Aim: The overall aim of this thesis, using a salutogenic framework, was to develop knowledge about experiences and perceptions of living with recessive limb-girdle muscular dystrophy and its influences on health, from the affected young adults’ and their parents’ perspectives. Methods: A qualitative explorative and descriptive study design was used. Semi-structured interviews were held with 14 young adults diagnosed with recessive limb-girdle muscular dystrophy, aged 20–0 years, and 19 parents. Data analyses were conducted using content analysis (I, II, III) and phenomenography (IV). In order to mirror the interview data, the participants also answered the 13-item sense of coherence questionnaire. Findings: Recessive limb-girdle muscular dystrophy has a major impact on the affected young adults’ and their parents’ lives as the disease progresses. Health described in terms of well-being was thus perceived to be influenced, not only by physical, emotional and social consequences due to the disease and worry about disease progression but also by external factors, such as accessibility to support provided by society and other people’s attitudes. There was, however, a determination among the participants to try to make the best of the situation. The importance of being able to mobilize internal resources, having social support, meaningful daily activities, adapted environment, the young adult being seen as a person and having support from concerned professionals, including personal assistance when needed, was thereby described. Self-rated sense of coherence scores varied. Those who scored above or the same as median among the young adults (≥56) and the parents (≥68) expressed greater extent satisfaction regarding social relations, daily activities and external support than those who scored less than median. Conclusion: This thesis highlights the importance of early identification of personal perceptions and needs to enable timely health-promoting interventions. Through dialogue, not only support needed for the person to comprehend, manage and find meaning in everyday life can be identified, but also internal and external resources available to enhance health and well-being, taking into account the person’s social context as well as medical aspects.

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.

Background: Expecting a child and becoming a parent is one of life’s major events, during which the parents’ perspective on life and their couple relationship changes. For some parents, childbearing entails a decrease in parental couple relationship quality. The way in which parents are able to cope with childbearing may be connected with their Sense of Coherence; which is a person’s ability to perceive life as comprehensible, manageable and meaningful. For parents’ positive childbearing experiences, professional and social support have been proven to be valuable. However, far from all parents have access to social support; furthermore, professional support does not always meet the needs of expectant parents. Hence, more research is needed to increase knowledge about expectant parents’ experiences of professiona land social support. In addition, more research is needed to explore factors associated with quality of couple relationship among parents during childbearing. Aims: The overall aim of the thesis was to explore professional and social support for first-time mothers and partners during childbearing in relation toquality of couple relationship and Sense of Coherence. Methods: The study’s designs were explorative, prospective and longitudinal; both qualitative and quantitative methods were used. Specifically, explorative designs, qualitative methods and phenomenographic analysis were used to explore expectant first-time mothers’ (I) and partners’ perceptions of professional support (II). Furthermore, an explorative design, qualitative method and qualitative content analysis were used to explore expectant first-time mothers’ experiences of social support (III). Within Study IV, a prospective longitudinal design, descriptive statistics, non-parametric tests and multiple linear regression analysis were used to evaluate factors associated with quality of couple relationship among first-time mothers and partners, during pregnancy and the first six months of parenthood. Results: The overall results of the thesis revealed both similarities and differences between expectant first-time mothers’ and partners’ perceptions of professional support, effects from social support and associated factors with perceived quality of couple relationship. The similarities were; both mothers and partners perceived that professional support could facilitate partner involvement, influence their couple relationship and facilitate contacts with other expectant parents. According to first-time mothers’ experiences, their couple relationship with their partner was also strengthened by social support during pregnancy. Further, the results showed that both first-time mothers’ and partners’ higher perceived couple relationship quality six months after birth, was associated with their higher perceived social support. The results showed also that both mothers and partners perceived their quality of couple relationship to decrease and Sense of Coherence to increase six months after childbirth, compared to the pregnancy. Differences revealed were such as: higher Sense of Coherence was only associated with mothers’ higher perceived quality of couple relationship, and first-time mothers reported perceiving more social support compared to the partners both during pregnancy, first week and six months after childbirth. Conclusions: Professional and social support can strengthen first-time mothers and partners both individually and as a couple, in their abilities to cope with childbearing. On the individual basis, the expectant parents could be strengthened through professional and social support that contributed to their understanding and feeling of being prepared for childbirth and parenting, for instance. As a couple, the parents were strengthened by professional support that included the partner’s role, as well as higher perceived social support overall. In contrast, lack of support could have a negative influence on the expectant parents’ feeling of being prepared for childbirth and parenting. Besides this, the results indicates that childbearing has a positive effect on parents’ abilities to cope with life even though their quality of couple relationship decrease. Professionals can use these results in their further understanding about how to offer satisfactory support to first-time mothers and partners during childbearing.

