This thesis deals with psychological issues concerning patients with malignant gliomas, and their spouses. There is no known medical cure, and the patients have a limited survival expectancy. Therefore studies evaluating new treatment modes, an overall supportive atmosphere, and attempts to avoid imposing unnessesary strain are necessary. Thirty consecutive patients with astrocytomas, grade III-IV, were included in a clinical trial with estramustine phosphate in addition to conventional treatment with surgery and radiotherapy. Both the patients and their spouses participated in the present study which aimed at a deeper understanding of the psychological processes relevant to their situation. By means of repeated thematically structured interviews, patients and spouses were followed separately during the entire course of the disease process. In addition to these interviews, all patients were assessed with a mini-mental examination, and five-month survivors were tested with a comprehensive neuropsychological battery. Questionnaires on reaction to the diagnosis and assessing psychosocial well-being were also administered to the patients. The interviews were analysed with grounded theory methodology and the findings were juxtaposed to concepts in psychoanalysis and coping theory. The main finding was that the patients, despite or owing to their severe medical situations, showed a marked capacity to create protection and hope. By means of biased perception they created an 'illusion' that palliated their strain. This finding is related to object-relational psychoanalysis with obvious implications for the crucial discussion on telling bad news. Another finding was that the spouses displayed different crisis trajectories depending on the overall status of their partners. Different senses of the relationship were related to different modes of coping. Especially spouses to patients with personality changes were put under severe strain and ought to be acknowledged by medical staff. Patients with no obvious deficits five months after termination of primary treatment nevertheless evidenced, at neuropsychological testing, a pronounced deficiancy in long-term memory, but no clear impairment in global intellectual capacities. Estramustine phosphate was found to have a negative impact on sexuality and might be one causative agent behind the decline in long-term memory, but these adversive effects did not seem to affect psychosocial well-being. The selective reminding technique proved to be sensitive in detecting deficits and is recommended in future clinical trials affecting the CNS. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1996, härtill 5 uppsatser.</p> / digitalisering@umu

LR fizinių asmenų bankroto įstatymas įsigaliojo 2013 m. kovo 01 d. Šiuo metu stinga tiek teismų praktikos, tiek ir teisės mokslininkų darbų aiškinant bei taikant fizinių asmenų bankroto įstatymo nuostatas. Šis stygius ypač jaučiamas sutuoktinio ir vaikų teisių apsaugos srityje- teismų praktika ir teisės doktrina tik netiesiogiai arba menkai nagrinėja klausimą, kaip turėtų būti užtikrinamos sutuoktinio ir vaikų teisės fizinio asmens bankroto procese. Šio darbo tyrimo tikslas- nustatyti kaip pasireiškia bei kokių ypatumų įgauna sutuoktinio ir vaikų teisių apsauga fizinio asmens bankroto procese. Šiam tikslui pasiekti Autorė analizuoja subjektus, kurie atsakingi už vaikų teisių apsaugą fizinio asmens bankroto procese, sutuoktinio de jure ir de facto teisinę padėtį, išlaikymo klausimą, išieškojimo ribas, nuostatas, susijusias su privataus gyvenimo apsaugą bei klausimą, kokių ypatumų įgautų santuokos nutraukimo procesas jei vienas ar abu iš sutuoktinių pateiktų pareiškimą dėl bankroto bylos iškėlimo. Kompleksinė temos prigimtis lėmė, jog Autorė darbe nagrinėjo teismų praktiką bei teisės mokslininkų darbus ne tik fizinių asmenų bankroto srityje, tačiau ir šeimos teisės, teismo sprendimo vykdymo srityse. Darbe papildomai pasiremiama kitų valstybių įstatymų nuostatomis bei jų taikymo praktika. Remiantis istoriniu ir lyginamuoju metodais Autorė atskleidė fizinių asmenų bankroto paskirtį bei šios paskirties įtaką sutuoktinio ir vaikų teisėms. / Lithuanian Law on the bankruptcy of natural persons came into force on the 1st of March 2013. At the moment there is a lack of both- case law and legal doctrine- on the interpretation and implementation of personal bankruptcy law provisions. This lack is especially seen in the spousal and child protection- the case law and the legal doctrine only indirectly or poorly analyze the subject of how the protection of the spouse and children in the personal bankruptcy procedure should be implemented. The purpose of the Study is to determine how manifests the protection of the spousal and the children rights in the personal bankruptcy procedure and if there are any changes. An Author in order to achieve this goal analyzes the entities that are responsible for the protection of children’s rights, the legal status of the spouse de facto and de jure, the boundaries of the debt collection, the provisions that are related to the protection of private family life and also the question how the personal bankruptcy would impact the divorce procedure. The complex nature of the subject have caused that an Author had to analyze not only the case law and the legal doctrine in the field of personal bankruptcy but also the case law and the legal doctrine in the field of family law and court decision enforcement. The case law and the legal provisions of other countries are analyzed by the Author additionally. On the basis of comparative and historical methods the Author disclose the purpose of... [to full text]

