Syftet med studien var att undersöka hur personer utan socionom- eller socialarbetarexamen som arbetar med socialt arbete riktat mot personer med alkoholmissbruksproblematik inom tredje sektorn (civilsamhället) lär sig om socialt arbete. Vidare syftade studien till att undersöka vilka former av kunskaper och förmågor som dessa respondenter ansåg vara av betydelse för att kunna utföra ett socialt arbete. Som teoretisk grund för studien användes teorier om lärande. En kvalitativ metod bestående av enskilda intervjuer med frivilliga och anställda i tredje sektorn från Mellansverige utfördes. En tematisk analys gjordes och resulterade i att ett antal teman framkom. Resultatet visar inte en heltäckande bild av kunskapsläget hos den tredje sektorn men visar dock att tidigare forskning överensstämmer med resultatet. Viktiga kunskaper var teoretiska kunskaper, den egna personens betydelse och bemötandet av den enskilde. Resultatet visade även att respondenterna tillskansade sig kunskap genom professionella relaterade till verksamheten, lärde sig genom arbetet och att egna erfarenheter visade en väg till kunskap. / The aim of the study was to investigate how people without social work education, who practice social work targeted at people with alcohol abuse problems in the third sector learn about social work. Furthermore, the study aimed at investigating which forms of knowledge and abilities the respondents considered to be of importance in order to perform social work. Theories underlying the study were theories of learning. A qualitative method of individual interviews with volunteers and employees in the third sector from central Sweden was performed. A thematic analysis was made and resulted in a number of themes. The result does not show a comprehensive picture of the knowledge situation in the third sector, but shows that previous research is consistent with the results. Important knowledge was theoretical knowledge, the significance of the individual person and the significance of the meeting with the individual. The result also showed that the respondents gained knowledge through professionals related to the organisation, learn by doing and that their own experience showed a path to knowledge.

Introduction: Results of previous studies have shown a significant association be- tween alcohol abuse and eating disorders which often co-occur as a comorbidity. The co-occurrence of these diseases brings significant medical, social, and psychological complications and predicts a worse course of both disease and outcomes. Objectives: The aim of this thesis is to verify the association between the alcohol abuse and eating disorders by detecting the prevalence of anorexia nervosa, bulimia nervosa and binge eating disorder in women who are receiving the treatment for alcohol abuse. Methods: The survey includes 51 women hospitalized for alcohol abuse in PN Bohnice. The data were obtained during the questionnaire survey using the Munich Eating Disorder Questionnaire (Munich ED-Quest) and the Alcohol Use Disorders Identifi- cation Test (AUDIT), supplemented by socio-demographic questions. The data were analyzed using descriptive statistics in SPSS. Results: In total, 25.5% of respondents suffer from eating disorders at some point. Currently, 9.8% of women with an average age of 38.6 years with a median of 40 years suffer from eating disorder. In the past, 23,5% of respondents were affected by eating disorders. For the current period, 1.96% of women have met the diagnostic criteria for anorexia nervosa and...

