Syftet med vårt arbete är att undersöka hur hemtjänstpersonal ser på problematisk alkoholkonsumtion i förhållande till självbestämmande bland äldre samt om det kan ha betydelse för deras omsorg av den äldre. Kvalitativa halvstrukturerade intervjuer genomfördes med hemtjänstpersonal (n=4) som analyserades hermeneutiskt utifrån teorier om makt och handlingsutrymme. Av resultaten framgår att självbestämmanderätten som Socialstyrelsen beskrivit den, är villkorad i hemtjänstpersonalens tolkning och att det saknas tydliga riktlinjer och rutiner i hemtjänstens arbete med äldre som har en problematisk alkoholkonsumtion. Resultaten visar att hemtjänstpersonalen gör individuella bedömningar i arbetet med äldre som har en problematisk alkoholkonsumtion. Det framgår att hemtjänstpersonalens arbete är förenat med svåra etiska ställningstaganden, där även maktförhållanden synliggörs och där hemtjänstpersonalen har tolkningsföreträde i förhållande till den äldre och förmynderi är en potentiell riskfaktor. En slutsats är att tydligare riktlinjer angående inköp av alkohol till äldre med en problematisk alkoholkonsumtion kan tänkas bidra till att hemtjänstpersonalen arbetar på ett mer likformigt sätt vilket i sin tur ökar rättssäkerheten för den äldre. / The aim of our study was to examine how integrity and self-determination is conceived by care assistants regarding older care takers with a problematic alcohol consumption, and if it affects their care provided. Qualitative semi-structured interviews, carried out with home care assistants (n=4) and analyzed hermeneutically with theories of power and discretion, showed that self-determination, as described by The Swedish National Board of Health and Welfare, is fulfilled only under certain conditions in the home care assistant’s interpretation. We also found a lack of guidelines and routines concerning problematic alcohol consumption among older care takers. Our results showed that home care assistants made individual assessments in their work with older care takers with problematic alcohol consumption actualizing a difficult ethical dilemma between neglect and paternalism. These ethical issues visualize power relationships where home care assistants have the prerogative to decide in relation to the care takers, where paternalism is a potential risk factor. Clear guidelines regarding the purchase of alcohol to older care takers with problematic alcohol consumption may contribute to home care assistants working more uniformly which leads to a higher state of legal security for the care takers.

- / Doctorat en Sciences Psychologiques et de l'éducation / info:eu-repo/semantics/nonPublished

Doctorat en sciences psychologiques / info:eu-repo/semantics/nonPublished

Guardianship maltreatment is one of the most harmful crimes to a society, but the literature is somewhat neglected about it, for example, in comparison with the offense of battering a person living in common dwelling, namely domestic violence. Even so, it devotes some attention, at least that part of the issue related to the particular child victims of this crime. Crimes against persons who are unable to care for themselves on their own and are dependent on the care of another person who subsequently hurting is the socially very harmful or even liquidation. This offense is special both in terms of characteristics of the offender, and in terms of its subject, which is a victim of this crime. The most important peculiarity is that the object of attack is a person who is in the care of another. That person is helpless, unable to care for themselves properly. This is followed by another peculiarity of this crime, which is the relationship of the perpetrator to the victim. This has to be helping the victim in dealing with matters of everyday life and be so supportive to him. Instead, he uses this dependence, helplessness and utter reliance of the victim's person and tortures him. The sad truth is that most of the crime is committed by family members of the victim, that the victim of the person closest to him to...

