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Tvång som vård : Patienters upplevelser av tvångsvård och tvångsåtgärder – en litteraturöversikt / Coercion as care : Patients’ experiences of coercive care and coercive interventions – a literature reviewGummesson, William, Jonsson, Anders January 2013 (has links)
Background For patients in need for psychiatric care who refuse treatment, coercive care might be necessary due to The Law of Psychiatric Compulsory Care, LPT. The purpose of this law is to make sure the patient later on will be able to increase autonomy. The most frequent patients in coercive care suffer from psychosis, heavy depression or having high risk of committing suicide. One of the most important tasks in the nurse profession is to increase patients’ autonomy. Therefore having ethical judgment is necessary to know when to use paternalism. To take note of patients’ experiences may increase awareness, making care more patient-centered. Aim To describe patients’ experiences of coercive care and coercive interventions in psychiatric care. Method A literature review has been conducted in order to compile what is currently known about the topic at hand. The result is based on ten scientific articles with findings responding to the aim of this study. The articles have been analyzed by identifying similarities and differences that have synthesized to a new whole. Result The literature review yielded a profound view of patients’ experiences when being in coercive care. Three main themes were found to cover the phenomenon. Those were Coercive Care - limits and possibilities, The care relationship is fundamental and From abuse to life saving. Discussion The result has been discussed using the theory about Care Suffering, as described by Katie Eriksson. This theory is applicable on the context of interest. The findings has also been discussed using earlier studies concerning coercive care, as well as studies emphasizing the perspective of the nurse’s using coercive restraint. Key words Coercive care, coercive interventions, psychiatric care, patients’ experiences.
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Sanction Success and Domestic Dissent GroupsSun, Yushuang 01 January 2015 (has links)
Despite the low success rate indicated by scholarly assessments, economic sanctions remain a commonly used foreign policy tool. Why do policymakers often turn to economic sanctions with great hope and enterprise in spite of their unimpressive success record? What determines a sanction outcome? Does the internal political dynamic of target matter in this case? How does it relate to different regime type? Hence this thesis examines the conditional relationship between the presence of domestic political opposition in the target state and sanction success conditional on the regime type by using data covering 763 US-imposed sanctions from 1945 to 2006. The findings suggest authoritarian regimes are more vulnerable to sanctions than their democratic counterparts in the presence of internal dissent groups in most cases. General Strikes are the best strategy to aid sanctions and coerce policy changes in authoritarian regimes. The presence of Guerrilla Warfare has the greatest substantive and statistical impact on sanction success. Consistent and organized internal dissent groups pose treats to the authority by weakening domestic stability or partnering with sender countries to push for policy changes.
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The passions of power politics : how emotions influence coercive diplomacyMarkwica, Robin January 2014 (has links)
In coercive diplomacy, actors employ the threat of force to get targets to change their behavior. The goal is to achieve the opponent's compliance without waging war. In practice, however, the strategy often falls short-even when coercers enjoy substantial military superiority. This finding inspires the central question of this thesis: What prompts leaders to reject coercive threats from stronger adversaries, and under what conditions do they yield? I argue that target leaders' affective reactions can help to explain why coercive diplomacy succeeds in some cases but not in others. Combining insights from psychology and social constructivism, this thesis presents a theory of emotional choice to analyze how affect enters into target leaders' decision-making. Specifically, it makes the case that preferences are not only socially but also emotionally constructed. The core of the theoretical framework outlines how five key emotions-fear, anger, hope, pride, and humiliation-help to constitute target leaders' preferences. This represents the first attempt to explore how a spectrum of emotions influences leaders' foreign policy decision-making. To test the analytic utility of emotional choice theory, the thesis examines nine major decisions by Nikita Khrushchev during the Cuban missile crisis in 1962 and ten main decisions by Saddam Hussein in the course of the Gulf conflict in 1990-91. The analysis yields mixed results: In the case of about a third of all decisions, the five key emotions exerted only minor effects or no impact at all. Another third of the decisions were influenced by one or more of these emotions to a degree similar to the impact of other factors. In the case of the final third of decisions, however, some of these emotions became the primary forces shaping the construction of preferences. Overall, emotional choice theory has thus advanced our understanding of the target leaders' decision-making in the missile crisis and the Gulf conflict, offering a more comprehensive explanation of why coercive diplomacy succeeded in one case but not in the other.