Despite the prevalence of remarriages and stepfamilies in North American society, there is a relative paucity of research regarding aspects of marital quality in stepfamilies relative to the abundance of empirical examination of first marriages. Related to the absence of clear norms and roles for remarried partners and stepfamily members, clinicians have noted that remarried individuals tend to hold beliefs and expectations of remarriage and stepfamily relations that are better suited to biologically-related nuclear families, as opposed to recognizing the unique and often complex circumstances of stepfamilies. As such, remarital quality may be particularly prone to disappointment due to unfounded expectations and beliefs that become problematic for adjustment of partners and their children. Similarly, the few guidelines for interactions between former spouses who continue to co-parent their shared children may lead to dissatisfaction for remarried parents attempting to manage these relationships. The current study aimed to predict two aspects of remarital quality – dyadic adjustment and relationship commitment – with a measure of the changes in one’s beliefs over time about remarriage and stepfamilies, while also accounting for remarriage length and the self-reported well-being of the responding remarried parents. Changes in beliefs about co-parenting with one’s former spouse were also assessed as potential predictors of co-parenting communication quality, which has sometimes been found to correlate with remarital quality. An online questionnaire was completed by 112 remarried mothers who shared parenting of their minor children with their former spouses. A small sample of 33 remarried fathers also participated, providing an initial comparison group with which to tentatively explore gender differences in changes in beliefs and their association with remarital and co-parenting quality. Most respondents reported remarital satisfaction and average communication quality with former spouses, providing little evidence for the spillover of conflict that has been noted previously. Emerging as predictive of better current remarital quality included a reported decline over time in the beliefs that stepfamilies only have a slim chance of success, and a belief that stepfamilies are “second-best” compared to nuclear families. Mothers who recalled the greatest decreases in these beliefs over time also reported more positive remarital adjustment at present, compared to those whose beliefs did not change as much. The earlier that these beliefs changed, the greater the benefits were to remarital adjustment. Change in beliefs was also predictive of co-parenting communication, more so than individual well-being. Few sex differences were noted. These findings suggest that changes in beliefs regarding marital transitions and co-parenting relationships are important for adjustment in these relationships and have potential to act as targets for intervention to facilitate smooth transitions to remarriage and stepfamily life. Highlighting the need for remarrying couples and their children to have opportunities to develop positive beliefs and expectations about stepfamilies, possible applications in terms of public policy, community education, peer support, and family resources are discussed.

The main author’s aim is to answer a question, if a strict legal regulation has an influence on the stability of institution of marriage. The author analyzes legal norms, regulating the conditions of dissolution of marriage in Lithuania and in other European countries. Also gives summarized conclusions and makes particular suggestions for improving existing legal norms, which regulates the conditions of dissolution of marriage.

