Bakgrund: Sjuksköterskeyrket är en profession med komplexitet där den professionella sjuksköterskan bör inneha kunskap och förståelse, färdighet och förmåga, värderingsförmåga och förhållningssätt, för att kunna leda och ansvara för en god patientsäker omvårdnad. Det examineras ungefär 5000 sjuksköterskor varje år i Sverige. Sjuksköterskestudenter som närmar sig examen upplever blandade känslor. Både en glädje över att snart vara färdiga sjuksköterskor, en oro över att inte besitta kompetens nog för rollen samt en osäkerhet inför att arbeta självständigt och att ansvara för beslut i patientrelaterade omvårdnadsfrågor. Efter två år i yrket väljer 30 % av de nyutexaminerade sjuksköterskorna att lämna yrket. Syfte: Syftet var att få en fördjupad förståelse av nyutexaminerade sjuksköterskors erfarenheter av sitt första år inom professionellt kliniskt arbete. Metod: Metoden som används är en litteraturöversikt som baseras på elva artiklar bestående av två med mixad metod, en av kvalitativ design samt sju med kvantitativ studiedesign med Benners (1984) teori från Novis till Expert som stöd som vid resultatdiskussion. Resultat: Den nyutexaminerade sjuksköterskans erfarenheter sammanfattas under fyra huvudteman: Rollförväntningar, Arbetskultur och Miljö, Utvecklande av kompetens samt Fokusskifte. Undertema till Rollförväntningar är Osäkerhet och Kaos. Undertema till Arbetskultur och Miljö är Introduktion och Handledning. De nyutexaminerade sjuksköterskorna hade förväntningar på rollen som sjuksköterska som ledde till en skrämmande erfarenhet i den kliniska verksamheten. Positiva erfarenheter hos de nyutexaminerade sjuksköterskorna var förenade med att ha en bra handledare och en stödjande arbetsmiljö. Efter att utövat professionen i nästan ett år upplevde de nyutexaminerade sjuksköterskorna en tillfredsställelse med utvecklingen av yrkeskompetensen. Under de första sex till tolv månaderna koncentrerade de nyexaminerade sjuksköterskorna sina krafter på lära känna den nya arbetsmiljön och erhålla acceptans från arbetskollegor. Vart efter trygghet i rollen växte, skiftade sjuksköterskan fokus från sina egna behov till patientens. Diskussion: Resultatet diskuterades med stöd av Benners teori. Resultatet visade på att flertalet av de nyutexaminerade sjuksköterskorna inte uppfattade sig redo att självständigt agera, hantera och organisera omvårdnaden och upplevde ett behov av mer empirisk erfarenhet för att hantera sin roll som sjuksköterska. De nyutexaminerade sjuksköterskorna var i behov av stöd vilket även Benner beskriver i sin teori. Att uppleva stöd från arbetskollegor och andra sjuksköterskor med mer gedigen erfarenhet var ytterst viktiga faktorer för den nyutexaminerade sjuksköterskans hälsa och kompetensutveckling, men flertalet av studierna visade på att nyutexaminerade sjuksköterskor upplevde att de saknade stöd. Den nyutexaminerade sjuksköterskan koncentrerar sig på den egna utvecklingen samt att följa utstakade riktlinjer, vilket kan orsaka att patienten hamnar i bakgrunden för den nyutexaminerade. Det är först när den nyutexaminerade sjuksköterskan skaffat sig tillräckligt med erfarenheter och självförtroende hen skiftar fokus från sina egna behov till patientens. / Background: The nursing profession is a profession with complexity where the professional nurses must have knowledge and understanding, skills and abilities, judgment and approach, to be able to lead and be responsible for good and safe patient care. Approximately 5000 nurses graduate every year in Sweden. Nursing students approaching graduation experienced mixed feelings. Both a delight to soon be finished nursing while concern was expressed about not possessing the skills enough for the role, as well as an uncertainty to work independently and be responsible for decisions in patient-related health issues. After two years in the profession approximately 30 % of the newly graduated nurses choose to leave the profession. Aim: The aim was to gain a deeper understanding of how the newly graduated nurses experience their first year in the professional clinical work. Method: The method used is a literature review based on eleven articles consisting of two with mixed method, one of qualitative design and seven with quantitative study design with Benner's (1984) theory from Novis to Expert as support for discussion of the results. Results: Four major themes emerged: Role Expectations, Work Culture and Environment, Development of expertise and Focus shift. Subthemes to Role Expectations is Uncertainty and Chaos. Subthemes to Work Culture are Environment's Introduction and Mentoring. The newly graduated nurses had expectations about the nursing role that led to a terrifying experience in clinical practice. Positive experiences of the graduate nurses were associated with having a good supervisor and a supportive work environment. After practicing the profession for nearly a year, the newly graduated nurses experienced satisfaction with the development of the professional skill. During the first six to twelve months the newly graduated nurses concentrated their energy on getting to know the environment and receive acceptance from