A descriptive, phenomenological research design was used to gain a deeper understanding of the nature and meaning of couples’ experiences as they made the transition to parenthood. Specifically, this study examined what is the lived experience of couples making the transition to parenthood and what meaning do they ascribed to the experience of brief, couple-focused, preventative interventions? Five couples who were expecting their first baby participated in this study. From the data provided, two major categories emerged. The first was the couples’ experiences with becoming new parents and the second was the couples’ experiences with therapy. Under the first category, five major themes emerged: (1) physical and emotional challenges, (2) bonding with baby, (3) satisfaction in roles and new identity, (4) impact of social support, and (5) stability of relationship satisfaction. Three themes were discovered under the category related to the couples’ experience with therapy: (1) facilitated communication, (2) stress management, and (3) preparation for the transition. This study concluded by discussing the essence of the phenomenon of couples’ experiences with the transition to parenthood and the meaning they ascribed to therapeutic interventions along with clinical implications of these findings.

Children's mental health problems are a significant public health concern. They are costly to society in both human and financial terms. This thesis contributes to the 'science of prevention' by examining issues related to the identification of children at risk of mental health problems. In particular, it was of interest to determine whether 'at-risk' children could be identified before the development of significant behavioural or emotional problems. Three areas were explored: family risk factors that predict the development of children's mental health problems, teachers' ability to identify family risk factors, and parent- and teacher-report screening methods. Data were collected from the parents and teachers of over 1000 children in preschool to Year 3 as part of the Promoting Adjustment in Schools (PROMAS) Project. Parents and teachers each completed two questionnaires at two time points, one year apart. Parents completed the Family Risk Factor Checklist - Parent (FRFCP) and the Child Behaviour Checklist (CBCL) and the equivalent instruments for teachers were, respectively, the Family Risk Factor Checklist - Teacher (FRFC-T) and the Teacher Report Form (TRF). The FRFC-P and FRFC-T were original to the current research and were designed to assess children's exposure to multiple family risk factors across five domains: adverse life events and instability (ALI), family structure and socioeconomic status (SES), parenting practices (PAR), parental verbal conflict and mood problems (VCM), and parental antisocial and psychotic behaviour (APB). Paper 1 investigated the psychometric properties of the FRFC-P and the potential for its use at a population-level to establish community risk factor profiles that subsequently inform intervention planning. The FRFC-P had satisfactory test-retest reliability and construct validity, but modest internal consistency. Risk assessed by the PAR domain was the most important determinant of mental health problem onset, while the PAR, VCM, and APB domains were the strongest predictors of mental health problem persistence. This risk factor profile suggests that, for the studied population, the largest preventive effects may be achieved through addressing parenting practices. Paper 2 examined teachers' knowledge of children's exposure to family risk factors using the FRFC-T. While teachers had accurate knowledge of children's exposure to risk factors within the ALI and SES domains, they had poor knowledge of children's exposure to risk factors within the PAR, VCM, or APB domains - the types of risk factors found in Paper 1 to be the most strongly related to children's mental health problems. Nevertheless, teachers' knowledge of children's exposure to risk factors within the ALI and SES domains predicted children's mental health problems at one year follow-up even after accounting for children's behaviour at the first assessment. Paper 3 investigated the potential of both the FRFC-P and FRFC-T for identifying individual, at-risk children. The accuracy of the FRFC in predicting internalising versus externalising disorders was compared against behavioural and simple nomination screening methods. For both parents and teachers, the behavioural screening methods were superior, however, the simple nomination method also showed promise for teachers. Both parents and teachers were more accurate at identifying children at risk of externalising mental health problems than children at risk of internalising problems. The performance of the FRFC and simple nomination methods in identifying children for selective interventions, before the development of significant behavioural or emotional problems, was also tested. Both the FRFC and simple nomination methods showed only modest predictive accuracy for these children. Combined, the results suggest that while on the one hand, the FRFC is useful for population level screening to inform intervention planning, on the other hand, it falls short of achieving good predictive accuracy for individual children. Future research should investigate ways to optimise predictive accuracy for individual children, particularly those at risk of developing internalising disorders. One option may be to use the FRFC in conjunction with behavioural screening methods. The challenge is to develop accurate screening methods that remain practical to complete at a population level. Finally, this body of research provides insight into the feasibility of offering selective preventive interventions within the school setting. While significant obstacles remain, there were several promising indications that using screening methods such as FRFC-T or simple nomination, teachers may be able to identify children earlier on the developmental pathway, before significant behavioural or emotional symptoms have developed.

