Coronary artery bypass grafting (CABG) föregås av en väntetid som kan vara påfrestande för patienten i och med att en hjärtkärlsjukdom är ett livshotande tillstånd. Effektivi-sering inom sjukvården har lett till förhållandevis korta vårdtider efter detta ingrepp. Med tanke på den relativt långa rehabiliteringsfas som följer läggs mycket av ansvaret för återhämtningen på patient och dennes närstående i hemmet. Syftet med studien var att belysa det sociala stödet och dess betydelse för patienten i samband med en CABG-operation. Studien genomfördes som en litteraturstudie. Resultatet visade att socialt stöd hade en positiv effekt på välbefinnan-det för patienter i samband med CABG-operation. Socialt stöd gavs i olika grad i form av emotionellt, informativt eller instrumentellt stöd, av sjuksköterska och närstående. De närstående utgjorde den viktigaste källan till stödet. Vissa patientgrupper hade större behov av socialt stöd än andra. Sjuksköterskan bör vara medveten om dessa utsatta grupper och försöka tillgodose deras behov av utökat stöd. Vidare forskning bör göras för att se hur detta utökade stöd bör utformas för att ge bäst effekt.

This thesis assessed responses toward rape against women as experienced by the victims and victim supporters in the context of the interaction between victims, supporters, and formal agencies in Tanzania. The overall research design was based on triangulation with a combination of qualitative and quantitative methods. A semi-qualitative study, in which free listings and semi-structured questionnaires were used, explored social reactions from 44 community nurses and 50 rape victims (Paper I). A tool developed from this first study was utilized for collecting data on people’s attitudes and their behavior toward rape and rape victims from a representative community sample of 1505 men and women aged 18-65 years (Paper II). Both studies helped to access suitable rape victims and supporters who participated in the third study to share experiences on the process of rape disclosure to formal and informal social networks (Papers III and IV). The results highlighted the salient social reactions and how rape victims perceived the impact of these reactions. Half of the participants interpreted rape situations based on social relationships, circumstances, and social status of the woman, rather than the legal definition. Two-thirds of the adults explained they would express negative social reactions toward a victim in some rape scenarios, and this correlated with their attitudes towards rape and rape victims. A variety of barriers in the informal and formal networks with potentially negative impacts on rape reporting, service utilization and, health outcomes were identified. In conclusion, successful interventions aimed at improving people’s response to rape, rape disclosure and, health outcomes in Tanzania should assume a holistic approach to address the negative factors identified at the individual, family and, community levels without forgetting the normative context that appears to underlie most decisions and practice.

In the wake of deinstitutionalization, people with psychiatric disabilities are, to a great extent, living in the community. In this thesis everyday life of people with psychiatric disabilities, living in independent housing with community-based social support to manage their daily life, is investigated. Special attention is paid to the characteristics and meaning of community-based social support. Through participating observational studies, interviews and time-geographic diaries, data have been gathered about everyday life of seventeen men and women. It is the interpersonal social conditions that have been the main target of the study, addressed as social networks and social support. Everyday life conditions are dependent on social as well as physical and material circumstances. Although the social conditions are emphasized in the study they are not looked upon as isolated dimensions but as part of everyday life circumstances. The everyday life perspective offers an opportunity to reveal the structures within which everyday life takes place. The time-geographic concepts “community-organized projects” and “individual-organized projects” were used to investigate the structures of everyday life, resulting in four substructures. Four types of everyday life and four patterns of networks connected to the different substructures were identified, showing great variations. The characteristics of community-based social support can be summarized as “the doing”, “the talking” and “the being with” in a reciprocal type of relationship. The meaning of support is shortly described as solution of and relieving problems, social companionship, security, protection and control. Community-based social support show similar importance regardless of the type of everyday life when it comes to solution of problems and different importance when it comes to aspects of support such as social companionship.