colleagues. When security grew in the nursing role, the nurse shifted the focus from their own needs to the patient's needs. Positive experiences of the newly graduated nurses were associated with having a good supervisor and a supportive work environment. Discussion: The results were discussed with Benners theory. The results showed that the majority of the newly graduated nurses did not perceive themselves ready to act independently, manage and organize care, and felt a need for more empirical experience to handle the nursing role. The newly graduated nurses stated a need for support from an experienced nurse, in which Benners agrees and describes in her theory. Experience support of colleagues and other nurses with more experience was extremely important factors for the newly graduates health and development of competence, but most of the studies showed that newly graduated nurses felt that they lacked support. As the competence increased the newly graduated nurse experienced that their previous focus on getting acceptance from colleagues was replaced by a focus on the patient and their care. According to Benners theory the newly graduated nurses concentrate on their own development and guidelines, which can cause the newly graduated nurse to lack focus on the patient.

The body of literature clearly articulates the unique needs of newly qualified teachers and the challenges they experience during their early career years. In addition, literature advocates for implementation of induction programmes to enable a smooth transition of the beginners into the profession. This empirical phenomenological study explored the induction experiences of newly qualified primary school teachers in Zimbabwe in an attempt to gain insights into the everyday issues they contend with. Purposive sampling was employed to select twenty participants who comprised of ten newly qualified teachers, five beginners whose experience in the field ranged from one to three years and five mentors. Data were collected mainly through three semi-structured interviews with newly qualified teachers and mentors, reflective essays written by beginners who were not so new in the profession and a focus group discussion with selected beginners. The protocol used for data explication was a simplified version of Hycner’s (1985) framework for phenomenological analysis suggested by Groenewald (2004). The findings yielded six themes and revealed that: new teachers experienced adaptation challenges relating to forging of new relationships, location of schools and nature of host communities; induction was largely informal and incidental, and the induction supports experienced by the new teachers were limited; the beginners had various teaching and social concerns that needed to be addressed; and, while the new teachers had derived some lessons from their first year of teaching, these were outweighed by their concerns and might not have made a significant impact on their classroom practices. The data also revealed that the partnership between teacher education institutions and schools in providing for teacher professional development was weak. The study concluded that the absence of a policy on induction in the country has resulted in lack of appreciation of the centrality of induction on the teacher development continuum and the haphazard manner in which issues of induction are being handled. The main recommendations from the study were that a policy on induction should be put in place, that schools are empowered to provide induction and induction supports that are amenable to the country’s context be fully exploited. / Curriculum and Instructional Studies / D. Ed. (Didactics)

Enligt tidigare forskning kan migration skapa en sexuell utsatthet till följd av att normer och sammanhang ändras. Syftet med denna studie är därför att identifiera och problematisera de värdenormer som konstrueras i nyanlända unga mäns tal om maskuliniteter i relation till sex- och samlevnad. Det teoretiska ramverket utgår från hegemonisk teori om maskuliniteter och hur subjektet positionerar sig i relation till andra. Sex semi-strukturerade intervjuer genomfördes av nyanlända unga män i åldern 18 år. Materialet analyserades med hjälp av diskursanalys. Baserat på de nyanlända unga männens berättelser identifieras två skilda diskurser: en patriarkal diskurs och en jämställdhets diskurs. / According to previous research, when it comes to sexuality, migration can create a risk for refugees as a result of changing norms and contexts. Therefore the purpose of the study is to identify and problematize the construction of those values and norms made visible in the way newly arrived young men talk about masculinities, in relation to sex and cohabitation. The theoretical framework is based on a hegemonic theory of masculinities and an understanding about how one as a subject position itself in relation to others. Six interviews using a semi-structured design were made with newly arrived young men at the age of 18. The interviews were analyzed using discourse as analytical method. The result identifies two different discourses. A patriarchal discourse and one equality discourse.

