The purpose of this qualitative phenomenological study was to investigate the perceptions of classroom-level educators regarding the application of trauma-informed instructional practices. This was achieved by evaluating educators' understanding of the influence of trauma on students, their level of familiarity with trauma-informed instructional practices, and their assessments of the effectiveness of these practices. Trauma refers to an individual's response to a single traumatic incident, a succession of traumatic events, or extended exposure to a traumatic event (SAMHSA, 2014). As awareness of the prevalence of childhood trauma has increased, it is acknowledged as a serious public health issue (Lang et al., 2015). Trauma-informed care is a strengths-based, victim-centered framework under which organizations recognize trauma, understand, and limit the potential long-term repercussions of exposure to traumatic experiences, even if an individual does not perceive trauma as influencing their behavior (Kubiak et al., 2017; Office for Victims of Crime, n.d.). Educators have a distinct advantage in identifying students' traumatic stress symptoms, which can directly affect social-emotional growth and academic achievement (Conley et al., 2014; Donisch et al., 2022). Schools play a crucial role in establishing settings that safeguard students against adverse childhood experiences (ACEs), cultivate resilience, and nurture a sense of belongingness (Conley et al., 2014; Hertz, 2020). Eight educators from one northeast Tennessee school district who provided general and special education instruction to students in PreK-12th grade participated in the study. Data collection consisted of one-on-one video conferencing interviews. The data were coded and analyzed to identify emerging themes, synthesized, and summarized (Creswell & Creswell, 2018). The following themes emerged: (a) increased awareness of trauma and ACEs, (b) desire for additional training, (c) diversity of adverse childhood experiences (ACEs) and trauma exposures, (d) perceived negative behaviors resulting from or masking trauma, (e) the significance of procedures and structure, (f) the need for supplementary resources, (g) the importance of relationship building, (h) importance of opportunities for success, (i) facilitation of individualized instruction, (j) increased empathy, (k) increased patience and self-awareness, and (l) emotional, physical, and mental stress.

Bakgrund: Schizofreni är en psykossjukdom som drabbar ungefär 0.4% av världens befolkning. Varför personer insjuknar i schizofreni har ännu inte identifierats. Men ett samband kan ses om personernas exponering för miljöfaktorer samt genetisk sårbarhet som kan öka riskerna för att insjukna.Syfte: Syftet med denna litteraturstudie var att sammanställa och beskriva personers upplevelser av att leva med schizofreni.Metod: Litteraturstudien baseras på 11 vetenskapliga artiklar av kvalitativ ansats där innehållet är från tidigare forskning inom samma ämne. Huvudresultat: Resultatet visade att deltagarna hade olika upplevelser av varför de insjuknat i schizofreni. För att leva med schizofreni är det viktigt att acceptera sin situation, sjukdomen kommer inte att försvinna. Känslan av hopp, tillhörighet och gemenskap var viktiga faktorer för personer med schizofreni för att klara av vardagen. Stigmatisering är en stor del av sjukdomen som påverkar personerna som lever med schizofreni. De hamnar i utanförskap och blir diskriminerade av både familj och samhälle vilket i sin tur leder till isolering och ensamhet. Slutsats: Litteraturstudien ger en överblick om hur personer som lever med schizofreni upplever sin sjukdom. Personer med schizofreni upplever ofta att de blir bemött på ett särskilt sätt relaterat till att de har en psykisk sjukdom i bakgrunden. I resultatet framkom det att känslan av hopp och tillhörighet var väsentligt för att klara av utmatningar i vardagen. Att acceptera sin sjukdom ansågs som en styrka för att hantera omgivningen på bästa sätt. / Background: Schizophrenia is a psychotic illness that affects approximately 0.4% of the world's population. Why people develop schizophrenia has not yet been identified, but a connection can be seen from the people's exposure to environmental factors as well as genetic vulnerability that can increase the risk of developing the disease. Aim: The purpose of the literature study was to compile and describe people's experiences of living with schizophrenia. Method: The literature study was based on 11 scientific articles of a qualitative approach where the content is from previous research in the same subject.Main results: The results show that the participants had different experiences of why they fell ill with schizophrenia. To live with schizophrenia is it important to accept your situation, the illness will not go away. The feeling of hope, belonging and community were important factors for people with schizophrenia to cope with everyday life. Stigma is a large part of the illness that affects people living with schizophrenia. They end up in isolation, are discriminated against both by family and society, which leads to isolation and loneliness. Conclusion: The literature study provides an overview of how people living with schizophrenia experience their illness. People with schizophrenia unfortunately experience that they are treated in a special way just because they have a mental illness in the background. In the results, it was shown that the feeling of hope and belonging was important to cope with the demands of everyday life, accepting one's illness was seen as a strength to deal with the environment in the best way.

