This study was conducted to replicate and extend previous research on infant caregiver behavior by demonstrating negative reinforcement of infant caregiver behavior in response to crying and teaching appropriate care responses under conditions of inconsolable crying. A computerized infant simulator was used to create a laboratory simulation of infant caregiving. In Study 1, participants were exposed to negative reinforcement conditions and an extinction condition. In the negative reinforcement condition, participants engaged in caregiving responses to escape from the cry. In the extinction condition, the cry was inescapable and two of three participants stopped engaging in the previously reinforced caregiving response. Data was collected on cumulative duration of caregiving responses. In Study 2, participants were taught a task analysis of appropriate care responses under conditions of inconsolable crying using behavior skills training. Data were collected on percentage of completed appropriate care responses. Results showed acquisition of appropriate care responses following training.

This study examined the effects of a parent-implemented intervention on preschool children's development of letter-naming and phonological awareness skills. Six parent-child dyads with children enrolled in a Head Start Program in West Central Florida were selected to participate in the study. A multiple baseline across participants design was used to evaluate the impact of an intervention package that included activities focusing on: (1) using mnemonics to learn letter names and (2) developing phonological awareness of the onsets of words through parent questioning and feedback. Phonological awareness development was measured using the Dynamic Indicators of Basic Early Literacy Skills First Sound Fluency (DIBELS-FSF) and letter-naming ability was measured using the DIBELS Letter Knowledge (DIBELS-LK) probes. Results showed that five of the six students responded favorably to the intervention, increasing their growth rate on at least one of the two measures. The final child showed little change in trends across the phases. Additionally, data was collected regarding intervention integrity of intervention implementation as well as social validity, or the acceptance and usefulness, of the intervention. Intervention integrity data revealed that the majority of parents completed the intervention with high levels of fidelity, although variability across parents was noted. Social validity data indicated that the parents found the program helpful and effective. Implications for research and practice are discussed.

This study examined the effect of a parent-implemented reading intervention on children's reading fluency. Five elementary school students identified as at-risk for reading failure participated in the study with their mothers. Baseline data for each student was collected before parents were trained by the researcher in implementation of the intervention procedure. Parents implemented the intervention four times per week for five weeks, while the researcher continued to collect assessment data twice per week. Follow-up data were then collected for each student two weeks after the intervention ended. The effects of the intervention were evaluated using a multiple baseline across participants design. Reading fluency was measured using Curriculum-Based Measurement of reading fluency (CBM-R) Results showed that three students had decreasing trends during baseline, but showed increases in reading fluency scores during the intervention and follow-up phases. A fourth student's scores during intervention and follow-up showed improvement over baseline scores, but with decreasing trends. The fifth student showed little change between baseline and intervention phases. Treatment integrity and social validity data also were collected. Integrity data indicated some variability in parents' implementation of the intervention, while social validity data revealed that parents and students liked the intervention program and found it helpful.

