Given roles and expectations of father involvement in South Korea are in transition from traditional breadwinner to an involved caregiver to children, it is plausible that Korean fathers show diverse involvement behaviors in the contexts of work, family, and parenting. Using a person-centered approach, we explored if there were groupings of Korean fathers who could be identified from their involvement with their children. We also examined if those subgroup memberships were related to various factors in work, family, and parenting domains. With a sample of 212 married working fathers and the 12 items of involvement behaviors, we found four heterogeneous subgroups of people: low-involved, accessibility-focused, involved-but-less-accessible, and highly involved fathers. Significant differences among the four profiles were also found regarding various factors such as job stress, work and family conflict, work schedule, maternal employment, parenting satisfaction, and perceived level of involvement. Suggestions for future research, practitioners, and policymakers were discussed.

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Barnvaccination har varit en av de mest betydelsefulla åtgärderna för att främja folkhälsan och förebygga sjukdomsrelaterade dödsfall hos barn. Barnvaccinationstäckningen har emellertid minskat globalt med anledning av en ökad tveksamhet kring vaccinationer. Studiens syfte var att undersöka hur specialistsjuksköterskor främjar vårdnadshavares följsamhet till det allmänna barnvaccinationsprogrammet. Studien var empirisk med kvalitativ studiedesign. Semistrukturerade intervjuer genomfördes med elva specialistsjuksköterskor inom barnhälsovården och analyserades med kvalitativ innehållsanalys, i enlighet med   Lundman och Hällgren Granheim (2017).   I resultatet framkom lokala riktlinjer och nationella riktlinjer för att främja följsamhet till barnvaccinationsprogrammet. Att ge vårdnadshavare generell information om barnvaccinationer var den viktigaste åtgärden för att främja vaccinationstäckningen. Vid tveksamheter till barnvaccination var det avgörande för specialistsjuksköterskan att ha ett personcentrerat förhållningssätt mot vårdnadshavare. Att ge kunskap samt använda ett tvärprofessionellt samarbete var också betydelsefullt. Vidare forskning kan fokusera på vårdnadshavares perspektiv på barnvaccination för att få ytterligare vägledning i hur barnvaccinationstäckningen kan främjas. Det kan också vara betydelsefullt med ytterligare forskning kring hur specialistsjuksköterskor kan bemöta vårdnadshavare som avstår vaccination för sitt barn. / Childhood immunizations have proven to be one of the most beneficial interventions to promote public health and prevent death among children, caused by diseases. The global coverage of childhood immunization has however decreased globally due to an increased hesitancy towards immunizations. The aim of this study was to examine how specialist nurses promote legal guardians’ adherence to the national childhood immunization program. This study was empirical with a qualitative study design. Semi-structured interviews with eleven specialist nurses in pediatric primary care were conducted. The interviews were analyzed using a qualitative content analysis.    The results showed both local guidelines and national guidelines to promote adherence to the childhood immunizations program. The main nursing intervention to promote childhood immunization coverage was to give legal guardians general information about the program. If hesitation, it was essential to have a person-centered approach towards the legal guardian. Educating guardians and using a multidisciplinary approach was also beneficial. Further research suggests focusing on the guardians’ perspective regarding childhood immunization as it may generate further guidance in how to promote immunization coverage. It may also be beneficial to conduct further research on how specialist nurses can respond to guardians who decline immunization for their child.

