published_or_final_version / Nursing Studies / Master / Master of Nursing

Många studier har gjorts inom området familjeterapi men sällan har barnens egna upplevelser utvärderats. Studiens syfte är att utforska barns erfarenheter av familjeterapi. Frågeställningarna behandlar barnens förväntningar inför terapin, men även deras skildringar av familjesamtalen och situationen efter avslutad terapi. I studien, som har en kvalitativ ansats, har åtta barn i åldrarna 5-12 år intervjuats med hjälp av semistrukturerade frågor och "tjejpingmetod" (Soltvedt, M. 2005). Resultaten visar att de flesta barn, trots sina positiva förväntningar innan terapin, upplever familjesamtalen i första hand som "vuxensamtal" där det är föräldrarna som får stöd och hjälp. De tycker att det har varit svårt att förstå och göra sig förstådda i samtalen. Barnen uttrycker en önskan om deltagande i samtalen men upplever ofta ett utanförskap, obehag och osäkerhet gällande sin roll i terapin. De flesta av barnen ser sig själva som "ensam problembärare", vilket är en bild som föräldrarna ofta bekräftar. Syskons deltagande lyfts fram som en tryggande faktor för barnen, liksom de icke-verbala inslagen i terapin. De barn som haft BOF (Barnorienterad familjeterapi) som behandlingsmetod eller andra icke-verbala inslag i terapin är nöjdast och har upplevt störst delaktighet. I studien visar barnen prov på sin kapacitet som informanter om sin situation. En förbättrad förståelse för barns upplevelser av familjeterapi möjliggör utvecklingen då det gäller terapeuters kompetens och terapeutiska metoder som på ett tydligare sätt är till gagn för både barn och vuxna. / Many studies have been done in the field of family therapy but the children's own experiences are rarely evaluated. The aim of the present study is to explore children's experiences of family therapy. The research questions addresses the children´s expectations before family therapy but also their descriptions of the family conversations and the situation after finished therapy. In the study, which has a qualitative approach, eight children (five boys and three girls) between 5-12 years of age, have been interviewed by using semi-structured questions and "tape method -playful conversation" (Soltvedt, M. 2005). The results shows that most children, despite their positive expectations prior to family therapy, experience family conversations primarily as an "adult conversation" where it is the parents that get support and help. They think it has been difficult to understand and make themselves understood in the conversations. The children expressed a desire to participate but often experienced exclusion, discomfort and uncertainty regarding their role in therapy. Most of the children see themselves as "single problem carrier", which is an image that parents often confirm. Siblings involvement is highlighted as a securing element, as well as the non-verbal elements of therapy. Those children that had BOF (Child-Oriented Family therapy) as a treatment method or other non-verbal elements of therapy are most satisfied and have experienced the greatest participation. In the study the children demonstrated their capacity as informants about their situation. An improved understanding of children's experiences of family therapy enables progress regarding the therapist's competence and therapeutic methods, which clearly is beneficial to both children and adults.

This study was a retrospective examination of the experiences of pediatric cancer patients and their families from a contextual perspective. The home, institution, and community contexts were investigated to reveal their influences on the coping efforts of the study participants. Ten families of children with cancer were interviewed, and data were analyzed qualitatively. Walker's (1985) family stress model and Lazarus' (1984) coping paradigm guided the study. The findings indicated that children were ambivalent in their attitudes toward the disease process. While they did not enjoy painful procedures, sickness, frequent hospitalizations, and baldness, they did welcome the special attention brought about by these stressors. Many of the children in the study understood the impact of their illness on the family. They felt guilty about family financial pressures, parental marital problems, and sibling conflicts that resulted from their cancer. Most feared relapse and death but hid their feelings to protect their parents. Mothers handled the stress of their child's illness by learning all they could about the disease, focusing completely on the sick child, and protecting the child from further harm. Fathers tended to take on the role of "strong one" while worrying about finances and attempting to keep the families together. Differing ways of coping between mothers and fathers often caused feelings of resentment and marital difficulties. Parental attitudes toward the staff at the medical center varied from trust, to wariness, to dependency. Parents enjoyed the support of family, friends, and community during the diagnosis phase, but felt bitter about the lack of support they received during the treatment and completion stages. Some parents believed that their exposure to the stressors of the illness process led to personal growth that they would not have experienced otherwise. Many parents emerged from the cancer ordeal with a desire to help others who were battling childhood cancer. They became involved in a variety of community agencies that served the families of children with cancer. / Ph. D.

No description available.

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

This thesis investigates the acceptability and efficacy of a brief universal preventive parenting intervention for child behavioural and emotional difficulties. The methodology included a systematic review, a literature review, a pilot randomised controlled trial and focus group discussions. The systematic review aimed to show whether behavioural and emotional difficulties are a significant problem in Greece. Greek children appeared to display high scores on, and prevalence of behavioural problems, compared to children from other countries. The results suggested that, based on parental reports, Greece seems to have a high prevalence in child behavioural and emotional difficulties. The literature review explored the effectiveness of universally delivered Triple P preventive interventions and identified research gaps. There was also insufficient evidence on the effectiveness of brief universal Triple P programmes to draw any definitive conclusions. No randomised trial had examined the short-term and long-term effectiveness of the Triple P brief universal interventions (Seminar Series). The pilot randomised trial explored the efficacy of the Triple P Seminar Series for the reduction of child behavioural and emotional difficulties. 124 parents were randomly allocated to receive three seminars on positive parenting, while parents in the control group received information on child development. There was a significant reduction in behavioural problems over time (primary outcome), and a reduction in parenting dysfunctional difficulties in the short-term. Parents gave positive feedback on the intervention indicating that overall it was acceptable, feasible, culturally relevant, and useful. Preliminary moderator analyses indicated that there were no moderator variables affecting the relation between group allocation and change in child disruptive scores. Preliminary mediator analyses suggested that a reduction in dysfunctional practices partially explained improvements in children's disruptive behaviours over time. Lastly, 46 parents of the intervention group shared their personal experiences regarding the Seminar Series during six focus groups. The facilitators of positive parenting were relevant to what they did before, during, and after their practices, while barriers included child, parent and external factors. The final conclusions after triangulation and the implications of this thesis for practice and further research were discussed.

