Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Bakgrund: I Sverige är barnhälsovården frivillig, att få ett hembesök när barnet är nyfött är ett erbjudande. Sedan år 2015 erbjuds föräldrar ytterligare ett hembesök när barnet är åtta månader. För att ge bra stöd till föräldrarna i deras egenvårdande roll är det viktigt att veta hur föräldrarna upplever hembesök från barnavårdcentralen (BVC). Syfte: Att undersöka föräldrars upplevelse och erfarenhet av hembesök från BVC. Metod: Data samlades in genom att lägga ut frågor på 2 föräldraforum under 3 månader och söka inlägg på 11 föräldraforum som svarade på studiens frågeställningar och som var skrivna år 2013 - 2016. Data analyserades med induktiv innehållsanalys. Resultat: Föräldrar hade varierade upplevelser av hembesök från BVC, från bekvämlighet, exempelvis upplevdes det som positivt att slippa ge sig ut i dåligt väder, till en känsla av att bli kontrollerad som förälder.  Många föräldrar kände inte till att BVC erbjuder 8-månaders hembesök, och en del kände inte till att BVC erbjöd hembesök överhuvudtaget. Flera föräldrar uttryckte en osäkerhet runt syftet med hembesök. Slutsats: Det är viktigt att distriktssköterskan har en bra rutin för hur, var och när informationen om hembesök skall ges för att informationen om hembesök skall nå fram till alla föräldrar. Informationen kan ha en stor betydelse för hur föräldrar kommer att uppleva hembesöket från BVC och om föräldrar tackar ja till hembesök. / Background: In Sweden, child healthcare is voluntary and home visit by a nurse when the baby is newborn is an offer. Since 2015, parents are offered a second home visit when the baby is eight months. To provide good support to the parents in their caring role it is important to know how the parents experience the home visits by the child health center (CHC). Objective: To investigate the parents' experience of home visits from CHC. Method: Data was collected by posting questions in two parent forums during 3 months and searching for posts in 11 parent forums from 2013 to 2016. Data was analyzed by inductive content analysis. Results: The parents had varying experiences of home visits; from comfort, for example was perceived as positive to avoid having to go out in bad weather, to a sense of being controlled as a parent. Many parents were unaware that the CHC offers a home visit at eight months, and some were unaware that home visits were offered at all. Several parents expressed an uncertainty about the purpose of the home visit. Conclusion: It is important that the district nurse has a good routine of how, where and when information about home visits is given to reach all parents. The information can have a significant impact on how parents will experience home visit from the CHC, and if they will accept home visits.

This study explored the risk that social workers face in the field while serving vulnerable adults to determine if there is need to implement mandated safety training based on social worker experiences and their desire for initial safety training. There needs to be a clear understanding of risks faced by social workers and their desire for safety training to implement safety standards and training for social workers across the board in social service agencies and academic institutions. There is minimal research currently on this topic and thus this study is paving the way for future research, as well as providing insight to risks faced by social workers who conduct field visits. This quantitative study presents different field situations that have put the social worker’s personal safety at risk and desire for safety training based on their personal experience. The results show a desire and need for mandatory safety training prior to entering the field. The results show a positive correlation between years in the field and risks faced in the field. Additionally, there was a positive correlation between age and desire for field safety training. There were differences found in risks experienced and desire for safety training by gender, education and ethnicity. This study is the start to understanding safety risks faced by social workers in the field and suggests developing safety training policy to ensure social worker safety in the field in both social service agencies and academic institutions.