Bakgrund: När patientens sjukdom inte längre kan botas övergår behandlingen från kurativ till palliativ. Avsikten med palliativ vård är att främja livskvalitet hos patienten samt närstående och i detta har sjuksköterskan en central roll. Behovet av palliativ vård är stort runt om i världen och det finns stora skillnader i kvalitén, även nationellt. För att möjliggöra en palliativ omvårdnad av högre kvalitet kan det vara förtjänstfullt att sjuksköterskan får en djupare förståelse för patientens behov. Syfte: Att undersöka vad patienterna anser viktigt i god palliativ omvårdnad. Metod: Denna studie är en litteraturöversikt vilken grundar sig på 15 vetenskapliga artiklar med kvalitativt ansats. Resultat: Resultatet påvisar att det är viktigt att patientens behov av trygghet, välbefinnande och värdighet uppfylls för upplevelsen av god palliativ omvårdnad. Behovet av trygghet innefattar att vården bör vara lättillgänglig, samordnad och kontinuerlig samt att vårdpersonalen är kompentent och kommunicera på ett rakt och anpassat sätt. Patienterna menar även att en adekvat symtomlindring, en hemlik miljö samt en meningsfull tillvaro är betydelsefullt för att uppleva välbefinnande. Patienterna anser tillika att när deras självständighet och inflytande upprätthålls samt när vårdpersonal uppvisar ett gott bemötande upplever de värdighet. Slutsats: Litteraturöversiktens resultat överensstämmer med palliativa vårdens grundsyn som presenteras i litteraturen och påvisar patientens specifika behov av trygghet, värdighet och välbefinnande. Detta bidrar till ökad förståelse för vikten av ett personcentrerat förhållningssätt då resultatet medvetandegör att behoven hos patienterna är individuella. / Background: The purpose of palliative care is to promote the quality of life of the patient and relatives. The need for palliative care is large around the world and there are large differences in quality. In order to enable high-quality palliative care, it may be beneficial for the registred nurse to gain a deeper understanding of the patient's needs. Aim: To investigate what patients consider important in good palliative care. Method: A Literature review based on 15 scientific articles with a qualitative approach. Results: The results indicates that it is important that the patient's need for security, well-being and dignity must be fulfilled for the experience of good palliative care. The need for security includes that care should be easily accessible, coordinated and continuous, and nursing stuff be competent and communicate in a straightforward and adapted manner. Patients also believe that adequate symptomrelief, a homelike environment and a meaningful life are important for experiencing well-being. Patients believes as well that when they maintaine independence and ascendant as well as when nursing staff show a good attitude, they experience dignity. Conclusion: The results complies with the basic view of palliative care presented in the literature and demonstrate the patient´s specific needs for safety, dignity and well-being. This can provide an increased understanding of the importance of a person-centered approach as the results show that the needs of patients are individual.

Context: Colorectal cancer (CRC) surgical treatment delay (TD) has been associated with mortality and morbidity; however, disparities by TD profiles are unknown. Objectives: This study aimed to identify CRC patient profiles of surgical TD while accounting for differences in sociodemographic, health insurance, and geographic characteristics. Design: We used latent class analysis (LCA) on 2005-2015 Tennessee Cancer Registry data of CRC patients and observed indicators that included sex/gender, age at diagnosis, marital status (single/married/divorced/widowed), race (White/Black/other), health insurance type, and geographic residence (non-Appalachian/Appalachian). Setting: The state of Tennessee in the United States that included both Appalachian and non-Appalachian counties. Participants: Adult (18 years or older) CRC patients (N = 35 412) who were diagnosed and surgically treated for in situ (n = 1286) and malignant CRC (n = 34 126). Main Outcome Measure: The distal outcome of TD was categorized as 30 days or less and more than 30 days from diagnosis to surgical treatment. Results: Our LCA identified a 4-class solution and a 3-class solution for in situ and malignant profiles, respectively. The highest in situ CRC patient risk profile was female, White, aged 75 to 84 years, widowed, and used public health insurance when compared with respective profiles. The highest malignant CRC patient risk profile was male, Black, both single/never married and divorced/separated, resided in non-Appalachian county, and used public health insurance when compared with respective profiles. The highest risk profiles of in situ and malignant patients had a TD likelihood of 19.3% and 29.4%, respectively. Conclusions: While our findings are not meant for diagnostic purposes, we found that Blacks had lower TD with in situ CRC. The opposite was found in the malignant profiles where Blacks had the highest TD. Although TD is not a definitive marker of survival, we observed that non-Appalachian underserved/underrepresented groups were overrepresented in the highest TD profiles. The observed disparities could be indicative of intervenable risk.

