal is a matter of mind-twisting, rather than tongue-twisting.These findings indicate that working memory for sign and speech has modality-specific components as well as nonmodality-specific components. Modality-specific aspects can be explained in terms of Wilson’s (2001) sensorimotor account, which is based on the component model (Baddeley, 2000), given that the functionality of the visuospatial sketchpad is extended to include language processing. Nonmodality-specific working memory processing is predicted by Rönnberg’s (2003) model of cognitive involvement in language processing. However, the modality-free, cross-modal and extra-modal aspects of working memory processing revealed in the present work can be explained in terms of the central executive and the episodic buffer, providing the functionality and neural representation of the episodic buffer are extended.A functional ontology is presented which ties cognitive processes to their neural representation, along with a model explaining modality-specific findings relating to sign language cognition. Predictions of the ontology and the model are discussed in relation to future work.
|
|
| 16. |
- 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.
|
|
| 17. |
- Thyberg, Ingrid, 1951-
(författare)
-
Disease and disability in early rheumatoid arthritis : A 3-year follow-up of women and men in the Swedish TIRA project
- 2005
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Rheumatoid arthritis (RA) is a chronic inflammatory disease, which often leads to disability. This study is based on three years’ follow-up data generated by patients included during 27 months 1996-1998 in a Swedish multi-centre project named ‘early interventions in rheumatoid arthritis’ (TIRA). Disease activity, disability and health-related quality of life (HRQL) were assessed by clinical and laboratory analyses, and self-reported estimations. The course during three years and relations between clinical/laboratory assessments versus HRQL were studied separately in women and men. The relation between grip force and self-reported activity limitations was analysed, and finally the use and effects of assistive devices were evaluated separately for women and men.Clinical/laboratory assessments and self-reported HRQL were substantially affected at the time for diagnosis, but the relations between clinical/laboratory assessments and self-reported HRQL were weak. Among the studied clinical/laboratory variables used here grip force, walking speed, and possibly physician’s global assessment of disease activity showed most stable relationships with the HRQL. However, the time course of clinical/laboratory and selfreported HRQL measurements followed similar patterns. Thus, most variables had improved considerably at the 3- and 6-months’ follow-ups and then remained stable but still affected over three years. An exception was the SF-36 scale ‘general health’, which was reduced to the same extent during the whole study period.As judged by the ‘Health Assessment Questionnaire’ (HAQ) and ‘Evaluation of Daily Activities Questionnaire’ (EDAQ), activity limitations were more pronounced in women than in men. By contrast, as reflected by ‘Signals of Functional Impairment’ (SOFI), men had slightly more affected function of the hands and upper extremities. Women with RA had about half of the grip force compared to male patients, which is in accordance with the differences between healthy women and men. At diagnosis, the grip force was reduced to about 30% in RA patients compared to healthy referents of the same sex. Already three months later, it improved but was still reduced to about 50% of healthy referents.Further analyses revealed that HAQ and EDAQ were strongly related to grip force independently of sex. Grip force below 114 N was found to be associated with substantial activity limitation in women as well as in men. Assistive devices (ADs) were more frequently used by women (78%) than men (54%), and were found to reduce activity limitations. The subgroups of women and men using ADs were comparable regarding disease activity and disability, and were generally more affected regarding activity limitations, compared to the subgroups that did not use ADs. Within the subgroups of patients using ADs, women and men had equivalent HAQ status and ADs were reported to reduce activity limitations in both women and men with recent-onset RA.The weak relation between clinical/laboratory assessments and self-reported HRQL supports the results by others. By means of HAQ, more pronounced activity limitations have been reported previously in women with RA, compared to male patients. In the present study, similar differences were recorded by EDAQ. Further analyses showed that reduced grip force was closely related to activity limitations independently of sex. This offers a new explanation to poor female outcome recorded by HAQ.
|
|
| 18. |
- Wass, Malin
(författare)
-
Children with Cochlear Implants : Cognition and Reading Ability
- 2009
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The present thesis investigated cognitive ability in children with severe to profound hearing impairment who have received cochlear implants (CIs). The auditory stimulation from a cochlear implant early in life influences most cognitive functions as a consequence of the plasticity of the brain in the young child. It is important to understand the cognitive consequences of auditory stimulation from CIs in order to provide adequate support to these children. This thesis examined three specific aspects of cognitive ability (working memory, phonological skill and lexical access), and reading ability in children with CIs, as compared to children with normal hearing in the same age. The relations between cognitive abilities and reading skills were also investigated, as well as the associations between demographic variables (e.g., age at implantation and communication mode), cognitive abilities and reading skills. The children with CI generally had lower performance levels than the normal hearing children in tasks of phonological and general working memory, phonological skills and lexical access. They had specific problems in tasks with high demands on phonological working memory, whereas their performance levels in tasks of visuospatial working memory were on par with the hearing children. A majority of the children with CI demonstrated reading skills within the normal range for hearing children, both for decoding and reading comprehension. The relations between demographic factors and cognitive skills varied somewhat between the studies. The patterns of result are discussed with reference to contemporary theories of working memory, phonological skills, and lexical access.
|
|
| 19. |
- 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.
|
|
| 20. |
- Öberg, Marie, 1962-
(författare)
-
Approaches to Audiological Rehabilitation with Hearing Aids : studies on pre-fitting strategies and assessment of outcomes
- 2008
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Fourteen percent of the Swedish population report subjective hearing loss. The number of persons suffering from hearing loss is expected to increase in accordance with the increased length of the average life span, causing an associated increase in the demand for hearing health care services as new patient groups who expect a higher quality of life begin to request hearing care. The main goal of this thesis was to develop new approaches in audiological rehabilitation to meet these demands and achieve user satisfaction.Two randomized controlled trials including 39 and 38 subjects, respectively were performed that evaluated two interventions, user-controlled adjustment and sound awareness training, which were performed prior to a hearing aid fitting. The new approaches focused on increasing user participation and activity. To evaluate the goals of audiological rehabilitation, e.g., reducing auditory impairment, optimizing auditory activities and minimizing participation restrictions, several standardized self-reporting instruments were used to assess activity limitations, participation restriction, satisfaction and psychosocial well-being. Several of the instruments were validated for a Swedish population in a postal survey including 162 subjects. Furthermore, an interview instrument that was appropriate for telephone interviews and a categorization rating scale were developed for assessing the global clinical impression of the audiological rehabilitation.Few significant differences in outcomes were found between the treatment and control groups in the short term, and the interventions did not achieve additional or more successful hearing aid users in the long term. Thus, it was concluded that the hearing aid rehabilitation was effective in and of itself, as both the treatment and control groups showed significant improvements in psychosocial well-being and reduced activity limitation and participation restriction. The self-report instruments were found to be valid, and a factor analysis indicated that the number of questionnaires could be reduced with a recommendation for further clinical use. The telephone interviews evaluating the clinical global impression of the audiological rehabilitation were found to be effective and showed success in a vast majority of the users. Advantages such as simpler administration and less time consumption warrant their continued use in additional audiological settings.The pre-interventions in these studies need to be further investigated before they could be recommended for clinical use also in a Swedish context. The international standardized self reports, however, can already be recommended for clinical use. A first attempt to evaluate global clinical impression by telephone interviews was found to be effective and further validations are suggested.
|
|