Research examining Adverse Childhood Experiences (ACEs) has mostly focused on the long-term effects of these experiences on adult mental and physical health. Less attention has been focused on the impact of ACEs on college student satisfaction, dropout rates, and major choice. The overarching questions for the current study sought to further research by (1) assessing if there is a relationship between the ACE scores of college students and their mental and physical health, (2) if ACEs play a role in student satisfaction or desire to drop out, and (3) determining if there is a connection between students with high ACE scores and their major choice. Survey data was collected from a sample of East Tennessee State University students. Findings serve to improve our understanding of the topic and promote research for the future.

Bakgrund: Mobbning sjuksköterskor emellan har synliggjorts sedan 1800-talet och är fortsatt ett problem på många sjuksköterskors arbetsplatser. Mobbningen påverkar sjuksköterskans psykiska välmående och i förlängningen patientens omvårdnad samt organisationen. Syfte: Syftet var att beskriva sjuksköterskors upplevelse av mobbning på arbetsplatsen. Metod: En beskrivande litteraturstudie genomfördes, vilken utgick från kvalitativ forskning som presenterades i nio originalstudier. En systematisk litteratursökning utfördes i databaserna PsycInfo, CINAHL och PubMed. De studier som inkluderades efter en urvalsprocess analyserades med Noblit och Hares meta-etnografiska analysmetod med en induktiv ansats. Huvudresultat: Under dataanalysen identifierades tre huvudteman som presenterades i resultatet tillsammans med tillhörande subteman. I det första huvudtemat Mobbning som en integrerad del av sjuksköterskeprofessionen framkom det att mobbning upplevdes vara en naturlig del av sjuksköterskeprofessionen där ett inrotat synsätt bestod av att bemöta nya sjuksköterskor med en hård och kränkande attityd som var menad att vara fostrande. I det andra temat Hur mobbningen tar sig till uttryck inom sjuksköterskeprofessionen beskrevs det att vanliga tillvägagångssätt var att försvåra den utsatta sjuksköterskans arbete för att denne skulle misslyckas, samt att mobbning i verbal form var den vanligast förekommande. I det tredje temat Sjuksköterskors upplevda fysiska och känslomässiga effekter av mobbning, förklarades mobbningens effekter på sjuksköterskor som ofta upplevde rädsla, maktlöshet och skuldkänslor vilket kunde leda till ångest och depression. Slutsats: Mobbning inom sjuksköterskeprofessionen har länge varit normaliserad och nyutexaminerade sjuksköterskor är mest utsatta. För att minska frekvensen av mobbning krävs att organisationen, ledningen och sjuksköterskan samverkar, med betoning på sjuksköterskans egenansvar och förmåga att reflektera över sitt eget bemötande och förhållningssätt. / Background: Bullying between nurses has been made visible since the 18th century and is still a problem in many nurses' workplaces. The bullying affects the nurse's psychological well-being and, by extension, the patient's care and the organization. Purpose: The purpose was to describe nurses' experience of bullying in the workplace. Method: A descriptive literature study was conducted based on qualitative research from nine empirical studies. A systematic literature search was performed in the databases PsycInfo, CINAHL and PubMed. The studies that were included after a selection process were analyzed using Noblit and Hare's meta-ethnographic analysis method with an inductive approach. Main results: During the data analysis, three main themes were identified which were presented in the results together with associated subthemes. In the first main theme Bullying as an integral part of the nursing profession, it emerged that bullying was considered a natural part of the nursing profession where attitudes against new nurses were entrenched by a harsh and humiliating approach that was meant to be nurturing. In the second theme, How bullying manifests itself in the nursing profession, it was described that bullying in a verbal form was the most common, and to make the exposed nurse's work more difficult was also a common expression. Nurses' perceived physical and emotional effects of bullying, was the third theme where the effects of bullying on nurses often were explained as experienced feelings of fear, powerlessness and guilt which could lead to anxiety and depression. Conclusion: Bullying in the nursing profession has long been normalized, and newly graduated nurses are most vulnerable. To reduce the frequency of bullying, it is required that the organization, the management and the nurse work together, with an emphasis on the nurse's personal responsibility and ability to reflect on their own treatment and approach.

