Bakgrund: Ett fungerande fallpreventivt arbete är av stor vikt både ur ett individ- och samhällsperspektiv och de mest effektiva fallförebyggande åtgärderna består av träning. Med ett mer digitaliserat samhälle har möjligheten att utöva träning med stöd av digital teknik utvecklats. Vidare forskning behövs för att undersöka hur äldre personer upplever träning med hjälp av digitala medel. Syftet med denna studie är att belysa äldre personers upplevelser och erfarenheter av en intervention där de under ett år erbjudits fallpreventiv träning med hjälp av ett digitalt program kompletterat med stödjande strategier.Metod: Denna kvalitativa studie baseras på en pragmatisk studie som innefattade intervjuer med äldre personer som erbjudits fallpreventiv träning med en applikation (Säkra steg) under ett år. Semistrukturerade telefonintervjuer gjordes med nio personer över 70 år, varav åtta kvinnor och en man. Materialet analyserades utifrån kvalitativ innehållsanalys.Resultat: De äldre personernas upplevelser och erfarenheter skildras i temat “Individuella komponenter ger insikt och stöd för eget ansvar” som sammanfattar de sex kategorier som analysen resulterade i. Det fanns en medvetenhet kring behovet av “att skapa bästa förutsättningar för ett hållbart åldrande” och för att möjliggöra det krävdes en “innehållsrik och värdefull träning”. Deltagarna utvecklade förmågor för “att finna egna strategier för upprätthållande” och “de stödjande strategiernas roll” hade liten inverkan. Deltagarna upplevde att “styrka i kropp och själ skapar en trygg tillvaro”. Det framkom även “luckor att fylla för en bättre upplevelse” vilka kan användas till utveckling av liknande interventioner.Slutsats: Studien har bidragit till ökad förståelse för äldre personers erfarenheter kring kombinationen träning och digitala medel, den stärker även insikten om att äldre är en heterogen grupp där träningen behöver anpassas utifrån varje enskild individ.

The aim of the thesis is to explore the first-year undergraduates' strategies of self-management. The thesis contains the theoretical and empirical part. The theoretical part deals with the transformation of higher education in Europe and in the Czech Republic followed by the changes in the university student career and lifestyle. Special attention is devoted to university socialization, the personality of the university student and their new roles. The next chapter of the theoretical part presents the concepts of personal management and academic self-management. Effective and successful university study and personal strategies of self-management then appear to be interdependent. The aim of the qualitative research is to explore and describe how the first-year students organize their study. Firstly, the content analysis of selected study plans was carried out and the orientation questionnaire survey was conducted among 165 first-year students at the Faculty of Philosophy and Arts, University of West Bohemia in Pilsen. Later, also other methods were applied: the diary of study week and electronic interviews. The data were analysed through open coding and thematic coding. Two basic types of students were distinguished based on the dominant out-of-class activities and the diversity of tendencies in independent...

1 UNIVERZITA KARLOVA V PRAZE FILOZOFICKÁ FAKULTA KATEDRA PSYCHOLOGIE DIPLOMOVÁ PRÁCE Klára Englertová Sebekoučování - dosahování cílů metodou "malých kroků" Self-coaching - attainment of goals by "small steps" Praha, 2014 Vedoucí práce: doc. MUDr. Mgr. Radvan Bahbouh, PhD. 2 ABSTRACT: This diploma thesis deals with methods of achieving goals and methods of increasing efficiency within the postponed activities in the context of self-coaching and self-management and this specifically for university population, which is indicated by the high prevalence of this phenomenon. The strategy of "small steps" or "quick wins" is described as possible self- coaching and self-management intervention. The validity of Procrastination scale is verified within the overview study by comparison with different studying strategies divided into those with and without delay. At the same time the techniques increasing students' efficiency are mapped, based on their subjective responses. Within the experimental study is then verified "efficient sprint" method, as a strategy of intense concentration on a short-term actions to achieve the goal. There are observed differences in subjectively rated advance toward the target and perceived difficulty of its attainment, specifically in severely procrastinating students. The results show a...

