Background Self-harm is a major and growing public health issue among young people worldwide. Self-harm is an important risk factor for suicide, which is one of the leading causes of death for young people. Although suicide rates are declining overall, this trend is not seen in young people. Young people with mental distress and/or suicidal thoughts are reluctant to seek help, and often drop out of treatment initiated after a self-harm episode. Many young people who self-harm have had contact with healthcare before their first self-harm episode, but often for reasons other than suicidal thoughts or psychiatric problems. In this context, physical illness is associated with increased risk for self-harm and suicide among young people. The present thesis investigated how young people perceived the help and support they received before and after an episode of self-harm. A further aim was to map the inpatient somatic healthcare contacts young patients had before an episode of self-harm, and determine any relationship to risk for self-harm and suicide. Method Four studies were conducted using qualitative and quantitative methods. Participants were people aged 16-24 years. The definition of self-harm was based on the intentional self-harm criteria in the International Classification of Diseases, tenth revision, which includes all forms of self-harm without ascribing suicidal intent. In the first two studies, 10 respective 9 participants with a first healthcare contact for self-harm were interviewed during 2009-2011. The interviews covered participants’ knowledge and experience of professional care before their healthcare contact for self-harm. Participants were interviewed a second time 6 months later about their experiences with professional care during the period since their initial interview. Qualitative content analysis was used for all interviews. For the next two studies, we selected 16,235 participants with a first hospitalisation for self-harm during 1999-2009 from the Swedish National Inpatient Register. These cases were compared with matched controls to determine the odds of having been admitted with a non-psychiatric diagnosis during the year preceding the self-harm admission. To assess risk for suicide, data were retrieved from the Swedish Cause of Death Register for all deceased participants until 2013, and group differences were determined using survival analysis. Results In the first interview, participants described how they wanted more information on where they could turn for professional help. They also wanted different help-seeking pathways and emphasised the importance of the quality of professional contact. After 6 months, participants stressed the importance of being able to rely on professionals and treatment. Their life circumstances significantly affected their treatment, and practical help was appreciated. The register studies showed that young people admitted for self-harm were more likely to have been hospitalised with symptomatic diagnoses such as abdominal pain and syncope/collapse, and somatic illnesses such as epilepsy and diabetes mellitus type 1. A higher proportion of cases (4.5%; women 2.6%, men 8.8%) died during the study period than controls (0.3%; women 0.2%, men 0.6%) (p<0.001). For both cases and controls, a higher proportion of those with a previous somatic admission died from suicide during the study period than those without a somatic admission (cases: 4.2% vs. 2.8%, p<0.05). For cases with a somatic admission, the hazard ratio was 1.43 (95% confidence interval 1.04-1.98) compared with those without somatic admissions (controlled for age, sex and psychiatric admission). Survival of cases with a previous somatic admission compared with those without was 98.4% versus 99.2% after the first year, 97.8% versus 98.9% after the second year, and 95.5% versus 96.9% after the tenth year. Conclusion These findings suggest that healthcare providers need to find new ways to reach young people at risk for suicidal behaviour. Access to professional help should be easy and direct. Treatment for young people after self-harm should be flexible, and be receptive to input from the patient. The importance of and need for basic practical help should not be overlooked. Somatic healthcare contact provides an opportunity for intervention, particularly as psychiatric problems can manifest as physical symptoms, and physical illness is a risk factor for self-harm and suicide.

