Abstract The subject of this study is the content description of fictional works, especially novels. Study is divided into two sections. In the first part of it the aim is to investigate the communicative process of fiction, the previous studies on the content description of fiction and the making of thesauruses for fiction. In the second part the aim is to create means for the analysis of fictional content description (based on the first part's theoretical discussion) and to make a general model for fiction search and retrieval system. The material for the empirical part of the study was gathered in Finnish public libraries. The aim of the empirical part of the study is to find out how the clients and the library professionals of public libraries describe novels by indexing and abstracting them - what differences they have and what is the consistency between them. The basic theoretical approach in this study is qualitative and specifically as seen within the grounded theory. The corpus of this study was analyzed both with qualitative and quantitative methods. Qualitative methods were mainly used when analyzing the abstracts and the indexings were analyzed with the the basic statistical methods as well as with the calculated consistency values for indexers. The main finding was that the abstracts and indexings were very unconsistent. One could also typify the abstracts in four categories: plot/thematical abstracts, cultural/ historical abstracts, abstracts that describe the reading experience and critical abstracts. Also, with the aid of statistics one could make a typical indexing string of each novel that consisted about 10-15 indexing terms which described the basic contents of each novel. In the end of the study a model for search and retrieval system for fiction is presented. Methodologically, the triangulative approach with different kinds of methods turned out to be fruitful. Especially when studying the human behaviour, both quantitative and qualitative methods are needed. When used together they test the findings and results and thus give more validity to the final results.

Most of the existing research on relationships between counselling and religion has addressed how practitioners provide services to religious clients or on strategies for working with people from specific religious traditions. The focus of this study is on how counselling professionals’ religious identity may impact on their clinical work. All the participants had at least one year of post-qualification experience working with religious and non-religious clients. Nine participants (6 female and 3 males) were interviewed and the data were analysed using a social constructionist version of Grounded Theory. This gave rise to four different yet highly related sub-categories. These were as follows: 1) Meaning making: Identity within the context of religion, 2) Keeping my faith life and my psychotherapy life separate, 3) Disclosure: The Unavoidable Blend between Religion and Counselling, 4) The Impact on Therapy. The findings of this study suggest that there is a tension in the way counselling professionals are managing their religious identity within their professional environment (i.e. training, supervision and counselling room). This tension seems to be centred on a need to protect their religious self from challenges imposed by professional colleagues, and a need, at least for some participants, to use the counselling room to reinforce their religious beliefs. While some participants have consciously chosen to keep their religious self out of the therapy room, others emphasise this split between religious and professional self is not possible when it comes to their counselling practice. The participants’ need to protect themselves from potential negative judgment was identified as a complex phenomenon that formed the basis of the core category ‘Protection’. The findings have added a novel perspective in recognising the impact a counselling practitioner’s religious beliefs has on their clinical, supervisory and training experiences.

This thesis demonstrates how systems ideas and grounded theory have been applied to provide a broader approach to researching hedgerows in England, drawing on the idea that holistic thinking brings together different people’s relationships with hedgerows and with each other concerning hedgerows. The cultural dimensions of hedgerows and their implications for future hedged landscapes were investigated through the collection and exploration of different groups perspectives - public, farmers and experts - in England and Canada, using a diversity of primary and secondary data sources. English hedgerows were important to all groups. Everyone liked hedged landscapes for aesthetic, visual and wildlife reasons. They were important for the way they break up the landscape; provide signs of the changing seasons; their sense of mystery and intimacy; their connections with the past and childhood memories. They are also seen as part of England’s history and national identity. Such cultural identity was absent in the Canadian data. However, some groups also held a rational or objective view which was dominant over this subjective or emotional view and which affects where they draw the boundaries to their systems of interest. Farmers were most concerned with their farms (and the hedgerows they owned) as a business, while experts dealt mainly with the ecological aspects of hedgerows. There was found to be little awareness of others groups views with different groups seeing the same action in very different ways. Even where there was contact between farmers and experts, there could be a lack of trust. Finally, it is noted that policy and practice towards hedgerows have ignored many of these relationships and that the approach used here offers opportunities to examine the different systems of interest.