Uppsatsen syfte är att öka kunskapen om vilka olika arbetssätt lärare använder för att inkludera nyanlända elever i samhällskunskapsundervisningen. Studien är en kvalitativ intervjustudie med inspiration från en fenomenologisk livsvärldsansats. Genom en kvalitativ forskningsintervju med grundskollärare i årskurs 4–6 har data samlats in och sedan kategoriserats. De tre teman som resultatet består av är: verktyg för inkludering, svårigheter vid inkludering och vikten av samhällskunskapsämnet. Studiens teoretiska utgångspunkt är sociokulturell teori och utifrån detta perspektiv har resultatet analyserats och teoretiska tolkningar har skapats. Resultatet i undersökningen visar att lärarna använder sig av flera olika verktyg för att inkludera nyanlända elever i samhällskunskapsundervisningen. Det framkommer att inkludering är ett svårtolkat begrepp som är väldigt beroende av individen vilket betyder att inkludering kan se väldigt olika ut. Samarbete med studiehandledare, ämnesövergripande arbetssätt, digitala verktyg, placering, att skapa förförståelse hos eleverna, gemenskap och samspel är alla viktiga delar i inkluderingsprocessen. I resultatet tas även svårigheter vid inkludering upp och dessa är bland annat abstrakta ämnesbegrepp, brister i svenska språket, svårigheter vid socialt samspel, missförstånd, elevernas olika erfarenheter, elevernas verklighetssyn, samhällskunskapsämnets breda innehåll och det faktum att ämnet är kontextbundet. Lärarna i studien är eniga om att samhällskunskapsämnet är en viktig del av de nyanlända elevernas inkluderingsprocess i det svenska samhället. / The purpose of this study is to increase the knowledge of different working methods teachers use to include newly arrived pupils in social studies. The study is a qualitative interview study with inspiration from a phenomenological life-world approach. Through a qualitative research interview with primary school teachers in grades 4–6, data has been collected. The collected data has been categorized based on three themes. The three themes that the result consists of are: tools for inclusion, inclusion difficulties and the importance of the social science topic. The theoretical starting point of the study is socio-cultural theory and from this perspective the result has been analyzed and theoretical interpretations have been created.   The results of the study show that teachers use several different tools to include newly arrived pupils in social studies. It appears that inclusion is a difficult-to-interpret-concept that is very dependent on the individual, which means that inclusion can look very different depending on the individual. Collaboration with study supervisors, interdisciplinary workingmethods, digital tools, placement, creating understanding of the students, community and interaction are all important parts of the inclusionprocess. The result also show difficulties with inclusion and these include abstract subject concepts, deficiencies in the Swedish language, difficulties in social interaction, misunderstandings, the students 'different experiences, the students' view of reality, the broad content of the social science subject and the fact that the subject is contextual. The teachers in the study agree that the subject of social studies is an important part of the newly arrived pupils' inclusionprocess in Swedish society.