<p>The purpose of this thesis was to investigate the implications and challenges of intercultural communication. An in-depth study was performed of the perspectives from people who work within an international organization. How they experience cultural differences and how they handle them, in particular when it comes to communication. Also, their perceptions of communicative competence were explored. The study was carried out at Svalorna India Bangladesh, at the Swedish office in Lund. Svalorna’s staff was interviewed on their experiences of intercultural communication. Both employees at the Swedish office and employees on location in India and Bangladesh were interviewed. The method used in the study was qualitative interviews where the interviewees could expand their answers fully as the interview developed. The main theory used was Geert Hofstede’s cultural dimensions, presented in the thesis and considered in the study. It was concluded that being aware of cultural differences and having knowledge of other cultures but also your own is important for understanding the so-called non-verbal communication in an intercultural situation. There are also differences in to what extent a certain culture uses non-verbal communication. Both India and Bangladesh, according to the interviewees, are high context cultures whereas Sweden has a low context culture. All the interviewees had similar experiences when it comes to intercultural communication. A cultural difference in the perception of time is an example of when verbal communication can be inadequate, if one is not aware of cultural differences. Both India and Bangladesh use polychronic time whereas in Sweden monochromic time is used. This is indeed confirmed by all interviewees. Many of Hofstede’s cultural dimension theories are found to be coherent with the results of this study, for example the Individualism.</p>

The emotional part of a museum experience is being debated and there is research pointing towards the affective part of learning. The purpose of this study is to examine how museum pedagogues reason about the usage of affective learning in their work and to investigate whether they consider affective pedagogy is a part of their work or not. Furthermore how they consider themselves working, or not working, with feelings in their pedagogy. A key factor in this study has been to work interdisciplinary with both museum pedagogy and social science with theoretical perspectives of feelings such as happiness, sadness, anger, disgust and fear, and with theories such as Feelings &amp; materiality and Pedagogy of Feeling. Methodologically a qualitative interview study museum pedagogues have been used together with observation of four Swedish state- and country museums. In this thesis it is shown that the interviewed museum pedagogues indeed have acknowledged the fact that the museum is an affective place, but the interviewed had different way of make use of feelings. They all agree on the fact that feelings can support the learning process, and that all the different feelings have their own effect on learning. Also that the museum pedagogues have some influence on the feeling that the exhibitions are to emit, which could be used in the pedagogues favor if the exhibition consists of hard and problematic feelings. However, in contrast to this it seems that few of the museum pedagogues discuss the affective influence of a upcoming exhibition or program, or evaluate a project in what feeling the visitors experienced during the visit. This is a two years master’s thesis in Archive, Library and Museum studies.

I dagens samhälle stöter barn och vuxna på digitala verktyg dagligen, tekniken och verktyg utvecklas allt mer.Skol- och fritidsverksamheten har i ansvar att utbilda och utveckla elever i digitalt användande för lärandeoch kritiskt tänkande. Syftet med denna studie är att undersöka hur fritidslärare uppfattar förutsättningarnaför att arbete med IKT i fritidshem. Genom en kvalitativ studie genomfördes undersökningen av nio fritidslärarei tre olika verksamheter. Resultatet påvisar ett positivt engagemang till IKT men att den grundläggandeutbildningen är bristande och fritidslärarna påtalar om utbildning.

