This study examines the healthworlds of first-generation Chinese immigrants in Boston's Chinatown. Through participant observation and interviews conducted within a local church and a local park community, three key issues emerged: how the space of Chinatown influences people's post-immigration healthworlds; the dynamics of community health supports and health challenges; and the daily health lives of these immigrant individuals within their respective families. Likewise, complex understandings of health coverage emerge that include not only health insurance, but also social forms of insurance. Community integration becomes not only a cultural tradition, but also how health resources and health support are linked and provided. This social form of insurance makes it possible for community members to reach out cultural and religious health resources and support in the context of everyday life.

Multiple disabilities does not just affect the individual, it affects caregivers as well. Once a child and parent receives the diagnosis of multiple disabilities they find themselves in a new territory, a new mindset. This study is a longitudinal autoethnographic personal narrative of a mother of a child with multiple disabilities using an intimate inquiry framework. Intimate inquiry allowed me as the researcher to explore my experiences as a reflection of the culture of caregivers of children with multiple disabilities. The purpose of this research was to attempt to understand what it means to raise a child with multiple disabilities from the inside with regards to the positive and negative transformations associated with raising and educating a child with multiple disabilities while achieving personal growth. Findings from my autoethnography suggest that caregivers from all aspects of the child’s life (family, home, school, child care, medical professionals) may share similar experiences and reactions addressed in the themes I identified. While this study specifically relates to caregiving for a child with multiple disabilities, it has the potential to relate to caregivers of any nature; those caring for their children, a spouse, or a parent or other family member.

This thesis examines the implications of age relations for older people’s negotiations of formal home care, family/friend caregiving, and self-care. Age relations constitute social processes, cultural discourses, and everyday practices that produce and sustain relations of inequality between and among people of different ages. Despite the overwhelming focus on care in the sociology of aging and in political discussions of aging societies, scholars have not clearly articulated how age relations shape, and are shaped by, experiences of later life care. Moreover, despite evidence that older people receive care from both formal care providers and family/friend caregivers—and that they continue to practise self-care when they receive care from others—we know little about the ways older care recipients negotiate the intersections that exist between these systems of care. Using data from a grounded theory study that involved qualitative interviews with 34 people aged 65 to 100 receiving home care in Ontario, this thesis considers how older people negotiate the intersections of formal home care, family/friend caregiving, and self-care, and how age relations can be used to understand experiences of later life care. Findings suggest that older care recipients attempt to strike a balance between self-care, formal home care, and family/friend caregiving, to access care that reflects their needs, preferences, and timelines. In doing so, they negotiate the tensions and contradictions that exist between the realities of impairment, illness, and care needs in later life; and the desire to remain self-sufficient and avoid “burdening” others with care needs. These findings provide insight into the everyday practices through which older people construct age relations in the context of care: when participants negotiate care arrangements, I suggest that they both reproduce and challenge the social processes and cultural discourses that are at the basis of age relations. Access to social and/or financial resources, however, had consequences for participants’ negotiations of care and of age relations. / Thesis / Doctor of Philosophy (PhD)

Bakgrund: Att leva med trauma kan leda till stor psykisk påfrestning. Ångest, skam, skuld, sorg och ilska är vanliga känslor som kan uppkomma. Sjuksköterskan bör besitta självförtroende, kunskaper och skicklighet i att hantera frågor gällande trauma hos patienter. Syfte: Att beskriva patienters upplevelser av att hantera och leva med trauma. Metod: En litteraturbaserad studie, baserad på analys av elva kvalitativa vetenskapliga artiklar. Resultat: Resultatet presenterades i två huvudkategorier; Betydelsen av gemenskap vid bearbetning av trauma samt betydande faktorer för att hantera trauma. Med sju tillhörande underkategorier; samhörighet och tillhörighet, den främjande effekten av att hjälpa andra, återhämtningsstrategier, copingstrategier, relevansen av en god vårdrelation, andlig och spirituell vägledning samt stöttning vid återhämtning från trauma. Det mest framträdande i resultatet, var att patienternas återhämtning främjades av att vara i sammanhang med andra som hade liknande erfarenheter. Coping- och återhämtningsstrategier, var individuellt framgångsrika hos patienterna och det var därför angeläget att få prova på flera olika strategier under behandlingen. Konklusion: Patienter har olika uppfattning om fungerande strategier för att hantera trauma. En god vårdrelation är betydande för patienter som bearbetar trauma. Sjuksköterskan behöver besitta kompetens för att kunna bemöta dessa patienter. / Background: Living with trauma can lead to great mental stress. Anxiety, shame, guilt, sadness and anger are common emotions that can arise. The nurse needs to have self-confidence, knowledge and skills in dealing with questions regarding trauma in patients. Aim: To describe patients’ experiences of dealing with and living with trauma. Method: A literature-based study, based on the analysis of eleven qualitative scientific articles. Findings: The results were presented in two main categories; The importance of community in processing trauma and significant factors in dealing with trauma. With seven associated subcategories; togetherness and belonging, the fostering effect of helping others, recovery strategies, coping strategies, the relevance of a good caregiving relationship, spiritual and spiritual guidance and support in recovery from trauma. Most prominent in the results, was that the patients' recovery was promoted by being in context with others who had similar experiences. Coping and recovery strategies were individually successful with the patients and it was therefore important to try several different strategies during the treatment. Conclusion: Patients have different perceptions of effective strategies for dealing with trauma. A good caregiving relationship is significant for patients processing trauma. The nurse needs to have competence to be able to deal with these patients.

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