Aim: To investigate families’ perceived life situation when living with cancer, with a focus on health and family sense of coherence. Methods: Study I is a population-based register study that explored how cancer influenced the health of cohabitating partners of persons with cancer in Sweden by examining the onset of new diagnoses, health care use, and health care costs among the partners. Study II focused on familial interaction patterns for families living with cancer in a palliative phase, based on family interviews, and analysed using Gadamerian hermeneutics. In study III, Family Sense of Coherence scale (S-FSOC-S) was culturally adapted and evaluated for reliability and validity, using psychometric analyses. Study IV explored associations between family sense of coherence and hope, anxiety, and symptoms of depression using descriptive statistics and nested linear regression. Results: Study I showed that the partners of persons with cancer had significantly increased health care use and health care costs both one and two years after the cancer diagnosis, and that use patterns and costs varied according to the type of cancer that had been diagnosed. Study II revealed that the familial interaction patterns were adjusted in response to changes in family life - changes which encompassed three different, but interrelated, patterns: power dynamics in the family, the “secret game” in the family, and multifaceted closeness and distance in the family. Study III suggested that S-FSOC-S is useful for assessing familial coherence and shows satisfactory reliability and validity. Study IV showed that stronger family sense of coherence was associated with higher hope and lower anxiety and symptoms of depression levels in both persons with cancer and their family members. Conclusions: Families’ life situation was affected by the cancer diagnosis, which had an impact on both individual family members and the family as a unit. The type of cancer may help to determine partners’ risk of ill health. The changed familial interaction patterns increased the families’ ability to deal with family life without hurting each other. The S-FSOC-S is a useful instrument for assessing family sense of coherence and can help identify families with weak family sense of coherence, who may need professional support.

No description available.

This study examined the utility of the Mini-Social Phobia Inventory (MS) as a self-report screening measure of Social Anxiety Disorder (SAD). It also assessed whether there were any differences in the way in which respondents used the MS and other self-report measures when administered via the internet, as compared to standard pen and paper format. Data was collected from Swedish populations, using on clinical sample (n=133) and two samples of university students (n=795). The MS demonstrated adequate concurrent, convergent and divergent validity, and satisfactory discriminative validity, with an optimal cut-off value of 3. The psychometric properties of the scale were found to be equivalent across administration formats. / Denna studie undersökte nyttan av Mini-Social Phobia Inventory (MS), ett kort självskattat screeningformulär för socialt ångestsyndrom (SAD). I studien undersöktes även om det fanns skillnader i användning av MS och andra självskattningsformulär när dessa administrerades via internet jämfört med det vanliga pennaoch-papper-formatet. Data samlades in från svenska populationer genom användning av ett kliniskt sample (n=133)och två samples bestående av universitetsstuderande (n=795). MS uppvisade adekvat samtidig, konvergent och divergent validitet samt tillfredsställande diskriminativ validitet, med ett optimalt cut-off-värde på tre. De psykometriska egenskaperna hos skalan ansågs vara likvärdiga mellan de olika administrationsformaten.

