Syftet med denna avhandling är att skapa kunskap om vad det innebär för yngre barn att genomgå nålrelaterade medicinska procedurer. Dessutom vad vårdande stöd i samband med dessa procedurer innebär utifrån barns, föräldrars och sjuksköterskors perspektiv. Nålrelaterade medicinska procedurer är undersökningar som barn behöver vara med om i vården för att motverka sjukdom, för att ta reda på varför barnet är sjukt och för att ge barnet behandling. Dessa åtgärder innebär att barn behöver vara med om nålstick. Med hjälp av deltagande observationer och livsvärldsintervjuer, som har dokumenterats genom videoobservationer, fältanteckningar och ljudinspelningar, har datainsamlingen genomförts i vården med yngre barn, 3-7 år, deras föräldrar och sjuksköterskor. Barnen har berättat om konsekvenser som de har upplevt av nålprocedurer och om att få stöd vid dessa åtgärder. Föräldrar och sjuksköterskor har berättat om sina erfarenheter av att ge stöd till barnen. Avhandlingens resultat visar att en framträdande konsekvens för barn under nålprocedurer är upplevelse av rädsla. Hur föräldrar och sjuksköterskor svarar an mot detta har en avgörande betydelse för om barnets rädsla ökar eller minskar. Denna avhandling bidrar med kunskap om barns upplevelser av nålprocedurer och behov av stöd samt hur stödet kan utformas vid dessa åtgärder. Emellertid, forskning inom området ärfortfarande otillräcklig och ytterligare forskning behövs där barns perspektiv lyfts fram i vården. / Aim: The overall aim of the thesis is to create knowledge about what it means for younger children to undergo needle-related medical procedures (NRMPs), and what caring support in relation to this means based on nurses’, parents’, and younger children's perspectives. Methods: The first and second papers used descriptive phenomenological analysis to describe the meanings of supporting younger children during NRMPs from the perspective of nurses (Ι) and parents(ΙΙ). The third and fourth papers used lifeworld hermeneutic analysis to explain and understand the consequences related to NRMPs (ΙΙΙ) and support (ΙV) during these procedures from younger children’s perspectives. Data has been collected by participant observations and lifeworld interviews documented by video-recorded observations, field notes, and audio-recorded interviews. In total 60 people participated, fourteen nurses, twenty-five parents, and twenty-one children. Main results: The results show that an important consequence for children of procedures with needles is experiences of fear. The child's fear affects how the child is able to manage the procedure and the support the child gets from adults is crucial to whether the child's fear increases or decreases. The support consists of giving support or receiving support. Parents support the child by safeguarding and protecting the child during the needle-related procedure; they “keep the child under the protection of their wings,” sometimes very close and sometimes a little further out under the wingtips. Nurses support the child by starting from individual child’s experiences and needs; they "balance on a tightrope" in an unpredictable situation. In the meeting between the child, the parents, and the nurses, the adults are guided by the child in what forms of support are provided. This continues until the needle-related medical procedure is completed and the child can walk proud and strong from the procedure with a feeling that "I can handle this.” Conclusions: Children’s need for support during needle-related medical procedures is primarily tied to children’s experiences of fear. For the child to experience a caring support, adults need to understand children’s experiences of fear as well as children’s need for support and what form the support should take. A caring support develops dialectically between children and adults in a circular movement. In such a dialectic, the child guides the adult and vice versa. That children have the capability of guiding adults during needle-related medical procedures shows that they are active and participating. Here it becomes clear that there is no objective location of the phenomenon of support. Support can therefore only be studied as a lived experience of those who need it.