The study explores and describes the satisfaction that clients placed at Trinity Children and Family Services have with the agency's therapeutic services. Therapeutic services in this case refers to the therapy that the residents receive from their individual and group therapists, and their interactions with the unit case manager/dorm supervisor and unit counselors.

(1) Background: Research on parental feeding practices and non-normative eating behavior including loss of control (LOC) eating and eating disorder psychopathology indicated separate associations of these variables with child weight status, especially in early childhood. This study cross-sectionally examined interaction effects of restriction, monitoring, pressure to eat, and children’s weight status on disordered eating in children aged 8–13 years. (2) Methods: A population-based sample of N = 904 children and their mothers completed the Eating Disorder Examination Questionnaire for Children and the Child Feeding Questionnaire. Child anthropometrics were objectively measured. Hierarchical linear and logistic regression analyses were conducted for cross-sectionally predicting global eating disorder psychopathology and recurrent LOC eating by feeding practices and child weight status for younger (8–10 years) and older (11–13 years) ages. (3) Results: Restriction x Child weight status significantly predicted global eating disorder psychopathology in younger children and recurrent LOC eating in older children. Monitoring x Child weight status significantly predicted eating disorder psychopathology in older children. A higher versus lower child weight status was associated with adverse eating behaviors, particularly in children with mothers reporting high restriction and monitoring. (4) Conclusions: Detrimental associations between higher child weight status and child eating disorder symptomatology held especially true for children whose mothers strongly control child food intake.

Family process stressors, family system resources, parental coping patterns, and parental adaptation were assessed for 58 mothers who had a child with cancer who was being seen at selected pediatric hematology-oncology centers in two Southeastern states. The respondents completed a self-report questionnaire containing the Coping and Health Inventory for Parents, five subscales from the Family Environment Scale, and items asking demographic questions. The dependent measure was the Parental Adaptation Assessment, a modified version of the Spinetta Family Adjustment Scale, developed for this study to measure parents’ perception of their adaptation to the experience of caring for a child with cancer. The criteria for subject inclusion in the study were: (a) two parents living in the home; and, (b) the child’s cancer diagnosis was to have occurred not less than 3 months and not more than 4 years prior to data collection. The Double ABCX Model of Family Adaptation was used as the basis for variable selection. Frequency distributions, correlations between the 11 independent variables and mother’s adaptation, and a stepwise regression analysis were used to analyze the data. Two family process stressors (conflict and control) and two family system resources (cohesion and expressiveness) were significantly (p < .05) correlated with mother’s adaptation. The regression analyses showed that two variables (cohesion and mother’s age) explained 34% of the variance in mother’s adaptation. Results show family cohesion and mother’s age to be the only significant predictors of her perceived adaptation. Family process stressors and parental coping patterns failed to account for any significant variance in mother’s adaptation. Implications for family stress theory, psychosocial oncology research, and family therapy practice are discussed. Recommendations for further research are suggested. / Ph. D.

En kunskapslucka gällande samverkan mellan socialsekreterare på barn och familj och poliser har påvisats. Syftet med föreliggande studie var därför att undersöka vilka hinder och framgångsfaktorer i samverkan och informationsutbyte som socialsekreterare på barn och familj och poliser upplever att det finns i ärenden där en förälder har drogproblematik. Metoden som används är kvalitativ intervjustudie där fyra socialsekreterare på barn och familj, och fyra poliser intervjuats via semistrukturerade intervjuer. Resultaten har analyserats med hjälp av tematisk analys samt kopplats till tidigare forskning och systemteoretiskt perspektiv. Resultatet visar att samverkan idag är till stor del begränsad av sekretess och att man arbetar för olika mål. Gällande informationsutbyte ses bra relationer och tillit som en framgångsfaktor och en brist på kunskap om varandras yrken som ett hinder. Utifrån den systeminriktade teorin framgår det att samverkan påverkas av alla tre systemen, mikro, meso, makro. / A study revealed a knowledge gap regarding collaboration between social workers in child and family services and police officers. The aim was to investigate the obstacles and success factors in collaboration and information exchange that social workers and police officers experience in cases involving parental substance abuse. The method used was a qualitative interview study involving four social workers and four police officers who were interviewed using semi-structured interviews. The results were analyzed using thematic analysis and linked to previous research and a systems theory perspective. Findings indicate that collaboration is largely constrained by confidentiality issues and differing objectives. Good relationships and trust are seen as a success factor for information exchange, while a lack of knowledge about each other's professions is identified as a barrier. From a systems perspective, collaboration is influenced by all three systems: micro, meso, and macro.