Magister Commercii - MCom / Introduction: Diabetes mellitus is a global health problem with a high mortality rate. Self-management is an essential part of diabetes management and it includes self-care behaviour tasks such as healthy eating, being active and taking prescribed medication. In the current digital age, the use of technology for self- management of the disease is an important consideration. As a first step towards this, individuals have to first accept and use the technology. However, the literature indicates low levels of technology use amongst diabetic patients in environments with low socio- economic indicators and amongst minority groups. Previous studies suggest that there are many factors that influence technology acceptance such as economic, social and cultural factors. Mobile health (m-health) received recognition in healthcare literature in recent years and are known for delivering effective and efficient interventions to patients with chronic conditions such as diabetes. An investigation into m-health acceptance for diabetes management is vital as it impacts the achievement of development goals, including the United Nations’ SDG 3. This research posits that the culture of patients is a possible reason for the low acceptance and use of technology. Research based on the proliferation of culture as a determinant for diabetes self-management at an individual level is limited, especially in the South African context. The main research question pursued in the study reported in this thesis is How does culture influence m-health acceptance of diabetic patients in disadvantaged communities? Research design and methodology: Using an interpretivist paradigm, a case study research design provided the basis to collect data from 20 diabetes patients in Mitchells Plain and Strandfontein. The theoretical model that was used as a lens for investigation comprised a juxtaposition of Hofstede’s cultural dimensions and Unified- Theory of Acceptance and Use of Technology 2 (UTAUT2). The analysis of the qualitative data was undertaken with Atlas Ti, using a thematic content analysis process. Results: Eight themes emerged from the data and key results of the study indicate that opinions towards medical practitioners, which reflects power distance has a positive impact on users and non-users. Diabetic patients comply with the opinions of their doctors as they fear disagreeing with them. As such, this may result in having a positive influence on a participant’s ability to adopt and use mobile applications. Caregiver influence, which reflects femininity, has a negative influence on users as a result of diabetic patients being responsible for taking care of their family and others are both home carers and providers for their families. This indicates that patients are more concerned with the quality of their life and family than with the adoption mobile applications. Future work: It is recommended that research should be conducted in other areas in the Western Cape, specifically in the Cape flats to see whether the same sorts of results will be achieved in different communities. This could help policymakers and application developers tailor mobile applications for this target population.

Bakgrund: Diabetes typ 2 är en vanligt förekommande folksjukdom som ökar globalt och inte minst i Sverige. Diabetes typ 2 kräver en noggrann egenvårdsaktivitet för att hålla blodsockret i balans genom fysisk aktivitet och hälsosam kost för att undvika komplikationer som sjukdomen kan bidra till. I dagsläget finns där inget bot mot sjukdomen, men det går att leva med sjukdomen genom att ändra sina levnadsvanor. Utifrån studierna från föreliggande litteraturstudie, behöver en ökad kunskap och förståelse om patienter som har diabetes typ 2 belysas för en förbättrad egenvård.  Syfte: Syftet med litteraturstudien var att sammanställa upplevelser av egenvård för patienter med diabetes typ 2.Metod: Litteraturstudien var baserad på 12 vetenskapliga studier av kvalitativ ansats. Studierna var hämtade från Cinahl och Pubmed som var granskat och analyserats för att identifiera teman som besvarar studiens syfte.  Resultat: Resultatet baseras på två huvudkategorier vilka är brist på kunskap och psykosocialt stöd och utmaningar för livsstilsförändringar. Huvudkategorierna har vardera två underkategorier: brist på fullständig information och stöd från vårdpersonalen, rädsla för att inte kunna leva ett normalt liv, anhörigas påverkan på livsstilsförändringar samt brist på egen motivation.  Konklusion: Personer som har diabetes typ 2 upplever utmaningar gällande livsstilsförändringar. Den information som ges till dessa patienter angående egenvård är inte alltid självklar för patienternas förståelse. Resultatet av denna studie visar att vänner och familj har ett stort inflytande på patientens följsamhet av egenvård. Patienter verkar behöva psykosocialt stöd för att kunna kommunicera med vänner och familj om sin diagnos, utan att frukta att bli stigmatiserade samt för att få nödvändigt stöd och motivation. / Background: Type 2 diabetes is one of the most commonly occurring chronic disease globally and is considered a challenge to public health even in Sweden. Although there is no permanent cure for the disease adherence to self-care activity to keep blood sugar levels in balance is critical to prevent the development of complications. Effective communication between nurses and patients with type 2 diabetes affects patients ́ adherence to self-care. Given that care should be patient-centered, there is a need to understand the patient ́s perspective on self-care so that nurses can offer better support to them.Aim: The purpose of the literature study was to compile experiences of self-care for patients with type 2 diabetes.Method: The literature study is based on 12 scientific studies of a qualitative approach. The studies taken from Cinahl and Pubmed have been reviewed using the SBU guidelines and analyzed using qualitative contact analysis specific for literature studies to identify relevant themes that respond to the aim of the study.Results: The results are based on two main categories which are lack of knowledge and psychosocial support and challenges for lifestyle changes. The main categories each have two subcategories.Conclusion: People with type 2 diabetes experience challenges regarding lifestyle changes. The information given to these patients regarding self-care is not always obvious for patients' understanding. Therefore, information and knowledge are factors that are crucial to facilitate patients' self-care.