This study is a qualitative, phenomenological inquiry into teachers’ and children’s ‘lived experiences’ of the child-teacher relationship in an Irish upper primary school context. It highlights the current need to re-focus our attention on the child-teacher relationship which Biesta (2004) argues is the 'location' of education. An overview of the literature on relational pedagogy is provided which connects the child-teacher relationship to broader theoretical debates including Heidegger's (1962) concept of Mitsein and Buber's I- Thou relation (1937). Hermeneutic phenomenology describes the overarching methodology following van Manen’s (1990) ‘lived experience’ approach. The study was conducted in a large, suburban, primary school with designated disadvantaged status. Before data generation commenced, a Children’s Research Advisory Group was established in the school following Lundy, McEvoy, and Byrne (2011). The function of this group was to advise about conducting research with children. Research participants included three teachers and five children from each of those teachers’ classes. Data generation featured the use of protocol writing and conversational interviews following van Manen (1990, 2014) and the use of embodied, drama methods which were unique to this study but inspired by the work of Norris (2000) and guided by O’Sullivan (2011). Data was also generated using visual methods drawing on the work of Mitchell (2011), Tinkler (2015) and Chappell and Craft (2011). In line with the phenomenological approach adopted, data was interpreted in what Gadamer (1989) describes as a circular manner. This involves attending to ‘parts’ whilst keeping in mind the ‘whole’ picture. This study identified three overarching thematic findings which find resonance with the fields of relational pedagogy and embodied teaching and learning as well as new insights at the point where these two areas overlap. These include how teachers and children relate to one another as ‘whole, embodied feeling beings’; the idea that there is a tension between ‘closeness’ and ‘distance’ in the child teacher relationship and that there is a need for both ‘structure’ and ‘freedom’ to feature in that relationship. Further, this study found that the child-teacher relationship is experienced as ‘knotted’ with social and contextual relationships. These findings are discussed in light of the concepts of ‘connectedness’ and ‘emergence’, features of complexity theory. This study provides new insights into how teachers and children experience their relationships with one another, thereby extending the body of knowledge on the child-teacher relationship.

Abuse negatively affects women living with HIV and AIDS. It can be a hindrance to living positively with the disease. Little is known about the essence of living with HIV, AIDS and abuse among women. The purpose of this study was to develop and refine guidelines for assessment of abuse in women living with HIV and AIDS. The objectives were to explore and describe the experiences of the women in Lilongwe, Malawi and to develop and refine guidelines for assessment of abuse in the women. In phase 1 of the study, descriptive phenomenology as espoused in life world research was used. Data were gathered using unstructured interviews from a purposefully selected sample of 12 women living with HIV and AIDS who had encountered abuse. The data were analysed using qualitative methods. The women’s experiences were characterized by humiliation from partners, families, neighbours and friends; hopelessness and blame. Harm emanated from being beaten, stress suffered from the abuse, interrupted antiretroviral drugs and possible re-infection with HIV due to unprotected sex. Abandonment of the women by their husbands and families was a common occurrence. Phase 2 of the study was the development of guidelines that can be used with women who experience abuse while living with HIV and AIDS. The guidelines were based on discussion of the findings of phase 1 in the context of an extensive literature review on the constituents. Modified Delphi technique was utilized to refine the draft guidelines. Two rounds were used to finalize the guidelines by a panel of ten experts who were purposefully selected based on their involvement in issues of gender-based violence, HIV and AIDS. The study findings though applicable to the context of the study, can be transferable to similar contexts. Recommendations made include validating the assessment guidelines and testing them in practice to evaluate the applicability and feasibility of using the guidelines. / Thesis (PhD)--University of Pretoria, 2013. / gm2013 / Nursing Science / unrestricted

Magister Curationis - MCur / The Western Cape Province of South Africa has the worst multifactorial crime problem in the country. It has the fastest growing crime rate in many crime categories, such as rape and gun related incidents. The youth in the Cape Flats faces many challenges, such as drug abuse and high incidents of violent attacks. The youth who are exposed to violence are inclined to be violent themselves and are at a higher risk of psychopathology. The experiences of the youth after a violent physical incident were unclear. The purpose of this study is to describe actions for the support of professional nurses at a community health centre to youth victims of physical violence in the Cape Flats. A phenomenological, exploratory, descriptive, contextual design was followed in this study. This study explored and described the lived experiences of youth victims of physical violence in terms of the support they received in a natural setting at a community health centre in the Cape Flats. Purposive sampling was used for the study, and data saturation determined the size of the sample, that was eight participants. Participants were male and female youth members between the ages of 18 and 27 years who had experienced a violent incident and visited a health care centre for follow-up treatment. They were given information sheets that explained the nature of the research project. Individual in-depth interviews were used to collect data. Interviews were conducted in one of the consultation rooms at a community health centre that was quiet and where minimal interruptions occurred. The researcher sought permission from the participants to conduct the interviews and to audio record those interviews. All ethical principles were adhered to in this study; that is confidentiality, anonymity, withdrawal, autonomy, and informed consent. Trust worthiness was ensured during the research process. In cases where participants had experienced psychological distress, they could be referred to a psychologist. However, none of the participants displayed any signs of emotional discomfort during the interviews. Data was analysed using Creswell’s six steps of open coding. All data would be kept under lock and key for five years after the research report has been made available. Main themes that emerged from the data analysis were related to violent incidents that had a negative impact on the participant; participants applied defence mechanisms to deal with their trauma, and participants experienced care and support either negatively or positively. A recommendation of this study is the implementation of an in-service training programme to the nurses who care for the youth after violent physical incidents.