Thesis (MComm (Industrial Psychology))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: The objective of this study is to determine whether the psychometric evaluation procedure, used by the South African Military Academy to make selection decisions, can validly predict academic performance of first year learners, whether this procedure is fair and whether the procedure is efficient. The sample used for this study consisted of three year groups (First Year Students of 2001, 2002 and 2003) enrolled at the Military Academy. In theory specific learning behaviours (learning competencies) are instrumental in attaining academic performance. These learning behaviours, in turn, depend on and are expressions of a complex nomological network of person-centered characteristics (learning competency potential). Differences in learning performance can be explained in terms of learning behaviours. Learning competencies are instrumental in achieving the learning outcomes for which the academic programme exists. Learning competencies, in turn, can be explained in terms of learner characteristics. In order to differentiate between candidates who have better or poorer training prospects in terms of a construct orientated approach to selection, a performance hypothesis on the person-centered drivers of the learning competencies is used. It is argued that the degree of competence in: (1) the core cognitive processes/competencies that constitute learning (transfer and automatization) and are necessary to create meaningful structure in novel learning material, (2) the intellectual drivers of these learning competencies (fluid intelligence and information processing capacity), (3) proficiency in English and (4) past academic performance, should discriminate between better or poorer academic performance of learners attending the academic programmes at the SA Military Academy. The grade point average of the first year first semester academic results is used as a measure of the criterion construct. Almost all of the results obtained in this study support the theory and propositions made by the performance hypothesis. Only one variable, accuracy of information processing, did not perform as predicted by the performance hypothesis. Prior learning explained the most variance in the criterion (r=0,4312). The inter-correlation amongst the predictors is used to infer the proportion of unique variance each predictor accounts for in the composite criterion. A regression of the composite criterion on the array of predictors (X2 – X12) revealed that only memory and understanding (X9) and prior learning (X12) uncovered relevant and unique information about determinants of performance on the criterion not conveyed by the remaining predictors in the model. The remaining predictors in the selection battery can consequently be considered redundant since they provide no new information not already conveyed by X9 and X12. When YGPA is regressed on the weighted combination of X9 and X12, only X12 significantly explains unique variance in YGPA when included in a regression model already containing X9. In the light of the reported findings there is no need to create a combined weighted linear predictor composite (Xcomp) which would form the basis of the actuarial mechanical decision rule that would guide selection decisions. Prior learning proved to be the only predictor that warrants inclusion in the actuarial mechanical prediction rule that will form the basis of selection decisions. In terms of the derived actuarial prediction rule the expected criterion performance of all applicants (E[Y|X12]) could consequently be estimated by inserting the measures obtained during selection of prior learning into the derived regression equation. The use of this equation could be regarded as permissible to the extent to which E[Y|X12] correlates significantly with YGPA. Since E[Y|X12] correlates 0,431 and statistically significantly (p<0,05) with YGPA, the predictions derived from this equation are valid. The findings of this research suggest that black and white students were sampled from the same population and therefore the use of the single, undifferentiated prediction rule would lead to fair selection decisions. To answer the question whether the selection procedure under investigation is adding any value to the organization, utility analysis is done based on the Taylor-Russell utility model as well as the Naylor-Shine interpretation of selection utility. A criterion-referenced norm table that expresses the risk of failure conditional on expected academic performance is derived from the use of only X12. Recommendations for further research are put forward. / AFRIKAANSE OPSOMMING: Die doel van