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Multilevel Monte Carlo methods and uncertainty quantificationTeckentrup, Aretha Leonore January 2013 (has links)
We consider the application of multilevel Monte Carlo methods to elliptic partial differential equations with random coefficients. Such equations arise, for example, in stochastic groundwater ow modelling. Models for random coefficients frequently used in these applications, such as log-normal random fields with exponential covariance, lack uniform coercivity and boundedness with respect to the random parameter and have only limited spatial regularity. To give a rigorous bound on the cost of the multilevel Monte Carlo estimator to reach a desired accuracy, one needs to quantify the bias of the estimator. The bias, in this case, is the spatial discretisation error in the numerical solution of the partial differential equation. This thesis is concerned with establishing bounds on this discretisation error in the practically relevant and technically demanding case of coefficients which are not uniformly coercive or bounded with respect to the random parameter. Under mild assumptions on the regularity of the coefficient, we establish new results on the regularity of the solution for a variety of model problems. The most general case is that of a coefficient which is piecewise Hölder continuous with respect to a random partitioning of the domain. The established regularity of the solution is then combined with tools from classical discretisation error analysis to provide a full convergence analysis of the bias of the multilevel estimator for finite element and finite volume spatial discretisations. Our analysis covers as quantities of interest several spatial norms of the solution, as well as point evaluations of the solution and its gradient and any continuously Fréchet differentiable functional. Lastly, we extend the idea of multilevel Monte Carlo estimators to the framework of Markov chain Monte Carlo simulations. We develop a new multilevel version of a Metropolis Hastings algorithm, and provide a full convergence analysis.
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Study of Film Growth Ferroelectricity on Bi0.9Pb0.1FeO3/SrRuO3/SrTiO3Liu, Kuei-Chia 30 July 2012 (has links)
BiFeO3, a material with coexistence of antiferromagnetic and ferroelectric phases at room temperature, has been expecting to be used on novel devices such as FeRAM and spintronics. In this research, it is found that the surface morphologies of SrTiO3 influence the subsequence growth of SrRuO3 and Pb-dopant BiFeO¬3 (PBFO) films. The domain structures are associated to various surface structure and different thickness of PBFO investigated by a piezoresponse force microscopy. The radial-polarization-like domains was found on the PBFO island structures, and the domain size and the remnant piezoresponse increases with the thickness increasing; in contrary, the shifting of the electric coercive field occurs in the thinner films.
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Patienters erfarenheter av sluten psykiatrisk tvångsvård : En beskrivande litteraturstudieMattsson, Madeléne, Hillman, Gabriella January 2016 (has links)
Bakgrund: Patienter som ofta vårdas inom den psykiatriska slutenvården är patienter med psykotiska störningar, depression och patienter med risk för självmord. Tvångsåtgärder som kan förekomma på en psykiatrisk vårdavdelning kan exempelvis vara bältesläggning, tvångsmedicinering och isolering. För att en sjuksköterska ska kunna vårda dessa patienter behövs såväl kunskap som förståelse. För att axla denna roll behöver sjuksköterskor mer forskning som är fokuserad på patienters erfarenheter. Syfte: Syftet med studien var att beskriva patienters erfarenheter av sluten psykiatrisk tvångsvård samt att beskriva de inkluderade artiklarnas urvalsmetod och undersökningsgrupp. Metod: Litteraturstudien genomfördes med en beskrivande design. Studien innefattas av elva stycken kvalitativa vetenskapliga artiklar som svarar på studiens syfte. Resultat: Fem teman var grunden till