Among women in North America, body dissatisfaction is prevalent and well documented. Women are often unhappy with their bodies and strive to change their bodies to fit the dominant cultural ideal of beauty and femininity. Within this context, in which women are expected to focus tremendous resources, time, and energy on bodily striving and body dissatisfaction, some women are able to resist these expectations. They experience joy with their bodies—joy that is not contingent on their appearance, size, or weight. With respect to women’s embodied experiences of joy, a number of significant gaps exist in the research literature. The current study examined women’s experiences of embodied joy through the use of qualitative research methods, including individual interviews and a focus group. A feminist constructivist grounded theory frame was utilized. The findings of this analysis indicated the presence of four core dimensions of women’s joyful body experiences as a form of resistance to bodily dissatisfaction. The first core dimension addressed the experience of embodied joy, which included attunement, growth, liberation, and thriving. The second core dimension addressed participants’ active creation of environments that nurtured joy, including: creating spaces that facilitated embodied joy, creating internal openness to the experience of joy, and seeking supportive social relationships. The third core dimension addressed enacting joy in the context of resistance and struggle, specifically when navigating the imposition of the other’s external gaze. This core dimension included the themes of media deconstruction, disengagement from problematic relationships, personal practices of resistance, and critical political consciousness. The fourth core dimension involved enacting joy in the context of resistance and struggle as a journey towards joy, which included reclaimed childhood experiences, disruption and reconnection, and guiding other girls and women. The present study has implications for clinical work as well as for health promotion. Ultimately, women’s experiences of embodied joy both reflected their resistance to cultural dictates and further enabled them to resist the dictate of bodily dissatisfaction.

Among women in North America, body dissatisfaction is prevalent and well documented. Women are often unhappy with their bodies and strive to change their bodies to fit the dominant cultural ideal of beauty and femininity. Within this context, in which women are expected to focus tremendous resources, time, and energy on bodily striving and body dissatisfaction, some women are able to resist these expectations. They experience joy with their bodies—joy that is not contingent on their appearance, size, or weight. With respect to women’s embodied experiences of joy, a number of significant gaps exist in the research literature. The current study examined women’s experiences of embodied joy through the use of qualitative research methods, including individual interviews and a focus group. A feminist constructivist grounded theory frame was utilized. The findings of this analysis indicated the presence of four core dimensions of women’s joyful body experiences as a form of resistance to bodily dissatisfaction. The first core dimension addressed the experience of embodied joy, which included attunement, growth, liberation, and thriving. The second core dimension addressed participants’ active creation of environments that nurtured joy, including: creating spaces that facilitated embodied joy, creating internal openness to the experience of joy, and seeking supportive social relationships. The third core dimension addressed enacting joy in the context of resistance and struggle, specifically when navigating the imposition of the other’s external gaze. This core dimension included the themes of media deconstruction, disengagement from problematic relationships, personal practices of resistance, and critical political consciousness. The fourth core dimension involved enacting joy in the context of resistance and struggle as a journey towards joy, which included reclaimed childhood experiences, disruption and reconnection, and guiding other girls and women. The present study has implications for clinical work as well as for health promotion. Ultimately, women’s experiences of embodied joy both reflected their resistance to cultural dictates and further enabled them to resist the dictate of bodily dissatisfaction.

Couple therapy is a frequently sought domain by couples who experience problems in their relationships. Couple therapy has been researched intensively, but few studies incorporate a holistic account of the therapeutic process. This study aims to explore and integrate the therapist's and the couple's experiences of change in the context of couple therapy. The ecosystemic epistemology and the narrative metaphor forms the foundation from which the therapy and the research is approached. Qualitative research methods are employed from within a naturalistic paradigm which allows for personal and unique meanings to emerge. Rich descriptions of the therapist's and the participant's stories of change are provided. Multiple perspectives are offered in the stories which reveal the reciprocal motions between the therapist's and the couples' change processes. Recurring themes are extracted from the stories which punctuate the pivotal change processes that were experienced by the therapist and the couples during the therapy. / Psychology / M.A. (Clinical Psychology)

Design philosophies in MMOs seem to have seen a shift in recent years. What used to be designs for social dependencies and challenging content seems to have become designs for social independence and casual play. This has not gone by unnoticed by communities of players that have gradually increased in size, hoping to find regression in design philosophies for their favorite games. This study combines the social component of Yee’s (2006) model for motivations for online play with Bradner’s (2001) concept of social affordances, and quantitative surveys with qualitative interviews in order to examine how the social player experience in World of Warcraft has changed in relation to changes made to the game. Some of the findings are that the incentives and necessity for socializing with strangers in the game has generally diminished as a consequence of changes made in the game that focus on practical efficiency. External factors that seems to have played a role in these results are age, technological contexts and life contexts of the respondents.

