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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

Kvinnors upplevelser av livskvalitet och psykosocial hälsa efter mastektomi vid bröstcancer : En kvalitativ intervjustudie

Hosio, Emma, Thunell Petersson, Isabell January 2014 (has links)
Bakgrund: Varje år drabbas cirka 8000 kvinnor av bröstcancer och är därmed den vanligast förekommande cancerformen hos kvinnor. Den främsta behandlingsformen är kirurgi där man vanligtvis väljer att utföra en mastektomi, där hela bröstet opereras bort, eller bröstbevarande kirurgi. Förlusten av ett eller båda brösten ger ofta fysiska och psykiska konsekvenser. Syfte: Syftet med denna studie var att beskriva kvinnors upplevelser av sin hälsorelaterade livskvalitet och psykosociala hälsa efter mastektomi med eller utan rekonstruktion. Metod: En deskriptiv studie med kvalitativ metod användes. Urvalet var strategiskt bestående av fem kvinnor som genomgått rekonstruktion/inte genomgått rekonstruktion med varierande åldrar samt olika civilstånd. Semistrukturerade intervjuer genomfördes och data analyserades med innehållsanalys. Resultat: Förändringen i självbild som en mastektomi ger kan leda till begränsningar i den vardagliga livsföringen. Kvinnorna blir dagligen påminda om den fysiska förändringen och upplever detta som psykiskt påfrestande. Dock upplever kvinnorna diagnosen i de flesta fall som ett uppvaknande och ser nu livet som en ny möjlighet. Samtliga kvinnor upplevde en brist i den information som ges av hälso- och sjukvården samt det stöd som erbjuds dem efter avslutad behandling. Slutsats: Resultatet av denna studie visar att kvinnor har olika uppfattning om livskvalitet. En del av kvinnorna upplever att det förändrade utseendet i samband med en mastektomi är ett hinder i vardagen. Dessa kvinnor har ett stort behov av information och stöd även en längre tid efter avslutad behandling, det ställer höga krav på sjukvårdspersonal inom dessa områden. / Background: Every year approximately 8000 women in Sweden are diagnosed with breast cancer and therefore it´s the most common form of cancer in women. The foremost treatment is surgery where the most common treatment is mastectomy, where the entire breast is surgically removed.The loss of one or both breasts often provides physical and psychological consequences. Aim: The aim of this study was to describe women’s experiences of their health related quality of life and psychosocial health after mastectomy with or without reconstruction. Method: A descriptive study with qualitative method was used. A strategic selection was conducted where five women who have undergone reconstruction or not, with varying ages and different marital status were selected. Semi-structured interviews were conducted and analyzed with content analysis. Result: The change in self-image can lead to limitations in everyday living. The women are reminded every day about the physical change and experience this as psychologically stressful. However in most cases the woman perceives the diagnosis as an awakening and now sees life as a new opportunity. All of the women experienced a lack of information provided by health care and support offered to them after completion of treatment. Conclusion: Women have different perceptions about quality of life. Some women feel that the altered appearance is an obstacle in everyday life. These women have a great need for information and support even a long time after completed treatment, this places high demands on the health care professionals in these areas.
12

The State of Knowledge on Posttraumatic Stress Disorder, Depression and Anxiety Among Refugee Women in Africa: A Scoping Review

Workneh, Aklile Fikre January 2017 (has links)
With over 65.3 million people of concern under the United Nations High Commissioner for Refugees mandate, the world is facing its biggest humanitarian crisis since the Second World War. The World Health Organization states that war and disasters have a large impact on a person’s mental health and psychosocial wellbeing, estimating that 5-10% of people who have experienced emergency situations suffer from mental health related problems. For refugee women in particular, research suggests that they have higher instances of mental health problems than other refugees which include depression, posttraumatic stress disorder, and anxiety. Using a scoping review methodology, this thesis examines the prevalence of refugee women’s mental health problems in the African context. It examines the experiences of these women living in African camps and the availability and accessibility of mental health services during their residency. Upon completion of the scoping review, the literature reveals that there is a high occurrence of mental health problems among refugee women residing in African camps. Furthermore, with relation to services it was found that varied mental health services are present but lack qualified personnel. Lastly, four themes emerged regarding refugee women’s experiences: violence, family life and losses, poor quality of life, and coping mechanisms.
13