hierdie studie is om te bepaal of die psigometriese evaluasie-prosedure wat deur die Suid Afrikaanse Militêre Akademie gebruik word vir keuringsbesluite, akademiese prestasie van eerstejaar leerders geldig voorspel, en of hierdie prosedure regverdig en effektief is. Die steekproef vir hierdie studie bestaan uit drie jaargroepe (eerstejaar studente van 2001, 2002 en 2003) wat ingeskryf was by die Militêre Akademie. Teoreties is daar spesifieke leergedrag (leerbevoegdhede) wat instrumenteel is in die bereiking van akademiese prestasie. Hierdie leergedrag hang af van en is weer „n uitdrukking van „n komplekse nomologiese netwerk van persoongesentreerde eienskappe (leerbevoegdheidspotensiaal). Verskille in leerprestasie kan verklaar word in terme van leergedrag. Leerbevoegdhede is instrumenteel in die bereiking van die leeruikomste waarvoor die akademiese program bestaan. Leerbevoegdhede, op sy beurt, kan weer verklaar word in terme van leerdereienskappe. Ten einde „n onderskeid te kan tref tussen kandidate met beter of slegter opleidingsvooruitsigte, in terme van „n konstrukgeorienteerde benadering tot keuring, word „n prestasiehipotese gebruik wat gebaseer is op die persoongesentreerde drywers van die leerbevoegdhede. Dit word aangevoer dat die graad van bevoegdheid in: (1) die kern kognitiewe prosesse/bevoegdhede waaruit leer bestaan (oordrag en outomatisasie) en wat nodig is om sinvolle struktuur in nuwe leermateriaal te skep, (2) die intellektuele drywers van hierdie leerbevoegdhede (vloeibare intelligensie en informasieverwerkingskapasiteit), (3) bevoegdheid in Engels, en (4) vorige akademiese prestasie sal onderskei tussen beter of slegter akademiese prestasie van leerders wat akademiese programme by die SA Militêre Akademie bywoon. Die gemiddelde van eerstejaar eerste semester akademiese uitslae is gebruik as meting van die kriteriumkonstruk. Byna al die resultate wat in hierdie studie verkry is ondersteun die teorie en proposisies soos aangevoer deur die prestasiehipotese. Slegs een veranderlike, akkuraatheid van informasie-prosessering, het nie gereageer soos voorspel deur die prestasiehipotese nie. Vorige leer het die meeste variansie in die kriterium verklaar (r=0,4312). Die inter-korrelasie tussen die voorspellers is gebruik om die proporsie unieke variansie wat elke voorspeller in die saamgestelde kriterium verklaar te skat. „n Regressie van die saamgestelde kriterium op die reeks voorspellers (X2 – X12) toon aan dat slegs geheue en begip (X9) sowel as vorige leer (X12) relevante en unieke informasie in verband met die determinante van prestasie in die kriterium weergee wat nie reeds weergegee word deur die oorblywende voorspellers in die model nie. Die oorblywende voorspellers in die keuringsbattery kan gevolglik as oorbodig beskou word aangesien hulle geen nuwe informasie verskaf wat nie reeds deur X9 en X12 oorgedra word nie. Wanneer YGPA geregresseer word op die geweegde kombinasie van X9 en X12, verklaar slegs X12 unieke variasie in YGPA wanneer dit ingesluit word in „n regressiemodel wat alreeds X9 bevat. In die lig van die gerapporteerde bevindinge is dit onnodig om ‟n gekombineerde geweegde liniêre voorspellerkombinasie (Xcomp) te skep om as basis van „n aktuariële meganiese besluitnemingsreël te dien aan hand waarvan keuringsbesluite geneem sal word. Vorige leer blyk die enigste voorspeller te wees wat insluiting regverdig in die aktuariële meganiese besluitnemingsreël wat die basis van keuringsbesluite sal vorm. In terme van die afgeleide aktuariële besluitnemingsreël sal die verwagte kriteriumprestasie van alle toekomstige aansoekers (E[Y│X12]) geskat word deur die meting van vorige leer verkry tydens keuring in die afgeleide regressievergelyking in te stel. Die gebruik van hierdie vergelyking kan as toelaatbaar beskou word in die mate waartoe E[Y│X12] betekenisvol met YGPA korreleer. Aangesien E[Y│X12] statisties betekenisvol 0,431 (p<0,05) met YGPA korreleer, kan die voorspellings afgelei vanuit hierdie vergelyking as geldig beskou word. Die bevindinge van hierdie navorsing dui daarop dat swart en wit studente van hierdie steekproef uit dieselfde populasie geneem is en daarom sal die gebruik van „n enkele, ongedifferensieerde voorspellingsreël lei tot regverdige keuringsbesluite. Om „n antwoord te verkry op die vraag of hierdie keuringsprosedure enige waarde tot die organisasie toevoeg is „n nutanaliese gedoen wat gebaseer is op Taylor-Russell se nutmodel so wel as die Naylor-Shine interpretasie van keuringsnut. „n Kriteriumgerigde normtabel, wat die voorwaardelike risiko op mislukking gebaseer op akademiese prestasie uitdruk, is afgelei deur die gebruik van slegs X12. Aanbevelings vir verdere navorsing word voorgestel.

