Background and aims: The individual’s experience of living with epilepsy is often neglected with the dominant focus being upon seizure control. However, the experience of living with epilepsy is more than the seizures. Epilepsy is an illness that is understood in many different ways and the narratives the person draws from will impact their own understanding, experience and management of the condition. Based upon this gap in the literature this study sought to hear the narratives of people diagnosed with epilepsy in adulthood as told to an outsider with the hope of developing understanding, informing clinical practice and improving support for people diagnosed with epilepsy in adulthood. Methodology: A qualitative approach was chosen for this project. A purposive sample of eight individuals diagnosed with epilepsy in adulthood was recruited. Individual interviews were conducted, audio-recorded and transcribed. Narrative analysis was used to analyse the transcripts with a focus upon both what was spoken about and how it was told. Analysis and findings: Each participant is introduced individually, presenting a ‘global impression’ of their narrative. This is followed by a consideration of the similarities and differences across all participants under the shared plots of stories of: onset; changes and challenges; and meanings of epilepsy. Within the shared plot of stories of onset are the storylines of ‘affirmation’ of self; ‘continuation’ of self; biographical disruption and searching for a cause. Within the changes and challenges shared plot there are storylines of: dependency; emotional expression; ‘I try to think positively’ and ‘It’s like talking about someone else.’ Within the final shared plot of meanings of epilepsy there are storylines of: something ‘normal’; something ‘all a bit scary’; something ‘people used to get locked up for’; a ‘hidden illness’ and ‘it’s not to be spoken about.’ The narratives show that having epilepsy is a journey that has different effects on people at different times of their lives and in different contexts. The findings are discussed in relation to clinical implications; strengths and limitations of the methodology and directions for future research.

Institutions of higher education in the United States have long been attractors for international students from all over the world. The number of international students had been constantly growing until the past couple of years. This is a concerning issue because international students play several important roles in higher education institutions. International students bring different points of view that enhance other students’ learning and institutions gain financial benefits from the presence of international students. Thus, it is important to understand how to improve the experience of international students. For the present study I used a phenomenological approach to explore the experiences of international students and their spouses. Participants in this study included 16.5 dyads from 12 different countries. The sample included both graduate international students and their spouses for various reasons. When studying acculturation, studies have traditionally focused on undergraduate students. The needs and experiences of undergraduate students are different from graduate students because they are usually in a different stage of life. It is also true that graduate students often relocate with their dependents, unlike undergraduate students, and therefore they have different challenges and responsibilities. It is important to include spouses because they are often an invisible population. Dependents have critical limitations such as the prohibition to work or study. This study was conducted through the lens of biographical disruption and participants’ accounts were analyzed to better understand the added communication work that they must manage. The findings showed that there was a relationship between acculturation categories and the amount and type of acculturation work. Finally, the study shows how international students and their dependents reconstruct their biographies by molding their identities. This study should be used to create new policies and services for international students and their dependents.

A cancer diagnosis often causes biographical disruption in the lives of young adult (i.e., 18-39; YA) survivors and their close social network members (i.e., familial, plutonic, or romantic relational partners with whom the survivor has a salient relationship; SNM). In order to integrate their illness into their lives, normatively regain balance and equilibrium, and achieve a “new normal” following a cancer diagnosis, YA survivors and their close SNMs must work to reconstruct their biographies by engaging in tangible interpersonal communication processes often used to initiate and maintain relationships. However, YA cancer survivors report facing social struggles due to the biographical disruption of their illness across the trajectory of diagnosis, treatment, and survivorship. To learn more about their unique social experience of cancer, I conducted private, open-ended narrative interviews with 20 YA survivor-close SNM dyads, 1 YA survivor-SNM close triad, and 10 individual YA survivors (N = 51). I used thematic narrative analysis to determine how and why YA cancer survivors and their close SNMs communicate social support messages with romantic partners, family, friends, peers, and one another. By examining the narratives of YA survivors, their close SNMs, and the dyad itself, this dissertation explores the interpersonal communication processes used to initiate and maintain relationships across the illness trajectory by focusing on the barriers and facilitators these individuals experience in the communication of social support. Through their individual narrative accounts, YA survivors explained why and how they perceived various support attempts from others to be positive or negative, and their close SNMs detailed their attempts to navigate the YA’s larger support network and assume the duties inherent in their newly-adopted “top supporter” role. In addition, reports from YAs and their SNMs revealed that they often engaged in mutual pretense, a unique and often unsustainable form of support that occurred between YA survivors and their close SNMs involving topic avoidance and emotional management. Implications for the advancement of interpersonal communication theory and for practical intervention targeting YA patients and survivors, their close SNMs, and medical practitioners are also discussed.