Comparing self-report measures of internalized weight stigma: the weight self-stigma questionnaire versus the weight bias internalization scale

Hübner, Claudia, Schmidt, Ricarda, Selle, Janine, Köhler, Hinrich, Müller, Astrid, de Zwaan, Martin, Hilbert, Anja January 2016 (has links)
Background: Internalized weight stigma has gained growing interest due to its association with multiple health impairments in individuals with obesity. Especially high internalized weight stigma is reported by individuals undergoing bariatric surgery. For assessing this concept, two different self-report questionnaires are available, but have never been compared: the Weight Self-Stigma Questionnaire (WSSQ) and the Weight Bias Internalization Scale (WBIS). The purpose of the present study was to provide and to compare reliability, convergent validity with and predictive values for psychosocial health outcomes for the WSSQ and WBIS. Methods: The WSSQ and the WBIS were used to assess internalized weight stigma in N = 78 prebariatric surgery patients. Further, body mass index (BMI) was assessed and body image, quality of life, self-esteem, depression, and anxiety were measured by well-established self-report questionnaires. Reliability, correlation, and regression analyses were conducted. Results: Internal consistency of the WSSQ was acceptable, while good internal consistency was found for the WBIS. Both measures were significantly correlated with each other and body image. While only the WSSQ was correlated with overweight preoccupation, only the WBIS was correlated with appearance evaluation. Both measures were not associated with BMI. However, correlation coefficients did not differ between the WSSQ and the WBIS for all associations with validity measures. Further, both measures significantly predicted quality of life, self-esteem, depression, and anxiety, while the WBIS explained significantly more variance than the WSSQ total score for self-esteem.
14

Health psychology in prevention and intervention programs for overweight and obesity in childhood and adolescence

Herget, Sabine 03 July 2019 (has links)
The present thesis provides insight into health psychology aspects of overweight and obesity prevention and therapy. Participation behavior, psychosocial well-being and mental health have been examined closely. Continuous adherence to physical activity programs designed to avoid development or progression of juvenile overweight and obesity is difficult to maintain in everyday-life of participants. Motivation for participation and a personal schedule, that complements intervention time requirements, is essential for success and sustainability of physical activity interventions. Media support in promoting adherence is a topic of controversial discussion, but might help to promote motivation for health behavior change if used appropriately for the right target group. Therefore, means of communicating with young people need to be analyzed and integrated into health messages in order to make them convincing and interesting. Further media devices and channels need to be investigated to achieve an up-to-date understanding of health promotion technology. Telephone counseling is as effective as face-to-face counseling regarding BMI reduction. However, its effect on psychosocial well-being and body image seems to be minor. The effect of parental delivery of health messages and information on psychosocial well-being and stress to their children regarding body image and related constructs needs to be further elucidated. Mediators and moderators should be investigated in order to be able to control health promotion content. Mental health plays a crucial role in the development and progression of extreme obesity in adolescence. Early mental health impairments such as internalizing and externalizing behavior may lead to pathological eating and pathological health behavior habits and consequent weight gain. During the course of a treatment program it is of great importance to focus on psychiatric comorbidities in order to achieve stable and long-lasting effects on weight loss and lifestyle behavior. Adolescents undergoing bariatric surgery often suffer from moderate to severe depressive symptoms or clinically diagnosed depression. The interdependency between depression and obesity impedes predictability of bariatric surgery on weight loss outcomes and compliance with lifestyle requirements after surgery. In any case, mental health needs to be closely examined before a patient undergoes surgery. Monitoring and stabilization of psychological well-being after invasive treatment could lead to the practice of beneficial health behavior, enduring weight stabilization and improved quality of life.
15

Psykosocial och sexuell hälsa hos unga män födda med analatresi. Att hantera sin livssituation med en medfödd missbildning