Text in English / As some criticism and hesitations have been expressed with regard to the implementation of provocation in psychotherapy, this study aimed to explore the experiences of clients and a therapist who participated in provocative psychotherapy. In order to do this, a concise theoretical description of the nature of provocative psychotherapy was provided along the lines of the work of Frank Farrelly and Maurizio Andolfi. Participants' experiences of provocation in psychotherapy were consequently presented by means of three case studies. A description of the experience of provocation in psychotherapy was co-created through the identifying of certain themes underlying of the three client groups' and the therapist's descriptions of their experiences. This was done by employing a qualitative research methodology to describe the experiences of clients and a therapist who participated in provocative individual-, couple- and family psychotherapy. / Psychology / M.A. (Clinical Psychology)

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-07-21T18:06:14Z No. of bitstreams: 1 jorgececiliodaherjunior.pdf: 3997005 bytes, checksum: 5cd16f8d9e7c45ac7f4ee338f307c068 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-07-22T15:35:32Z (GMT) No. of bitstreams: 1 jorgececiliodaherjunior.pdf: 3997005 bytes, checksum: 5cd16f8d9e7c45ac7f4ee338f307c068 (MD5) / Made available in DSpace on 2016-07-22T15:35:32Z (GMT). No. of bitstreams: 1 jorgececiliodaherjunior.pdf: 3997005 bytes, checksum: 5cd16f8d9e7c45ac7f4ee338f307c068 (MD5) Previous issue date: 2016-05-20 / Introdução: A hipótese da autonomia da consciência em relação ao cérebro é um tema controverso sobre o qual há uma longa história de investigações científicas. Entretanto, ainda não se realizou uma análise sistematizada das publicações sobre esse tema, que possibilite conhecer o estado da arte nesse campo e determinar lacunas e limitações metodológicas. Objetivos: Fazer um levantamento bibliométrico das publicações que investigaram experiências habitualmente associadas à possibilidade da existência da consciência independente do cérebro nas principais bases de dados científicos. Métodos: Avaliaram-se todos os artigos contidos no Pubmed, Web of Knowledge, PsycINFO, Science Direct e Scopus até 31/12/2015, através de operadores booleanos, envolvendo os seguintes campos: Experiências de quase morte(NDE), Experiências fora do corpo(OBE), Experiências de final de vida(ELE), Possessão(POS), Memórias sugestivas de vidas passadas(PLM), Mediunidade(MED), transcomunicação, detecção de “espíritos” e relação mente-cérebro. Foram excluídos artigos científicos fora do tema ou de outras áreas, publicações não científicas, referências de livros e capítulos de livros. Resultados: Dos 9065 artigos encontrados, 1954 artigos foram incluídos (598 NDE, 223 OBE, 56 ELE, 224 POS, 244 PLM, 565 MED, 44 outros). Ao longo das décadas, notou-se um aumento na quantidade de artigos em todos os campos avaliados, com exceção dos estudos em Mediunidade, no qual houve um declínio no final do sec XX e uma retomada no sec XXI. Em relação aos tipos de artigos, com exceção de Past-life memories e End-of-life experiences (predominando estudos originais), os demais campos possuíram predomínio de artigos de revisão. Os artigos foram publicados em periódicos com fator de impacto médio comparável com outras áreas da ciência, como por exemplo psicologia positiva e reabilitação cardiovascular. Conclusão: De forma geral as pesquisas sobre sobrevivência da consciência têm aumentado nas últimas décadas, em revistas com fator de impacto semelhante ao de outras áreas, porém com predomínio de revisões. A identificação dessas lacunas pode auxiliar na elaboração de novas pesquisas na área. / Introduction: The hypothesis of autonomy of the consciousness in relation to the brain is a controversial subject with a long history of scientific investigations. To date, however, no systematic analysis of the publications on this topic, establishing the state of art in this field and identifying methodological gaps and limitations, has been conducted. Objectives: To conduct a bibliometric search of publications investigating experiences commonly associated with the possibility of the existence of a consciousness independent of the brain held on the main scientific databases. Methods: A search of all articles held on the Pubmed, Web of Knowledge, PsycINFO, Science Direct and Scopus databases up to 31/12/2015 was