The Chinese market transition has provided new opportunities for individuals to improve social status. In contemporary urban China, do people have equal access to opportunities to obtain occupational status? Following theories of human capital, social network and market transition, this study uses a dataset of the 2003 China General Social Survey and interviews, to explore different effects of human capital, family background and social network on occupational mobility from a perspective of work sector change. The first major finding is that the returns for education were highest for those whose first and second occupations were in the state sector. Work experience and party membership were significant only for workers remaining in the state sector and human capital was often considered equal to work ability. In the private sector, occupational status depended on recognition of the ability to work. Secondly, family background was meaningful for workers transferring within both sectors. In the state sector, the effects were mainly through the use of fathers’ political power to make occupational promotion whereas in the private sector, it came down to economic support or information transmission. Thirdly, social network was significant in the form of strong ties if workers stayed in the state sector or transferred there from the private sector. It mainly took the form of job information for those staying in or transferring to the private sector. And last, education significantly affected income for all groups but with the highest returns for stayers. I conclude that for one thing, human capital, family background and social network exert markedly different effects on occupational mobility in four subgroups in contemporary urban China. The use of political power is the main influence of family background and social network, especially for those transferring to the state sector. The institutionalization of occupational promotion based on political power may result in unequal opportunity for job and status mobility and consequently the stagnation of economic and social development. In order to establish a fair labour market, five policy proposals are made related to promotion of a market-oriented economy, disclosure of information in the labour market, law regulation, reform of distribution of socioeconomic benefits, and political system reform.

The goal of this study was to examine the views and perspectives of Tamil mental health outpatients and mental health care workers on the impact social activities and social network has on mentally ill patients’ general and mental health. The study was conducted at an outpatient mental health program at a Canadian hospital, using the grounded theory approach. Data were collected through questionnaires, document review and semi-structured interviews. Results showed that the mental health program had a positive impact on the mental health outpatients’ quality of life, including improvement in mental health, physical health, social network and social skills. The importance of cultural integration in mental health programs was discussed. Furthermore, barriers in accessing and utilizing mental health resources were highlighted and recommendations for program development were provided. Mental health programs can be effective in helping to improve the quality of life for Tamil consumers of outpatient mental health services. / UOIT

Despite the well-recognized importance of interpersonal relationships within the work environment, there is no comprehensive approach or set of studies that provide a complete picture. As a step towards providing a complete picture, this research presents a qualitative exploratory study of how people experience the work environment through task and work-social interactions and through policies and norms present in the work environment. The purpose of this study is to understand the overall work experience from purely work-social and purely task network perspective. A semi-structured question-based set of interviews were performed among professionals from a Canadian university alumni society. The transcripts of the interviews were then manually coded and analyzed using statistical methods. The study found an overall higher level of positive responses for co-workers in the work-social network, as well as a preference for work-social co-workers in building a team for a hypothetical company. The study also found a general willingness to select only the best ranked co-workers from task network, whereas a leniency towards the selection of co-workers from work-social network was observed despite their lower ranking. At the same time, the study identified some of the most desirable attributes of fellow co-workers both in the task and work-social networks from an employee’s perspective. The significance of the people and team was found more important to the employees than factors such as specific task performed or compensation. This exploratory study provided insights into how employees view their co-workers and their work environment.

The purpose of this study was to explore the meaning of physical activity experiences to older women. A qualitative hermeneutic phenomenological design was used. A purposeful sample of 9 women, age 67 to 83 years old, enrolled in a group physical activity program participated in the study. Data was collected through in-depth semi-structured interviews, artifact documentation, and descriptive and reflective fieldnotes. The transcripts and significance of the artifacts were analyzed using thematic line-by-line analysis. Three themes emerged from the thematic analysis, trading roles, a happier me, and pride and delight. <p>Trading roles refers to the womens perceptions of a new era of their lives given the transition experienced in their life roles. Many of the things they considered stable in their lives changed. Friends dropped away, family moved, they no longer fulfilled the role of wife, and their active grandmothering period was ending. <p>The theme, a happier me, speaks of the impact their involvement in a physical activity program had on their social lives. Living as widowed or single women, they recognized that they could become isolated within their own homes. Engaging in a physical activity program provided a context where they could expand their social network. The interaction with others in a physical activity program brought a sense of happiness and well-being to their days.<p>The theme, pride and delight, captures the deep understanding of their own sense of well-being and took pride in planning and developing the physical activity program. The assumption that more knowledgeable others must plan, implement, and evaluate programs to meet the needs of older adults was challenged by these participants. <p>The meanings of the experiences were interpreted with the support of Weiss (1973) theoretical framework on loneliness. The results of the study highlighted the importance of the contacts made in the physical activity program to the social network of the women, including provisions of attachment, nurturance, and social integration. Physical activity programs for older adults have the potential to expand the social network of older adults and with further research may prove to be an effective intervention for social isolation and ultimately loneliness.