Ivarsson, Camilla January 2011 (has links)
The aim of this study was to examine young men born between 1990-1995 with anorectal malformations (ARM) whom have undergone the new PSARP-operation starting in 1990, and how they experience their psychosocial and sexual health. The study also examines how they cope with their life situation and what their experience is of the health care and how they were responded to through out the years. This study is a qualitative research and consists seven semi- structured interviews with young men between sixteen and twenty years old. The analyses of this material resulted in three themes around which the study centers: psychosocial health, sexual health and the medical establishment and the informants thoughts about the proposition of counseling for themselves and other individuals born with ARM. The study shows that these young men have a good psychosocial health and a likely reason for that is good parental relationships and close friendships. It is difficult to draw any general conclusions about their sexual health, because there are several factors that played a role in this respect: there is a relatively widespread in their young age, their deformities are of various degrees and requires very different care and they have very different sexual experiences. However, there are factors which indicate that sexual health is affected by the congenital malformation. The study also showed that the young men have different coping strategies to manage their life situation in order to avoid exclusion and stigma. And that there are different needs for counseling among young ARM patients.
16

The Relationship between Social Isolation and Wellbeing in Older Adults

Sen, Keya 08 1900 (has links)
This dissertation contributes to research on social isolation in older adults aged 65 years and above through three essays that expand our understanding of the social determinants of health and identify the social and interpersonal factors that contribute to elderly wellbeing. This dissertation examines the significant factors contributing to the problem of social isolation, and how the availability of interest-based, low-cost engagement resources in the community can alleviate social isolation and foster healthy aging. Essay 1 is a systematic literature review with implications for future research that explores how technological skills and training based on user intention and availability of resources can alleviate social isolation. Essay 2 is a qualitative study that evaluates the effectiveness of a unique community-based senior exercise program in fostering social integration and in reducing social isolation. Essay 3 is a quantitative study that examines the magnitude and direction of the correlated relationships among the determinants of social inclusion and the impact of social and interpersonal processes on senior wellbeing. These three essays provide insight into the social isolation phenomenon that negatively impacts senior wellbeing and recommends solutions derived from a data driven examination of the problem that is especially applicable to economically disadvantaged senior communities. Moreover, this research provides community partners and gatekeepers a foundation for future research on the social isolation phenomenon and strategies for developing digital confidence and mobility program strategies that foster social inclusion and reduce social isolation for older adults.
17

"Ska du ta hand om mig?" : En litteraturstudie om socialt assisterande robotar i demensvården / "Are you going to take care of me?” : A literary review about socially assistive robots in a dementia care setting

Birgersson, Fredrik, Ladeby, Ludvig January 2016 (has links)
Bakgrund: Demens är en sjukdom som drabbar en stor del av en alltmer åldrande befolkning i världen. Patienter som lider av demens kan drabbas av olika symtom som t.ex. kommunikationssvårigheter, personlighetsförändringar samt emotionell avtrubbning. Dessa symtom kan vara svåra att behandla och påverkar patienter, anhöriga och vårdpersonal. Tidigare forskning har visat att socialt assisterande robotar kan ha en god inverkan på människor som lider av demenssjukdom. Syfte: Syftet med denna litteraturstudie är att beskriva vilken inverkan på hälsan socialt assisterande robotar har hos patienter som lider av demenssjukdom.Metod: En litteraturstudie grundat på tio vetenskapliga artiklar, som tagits fram utifrån syftet. Resultat: Resultatet presenterades utifrån två kategorier, Psykosocial hälsa och Livskvalitet. Interventioner med socialt assisterande robotar hade en god inverkan på den psykosociala hälsan, medan livskvalitet påverkades med varierat resultat beroende på vilket stadie av demens som den drabbade befinner sig i. Slutsats: Sammanfattningsvis ges ett intryck av att socialt assisterande robotar kan hjälpa vårdpersonal i deras omvårdnadsarbete för patienter med demens, och att dessa robotar har en övervägande god inverkan på demensdrabbades hälsa. Betydelse: Kunskap om vad socialt assisterande robotar har för inverkan på hälsa hos demensdrabbade är angeläget, för att i framtiden kunna implementera omvårdnadsåtgärder med denna typ av robotar. / Background: Dementia is a disease which affects a large part of an increasingly aging population in the world. Patients suffering from dementia may suffer from various symptoms such as communication difficulties, personality changes and emotional blunting. These symptoms can be difficult to treat and affects patients, relatives and health professionals. Previous research has shown that socially assistive robots could have a good effect on people suffering from dementia. Aim: The purpose of this study is to describe the impact on health of socially assistive robots in patients suffering from dementia. Method: A literature study based on ten scientific articles, which has been devised based on the purpose. Results: The results are presented on the basis of two categories, psychosocial health and quality of life. Interventions with socially assistive robots had a good impact on the psychosocial health, while quality of life was affected with varied results depending on the stage of dementia that the patient is in. Conclusion: In conclusion, the given impression is that socially assistive robots could help health professionals in their nursing work for patients with dementia, and that these robots have a predominantly good effect on demented people’s health. Significance: The knowledge of how socially assistive robots impact the health of people who suffers from dementia is imperative, to eventually be able to implement nursing interventions with this type of robots.
18