Bakgrund: I Sverige har antalet invånare med utländsk bakgrund ökat de senaste åren vilket medför att hälso- och sjukvården vårdar allt fler patienter som inte kan det svenska språket. Informationsutbytet mellan patienten och sjuksköterskan är en viktig del av vårdandet. Arbetet inom hemsjukvården kan vara utmanande då allt fler patienter vårdas hemma, och sjuksköterskor ska kunna leva upp till de krav som ställs på att ge alla patienter god vård på lika villkor. Språkliga hinder kan vara en utmaning för sjuksköterskor i mötet med patienter. När kommunikationen inte fungerar på grund av språkbarriärer riskerar patientens vård att drabbas negativt. Syfte: Syftet med studien var att beskriva sjuksköterskors erfarenheter av språkbarriärer vid mötet med patienter i hemsjukvården. Metod: Studien genomfördes med en kvalitativ induktiv ansats med åtta semistrukturerade intervjuer. Tre distriktssköterskor, en specialistsjuksköterska inom vård av äldre samt fyra sjuksköterskor deltog. Datainsamlingen analyserades utifrån en kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre huvudkategorier och tio underkategorier. Sjuksköterskorna använde sig ofta av olika strategier för kommunikation, genom kroppsspråket samt anhöriga och vårdpersonal som tolkar. Vidare upplevde sjuksköterskorna utmaningar i vårdarbetet vid språkbarriärer, där mer tid avsattes för patienterna. Även förutsättningar för god vårdrelation samt bedömning försvårades vid språkbarriärer. Sjuksköterskorna upplevde även skillnader i vårdmötet när ett gemensamt språk saknas, där kunskapen om olika kulturer upplevdes bristande. Språkbarriärer påverkade även sjuksköterskornas arbetsbelastning samt patienters förväntningar på hemsjukvården. Slutsats: Det krävs en fungerade kommunikation för att skapa en god vårdrelation. Att använda auktoriserad tolk är inte alltid optimalt inom hemsjukvårdens verksamhet då det krävs mer planering. Ofta tolkar anhöriga och kollegor istället. Det upplevdes ta mer tid att vårda patienter som inte talar svenska, önskemål fanns om att verksamheten anställer fler sjuksköterskor. Bristande kunskap om olika kulturer upplevdes, mer utbildning inom kulturella skillnader var önskvärt för att vårdrelationen med patienten kan förbättras. Förväntningarna på hemsjukvården upplevs höga från patienter som inte talar svenska, genom lättillgänglig skriftlig information på olika språk om hemsjukvårdens verksamhet kan rätt information nås ut till patienterna. / Background: In Sweden the number of residents with a foreign background has increased, and as a result it is becoming more common in the health care to care for patients who cannot speak the Swedish language. The exchange of information between the patient and the nurse is an fundamental part of the care. The work within home care can be challenging as more patients are cared for at home and nurses must be able to live up to the requirements that are set, for all patients to receive good care on equal terms. Linguistic barriers can be a challenge for nurses when meeting patients. When the communication does not work due to language barriers, the patient's care risks being affected negatively. Aim: The aim of the study was to describe nurses' experiences of language barriers when meeting patients in home care. Method: The study was conducted with a qualitative inductive approach with eight semi-structured interviews. Three district nurses, one specialist nurse in the care of the elderly and four nurses participated. The data collection was analyzed based on a qualitative content analysis. Results: The analysis resulted in three main categories and ten subcategories. The nurses often used different strategies for communication, through the body language, and relatives and nursing staff as interpreters. Furthermore, the nurses experienced challenges in the health care by language barriers, where increased time was spent for the patients. Prerequisites to establish a good care relationship and nursing assessment were more difficult due to language barriers. The nurses also experienced differences in health care meeting when a common language is missing, where the knowledge of cultural differences was felt to be lacking. Language barriers also affected the nurses' workload and patients' expectations of home care. Conclusion: A well-functioning communication is required to create a good care relationship. Using an authorized interpreter is not optimal within the home care, as more planning is required. Instead relatives and colleagues are used as interpreters. It was perceived to take more time to care for patients who do not speak Swedish, therefor there was a wish that more nurses should be hired. Lack of knowledge in cultures was experienced, more education in cultural differences was desirable to improve the care relationship. The expectations of home care were high from patients who dont speak Swedish, through easily accessible information about home care in different languages can the right information reached to the patients.