The population of older adults with chronic disease is increasing, yet little is known about their perception of chronic disease and self-management. To develop successful and sustainable chronic disease self-management interventions in the older adult population, health care providers must first understand older adults’ attitudes toward health status and behavior change. This pilot study was conducted to determine the feasibility of the study design. The purpose of this pilot study was to assess the appropriateness of using a mixed-methods research design to investigate Appalachian older adult’s attitude toward the chronic disease experience and health behavior change. A convergent, parallel mixed-method design included a quantitative questionnaire and qualitative focus groups in churches in northeast Tennessee. The aim of the study was met, and the methodology of the study was found to be feasible for larger studies. Divergence of data was found when evaluating qualitative and quantitative data. The study instrument was found to be reliable for future use. The implications of the results suggest that the study design is appropriate for the purpose of the study.

Bakgrund: Diabetes är en vanlig dödsorsak världen över och diabetes typ 2 är den diabetesform som ökar mest i världen. Patientens förmåga att kunna använda ny tillförd hälsofrämjande kunskap är avgörande för egenvård vid diabetes. Låg hälsolitteracitet kan vara ett hinder för positiv hälsoutveckling. Syfte: Syftet var att belysa hur sjuksköterskan kan arbeta med hälsolitteracitet för att stödja egenvård hos patienter med diabetes typ 2. Metod: En allmän litteratursökning utfördes genom systematiska sökningar i databaser. Resultatartiklarna granskades via kvalitativ innehållsanalys. Bärande begrepp och textenheter kodades och innehållet sorterades i huvudkategorier eller underkategorier. Resultat: Tio kvalitativa artiklar bearbetades. Två huvudkategorier samt fem underrubriker identifierades. Första huvudrubrik var “Patientens stödjande relationer”. Underkategorierna innefattade vårdrelationen mellan patient och sjuksköterska samt det sociala nätverket som resurs. Andra huvudrubriken var: “Sjuksköterskans pedagogiska strategier”. Underkategorierna innefattade att tillgodose patientens behov av motivation, praktiska tillvägagångssätt för inlärning samt individanpassad information. Slutsats: Studien visar att strategier kan användas av sjuksköterskor för att stärka patientens hälsolitteracitet vid diabetes typ 2. När patientens hälsolitteracitet stärks främjas egenvården. / Background: Diabetes is a common cause of death worldwide and diabetes type 2 is the fastest growing form of diabetes in the world. The patient's ability to use new added health-promoting knowledge is crucial for self-care in diabetes. Low health literacy can be an obstacle to positive health outcomes. Aim: The aim was to illustrate how nurses can work with health literacy to support self-care in patients with diabetes type 2. Method: A general literature search was performed through systematic searches in databases. The result articles were reviewed through qualitative content analysis. Core concepts and text units were coded and sorted into main categories and subcategories. Results: Ten qualitative articles were processed. Two main categories and five subcategories were identified. The first main category was "The patient’s supportive relationships". The subcategories included the care relationship between patient and nurse and the social network as a resource. The second main category was: "Nurses pedagogical strategies". The subcategories included meeting the patient's needs for motivation, pedagogical strategies and customize information and education. Conclusion:The study shows that strategies can be used by nurses to strengthen health literacy in patients with type 2 diabetes. When the patient's health literacy increases, self-care improves.

