Résumé : La consommation problématique de substances psychoactives (SPA) représente un problème de santé pour certains hommes gais/bisexuels. Leur consommation présente des caractéristiques particulières, parfois associées à leur vécu homosexuel, et ils tardent à consulter des services en toxicomanie. Cette étude qualitative descriptive vise à : 1) décrire et comprendre les interrelations entre certaines dimensions du vécu homosexuel et les trajectoires de consommation de SPA chez les hommes gais et bisexuels; 2) documenter leur expérience quant à leur utilisation des services en toxicomanie; 3) établir des liens entre ces expériences et leur vécu homosexuel; et, 4) identifier leurs besoins en matière de services. 35 entrevues semi-dirigées ont été menées auprès d’hommes gais/bisexuels, âgés en moyenne de 46 ans, ayant une consommation problématique de SPA. L’ensemble du matériel a fait l’objet d’une analyse thématique. Les trajectoires de consommation de SPA et le vécu homosexuel s’entrecroisent au moment de la découverte et de l’acceptation des désirs homoérotiques; lors de l’expérimentation sexuelle; lors de la rencontre d’un partenaire sexuel/affectif; dans le contexte de relations sociales au sein du milieu gai. La majorité des hommes interrogés avait déjà utilisé des services en toxicomanie, mais seulement moins de la moitié d‘entre eux avait été dirigée vers un tel service. L’augmentation de la consommation surgit souvent alors que la personne éprouve de la difficulté à accepter son orientation sexuelle, lors des expérimentations sexuelles ou au moment d’un diagnostic de VIH. Cette augmentation mène parfois la personne à se questionner quant à sa consommation et à demander de l’aide auprès d’un service spécialisé. Dans certains cas, la consommation problématique n’a pas été détectée au bon moment. De plus, la sexualité n’est pas suffisamment abordée dans le cadre des services en toxicomanie. Les résultats montrent l’importance de tenir compte des différentes dimensions du vécu homosexuel, dont la sexualité, dans les stratégies de prévention de la consommation auprès de cette population, ainsi que dans les thérapies pour la toxicomanie. De plus, la détection de la consommation problématique au sein de cette population représente un défi. / Abstract : The problematic consumption of psychoactive substances (PAS) constitutes a health problem for certain gay/bisexual men. Their consumption has particular characteristics sometimes associated to their homosexual experience and their delay to consult addiction services. The present qualitative descriptive study, inscribed in symbolic interactionist perspective, aims to: 1) describe and understand the interrelations between certain dimensions of the gay life course experience and the consumption trajectories of PAS among gay and bisexual men; 2) document their experience in relation to their use of addiction services; 3) establish links between their experiences and their gay life course experience; and, 4) identify their needs in matter of services. Thirty five semi-structured interviews were conducted with gay/bisexual men, who have a problematic consumption of PAS and have an average age of 46 years. The whole material has been analysed thematically. The addiction trajectories and the homosexual experience intersect at the time of the discovery and acceptance of homoerotic desires, during sexual experimentation; when finding a sexual/emotional partner; and as part of the socialization in the gay community, particularly in sexualized spaces. Most participants have used substance abuse services but only about half of them have received a reference to such services. The increase in consumption often emerges when they have problems accepting their sexual orientation, during sexual experimentation or when they receive an HIV diagnosis. The increase of consumption associated to these life events sometimes leads the participants to question their consumption and to demand help from a specialized service. For certain participants their consumption has not been detected in a good moment. Moreover, sexuality is not addressed in the addiction services. The results show the relevance of considering the different dimensions of the homosexual experience, including sexuality, in the prevention strategies for consumption as well as in the addiction therapies for this population. In addition, the detection of problematic consumption in this population represents a challenge.