Syftet med denna litteraturstudie var att beskriva existentiella och psykosociala upplevelser hos patienter med ALS. Nio kvalitativa artiklar valdes ut och inkluderades till litteraturstudiens resultat. Artiklarna beskrev upplevelser från patienter i olika kontexter där existentiella och psykosociala aspekter berördes. Det framkom i resultatet att patienter upplevde meningsfullhet och att familjen var betydande för deras välmående, men också hopplöshet och känslan av att vara en börda för andra vilket utgjorde svårigheter att finna mening i livet. Patienter upplevde lidande i flera dimensioner och hanterade sin situation med hjälp av olika strategier, attityder och förhållningssätt. Slutsatser som författarna för denna litteraturstudie kunde dra från resultatet var att patienterna går igenom flera dimensioner av lidande vilket ställer krav på sjuksköterskan att lindra dessa. Sjuksköterskan ska också hjälpa patienten att framhäva sina styrkor och skapa en större förståelse för att patienten skall nå acceptans. En annan slutsats som drogs var att familjens involvering i omvårdnaden kunde vara positiv då de står närmast patienten och det visade sig vara en positiv faktor för att acceptera situationen. ALS är en neurodegenerativ sjukdom som förstör motorneuron i hjärnan. Det leder till att den viljestyrda muskulaturen förlorar sin funktion. Till sist drabbas även muskulaturen kring lungorna som leder till minskad lungkapacitet. Från symtomdebut är överlevnadssikten cirka två till fem år där vanligaste dödsorsaken är koldioxidnarkos. Tidigare forskning har framfört positiva och negativa känslor hos patienter med ALS. Upplevelser att kroppen misslyckas i förtid samt behov av att prata om döden framkom. Kommunikation med vården var viktig för att patienter skulle uppleva att sjukdomen var hanterbar. Litteraturstudien använde bärande begrepp såsom lidande och försoning. En kvalitativ ansats användes då upplevelser skulle undersökas och analysen utgick från Fribergs femstegsmodell. Diskussionen utgick från resultatets huvudteman Främjande aspekter för meningsfullhet samt Utmanande aspekter för livsvillkor. Denna litteraturstudie är viktig då den bidrar till en ökad kunskap och förståelse för hur patienter med ALS upplever existentiella och psykosociala aspekter. Genom kunskap kan vården utvecklasoch främja vårdkvaliteteten för patienterna och samtidigt stärka sjuksköterskan i sin yrkesroll.Främjande och utmanande aspekter som påverkade välbefinnandet hos patienter identifierades och diskussionen ledde således till sjuksköterskans funktion samt litteraturstudiens bärande begrepp, lidande och försoning.

Alzheimer's disease affects many people worldwide and is often cared for by a family member. It is not uncommon for family members to become caregivers. The aim was to describe the experiences of family caregivers in caring for a loved one with Alzheimer's disease. The method used was a literature review with a qualitative approach, conducted using Polit and Beck's (2020) nine-step model. Ten articles were identified and analyzed using thematic analysis. Results: The analysis resulted in three main themes and seven subthemes: Emotional reactions with subthemes: Transition from family member to caregiver, during the progression of the disease, fear for the future. The caregiver role with subthemes: Responsibility and duty, challenges and sacrifices, and the theme Need for knowledge and support and with the subthemes: Knowledge and Support. The conclusion shows that family members caring for their loved ones with Alzheimer's experience difficulties in handling the caregiver role, both emotionally and instrumentally. They often experience a lack of support from the healthcare system, highlighting the importance of nurses applying family-centered care. Suggestions for further research: Developing interventions to implement family-centered care.