Continuing medical education has been characterized as didactic and ineffective. This thesis explores the use of Knowledge Building theory, pedagogy, and technology to test an alternative model for physician engagement—one that emphasizes sustained and creative work with ideas. Several important conceptual changes in continuing medical education are implied by the Knowledge Building model—changes that extend the traditional approach through engagement in (a) collective responsibility for group achievements rather than exclusive focus on individual advancement and (b) work in design-mode, with ideas treated as objects of creation and assemblage into larger wholes and new applications, with extension beyond belief-mode where evidence-based acceptance or rejection of beliefs dominates. The goal is to engage physicians in “cultures of participation” where individual learning and collective knowledge invention or metadesign advance in parallel. This study was conducted in a continuing medical education End-of-Life Care Distance Education course, for family physicians, from 2004 to 2009. A mixed methods case study methodology was used to determine if social-mediated Knowledge Building improved physicians’ knowledge, and if so, what social network structural relationships and sociocognitive dynamics support knowledge improvement, democratization of knowledge, and a metadesign perspective. Traditional pre-/posttest learning measures across 4-years showed significant gains (9% on paired t-test = 5.34, p < 0.001) and large effect size (0.82). Social network analysis of ten 2008/2009 modules showed significant difference in density of build-on notes across groups. Additional results demonstrated a relationship between high knowledge gains and social network measures of centrality/distribution and cohesion. Correlation of posttest scores with centrality variables were all positive. Position/power analyses highlighted core-periphery sociocognitive dynamics between the facilitator and students. Facilitators most often evoked partner/expert relationships. Questions rather than statements dominated the discourse; discourse complexity was elaborated/compiled as opposed to reduced/dispersed. Themes beyond predefined learning objectives emerged and Knowledge Building principles of community responsibility, idea improvability, and democratization of knowledge were evident. Overall, results demonstrate the potential of collective Knowledge Building and design-mode work in continuing medical education, with individual learning representing an important by-product. There were no discernible decrements in performance, suggesting significant advantages rather than tradeoffs from engagement in Knowledge Building.

Girl gamers, while a substantial part of the gaming population, are often largely ignored in both the gaming industry and academic literature. In particular, there have been few investigations to date on what comprises the identity of a girl gamer, particularly outside the context of gameplay. To that end, the current study aims to investigate how girl gamers enact their identities as girl gamers on Twitter, a social network site. Eight Twitter accounts whose users self-identified as either Gamer Girls or Girl Gamers on a Twitter user directory where identified and the profiles and tweets of each collected for a two week period. This data was then analyzed according to Hecht’s communication theory of identity in order to determine how girl gamers enact their identity in an online context.

Continuing medical education has been characterized as didactic and ineffective. This thesis explores the use of Knowledge Building theory, pedagogy, and technology to test an alternative model for physician engagement—one that emphasizes sustained and creative work with ideas. Several important conceptual changes in continuing medical education are implied by the Knowledge Building model—changes that extend the traditional approach through engagement in (a) collective responsibility for group achievements rather than exclusive focus on individual advancement and (b) work in design-mode, with ideas treated as objects of creation and assemblage into larger wholes and new applications, with extension beyond belief-mode where evidence-based acceptance or rejection of beliefs dominates. The goal is to engage physicians in “cultures of participation” where individual learning and collective knowledge invention or metadesign advance in parallel. This study was conducted in a continuing medical education End-of-Life Care Distance Education course, for family physicians, from 2004 to 2009. A mixed methods case study methodology was used to determine if social-mediated Knowledge Building improved physicians’ knowledge, and if so, what social network structural relationships and sociocognitive dynamics support knowledge improvement, democratization of knowledge, and a metadesign perspective. Traditional pre-/posttest learning measures across 4-years showed significant gains (9% on paired t-test = 5.34, p < 0.001) and large effect size (0.82). Social network analysis of ten 2008/2009 modules showed significant difference in density of build-on notes across groups. Additional results demonstrated a relationship between high knowledge gains and social network measures of centrality/distribution and cohesion. Correlation of posttest scores with centrality variables were all positive. Position/power analyses highlighted core-periphery sociocognitive dynamics between the facilitator and students. Facilitators most often evoked partner/expert relationships. Questions rather than statements dominated the discourse; discourse complexity was elaborated/compiled as opposed to reduced/dispersed. Themes beyond predefined learning objectives emerged and Knowledge Building principles of community responsibility, idea improvability, and democratization of knowledge were evident. Overall, results demonstrate the potential of collective Knowledge Building and design-mode work in continuing medical education, with individual learning representing an important by-product. There were no discernible decrements in performance, suggesting significant advantages rather than tradeoffs from engagement in Knowledge Building.