The overall aim was to investigate the quality of palliative care from the patient perspective, to adapt and psychometrically evaluate the Quality from Patients’ Perspective instrument specific to palliative care (QPP-PC) and investigate the relationship between the combination of person- and organization-related conditions and patients’ perceptions of care quality. Methods: In the systematic literature review (I), 23 studies from 6 databases and reference lists in 2014 were synthesized by integrative thematic analysis. The quantitative studies (II–IV) had cross-sectional designs including 191 patients (73% RR) from hospice inpatient care, hospice day care, palliative units in nursing homes and home care in 2013–2014. A modified version of QPP was used. Additionally, person- and organization-related conditions were assessed. Psychometric evaluation, descriptive and inferential statistics were used. Main findings: Patients’ preferences for palliative care included living a meaningful life and responsive healthcare personnel, care environment and organization of care (I). The QPP-PC was developed, comprising 12 factors (49 items), 3 single items and 4 dimensions: medical–technical competence, physical–technical conditions, identity–oriented approach, and socio-cultural atmosphere (II). QPP-PC measured patients’ perceived reality (PR) and subjective importance (SI) of care quality. PR differed across settings, but SI did not (III). All settings exhibited areas of strength and for improvement (II, III). Person-related conditions seemed to be related to SI, and person- and organization-related conditions to PR, explaining 18–30 and 22-29% respectively of the variance (IV). Conclusions: The patient perspective of care quality (SI and PR) should be integrated into daily care and improvement initiatives in palliative care. The QPP-PC can measure patients’ perceptions of care quality. Registered nurses and other healthcare personnel need awareness of person- and organization-related conditions to provide high-quality person-centred care. / Knowledge about patients’ perceptions of palliative care is limited and valid instruments are needed. The aim of this thesis was to investigate quality of palliative care from the patient perspective, adapt and evaluate an instrument to measure patients’ perceptions of quality in palliative care (QPP-PC), and investigate the relationship between the combination of person- and organization-related conditions and patients’ perceptions of care quality. A systematic literature review and quantitative methods were used. Patients’ preferences in palliative care included help living a meaningful life and responsive personnel, care environment and organization of care. The QPP-PC was developed and identified patients’ perceptions of areas of strength and for improvement in hospice inpatient and day care, palliative units in nursing homes and home care settings. Perceptions of care quality seemed to be related to person- and organization-related conditions, and differed across settings, although subjective importance did not. The patient perspective of care quality should be integrated into daily care and quality work, and QPP-PC can be used in such work. Registered nurses and other healthcare personnel need awareness of person- and organization-related conditions to provide high-quality person-centred palliative care. / Den overordnede hensikten var å undersøke kvalitet i palliativ behandling og omsorg fra pasientens perspektiv, å utvikle og psykometrisk evaluere spørreskjemaet Kvalitet ut fra Pasientens Perspektiv (KUPP) for palliativ omsorg (KUPP-PO), samt å undersøke sammenhengen mellom person- og organisasjonsrelaterte forhold og pasientenes erfaringer av kvalitet. Metode. I den systematiske oversiktsartikkelen (I) ble 23 studier fra seks databaser og referanselister syntetisert i 2014 med integrativ tematisk analyse. De kvantitative studiene (II-IV) hadde et tverrsnittsdesign som inkluderte 191 pasienter (svarprosent: 73) fra hospice-døgnavdeling, hospice-dagavdeling, lindrende enheter i sykehjem og hjemmetjeneste i 2013 til 2014. En modifisert versjon av KUPP ble brukt. I tillegg ble person- og organisasjonsorienterte forhold kartlagt. Deskriptiv og  inferensiell statistikk, samt psykometrisk evaluering ble anvendt. Hovedfunn. Pasientene ønsket at palliativ behandling og omsorg skulle omfatte hjelp til å leve et meningsfullt liv og at helsepersonell, omsorgsmiljø og organisering av omsorgen var lydhør for og handlet eller var tilrettelagt i samsvar med deres preferanser (I). KUPP-PO ble utviklet og omfattet 12 faktorer (49 spørsmål), 3 enkeltstående spørsmål og fire dimensjoner; medisinsk-teknisk kompetanse, fysisk-tekniske forhold, identitetsorientert tilnærmingsmåte og sosiokulturell atmosfære (II). KUPP-PO målte pasientenes erfaringer og subjektiv betydning av kvalitet. Pasientens erfaringer av kvaliteten med palliativ behandling og omsorg varierte utfra kontekst, men subjektiv betydning varierte ikke. Alle omsorgskontekstene viste styrker og forbedringsområder (II, III). Personrelaterte forhold så ut til å være forbundet med subjektiv betydning mens person- og organisasjonsorienterte forhold så ut til å være forbundet med erfaring med behandling og omsorg, og forklarte respektivt 18–30/22-29% av variansen (IV). Konklusjon: Kvalitet fra pasientens perspektiv (subjektiv betydning og erfaring) bør integreres i daglig behandling og omsorg og i forbedringstiltak i palliativ omsorg. KUPP-PO kan måle pasientenes erfaringer i kvalitetsutviklingsarbeid. Sykepleiere og annet helsepersonell trenger å være bevisst person- og organisasjonsrelaterte forhold for å utføre personsentrert behandling og omsorg av høy kvalitet.