Although more people are transitioning into environmental sustainability careers, there is still a demand. This presents an opportunity for undergraduate engineering students to satisfy the demand for environmental sustainability professionals. The purpose of this qualitative exploratory study was to explore environmental sustainability learning experiences, from small in-class experiences to internships, and future career choices. By utilizing the social cognitive theory (SCCT) as a theoretical lens, this study explored participants' environmental sustainability interests, learning experiences related to environmental sustainability and their interest in pursuing a future career in environmental sustainability. This research addresses a gap in the existing literature by exploring how undergraduate engineering students' environmental sustainability learning experiences impact their decisions to pursue careers in this field, framed by the SCCT. The perspectives of twenty-five undergraduate engineering students in various engineering disciplines at Virginia Tech, an R1 public university in Blacksburg, Virginia. The participants were enrolled in ENGR3124, Introduction to Green Engineering, during the Fall 2022 semester and were interviewed for the study. Semi-structured online interviews were conducted via Zoom, allowing students to provide detailed information about their learning experiences and future career plans. Data was analyzed to (1) identify students' interest in pursuing a career in environmental sustainability (2) determine if students' interests have changed since they began their undergraduate studies (3) explore how learning experiences have impacted the students' future career choice. The findings discover that exposure to environmental sustainability learning experiences plays a meaningful role in impacting students' interests in pursuing careers in sustainability. Results reveal that factors such as personal values and salary considerations inspire career choices. Outcomes from this research suggest that promoting a connection between engineering education and environmental sustainability can inspire future engineers to actively pursue environmental sustainability careers and find solutions to sustainability issues. This underscores the significance of integrating sustainability experiences, such as a current events discussion in class or projects with an environmental sustainability element, into undergraduate engineering education. This research contributes to addressing the growing demand for people to address environmental sustainability issues, highlighting the role of learning experiences in shaping students' career interests. Further research in this area will be necessary for further developing strategies to encourage students to pursue sustainability-related careers and contribute to environmental sustainability initiatives. / Doctor of Philosophy / Experts are transitioning into environmental sustainability careers, though a gap exists between supply and demand. This presents an opportunity for undergraduate engineering students to fulfill the demand as environmental sustainability professionals. This qualitative exploratory study investigated environmental sustainability learning experiences and future career interests in environmental sustainability. The social cognitive theory (SCCT) was utilized as a theoretical lens, exploring participants' environmental sustainability interests, associated learning experiences and their interest in pursuing a future career in environmental sustainability. Twenty-five undergraduate engineering students in various engineering disciplines were interviewed for this study. Data was analyzed to (1) identify students' interest in pursuing a career in environmental sustainability (2) determine if students' interests have changed since they began their undergraduate studies (3) discover how learning experiences have impacted the students' future career choice. The findings conclude that exposure to environmental sustainability learning experiences is impactful and plays an important role, impacting students' interests in pursuing careers in sustainability. Results unveil that elements such as personal beliefs and salary considerations inspire career choices. This research contributes to addressing the demand for people to tackle environmental sustainability issues, emphasizing the role of learning experiences in shaping students' career interests.

Bakgrund: Fler män än kvinnor drabbas av hjärtinfarkt, vilket har resulterat i att tidigare forskning kring sjukdomen har baserats på mäns upplevelser. Kvinnor upplever ett större spektrum av symtom och har annorlunda riskfaktorer gentemot män. Tydliga förseningar i kvinnors vårdsökande kan ses. Syfte: Syftet var att belysa kvinnors upplevelser av att drabbas av hjärtinfarkt. Metod: En allmän litteraturstudie genomfördes på 11 artiklar. Innehållet av artiklarna analyserades och teman urskildes. Resultat: Fyra teman identifierades: brist på kunskap, känslan av ansvar, bemötandet av vården och livet efter hjärtinfarkten. I resultatet framkom det att kvinnor upplevde prodromala symtom som var atypiska, vilket försvårade kvinnornas förmåga att identifiera orsaken till symtomen. Kvinnorna prioriterade bort att söka vård, då kvinnorna präglades av känslan av ansvar gentemot sina anhöriga och sitt arbete. Många kvinnor kände sig ignorerade när de till slut sökte vård. Konklusion/implikation: Bristen på kunskap kring kvinnors atypiska symtom kan leda till förseningar i vårdsökande. Genom vidare forskning på kvinnors upplevelser, symtom och riskfaktorer kan kunskap spridas och bidra till att kvinnor får möjlighet till adekvat vård. / Background: More men than women suffer from myocardial infarction, which has resulted in previous research being based on men’s experiences. Women experience a greater spectrum of symptoms and have different risk factors than men. A distinct delay can be seen when women seek care. Aim: The purpose was to shed light on women's experiences when suffering a myocardial infarction. Method: A general literature study approach was conducted on 11 articles. The content of the articles was analyzed, and themes were distinguished. Result: Four themes were identified: lack of knowledge, feeling of responsibility, treatment in healthcare services and life after a myocardial infarction. The result showed that women experienced prodromal symptoms that were atypical, which complicated women’s ability to identify the cause of the symptoms. The women did not prioritize seeking care, as the women were influenced by the feeling of responsibility towards their relatives and work. Many women felt ignored when they finally sought care. Conclusion/implication: The lack of knowledge about women's atypical symptoms can lead to delays in seeking care and diagnosis. Through further research into women's experiences, symptoms and risk factors, knowledge can be spread and contribute to women having the opportunity for adequate care.