Orientador: Ana Maria Canesqui / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-18T01:36:03Z (GMT). No. of bitstreams: 1 Montagner_MariaInez_D.pdf: 1108886 bytes, checksum: ae9ac0b78b9f5a640434d3144b088613 (MD5) Previous issue date: 2011 / Resumo: A proposta desta tese foi realizar uma pesquisa sobre a experiência de mulheres portadoras de câncer de mama, no Hospital de Base do Distrito Federal (HBDF), em Brasília. Utilizando como referencial teórico a experiência com a enfermidade e, como fundamento, o conceito de ruptura biográfica de Michael Bury, buscamos entender as maneiras como elas vivenciam o adoecimento, articulado com as escolhas pessoais e profissionais e suas estratégias sociais. Para tanto, assumimos que essas experiências se expressam em muitas áreas da vida social, refletem e são o reflexo de suas crenças, costumes e valores, bem como de suas relações sócio-familiares. Em síntese, nossa questão central, como essas mulheres portadoras de câncer de mama conseguiram articular a sua condição de adoecimento com as suas atividades profissionais, religiosas e sociais, com suas vidas cotidianas e familiares. Esta pesquisa compõe-se de três momentos. Num primeiro, a observação em sala de espera no HBDF buscando compreender os espaços percorridos por essas mulheres dentro do hospital na procura pela confirmação da enfermidade, no tratamento e na cirurgia, como elas se relacionam com os profissionais da saúde e com as outras mulheres que também fazem parte deste universo. Um segundo, a realização de uma entrevista focada, semi-estruturada, com as mulheres com câncer de mama. Por fim, em um terceiro momento, com base na teoria de Michael Bury, buscamos esboçar as estratégias destas mulheres frente à ruptura biográfica, mantendo o foco principal nas suas experiências com o adoecimento. A metodologia foi a da pesquisa social, dentro de uma perspectiva qualitativa e com os referenciais da sociologia da saúde. Com este trabalho, esperamos contribuir para o entendimento sobre o câncer de mama, em especial, na perspectiva de mulheres que não tem planos de saúde e dependem unicamente do Sistema Único de Saúde, SUS / Abstract: The purpose of this thesis was to conduct a research on experiences of women with breast cancer at the Hospital of Base of the Federal District (HBDF), in Brasilia, Brazil. Using the theoretical framework of the illness experience and founded on the concept of biographical disruption Michael Bury, we seek to understand the ways they experience the illness, combined with the personal and professional choices and their social strategies. To this end, we assume that these experiences are expressed in many areas of social life, reflect and are a reflection of their beliefs, customs and values, as well as their social and family relationships. In summary, our main issue is such as women with breast cancer were able to articulate their condition of sickness with their professional activities, religious and social, with their everyday lives and families. This research is composed in three moments. At first, the observation in the waiting room at HBDF seeking to understand the spaces covered by these women in the hospital in search for confirmation of the disease, treatment and surgery, as they relate to health professionals and with other women also part of this universe. A second, conducting a focused interview, semi-structured, with women with breast cancer. Finally, in a third time, on the theory of Michael Bury, we outline the strategies these women facing the biographical disruption, keeping the focus on their experiences with the illness. The methodology was that of social research within a qualitative perspective and with the reference of the sociology of health. With this work, we hope to contribute to the understanding of breast cancer, especially in the perspective of women who have no health insurance and depend solely on the Health System, SUS / Doutorado / Saude Coletiva / Doutor em Saude Coletiva