Kartläggning av sjukfrånvaro på en distributionscentral / Mapping of absence due to illness at a distribution center

Andersson, Sofia, Egger, Amanda January 2016 (has links)
Purpose – The purpose of this study is to identify patterns in the absence due to illness at a distribution center with higher absence due to illness compared to other companies in the same industry, and to investigate how managers work with routines for absence due to illness. To achieve the purpose, it has been divided into two research questions: Which patterns in absence due to illness can be found at a distribution center with higher sick leave compared to other companies in the same industry? How do managers work with routines regarding the absence due to illness at a distribution center with higher sick leave compared to other companies in the same industry? Method – Theories about sick leave, work environment, psychosocial health, motivation, organization and leadership were collected to fulfil the purpose of the study. A case study was carried out to collect empirical data on the basis of interviews and document studies which then were compared with the theory for further analysis. Findings – The study identifies patterns that were found after mapping the statistics of the absence due to illness on the case company. The result shows that women have higher absence due to illness than men, mostly younger women and older men. Permanent and temporary employees have more absence due to illness than workers on deputy posts and that employees who have worked one to three years have more absence due to illness than other groups. The mapping also shows that employees have the highest sick leave in the fall, on Mondays and only one day is most prevalent. There are clear routines regarding sick leave and rehabilitation at the case company. Improvements can be made with the documentation in the web-portal for sick leave, how the first day reporting sick should be done, and that a comprehensive action plan could be designed for managers to use. The study shows that the managers who are committed and have a higher focus on creating a good group dynamic through activities generally have lower absence due to illness. By creating a satisfying work environment where employees have the opportunity to participate, influence, take responsibility, develop and be seen and heard can therefore improve productivity, motivation and workplace health. Implications – A mapping of absence due to illness can improve the same work on other companies and create a greater understanding of why some groups have higher absence due to illness in the workplace than others. This case study also shows that the work environment, motivation and leadership are essential to encourage health in the workplace which can be applied on companies in several sectors. Limitations – Deviation may have occurred as a large amount of data during the study was processed. To do a mapping is considered generalizable but the result may differ between companies, therefore is the study not applicable in all contexts. The authors consider however that the study could be applied in general to other businesses as work environment and absence due to illness is an issue in all industries. / Syfte – Syftet med studien är att kartlägga mönster i sjukfrånvaro på en distributionscentral vars sjukfrånvaro är högre än liknande aktörer inom samma bransch samt att undersöka hur chefer arbetar med rutiner kring sjukfrånvaro. För att uppnå syftet har det brutits ned i två frågeställningar: Vilka mönster kring sjukfrånvaro kan hittas på en distributionscentral vars sjukfrånvaro är högre än liknande aktörer inom samma bransch? Hur arbetar chefer med rutiner kring sjukfrånvaro på en distributionscentral vars sjukfrånvaro är högre än liknande aktörer inom samma bransch? Metod – Teorier om sjukfrånvaro, arbetsmiljöarbete, psykosocial hälsa, motivation, organisation och ledarskap samlades in för att uppfylla studiens syfte. En fallstudie genomfördes för att samla in empiri utifrån intervjuer och dokumentstudier som sedan jämfördes med teori för vidare analys. Resultat – Studien identifierar mönster som framkom efter kartläggningen av sjukfrånvarostatistiken på fallföretaget. Resultatet visar att kvinnor har högre sjukfrånvaro än män, främst yngre kvinnor och äldre män. Tillsvidareanställda och visstidsanställda har högre sjukfrånvaro än anställda på vikariat samt att medarbetare som varit anställda ett till tre år har högre sjukfrånvaro än övriga grupper. Kartläggningen visar dessutom att anställda har högst sjukfrånvaro på hösten, måndagar och att en dag är mest förekommande. Det finns tydliga rutiner kring sjukfrånvaro och rehabilitering på fallföretaget. Förbättringar kan göras med dokumentation i fallföretagets webbportal för sjukfrånvaro, hur första sjukanmälan ska gå till samt att en åtgärdsplan på gruppnivå skulle kunna utformas för chefer att använda. Studien visar att de chefer som är engagerade och har högre fokus på att skapa gemenskap genom aktiviteter generellt har lägre sjukfrånvaro. Genom att skapa en tillfredsställande arbetsmiljö där medarbetare har möjlighet att delta, påverka, ta ansvar, utvecklas samt bli sedda och hörda kan därmed produktiviteten, motivationen och hälsan på arbetsplatsen förbättras. Implikationer – En kartläggning av sjukfrånvaro kan underlätta arbetet med sjukfrånvaro på andra företag och skapa en större förståelse kring varför vissa grupper har högre sjukfrånvaro än andra på arbetsplatsen. I studien framgår dessutom att arbetsmiljöarbete, motivation och ledarskap är viktigt för att främja hälsan på arbetsplatsen vilket kan appliceras på företag inom flera branscher. Begränsningar – Avvikelser kan förekomma då en stor mängd statistik under studien har bearbetats. Metoden att göra en kartläggning anses generaliserbar men resultatet kan skilja sig mellan olika företag, därför kan inte hela studien tillämpas i alla sammanhang. Författarna anser däremot att studien bör kunna appliceras på andra verksamheter då frågor om arbetsmiljö och sjukfrånvaro är aktuellt i alla branscher.
19