Prehospital emergency care (PEC) with the emergency call to the Emergency Medical Dispatch (EMD) centre is an essential part of the health-care system. It is important to obtain knowledge about the links in the PEC chain from the perspectives of those providing the service and those receiving it. The overall aim of this thesis was to describe the challenges surrounding PEC based on the experiences of patients, spouses and personnel. A qualitative descriptive design was used in the five papers included. The data analysis methods were phenomenological-hermeneutics (I–III), qualitative content analysis (IV–V) and descriptive statistics (V). Interviews with thirteen patients who had called the EMD-centre due to acute chest pain (I) revealed a general satisfaction with PEC. They were aware of the number to call in an emergency but were uncertain when to call. The potentially life threatening emergency situation was marked by vulnerability and dependency and was fraught with pain, fear and a sense of aloneness. An overall theme of aloneness emerged from the interviews with nineteen spouses who had placed an emergency call for their husband or wife that was experiencing acute chest pain (II). The challenges in being a spouse to a person in need of PEC were associated with: “Being responsible and trying to preserve life” and “Being able to manage the uneasiness and feel trust in an uncertain situation”. The spouses were in an escalating spiral of aloneness, worry, uncertainty, stress, fear of loss and desperation. Interviews with sixteen emergency operators dealt with situations they considered difficult to deal with and their reflections on how they managed such situations (III). Uncertainty, communication difficulties and insufficient resources characterized those situations. Skills, knowledge, experience, as well as personal qualities such as sensitivity, self-insight, empathy and intuition were regarded as important when handling them. Interviews with four nurses and fifteen emergency operators related to their experiences of working together for two years at an EMD-centre were conducted after the nurses were added to the EMD-centre to increase medical and nursing competence (IV). Initial frustration and scepticism changed to positive experiences with improved cooperation and service. The nurses voiced difficulties dealing with the more medically urgent calls and the emergency operators with the more complicated and diffuse medical cases. A total of 336 questionnaires related to alarms involving acute chest pain and given the highest priority by the emergency operator were collected in a study aimed at describing the ambulance personnel’s perceptions of the quality of the information received from the EMD-centre (V). The ambulance personnel perceived most of the information such as patient assessment, condition, history, preparedness and in particular pain status to be of high quality. In summary: In PEC there is many interdependent complexities that present demands and challenges to the actors involved (I–V). In general those who received emergency assistance from PEC were satisfied, but the margins between success and failure are small. Risks for errors exist throughout the PEC chain and time poses a challenge. Understanding is crucial for all involved, and the same situation can be experienced differently. Challenges inherent in PEC are the communication problems, unpredictability and uniqueness along with daring to be in the acute situation and dealing with a sense of aloneness, uncertainty and dependency. The personnel that do not have the ability to see the person they are helping are even more challenged. Important attributes for PEC personnel are caring attitudes, personal skills, experiences and professional knowledge. PEC personnel have the authority and power to act and make decisions, in which responsibility, sensitivity, and human dignity must be addressed. Lives are saved with PEC despite all the challenges and possibilities for error, such as those that exist between the different actors. It is vital that the PEC chain is as strong as possible.

Sammanfattning Syftet med denna studie var att beskriva äldre änkors/änklingars uppfattningar kring det eventuella stöd som erbjudits eller saknats dem, samt övriga underlättande faktorer under perioden de vårdade sin livspartner i hemmet.   Metoden som användes var kvalitativ och datainsamlingen bestod av semistrukturerade intervjuer. Informanterna var 4 kvinnor och 2 män i åldern 60-79 år med anknytning till anhörigcenter, ett kommunalt stöd för anhörigvårdare. Data analyserades med manifest innehållsanalys enligt Graneheim och Lundman (2004). Analysen identifierade två teman; Uppfattningar kring stöd från samhället, släkt och vänner samt Övriga underlättande faktorer.   Resultatet gav sex kategorier som informanterna framhöll som viktiga; Känsla av stöttning, Praktisk assistans, Information, Fokus på anhörigvårdaren, Upplevelse av hur den närstående mår, samt; Miljöombyte. I huvudsak visar resultatet på vikten av information och tillvägagångssättet som information ges på. Även samtalsterapi och en kontaktperson knuten till offentlig sektor efterfrågas för att underlätta i anhörigvårdarens vardag. Vidare är stöd som bidrar till att bibehålla ett socialt och varierande liv av stor vikt.   Slutsatsen är att de före detta anhörigvårdarna påverkas mycket av känslan av att de fått direkt eller indirekt stöd. Denna känsla är till stor del kopplad till vilket bemötande och vilken information som getts från i första hand offentlig sektor. Väsentliga skillnader för anhörigvårdarna kan därför uppnås med relativt små medel. / Bodin, A. (2013) Elderly informal caregivers perception about support and other relieving factors. Bachelor’s thesis in public health. The faculty of health and occupational studies, University of Gävle, Sweden.   Abstract The purpose of this study was to describe widow’s/widower’s perception of the support they had been offered or missing from society and relatives/friends during their time as informal caregiver to their spouse. The purpose was also to describe other possible relieving factors.   The method used was qualitative semi structured interviews that were held with 4 women and 2 men. Data was analyzed according to Graneheim &amp; Lundman (2004). Two themes were identified; “Experiences of support from society, relatives and family” and “Other relieving factors”.   The main results showed that the way information is given is important both when it comes to approach and procedure. A contact person is desirable. Support that benefits the informal caregiver’s social life is highly appreciated by the informants.   The conclusion is that the feeling of support is crucial and is connected to the way personnel is treating the informal caregiver. The ideal solution could proposedly be for the society to introduce a long-term course, giving adequate information and discussing the majority of aspects of being an informal caregiver, such as care, the spouse’s state of ill-health and how to preserve your own quality of life.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

Diss. Linköping : Univ., 2003.

Diss. Umeå : Umeå universitet, 2006.

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2007. / Source: Masters Abstracts International, Volume: 45-05, page: 2467. Adviser: Alfred McAlister. Includes bibliographical references.