performed with boolean operators involving the following fields: Near-death experiences (NDE), Out-of-body experiences (OBE), End-of-life experiences (ELE), Possession (POS), Memories suggestive of past lives (PLM), Mediumship (MED), transcommunication, detection of “spirits” and mind-brain relationship. Scientific articles unrelated to the topic or on other areas, unscientific publications, book references and book chapters were all excluded. Results: Of the 9065 articles retrieved, 1954 were included (598 NDE, 223 OBE, 56 ELE, 224 POS, 244 PLM, 565 MED, 44 others). Over the decades, there was an evident increase in the number of articles on all the fields, with the exception of studies on Mediumship which showed a decline during the late twentieth century and subsequent rise in the early twenty-first century. Regarding the types of articles found, with the exception of Past-life memories and End-of-life experiences (mostly original studies), publications were predominantly review articles. The articles were published in journals with an average impact factor similar to other areas of science, such as positive psychology and cardiovascular rehabilitation. Conclusion: Overall, publications of studies on survival of the consciousness have tended to increase over recent decades in journals with similar impact factors to other areas, although these studies were predominantly review articles. Identifying gaps can help guide future studies in the area.

Bakgrund: Barnmorskor och sjuksköterskor världen över möter och vårdar kvinnor som av olika skäl genomför en inducerad abort. Det kan vara en utmaning som kräver både kunskap och stöd för dem som arbetar inom abortvården. Syfte: Syftet med studien var att belysa barnmorskors och sjuksköterskors erfarenheter av att vårda kvinnor i samband med inducerad abort. Ordet erfarenheter innefattar upplevelser och åsikter baserat på erfarenheter. Metod: Studien genomfördes som en kvalitativ metasyntes med metaetnografi som analysmetod. Tjugosju (27) artiklar inkluderades i resultatet. Resultat: Tre huvudkategorier och tio mönster belyser barnmorskors och sjuksköterskors erfarenheter av att vårda kvinnor i samband med inducerad abort. Dessa var att göra ett bra arbete genom att vara ett stöd, att åsidosätta egna värderingar och att skapa goda upplevelser för kvinnan. Barriärer för kvalitativ abortvård i form av negativa attityder från omgivningen, brister i verksamheten, bristande preventivmedelsanvändning, egna känslor och ta emot fostret. Behov hos vårdgivarna i form av stöd och kunskap. Slutsats: Den abortsökande kvinnan är i behov av stöd och icke dömande attityder från vårdgivare. Barnmorskor och sjuksköterskor behöver ha kunskap och få stöd i arbetet med abortvård. Brist på stöd och kunskap hos barnmorskor och sjuksköterskor kan påverka attityder om kvinnors rätt till inducerad abort inom kollegiet på en arbetsplats, vilket i sin tur kan ha en inverkan på den abortsökande kvinnans omvårdnad. / Background : Midwives and nurses all over the world meet with and care for women who, for various reasons, are undergoing induced abortion. It may be a challenge that requires both knowledge and support for those working in abortion care.Objective: To describe midwives and nurses’ experiences of caring for women who undergo induced abortion. The word experience includes perceptions based on experiences. Method: The study was conducted as a qualitative metasynthesis using meta-ethnography as analysis of data. Twenty-seven (27) peer-reviewed scientific articles were included in the result. Result: Three main categories and ten different patterns highlighted the midwives and nurses' experiences of caring for women undergoing an induced abortion. These were doing a good job by being supportive, putting own values aside and with the goal to create good experiences for the woman. Barriers to qualitative abortion care included negative attitudes from the surroundings, own feelings, receiving the fetus and various issues at the abortion care clinics. The third category was the caregivers’ needs which included support and knowledge. Conclusion: The abortion-seeking woman is in need of support and non-judgmental attitudes from caregivers. Midwives and nurses need knowledge and support in the work of abortion care. Lack of support and knowledge can affect midwives and nurses’ attitudes towards induced abortion as a woman’s right, which in turn can affect the women in need of abortion care.