Skolverkets statistik visar att matematik är det kärnämne där svenska elever presterar lägst. Denna studie undersöker om intensivundervisning av fem elever i matematiksvårigheter i årskurs 7 kan stärka deras känsla av sammanhang (KASAM) inom matematiken enligt Antonovskys teori. Enligt Antonovsky skapas KASAM om begreppen begriplighet, hanterbarhet och meningsfullhet uppfylls. Begriplighet innebär att elevens kunskaper inom ämnet är höga, hanterbarhet betyder att elevens tilltro till sina förmågor är höga och meningsfullhet innebär att eleven ser nyttan med matematiken. Intensivundervisningen bedrevs under sex veckor med tre halvtimmeslektioner per vecka och eleverna deltog i par. Inför intensivundervisningen undersöktes elevernas kunskapsnivåer och uppfattningar om matematikämnet genom en kartläggning baserad på Magnes diagnoser och en intervju, dessa följdes upp efter insatsen med en ny diagnos och intervju. De inledande och avslutande resultaten jämfördes och analyserades utifrån begriplighet, vilket syntes i resultaten på kartläggningen och diagnosen, hanterbarhet och meningsfullhet som analyserades utifrån elevernas svar på intervjuerna. Genom den nya lärmiljön, den konstanta kommunikationen med positiv feedback och det praktiska material som med fördel används stärks två av begreppen inom KASAM tydligt. Detta visade studiens resultat vad gäller hanterbarhet och meningsfullhet som förbättrades för samtliga elever, den data som samlades in gällande begriplighet blev för svårtolkat för att ge ett tydligt resultat. En längre insats förespråkas då det hade gett en större möjlighet för eleverna att befästa kunskaperna och det framförallt gällande elever med stora kunskapsluckor. / According to the Swedish National Agency for Education’s statistics, mathematics is the core subject in which the Swedish students perform the lowest. This study examines if interventions in mathematics can help five students in year seven, which experience mathematic difficulties, feel a sense of coherence (SOC) within the subject as per Antonovsky’s theory. According to Antonovsky SOC is created if the concepts of comprehensibility, manageability and meaningfulness are fulfilled. Comprehensibility means that the student’s knowledge of the subject is good, if the manageability is high the student is confident in their abilities, and meaningful means that the student sees the benefit of mathematics. The intervention was conducted over six weeks, with three half-hour long lessons per week where the students participated in pairs. Prior to the intervention the students’ levels of knowledge and their perception of mathematics were examined through a survey based on Magne’s diagnosis and an interview, after the intervention they were followed up with a new diagnosis and interview. The initial and the final results were compared and analysed based on comprehensibility, which was shown in the result of the survey and the diagnosis, manageability and meaningfulness, which were analysed based on the interviews. With the help of the new learning environment, the continuous communication with positive feedback and the concrete material, which is beneficial to the teaching, two of the concepts of SOC are clearly strengthened. The result of the study shows this when it comes to manageability and meaningfulness for all the participating students, the data collected concerning the concept of comprehensibility was too difficult to interpret to give a distinct result. A lengthier effort is advocated to give the students a better opportunity to consolidate the new knowledge, this in particularly when it comes to students with large gaps in knowledge.

No description available.