Vård- och omsorgspersonal påverkas i dagsläget av hög stressrelaterad ohälsa, samtidigt som få interventioner implementeras för att hantera det. Studiens syfte var att utforska vård- och omsorgspersonals upplevelse av en internetbaserad stresshanteringskurs utifrån compassionfokuserad terapi med fokus på kursens genomförbarhet och hur den påverkat hantering av arbete och vardagligt liv. Flertalet regioner i Sverige representerades av elva deltagare som arbetade med direkt patientkontakt inom vård- och omsorg. Deltagarna besvarade frågeformulären Treatment Credibility Scale och “Utvärdering av stresshanteringskursen”. Sju deltagare deltog även i en semistrukturerad intervju som syftade till att utforska upplevelsen av kursen. Det insamlade materialet analyserades med kvalitativ innehållsanalys samt deskriptiv sammanställning av frågeformulären. Resultatet påvisade att kursen hade hög genomförbarhet som ökade deltagarnas upplevda stresshantering. Alla deltagarna beskrev nya förhållningssätt utifrån bland annat ökade insikter och nya färdigheter. Studiens resultat indikerar att en liknande kurs kan implementeras i större skala för att öka vård- och omsorgspersonals hantering av stress samt öka välmående. / Care and nursing staff are currently affected by high-stress-related health issues, while few interventions are implemented to handle it. The purpose of the study was to explore care and nursing staff´s experiences of an internet-based stress management course based on compassion-focused therapy with a focus on the course's feasibility and how it affected coping of work and everyday life stress. Some regions in Sweden were represented by eleven participants who worked with direct patient contact in healthcare. Participants answered the questionnaires Treatment Credibility Scale and “Evaluation of the stress management course”. Seven participants also participated in a semi-structured interview which aimed to explore the experience of the course. The material was analyzed with qualitative content analysis and a descriptive compilation of the questionnaires. The results showed that the course had high feasibility that increased the participants' stress management. All participants described new approaches based on, for instance, increased insights and new skills. The results of the study indicate that a similar course can be implemented to a greater extent to increase care and nursing staff's coping of stress and well-being. / ICOP

Rapid scientific and technological advances in health care mean that nurses need to keep learning and engage in professional education so that they can continue to provide safe and quality care. Education programs which prepare nurses for practice as a registered nurse have a vital role to play in ensuring that graduates are self-directed in responding to the need for ongoing learning throughout their professional career. In many countries, improving students’ readiness for self-directed learning has thus gained increasing recognition as being an important goal of nursing education programs. This level of interest in developing self-directedness in learning is evident in many policy documents and research in Taiwan. The aim of this study was to investigate factors influencing self-directed learning readiness amongst Taiwanese nursing students. A conceptual framework adopted from Biggs’s ‘3P model of teaching and learning’ was constructed to guide this study’s investigation. This study employed a two-staged mixed-method design to obtain a better understanding of Taiwanese students’ experience of SDL in undergraduate nursing programs. Stage one of the present study was a qualitative approach using semi-structured interview to explore students’ experiences with learning activities which they perceived to be self-directed in their undergraduate programs. Eight students were interviewed. Findings from this stage reveal that participants perceived a shift in teaching and learning styles between their previous nursing programs and the university. The more frequent use of student-directed learning activities, in which students were encouraged to be active and to take responsibility for their learning tasks, was one of the changes in teaching and learning approaches perceived by participants. Participants further suggested a number of factors that influenced the outcomes of these learning activities, including teacher-student interaction, facilitation process and learning resources. Stage two of this study used a quantitative approach consisting of two phases: instrument pilot testing and a cross-sectional survey. In the first phase, the instruments were translated into Chinese through a rigorous translation process and tested with a convenience sample of nursing students in Taiwan. Results indicated the translated instruments were reliable and stable. The second phase, a cross-sectional survey, was conducted to examine the conceptual framework of this study. A total of 369 undergraduate nursing students completed the questionnaire. Results of data analysis provides support for the conceptual framework proposed for this study, suggesting that students’ achievement goals and their perceptions of the learning environment significantly influence their adoption of learning approaches and the development of SDL readiness. Based on the results, this study provides practical implications that nurse educators may adopt to enhance students’ SDL readiness. This study also provides theoretical implications and recommendations for future research. It is envisaged that these recommendations may help future researchers focus their research design and further understandings of how to help students develop their ability to become self-directed learners.