Bakgrund Trycksår definieras som en lokal skada i huden och/eller i underliggande vävnad som uppstår till följd av ett kraftigt eller långvarigt tryck med eller utan kombination av skjuv. Skadan har en negativ inverkan på personens livskvalité, såväl fysisk, psykiskt och socialt. Trots att riskfaktorer och förebyggande åtgärder är väl kända så minskar inte prevalensen av trycksår. Sjuksköterskan är ansvarig för den trycksårsförebyggande omvårdnaden. För att säkerställa att omvårdnaden som ges är patientsäker och av god kvalité ansvarar sjuksköterskan för att ordinera evidensbaserade omvårdnadsåtgärder anpassade efter patientens behov och förutsättningar. Syfte Syftet var att belysa faktorer som påverkar den trycksårsförebyggande omvårdnaden för äldre personer inom slutenvården. Metod En icke-systematisk litteraturöversikt genomfördes för att besvara studiens syfte. Från litteratursökningar i databaserna PubMed och CINAHL framkom 19 vetenskapliga artiklar med både kvantitativ samt kvalitativ metod. Kvalitén av artiklarna granskades enligt Sophiahemmet Högskolas bedömningsunderlag. Genom en integrerad dataanalys formulerades tre huvudkategorier med tillhörande subkategorier. Resultat Från litteraturöversiktens resultat framgick det att trycksårsförebyggande omvårdnad för äldre inom slutenvården utfördes i varierande grad. Faktorer som påverkade utvecklingen samt uppkomsten av trycksår inkluderade sjuksköterskans utbildning, patientens medverkan, utförandet av förebyggande åtgärder samt användningen av riskbedömningar, hjälpmedel och dokumentation av trycksårsarbetet. Slutsats Genom att utföra trycksårsförebyggande omvårdnad och ta i beaktande de faktorer som kan påverka omvårdnaden, framkom det att antalet trycksår minskade. För att uppnå en lyckad trycksårsprevention krävs evidensbaserad kunskap och utbildning hos de kliniskt verksamma sjuksköterskorna. Det krävs även ett stöd från verksamheten för att minska sjuksköterskornas arbetsbelastning och motverka tidsbristen för omvårdnaden. / Background Pressure ulcers are defined by a local damage in the skin and/or underlying tissue that occurs as a result of heavy and/or prolonged pressure with or without the combination of sheer. The damage has a negative impact on the person's quality of life both physically, mentally and socially. Despite riskfactors and preventative interventions being well known, the prevalence of pressure ulcers does not decrease. The nurse is responsible for the nursing care given to prevent pressure ulcers. To ensure that the care provided is patient-safe and of good quality, the nurse is responsible for prescribing evidence-based interventions according to the patients’ needs and condition. Aim The aim of this literature review was to shed light on factors affecting the pressure ulcer prevention care for older people in inpatient care. Method A non-systematic literature review was conducted. Searches in the databases PubMed and CINAHL resulted in 19 scientific articles with both quantitative and qualitative design. The quality of the articles was assessed according to Sophiahemmet university’s evaluation basis. Through an integrated data analysis, three main categories were formulated with associated subcategories. Results The results showed that the pressure ulcer prevention care for the older people in inpatient care was carried out in varying degrees. Factors that affected the development and onset of pressure ulcers included the nurse’s education, patients’ participation, the performance of preventative measures and the use of risk assessments, aids and documentation of the pressure ulcer care. Conclusions By performing pressure ulcer prevention care and considering the factors that can affect the care, it was found that the number of pressure ulcers decreased. To achieve successful pressure ulcer prevention, evidence-based knowledge and education of the clinically active nurses is required. Support from the organization is required to reduce the nurses workload and counteract the lack of time for nursing.