本研究係以實證的方式，探討我國上市公司財務報表公告日之時間落差特性。研究主題包括： 　　1.我國上市公司財務報表公告時間特性為何？ 　　2.公司財務報表的公告時點是否因公司規模、未預期盈餘、相對獲利能力、審計作業複雜度及會計師查核報告的不同而有所差異？ 　　3.我國證券市場是否存有公告時間落差愈長，其資訊內涵愈少的現象？ 　　4.我國上市公司財務報表是否有好消息提早公告，壞消息延遲公告的現象？ 　　5.民國77年證交法的修訂，對上述特性有何影響？ 　　本研究的測試期間為民國71年至民國82年，由於民國77年1月29日證交法修訂時對財務報表公告期限有了較明確的規範，故本研究依證交法對公告期限規範的有無，將樣本區分為二組。第一組（民國71年至75年）包括46家公司，共230個觀測值，第二組（民國76年至82年）包括85家公司，共595個觀測值。實證結果彙總如下： 　　1.不論從年度別或各公司別加以測試，證交法修訂前後年度之時間落差特性皆有明顯的不同。因此，民國77年證交法的修訂應可增進財務報表公告的時效性及可預測性，利於投資者及時取得會計資訊。 　　2.不論在證交法對公告期限有無規範，公告時間落差和公司規模皆呈反向關係。 　　3.在證交法修訂前，未預期盈餘和公告時間落差呈反向關係，而在證交法修訂後，則無法偵測出此現象。 　　4.在證交法修訂前，相對獲利能力和公告時間落差呈反向關係，但在證交法修訂後，其關係不若修訂前顯著。 　　5.未發現審計作業複雜度和公告時間落差有關。 　　6.未發現會計師查核報告型態和公告時間落差有關。 　　7.不論證交法對公告期限有無規範，皆無法偵測出財務報表的資訊內涵會隨著公告時間落差的增減而改變。 　　8.在證交法修訂前，當盈餘具好消息型態時，管理當局確有提早公告的傾向；在證交法修訂後，則無法偵測出此一現象。 　　9.就股價面而言，無論在證交法修訂前或修訂後，皆未發現有好消息提早公告，壞消息延遲公告的現象。 　　10.如以盈餘、股價綜合探討。在證交法修訂後，當盈餘具好消息且提早公告者，確會有正的異常報酬，除此之外，其他各組皆無法偵測出盈餘、股價及提早（延遲）時間落差三者間有任何關係。

Contexte. Objectifs principaux : explorer l’expérience vécue vécu des neurologues et des patients des annonces de mauvaises nouvelles dans la sclérose en plaques, le vécu de la pathologie ainsi que de la qualité de leur relation dans le contexte du suivi d’un projet thérapeutique, et d’envisager la création d’un outil clinique réflexif pour les neurologues destiné à contribuer au maintien d’une relation de qualité durant l’ensemble du parcours de soins. Méthodologie. Étude qualitative multicentrique ; analyse des verbatims : 63 entretiens cliniques de recherche - 35 patients et 20 entretiens - 20 neurologues ; 3 entretiens - relecture d’items ; triangulation méthodologique ; triangulation des observateurs/résultats ; analyse IPA et analyse clinique d’orientation psychodynamique. Résultats. Les annonces de mauvaises nouvelles dans la SEP sont vécues comme des expérience anxiogènes pour la majorité des neurologues de la recherche, des situations source de frustration et parfois d’impuissance. Les impacts psychiques engendrés par les annonces de mauvaises nouvelles, la perception dans certains cas d’une relation au médecin dénuée d’empathie, le sentiment d’impuissance lié au caractère imprévisible de l’évolution de cette maladie progressivement handicapante ainsi qu’une défiance quant à l’efficacité des traitements proposés expliquent en partie la fragilité de l’alliance thérapeutique avec le neurologue et les réactions psychologiques parfois extrêmes des patients qui en découlent. Conclusion et ouverture. Résultats obtenus : engager une réflexion éthique sur les informations à transmettre au patient, et proposer une formation aux neurologues basée sur l’outil élaboré / Context. This research aims to explore the neurologist’s and patient’s lived experiences of breaking bad news in multiple sclerosis and the lived experience of this disease, to understand the basic conditions of their relationship, and to create reflective clinical tools aimed at helping neurologists to maintain the quality of their relationship with the patients. Methodology. Multicentre qualitative study presents the results obtained from the analysis of 83 clinical research interviews with 35 patients and 20 neurologists, using IPA and a clinical psychodynamic. Results. Breaking bad news (BBN) in multiple sclerosis are lived as stressful experience for the majority of the neurologists of the research, a situations lived with frustration and sometimes powerlessness. Psychic impacts engendered by the BBN, the perception in certain cases of a relation to the doctor divested of empathy, the feeling of powerlessness linked to the unpredictable character of the evolution of this gradually crippling disease as well as a mistrust as for the efficiency of the proposed treatments explain partially the fragility of the therapeutic alliance with the neurologist and sometimes the extreme psychological reactions of the patients. Conclusion and opening. Results obtained : engage an ethical reflection on the information to transmit to the patient, and to suggest training to neurologists based on the tool created in tis research