<p>The purpose of this constructivist grounded theory study was to explore women's experiences with endometriosis through diagnosis, treatment, and coping. Conducted using a health geography, medical sociology, and medical anthropology theoretical framework and a constructivist grounded theory methodology, the following research objectives guided this study: (a) document the experiences and consequences of receiving a medical diagnosis of endometriosis from the perspective of a group of women living in Hamilton, Ontario; (b) explore the iterative process the women experienced while seeking relief from the symptoms of endometriosis; (c) interpret the meaning of 'coping' that women on the journey for a reliable diagnosis and effective treatment for endometriosis experienced; and (d) formulate a coherent, middle-range interpretive substantive theory of the women's journey, in order to help others better understand the endometriosis experience from the patient's perspective.</p> <p>Seventy women were interviewed, and the middle-range substantive theory that emerged from this study is grounded in their experiences. The results indicate that the women experienced endometriosis as a journey through constant interaction with the social worlds they had defined through diagnosis, treatment, and ultimately coping. Studying their everyday life experiences and mapping those in the context of their biomedical, personal, and informational social worlds allow for a broader understanding of the varying ways that the women interviewed perceived the treatment processes and their treatment options, made sense of their symptoms, and experienced uncertainty about the influence change could have on their everyday lives. By incorporating their individual experiences and knowledge, their social world and descriptions of these worlds reflect the entirety of the endometriosis experience. Finally, if one examines endometriosis only from the perspective of being diagnosed, treated, and learning to cope with the disease, many facets of the journey are missed. Understanding these individual experiences as a journey, instead of just diagnosis, treatment, and coping, has practical implications for healthcare providers treating endometriosis.</p> / Thesis / Doctor of Philosophy (PhD)

Introduction Simulation-based learning is an example of learning in context in which clinical contexts are recreated in controlled settings to facilitate deliberate practice. While widely regarded as effective, unanswered questions exist about what elements of the clinical context must be recreated in simulated settings to promote authenticity. Moreover, the degree of authenticity (or fidelity) required for optimal learning is not known, with current thinking often deemphasizing the importance of physical realism. We therefore sought to explore contextual influences on performance in a ‘context-rich’ clinical setting: paramedicine. Methods We followed constructivist grounded theory principles and recruited currently practicing paramedics to participate in one-on-one, semi-structured interviews. We asked the participants to describe a recent experience in which they attempted to resuscitate a victim of sudden cardiac arrest and asked them how to recreate their experiences in simulated settings. Results Fourteen paramedics provided a total of seventeen interviews, each describing a distinct cardiac arrest event, yielding over ten hours of audio data for analysis. We iteratively identified three major interrelated themes describing contextual influences: the event – its physical characteristics, circumstances and people present; the conceptual response – the cognitive processes and challenges encountered; and the emotional response – the degree of emotional engagement in the management of the resuscitation. We also identified a major theme related to how to simulate these events. Collectively, our results suggest a complex and dynamic interplay between the physical, conceptual and emotional domains of context. Conclusion In contrast to other conceptualizations of context and fidelity, our results suggest that conceptual and emotional responses occur as a result of physical features in the practice environment, arguing in favour of physical authenticity in simulation. / Thesis / Master of Science (MSc) / Educators in the health professions have the important task of preparing their students – future physicians, nurses, paramedics, etc. – to perform effectively in clinical practice. This transition from healthcare student to healthcare professional is challenging, in part because classrooms and clinical contexts are different entities: the environment, the people within it, the way knowledge is generated, recalled and applied are all different. To narrow the gap between classroom and clinical practice, educators often promote learning in context, using various strategies to make the classroom more like the clinic (or any other setting in which health care is delivered). The challenge, however, is that exactly what features of the practice setting (context) should be recreated to promote learning is not known. We undertook this study, viewing the clinical context through a paramedic lens, to better understand what features present in real world conditions might influence learning and performance.

Vad försöker man göra inom ungdomsinriktad drogprevention och vad uppfattas som viktigt? Syftet med denna studie var att undersöka vad som händer inom preventionsarbete i Thailand. Analys med grounded theory av intervjuer med 27 personer, främst thailändare, med praktisk erfarenhet av drogpreventiv verksamhet. Motkrafter till missbruk i Thailand genomsyras av en moraliskt betingad grundhållning med en i grunden autonom människosyn. Genom sociala och pedagogiska nätverk, positiva alternativ, utveckling, relevanta budskap och kritiskt tänkande arbetar man med målgruppen för de preventiva insatserna som en autonom och aktiv part. Arbetet kräver en problemanalys och stödinsatser ges baserade på tillit. Likaså vill preventionsarbetarna bli betraktade med tillit av exempelvis överordnade instanser. Skillnader finns mellan hållningen på basnivå och centralt deklarerade "krig mot narkotikan". Målgruppen för drogpreventiva insatser bör betraktas som en aktiv part att samverka med för att uppnå hållbara resultat.