Philosophiae Doctor - PhD / Background:The Project reported on in this thesis took place between 2003 and 2006 and focused on the problem of high rates of low birth weight in the West Coast /Winelands area of the Western Cape Province, South Africa. A 32 page woman’s health handbook (WHH) was developed and field-tested using a participatory action research approach. The purpose of the WHH was to provide a health promotion tool that would increase the likelihood of satisfactory birth outcomes in future by: improving the continuity of care for women, especially in pregnancy; improving the interaction between health service providers and women during health consultations; and enabling women to improve their broader health literacy.Methods:The Project used both qualitative and quantitative methods and was carried out in three phases following steps in strategic communication development: situational and audience analysis; strategic design and development; and,field testing. The process involved three levels of stakeholders, or audiences: primary (women working on farms); secondary (local health service providers); tertiary (regional and provincial health department officials).Phase I began with a situational analysis of the two research sites in 2003 - Vredendal and Stellenbosch areas. Data was collected through key informant interviews, secondary data and general observations. The information on the two sub-districts was summarised. In order to understand the lifestyle and contextual issues facing the primary audience focus group discussions and key informant interviews with all three levels of the audience were carried out in 2004. The analysis utilised an inductive approach to generate themes that integrated the information from all sources and a framework for understanding substance use was developed. Ideas for the format and contents of the WHH were collected utilising the same methods and were summarised into categories.Phase II utilised the findings of Phase I to develop the first version of the WHH. This was pre-tested with all levels of the audience in individual interviews or focus groups to assess its accessibility, contents and appropriateness. The findings were used to prepare the second version of the WHH for Phase III.In Phase III the second version of the WHH was tested by recruiting a cohort of 103 participants who were utilising the antenatal clinic services in the two sites in 2005. A pre- and post-intervention questionnaire was used to collect qualitative and quantitative data to characterise the participants and, assess if the WHH that was given to them to keep had influenced their health knowledge and substance use behaviour. Analysis included simple frequencies, and a comparison of key outcome measures from the pre- and post-intervention questionnaires. Secondary level audience representatives were also interviewed, and content analysis carried out to identify theirperceptions of the WHH and any potential barriers to its future use in the clinics. A final version of the WHH was developed and 10 000 copies made available through a resource centre. The dissemination of a batch of the final version was followed up in 2006.Results:The first phase identified the extent to which environmental and health-related behaviour contributed to low birth weight, as well as, other negative consequences in the lives of the primary audience. Important factors noted included the resource poor and stressful environment in which farm-based women live and work, and the high rates of women smoking cigarettes and drinking alcohol in general, and through pregnancy.A first version of the WHH was developed and pre-tested in the second phase by applying principles of designing health education materials for audiences with mid to low literacy levels. Results from this stage led to the development of the second version of the WHH.Although the evaluation of the second version of the WHH did not show any significant change in the health knowledge of the participants on the pre- and post-test analysis, there was a reduction in the use of alcohol, and very positive feedback on utilisation issues from all audiences. There was widespread dissemination of the final version of the WHH, however, neither the provincial nor the regional health authorities had incorporated it into their annual health promotion plan or budget.Conclusion:The participatory action research approach in the development of the WHH ensured that the form and contents was appropriate for most of the primary audience and that the secondary and tertiary audiences were supportive of its potential to positively women’s health in the region in the future. The main factors that limited the impact of the WHH include the need for the health service providers to consistently practice interactive health consultations using the WHH, and the need for the reproduction and dissemination of the WHH to be led by the provincial health department.It is recommended that brief training of health service workers is required in order to ensure that the final version of the WHH is utilised to its full potential and, that the provincial and regional health authorities devise a reproduction and dissemination plan to ensure that all women using the public health services receive their own copy of the WHH.

Over the past decade, the "problem" of Fetal Alcohol Syndrome and Fetal Alcohol Effects among Aboriginal peoples has received increasing attention from the Canadian nation-state. However, few feminist, anti-racist, anti-ableist, and anti-colonial scholars have offered a critique of FAS/E "prevention" policies aimed at Aboriginal women. In this dissertation, I present my analysis of the "official knowledge" and "public pedagogies" articulated in one such policy, The First Nations and Inuit Fetal Alcohol Syndrome/ Fetal Alcohol Effects Initiative (herein "the Initiative"). This analysis unravels the complex and contradictory tensions in contemporary state policy formation. My findings show how the Initiative paradoxically supports the development of inclusive, grassroots approaches to FAS/E prevention in Aboriginal communities while at the same time eclipsing the voices and concerns of Aboriginal women. Though neglected in the official policy texts and talk of the Initiative, young Aboriginal mothers' agency and insights are central in the dialectic of ideology, discourse, and lived experience that this study documents. To facilitate this shift, I engage a productive methodological synthesis of textual analysis, institutional ethnography, and participatory research, by grounding my analysis of the texts in indepth group interviews with six Aboriginal mothers whose lives include substance use and FAS/E. This study offers significant implications for the development of future policy, research, and "culturally appropriate" pedagogy for and about FAS/E "prevention". My findings do not support the outright rejection of medical models of disability, as has been favoured by many critical theorists and activists on the grounds that such models are universally oppressive and disenfranchising. Rather, the women's insights into their own lived experiences emphasize the simultaneously enabling and disabling consequences of medicalization. Accordingly, my findings underscore the urgent need to reconsider the roles of "race", gender, class, nation and dis/ability in contemporary theories and practices of substantive citizenship and nation-building in and outside of education. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate

Alcohol abuse is a ubiquitous issue for college students across the United States (U.S.) including Native Hawaiians and Pacific Islanders (NHPI). As compared to their counterparts, NHPI students tend to underutilize university counseling services and have significantly lower retention rates than their White counterparts. Considering that NHPI may be reluctant to go to counseling, their levels of distress and alcohol abuse may have to reach a higher threshold before they seek treatment. This study examined NHPI college students' presenting levels of alcohol abuse both at intake and over time and compared these students to students from other ethnic/racial groups. Data were gathered from the Center for Collegiate Mental Health (CCMH), a practice-research network used by hundreds of college counseling centers across the U.S. Aggregated data from the years 2012-2015 included variables measured by the Standardized Data Set (SDS) and the Counseling Center Assessment of Psychological Symptoms (CCAPS). The data were analyzed using Latent Growth Modeling (LGM) to assess the differences at intake and over time in alcohol abuse and distress across ethnic groups. Results of this study indicated that NHPI college students at college counseling centers had higher levels of alcohol abuse and presenting distress at intake than students from other ethnic/racial groups. However, NHPI did not have significantly different changes in levels of alcohol abuse from session one to session 12 as compared to other students. Implications and directions for further research are also discussed.