Si l’importance de la communication dans la prise en charge des patients en oncologie n’est plus à démontrer, elle n’en demeure pas moins une difficulté pour les soignants. Les soignants se retrouvent fréquemment confrontés à des contextes communicationnels complexes pour lesquels ils se sentent bien souvent démunis et insuffisamment formés. Des formations adaptées et spécifiques sont nécessaires afin d’assurer un changement durable des stratégies de communication utilisées par les soignants dans leur pratique clinique. Cette thèse vise à apporter une contribution à la formation des soignants à la communication en oncologie et à l’étude du transfert des compétences dans la pratique clinique. Ce travail de thèse porte sur l’analyse de deux contextes de communication différents :l’annonce de mauvaises nouvelles et la communication autour des traitements. Au travers de ces deux contextes, trois objectifs ont été poursuivis :(a) la modélisation d’un programme de formation adapté à un contexte de communication spécifique, (b) l’évaluation de l’efficacité de ce programme de formation ou l’évaluation du transfert des compétences apprises dans la pratique clinique et (c) l’évaluation de l’impact de ce programme de formation à la communication sur le patient (et sur le proche) simulé ou réel.Dans le cadre de ce travail de thèse, nous avons donc pu évaluer l’efficacité de deux formations à la communication spécifiquement développées pour ces deux contextes de communication. La formation à l’annonce de mauvaises nouvelles a permis une amélioration de la répartition du temps consacré à chaque phase du processus d’annonce ainsi que l’acquisition de stratégies de communication. Elle a également permis une augmentation de l’activation physiologique des médecins, reflétant un meilleur niveau d’engagement cognitif et émotionnel dans la tâche. Concernant la formation à la communication donnée en radiothérapie aux équipes multidisciplinaires, elle a permis le transfert des compétences acquises durant la formation dans la pratique clinique. Ces formations ont également montré un impact sur les patients et les proches réels ou simulés en permettant que les soignants leur laissent plus de place pour s’exprimer. La formation à la communication en radiothérapie a également montré un impact sur la satisfaction des patients. Ce travail de thèse souligne l’importance de développer des formations à la communication spécifiques aux différents contextes communicationnels ainsi que la nécessité de travailler à l’optimisation du transfert des compétences acquises durant ces formations dans la pratique clinique. / Doctorat en Sciences psychologiques et de l'éducation / info:eu-repo/semantics/nonPublished

Title: Bereavement in people with developmental disabilities Author: Kristýna Štaffová Department: Department of Special Education Supervisor: doc. PhDr. Jan Šiška, Ph.D. Abstract This thesis is devoted to the topic of mourning of people with developmental disabilities. In this paper we focus on the positive influence of the grieving process before it starts, that means, how can we inform an individual with developmental disabilities in a sensitive way about an illness or a death of his beloved. In the introduction we describe bases which are characteristic for people with developmental disabilities and which are useful to consider when communicating bad news. Subsequent chapters are devoted to describing the preparation and process of telling bad news to people with developmental disabilities. The thesis is supplemented by practical examples for better representation of the discussed topic. The conclusion is dedicated to description of the grieving process of 3 persons with developmental disabilities. Key Words person with developmental disabilities, dying, death, grieving, grief, grieving process, bereavement, loss, bad news