While the role of the school principal has received much attention in stable environments, little research exists on principals working in conflict-affected countries. The purpose of this phenomenological study is to uncover perceptions of Somali principals in Mogadishu regarding their roles and lived experiences, as well as the challenges they face as they lead their schools amid ongoing conflict. In order to understand the different dimensions of the principal’s role and how this role is experienced in such a context, a descriptive phenomenology has been employed. A purposeful sample of eight primary school principals in Mogadishu, which has been the epicentre of the ongoing conflict, was indentified and the principals were interviewed. Through the six-step approach to phenomenological data analysis, as suggested by Creswell (2013), 11 themes were identified. Findings revealed that principals perceived their role as supporting teachers personally and professionally, supervising instruction, facilitating teacher professional development when the security situation permits, having good relationships with governing bodies, and building community collaboration. Findings also showed that, besides security concerns, student mobility, poor facilities, shortage of trained teachers and student discipline were the major challenges to principals. Findings further indicated that principals acted as boundary spanners using a variety of buffering and bridging strategies in an attempt to minimize uncertainty and security risks, as well as to adapt the school to the volatile environment. Furthermore, commitment to keep schools open, despite the huge challenges, a sense of responsibility for student safety, and calm and courageous actions in the face of danger were perceived as critical factors in sustaining principals in their positions. Four conclusions were drawn from the study, including principals’ lack of unity in the perception of their roles, principals’ lack of pre-service training, the possibility and essentiality of providing education during armed conflicts, and the importance of creating strong bonds through principals’ supportive roles. Recommendations were offered for primary principals, local educational umbrellas, NGOs, and UN agencies, as well as for further research possibilities.

A thorough examination of policies and guidelines tailored towards enabling access to land and housing in Gaborone suggests incongruences' inherent in these strategies. Besides, planners and policymakers' continuous oversight to recognise the complexities of the urban everyday survival strategies and the lived experiences of the populace needs to be investigated. Numerous interventions have been introduced to facilitate land and housing access for low-income households in Gaborone. Even so, restricted access to these assets remains an enormous task, proven complex and problematic to resolve. The empirical evidence specifies the predominant situation articulated by a clash of rationalities between policies and everyday socio-economic practices of access to land and housing by low income households in Gaborone. The investigation of these tensions between policies promoting access to land and housing and the advocacy of the Self-Help Housing Agency as the primary rationale for home building and ownership by low-income households in Gaborone was articulated through policy assessment and analysis. Furthermore, in-depth interviews to appreciate the affected populace's lived experiences in response to the practicality of these policies was conducted. In terms of findings, this research has established that urban environments are persistently transformed with new configurations relating to access to land and housing frequently surfacing. Moreover, urban land and housing management policies fail to get in touch with the complexities of grassroots experience with access to land and housing in Gaborone. There is also the entrenchment of low-income households in a vicious circle of poverty and living precariously at the urban fringes with no security of tenure and affordable housing opportunities. All these experiences and practices resonate with the current endeavours to evaluate the realities of accessing land and housing resources in cities, as well as their correlation with promoting livelihood strategies for low-income households.

Bakgrund: I Sverige lever närmare en procent av befolkningen med venösa bensår. Såren uppstår på grund av venös insufficiens. Venösa bensår är ett stort folkhälsoproblem i hela världen. Personer som har ett stillasittande levnadssätt och är överviktiga har en högre risk än genomsnittsbefolkningen att utveckla venösa bensår. Såren är svårläkta och drabbar främst äldre personer. Sjuksköterskan har det yttersta ansvaret för patientens omvårdnad. Syfte: Syftet var att belysa personers upplevelser av att leva med venösa bensår. Metod: En litteraturöversikt har använts som metod. Ur databaserna PubMed och CINAHL Complete hämtades tio stycken vetenskapliga artiklar som grundar sig på forskning enligt kvalitativ metod. Resultat: Tre huvudteman och tre underteman identifierades. Det första huvudtemat var Smärta och dess hantering. Det andra huvudtemat var Påfrestningar till följd av odör och exsudat. Det tredje huvudtemat var Ett förändrat liv och har följande underteman; Beroende, Behandling och läkning samt Kunskapsbrist. Diskussion: I metoddiskussionen diskuterades litteraturöversiktens styrkor och svagheter. Resultatfynd associeras till vårdkontext och diskuteras i relation till bakgrund, ny forskning samt Katie Erikssons teori där lidande och vårdprocessen fokuseras. / Background: Nearly one percent of the Swedish population lives with venous leg ulcers. Venous leg ulceration is caused by venous insufficiency. This is a big public health problem worldwide. People who live their lives sedentary and are overweight suffers a greater risk of evolving venous leg ulcers. These types of ulcers are slow-healing and mostly affects elderly people.  The responsibility for patient care is the nurse. Aim: The aim of the study was to enlighten people’s experiences of living with venous leg ulcers. Method: A literature review was used as method. PubMed and CINAHL Complete were used as databases. Ten scientific qualitative articles were found. Results: Three main topics and three subtopics were identified. The first main topic was Pain and its management. The second main topic was Strains following odour and exudate. The third main topic was A different life with following subtopics; Dependence, Treatment and healing and Knowledge deficit. Discussion: The strengths and weaknesses of the literature review is discussed in the method discussion. The results are discussed in nursing context and is related to background, new research and Katie Eriksson’s theory with suffering and care process.