Heart failure patients are responsible for managing fluctuations in symptoms between exacerbations by employing treatment adherence, active monitoring, and management strategies based on expert guidelines. Despite education, delayed help seeking persists among those in the need of acute medical intervention, as evidenced by high hospital admission and readmission rates. The purpose of this qualitative grounded theory study was to explore the decision making processes undertaken by heart failure, community-dwelling individuals as they experience symptom changes. Eighteen face-to-face interviews were conducted with participants who had heart failure and received self-management education from a home care agency in Southern Ontario, Canada. Data were analyzed using iterative steps of open, axial, selective coding, and qualitative software text queries. Three process themes were identified: perceiving symptoms, normalizing symptoms, and adapting to symptoms, with an overarching theme of control and absence of consultative behaviors. The central concept revealed in this study was normalizing symptoms in heart failure which included actions taken by participants to mitigate symptom fluctuations. Daily fluctuations were assimilated into normal life resulting in desensitization of symptom recognition and a loss of functional capacity. These findings can be used to inform system changes needed to strengthen consultative patient-health professional relationships required for effective self-management problem-solving. This study leads to positive social change by explaining how self-management is practiced from the patient's perspective, which can inform practice recommendations and future research.

Health literacy is the ability to understand and act on health information and is linked to health outcomes. It is unclear how health literacy skills are developed in patients with complex conditions, such as cardiovascular disease and diabetes. The purpose of this grounded theory study was to gain perspectives of both patients and healthcare professionals on how health literacy skills were developed in patients with cardiovascular disease or diabetes. The research questions addressed how knowledge and skills were acquired, the role of digital tools, instructional strategies used by healthcare professionals, and how the instructional strategies of the healthcare professionals matched the learning preferences and needs of the patients. A social ecological framework was used, which underscored the importance of understanding health literacy from multiple sources. Semistructured interviews were conducted on 19 healthcare professionals and 16 patients. Emergent key themes included: (a) social support plays an important role as a learning opportunity; (b) many patients get their information from internet searches; (c) instructional strategies should be personalized, interactive, social, and relevant; and (d) patients are self-directed learners. Linking of these themes led to the development of the health literacy instructional model, which is a 3-step approach, including an emotional support, behavioral approach, and instructional strategy. Social support was the common element in all 3 phases and was perceived to be key to developing health literacy skills, resulting in the key implication for social change. Recommendations are to consider social support in the development of health literacy instructional strategies.

Chronic conditions are public health threats. The Chronic Disease Self-Management Program (CDSMP) is an evidence-based disease management program that addresses personal self-management of chronic conditions. The CDSMP involves peer trainers who instruct and assist with chronic disease preventive measures. Although disease management demonstrates promise to improving patient self-maintenance, previous researchers have not evaluated how the program affects program leaders. The purpose of this study was to discover how self-help leaders feel about the CDSM program. The overarching research question asked about perspectives that self-help leaders had toward the program. Through a narrative qualitative approach, the perceptions of peer leaders were examined to determine if the program was personally beneficial. Guided by the social cognitive theory, a purposeful convenience sample of 20 participants completed the study. The participants were practicing peer trainers in the CDSMP program. Data analysis included hand coding using open and axial coding and content analysis. Study findings included themes surrounding how the CDSMP program benefits health in general as well as the management of facilitators' own chronic diseases, health behaviors, and increased quality of life. The ability for chronic disease management leaders to experience positive effects of the program they administer may result in positive social change. This awareness can positively affect social change by enhancing an already established evidence-based community health program with stronger and better-equipped leaders.