Kuratorns betydelse för den psykosociala hälsan

Olsson, Patrick, Svedin, Lea January 2010 (has links)
<h1>Abstract</h1><p>Syftet med vår studie är att undersöka vilken betydelse kuratorn har för den psykosociala hälsan. Vi har för det här ändamålet gjort tio stycken kvalitativa intervjuer med kuratorer inom skola, ungdomsmottagning, samt barn- ungdoms- och vuxenpsykiatrin. Vi har utgått från en hermeneutisk ansats. Resultatet har analyserats utifrån Aaron Antonovskys, Thomas J. Scheffs, samt Moria von Wrights teorier. Vårt resultat visar att kuratorn har en betydelse för den psykosociala hälsan hos eleven/patienten inom ramen för deras nätverk. Det var dock ibland svårt för kuratorn att precisera exakt vad som leder till förändringarna eftersom de ser sig som en del av helheten. Resultatet visar vidare att kuratorerna med olika metoder kan öka begripligheten och meningsfullheten hos eleverna/patienterna, för att de ska få en bättre känsla av sammanhang, och därmed lättare att hantera sin vardag. Inom psykiatrin fokuseras det mycket på ett patogent synsätt medan skolan och ungdomsmottagningen mer använder ett salutogent synsätt. Den punktuella positionen visar sig vara viktig i utredningsfasen av eleverna/patienterna men kuratorerna själva lyfter även fram vikten av en relationell position. Kuratorerna kan genom samtal uppmärksamma de sociala banden, lyfta fram dess betydelse för att eleverna/patienterna ska kunna bevara dem. Det här genom att eleverna/patienterna på ett bättre sätt kan hantera sina skam- och stolthetskänslor.</p> / <h1>Abstract</h1><p>The aim of our study is to investigate witch role the counselor has for the psychosocial health. For this purpose we have made ten qualitative interviews with counselors at schools, in one youth center, and at a child-youth and adult psychiatry. Vi har utgått från en hermeneutisk ansats.We have used a hermeneutic approach. Resultatet analyserades utifrån Aaron Antonovsky, Thomas J. Scheff, samt Moria von Wright.We`ve based our result in Aaron Antonovsky´s, Thomas J. Scheff´s, and Moria von Wright´s theories.Vårt resultat visade att kuratorn har en betydelse för den psykosociala hälsan hos eleven/patienten inom ramen för deras nätverk. Our result showes that the counselor has got an impact in the psychosocial health of the student / patient within their network. Det var dock ibland svårt för kuratorn att precisera exakt vad som ledde till förändringarna eftersom de såg sig som en del av helheten. However, it was sometimes difficult for the counselor to clarify exactly what leeds to the changes as they see themselves as one part of the whole. The Result further showes that the counselor using different methods could increase the comprehensible and meaningfulness to the students/patients, so that they could get a better sense of context, and thus easier to manage their everyday. In psychiatry the approach is pathogenic and at schools and the youth clinic it is salutogenic. The punctate location prove to be important in the investigation phase of the students / patients, but the counselors themselves even highlight the importance of a relational position. Kuratorerna kunde genom samtal uppmärksamma de sociala banden, lyfta fram dess betydelse för att eleven/klienten skulle kunna bevara de sociala banden genom att de på ett bättre sätt kunde hantera sina skam- och stolthetskänslor.Counselors can, through conversations, rise attention to the social ties, highlighting its importance so that the students / patients is able to maintain them. This is made through that the students/patients, in a better way, is able to deal with their shame and feelings of pride.<strong></strong></p>
20