在老人人口數增加、失能老人人口數俱增、及婦女勞動參與率上昇的人口趨勢下，女性花費在照顧老人的時間將逐漸超過照顧子女的時間；在此同時，就業也將占據婦女生命中的絕大部份，未來將有許多中年婦女必須同時擔負就業與老人照顧的責任。為深入瞭解這群婦女的獨特感受，本研究的目的包括：(1)瞭解職業婦女照顧家中老年親屬的情形及其經驗。(2)探討婦女兼顧「就業與老人照顧」之經驗感受。(3)探索職業婦女為兼顧「就業」和「老人照顧」所採取之因應策略。(4)分析職業婦女歷經不同處境及採取相異因應策略之原因。(5)根據研究結果提出政策上的建議。 本研究採用質化研究的深入訪談法，計訪問12位從事全職工作的女性老人照顧者。研究發現：(1)職業婦女為老年親屬所提供的社會支持包括：日常生活活動的協助、提醒和監督老人執行日常生活活動、生病時的照顧、照顧管理、陪伴及情緒支持等項目。(2)老人照顧對職業婦女之意義：以文化規範及情感因素佔關鍵性的地位。(3)就業對職業婦女的意義：包括物質報酬、心理報酬、及生活寄託。(4)婦女兼顧「老人照顧」與「就業」責任時面臨錯綜複雜的感受。(5)職業婦女處理「老人照顧」與「就業」衝突之因應策略：可分為「調整照顧責任」、及「調整就業行為」兩類。(6)職業婦女的角色衝突及所採取之五種因應策略。 根據上述結論，本研究針對政策意識型態、企業界及政府提出建議。 目　錄 第一章 研究動機與目的 1 第二章 文獻探討 5 第一節 就業者照顧老年親屬的情形 5 第二節 婦女兼顧「老人照顧」和「就業」之經驗感受 10 第三節 職業婦女兼顧「老人照顧」和「就業」所採取的工作調整行為 13 第四節 從角色理論來看職業婦女兼顧「老人照顧」和「就業」的處境 15 第五節 從交換理論分析職業婦女採取不同工作調整行為之因素 19 第三章 研究設計 22 第一節 研究方法 22 第二節 資料蒐集與分析 23 第三節 研究對象與研究者的角色 24 第四節 樣本的相關資料 26 第四章 分析結果 32 第一節 職業婦女所提供的社會支持 32 第二節 老人照顧對職業婦女的意義 38 第三節 就業對職業婦女的意義 47 第四節 婦女兼顧「老人照顧」與「就業」責任之經驗感受 54 第五節 職業婦女處理「老人照顧」與「就業」衝突之因應策略 75 第六節 職業婦女的角色衝突及所採取之因應策略 94 第五章 結論與建議 107 第一節 結論 107 第二節 相關議題的探討 110 第三節 建議 115 第四節 研究限制及對未來研究之建議 119 參考書目 121 附錄一 訪談導引 129 附錄二 受訪者資料 132 附錄三 受照顧老人資料 133 表 目 錄 表3-1 樣本基本資料 28 表3-2 老人日常生活活動（ADLs）能力失能情形 29 表3-3 老人工具性日常生活活動（IADLs）能力失能情形 30 表3-4 照顧者提供老人照顧工作的協助項目 31 表3-5 老人的失能情形和照顧者提供的協助項目數 31 表4-1 受訪者的「老人照顧」及「就業」角色 97 圖 目 錄 表4-1 Kopelman et al.的工作--家庭衝突模型 94 表4-2 Higgins et al.的工作--家庭衝突模型 94 / The results of a qualitative study on the lives of 12 women who work full-time and care for the elderly are presented. Respondents provide assistance for the elderly, and they have to remind the elderly to carry out the activities of daily living. Also, women play as a carer, care manager, and emotion supporter. The meaning for women to wok is the material reward, the psychological reward, and life goals. When women care for the elderly and work in the meantime, complex feeling will come to their mind. They have to adjust their work or care responsibility when they feel conflict between work and elder care. Policy and practice implications are also discussed.

<p>This dissertation aims to examine and deepen the knowledge of family member caregiving where the care recipient is an elderly person who immigrated late in life. It also aims to contribute to the knowledge of the complexities underlying informal care giving and add to our understandings of what it means to be an immigrant in Sweden. The caregiver is in focus. The research conducted is explorative and partly inductive. The main material used is a qualitative interview study carried out with family members from different countries who are providing informal care to elderly immigrant relatives. The analysis gives three patterns of caregiving. One shows help from informal caregivers only who are not compensated economically. Another shows help from family members who are compensated. The third shows help from family members <i>and</i> staff from the public care system. Three ideal-typical informal caregiver roles show different positions vis-à-vis the new: “guardian”, “filter” and “reinterpreter of traditional care ideals”. Swedish born and immigrated informal caregivers are also compared through analysis of data gathered in telephone interviews with a representative selection of inhabitants in the County of Stockholm.</p><p>A philosophy of action together with theory on integration and multiculturalism serves as theoretical frameworks to understand discrepancies and ambiguities in the data. Young immigrants experience different integration processes than do the older ones. They strive to protect older family members from changes linked to the migration experience. <i>Talk about dependence on culture </i>underlines family feelings and legitimates the processes of protection. Preconceptions about great differences between Swedish born and immigrant families are not supported by quantitative data. A conclusion is that protection can be understood in relation both to the traditional and the new, the latter in the forms of meetings with Swedish society where unequal relations prevail. It is a kind of counter-strategy where the range of actions is diminished, and thus it has its own logic. Protection can be loosened up when the circumstances change and the range of actions grow.</p>

