Children and adolescents with cerebral palsy (CP) often receive botulinum toxin (BoNT-A) to manage spasticity. Our 2014 study developed an inventory of parents’ goals for BoNT-A treatment, but reasons for selecting these goals were unclear. The current study aimed to describe and categorize the effects of BoNT-A that parents observed according to WHO’s International Classification of Functioning, Disability and Health (ICF) framework. This qualitative study used interpretive description. Fifteen parents of non-ambulatory young people with CP (mean age 10.2 years, SD 3.9, 7 males) who received BoNT-A were recruited through McMaster Children’s Hospital’s Spasticity Management Clinic. Interviews were conducted in-person or by telephone for 20-60 minutes. The research team read the initial transcript, identified codes, and finalized the coding framework. Member checking was conducted to enhance trustworthiness. The key theme was that parents needed to find the right path to do what is best for their child. Parents described how they learned about both positive and negative effects of BoNT-A treatment: some parents emphasized the child’s pain during BoNT-A injections (negative), but also felt that BoNT-A was helpful for their child (positive). Most effects of BoNT-A were coded at the ICF activity level, such as dressing These observations helped inform parents’ decision to continue with BoNT-A and identify future goals. This study provides insight into parents’ journey of learning about BoNT-A and goal-setting for their child. Parents’ perspectives will be used to refine the 2014 inventory of goals to facilitate collaborative goal-setting for BoNT-A treatment. / Thesis / Master of Science (MSc) / Children diagnosed with cerebral palsy (CP) receive botulinum toxin (BoNT-A) as a treatment to reduce muscle tone. Current research on the use of BoNT-A injections in non-ambulatory children with CP is scarce and may not incorporate the perspectives of the family about their goals for treatment. This study interviewed parents to ask about the effects that they observed in their child after BoNT-A treatment. Fifteen parents were interviewed and all parents spoke about their journey of “finding the right path to do what is best for my child” as they learned about the possible effects of BoNT-A treatment for their child. By learning about parents’ journey, informational resources can be developed and shared with other parents about the effects of BoNT-A treatment. It is important to help parents understand these effects, which would allow them to discuss and identify appropriate goals with healthcare professionals in future BoNT-A treatment sessions.

This study aims at exploring and developing an approach for user-centred product planning for product managers in multi-product tech companies. Applying the Design Thinking methodology in this research project allows for product managers to be involved in the design process as a whole. From research and interviews with product managers it can be seen that there is a global understanding of the importance of a shift in focus towards user experience rather than product features while planning, but that there are no clear means yet to facilitate this. Through co-design with product managers as well as individual prototyping, a lo-fi prototype of a planning tool is developed and tested. The results show that the prototype successfully facilitated multi-product planning and shifted the focus from features to experiences. The methodology used can be reproduced in analogous companies and the results can be used as a starting point to continue adapting and developing the approach. / Denna studie syftar till att utforska och utveckla ett tillvägagångssätt för användarcentrerad produktplanering för produktchefer inom tekniska produktutvecklingsbolag som utvecklar flera olika samverkande produkter. Metoden Design Thinking har använts i detta forskningsprojekt, vilket möjliggjort att produktchefer kunnat att vara involverade i designprocessen som helhet. Från initiala intervjuer med produktchefer framkom det att de förstod vikten av att ha fokus på användarupplevelse snarare än produktegenskaper under planering av flerproduktslösningar, men att de i dagsläget inte finns några tydliga verktyg för att underlätta detta. Genom samdesign med produktchefer formades ett antal prototyper av ett planeringsverktyg. En Lo-Fi-prototyp utvecklades och utvärderades av produktägare. Testerna visade att multiproduktplanering framgångsrikt underlättades och flyttade fokus från funktioner till användarupplevelser. Den metodik som använts här kan reproduceras i liknande företag och resultaten kan användas som utgångspunkt för att fortsätta anpassa och utveckla arbetssättet.