Kuratorns betydelse för den psykosociala hälsan

Olsson, Patrick, Svedin, Lea January 2010 (has links)
Abstract Syftet med vår studie är att undersöka vilken betydelse kuratorn har för den psykosociala hälsan. Vi har för det här ändamålet gjort tio stycken kvalitativa intervjuer med kuratorer inom skola, ungdomsmottagning, samt barn- ungdoms- och vuxenpsykiatrin. Vi har utgått från en hermeneutisk ansats. Resultatet har analyserats utifrån Aaron Antonovskys, Thomas J. Scheffs, samt Moria von Wrights teorier. Vårt resultat visar att kuratorn har en betydelse för den psykosociala hälsan hos eleven/patienten inom ramen för deras nätverk. Det var dock ibland svårt för kuratorn att precisera exakt vad som leder till förändringarna eftersom de ser sig som en del av helheten. Resultatet visar vidare att kuratorerna med olika metoder kan öka begripligheten och meningsfullheten hos eleverna/patienterna, för att de ska få en bättre känsla av sammanhang, och därmed lättare att hantera sin vardag. Inom psykiatrin fokuseras det mycket på ett patogent synsätt medan skolan och ungdomsmottagningen mer använder ett salutogent synsätt. Den punktuella positionen visar sig vara viktig i utredningsfasen av eleverna/patienterna men kuratorerna själva lyfter även fram vikten av en relationell position. Kuratorerna kan genom samtal uppmärksamma de sociala banden, lyfta fram dess betydelse för att eleverna/patienterna ska kunna bevara dem. Det här genom att eleverna/patienterna på ett bättre sätt kan hantera sina skam- och stolthetskänslor. / Abstract The aim of our study is to investigate witch role the counselor has for the psychosocial health. For this purpose we have made ten qualitative interviews with counselors at schools, in one youth center, and at a child-youth and adult psychiatry. Vi har utgått från en hermeneutisk ansats.We have used a hermeneutic approach. Resultatet analyserades utifrån Aaron Antonovsky, Thomas J. Scheff, samt Moria von Wright.We`ve based our result in Aaron Antonovsky´s, Thomas J. Scheff´s, and Moria von Wright´s theories.Vårt resultat visade att kuratorn har en betydelse för den psykosociala hälsan hos eleven/patienten inom ramen för deras nätverk. Our result showes that the counselor has got an impact in the psychosocial health of the student / patient within their network. Det var dock ibland svårt för kuratorn att precisera exakt vad som ledde till förändringarna eftersom de såg sig som en del av helheten. However, it was sometimes difficult for the counselor to clarify exactly what leeds to the changes as they see themselves as one part of the whole. The Result further showes that the counselor using different methods could increase the comprehensible and meaningfulness to the students/patients, so that they could get a better sense of context, and thus easier to manage their everyday. In psychiatry the approach is pathogenic and at schools and the youth clinic it is salutogenic. The punctate location prove to be important in the investigation phase of the students / patients, but the counselors themselves even highlight the importance of a relational position. Kuratorerna kunde genom samtal uppmärksamma de sociala banden, lyfta fram dess betydelse för att eleven/klienten skulle kunna bevara de sociala banden genom att de på ett bättre sätt kunde hantera sina skam- och stolthetskänslor.Counselors can, through conversations, rise attention to the social ties, highlighting its importance so that the students / patients is able to maintain them. This is made through that the students/patients, in a better way, is able to deal with their shame and feelings of pride.

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