Inledning: Inom barn- och ungdomspsykiatrin (BUP) i Stockholms län finns fyra Mellanvårdsmottagningar. Dessa är en förstärkning till Öppenvården och kan arbeta intensivt med familjer i deras hem eller närmiljö. Frågeställningar: Syftet med denna studie är att få ökad förståelse och kunskap om hur familjer, som haft kontakt med BUP Mellanvård, upplever hembesök som arbetsmetod samt hur de upplevt den behandlingsinsats som de fått. Studiens frågeställningar är: Hur upplever familjer hembesök som arbetsmetod? Vilken betydelse har platsen för kontakten? Hur blev relationen mellan behandlare och familj? Hur blev utfallet av behandlingsinsatsen? Metod: Sex familjer deltog i studien som genomfördes med hjälp av semistrukturerade intervjuer. Svaren presenteras i komprimerad och sammanfattad form under respektive område; hemmet, behandlingen och relationerna. Resultat: Resultatet visar att föräldrarna såg främst praktiska fördelar med hembesök, de upplevde det heller inte besvärande att ta emot behandlare i det egna hemmet. Föräldrarna hade överlag mer positiva upplevelser kring hembesöket än vad barnen upplevde, men de tyckte inte att platsen i sig i särskilt stor grad påverkade varken relationerna eller behandlingsinsatsen. De negativa svaren och reflektionerna som kom fram vid intervjuerna rörde främst utfallet av behandlingsinsatsen som helhet. Diskussion: De familjer som vid intervjutillfället fortfarande befann sig i en svår situation ansåg inte att insatsen från BUP Mellanvård varit till hjälp för dem. De uttryckte under intervjun brister som de upplevt i behandlingen och i kontakten med behandlarna, åsikter som de inte hade fört fram under pågående kontakt. Ett utvecklingsarbete inom BUP Mellanvård vore av stor betydelse för att på ett bättre sätt, under pågående behandlingskontakt, kunna fånga familjernas reflektioner och upplevelser. / Introduction: Within child and adolescent psychiatry (BUP) in Stockholm County Council there are four ”Between care” clinics, strengthening the Outpatient services and they work intensively with families in their homes and/or immediate environment.  Questions: The purpose of this study is to increase understanding and knowledge about how families who had contact with BUP ”Between care” experienced home visits and the overall treatment provision they received. The research questions are: How do families experience home visit as a method of providing treatment? How important is location for treatment? How did the relationship between the therapist and the family develop? What was the outcome of the treatment intervention?  Method: Six families participated in the study which carried out using semi-structured interviews. The answers are presented in a condensed and summarized format for the following areas: home, treatment and relationships.  Results: The results showed that parents saw mainly practical advantages of home visits, and did not feel uncomfortable receiving the therapist in their own home. Parents, by and large, had more positive perceptions of the home visits than those experienced by the children, but did not perceive the location to influence either the relationships nor the treatment to a great extent. The negative responses and reflections that emerged during the interviews focused mainly on the outcome of the entire intervention.  Discussion: The families who at the time of the interview were still in a difficult situation did not consider the intervention of BUP ”Between care” helpful to them. During the interview they mentioned shortcomings they experienced in treatment and in their contact with therapists, views that they had not previously expressed during the on-going contact. A development of BUP ”Between care” would be of great importance to better capture families reflections and experiences while undergoing treatment.

京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第19636号 / 社医博第69号 / 新制||社医||9(附属図書館) / 32672 / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 佐藤 俊哉, 教授 今中 雄一, 教授 小西 郁生 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

No / Aims and objectives. The current study sought to identify how many mothers from 149 visits carried out by seven health visitors identified support as a feature of the visit, whether this type of support was unique to the health visitor and what support meant to them. These responses were then compared with the taxonomies of social support from the social support literature. . Some studies of client perceptions describe support as an element of home visits by health visitors. However, the importance, relevance and impact on the client of this support are not described in detail. Social support theory suggests that there are tangible benefits to people's well-being and their ability to cope with various challenges that may arise from individuals' perceptions of receiving support. Design. Qualitative study using semistructured interviews. Methods. Seven volunteer health visitors recruited 149 women into the study. These clients were interviewed by the researcher, usually within one week of the home visit by their health visitor. The discussions were audio-taped and the resulting transcripts analysed using content analysis. Findings. Thirty-seven women identified receiving support which they said was only available from the health visitor. The relevance of this support to the mother and the impact on her well-being varied within the group suggesting differing perceptions of support by clients according to their personal situation. There was a correspondence between the descriptions of support given by the women and the taxonomies of social support from the social support literature. Conclusion. For some interactions between clients and their health visitors the existing theory of social support may provide an explanation of how health visitors contribute to clients' perceived ability to cope and well-being. Relevance to clinical practice. Social support may be defined as a possible outcome of health visiting. This concept will have use within educational programmes to demonstrate to students how health visiting can have an impact on clients' well-being. Similarly, the concept could be used to investigate and record health visiting practice.