La santé sexuelle, promue par l’Organisation mondiale de la santé, revêt une importance fondamentale pour la santé physique et émotionnelle et le bien-être des personnes. Chez les femmes, la survenue d’une lésion médullaire (LME) peut, comme chez les hommes, altérer la fonction et l’activité sexuelles, et l’amélioration de leur sexualité peut avoir une influence positive sur leur qualité de vie. Très peu de données sont actuellement disponibles concernant la sexualité des femmes lésées médullaires (LM) en France et les modalités de prise en charge des troubles associés. L’objectif de cette thèse est de décrire l’expérience de ces femmes en matière de sexualité et la diversité des modalités de prise en charge potentielles des troubles associés.Ce travail, qui repose sur une approche de santé publique interdisciplinaire, biomédicale, psychosociale et épidémiologique, qualitative et quantitative, comprend trois parties.Une revue systématique et qualitative de la littérature a permis d'identifier les recommandations, les conseils d'experts, ou les données d'études destinées à l'éducation sexuelle des femmes LM.La bonne gestion des complications de la lésion, un abord prudent, multidisciplinaire, l’implication des pairs, l’accompagnement dans la durée apparaissent au premier plan des enseignements de cette littérature.Une étude réalisée à partir des données recueillies au sein d’une nouvelle consultation de gynécologie, dédiée à la prise en charge de femmes en situation de handicap, a montré que des femmes LM insérées dans un réseau de soins multidisciplinaire et spécialisé n’avaient que rarement bénéficié des soins gynécologiques et des mesures de préventions nécessaires, y compris en lien avec une activité sexuelle majoritairement préservée. Ce type de consultation pourrait constituer une opportunité pour aborder leur vie sexuelle et identifier leurs besoins éventuels dans ce domaine.Une enquête qualitative menée auprès de 20 participantes a montré que la survenue d’une LME constituait une rupture biographique importante au delà de la lésion elle-même. Ces femmes peuvent avoir des réactions très différentes en fonction de leur histoire et de leur situations personnelles et ont ainsi une expérience bouleversée de leur sexualité.Ces travaux éclairent ainsi les besoins en termes de prise en charge de la sexualité chez les femmes blessées médullaires, et proposent des orientations pour les modalités de prises en charge futures. / Sexual health, as advocated by the World Health Organization, is key to physical, emotional health and well-being.As well as in men, the occurrence of a spinal cord lesion (SCL) in women may negatively impact their sexual function and sexual activity. Improving their sexual function and sexual activity would improve their quality of life. However, very little data is currently available on the sexuality of spinal cord injured women in France. The aim of this thesis was to describe these women’s experiences with sexuality and the diversity of potential management modalities for associated disorders.Based on an interdisciplinary public health approach this work associated biomedical, psychosocial and epidemiological, qualitative and quantitative perspectives. It included three steps.A systematic and qualitative review of the literature identified recommendations, expert advices, or research data for sex educating women with SCL; in order to identify practical strategies for setting up such support. Well-managed complications of the lesion, a careful, multidisciplinary approach, peer support and long-term follow-up are at the top of this literature's teaching priorities.Data collected from a newly equipped outpatient gynecological clinic specifically for women with disabilities were analyzed. They showed that despite a frequently preserved sexual activity, women with SCL had hardly received any gynecological and specific preventive care despite a persistent sexual activity. Moreover, this was also true in those who were in a multidisciplinary and specialized care network. However, this type of consultation could be an opportunity to address their sexuality and identify their potential needs in this area.A qualitative study conducted with 20 participants showed that the occurrence of a SCL represented a significant biographical disruption beyond the lesion itself. These women may have very different reactions depending on their history and personal circumstances and thus have a life-changing experience of their sexuality.This work sheds some light on the needs in terms of sexual care for women with SCL, and suggests guidelines for future care modalities.