No / This report summarizes results of the first EC/NSF joint Advanced Research Workshop, which identified key research challenges and opportunities in information technology. The group agreed that the first joint research workshop should concentrate on the themes of human-centered computing and VEs. Human-centered computing is perceived as an area of strategic importance because of the move towards greater decentralization and decomposition in the location and provision of computation. The area of VEs is one where increased collaboration should speed progress in solving some of the more intractable problems in building effective applications

The purpose of the United Nations (UN) peace operations is to help states navigate a path towards stability and sustainable peace, yet sexual exploitation and abuse perpetrated by the peacekeepers and other personnel is often an unintended consequence of the missions. Though the UN has employed several victim-centred measures to address the issue, peacebuilding practices often employ a simplistic discourse about the victims that recognizes only certain type of ‘ideal’ victims. It risks disregarding the different conceptualisations of justice that victims have, along with their individual wants and needs. Leaning on van Dijk’s view on social power that deems institutions as locations producing dominant discourses and influencing people’s minds, it is crucial to study which discourses the UN engages with. Thus, through a methodological combination of critical discourse analysis and policy analysis, this study scrutinizes the discourses about the victims present in the resolutions and training materials that specifically apply a victim-centred approach. The findings indicate that the discourses entail characteristics of both ideal and complex political victim discourses, and that above all, the UN positions itself as the saviour of the victims. As this discourse is likely to continue reproducing power imbalances that place victims into a dependant position, this study emphasises a serious need for re-evaluation of the UN’s own discursive positioning.

Syftet: Syftet med studien var att undersöka arbetsterapeuters erfarenheter av att arbeta familjecentrerat inom strokerehabilitering. Metod: I studien användes en kvalitativ metod. Nio arbetsterapeuter intervjuades utifrån en semistrukturerad intervjuguide. Datamaterialet analyserades med kvalitativ innehållsanalys med induktiv ansats. Resultat: Analysen resulterade i två kategorier med tio underkategorier som beskriver arbetsterapeuternas erfarenheter av att arbeta familjecentrerat inom strokerehabilitering. Resultatet visade att arbetsterapeuterna i viss mån arbetar familjecentrerat. De har den strokedrabbade i huvudfokus men beaktar även de anhörigas behov och önskemål för att få ett fungerande vardagsliv för hela familjen. Dock finns det yttre och inre faktorer som hindrar arbetsterapeuternas möjlighet till att arbeta familjecentrerat i den utsträckning de önskar. Slutsats: Det kan vara svårt att dra en gräns mellan vad som är personcentrerat och familjecentrerat då arbetsterapeuterna har den strokedrabbade i fokus men behöver beakta anhöriga och familjen som helhet då de anses som viktiga. Studien kan inspirera arbetsterapeuter att applicera ett familjecentrerat arbetssätt och kan stödja dem i att implementera familjecentrerade åtgärder. Dock behövs det mer forskning som visar på effekten av familjecentrerade arbetsterapeutiska åtgärder vid stroke. / Aim: The aim of the study was to explore occupational therapists' experiences of working family-centred in stroke rehabilitation. Method: A qualitative method was used in the study. Nine occupational therapists were interviewed based on a semi-structured interview guide. The data was analyzed using a qualitative content analysis with an inductive approach. Results: The analysis resulted in two categories with ten subcategories that describe the occupational therapists' experiences of working family-centered in stroke rehabilitation. The results showed that the occupational therapists work family-centred to a certain extent. The stroke patient is the main focus during the rehabilitation, but the occupational therapists also consider the relatives needs and wishes in order to have a functioning everyday life for the whole family. But, there are external and internal factors that hinder the occupational therapists to work family-centered to the extent they wish. Conclusion: It can be difficult to separate person-centred approach and family-centred approach, because the occupational therapist has a main focus on the stroke patient but also needs to consider the relatives and the family as a whole. The study can inspire occupational therapists to apply a family-centered approach and support them in implementing family-centered interventions. However, more research is needed that shows the effect of family-centered occupational therapy interventions in stroke.