The purpose of this work is to center dance at the heart of Métis identity expressions, where reconnecting with who we are through dance is intimately grounded within an Indigenous understanding of restoring wellbeing. Exploring the experiences of four prominent Métis women allowed a space to celebrate the voice of dancers as they make sense of what it means to practice Métis dance within their lives. This research further focuses on the experiences of Métis dance as an understanding of Indigenous wellbeing. The lived experiences were collected and reviewed within an Indigenous research framework grounded in the Cree and Métis values of Mino-pimatisiwin (good life) and Wahkotowin (kinship) (Hart, 1999; Kelsey, 2008). Both concepts deeply inform the processes related to our reciprocal relationship to all things, living and non-living and further place emphasis on our shared responsibility to honour, respect and acknowledge Indigenous knowledge and its value to our communities. There were three findings that emerged from this study: Understanding Métis dance (1) as a restorative and relational praxis of self-knowing; 2) as intergenerational knowledge transfer; 3) as a site for growing cultural awareness and self esteem. The voices of the women celebrate Métis peoplehood through the restorative practice of dance and in doing so allow us to un-settle and re-center the notion of Métis identity and dispel the question of “authenticity” (Lawrence, 2003). These are our own personal stories to tell, and only we can rewrite them in a way that is beneficial and meaningful to us.

With an increase in diagnosis rates of autism in Trinidad, more parents of children with autism, especially single fathers, face numerous challenges on a daily basis. There is a lack of research on this topic and therefore an inadequate understanding of the experiences of Trinidadian single fathers as primary caregivers for children with autism. The purpose of this phenomenological study was to explore and depict the lived experiences of single fathers of children with autism. Social support theory was the guiding conceptual framework to explore and understand how single fathers effectively manage their daily challenges. Ten single fathers from Southern Trinidad were recruited through criterion sampling and they engaged in semi-structured interviews individually. Moustakas's steps to phenomenological analysis were used to analyze the data. There were seven major themes that emerged from describing the lived experience of single fathers of children with autism: (a) challenges, (b) social support systems, (c) day-to-day experiences, (d) the role of the father within the family, (e) effects on social life, (f) sibling reactions, and (g) adaptive coping mechanisms. This study may engender social change, as the findings may be used to support single fathers to continue to provide care for their children. This study could result in improved understanding and support for their children both at home, in school, and in the community. The findings will be available to other fathers who share similar experiences. Special education service providers may gain further information to improve their services to families of children with disabilities.

Currently, the high level of burnout among military psychologists resulting from contemporary military service is gaining attention. However, there is insufficient knowledge of their lived experiences of burnout. The purpose of this phenomenological study was to explore burnout, based on the military occupational mental health, military job demand-resources models, and biopsychosocial models. Eleven active duty and prior service military psychologists were recruited for interviews using snowball sampling. The first phase of data analysis employed NVivo software. The second and third phase used the 7-step modified version of the Van Kamm method, resulting in 7 themes and 1 discrepant case. The key findings indicated that the unique nature of military bureaucracy provided the environment that fostered burnout into a taboo milestone. Furthermore, the challenging task associated with finding meaning and balance for the ambiguous role of being a military psychologist also compounded the experiential factors contributing to burnout. Several shared experiential indications foretelling of burnout were identified. However, the reality of how military psychologist experienced burnout differed from textbook knowledge, indicating there is a theory-practice gap in personally diagnosing burnout progression. Military psychologists also indicated the theory-practice gap between the available resources for burnout and their limiting utilization practicability. The results of this study can be used to make a positive social change by better informing the development of prevention strategies benefiting not only military psychologists but potentially all military members who routinely describe themselves as burned out.