SJUKSKÖTERSKORS UPPLEVELSER OCH ERFARENHETER AV BRYTPUNKTSSAMTAL MED PATIENT I LIVETS SLUTSKEDELITTERATURSTUDIEHolgersson M, Johannesson J. Sjuksköterskors upplevelser och erfarenheter av brytpunktssamtal med patient i livets slutskede. Examensarbete i omvårdnad 15 högskolepoäng. Malmö Universitet: Fakulteten för Hälsa och samhälle, Institutionen för vårdvetenskap, 2020.Vid ett brytpunktssamtal har sjuksköterskorna en framträdande och viktig roll. Då patienten är i livets slutskede och vården går från botande till lindrande är det viktigt att det sker i rätt tid och på rätt sätt. Sjuksköterskors medverkan vid brytpunktssamtalet ska medföra en trygghet för patient och anhörig och genom sin kännedom om patienten kan sjuksköterskorna bidra till en bättre omvårdnad vid livets slut. Syfte: Syftet med studien var att undersöka sjuksköterskors upplevelser och erfarenheter runt brytpunktssamtal med patienter i livets slutskede. Metod: En litteraturstudie utfördes där tio artiklar med kvalitativ design som svarade upp mot syftet valdes ut. En innehållsanalys genomfördes där artiklarna granskades och syntetiserades ner till ett resultat. Resultat: Resultatet mynnade ut i fyra huvudteman: Kommunikation inom teamet och med patient och anhörig. Interaktionen i teamet och med patient och anhörig. Relationer och upplevelser i mötet med patient och anhörig och slutligen sjuksköterskors upplevelser och känslor i sitt arbete med patienten före, under och efter brytpunktssamtal. Sjuksköterskorna i studien efterlyste mer utbildning i att hantera sin roll vid brytpunktsamtal. Sjuksköterskorna har ofta vårdat patienten under en längre tid och har skapat en relation och lärt sig vad som är viktigt för just den patienten vilket är en stor tillgång under brytpunksamtalet för att tillgodose patientens önskemål och skapa förutsättningar för god omvårdnad. Konklusion: Kommunikation i teamet och förberedelser är viktigt i arbetet runt patient och anhörig vid brytpunktssamtal. Sjuksköterskorna behöver utbildning och erfarenhet av brytpunktssamtal för att känna sig trygg i sin roll för att utgöra ett bra och tydligt stöd för patient och anhörig i brytpunktssamtal. Nyckelord: Brytpunktssamtal, erfarenheter, palliativ vård, sjuksköterskor, upplevelser. / NURSÉS EXPERIENCES IN BREAKING BAD NEWS DIALOGUES WITH PATIENTS IN THE END OF LIFEA LITERATURE REVIEWHolgersson M, Johannesson J. Nursés experiences in breaking bad news dialogues with patients in the end of life. Degree Project in nursing 15 credit points, Malmö University: Faculty of Health and Society, Department of Care Science, 2020.The nurses has a prominent and important role in breaking bad news dialogues. As the patient is in the final stage of life and the care goes from curative to palliative, it is important that this is done at the right time and in the right way. The nurse´s participation in breaking bad news dialogues should bring a feeling of safety for both the patient and relatives and through the knowledge of the patient the nurses can contribute to a better care in the final stages of life. Purpose: The purpose with the study was to analyze nurses experience and knowledge about breaking bad news dialogues with patients in the final stages of life. Method: A literature study was conducted where ten articles of qualitative design that responded to the purpose were selected. A content analysis was done where the articles were reviewed and synthesized down to a result. Result: The outcome resulted in four main themes. Communication within the team and with patient and relatives. The interaction in the team and with the patient and relatives. Relationships and experiences in the meeting with patient and relative and finally the nurse´s experiences and emotions in their work with the patient before, under and after breaking the bad news. The nurse has often cared for the patient during a longer period of time and has created a relationship and learned what is important for that particular patient which is a huge asset during the breakpoint dialogue to meet the patient´s wishes and create conditions for good nursing. Conclusion: Communication in the team and preparation are important in the work regarding patient and relatives in breaking bad news dialogues. The nurse need education and experience in breaking bad news dialogues to feel safe in her role to be a good and distinct support for patient and relative in breaking bad news dialogues. Keyword: Breaking bad news, life experiences, lived experiences, nurses, palliative care.