Bakgrund: I dagens samhälle är alkohol- och narkotikaproblematik vanligt förekommande. Alkohol- och narkotikaproblematik leder till negativa förändringar i vardagen. Utifrån ett samhällsperspektiv råder det stigmatisering av alkohol- och narkotikaproblematik vilket leder till att personer undviker att söka vård. Syfte: Att beskriva hur patienter med alkohol- och/eller narkotikaproblematik upplever vårdpersonalens bemötande inom sjukvården. Metod: Allmän litteraturstudie med induktiv ansats. Resultat: Resultatet presenteras i två teman vilka är bemötande som stöd och bemötande som hinder. I resultatet framkom det att vårdpersonalens bemötande upplevdes som stödjande eftersom vårdpersonalen lyssnade och bemötte patienter professionellt samt att vårdpersonalen visade att de hade goda kunskaper i mötet med patienter. Vidare framkom det i resultatet att patienter upplevde vårdpersonalens bemötande som ett hinder i vårdprocessen eftersom vårdpersonalen bemötte patienter otillräckligt och ovärdigt i form av diskriminering, stigmatisering samt maktmissbruk. Konklusion: Resultatet presenteras i två teman vilka är bemötande som stöd och bemötande som hinder. Resultatet kan bidra med ökad förståelse hos vårdpersonal som möter personer med alkohol- och/eller narkotikaproblematik vilket på så vis kan bidra till bättre förutsättningar för ett gott bemötande. / Background: In today's society, alcohol and drug problems are common. Alcohol and drug problems lead to negative changes in everyday life. From a societal perspective, there is the stigma of alcohol and drug problems, which leads to people that avoid seeking care. Purpose: To describe how patients with alcohol and/or drug problems experience the treatment of healthcare professionals in the healthcare sector. Method: General literature study with inductive approach. Result: The result is presented in two themes which are supportive treatment and obstructive treatment. In the result, it was found that the care staff's treatment was experienced as supportive because the care staff listened and treated patients professionally and that the care staff showed that they had good knowledge in the meeting with patients. Furthermore, it emerged in the results that patients perceived the treatment of care staff as an obstacle in the care process because the care staff treated patients insufficiently and unworthily in the form of discrimination, stigmatization and abuse of power. Conclusion: The result is presented in two themes, which are supportive treatment and obstructive treatment. The result can contribute to increased understanding among healthcare professionals who meet people with alcohol and/or drug problems, which can thus contribute to better conditions for good treatment.

Bakgrund: Substansmissbruk är ett växande folkhälsoproblem vilket leder till att sjuksköterskor möter personer med missbruksproblematik i större utsträckning än tidigare. Denna grupp vårdsökande löper ökad risk att utsättas för stigmatisering till följd av bristande kunskap om substansmissbruk och beroende. Detta kan medföra negativa konsekvenser gällande personcentrerad vård vilket kan innebära sämre vårdkvalitet för personer med substansmissbruk. Syfte: Att beskriva sjuksköterskors upplevelser av att vårda personer med substansmissbruk. Metod: En litteraturöversikt med kvalitativ design och induktiv ansats. Sammanställning av elva vetenskapliga artiklar som kvalitetsgranskats och sedan analyserats utifrån fem steg. Resultat: Resultatet visar att flertalet faktorer påverkar vården av personer med substansmissbruk. Två kategorier framträdde under analysen. Kategorin Kunskapsluckor redovisas med tre underkategorier (Specifik kunskap, Tillitsfull vård samt Professionellt ansvar). Den andra kategorin; Etiska utmaningar redovisas i två underkategorier (Jämlik vård trots rädsla samt Frustration och otillräcklighet). Slutsats: Det finns okunskap hos sjuksköterskor gällande vårdsökande personer med substansmissbruk. Kunskapsbristen kan leda till fördomar och osäkerhet hos sjuksköterskor vilket kan göra det utmanande att vårda personcentrerat. Konsekvensen ka bli försämrad vård för denna grupp vårdsökande. Ökad kunskap samt större erfarenhet är nödvändig för att förbättra vårdkvaliteten för personer med substansmissbruk. / Background: Substance abuse is a growing public health problem. This group of care seekers is at increased risk of stigma settings because of general ignorance regarding substance abuse and addiction. This may lead to negative consequences when it comes to offering person-centered care to this group of people. Aim: To describe nurses’ experiences of caring for people with substance abuse. Method: A literature review with qualitative design and an inductive approach. A compilation of eleven scientific articles which has been quality checked and then analyzed from five steps. Findings: There are several elements affecting the medical care for persons with substance abuse. Two categories emerged through the analysis. The first category:  Lack of knowledge is described in three subcategories (Specific knowledge, Reliant care and Professional responsibility). The other category: Ethical challenges is described in two subcategories (Equal care despite of fear and Frustration and inadequacy).  Conclusion: There is a general ignorance amongst nurses’ regarding the care for people with substance abuse. The lack of knowledge might stimulate preconceptions and insecurity among nurses. Increased knowledge and greater experience are needed to improve person-centered care for this group of care seekers.