Ein Schlüsselprozess in der Immunantwort ist die durch das proinflammatorische Zytokin Interferon-gamma (IFNg) induzierte transiente Akkumulation von neu synthetisierten defekten Proteinen, die durch Anknüpfen von Polymeren des Proteins Ubiquitin (Ub) post-translational modifiziert werden. Die Ubiquitinierung ist das Schlüsselsignal für den Abbau dieser Proteine. Die Abbauprodukte dienen unter anderem als Quelle für die Prozessierung von Antigenen. Um die frühe Immunantwort besser zu verstehen, wurden im Rahmen dieser Arbeit die Identität und Charakteristika dieser neu synthetisierten Proteine, sowie die Topologie ihrer post-translationalen Modifizierung durch Ub untersucht. Dazu wurde die massenspektrometrischen Analyse ubiquitinierter Proteine weiterentwickelt, indem die experimentellen Konditionen auf deren Analyse optimiert wurden. Insbesondere konnte gezeigt werden, dass die kombinierte Verdauung der Ub-Konjugate mittels zweier Peptidasen die Identifizierung der Proteinpeptide und der Indikatorpeptide für Ubiquitinierungsstellen entscheidend verbessert. Es wurde demonstriert, dass eine selektive Isotopenmarkierung der neu synthetisierten Proteine möglich ist. Mit Hilfe dieser Methode gelang es, Veränderungen der Ub Modifikationen bezüglich der Topologie sowie quantitative Unterschiede der ubiquitinierten Proteine aus humanen HeLa-Zellen in An- und Abwesenheit von IFNg zu identifizieren. Nach Induktion durch IFNg wurden drei polyubiquitinierte, drei mono- oder polyubiquitinierte und 111 potentiell ubiquitinierte Proteine identifiziert. Diese Proteine zeigten, dass keine generelle Ubiquitinierungspräferenz für die durch IFNg verstärkt transkribierten Gene besteht. Die Ergebnisse dieser Arbeit erweitern das Verständnis der frühen zellulären Immunantwort und tragen zum Verständnis von Krebs- und Autoimmunerkrankungen sowie chronischen Entzündungsprozessen bei. Möglicherweise bilden sie die Grundlage für die Weiterentwicklung entsprechender Therapien. / A key process within the immune response of organisms is the transient accumulation of newly synthesized defective proteins affected by the proinflammatory cytokine interferon-gamma(IFNg). These proteins are post-translationally modified by attachment of polymers of the protein ubiquitin (Ub), which represents the key signal for targeting them to degradation. The resulting peptides can serve as sources for antigen processing. In order to get an insight into the details of the cellular early immune response, the identity and characteristics of the newly synthesized proteins and the topology of their post-translational modification with Ub were investigated. An essential progress of the mass spectrometric approach was achieved by optimizing the experimental conditions with regard to the requirements of the analysis of the targeted proteins. In particular, it could be shown that a combined digestion of Ub-conjugates with two peptidases leads to an improved detection of protein peptides and indicator peptides for ubiquitination sites. It was shown that a selective isotopic labeling of the newly synthesized proteins was possible. With this method, a decisive step forward was made in the understanding of changes of the Ub modifications with respect to the topology and in clarifying the quantitative differences between Ub-conjugates from IFNg treated and untreated human HeLa cells. Three IFNg induced polyubiquitinated proteins, three mono- or polyubiquitinated as well as 111 potential Ub-substrates could be identified. These proteins did not show any general ubiquitination preference for genes whose transcription is enhanced in presence of IFNg. The results obtained in this work help to broaden and refine the general picture of the early cellular immune response. They contribute to the knowledge on molecular processes of cancer, autoimmune diseases or chronic inflammation and, potentially, can give hints for the continued development of corresponding therapies.