beskrivningen av denna litteraturstudie: Betydelsen av relationen till vårdpersonalen, Betydelsen av information, Förståelsen av att vårdas mot sin vilja, Erfarenheter av tvångsåtgärder samt Erfarenheter av vårdmiljön. Resultatet avslutas med en beskrivning av artiklarnas urvalsmetod och urvalsgrupp. Slutsats: Patienter beskrev både bra och dåliga erfarenheter av sluten psykiatrisk tvångsvård. Viktiga aspekter som framgick enligt patienterna var: God information, god relation till vårdpersonal, förståelse samt en god vårdmiljö. Det är av stor vikt att sjuksköterskan har god kunskap om patienters erfarenheter för att kunna ge så god omvårdnad som möjligt. / Background: Patient who is treated in a locked psychiatric coercive care unit is patient with psychotic disorders, depression and patients with risk for suicide. Coercive measures that may be present in a psychiatric ward could be, for example medical restraint, forced medication and isolation. For a nurse to be able to care this patients who is in a need for good care it´s important with knowledge and understanding. To handle this role, nurses need more research and focus at the experiences of patients. Purpose: The aim of this study was to describe patient´s experience of a locked psychiatric coercive care unit. Present the selected articles' selection method and study group. Method: This is a literature study with a descriptive design. In this study eleven articles of qualitative approach are included to answer to the purpose of this study. Results: The result is based on five themes: Significance of relationship with health professionals, Significance of information, Understandning of being cared against their own will, Experience of being cared under coercion and Experience of the care environment. The last part om the result descibe the selctions method and the of the study group of the article. Conclusion: Patients described both good and bad experiences of locked psychiatric care. According to the patient important aspects was: Good information, Good Relationships with the health professionals and understanding, God care environment. It´s of great importance that the nurses have good knowledge about patients experience to be able to give such good nursing care as possible.
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Sjuksköterskans erfarenhet av framprovocerade tvångsåtgärder inom psykiatrisk slutenvård : En kvalitativ intervjustudie / Nurses’experiences of provoked coercive measures in psychiatric inpatient care : a qualitative interview studyOsein, Michelle, Ingvarsson, Sebastian January 2022 (has links)
Bakgrund: Tvångsåtgärder är en omdiskuterad intervention och leder till att patientens autonomi åsidosätts. Personal kan medvetet eller omedvetet framprovocera situationer som kan leda till tvångsåtgärder. Syfte: Syftet med studien var att undersöka sjuksköterskans erfarenheter av framprovocerade tvångsåtgärder inom psykiatrisk slutenvård. Metod: En kvalitativ intervjustudie utfördes där nio sjuksköterskor intervjuades. En kvalitativ innehållsanalys med induktiv ansats genomfördes vilket gav tre slutkategorier. Resultat: Resultatet beskrev varför framprovocerade tvångsåtgärder uppstår, hur tvångsåtgärder provoceras fram av personal samt hur framprovocerade tvångsåtgärder kan undvikas. Framprovocerade tvångsåtgärder kunde uppstå när personal inte hade tålamod, kunskap eller tillämpande personalperspektivet. En vårdkultur som präglades av machokultur kunde leda till framprovocerade tvångsåtgärder. Genom att arbeta förebyggande med alternativa lösningar, ha ett lågaffektivt bemötande och ha rätt kompetens och kunskap på avdelningen kunde framprovocerade tvångsåtgärder undvikas. Slutsats: En djupare förståelse för varför och hur framprovocerade tvångsåtgärder uppkommer framkom men även hur preventivt arbete kunde utföras. Framprovocerade tvångsåtgärder är ett område som kan vara svårt att prata om men som är viktigt att belysa. Genom den ökade kunskapen hoppas författarna möjliggöra reflektion på arbetsplatserna och att vidare forskning utförs i syfte att belysa området.