Philosophiae Doctor - PhD / This thesis is about HELLP Syndrome (hemolysis, elevated liver enzymes, low platelet count in pregnancy): a devastating maternal hypertensive complication that results in multi-system changes that can rapidly deteriorate into organ failure and death. Despite rapid advancesin medical technology and medical science this disease continues to take the lives of women and their infants. The only effective intervention for this disorder is immediate termination irrespective of the gestational stage of the pregnancy. The primary objective of this thesis was to explore the subjective experiences and meaningmaking processes of women in and through their high-risk pregnancies. This objective crystallised into the following aims: to facilitate and listen to the voices of women who were HELLP Syndrome survivors; to explore the reported bodily, psychological and emotional experiences of HELLP Syndrome survivors; to understand the role medical intervention and biomedical discourses play in these women’s experiences and finally to explore the subjective experiences of HELLP Syndrome in the context of traditionallyheld notions of motherhood. The study was couched in a feminist poststructuralist epistemology. A material-discursive framework which comprised phenomenological and poststructuralist theorising was usedin an attempt to understand both the lived experiences as well as the discursively constructed nature of those subjective experiences. Thus the analysis encompassed both a broadly phenomenological framework to understand the lived experiences of HELLP Syndrome, and a discourse analysis to explore the meaning-making processes of participants in relation to larger social discourses, in particular the dominant biomedical and motherhood discourses. A qualitative approach using in depth semi-structured interviews was utilisedto gather data. Eleven participants from very diverse backgrounds consented to be part of thisstudy. The findings of the study highlighted the immense trauma, difficulties and challenges participants faced in these high-risk situations. What was evident from the analysis was that their experiences were so diverse and werecompletely shaped by the severity of the disorder and the gestational stage of the pregnancy. Some women ended up in the Intensive Care Units (ICU) and had near-death experiences, some had very premature babies, while some of the participants lost their babies during the process. With regards to the emotional, psychological and corporeal aspects of the disorder,participants described their situations as a disaster, painful and difficult. Due to the rapid deterioration of symptoms, they described the tempo of these events as a whirlwind in which they felt they had no control. Emotions ranged from shock, total disbelief and surprise to anger, helplessness and powerlessness. Lacking knowledge and access to appropriate information further compounded the situation for participants. Theparticipants who had premature babies found the Neonatal Intensive Care Unit experience (NICU) extremely challenging and stressful. A discourse analysis revealed that women’s talk was shaped by the disciplinary frameworks oftechnocratic medicine and patriarchal notions of gender. Participants’ discourses about their encounters inthe medical context werelocated in, and shaped by, the structure of health care in our country. In this regard binaries (like private versus public health care, women versus men and nurses versus doctors) were evident. Furthermore their hospital stay reflected their experiences in the Intensive Care (ICU) and the Neonatal Intensive Care Units (NICU) both of which are highly technologically orientated and managed. Biomedical discourses that filtered through the participants’ talk were: medicine as indisputable truth;mechanistic model of the body as machine; medical doctors as gods and the foetus as ‘super subject’. Discourses of risk were inevitably taken up as participants tried to make sense of both their current pregnancies and the potential ones to follow. The passage into motherhood for these participants was dependent on whether they had live babies or not. For those who had live babies it was a difficult time as they had to contend with their own recovery as well as the prematurity of their infants. The NICU experience was