Syftet med denna uppsats var att utveckla kunskap om integrationsproblematiken för nyanlända ungdomar på språkintroduktion i Sverige. Kvalitativa intervjuer med en narrativ utgångspunkt användes som metod för datainsamling, där fem stycken nyanlända elever på språkintroduktion intervjuades. Det centrala teoretiska begreppet vilken tillämpades som analysverktyg i denna studie, har av oss tolkats utifrån Riessman, Johansson och Ricoeurs teorier om narrativ identitet. Studien utgick ifrån frågeställningar om hur eleverna framställer språkintroduktion, språk och gemenskap, samt hur deras identiteter framträder i deras narrativ. Följande frågeställningar låg därmed till grund för uppsatsen: hur framställs elevernas relation till språkintroduktion i deras berättelser, hur framträder elevernas identiteter i berättelserna, samt vilken funktion har språk och gemenskap i elevernas berättelser? Det övergripande narrativet präglades av elevernas förväntningar, besvikelser, ambivalens och slutligen lösningar. Resultatet visade att elevernas modersmål huvudsakligen framställdes i negativa termer, då ett användande av modersmålet framför det svenska språket hämmar språkfärdigheter i svenska och skapar svårigheter att integreras i den sociala gemenskapen i samhället. Oavsett grad av social gemenskap, framkom det i denna studie att elevernas identitet som invandrare blir bestående även efter språkintroduktion. Slutligen synliggjordes en ambivalent inställning kring hur eleverna framställer språk, skola och gemenskap, vilket illustrerade fenomenens mångsidiga inverkan på elevernas tillvaro. / The purpose of this essay was to develop knowledge about integration problems for newly arrived adolescents in a language introduction program in Sweden. Qualitative interviews with a focus on narrative aspects was used as a method for data collection. Five newly arrived pupils at language introduction program were interviewed. The central theoretical concept, which has been used as a tool for analysing in this study, has been understood through theories surrounding narrative identity by Riessman, Johansson and Ricoeur. This study was based on questions regarding how students present language introduction program, language and community, and how their identities appear in their narratives. Therefore, the following questions made the foundation of this essay; how is the students’ relation to language introduction program presented in their narratives, hur does the students’ identities appear in their narratives, and what function does language and community have in their narratives? The overarching narrative was characterized by the students’ expectations, disappointments, ambivalence, and finally, solutions. The results of this study showed that the students’ mother tongue was mainly presented in negative terms. Using the mother tongue, rather than the swedish language, inhibits language skills in swedish, and thus create difficulties concerning the integration into the social community. Regardless of the level of social inclusion, this study showed that the students’ identity as immigrants remain permanent even after language introduction. Finally, an ambivalent attitude was highlighted regarding how the students describe language, school and community. This illustrates the diverse effects of the phenomena on the students’ situation.

Barriers to reaching human immunodeficiency virus (HIV) testing prevent Canada from achieving The Joint United Nations Programme on HIV and AIDS (UNAIDS) target of 90 percent of undiagnosed people living with HIV knowing their HIV status by 2020 and receive treatment.(1) Fourteen percent (9,090 of 63,100) of Canadians living with HIV were unaware of their status by the end of 2016.(1)(p.9)Individuals exposed to HIV through heterosexual contact are overrepresented (28%) among the undiagnosed people living with HIV in Canada compared to other groups, such as men who have sex with men (18%) and people who inject drugs (20%).(2)(par.15)The reasons preventing this population to present themselves for testing in Ottawa, Ontario, remain poorly understood in the literature. Most of the literature on barriers to accessing HIV testing focuses on the traditional key groups who are likely to test, and limits analysis of these barriers on one or two levels. Equally, health service providers rarely understand challenges behind HIV testing for particularly young heterosexual African migrant men. These challenges may be contributing key barriers to HIV testing. On other hand, late presentation to treatment remains a global issue. Psychosocial outcomes especially after a new positive diagnosis can delay reaching early treatment and prevention services. Indeed, all test results negative or positive have consequences. Even those with a new negative test can return to risk taking behaviour if they delay accessing prevention education. Yet no systematic study exists in this area essential for quality improvement. Programming more equitable HIV testing services will require more comprehensive evidence about challenges and barriers behind accessing HIV testing and treatment to achieve UNAIDS target of 90 percent of