published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Bakgrund: Hopp är ett fenomen som är svårt att definiera. Hopp upplevs på olika sätt och i olika omfattningar av patienter med en dödlig sjukdom. Upplevelsen av hopp samspelar med upplevelsen av hopplöshet. Hopp är betydelsefullt för patienter i palliativ vård och kan ge patienter förmåga att uthärda lidandet och det betraktas som en inre resurs som är viktig för att uppnå livskvalitet. Syfte: Att studera patienters upplevelser av hopp i livets slutskede. Metod: En litteraturstudie gjordes utifrån vetenskapliga artiklar. Tio artiklar var funna och granskades. Nio artiklar var kvalitativa och en var kvantitativ. De utvalda artiklarna studerades och meningsbärande enheter plockades ut och utvecklades till kategorier. Resultat: Resultatet är presenterat utifrån symtomlindring, självständighet, relationer, positiv inställning, syntes och acceptans. Resultatet belyser patienters upplevelser av hopp samt hur betydelsefullt hoppet är i livets slutskede. Upplevelsen av hopp är att ha en god symtomlindring, att få vara med familj och vänner och att vara oberoende. Diskussion: Patienters upplevelse av hopp diskuteras i relation till annan forskning om patienters upplevelser om hopp och i relation till de sex S:n. Det diskuteras även betydelsefulla aspekter kring hur sjuksköterskor kan främja patienters upplevelse av hopp. / Background: Hope is a phenomenon that is difficult to define. Hope is experienced in different ways and in different degrees by patients with a terminal illness. The experience of hope interacts with the experience of hopelessness. Hope is important for patients in palliative care and is able to give patients the ability to endure suffering and it is considered as an inner resource that is important to achieve quality of life. Aim: To study patients’ experiences of hope at the end of life. Method: A literature study was made by scientific articles. Ten articles were found and examined. Nine articles were qualitative and one was quantitative. The selected articles were studied and significant units were picked out and developed into categories. Results: The results are presented by symptom relief, independence, relationships, positive attitude, synthesis and acceptance. The results illustrate patients’ experiences of hope and how meaningful hope is at the end of life. Hope is having a good symptom relief, being with family and friends and being independent. Discussion: Patients’ experiences of hope are discussed in relation to other research on patients’ experiences of hope and in relation to the six S words. It also discusses important aspects of how nurses are able to foster patients’ experiences hope.

Forskning har visat att arbetssökandes motivation till att söka arbete påverkar deras hälsa och sociala liv. Tre motivationsteorier som utvecklats inom området och som ligger till grund i studien är Förväntning- och värdeteorin, Målsättningsteorin och Självbestämmandeteorin. Syftet med studien var att undersöka hur positivt psykologiskt kapital, inskrivningstid på arbetsförmedling samt tillgång till jobbcoach eller inte inverkar på arbetssökandes inre motivation. En enkätstudie genomfördes där 154 arbetssökande, 83 män och 70 kvinnor deltog. De fick ta ställning till 50 påståenden gällande tron på den egna förmågan, hopp, hantering av motgång och inre motivation. Resultatet visade att den främsta variabeln som förklarar inre motivation hos arbetssökande är hopp, som innebär hopp om framtiden. Det visade sig att tiden som individen är arbetssökande och tillgång till jobbcoach, inte hade någon betydelse för inre motivationen. Slutsatsen är att trots att det råder lågkonjunktur så finns hopp om framtiden. Key words: length of unemployment, hope, intrinsic motivation

Physical and psychosocial symptoms in advanced chronic obstructive pulmonary disease (COPD) are cumulative and profound; global financial and human costs are huge. COPD in late stages runs an unpredictable downward course of increasing, potentially fatal exacerbations. Nevertheless many physicians avoid advance care planning in this context, a choice that tends to promote last minute crisis decision-making. To explore a more ethically sound proactive approach to end-of-life care decision-making I conducted a qualitative study informed by the question: “What is required for meaningful and effective advance care planning in the context of advanced COPD?” Fifteen participants (eight patients with advanced COPD plus seven intimate others) participated in two in-home advance care planning discussions that incorporated patient-centred care principles. Session transcripts were analyzed using "interpretive description." Despite initial wariness, participants were able to discuss their care-related hopes and preferences and reported that the process was a positive one. Interpretation of the positive feedback suggested participants experienced the process as a chance to: a) talk with an attentive clinician, b) learn, c) consider care-related goals and preferences, and, d) have intimate others hear about these goals/preferences. Interpretation of the process that led to this positive assessment is described in terms of a thematic network. The overarching global theme of this network was "advance care planning as collaborative care," which involved three organizing themes--partnering, negotiating ambiguity, and being a resource--and a cluster of basic themes related to each of these. The "collaborative care" approach is discussed as a guide to advance care planning in advanced COPD. Like other advance care planning models, the study approach included a skilled clinician facilitator, provision of targeted information, and attention to readiness. There were four new elements: focus on caring, engaging hope, facilitator reflective praxis, and contextual sensitivity. While potentially enhancing the "care" dimension in advance care planning, the study approach may incidentally improve resource allocation and satisfaction with outcomes. Done well it may enhance decision-making and care planning, and, just as importantly, be experienced as care itself at a time and by those often neglected in this regard.

Time perspective (TP) represents a person's tendency to focus more on the past, present or future and has been shown to predict measures of individual well-being (Boniwell, et al., 2010). This study examined the relationship between one’s time perspective and measures of hedonic and eudaimonic well-being, specifically positive and negative affect, satisfaction with life, and self-actualization. Furthermore, this study explored hope across the different time perspectives. Two hundred and eighty eight Canadian adults were recruited via social media websites. Hierarchical cluster analysis was used to validate the Balanced Time Perspective construct and suggests that the Hedonism time profile is as adaptive as the Balanced Time Perspective. Correlational analysis was used to examine the association between hope and the five different time perspectives. Results indicate that the past positive time perspective is most predictive of high levels of hope. Results were discussed and integrated into current time perspective and hope research.

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Dene women are leading and directing efforts toward "healing" themselves, their families, and their communities. Employing a modality of montage and storytelling, this thesis explores this enigmatic concept of "healing" among Dene, and its gendered dimensions, in the community of Fort Good Hope, Northwest Territories. This account challenges the limitations of a resistance-hegemony paradigm often used to describe Aboriginal actions as embedded within colonial relations, and endeavours toward a more nuanced analysis which explores Dene "healing" beyond the colonial space. "Healing" is emerging as a vehicle for the assertion and celebration of Dene identity, Dene tradition and "Dene ways". This thesis further explores how many Dene women in Fort Good Hope are mobilizing the power of tradition, such as -aet'sechi/ (practices associated with "becoming woman"), as a means of "healing" social/health concerns, and influencing gender and power relations in the community.

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