<p>För många närstående förändras livet radikalt när  en anhörig diagnostiseras med hjärtsvikt. Att leva med hjärtsvikt är som att "knacka på dödens dörr och aldrig veta vad som är att vänta av morgondagen". Att stanna hemma och vårda en en anhörig under palliativ fas innebär stora påfrestningar i närståendes liv. Syfte: Att belysa närståendes upplevelser när anhörig med hjärtsvikt vårdas palliativt i hemmet. Metod: Studien utfördes som en allmän litteraturstudie. Tolv kvalitativa och tre kvantitatva vetenskapliga artiklar ingick. Resultat:  Närstående som vårdade en anhörig palliativt i hemmet upplevde social isolering, stress och ångest och krav på att vara en "stöttepelare". Närstående upplevde också att informationen om tillstånd och prognos var bristfällig. Upplevelsen av att känna stöd från vårdpersonal varierade och närstående ville vara delaktiga i vården. Slutsats: Det är klarlagt att hjärtsvikt har en betydande påverkan på närståendes liv. Närståendes situation behöver studeras vidare och då speciellt när det gäller palliativ hemsjukvård.</p> / <p>For many next of kin important changes took place when heart failure was diagnosed. Meanings of living with heart failure emerged as "knocking on death's door" yet surviving and never knowing what to expect of tomorrow. Staying at home in the palliative phase of life brings multiple complex issues for next of kin who is subject to stress during a along period of time. The aim of the study was: To illuminate next of kin's experiences when a partner with heart failure is taken care of in palliative home care setting. Method: A general litterature review based on twelve qualitative and three quantitative scientific articles. Findings: Next of kin in palliative home care setting described situations of being restricted, they experienced stress and anxiety, and took on the role of being "a pillar of strength". Next of kin also described how they lacked adequate medical information. Som next of kin experienced  that they received support from healthcare personnel but some lacked concrete support. Next of kin also felt it important to have influence on decisions. Conclusion: It is clear that heart failure seriously affects the lives of next of kin. This group need to be further investigated, especially when it comes to palliative care at home.</p>

<p><strong>Bakgrund:</strong> Allt fler personer som haft stroke vårdas i hemmet med stöd från sin familj. Anhörigvårdare upplever att de ”kastas in” i rollen som vårdare och är dåligt förberedda och informerade om den nya situationen. <strong>Syfte:</strong> Syftet var att beskriva anhörigvårdares behov av utbildning och information vid vård av en familjemedlem med stroke. <strong>Metod:</strong> En allmän litteraturöversikt genomfördes och baserades på 16 vetenskapliga artiklar. <strong>Resultat: </strong>Anhörigvårdare hade behov av utbildning och information om sjukdomen stroke, dess orsak, riskfaktorer och behandling samt utbildning i basal omvårdnad för att kunna vårda sina anhöriga i hemmet. Dessutom behövde de utbildning och information om stöd och service från samhället bland annat om hur de kunde bli avlastade i sin vårdarroll. De behövde även information om tillgänglig vårdkoordinator/kontaktsjuksköterska och anhörig/patientförening att vända sig till för information och stöd. <strong>Slutsats:</strong> Anhöriga behöver involveras mer i vården och därmed ses som en samarbetspartner. Med hjälp av familjesamtal kan distriktssköterskan ta reda på familjens individuella behov av utbildning och information. Författarna föreslår ett utbildnings/informationsprogram för anhöriga för att på så vis undvika att de upplever att de ”kastas in” i vårdarrollen.</p>