described as tiring, trying and cumbersome. For mothers who lost their babies it was a time of profound sadness and loss coupled to the notion that motherhood itself was lost. This loss of their children symbolised broken dreams, severed connections and a powerful taboo. In addition, discourses in which motherhood was naturalised and normalised saturated their talk and framed their experience in a narrative of deficit and failure. The ideologies of mother blame and the ‘all responsible’ mother were pervasive in their discussions. In conclusion, this high-risk situation represented a time of tremendous uncertainty and unpredictability for all participants and was powerfully shaped by dominant discourses about motherhood and the biomedical discursive and institutional framework in which participants were subjugated. The study thus highlights how the HELLP syndrome experience illuminates the erasure of women’s subjectivities while the foetus/infants’ life takes precedence. This has significant implications for scholarship in general and feminist scholarship in particular and highlights the need for this type of engagement in an area that has remained on the periphery of feminist research. / South Africa

Bakgrund: Överrapportering vid skiftbyte är en essentiell del av sjuksköterskans kliniska arbete, trots detta råder inte konsensus om vilken rapporteringsmetod som är bästa praxis. I takt med en större personcentrering av vården står patientens rätt till delaktighet och medbestämmande i större fokus, och bedsiderapportering har vuxit fram som ett alternativ till den traditionella rapporten. Syfte: Att belysa hur sjuksköterskor och vuxna patienter i den somatiska slutenvården beskriver sin upplevelse av bedsiderapportering. Metod: Denna litteraturöversikt genomfördes som en förenklad metasyntes där dataanalysen baserades på kvalitativ innehållsanalytisk teknik. Resultat: Tre huvudteman framkom gällande patienters upplevelse av bedsiderapportering: patientmedverkan, bättre vårdupplevelse samt möjliga hinder. Ytterligare tre huvudteman framkom för sjuksköterskors upplevelser: upplevda fördelar, möjliga hinder och förutsättningar för bedsiderapportering. Både patienter och sjuksköterskor beskrev positiva upplevelser av bedsiderapportering med den främsta fördelen att patienten blev mer delaktig i vården. Patienter beskrev en ökad trygghetskänsla och ett tillgodosett informationsbehov. Sjuksköterskor beskrev hur patientsäkerheten förbättrades och prioriteringar underlättades av bedsiderapportering. Oro kring sekretess och känslig information lyftes av både sjuksköterskor och patienter. Slutsats: Bedsiderapportering kan utgöra ett värdefullt verktyg i en mer personcentrerad vård, men att ytterligare kunskap behövs kring hantering av sekretessen. / Background: Shift reporting is an essential part of the nurse’s clinical work, despite this there is no consensus about what constitutes best practice. As personcentredness is becoming more important, more focus is on the patients’ right to participation and shared decision-making, and bedside reporting has become an alternative to the traditional shift report. Aim: To illustrate how nurses and adult inpatients within the somatic care describe their experience of bedside handover. Method: This literature review was conducted through a simplified meta-synthesis approach based on qualitative content analysis as a tool for the analysis of data. Results: Three main themes regarding patients’ experiences of bedside handover emerged: patient participation, improved care experience and possible barriers. Three additional main themes regarding nurses’ experiences emerged: perceived advantages, possible barriers and enabling factors for bedside handover. Both patients and nurses reported positive experiences of bedside handover, with the foremost advantage being the patients’ involvement in their care. Patients described an increased feeling of safety and that their needs of information were met. Nurses described how patient safety was improved and how prioritization was facilitated. Both nurses and patients had concerns about confidentiality and sensitive information. Conclusion: Bedside handover can be used as a valuable tool in the work towards a more person centred care, but there is a need for further knowledge about how confidentiality can be managed.