Objective This study tested the effectiveness of a brief, learner-centered, breaking bad news (BBN) communication skills training module using objective evaluation measures. Methods This randomized control study (N = 66) compared intervention and control groups of students (n = 28) and residents’ (n = 38) objective structured clinical examination (OSCE) performance of communication skills using Common Ground Assessment and Breaking Bad News measures. Results Follow-up performance scores of intervention group students improved significantly regarding BBN (colon cancer (CC), p = 0.007, r = −0.47; breast cancer (BC), p = 0.003, r = −0.53), attention to patient responses after BBN (CC, p < 0.001, r = −0.74; BC, p = 0.001, r = −0.65), and addressing feelings (BC, p = 0.006, r = −0.48). At CC follow-up assessment, performance scores of intervention group residents improved significantly regarding BBN (p=0.004, r = −0.43), communication related to emotions (p = 0.034, r = −0.30), determining patient's readiness to proceed after BBN and communication preferences (p = 0.041, r = −0.28), active listening (p = 0.011, r = −0.37), addressing feelings (p < 0.001, r = −0.65), and global interview performance (p = 0.001, r = −0.51). Conclusion This brief BBN training module is an effective method of improving BBN communication skills among medical students and residents. Practice implications Implementation of this brief individualized training module within health education programs could lead to improved communication skills and patient care.

Yes / Drawing on distinct German institutional characteristics related to cultural, legal, financial, and regulatory features, this paper investigates the extent to which environmental incentives influence German non-financial firms in revealing risk information in their annual report narratives. The paper also examines whether risk-related disclosure (aggregate risk reporting and the tone of news about risk) is useful by investigating its impact on market liquidity and investor-perceived risk. We find that the decision to provide or withhold such risk information is less likely to be significantly associated with environmental incentives. Among those incentives, we find that German firms are significantly influenced by their underlying risks rather than other factors including ownership structure, capital structure, external equity finance, and borrowing. The decision to disclose is likely to be influenced by the size of the firm and whether or not it produces lengthy annual reports. The results also suggest that the impact of aggregate risk reporting levels was not observable until a distinction was made between bad and good news about risk. Specifically, we find that the German market tends to positively (negatively) price good (bad) news about risk by either improving (worsening) market liquidity through removing (creating) information asymmetries, or reducing (increasing) investor-perceived risk.

Nous cherchions à explorer les compétences que les intervenants du service des urgences (SU), des médecins et des infirmières travaillant en équipe dans des rôles complémentaires, ont développées dans la divulgation d‘un décès, pour éclairer l‘apprentissage de cette compétence de « Communicateur ». Nous avons utilisé des entrevues semi-dirigées et un échantillonnage non probabiliste de 8 intervenants. Nous avons analysé les entrevues à l‘aide de méthodes qualitatives reconnues. Le nombre total de présences de nos intervenants à une divulgation est estimé supérieur à 2000. Notre analyse a démontré qu‘ils utilisent une structure de divulgation uniforme. Néanmoins, ils repoussaient l‘utilisation d‘un protocole, parce que jugé trop rigide. La flexibilité et l‘empathie se sont révélées des qualités essentielles pour les intervenants. Nous représentons la visite de la famille comme un épisode de désorganisation/dysfonction qui se résorbe partiellement durant le séjour au SU. Nous proposons un modèle pédagogique qui est basé sur nos résultats. / We explored the competencies that Emergency Department (ED) healthcare providers (HPs), physicians and nurses working as team members with complementary roles, have developed through notifications of death, to inform the teaching of this ‘Communicator‘ competency. We used semi-structured interviews on a non-probabilistic sample of 8 HPs. We analyzed the interviews using recognized qualitative methods. The total self-estimated number of death notifications attended by our HPs is superior to 2000. Analysis showed that experienced HPs use a uniform structure to death notification in ED. In spite of this, the use of a protocol for notification was considered inappropriate because it was deemed too rigid. Flexibility and empathy emerged as essential qualities for HPs. We submit that the family‘s ED visit is an episode of disorganization/dysfunction that gets partially resolved during their stay. Based on our results, we propose an educational model for teaching delivery of news of death in the ED.