undiagnosed people living with HIV knowing their status and receive treatment. This research aimed to contribute to this evidence through two phases. Phase 1 used the Joanna Briggs Institute methods to implement a scoping review on psychosocial outcomes and their measurements immediately following a new HIV diagnosis. This review considered all participants who tested for HIV – whether their results were positive or negative, as any test results have consequences, and regardless of age, sex, or setting – reported in published articles between 2007 -to the present date. Paper 1 presents the scoping review. Phase 2 relied on a qualitative methodology using Grounded Theory informed by a socio-ecological framework and a framework of access to healthcare to understand experiences of accessing HIV testing services in two parts: 1) to examine barriers to reaching HIV testing among young heterosexual African migrants, focusing on young men, in Ottawa (Paper 2); and 2) to identify challenges experienced by health service providers who make accessible HIV testing services to this population in Ottawa (Paper 3). There is some ambiguity in the use of the terms “first generation immigrants” and “second generation immigrants” (or children of first immigrants). In this study, the term migrants referred to both. Selecting participants from both groups (first and second generation) was important to include a wide variety of experiences and interpretations that reflect the study population. Furthermore, the term “health service providers” was used to refer to both healthcare providers and frontline service providers. Healthcare providers referred to those who conduct HIV testing in health facilities, whereas frontline service providers referred to those who provide care and support services needed by members in their communities before and after testing within AIDS organizations and community-based organizations.

Cette thèse étudie pour la première fois les pratiques langagières de la communauté grandissante des immigrés égyptiens en France. L’analyse morphosyntaxique a comme cadre la théorie insertionnelle Matrix Language Frame de Myers-Scotton (1993, 1997 et 2000). Nous constatons que les Égyptiens de la première génération recourent à l’alternance codique sans s’en rendre compte ou sans le reconnaître tandis que ceux de la deuxième génération sont conscients des caractéristiques linguistiques nées du contact des langues. De plus, la femme égyptienne, avec son rôle de maintien de l’arabe auprès de ses enfants, trouve sa féminité dans l’apprentissage du français et par conséquent elle joue un rôle important dans la pratique de l’alternance codique au sein de la famille. Les raisons de l’alternance codique chez les Égyptiens sont variées, par exemple : la citation ou le discours rapporté ; la désignation d’un interlocuteur en faisant intégrer à un groupe un interlocuteur tenu à l’écart ; l’humour qui caractérise notamment les Égyptiens de la première génération ; la spontanéité et la précision en optant directement pour le lexème le plus immédiatement disponible, même s’il est dans une langue différente par rapport au reste de la communication. Nos informateurs de la première génération ont recours aux procédés morphologiques pour simplifier l’usage des mots français ayant des sons qui n’existent pas en arabe égyptien ou ceux qui se composent de plus de trois syllabes. Nous exploitons les caractéristiques de ce contact des langues pour aider les élèves égyptiens nouvellement arrivés à réussir leur scolarité et s’intégrer dans la société française via la maîtrise du français. / This thesis analyses for the first time the language practices of the growing community of Egyptian immigrants in France. The morphosyntactical analysis is made in the framework of insertional theory Matrix Language Frame of Myers-Scotton (1993, 1997 and 2000). We find that the Egyptians of the first generation resort to code switching without realizing it or recognizing it while those of second generation are aware of the linguistic characteristics of the language contact. Furthermore, the Egyptian woman, with her role of maintaining Arabic with her children, finds her femininity in learning French and therefore she plays an important role in the practice of code switching within the family. The reasons of the code switching in the Egyptian community are varied, for example, the quotation or the reported speech ; the designation of an interlocutor by integrating into a group an interlocutor kept apart ; the humor that particularly characterizes the Egyptians of the first generation ; the spontaneity and the precision by opting directly for the most immediately available lexeme even if it is in a different language than the rest of the communication. Our informants of the first generation use morphological procedures to simplify the use of French words having sounds that don’t exist in Egyptian Arabic or those that consist of more than three syllables. We use the characteristics of this language contact to help Egyptian students newlly arrived to succeed in their schooling and integrate into the French society through the mastering of French language.