Aim: The overall aim of this thesis was to study prognostic factors for prolonged disability in back pain in the general population and physiotherapists’ screening for prolonged disability, applying a social cognitive learning perspective. Methods and results: Studies I and II were based on a survey in the general population in Sweden. Study I included 1024 individuals aged 20-50 years, reporting non-specific back pain. Four groups (n = 100, 215, 172 and 537) based on duration and recurrence of back pain were formed and compared. After controlling for pain intensity, catastrophising and expectations of future pain were positively correlated to pain duration. Perceived social support was negatively correlated to pain duration. Study II was longitudinal over 12 months and analysed one group reporting first-episode back pain (n = 77), and one group reporting long-term back pain (n = 302). Future pain intensity and disability were predicted by initial levels of pain and disability and pain-related cognitions in both groups. Study III examined the inter-rater reliability of a research protocol for assessment of physiotherapists’ telephone screening for prolonged disability. The results demonstrated sufficient inter-rater reliability. Study IV evaluated the effect of a tailored skills training intervention on physiotherapists’ screening for prolonged disability in back pain. Four physiotherapists in primary care participated in four quasi-experimental single-subject studies. Effects were seen in all participants, with increased screening of prognostic factors and less time spent on detailed discussions about back pain. Conclusions: The identification of mainly cognitive explanatory variables indicates the relevance of a social cognitive perspective of back pain-related disability (studies I and II). Physiotherapists’ telephone screening for prolonged disability in back can be reliably assessed (study III). It is suggested that interventions based on social cognitive theory are effective in producing change in specified clinical behaviours in physiotherapists (study IV).

This dissertation aims to examine and deepen the knowledge of family member caregiving where the care recipient is an elderly person who immigrated late in life. It also aims to contribute to the knowledge of the complexities underlying informal care giving and add to our understandings of what it means to be an immigrant in Sweden. The caregiver is in focus. The research conducted is explorative and partly inductive. The main material used is a qualitative interview study carried out with family members from different countries who are providing informal care to elderly immigrant relatives. The analysis gives three patterns of caregiving. One shows help from informal caregivers only who are not compensated economically. Another shows help from family members who are compensated. The third shows help from family members and staff from the public care system. Three ideal-typical informal caregiver roles show different positions vis-à-vis the new: “guardian”, “filter” and “reinterpreter of traditional care ideals”. Swedish born and immigrated informal caregivers are also compared through analysis of data gathered in telephone interviews with a representative selection of inhabitants in the County of Stockholm. A philosophy of action together with theory on integration and multiculturalism serves as theoretical frameworks to understand discrepancies and ambiguities in the data. Young immigrants experience different integration processes than do the older ones. They strive to protect older family members from changes linked to the migration experience. Talk about dependence on culture underlines family feelings and legitimates the processes of protection. Preconceptions about great differences between Swedish born and immigrant families are not supported by quantitative data. A conclusion is that protection can be understood in relation both to the traditional and the new, the latter in the forms of meetings with Swedish society where unequal relations prevail. It is a kind of counter-strategy where the range of actions is diminished, and thus it has its own logic. Protection can be loosened up when the circumstances change and the range of actions grow.

Antalet personer med demenssjukdomar ökar i takt med att befolkningen blir allt äldre och en stor del av vården av personer med demenssjukdom utförs av anhöriga. För att kunna stödja anhörigvårdare är det viktigt att sjuksköterskor har kunskap om hur anhöriga upplever sin situation. Syftet med studien var att beskriva anhörigas upplevelse av att vårda personer med demenssjukdom. För att besvara syftet har en litteraturstudie genomförts där 12 kvalitativa artiklar analyserats. Ur analysen framkom sju teman: Upplevelse av stress, svårigheter och otillräcklighet, Upplevelse av sorg och förlust, Upplevelse av förändrade relationer och roller, Upplevelse av förpliktelse, Upplevelse av välbefinnande, Upplevelse av stöd, samt Upplevelse av att bemästra och skapa mening i sin situation. Resultatet i denna studie kan bidra till en ökad förståelse för hur anhörigvårdare upplever sin situation, något som erfordras för att sjukvården skall kunna erbjuda anhöriga som vårdar personer med demenssjukdom ett adekvat stöd. / The number of people with dementia is increasing whilst the population gets older.  A great part of the care is provided by relatives. In order to support family caregivers’ nurses are required to obtain knowledge about how relatives perceive their situation. The purpose of this study was to describe the experience of relatives providing care for persons with dementia. To answer the purpose a literature study was made where 12 qualitative articles were analyzed.  Findings illustrates seven themes: The experience of stress, difficulties and inadequacy, The experience of grief and loss, The experience of changing relationships and roles, The experience of obligation, The experience of wellbeing, The experience of support, and finally The experience of coping and making sense of the situation. The result of this study could contribute to an increased understanding of how family caregiver’s experience their situation. This is required in order to offer relatives who provide care for a person with dementia an adequate support.