SJUKSKÖTERSKORS UPPLEVELSER OCH ERFARENHETER AV BRYTPUNKTSSAMTAL MED PATIENT I LIVETS SLUTSKEDELITTERATURSTUDIEHolgersson M, Johannesson J. Sjuksköterskors upplevelser och erfarenheter av brytpunktssamtal med patient i livets slutskede. Examensarbete i omvårdnad 15 högskolepoäng. Malmö Universitet: Fakulteten för Hälsa och samhälle, Institutionen för vårdvetenskap, 2020.Vid ett brytpunktssamtal har sjuksköterskorna en framträdande och viktig roll. Då patienten är i livets slutskede och vården går från botande till lindrande är det viktigt att det sker i rätt tid och på rätt sätt. Sjuksköterskors medverkan vid brytpunktssamtalet ska medföra en trygghet för patient och anhörig och genom sin kännedom om patienten kan sjuksköterskorna bidra till en bättre omvårdnad vid livets slut. Syfte: Syftet med studien var att undersöka sjuksköterskors upplevelser och erfarenheter runt brytpunktssamtal med patienter i livets slutskede. Metod: En litteraturstudie utfördes där tio artiklar med kvalitativ design som svarade upp mot syftet valdes ut. En innehållsanalys genomfördes där artiklarna granskades och syntetiserades ner till ett resultat. Resultat: Resultatet mynnade ut i fyra huvudteman: Kommunikation inom teamet och med patient och anhörig. Interaktionen i teamet och med patient och anhörig. Relationer och upplevelser i mötet med patient och anhörig och slutligen sjuksköterskors upplevelser och känslor i sitt arbete med patienten före, under och efter brytpunktssamtal. Sjuksköterskorna i studien efterlyste mer utbildning i att hantera sin roll vid brytpunktsamtal. Sjuksköterskorna har ofta vårdat patienten under en längre tid och har skapat en relation och lärt sig vad som är viktigt för just den patienten vilket är en stor tillgång under brytpunksamtalet för att tillgodose patientens önskemål och skapa förutsättningar för god omvårdnad. Konklusion: Kommunikation i teamet och förberedelser är viktigt i arbetet runt patient och anhörig vid brytpunktssamtal. Sjuksköterskorna behöver utbildning och erfarenhet av brytpunktssamtal för att känna sig trygg i sin roll för att utgöra ett bra och tydligt stöd för patient och anhörig i brytpunktssamtal. Nyckelord: Brytpunktssamtal, erfarenheter, palliativ vård, sjuksköterskor, upplevelser. / NURSÉS EXPERIENCES IN BREAKING BAD NEWS DIALOGUES WITH PATIENTS IN THE END OF LIFEA LITERATURE REVIEWHolgersson M, Johannesson J. Nursés experiences in breaking bad news dialogues with patients in the end of life. Degree Project in nursing 15 credit points, Malmö University: Faculty of Health and Society, Department of Care Science, 2020.The nurses has a prominent and important role in breaking bad news dialogues. As the patient is in the final stage of life and the care goes from curative to palliative, it is important that this is done at the right time and in the right way. The nurse´s participation in breaking bad news dialogues should bring a feeling of safety for both the patient and relatives and through the knowledge of the patient the nurses can contribute to a better care in the final stages of life. Purpose: The purpose with the study was to analyze nurses experience and knowledge about breaking bad news dialogues with patients in the final stages of life. Method: A literature study was conducted where ten articles of qualitative design that responded to the purpose were selected. A content analysis was done where the articles were reviewed and synthesized down to a result. Result: The outcome resulted in four main themes. Communication within the team and with patient and relatives. The interaction in the team and with the patient and relatives. Relationships and experiences in the meeting with patient and relative and finally the nurse´s experiences and emotions in their work with the patient before, under and after breaking the bad news. The nurse has often cared for the patient during a longer period of time and has created a relationship and learned what is important for that particular patient which is a huge asset during the breakpoint dialogue to meet the patient´s wishes and create conditions for good nursing. Conclusion: Communication in the team and preparation are important in the work regarding patient and relatives in breaking bad news dialogues. The nurse need education and experience in breaking bad news dialogues to feel safe in her role to be a good and distinct support for patient and relative in breaking bad news dialogues. Keyword: Breaking bad news, life experiences, lived experiences, nurses, palliative care.