目的：基於初診斷乳癌患者的心理沮喪反應存在個別差異性之假設，本研究旨在探討乳癌患者的心理沮喪發展軌跡及其與資源變化、因應風格之間的關係，並採用動態性的壓力調適觀點來說明影響個體間發展差異與個人內變化之因素。三個主要的目的為（1）初診斷乳癌患者是否具有不同的心理沮喪發展軌跡？（2）隨時序變化的資源變化與因應風格可否區辨不同的軌跡組別；以及（3）不同軌跡組別的資源變化與因應風格對其心理沮喪之影響是否不同？ 方法： 本研究採用貫時性的研究設計，共收錄200名初診斷乳癌患者。患者於診斷後的手術前一天進行評估，並於術後一個月、術後四個月、術後七個月及術後一年進行後續的追蹤。每一點的心理沮喪分數採用中文的醫院版焦慮與憂鬱量表（HADS）來測量，追蹤時間點的資源變化與癌症因應風格之分數，分別是以修編的資源改變量表（資源流失與資源獲得）與台灣版癌症心理調適量表（Mini-MAC）進行評估。 結果：潛在類別成長模式的結果顯示，相較於過去的研究，心理沮喪的變化軌跡可區辨出「韌性組」、「復原組」、「晚發組」及「慢性組」。潛在成長曲線模式的分析顯示，相較於其他三組，「韌性組」的壓力因應特性為：診斷之後維持在低資源流失、較低的初始AP，以及較低的CA成長率；相較於「韌性組」，「復原組」還具有下降較慢的FS；「晚發組」與「慢性組」又比前兩組具有更高的初始HH與較高的AP成長率，而「慢性組」比起其他三組在診斷初期具有最高的資源流失、最高的HH以及最低的FS。階層線性模式的分析顯示，四組之中的資源流失與因應風格皆可預測心理沮喪，作用的差異之處主要出現在「慢性組」的資源獲得與CA具有減緩心理沮喪之效果，以及各組之內的預測因子不同。 結論：本研究支持罹癌後的壓力反應具有個別差異性，並且指出乳癌患者的心理沮喪反應具有四種不同的發展型態。本研究也強調於連續變化的向度中考量不同的心理沮喪發展軌跡及其相關的壓力調適因子亦具有時序變化之重要性。有關的理論與實務意涵將於後作進一步地討論。 / Objectives: This study assumed the psychological distress of newly-diagnosed breast cancer (BC) patients existed the entities of the individual difference, so this study examined distinct development trajectories of psychological distress amongst BC patients and their relationship with resource changes and coping styles, and adopted a dynamic stress-coping perspective to shed light on the factors that contribute to the diversity of inter-individual development and intra-individual change. The three major purposes were (1) to determine if there are distinct development trajectories of psychological distress amongst newly-diagnosis BC patients; (2) to test whether time-varying resource changes and coping styles can distinguish the trajectory groups; (3) to explore whether the effect of time-varying resource changes and coping styles on psychological distress differ within each trajectories group. Methods: A longitudinal reasarch study of 200 newly-diagnosed BC patients was recruited and participants were assessed at the day before surgery, and again at the 1-month, 4-month, 7-month and 1-year post-surgery follow-ups. Psychological distress was measured at the five time-points using the Chinese version of Hospital Anxiety and Depression Scale (HADS). Resource changes and cancer-specific coping were assessed at all follow-ups using the revised Resource Change Scale and the the Chinese version of Mini-MAC Scale, respectively. Results: Latent Class Growth Analysis (LCGA) identified four latent classes of BC patients with distinct developmental trajectories of psychological distress - resilience, recovery, late onset and chronic dysfunction. Latent Growth Curve Model (LGM) revealed that the stress-coping properties of the resilience group featured a stabilized lower level of resource loss after diagnosis, a lower level of initial AP-coping and a lower growth rate of CA-coping when compared with the others. The recovery group was more likely to have a lower decrease of FS-coping than the resilience group. Moreover, the late onset group and the chronic dysfunction group were more likely to have a higher level of initial HH-coping and a higher increase in AP-coping, and the chronic dysfunction group was characterized by the highest level of initial resource loss and HH-coping, and the lowest level of initial