La survenue d’une incapacité motrice est un évènement majeur qui ne se limite pas à des dimensions corporelles, mais implique également des dimensions sociales. Elle provoque chez les personnes des perturbations biographiques qui se caractérisent par des ruptures et des bifurcations dans leurs trajectoires de vie ainsi que par la perte de place et de rôle dans la vie sociale. La survenue du handicap oblige à une réorganisation des conditions de vie et à une recomposition du quotidien lors du retour dans le milieu ordinaire après un séjour dans un centre de rééducation consécutif à la survenue de l’incapacité. L’expérience du handicap moteur permet ainsi de saisir la dynamique sociale des trajectoires de vie et les ressources sollicitées par la personne en incapacité motrice dans le processus de sa reconstruction sociale. À partir d’entretiens menés auprès des hommes et des femmes en incapacité motrice et vivant à domicile à Yaoundé (Cameroun), cette thèse a pour objectif d’analyser les interactions entre l’incapacité motrice et l’environnement social dans la réorganisation de leurs trajectoires de vie et dans leurs différentes activités suite à la survenue de l’incapacité. En adoptant un modèle social du handicap, elle met en relief les perturbations biographiques et les ressources sollicitées dans les différentes trajectoires pour maintenir et adapter leur identité. Cela permet une analyse située des mécanismes de construction du handicap à partir des expériences des individus / The occurrence of a motor disability is a major event that is not limited to corporal dimensions, but also involves social dimensions. Individuals are faced with biographical disruptions characterized by breaches and bifurcations in their lifetrajectories and by the loss of place and role in social life. The occurrence of disability calls for a reorganization of living conditions and of the day-to-day life when returning to their usual environment after a stay in a rehabilitation centre. Experiencing motor disability thus makes it possible to grasp the social dynamics of life trajectories and the resources solicited by persons with motor disability in the process of their social reconstruction.Based on interviews conducted with men and women with motor disabilities and living at home in Yaoundé (Cameroon), this thesis aims at analysing the interactions between motor disability and social environment in the reorganization of their life trajectories and in their different activities following the onset of disability. By adopting a social model of the handicap, it highlights the biographical disruptions and the resources needed in the different trajectories to maintain and adapt their identity. It allows a situated analysis of the mechanisms of production of disability from the experience of individuals.

La dépression et l’antidépresseur, phénomènes plus vastes, plus complexes que l’ordre biomédical ne l’entend, répondent à des logiques qui dépassent les seules considérations organiques, corporelles. Certaines recherches montrent d’ailleurs que ces deux entités sont autonomes l'une de l'autre, signifiant que les antidépresseurs sont prescrits pour des raisons indépendantes de la prévalence de problèmes de santé mentale. C’est dans cette optique que, dans ce mémoire, nous examinons les raisons pour lesquelles les individus ont recours aux antidépresseurs suite à une rupture conjugale. C’est à l’aide des récits de huit femmes ayant pris des antidépresseurs suite à une rupture conjugale qu’on a donc investigué les rouages du recours à ces médicaments. À la lumière des résultats, on observe effectivement que la prise d’antidépresseurs semble répondre à une logique qui soit extra–médicale. D’abord par le constat que seules trois d’entres ces huit femmes ont justifié leur prise d’antidépresseurs par la réception d’un diagnostic formel de dépression. Ensuite, par la découverte qu’elle se déploie essentiellement selon une double symbolique au centre duquel prime le lien social. En effet, on a recours aux antidépresseurs suite à une rupture conjugale parce qu’ils sont à la fois l’incarnation d’un lien de confiance avec un être semblable à soi, empathique, le médecin, et le symbole d’un retour à la vie dite ‘normale’ où les manières d’être et d’interagir sont conformes à celles du groupe auquel on s’identifie. On croit que l’importance accordée à la confiance au médecin et à la normalisation quant au recours à l’antidépresseur témoignent du resserrement des liens d’identification propre à l’individualisme contemporain lesquels, en opposition aux grands récits de jadis, sont désormais axés sur une intimité de valeurs et d’objectifs entre semblables. / Depression and antidepressants are far more complex phenomenons than the biomedical order pretends. Some research show that these two entities are independant from one another, meaning that antidepressants are prescribed for reasons independant of mental health problems. In this master’s thesis we examine why individuals have recourse to antidepressants following a relationship break-up; the relationship (marital or not) break-up being a critical situation associated with the prevalence of depression. Eight women who took antidepressants following a relationship break-up were interviewed for this study. The findings show that the recourse to antidepressants appears to respond to a logic that is non-medical. First, by the fact that only three of the eight women interviewed justified their recourse to antidepressants by receiving a diagnosis of depression. Second, by the discovery that these women relied on antidepressants because they are the embodiment of a relationship of trust with someone familiar to themselves, the doctor, and the symbol of a return to a ‘normal’ life.