Alkoholkonsum beginnt häufig bereits im Jugendalter. Allerdings fehlen bisher Erkenntnisse darüber, ob, wie häufig und aufgrund welcher Merkmale Jugendlichen und junge Erwachsene auch bereits klinisch definierte Mißbrauchs- und Abhängigkeitsdiagnosen entwickeln. In der vorliegenden Arbeit werden Ergebnisse einer repräsentativen Untersuchung an 3021 Jugendlichen im Alter von 14-24 Jahren vorgestellt. Neben der Prävalenz von Alkoholmißbrauch und -abhängigkeit nach DSM-IV werden Daten zur Häufigkeit und Menge des Alkoholkonsums berichtet sowie erste Symptome beschrieben. 9,7% der befragten Jugendlichen erhielten aufgrund von DSM-IV-Kriterien eine Mißbrauchsdiagnose, 6,2% eine Abhängigkeitsdiagnose. Bei männlichen Jugendlichen war die Prävalenz wesentlich höher als bei weiblichen. Die Prävalenz war in den älteren Geburtskohorten höher. Als erstes Missbrauchssymptom trat am häufigsten "Gebrauch mit körperlicher Gefährdung" (91,9%), als erstes Abhängigkeitssymptom "Toleranzentwicklung" (34,3%) auf. Erste diagnostische Kriterien einer Alkoholstörung traten zumeist deutlich vor dem 18. Lebensjahr auf. Diese Daten unterstreichen, daß Alkoholmißbrauch und -abhängigkeit bereits im Jugend- und frühen Erwachsenenalter häufig sind. / Alcohol use frequently begins in adolescence. However, only few studies have reported the prevalence of alcohol abuse disorders in adolescents. This paper reports results from a representative study in a sample of 3021 adolescents, aged 14-24 years. The Prevalence of alcohol abuse and dependence according to DSM-IV criteria, as well as the prevalence, frequency and quantity of alcohol abuse and a description of the first occuring symptoms, are presented here. Alcohol abuse was reported by 9.7% of respondents and alcohol dependence by 6.2%. Males were more likely to report an alcohol disorder than females, and the prevalence also increased in the older age cohorts. The most frequent initial symptoms were "hazardous use" (91.9%) for abuse and "tolerance" (34.3%) for dependence. First symptoms have been shown to occur long before the age of 18. These results show that even in adolescents and young adults alcohol abuse and dependence are frequent disorders.

First use and initiation of regular alcohol use has been frequently found to start in adolescence. However, only few studies have also investigated how many adolescents proceed during ages 14–24 to harmful drinking or even develop alcohol use disorders. This paper – using the EDSP baseline sample of 3,021 community respondents from the Munich area – examines the prevalence of use, abuse and dependence and investigates the dose/disorder relationship. Alcohol abuse was reported by 9.7% of respondents and alcohol dependence by 6.2%. Men were more likely to report an alcohol disorder than women, prevalence also increased in the older age cohorts. However, even among 14- to 17-year-olds a substantial proportion of respondents report high and regular consumption rates, the occurrence of abuse and dependence criteria and even a full dependence syndrome. There is however only a moderate association between average number of standard drinks consumed with the risk of developing abuse and dependence. In light of the substantial rates among adolescents and young adults the validity of DSM-IV alcohol disorder criteria is discussed.

Att utarbeta effektiva arbetssätt för att hjälpa människor ifrån hemlöshet är en angelägensamhällsfråga. Vår undersökning genomförs i samverkan med Socialförvaltningen i Uppsala kommun. I studien har vi intervjuat klienter och handläggare om deras upplevelser och syn på hur en boendekedja för klienter med missbruksproblematik fungerar. Resultatet av vår studie visar att boendekedjan förenklar arbetsprocessen med denna klientgrupp och leder till att fler klienter snabbare kan få ett bostadssocialt hyreskontrakt. Det framkommer också att det finns en diskrepans mellan hur handläggare och klienter uppfattar tydligheten i processen.