FS-coping compared with the other groups. The Hierarchical Linear Model (HLM) indicated that resource loss and use of coping styles could significantly predict levels of psychological distress in each trajectory group. The major differences that appeared were in the positive effect of resource gain and use of CA-coping on decreasing distress symptoms amongst people in the chronic dysfunction group, as well as in the different predictors that were found in each trajectory group. Conclusions: The present study shows that there are individual differences in cancer-specific stress responses and outlines four different developmental patterns of psychological distress amongst newly-diagnosed Taiwanese BC patients. This study also stressed the importance of considering time-serial continuity of distinct developmental trajectories with regards to psychological distress as well as the related stress-coping factors which also varies with time. Further theoretical and practical implications are discussed in depth in the content of the study.

Η παρούσα μελέτη αποσκοπούσε στη διερεύνηση των επιμορφωτικών αναγκών των νεοδιόριστων δασκάλων. Μετά τον προσδιορισμό και την καταγραφή των προβλημάτων που αντιμετωπίζουν οι δάσκαλοι στο καθημερινό τους έργο, προσπαθήσαμε να προσδιορίσουμε τις προσωπικές τους ανάγκες για επιμόρφωση, διαχωρίζοντάς τες σε συνειδητές και ρητές και σε συνειδητές και μη ρητές. Στη συνέχεια εξετάσαμε κατά πόσο το πρόγραμμα της εισαγωγικής επιμόρφωσης το οποίο είναι υποχρεωμένοι να παρακολουθήσουν οι νεοδιόριστοι δάσκαλοι, ανταποκρίθηκε στα προβλήματα και κάλυψε τις επιμορφωτικές ανάγκες τους. Για τη μελέτη των παραπάνω θεμάτων, χρησιμοποιήσαμε τη θεωρία των κοινωνικών συστημάτων και ως ερευνητικό εργαλείο το ερωτηματολόγιο. Για την επεξεργασία των δεδομένων χρησιμοποιήθηκαν τόσο η ποσοτική ανάλυση, όσο και η ποιοτική ανάλυση περιεχομένου. Τα αποτελέσματα της μελέτης έδειξαν, ότι τα προβλήματα και οι επιμορφωτικές ανάγκες είναι πολλά, ενώ το πρόγραμμα της εισαγωγικής επιμόρφωσης δεν ανταποκρίθηκε στα προβλήματα και στις ανάγκες που είχαν οι νεοδιόριστοι δάσκαλοι για επιμόρφωση. / The study aimed to analyze the training needs of newly appointed primary teachers. After defining and recording the daily problems that schoolteachers face in their work, we tried to impose their personal needs for in-service training by dividing them into two categories: conscious and explicit ones and in conscious and not explicit ones. The next step was to examine the grade to which the program of introductive in-service training which, the newly appointed primary teachers are obliged to follow, covered their training needs and gave solution to some of the existing problems. In order to investigate the above-mentioned subjects, we applied the theory of social systems. As a research tool in our study we used the questionnaire. Quantitative as well as qualitative content analysis, have been used in order to analyze data. The study showed multiple problems, and indicated the great need for future training. Finally, the introductive training program did not correspond to the problems and the needs that the newly appointed primary teachers faced