Background: The number of people suffering from myocardial infarction in Sweden is decreasing, despite this the prevalence is high. Being diagnosed with myocardial infarction results in medical interventions, lifestyle changes and eventual pharmacological treatment to prevent relapse. Aim: The aim of this study was to describe patients' experience of life after amyocardial infarction. Method: A literature-based study was used, based on ten qualitative articles. The articles were analyzed in a five step-model, which resulted in three main-themes and sixsub-themes. Results: The results present life after myocardial infarction as difficult to understandand manage. This could be related to their physical and mental changes, which resulted in fear and anxiety that affected their everyday lives through experienced limitations. Fatigue where also a contributing factor in the limitations of everyday life due to energyloss. This was hard to handle without support from both relatives and health care professionals. It was essential to be meet as a unique human and not reduced to a diagnosis. Life became more valuable through the survival and gave the individuals a second chance with different priorities. Some adjusted to the lifestyle changes, while others were reluctant. Returning to work where seen as an indicator for being healthy and a return to life as before. Conclusion: To establish well-being and security through nursing, a holistic approach that is the basis of person-centered care helps nurses to see the individual situation. / I Sverige minskar antalet personer som drabbas av hjärtinfarkt trots detta är förekomsten fortfarande hög och ca 5800 avlider varje år. Hjärtinfarkten medför både fysiska och psykiska förändringar hos den drabbade. Syftet med denna litteraturstudie är att belysa patienters upplevelse av livet efter en genomgången hjärtinfarkt. I studiens resultat framkom det att både män och kvinnor såg situationen och livet efter en hjärtinfarkt som svår att hantera, då både kroppen och hjärtat inte längre upplevdes pålitligt. Detta resulterade i rädsla och oro som begränsade det vardagliga livet. Personerna upplevde att det var svårt att tolka kroppsliga signaler, vilket gav en osäkerhet som resulterade i ångest och katastrof tankar om döden. Detta medförde även att de inte vågade anstränga sig fysiskt. Känslor som ilska, frustration och nedstämdhet upplevdes på grund av den mentala och fysiska utmattningen som var svår att förstå. Personerna kunde inte utföra vardagsaktiviteter i samma utsträckning som innan hjärtinfarkten, vilket resulterade i en känsla av passivitet. Det utrycktes även ett behovav stöd från anhöriga och vårdpersonal för att klara av sin situation och det vardagligalivet. Vårdpersonalens bemötande och agerande var avgörande för hur patienterna förstod informationen som gavs, deltog i rehabilitering och klarade att genomföra nödvändiga förändringar när det gäller ohälsosamma levnadsvanor. Vårdpersonalens förmåga att skapa en trygg atmosfär tillsammans med att se patienten som människa var viktigt för att uppnå välbefinnande. Anhöriga sågs som en resurs för personerna då de kunde avlasta vardagssysslorna samtidigt som de lyssnade, vilket gav trygghet och välbefinnande hemma. Patienter upplevde att familjen satt för höga krav och fick då stödet från vänner. Partnerrelationen kunde påverkas genom den minskade sexuella relationen som grundade sig i rädsla för de fysiska förändringarna och upplevdes svårt att prata om med partnern. Livet efter en hjärtinfarkt beskrevs som en ny chans till livet där nya värderingar uppstod. Personerna upplevde att arbetsgivarens attityd och förståelse för situationen var avgörande för fortsatt sjukskrivning. För att kunna möta patientens unika behov och skapa välbefinnande genom omvårdnad, är personcentrerat förhållningssätt lämpligt för att vidhålla en helhetssyn på patienten och inte bara det fysiologiska tillståndet.