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Socialarbetares upplevelser av tvångsvårdens och tvångsåtgärdernas effekter för SiS-placerade ungdomar : En kvalitativ studie / Social Workers’ Experience of the Effect of Coercive Care and Coercive Measures for Young People Placed in SiS-institutions : A Qualitative StudyJallow, Josefin, Sobczyk, Isabella January 2024 (has links)
The purpose of this study is to examine how social workers´ in child protective services, and staff working within Swedens´ National Board of Institutional care institutions, so called SiS (Statens institutionsstyrelse) experience the effect coercive care and coercive measures have on young people placed in SiS-institutions. A vast majority of the youths placed in SiS-institutions, are placed there by coercion. While placed at the institution, the staff working there, has the right to perform coercive measures if necessary. The media in Sweden has reported a number of mistreatment and abuse going on within the institutional walls during recent years. But not much focus is put on the effect of the design of the SiS-instititutions, in terms of the coercive character of the institutional care. With a qualitative approach, this study presents an analysis of empirical data, collected from five semi stuctured interviews, with both social workers, working with placement of youths to SiS-institutions, and staff working in the SiS-institutions. The empirical data has shown that the social workers who works with placing youths at the SiS-institutions, generally don´t believe in institutional care as a concept, and that social workers working with placement to SiS-instiitutions generally are very aware of the negative consequences of placing a young person in an institution. The interviews also showed that the social workers generally don´t see positive results in terms of behavioural changes after the placement. When interviewing staff working in the SiS-institutions about coercive measures, the interviews showed that the staff had a lot of room for action, even though they are often lacking relevant education and experience. This in turn increases the risk of having to perform coercive measures, which both testimonies of youths placed in SiS-institutions, and research have shown has a harmful effect for the youths. The data has been analyzed with theories that touch on the subject of power, and social workers room for action. The main conclusions are that the social workers experience of the effect of coercive care at SiS-institutions, is that it in the majority of the cases has no effect, or the effect of making the youths situation worse. Regarding coercive measures, the empirical data collected from the staff working in SiS-institutions, showed that staff experienced the youths as discouraged from behaving against the rules in the institutions, so that they can avoid being the target of coercive measures. But that coercive measures is also uses as a tool by the staff to set boundaries, and create a trusting relationship between staff and the youths placed in the institutions. Although staff describe coercive measures as somewhat of a tool, it can not be ignored that reasearch, testimonies in the media and empirical data also shows that the youths can feel and behave worse when being the subject of a coercive measure.
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Land Reforms: A Successful Course of Action?Högman, Alve, Sällström, Pär January 2008 (has links)
<p>The problem with unequal distribution of land ownership, in developing countries, has been debated in numerous papers. It is important to solve this problem and one of the major contributions in finding a solution is the implementation of a land reform. The aim of this paper is to elucidate the outcome of two different approaches to land reform, i.e. coercive and market based, and to find out how successful they are in reducing the concentration of land ownership in a sustainable direction. The conclusion of this paper is that neither of the approaches alone is successful in this task, the strength lies instead in a combination of the coercive and market based approach.</p>
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Hur tillgodogör sig klienter med missbruksproblematik dialektisk beteendeterapi inom tvångsvården?Eriksson, Anna-Sara January 2017 (has links)
Studier har visat att dialektisk beteendeterapi (DBT) är en tidskrävande integrerande behandlingsform. DBT beskrivs utifrån fyra hörnstenar: inlärningsteori, kognitiv teori, dialektisk filosofi och zenbuddistisk filosofi. DBT utvecklades för självskadebeteende, senare utvecklades den också för annan beteendeproblematik. Syftet med denna studie var att undersöka hur behandlare och behandlingsassistenter med DBT erfarenheter upplever att klienterna tillgodogör sig DBT-behandlingen och om män respektive kvinnor tillgodogör sig olika. En man och fem kvinnor i Sverige med olika yrkeserfarenheter inom DBT intervjuades mellan 45-60 minuter om hur DBT-behandling av klienter tillgodogörs på LVM-hem utifrån behandlarens perspektiv. Intervjuerna meningskoncentrerade och resulterade i fem teman: a) främja positiv utveckling; b) en ökad kunskap; c) en ökad självkontroll; d) en ökad självkänsla; e) ett ökat välbefinnande. Slutsatsen är att ökad kunskap om sin personlighet främjar positiv utveckling att tillgodogöra sig verktyg för att öka självkontrollen, vilket kan leda till ökad självkänsla som främjar till ett ökat välbefinnande.
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