Bakgrund: Personcentrerad vård är ett globalt känt begrepp inom hälso- och sjukvård. Personcentrerad vård är ett etiskt förhållningssätt som innebär att se människans behov och önskemål och bortse från diagnos och sjukdom. Personcentrerad vård ses öka välbefinnande och hälsa hos den äldre individen. Det finns studier som beskriver hur personcentrerad vård används och dess fördelar och utmaningar inom vård- och omsorgsboenden, dock finns det få studier genomförda inom slutenvård. Syfte: Att beskriva sjuksköterskans erfarenheter av användandet av personcentrerad vård hos personer 65 år och äldre inom slutenvården samt beskriva om det fanns skillnad i skattning av användandet mellan grund- och specialistutbildad sjuksköterska, examensår och antal verksamma år i yrket. Metod: Beskrivande och jämförande enkätstudie med kvantitativ ansats. Enkätundersökningen utfördes med det validerade mätinstrumentet mP-CAT. Deltagare var 75 sjuksköterskor från olika slutenvårdsavdelningar i ett län i Mellansverige. Huvudresultat: Studiens resultat visar att sjuksköterskor erfar att de till stor del tillämpar personcentrerad vård av äldre inom slutenvård. Deltagarna beskriver att de ofta diskuterar hur de ska ge en vård som utgår från den enskildes behov och att de tar hänsyn till den enskildes önskningar i den vård som ges. Miljöfaktorer och organisatoriska strukturer var faktorer som identifierades försvåra eller hindra användningen av personcentrerad vård. Det framkommer ingen signifikant skillnad gällande tillämpningen av personcentrerad vård beroende på examensår, specialistutbildning och antal verksamma år. Slutsats: Sammanfattningsvis visar studien att en hög grad av personcentrerad vård av äldre inom slutenvård ges. För att ge medarbetare ytterligare förutsättningar att tillämpa en högre grad personcentrerad vård kan miljöfaktorer och organisatoriska strukturer utvecklas och förfinas. / Background: Person-centred care is a globally known concept in healthcare. Person-centered care is an ethical approach that means seeing the person's needs and wishes and disregarding diagnosis and illness. Person-centred care is seen to increase the well-being and health of the elderly person. There are studies that describe how person-centred care is used and its benefits and challenges within nursing homes, however, there are few studies conducted within inpatient care. Aim: To describe the nurse's experiences of the use of person-centred care for people aged 65 and older in inpatient care, and to describe whether there was a difference in the estimation of the use between basic and specialist trained nurses, year of graduation and number of active years in the profession. Method: Descriptive and comparative survey study with a quantitative approach. The survey was carried out with the validated measuring instrument mP-CAT. Participants were 75 nurses from different inpatient care departments in a county in central Sweden. Main results: The results of the study show that nurses experience that they use person-centred care for the elderly in inpatient care. The nurses describe that they often discuss how to provide care based on the individual's needs and that they take the individual's wishes into account in the care provided. Environmental factors and organizational structures were factors identified as obstacle or aggravate the use of person-centred care. There is no significant difference regarding the application of person-centred care depending on the year of graduation, specialist training and number of working years. Conclusion: The study shows a high degree of person-centred care for the elderly in inpatient care. In order to give employees additional conditions to apply a higher degree of person-centered care, environmental factors and organizational structures can be developed and refined.