L’objectif de cette recherche est d’étudier, chez l’adolescent, les mécanismes psychopathologiques et psychologiques impliqués dans la co-occurrence de comportements antisociaux et de conduites de consommation et responsables de la « pathologisation » de la consommation de substances psychoactives, par l’adoption conjointe d’une approche centrée sur la personne et centrée sur les variables et la mise en place d’un dispositif d’étude multi-échantillons. Ainsi, cette recherche comporte trois volets : 1) une étude en milieu scolaire menée auprès de 1025 collégiens âgés de 12 ans à 16 ans, 2) une étude en milieu psychiatrique menée auprès de 168 adolescents suivis ou hospitalisés pour un trouble externalisé ou internalisé, âgés de 12 ans à 18 ans, et 3) une étude en addictologie menée auprès de 43 adolescents abuseurs/dépendants à une substance psychoactive, âgés de 12 ans à 18 ans. Un protocole d’évaluation pluri-source (adolescents, parents, enseignants) a permis d’évaluer les comportements antisociaux, les conduites de consommation, les conduites à risques, les troubles et symptômes externalisés et internalisés (et les antécédents de troubles), la personnalité, le stress perçu et les stratégies de coping de ces adolescents. Ce dispositif a permis de montrer que les adolescents les plus susceptibles d’associer ces deux comportements et d’adopter des conduites de consommation à risques présentent des difficultés à la fois relationnelles (faible coopération, trouble oppositionnel avec provocation, faible transcendance), émotionnelles (symptômes dépressifs, troubles internalisés, intolérance à la frustration, stress perçu dans le domaine scolaire ou dans la relation aux parents, stratégies d’adaptation dysfonctionnelles) et comportementales (forte recherche de nouveauté, comorbidité TDAH/TOP). La pathologisation des conduites de consommation relèvent d’enjeux similaires à l’adoption de conduites de consommation à risques. Néanmoins, le risque de pathologisation serait d’autant plus important que les enjeux émotionnels et relationnels relèvent de manifestations tempéramentales (faible dépendance à la récompense sociale). En termes de prévention des conduites de consommation à l’adolescence et de leur pathologisation, il paraît primordial de bien distinguer ces différents niveaux de vulnérabilité (psychopathologique, psychologique, tempéramentaux, adaptatif). / This work aims to study, among adolescents, the psychopathological and psychological mechanisms involved in the co-occurrence of antisocial behaviors and psychoactive substance use and in the “pathologizing” of psychoactive substance use through a person-centered and a variable-centered approach and based on a multi-sample plan. This research focus on: 1) 1 025 middle and high school students aged between 12 to 16 years old, 2) 168 inpatients and outpatients adolescents aged between 12 to 18 years old, and 3) 43 psychoactive substance abusers/dependent adolescents aged between 12 and 18 years. A multi-source assessment (adolescents, parents, teachers) was used to collect information about adolescents’ antisocial behaviors, psychoactive substance use, risk-taking behaviors, past and present externalized and internalized disorders and symptoms, personality, perceived stress and coping strategies. The results show that adolescents are most likely to associate antisocial behaviors and psychoactive substances use and to have a risky psychoactive substance use when they present both relational problems (low cooperation, oppositional defiant disorder, low transcendence), emotional difficulties (depressive symptoms, internalizing disorder, intolerance to frustration, perceived stress in school and in relationships with parents, dysfunctional coping strategies) and behavioral dysregulation (high novelty seeking, ADHD/ODD comorbidity). Mechanisms involved in the pathologizing of psychoactive substance use are similar to the adoption of risky psychoactive substance use. Nevertheless, the risk of pathologizing is all the more important when emotional and relational problems are temperamental expression (low social reward dependence). In terms of prevention of risky psychoactive substance use in adolescence and of its pathologizing, it seems important to distinguish between these different levels of vulnerability (psychopathological, psychological, temperamental, adaptative).

Submitted by Maicon Juliano Schmidt (maicons) on 2015-04-27T18:31:32Z No. of bitstreams: 1 Marli Kasper Rex.pdf: 774727 bytes, checksum: 570f912fd28db90bdbde75b81dfb284b (MD5) / Made available in DSpace on 2015-04-27T18:31:32Z (GMT). No. of bitstreams: 1 Marli Kasper Rex.pdf: 774727 bytes, checksum: 570f912fd28db90bdbde75b81dfb284b (MD5) Previous issue date: 2012-12-03 / Nenhuma / Esta dissertação é composta por dois artigos: um ensaio teórico e um estudo empírico. O artigo 1, ensaio, buscou examinar como a Abordagem Centrada na Pessoa (ACP) pode contribuir para compreender as repercussões do câncer de mama para a mulher. O estudo mostra a necessidade do olhar humanizado e do atendimento integral às mulheres com câncer de mama, permitindo um olhar diferenciado, preventivo e adequado às características das pessoas, como proposto nas premissas básicas do Sistema Único de Saúde. O artigo 2 buscou examinar e compreender as reações emocionais de mulheres no percurso de investigação do câncer de mama e o seu impacto na comunicação do diagnóstico. Trata-se de um estudo qualitativo com delineamento de estudos de casos múltiplos, fundamentado a partir do referencial teórico da ACP. Participaram três mulheres com idade entre 46 e 54 anos, usuárias de uma Unidade Básica de Saúde de uma cidade do interior de Santa Catarina. A seleção das participantes foi feita por conveniência. Para a coleta dos dados utilizou-se um formulário com a caracterização da paciente, uma ficha de observação para anotação de campo e duas entrevistas semiestruturadas, que foram gravadas e transcritas na íntegra. Após a descrição e análise abrangente de cada caso, os dados foram organizados em temáticas e identificou-se quatro categorias: 1) Do período de investigação da doença à definição do diagnóstico; 2) Percepção da doença; 3) Comunicação e impacto do diagnóstico; 4) Relação entre profissionais, clientes e familiares. Os resultados permitiram identificar que as mulheres durante a suspeita até a confirmação do diagnóstico passam por um período conturbado e apresentam diversas reações como: perda do sentido da vida, insegurança, angústia, ansiedade, desamparo, medo da morte o que influencia no seu estado emocional, físico e social. Além disso, o estudo apontou outros fatores agravantes para a sua saúde como a falta de informação, falta de apoio por parte dos familiares e equipe de saúde, dificuldades de acesso ao tratamento, morosidade no atendimento e precariedade do sistema, o que prejudica a mulher e retarda o diagnóstico da doença, diminuindo as chances de cura. Destaca-se a importância de uma abordagem centrada na pessoa e, não somente na doença, voltada ao atendimento humanizado, com estratégias que proporcionem ações mais positivas em relação ao cuidado, prevenção e tratamento da saúde da mulher. / This dissertation consists of two articles: a theoretical essay and an empirical study. The first article is an essay which sought to examine how the Person Centered Approach (PCA) can put it in way of understanding the implications of breast cancer for women. The study shows the need of a humane look and comprehensive care for women with breast cancer, allowing a different preventive and appropriate view to the people characteristics as once proposed in the basic premises of the Unified Health System. Essay 2 sought to examine and understand women emotional reactions in the course of breast cancer investigation and its impact on diagnosis communication. This is a qualitative study design with multiple case studies based from the PCA theoretical background. The participants were three women aged between 46 and 54 and also Basic Health Unit users from a city in the countryside of Santa Catarina. The participants’ selection was carried out by convenience. To collect the data it was used a sociodemographic data and two semi-structured interviews which were taped and verbatim transcribed. After a comprehensive description and analysis of each case, the data were organized into themes and four categories were identified: 1) From the disease investigation period to the diagnosis definition; 2) Disease perception; 3) Diagnosis communication and impact; 4) Relationship between professionals, clients and their families. The results showed that from diagnosis suspicion to confirmation, women go through a difficult period and they present several reactions such as: loss of life meaning, insecurity, distress, anxiety, helplessness, fear of death which impacts on their emotional, physical and social state. In addition, the study has found other aggravating factors to their health as lack of information, lack of support from family and healthcare team, access difficulties to treatment and delays in the system which have a harmful effect on women and also delay the disease diagnosis reducing the chances of a cure. The study highlights the importance of a person-centered approach and not only in the disease itself, focused on a humanized service with strategies that provide more positive actions in relation to care, prevention and treatment of women's health.