Context: Tobacco use among medical students is of public health concern, given their role as future role models for healthy lifestyles. This study sought to determine the prevalence and determinants of tobacco use and nicotine dependence in medical students in Pretoria. In particular, this study explored the role of sense of coherence – a measure of stress-coping ability – on tobacco use patterns among medical students. Furthermore, we examined the students’ knowledge of smoking cessation approaches, their perceptions with regard to the availability and adequacy of tobacco control curricula, and their perception of their role as ”role models” for their patients. Methods: This cross-sectional analytical study, involving undergraduate medical students in their 2nd and 6th year of study at the universities of Pretoria and Limpopo (MEDUNSA), was conducted during August and September 2008. Consenting participants completed a self-administered questionnaire (N=722). Information obtained included: demographic characteristics of respondents, alcohol use, past and current use of various tobacco products, perception of availability and adequacy of training in tobacco control (TC), support for various TC legislation and perception of the role of doctors in smoking cessation. A six-item Antonovsky’s sense of coherence scale (SOC) was also included to measure respondents’ ability to cope with stress. Nicotine dependence was measured using the diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV). Data analysis included chi-square statistics, t-test and multiple logistic regression analysis. Level of significance was set at p<0.05. Results: Prevalence of cigarette smoking in medical students was 17.3%. Cigarette smoking was significantly higher among the 6th (21.5%) than among the 2nd year (14.1%) students and was also significantly higher among males (20.4%) than among females (14.4%). In a bivariate analysis, problem drinkers were more likely to be smokers (37.5%) as compared to non-problem drinkers (13%). Compared to non-smokes, smokers were more likely to have a lower SOC [Mean(sd); 26.8 (8.8) vs 28.8 (7.4); p=0.019] and were less likely to attach importance to being seen as a role model by patients. Only 21.9% felt their training curriculum contained TC issues and of these a little over half felt the TC content was inadequate. After controlling for potential confounders, the factors that were independently associated with the current smoking status were, having lower support for TC legislation (OR=0.49; 95% CI= (0.41-0.59) and attaching less importance to being seen as a role model by patients (0.62; 0.41-0.91). Other factors associated with cigarette use included: being a 6th year student (OR=2.17; 95% CI; 1.32-3.58), having a drinking problem (2.17; 1.28-3.68), reporting exposure to others smoking at home (3.29; 1.91-5.66) and having received previous formal training in cessation (0.55; 0.32-0.95). Younger age (0.86; 0.77- 0.97), lower SOC (0.94; 0.90-0.99), and lower level of support for TC legislation (0.56; 0.40-0.79) were independently associated with nicotine dependence. Conclusions: This study’s findings suggest that tobacco use is prevalent among medical students and tobacco use is strongly associated with alcohol abuse. In addition to offering tobacco cessation services to these students, these findings highlight the need to institute a curriculum on tobacco control that includes not only teaching cessation counselling skills to medical students, but that also encourages them to become advocates for TC legislation and to recognise themselves as important role models in the society. Copyright / Dissertation (MMed)--University of Pretoria, 2009. / School of Health Systems and Public Health (SHSPH) / MMed / Unrestricted

There is an ongoing shortage and high demand for basic and specialized nurses in health care sectors in Sweden. The sick leave among healthcare workers has been remarkably increasing since 2012. Number of sick leaves has been increased among health care workers including midwives and specialized nurses regardless to their level of education. Aim of the study is to learn more about competence, competence growth and how it has impact on nurse health at their working place.Qualitative semi-structured interview method is used in this study and snowball sampling method is used to select the study participants. Interview data of all participants are analyzed using thematize analysis method. Eight nurses took part in this study and seven of them are working in hospital and one participant is working in an elderly care home. Almost all of the participations reported that competence is one of the key requirements for health care workers. The participants reported that the competence and the competence growth in working place are associated with professional experience, resources, peer support, cooperation, personal characteristics, attitude of managers and colleagues towards skills development, work environment, training towards knowledge updating and specialization and short terms courses. The study results show that most of participations have stable sense of coherence (KASAM) and the ability to associate the works with coherence is high. Five of eight participations scored high in of sense of coherence and it’s three components: comprehensibility, manageability and meaningfulness. One participant scored high in comprehensibility, manageability and whereas low in meaningfulness. Two participants scored high in comprehensibility and meaningfulness whereas low in manageability. The components of sense of coherence are often associated with good health in many studies. However, further researches to assess the relationship between the variables sense of coherence and nurses competent are required and it can be helpful for health promotional works among heath care workers.