Bakgrund: Bröstcancer är den vanligaste cancerformen i Sverige när det gäller cancerdiagnos hos kvinnor. Det är en livshotande diagnos som ofta behandlas med kirurgi i form av mastektomi. Mastektomi medför både psykisk och fysisk påfrestning på kvinnorna som kan ge upphov till lidande. Sjuksköterskan har ansvar för kvinnan och den personcentrerade vården där både psykiska, fysiska och sociala svårigheter ska uppmärksammas. Syfte: Syftet var att belysa kvinnors upplevelser av vårdprocessen i samband med mastektomi till följd av bröstcancer. Metod: En litteraturstudie baserad på kvalitativ forskning valdes som metod och analyserades systematiskt. Resultat: I resultatet framställs tre huvudteman med tillhörande subteman. Det första huvudtemat Ett förändrat liv med tillhörande subteman Den initiala reaktionen och Behov av stöd. Det andra huvudtemat Information och delaktighet med tillhörande subteman Individanpassad information och Delaktighet och påtryckning samt det tredje huvudtemat En förändrad livsvärld med subteman Förlust, sorg och rädsla och Acceptera det nya. Konklusion: Kvinnor som drabbas av bröstcancer, med efterföljande mastektomi, upplever känslor som kräver ökat stöd där vården behöver arbeta personcentrerat. Kvinnorna behöver känna delaktighet och trygghet i sin vård. Individanpassad information och närvarande vårdpersonal har positiv betydelse för vården av kvinnor efter mastektomi. / Background: Breast cancer is the leading cancer diagnosis amongst women in Sweden. Breast surgery referred to as mastectomy is the most common treatment for this life- threatening condition. A mastectomy is both physically and mentally challenging and as a result can lead to suffering. Nurses have a duty of care regarding individualised care and in the identification of physical, mental and social difficulties related to the diagnosis. Aim: The purpose of this study was to highlight women's experiences of the care process related to mastectomy due to breast cancer. Method: A qualitative literature review-based approach was chosen and the the literature was systematically analysed. Findings: The result identified three main themes with associated subthemes. The first main theme A changed life with associated subthemes The initial reaction and Need for support. The second main theme Information and participation with associated subthemes Individualised information and Participation and pressure, as well as the third main theme A changed lifeworld with subthemes Loss, grief and fear and Accept the new. Conclusion: Women who suffer from breast cancer, with a subsequent mastectomy, experience feelings that require increased support where care needs to be person-centred. These women need to feel participation and security in their care. Individualised information and high healthcare staff presence have a positive impact on the care of women after a mastectomy.

Yes / Background: A Personal Health Record (PHR) is an electronic record that individuals use to manage and share their health information, e.g. data from their medical records and data collected by apps. However, engagement with their record can be low if people do not find it beneficial to their health, wellbeing or interactions with health and other services. We have explored the beliefs potential users have about a PHR, how it could be made personally relevant, and barriers to its use. Methods: A qualitative design comprising eight focus groups, each with 6–8 participants. Groups included adults with long-term health conditions, young people, physically active adults, data experts, and members of the voluntary sector. Each group lasted 60–90 min, was audio recorded and transcribed verbatim. We analysed the data using thematic analysis to address the question “What are people’s beliefs about making a Personal Health Record have relevance and impact?” Results: We found four themes. Making it work for me is about how to encourage individuals to actively engage with their PHR. I control my information is about individuals deciding what to share and who to share it with. My concerns is about individuals’ concerns about information security and if and how their information will be acted upon. Potential impact shows the potential benefits of a PHR such as increasing self-efficacy, uptake of health-protective behaviours, and professionals taking a more holistic approach to providing care and facilitating behaviour change. Conclusions: Our research shows the functionality that a PHR requires in order for people to engage with it. Interactive functions and integration with lifestyle and health apps are particularly important. A PHR could increase the effectiveness of behaviour change apps by specifying evidence-based behaviour change techniques that apps should incorporate. A PHR has the potential to increase health-protective behaviours and facilitate a more person-driven health and social care system. It could support patients to take responsibility for self-managing their health and treatment regimens, as well as helping patients to play a more active role when care transfers across boundaries of responsibility. / Leeds Informatics Board

Yes / Although training and workforce development are high on the policy agenda at present (eg DoH 2009), there has been less progress in thinking about the kind of education that might be needed in order to provide dementia care that is genuinely person-centred. A continuing obstacle here is the tendency to assume that people who have dementia are to be understood ¿ as a group ¿ by virtue of their shared diagnosis rather than by their lived experience, in which diagnosis is an interruption rather than the whole story. Three approaches to overcoming this obstacle that I will discuss below are arts-based learning, teaching social history awareness, and increasing the involvement of the ¿experts by experience¿, people with dementia themselves.

No / The author explains how Dementia Care Mapping can be used as powerful preventative tool for safeguarding people with dementia from abuse. Used as part of the process of developing person-centred care, the Dementia Care Mapping tool can be used to identify the preconditions of abuse within care settings.