Syftet med denna studie var att beskriva äldres upplevelser och erfarenheter av uppsökande verksamhet i Osby kommun. Förebyggande hälsoinsatser för äldre bedrivs i Sverige med olika benämningar. I Osby kommun bedrivs de med benämning uppsökande versamhet. Uppsökande verksamhet med förebyggande insatser och råd kan stärka äldres egenvård och skjuta upp funktionsnedsättning samt förbättra den äldre personens välbefinnande och livskvalitet. Ur samhällsekonomiskt perspektiv kan uppsökande verksamhet också minska kostnader för vård och omsorg på sikt. Metoden är en kvalitativ intervjuundersökning med öppna frågor. Studie genomfördes under Juni- November år 2015 och tio äldre personer intervjuades. Av dessa var det fem kvinnor och fem män. Intervjuerna analyserades enligt Graneheim och Lundmans kvalitativa innehållsanalys. I resultatet framkom två kategorier och sju subkategorier. Essenserna som hittades från intervjuerna var: förväntningar, tillit i mötet, attityder till förändring, information, utförarens kompetens och personlighet, vikten av relation och kreativitet. Resultatet visar tydligt att äldre upplever arbetet med uppsökande verksamhet värdefullt och vill se detta arbete fortsätta. Denna studie ger utan tvekan stöd att utföra uppsökande verksamhet och uppsökande verksamhet kan ses som en redskap för de äldre att skapa bra förutsättningar att bevara hälsan och ger möjlighet till ett aktivt och självständigt liv. / The purpose of this study was to describe elderly persons experiences of preventive home visits in the Osby municipality. Preventive home visits with preventive actions might help elderly `s self-care abilities and postpone the effects of ageing and disability, in order to give elderly better well-being and good quality of life. This qualitative study and data was collected by qualitative interviews using open queries. The respondents were ten elderly persons (five females and five males). Interviews were carried out during June to November 2015. The material was analysed using Qualitative content analysis as described by Graneheim and Lundman. The analysis resulted in two categories and seven subcategories. In summary the subcategories were: expectations, confidence in the meet, attitudes on change, information, providers competence and personality, importance of relationship and creativity. The results of the study clearly indicates that the preventive home visits are appreciated and valuable to the elderly. All respondents claimed that the visit was a positive event in their lives and want to see it continue in the future. This study gives evidence to carry out the preventive home visits. The preventive visits gives elderly better conditions for maintaining a healthy and satisfactory ageing and independent life.

The purpose of this thesis is to study security for digital home visits, where traditional home visits are replaced by digital home visits using digital technology. The report examines the safety aspects for welfare technology solutions where data is collected from sensor systems and digital platforms and examines di↵erent Swedish laws that implies on a digital home visit. The study proposes an implementation of a prototype application to support users, relatives, and healthcare professionals to conduct digital home visits in a safe manner. The chosen scenario of the digital home visit was to check whether the person has eaten food during the day or not. This was done in a lab kitchen at Lule°a University of Technology with help of Z-wave sensors and a implemented systems. The result is displayed on a secure website. The solution is discussed and compared to other technical solutions of this problem and also to several Swedish laws. This paper finishes with a section aimed to provide a variety of recommendations when implementing a similar system.

Background: The parenting usually entails great joy but can also involve major challenges. Parenting is not always experienced positively, on occasion it can be very stressful. Studies show that early intervention can enhance the parenting role and promote connection between the child and the parent and thus facilitate illness prevention in children.  Aim: To illustrate child health, nurses and parenting counselors provided extended home visits for new parents.    Method: A qualitative design and the phenomenological approach are used. Seven interviews were carried out with Child health nurses and parenting counselors. The results were analyzed with a content analysis.  Results consist of four headings; Prerequisites for good cooperation, The importance of the meeting place, Concrete support for parents, Challenges to support parents  Conclusion: The result shows that the project helped child health nurses and parenting counselors provide increased security and support in the parenting role. They have learned that the collaboration in the project has been experienced positively as they together can support families with their specific knowledge. Their view is that the families appreciate the support offered and it is easier for them to discuss sensitive topics in their own home. The prerequisites for being able to respond to challenges in the project require staff support from the manager and training in different cultural approaches.

Public schools teachers in the U.S. strive to reach the needs of all students in the elementary classroom. However, teachers are increasingly expected to follow standardized curriculum. Culturally Sustaining Pedagogy (Paris, 2012) pushes toward individualized educational practices and against the assimilationism embedded in standardization. This study considers the ways in which nine women-identified teachers, one Black, two Latina, six white, who teach elementary school in a Midwestern university town, experience, discuss, and implement Culturally Sustaining Pedagogy in a professional development course, specifically through the lens of the following question: In a course on culturally sustaining pedagogy, how do teachers experience race, culture, families, and family literacies? Grounded in empirical research that considers teaching and learning through a sociocultural lens, and in the theoretical scholarship of Critical Discourse Analysis and Critical Pedagogy, the purpose of this qualitative, narrative inquiry is to describe teachers’ learning and responses to culturally sustaining pedagogical practices in order to understand this process and its implementation. Data for this qualitative inquiry were gathered over five months in a professional development course setting using the qualitative methods of observations, interviews, audio recordings, photographs, detailed field notes, and participant self-reflections. The data collected was analyzed through descriptive coding (Miles, Huberman, & Saldaña, 2014), narrative analysis (Schaafsma & Vinz, 2011), and Critical Discourse Analysis (Fairclough, 2015; Gee, 2014). Results from the study suggest that engagement in culturally sustaining practices is constrained by the standardizations of school, in addition to the discomfort and lack of knowledge of some teachers when talking about race and power in the elementary classroom. Findings also suggest that teachers’ explicit engagement with research and discussions regarding these constraints led to new culturally sustaining practices.