Background Younger indoor tanning initiation leads to greater melanoma risk due to more frequent and persistent behavior. Despite this, there are no published studies exploring the predictors of indoor tanning initiation in teen populations. Purpose This longitudinal study uses latent profile analysis to examine indoor tanning initiation in indoor tanning risk subgroups from a national sample of female adolescents. Methods Latent profile analysis used indoor tanning beliefs and perceptions to identify indoor tanning initiation risk subgroups. The teens in each subgroup were reassessed on indoor tanning initiation after a year. Results Three subgroups were identified: a low risk, anti-tanning subgroup (18.6 %) characterized by low scores on positive indoor tanning belief scales and high scores on beliefs about indoor tanning dangers; a moderate risk aware social tanner subgroup (47.2 %) characterized by high scores on positive indoor tanning belief scales but also high scores on beliefs about indoor tanning dangers; and a high risk risky relaxation tanner subgroup (34.2 %) characterized by high scores on positive indoor tanning belief scales and low scores on beliefs about indoor tanning dangers. Teens in the aware social tanner and risky relaxation tanner subgroups were significantly more likely to initiate indoor tanning in the following year. Conclusions These findings highlight the need to identify teens at risk for indoor tanning initiation and develop tailored interventions that will move them to the lowest risk subgroup. Subgroup correlates suggest parent and peer-based interventions may be successful.

Although organizational citizenship behaviors toward individuals (OCB-I) have been studied over decades, the beneficiary side of OCB-I has been understudied. The co-existing and interactive possibility of benefactor OCB-I and beneficiary OCB-I within individuals has been ignored. Therefore, this research adopted a person-centered approach and examined different profiles of benefactor OCB-I and beneficiary OCB-I on the basis of Grant’s (2013) theory. Results from Study 1 data (cross-sectional data) and Study 2 data (multiple waves of data) revealed the three profile groups: vigorous (high benefactor OCB-I and high beneficiary OCB-I), moderate (moderate benefactor OCB-I and moderate beneficiary OCB-I), and passive OCB-I groups (low benefactor OCB-I and low beneficiary OCB-I). Also, the three profiles were significantly differentiated by positive affect, other-oriented empathy, task interdependence, and job satisfaction. Furthermore, the vigorous OCB-I group showed the lowest psychological strain while the passive OCB-I group showed the lowest physical strain. The results offer theoretical implications for Grant’s (2013) theory, OCB-I and employee health research, and equity theory in comparison to conservation of resources theory. In addition, practical implications for enhancing employee health are discussed.