La dépression et l’antidépresseur, phénomènes plus vastes, plus complexes que l’ordre biomédical ne l’entend, répondent à des logiques qui dépassent les seules considérations organiques, corporelles. Certaines recherches montrent d’ailleurs que ces deux entités sont autonomes l'une de l'autre, signifiant que les antidépresseurs sont prescrits pour des raisons indépendantes de la prévalence de problèmes de santé mentale. C’est dans cette optique que, dans ce mémoire, nous examinons les raisons pour lesquelles les individus ont recours aux antidépresseurs suite à une rupture conjugale. C’est à l’aide des récits de huit femmes ayant pris des antidépresseurs suite à une rupture conjugale qu’on a donc investigué les rouages du recours à ces médicaments. À la lumière des résultats, on observe effectivement que la prise d’antidépresseurs semble répondre à une logique qui soit extra–médicale. D’abord par le constat que seules trois d’entres ces huit femmes ont justifié leur prise d’antidépresseurs par la réception d’un diagnostic formel de dépression. Ensuite, par la découverte qu’elle se déploie essentiellement selon une double symbolique au centre duquel prime le lien social. En effet, on a recours aux antidépresseurs suite à une rupture conjugale parce qu’ils sont à la fois l’incarnation d’un lien de confiance avec un être semblable à soi, empathique, le médecin, et le symbole d’un retour à la vie dite ‘normale’ où les manières d’être et d’interagir sont conformes à celles du groupe auquel on s’identifie. On croit que l’importance accordée à la confiance au médecin et à la normalisation quant au recours à l’antidépresseur témoignent du resserrement des liens d’identification propre à l’individualisme contemporain lesquels, en opposition aux grands récits de jadis, sont désormais axés sur une intimité de valeurs et d’objectifs entre semblables. / Depression and antidepressants are far more complex phenomenons than the biomedical order pretends. Some research show that these two entities are independant from one another, meaning that antidepressants are prescribed for reasons independant of mental health problems. In this master’s thesis we examine why individuals have recourse to antidepressants following a relationship break-up; the relationship (marital or not) break-up being a critical situation associated with the prevalence of depression. Eight women who took antidepressants following a relationship break-up were interviewed for this study. The findings show that the recourse to antidepressants appears to respond to a logic that is non-medical. First, by the fact that only three of the eight women interviewed justified their recourse to antidepressants by receiving a diagnosis of depression. Second, by the discovery that these women relied on antidepressants because they are the embodiment of a relationship of trust with someone familiar to themselves, the doctor, and the symbol of a return to a ‘normal’ life.

Ålderns och åldrandets betydelser för människor som under lång tid har levt med fysiska funktionsnedsättningar har hittills fått begränsad uppmärksamhet såväl i forskning som i andra sammanhang. Samtidigt pekar såväl åldersgränser i det offentliga stödsystemet som tidigare forskning mot att ålder och åldrande kan få speciella innebörder för människor som lever med funktionshinder. Syftet med den här avhandlingen är att tolka innebörder av åldersnormer och upplevd ålder för människor som i dagens Sverige befinner sig i de kronologiska åldrarna kring 65 med fysiska funktionsnedsättningar som funnits med under minst 30 år. Med åldersnormer avses ”enhetliga uppfattningar om de ’typiska’ åldrar då man innehar vissa roller under livsloppet”. Subjektiv ålder syftar på ”hur gammal man känner sig”. Åldrarna kring 65 har valt därför att det är en del av livsloppet då ålder, åldrande och åldersnormer kan förväntas få särskilt stor betydelse. En intervjustudie med 20 personer i åldrarna 56-72 har genomförts. Planeringen, genomförandet och analysen av intervjuerna har utgått från ett livsloppsperspektiv. Tolkningen av de intervjuades utsagor visar bland annat hur människor kan anamma ”äldrenormer” som ofta beskrivs som negativa i andra sammanhang på ett sätt som resulterar i något för individen positivt. Till skillnad från befintliga teorier om hälso- och funktionstillståndets betydelse för människors subjektiva ålder pekar studien också mot att det kan finnas en rad olika möjligheter att känna sig ung eller ”inte gammal” med funktionsnedsättningar och sjukdomar. Mot bakgrund av intervjupersonernas beskrivningar av sina dagliga liv framstår det därtill inte som orimligt att en ålderspensionär med omfattande funktionsnedsättningar med hjälp av ett individuellt anpassat stöd och hjälpmedel kan tillägna sig ett modernt och fritidsaktivt pensionärsideal på ett sätt som får som konsekvens att hon utformar sitt liv på ett ”tredje-ålder-likt” sätt. Ålder och åldrande framträder emellertid inte som betydelsefullt för alla aspekter av de intervjuades liv med funktionshinder. Särskilt inte för hur vissa förändringar av det egna funktionstillståndet upplevs. / The significance of age and ageing for