<p>Att framföra ett utryckningsfordon skiljer sig från att framföra en vanlig bil bland annat för de större friheter gällande trafikregler utryckningsförarna har. Dessa inkluderar både rätten att köra i högre hastigheter än annan trafik, men även möjligheten att kräva fri väg från andra trafikanter. Detta skapar en speciell interaktion mellan trafikanterna i trafiken där utryckningsfordonet kan ses som en lagligt olaglig agent. Avsaknaden på restriktioner gör dock körningen helt beroende på de enskilda utryckningsförarnas bedömning kring körbeteende. Trots det finns det inga nationella riktlinjer i Sverige fällande utbildning av utryckningsförare.</p><p>Den här studien undersökte normer och värderingar kring trafiksäkerhet hos operativ personal inom en ambulansorganisation. Semistrukturerade intervjuer genomfördes vilka var fokuserade på ett antal faktorer som förväntades kunna påverka trafiksäkerheten.</p><p>En tendens att se andra trafikanter som skyldiga för farliga situationer observerades, så väl som effekten olika uppdrag har på körningen, ett fenomen tidigare identifierat som ”red mist” (Dorn & Brown, 2003). Körningen ansågs vara ett känsligt ämne att kritisera och kollegors körstil sågs delvis bero på individuella skillnader. En påverkan på körningen av SOS Alarm påvisas samt att förarutbildningar nedprioriterats inom organisationen. En positiv attityd mot nationella riktlinjer som ett sätt att garantera förarutbildning observerades. Studien öppnar upp för ett flertal framtida studier vilka diskuteras.</p> / <p>Drivers of emergency vehicles (EV) are agents in the traffic system that by law are permitted to perform actions which are illegal for other road users. Not only can EV drivers legally drive above the speed limit, but they can also demand right of way by the use of warning lights and sirens. The lack of restrictions leaves the driving solely dependent on the judgment of each EV driver. Thus, the drivers should be well trained not just in driving skills but specifically in terms of risk assessment and self-assessment. However, there are no national guidelines in Sweden on training of EV drivers.</p><p>This study investigated the traffic safety norms among some ambulance drivers in Sweden. Semi-structured interviews were conducted focused on factors deemed important for traffic safety.</p><p>A tendency to attribute the reasons for risky situation to other drivers was found, as well as the presence of the condition dubbed “red mist” (Dorn & Brown, 2003). Driving was considered a sensitive matter in terms of critiquing and driving behaviour is partly attributed to individual differences. A positive attitude towards national guidelines was observed, as a way to ensure the sufficient EV driver training quality. A broader view of patient safety during pre-hospital health care is proposed to include EV transportation requirements.</p>

The purpose of this thesis was to investigate the implications and challenges of intercultural communication. An in-depth study was performed of the perspectives from people who work within an international organization. How they experience cultural differences and how they handle them, in particular when it comes to communication. Also, their perceptions of communicative competence were explored. The study was carried out at Svalorna India Bangladesh, at the Swedish office in Lund. Svalorna’s staff was interviewed on their experiences of intercultural communication. Both employees at the Swedish office and employees on location in India and Bangladesh were interviewed. The method used in the study was qualitative interviews where the interviewees could expand their answers fully as the interview developed. The main theory used was Geert Hofstede’s cultural dimensions, presented in the thesis and considered in the study. It was concluded that being aware of cultural differences and having knowledge of other cultures but also your own is important for understanding the so-called non-verbal communication in an intercultural situation. There are also differences in to what extent a certain culture uses non-verbal communication. Both India and Bangladesh, according to the interviewees, are high context cultures whereas Sweden has a low context culture. All the interviewees had similar experiences when it comes to intercultural communication. A cultural difference in the perception of time is an example of when verbal communication can be inadequate, if one is not aware of cultural differences. Both India and Bangladesh use polychronic time whereas in Sweden monochromic time is used. This is indeed confirmed by all interviewees. Many of Hofstede’s cultural dimension theories are found to be coherent with the results of this study, for example the Individualism.