Pourquoi un événement en apparence si naturel qu’est l’accueil d’un bébé se révèle t-il si bouleversant et si complexe ? Pourquoi cette présence peut-elle provoquer joie et émerveillement ou angoisse et violence ? N’est-ce pas parce que l’enfant si vulnérable détient aussi une puissance créatrice ? Créateur de relations et d’émotions, il est d’emblée un être d’esprit. Il commence sa vie avec son lot, son daimon singulier. Suivant celui-ci il sera « jeté-dans-le monde » ou accueilli. Trait d’union entre les forces les plus archaïques et la civilisation, le très jeune enfant nous montre à quel point les mouvements de son corps sont le reflet de sa vie psychique. C’est pourquoi une attention aux soins de maternage, au jeu et aux activités d’éveil va être, avec ses parents, au coeur du processus d’intersubjectivité. Cette éducation première prenant sa source dans le soin est déjà de l’ordre du politique et suppose une éthique qui permette à l’enfant de s’épanouir et d’habiter le monde / A baby's arrival is such a natural occurrence: why does it cause so much upheaval? Why does its presence create so much joy and wonderment or else such angst and violence? Is it because the child possesses both vulnerability and colossal creative potential? Creator of relationships and of emotions, from the beginning, the child is a spiritual being. He starts out life with his fate, his particular daimon. After his arrival, he will be thrown in the world or he will be welcomed and integrated. As he is at the interplay between the most archaic forces and civilization, the very young child demonstrates that his physical movements reflect his psychic life. Along with his parents, maternal care, play, and his activities are at the core of the intersubjective process. The care of the child is his initial education and is already reflective of political acts and presupposes an ethic which will allow the child to blossom and to inhabit his world

Background: Childhood maltreatment is associated with the development and maintenance of mental disorders. The purpose of this naturalistic study was (a) to identify different patterns of childhood maltreatment, (b) to examine how these patterns are linked to the severity of mental disorders and (c) whether they are predictive of treatment outcome. Methods: 742 adult patients of a university hospital for psychotherapy and psychosomatics were assessed at intake and discharge by standardized questionnaires assessing depression (Beck Depression Inventory, BDI) and general mental distress (Symptom Check List-90-R, SCL-90-R). Traumatic childhood experience (using the Childhood Trauma Questionnaire, CTQ) and ICD-10 diagnoses were assessed at intake. Results: The patients could be allocated to three different patterns of early childhood trauma experience: mild traumatization, multiple traumatization without sexual abuse and multiple traumatization with sexual abuse. The three patterns showed highly significant differences in BDI, General Severity Index (GSI) and in the number of comorbidity at intake. For both BDI and GSI a general decrease in depression and general mental distress from intake to discharge could be shown. The three patterns differed in BDI and GSI at intake and discharge, indicating lowest values for mild traumatization and highest values for multiple traumatization with sexual abuse. Patients with multiple traumatization with sexual abuse showed the least favourable outcome. Conclusion: The results provide evidence that the severity of childhood traumatization is linked to the severity of mental disorders and also to the treatment outcome in inpatient psychotherapy. In the study, three different patterns of childhood traumatization (mild traumatization, multiple traumatization without sexual abuse, multiple traumatization with sexual abuse) showed differences in the severity of mental disorder and in the course of treatment within the same therapy setting.

Philosophiae Doctor - PhD / The primary intent of this study was to seek solutions to the practical problems experienced by practitioners in their management of child abuse cases. A fundamental problem regarding the current management of child abuse is that there is no guarantee that a child entering the child protective system will be dealt with in terms of a set procedure and/or protected against further abuse. To address this problem in the Western Cape, the Intervention Research (IR) methodology (Rothman & Thomas, 1994) was used to develop a Protocol for the Multi- Disciplinary Management of Child Abuse and Neglect. The protocol was designed for agencies that intervene in instances of child abuse. It establishes criteria and procedures for interdisciplinary co-ordination and effective case management, delineates the professional roles and responsibilities and provides step-by-step intervention procedures. The Intervention Research Design and Development methodology provided a useful framework to apply social science research methods to child protective practice and policy reform. IR focuses on the design of practice guidelines for intervention and policy reform. It can be conducted in a diversity of practice settings and therefore enhances collaborative efforts and inter-agency exchange among practitioners and among practitioners and universities. The study evolved through six phases involving inter-as well as intra-disciplinary activities. These activities were guided by systematic and deliberate research procedures, techniques and instruments. The research phases included: problem analysis; information gathering and synthesis; the development and design of the protocol; testing the protocol through a process of workshops and finally, the launch and dissemination of the protocol. A core element of the study was the active participation and collaboration of a broad range of key stakeholders, including: victims of child abuse, their families, service providers, and policy makers. The methods and instruments used were therefore designed to enhance participation and included interviews, workshops and observation of court processes. The bottom-up approach and collaborative design enhanced the level of contextual relevance, ownership and the commitment of stakeholders. As a demonstration of this commitment, the protocol has been endorsed by the Ministry of Justice and the Ministry of Health and Social Services of the Western Cape. The Department of Social Services has committed financial support to the project and is pilot testing it in three districts. The study cautions that protocols alone cannot eradicate and solve all the problems in the child protective field and asserts that there is an urgent and critical need to develop and to implement a National Strategy on Child Abuse. Such a National strategy should include legislation that supports and enforces all aspects of a national policy on child abuse. At minimum, national policy should ensure consistent political will and leadership. This means that broad statements about the obligations of politicians and state officials is not enough. These should be followed by specific accountability and measuring mechanisms for enforcement. State policy should also provide guidelines for standardized and appropriate working conditions, recruitment and training of staff. Furthermore, it should provide for a broad array of effective and accessible services to all children and families and the co-ordination of such services. Finally, legislation should include specific obligations regarding the appropriation of adequate and flexible funding to see that commitments made to children are realised.