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Introduction In recent years the concept of ‘recovery’ has become increasingly prevalent in both government and health service policy, and in the terminology used by mental health service users. The current study examines the experiences of recovery as described by service users living in a rural / semi-rural population. This is in contrast to the majority of similar studies, which have tended to focus on urban centres where population characteristics, and the services available to service users, differ in many ways. As such, the aim of the current study was to add to the growing theory regarding what constitutes recovery from the viewpoint of service users living in a relatively remote area of the UK. Methodology Eight adult participants, all of whom defined themselves as either recovering or having recovered from significant mental health problems, were interviewed about their experiences using a semi-structured interview. Interviews were audio-recorded, transcribed and analysed for emerging themes using a social constructionist version of Grounded Theory. Data Analysis & Discussion Analysis revealed a consistent set of themes emerging from the participant interviews. These are encapsulated in the concept of reflection and integration, and the dynamic nature of these phenomena over time. Participants made reference to the nature of their problems and the impact they had on relationships, the treatment they had sought and received, and the effects of their experiences on their notions of themselves as individuals. Conclusions The findings of the current study are discussed in the light of existing relevant literature and in relation to current policy initiatives. Comparisons to the emerging theory regarding recovery are drawn, and distinctions made between the existing theory and the findings which appear to be particularly pertinent to the sample population. Suggestions for clinical applications are made. Limitations of the study are also addressed, and areas for potential further research are outlined.

With the corporatization of healthcare, combined with rapid advances in medical technology, frontline health care workers, especially nurses, are facing an increase in daily ethical dilemmas, with potential increases in moral distress. The contributing factors and negative effects of moral distress are well researched, in particular as they impact nurses in specialty areas. However, understanding how nurses navigate moral distress, specifically in general medical and surgical units, is not as well understood. The purpose of this study was to understand and articulate the processes that nurses carry out when navigating moral distress, by exploring their interactions with the health care environment. Using grounded theory methodology, a substantive theory was developed to explain the process. The participants in this study were all registered nurses from an acute care academic hospital, who worked on non-specialty medical and/or surgical units. Data collection consisted of audio-recorded face-to-face interviews that were transcribed post interview. All the events and situations that resulted in the experience of moral distress were primarily rooted in organizational structures, which often blindsided the nurses in this study, and led to a sense of feeling ill-equipped and unsupported to respond in the moment. Furthermore, the participants expressed their inability to be agents of change due to the established organizational expectations. The basic social process for navigating moral distress was “Just getting through the shift”. This theory is comprised of the categories of Experiencing Moral Distress, Making Sense of the Situation, and Finding the Way. In working through these processes, the participants engaged in navigating moral distress. Making sense of the situation was an ongoing process that nurses engaged in whereby they sought out knowledge in various ways, such as exploring internal resources, and building relationships with their peers, their patients, and patients’ families. Throughout this iterative process of making sense of the situation, the nurses were then able to find their way. Participants discussed positive outcomes such as reflecting and learning from the experience. However, despite this response, there was a feeling of powerlessness to make a difference. Therefore, they focused on providing the best care they could and getting on with their shift without experiencing closure. / Graduate

Health regions in Canada are primarily associated with the rationalization of conventional, historically expensive provincial health care systems. At the same time, it is unclear what contribution health regions make to advancing health system reform, particularly health-promoting activities. This work sets out to understand the relationships between regionalization and health-promoting activity by studying two health regions in Canadian provinces that have different approaches to regionalization (British Columbia and Ontario). I use a constructivist grounded theory methodology (Charmaz, 2006) to analyse data from nineteen key informant interviews with senior management working in the two regional health authorities and in provincial health organizations. The iterative analysis of the empirical data and the review of corporate documents from both regional organizations result in the identification of three core themes grounded in the data. The dominant theme emerging from the analysis is identified as place-making referring to a region’s ability to facilitate health-promoting activity by making the region a place with special meaning and resonance for the populations served. The other two themes are creating space within organizations for health-promoting activity and developing networks. The former refers to a region’s willingness and ability to operationally support health-promoting activity and the latter refers to efforts undertaken to establish relationships with other organizations in the health-promotion and healthcare networks. I conclude that these three themes characterize critical components of a therapeutic region. A therapeutic region suggests a conceptualization of regional health authorities (RHAs) in which priority is given to health-promoting activities, alongside an entrenched curative healthcare agenda (the medical model). A therapeutic region is conceived of as a region that implements policies and develops structures aimed at achieving improvements in the overall health status of the population it serves. In this research I develop a four-cell matrix to frame the theory of therapeutic regions. One axis represents a continuum of place-making, while the second axis reflects a continuum depicting how regions develop the two other themes -- one extreme represents a piecemeal or patchwork approach, and the other an integrated strategic approach. The implications of this research relate to practice and policy. The practice of improving the health of the population served requires regions to open pathways, and remove longstanding barriers by making place-making core to all community engagement and develop health-promoting activity within their organizations and their networks. Policy-makers need to bring clarity to the regions’ role in health-promoting activity. This research indicates that health-promoting activity, innovation and progress occur when a region has the ability to manage both conventional, curative health care and health-promoting activities. Whether that is through direct governance or new ways to bring together decision-making, service co-ordination and evaluation is a subject for future work. / Graduate