The purpose of this study is to describe and explore the happiness, sense of coherence and resilience of rural teachers from a positive psychology framework where positive and healthy adaptation is emphasized. This study forms part of the dissemination phase of a longitudinal study known as STAR (Supportive Teachers Assets and Resilience). Completed questionnaires by twelve rural teachers in STAR schools (2 primary and 1 secondary) in rural Mpumalanga were purposively sampled as data sources for secondary analysis. The measures included the Oxford Happiness Questionnaire (OHQ), Resilience Scale (RS-14) and the Orientation to Life Questionnaire (SOC-13). Results are presented as descriptive and non-parametric statistics. Results indicated that teachers possess High Moderate to High levels of happiness, Moderate to High Moderate sense of coherence, and High Moderate to high levels of resilience. There was no significant relationship between happiness, sense of coherence and resilience. No significant differences were observed between levels of happiness, sense of coherence and resilience of teachers in (Pre- STAR intervention and post- STAR intervention); nor with regards to gender. Theorizing the findings of this study within the theoretical framework of positive psychology indicates that despite significant risk and adversity, teachers are able to demonstrate positive psychological constructs in the form of happiness (extraversion, kindness, humor, sense of purpose, aesthetic appreciation, locus of control, positive affect, self-efficacy, physical health and self-esteem ), sense of coherence (comprehensibility, manageability and meaning) and resilience (self-reliance, having a purposeful and meaningful life, equanimity, perseverance and existential aloneness). / Dissertation (MEd)--University of Pretoria, 2013. / gm2014 / Educational Psychology / unrestricted

Bakgrund: Hjärtsvikt är en växande folksjukdom som drabbar allt fler individer i världen. Hjärtsvikt är ett tillstånd när hjärtat inte kan pumpa tillräckligt med blod för att tillgodose kroppens behov, vilket påverkar både hälsan och det vardagliga livet. För att sjuksköterskor ska kunna ge god vård till personer med hjärtsvikt krävs det kunskap och förståelse kring upplevelsen av att leva med hjärtsvikt. Syfte: Att beskriva personers upplevelse av att leva med hjärtsvikt.   Metod: En litteraturöversikt med utgång i forskning med kvalitativ design och induktiv ansats. Resultatartiklar insamlades från databaserna CINAHL, MedLine och PsycInfo som analyserades med hjälp av Fribergs femstegsanalys. Resultat: I resultatet uppkom tre teman och sex underteman. Dessa teman beskriver vilka förändringar hjärtsvikt förde med sig och hur det påverkade vardagen. Slutsatser: I litteraturöversikten framkom det olika aspekter av att leva med hjärtsvikt. Hjärtsvikt skapade begränsningar och emotionella förändringar i livet. Bristen på information från sjukvården försvårade hanteringen av hjärtsvikt. Nivå av KASAM kan påverka förutsättningar till att kunna hantera sjukdomen. För att underlätta omvårdnad och stöttning är det betydelsefullt att sjuksköterskor inneha kunskap och förståelse för upplevelsen av att leva med hjärtsvikt. / Background: Heart failure is a growing public health problem and is affecting many people around the world. Heart failure is a condition when the heart is unable to pump sufficiently to maintain blood flow to meet the body’s needs which affect the health and the daily life. For nurses to be able to provide good healthcare, it requires knowledge of experience of people living with heart failure. Aim: To describe people’s experience of living with heart failure. Method: A literature review based on qualitative design and inductive approach. Result articles were collected from the databases CINAHL, MedLine and PsycInfo and analyzed using Friberg’s five-step analysis. Result: The result revealed tree themes and six sub-themes. These themes describe how heart failure changed and affected everyday lives of people living with it. Conclusion: The literature study revealed various aspects of living with heart failure. Heart failure created limitations and emotional changes in life. The lack of knowledge from the healthcare made managing heart failure difficult. The level of SOC can affect the prerequisites of managing the disease. It is important that nurses have knowledge and understanding of the experience of living with heart failure, to facilitate nursing.