This thesis focuses on the skills necessary to detect children being at risk from the adults in their surroundings based on the signals that the children manifest. The specific signs are described in the theoretical part, for example, different child expressions (on psychological, physical or behavioural level etc.) which can accompany risk exposure. The thesis also focuses on analysis of different environments in which these signals can be detected (family, school, medical examination etc.). Risk factors of children being exposed to danger in their own families are also analysed. Knowledge of these factors can facilitate the detection by surrounding people. The empirical part examines the signals most frequently used for the detection of children at risk by the adults in their proximity, as well as signs which don't get much attention (the adults are unable to perceive those signals, or they don't consider them as important). This analysis uses the data from "Children Crisis Center" (Dětské krizové centrum). Quantitative content analysis was used for the data survey. The quantity of signals registered by the family carers was compared to the quantity of signals only discovered by psychological examination. The conclusion reached by this analysis suggests, that family carers are not yet very...

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El objetivo del estudio fue determinar la relación entre las habilidades sociales y el autoconocimiento en adolescentes institucionalizados por situación de desprotección. El diseño de la investigación fue predictivo y correlacional, participaron 171 adolescentes de 12 a 17 años (hombres = 54%), se utilizaron la Escala de habilidades sociales de Goldstein (Tomás & Lescano, 2003) y la dimensión Autoconocimiento de la escala Arc-inico de autodeterminación (Requena, 2018); ambos con adecuadas propiedades psicométricas. Los resultados muestran correlaciones positivas y moderadas entre las dimensiones de habilidades sociales y autoconocimiento. Asimismo, las habilidades prosociales, de comunicación y proamicales son plausibles predictoras del autoconocimiento (R2=0.47). Por último, el rango promedio de las habilidades prosociales, relacionadas a los sentimientos y alternativas a la violencia, aumentan en función del tiempo de permanencia en la institución. Se concluye que las habilidades sociales se relacionan con el autoconocimiento y tienen un valor predictivo sobre la misma. / This research aimed to determine the relationship between social skills and self-awareness in institutionalized adolescents admitted due to vulnerable situation. A predictive and correlational design was used, there were 171 participants of both sexes from 12 to 17 years old (men = 54%). For data collection was used the Goldstein Social Skills Scale (Tomás & Lescano, 2003) and the Self-awareness dimension of the Arc-inico Self-Determination Scale (Requena, 2018). Appropriate psychometric properties were obtained from both instruments. Results shows positive and moderate correlations between all dimensions of social skills and self-awareness. Likewise, Prosocial, communication and pro friendly skills could predict self-awareness (R2=0.47). The mean rank of Prosocial skills, feelings related skills and alternative skills to violence increases in relation of the permanency time in the institution. It is concluded there is a relationship between social skills and self-awareness. Prosocial, communication and pro friendly skills better predict self-awareness. / Tesis