Bakgrund: Psykisk ohälsa är ett globalt växande folkhälsoproblem, där depression är den vanligaste diagnosen. En typ av depression är postpartumdepression, som drabbar kvinnor i nära anslutning till förlossningen av barn. Uppskattningsvis drabbas ca tio procent av alla kvinnor som föder barn världen över av postpartumdepression. Symtomen för postpartumdepression liknar symtomen vid depression men riktar sig ofta mot delar av moderskapet. Dessutom förekommer vissa fysiska symtom och en del upplever suicidala tankar. Sjuksköterskan har en viktig roll för att fånga upp kvinnor som drabbats eftersom de ofta söker vård för andra problem. Kontinuerliga samtal och mentalt stöd är en viktig del i behandlingen. Syfte: Syftet var att beskriva kvinnors erfarenheter av att leva med postpartumdepression. Metod: Litteraturöversikt gjord utifrån tio vetenskapliga artiklar som hämtats från Cinahl Complete och PubMed. Resultat: Resultatet presenteras under fyra huvudteman: ohälsa hos mammor efter förlossning, erfarenheter av stöd och relationer, känsla av skam och rädsla inför vårdkontakt och förhållningssätt till sjukdom och behandling. Slutsats: Resultaten i de olika artiklarna skiljer sig åt beroende på kvinnornas tidigare erfarenheter och vart de kommer ifrån. Kvinnornas kulturella arv, traditioner och religion kunde påverka sättet deltagarna såg på postpartumdepression och hur de hanterade det. En aspekt som lyftes upp av många kvinnor var behovet av stöd från partner, vård och omgivning. / Background: Mental illness is a globally growing public health problem where depression is the most common diagnose. One type of depression is postpartum depression, it affects women in close proximity to childbirth. Approximately ten percent of all women globally who give birth suffers from postpartum depression. The symptoms for postpartum depression resembles the symptoms for depression but often turns toward parts of the motherhood. Physical symptoms also occur and some experience suicidal thoughts. The nurse play an important role in noticing women affected since they often seek healthcare for other problems. Continuously having conversations and mental support is a crucial part of treatment. Aim: The aim was to describe womens experiences of living with postpartum depression. Method: Literature review based on ten scientific articles retrieved from Cinahl Complete and PubMed. ​Results: The results are presented under four main themes: illness in mothers after childbirth, experiences of support and relationships, feelings of shame and fear before healthcare contact and attitudes to illness and treatment. ​Conclusions: The results from the different articles differs depending on where the women come from and their different experiences. The womens cultural heritage, traditions and religion could affect the way participants viewed postpartum depression and how they handled it. One aspect many women mentioned was the need of support from a partner, health care and their surrounding.

Background: Polycystic ovary syndrome (PCOS) affects 6-10% of women and has a range of impacts on women’s reproductive, psychological, metabolic, and cardiovascular health. A lifelong condition, symptoms of PCOS may start in adolescence and extend into post-menopause. Despite being such a pervasive disorder, with significant burden of disease for some women, it may be underrecognized within the medical and general communities. Recent studies suggest that women with PCOS may not be diagnosed early or receive appropriate guidance and information from physicians. Little is known about women’s experiences in Canada. This thesis explores experiences with diagnosis and management in Canada and assesses the barriers and facilitators women face while seeking care for their condition. Methods: Research questions were addressed using a multi-methods approach. Participants were recruited from online PCOS groups on Facebook, Reddit, and stand-alone PCOS forums. An online questionnaire measured participants’ time to diagnosis, number of doctors seen, and satisfaction with information provided. Descriptive statistics, Chi-square tests, Fisher’s exact tests, and Spearman’s rank correlations assessed characteristics of the sample and correlations between demographic factors and satisfaction measures. Twenty-five follow-up interviews were held over the phone to elicit greater richness of experiences. Qualitative data were analyzed using thematic analysis and the interpretive description framework. Results: The e-survey was completed by 296 women aged 18-60 with a self-reported diagnosis of PCOS. Approximately a third (34%) of respondents waited for more than 2 years before attaining a diagnosis and 41% saw 3 or more doctors. Most participants were dissatisfied with the information provided to them about PCOS (66%). Many did not receive any information about lifestyle management (42%) or medical therapy (28%). Barriers to diagnosis and management included lack of knowledge and/or concern in physicians. Women received insufficient information about PCOS implications (including mental health) at the diagnosis and subsequent visits. Few participants had physicians who were involved with PCOS management. Peri- and post-menopausal women especially lacked support and medical information on how to manage symptoms. Facilitators to diagnosis and management included self-education, self-advocation, and social support. Women identified a need for greater PCOS awareness in primary care physicians and the general community. Few women had heard of PCOS prior to their diagnosis. Conclusion: This thesis found delays to diagnoses and dissatisfaction in women around the care and information they received from doctors. Perceived lack of knowledge and engagement in physicians resulted in most barriers to diagnosis and management. Few participants had physicians whom they could rely upon for information and guidance. Greater awareness of PCOS is needed in the medical community, particularly in primary care. Women and girls may benefit from greater PCOS awareness early in life in health class at the elementary and/or secondary levels.