Background: The vast majority of infants born with congenital heart disease (CHD) reach adulthood because of the developments in cardiology in recent decades. This thesis aims to describe the psychosocial situation of child/adolescent cardiac patients and their families, investigate the situation faced by parents and siblings initially and over time, investigate the approaches paediatric cardiologists use in encountering the family, and describe the teamwork occurring in paediatric cardiology teams (PCTs) in Sweden. Theoretical framework: The theoretical framework was based on a quality of life model applied to children, a stress-coping model, and a psychosocial approach including support, profession, and teamwork. Methods: The research combines quantitative data collection/analysis and qualitative research interviews/content analysis. Results: Complexity: The three grades of medical complexity differed regarding the number and severity of psychosocial symptoms, the children with the most complex CHD having the most severe symptoms. The most frequent symptoms in the whole patient group regarding various spheres were: healthcare and treatment-related needs in the external sphere, family symptoms in the interpersonal sphere, and mental/psychosomatic symptoms in the personal sphere. Coping: Being informed of a child’s/sibling’s heart disease has emotional consequences, so information, communication, and support are essential. Breaking the news of a child’s disease can be described as a turning point still significant after ten years. The professionalism of the doctor’s approach in breaking the news is crucial. Profession: Among paediatric cardiologists, how to break bad news to a family is an important concern, evident in findings regarding the significance of trust and confidence and the use of various emotional positions. Paediatric cardiologists commonly wish to be skilled at handling this situation, and attaining the needed skills calls for reflection, education, and sharing experience. Team: PCTs in Sweden aim and try to work in a structured way. In PCTs, there is a need for leadership, resource coordination, coaching, and a forum for joint reflection. Dependence on the physician on the team was identified in all PCTs. The challenge of managing increasing complexity at both the family and system levels requires interprofessional teams. Conclusions: These studies illustrate the psychosocial complexity and the need of psychosocial support. Emotional consequences, communication, information and support are essential both for the children, parents/families and for the professionals. To manage this complexity organizational alteration action plans are required. There is a need for a forum to stimulate dialogue and common reflection in the local PCT and at the regional and national centres.

Nous cherchions à explorer les compétences que les intervenants du service des urgences (SU), des médecins et des infirmières travaillant en équipe dans des rôles complémentaires, ont développées dans la divulgation d‘un décès, pour éclairer l‘apprentissage de cette compétence de « Communicateur ». Nous avons utilisé des entrevues semi-dirigées et un échantillonnage non probabiliste de 8 intervenants. Nous avons analysé les entrevues à l‘aide de méthodes qualitatives reconnues. Le nombre total de présences de nos intervenants à une divulgation est estimé supérieur à 2000. Notre analyse a démontré qu‘ils utilisent une structure de divulgation uniforme. Néanmoins, ils repoussaient l‘utilisation d‘un protocole, parce que jugé trop rigide. La flexibilité et l‘empathie se sont révélées des qualités essentielles pour les intervenants. Nous représentons la visite de la famille comme un épisode de désorganisation/dysfonction qui se résorbe partiellement durant le séjour au SU. Nous proposons un modèle pédagogique qui est basé sur nos résultats. / We explored the competencies that Emergency Department (ED) healthcare providers (HPs), physicians and nurses working as team members with complementary roles, have developed through notifications of death, to inform the teaching of this ‘Communicator‘ competency. We used semi-structured interviews on a non-probabilistic sample of 8 HPs. We analyzed the interviews using recognized qualitative methods. The total self-estimated number of death notifications attended by our HPs is superior to 2000. Analysis showed that experienced HPs use a uniform structure to death notification in ED. In spite of this, the use of a protocol for notification was considered inappropriate because it was deemed too rigid. Flexibility and empathy emerged as essential qualities for HPs. We submit that the family‘s ED visit is an episode of disorganization/dysfunction that gets partially resolved during their stay. Based on our results, we propose an educational model for teaching delivery of news of death in the ED.