people who have experienced a physical impairment under a long period of time is an area that has received little attention in both policies related to disability and the elderly as well as in social scientific research on disability and social gerontology. At the same time, age limits related to public support for disabled people, as well as related theories and empirical studies indicate that age and ageing can have specific meanings for people living with impairments. The aim of this thesis is to interpret the significance of age norms and subjective age for people in today’s Sweden who are approximately 65 years old with physical impairments that have existed for at least 30 years. Age norms refer to commonly accepted interpretations of what is associated with a certain age or phase of life, while subjective age refers to ”how old one feels”. The years around 65 have been chosen because they stand out as a time in life when age, ageing and age norms are expected to take on a particularly palpable meaning. An interview-study of 20 persons between 56-72 years of age was conducted. A life course perspective was used, both as a theoretical departure and as a methodological tool. Among other things, the interpretation of the interviews reveals how people can acquire and apply age norms that are often described as negative in other contexts in a way that results in something positive for the individual. In contrast to existing theories that emphasize the centrality of good health to be able to ”feel young”, the study at hand also indicates that those with a medically-defined chronic illness or physical impairment may experience age in a number of ways, without this necessarily involving their diagnosis or impairment. Furthermore, the interview subjects’ descriptions of their daily lives suggest that it is not unreasonable to surmise that a pensioner with impairments in today’s Swedish society can achieve a modern and leisurely ”third age” pensioner ideal. But age and ageing do not emerge as important to all aspects of life. This is particularly the case with respect to experiences of various changes in one’s own physical condition.

Avhandlingens syfte är att beskriva och analysera arbetets betydelse i starta eget–bidragsföretagares liv. Material har samlats in dels genom en omfattande enkätstudie som omfattar hela populationen nuvarande och tidigare företagare från 1995 i Östergötlands län, dels genom en serie livsberättelseorienterade intervjuer med ett urval aktiva respektive före detta företagare med fokus på deras inställning till arbete. Resultaten visar bland annat att etableringsmotiven ofta utgår främst från strukturer och omständigheter utanför individen och att dennes handlande när det gäller att starta eget i mycket bygger på ett oreflekterat förhållningssätt. Analyserna lyfter också fram de identitetsskapande aspekterna av arbete och visar att den del av identiteten som är knuten till arbete i många fall mycket starkt påverkar eller omformar övriga identitetsaspekter. SeB-företagarna kan betraktas som ”nödvändighetsentreprenörer” då de skapar nya arbetstillfällen åt sig själva. Bland nuvarande företagare anser drygt hälften att deras liv tagit en positiv riktning. De mest negativa återfinns i gruppen tidigare SeB-företagare, av vilka drygt en tredjedel anser att deras liv tagit en negativ riktning. Bland fördelarna med företagande framhålls av de studerade personerna framför allt möjligheten till en upplevd egenkontroll i arbetet. Nackdelar som betonas är ekonomisk oro, kompetensbrist och brist på sociala relationer. / The thesis aims to describe and analyze the importance of work for those who start up in business through the active labour market programme – the start-up grant entrepreneur. The material was collected partly through an extensive questionnaire study covering the entire population of current and former entrepreneurs in subsidized enterprises from 1995 in Östergötland, Sweden, and partly by a series of life story-oriented interviews about attitudes to work with a sample of active or former entrepreneurs. The results show, inter alia, that the establishment motives are often essentially based on the structure and circumstances beyond the individual and that his/her actions in terms of starting their own business are largely based on a non reflective approach. The analysis also highlights the identity-building aspects of work and shows that in many cases the part of one’s identity that is associated with work significantly affects other identity issues. Start-up entrepreneurs can be regarded as ”necessity entrepreneurs” when they create new jobs for themselves. Among the current workers, just over half believe that their lives have taken a positive direction. The most negative is the group of former start-up entrepreneurs, in which just over one third indicate that their lives have taken a negative direction. The benefits of entrepreneurship highlighted by the studied subjects include the possibility of a perceived self-monitoring at work. Disadvantages indicated by the same people include economic concerns, skills shortages and lack of social relationships.