I dagens samhälle har det framkommit att tekniken som utvecklas sällan eller aldrig har anpassats efter närståendevårdares behov och situation. För att kunna förändra närståendevårdarnas förutsättningar för användandet av teknologi och webbaserade tjänster är det viktigt att deras syn på teknologi och webbaserade tjänster kommer fram. Syftet med studien är att beskriva hur närståendevårdare ser på teknologi och webbaserade tjänster i vårdandet av en äldre närstående i hemmet med en diagnostiserad demenssjukdom. Lämplighetsurval med nio informanter som uppfyllde inklusionskriterierna genomfördes i samarbete med anhörigkonsulenter. En ostrukturerad intervjuguide användes som datainsamlingsinstrument. Databearbetningen genomfördes genom kvalitativ analys. Resultatet visar att det finns tre utmärkande områden som belyser närståendevårdares syn på teknologi och webbaserade tjänster i vårdandet av en äldre närstående i hemmet med en diagnostiserad demenssjukdom. Dessa områden är: att teknologi och webbaserade tjänster ska underlätta vårdandet, underlätta kommunikation samt hinder för användning av teknologi och webbaserade tjänster. Enligt informanterna är det viktigt att teknologi och webbaserade tjänster ska underlätta vårdandet genom att de ska vara lätta att använda, ge en trygghet samt vara anpassade efter närståendevårdares situation utifrån deras förslag på förbättringar. Det är också viktigt att teknologi och webbaserade tjänster underlättar kommunikation i vården av deras närstående. Informanterna anser att det är vikigt att kommunikationen med vårdpersonal/nätverk underlättas, att de får stöd och hjälp vid användandet av teknologi och webbaserade tjänster samt att kommunikationen underlättas genom ljud och bild kombinerat. Hinder för användning av teknologi och webbaserade tjänster beror enligt informanterna på avsaknad av behov, avsaknad av information samt att det är något för andra men inte för dem. Det är viktigt att dessa aspekter tas i beaktande för att teknologi och webbaserade tjänster ska anpassas utifrån målgruppen. / In today's society, it has emerged that the development of technology rarely or never accommodates to the significant others’ needs and situation. In order to change significant others’ requirements for the use of technology and web-based services, it is important that their views on technology and web-based services are attended to. The study aim was to describe significant others’ views on technology and web-based services in home care of an elderly next-of-kin with diagnosed dementia. Convenience sampling of nine informants, in relation to certain inclusion criteria, was conducted in collaboration with relative consultants. The method for data collection was qualitative interview by use of an unstructured guide. Data processing was carried out by qualitative analysis. The results show that there are three distinctive areas which highlight significant others’ views on technology and web-based services in home care of an elderly next-of-kin with diagnosed dementia. These areas are: that technology and web-based services will facilitating care, will facilitate communication, and barriers to use technology and web-based services. According to informants, it is important that technology and web-based services will facilitate the care of an elderly next-of-kin, that they are easy to use, providing the security and adapted significant others’ situation based on their suggestions. It is also important that technology and web-based services will facilitate communication in the care of their next-of-kin. The informants believes it is important to communicate with professionals/ network, that they get support and help in using technology and web-based services and communication facilitated by the sound and image combined. Barriers for using technology and web-based services depends according to informants on the absence of need, lack of information and that there is something for others but not for them. It is important that these aspects are taken into account so technology and web-based services will be adjusted based on the audience. / Teknikstöd för anhörigvårdare/närståendevårdare

<p>I dagens samhälle har det framkommit att tekniken som utvecklas sällan eller aldrig har anpassats efter närståendevårdares behov och situation. För att kunna förändra närståendevårdarnas förutsättningar för användandet av teknologi och webbaserade tjänster är det viktigt att deras syn på teknologi och webbaserade tjänster kommer fram. Syftet med studien är att beskriva hur närståendevårdare ser på teknologi och webbaserade tjänster i vårdandet av en äldre närstående i hemmet med en diagnostiserad demenssjukdom. Lämplighetsurval med nio informanter som uppfyllde inklusionskriterierna genomfördes i samarbete med anhörigkonsulenter. En ostrukturerad intervjuguide användes som datainsamlingsinstrument. Databearbetningen genomfördes genom kvalitativ analys. Resultatet visar att det finns tre utmärkande områden som belyser närståendevårdares syn på teknologi och webbaserade tjänster i vårdandet av en äldre närstående i hemmet med en diagnostiserad demenssjukdom. Dessa områden är: att teknologi och webbaserade tjänster ska underlätta vårdandet, underlätta kommunikation samt hinder för användning av teknologi och webbaserade tjänster. Enligt informanterna är det viktigt att teknologi och webbaserade tjänster ska underlätta vårdandet genom att de ska vara lätta att använda, ge en trygghet samt vara anpassade efter närståendevårdares situation utifrån deras förslag på förbättringar. Det är också viktigt att teknologi och webbaserade tjänster underlättar kommunikation i vården av deras närstående. Informanterna anser att det är vikigt att kommunikationen med vårdpersonal/nätverk underlättas, att de får stöd och hjälp vid användandet av teknologi och webbaserade tjänster samt att kommunikationen underlättas genom ljud och bild kombinerat. Hinder för användning av teknologi och webbaserade tjänster beror enligt informanterna på avsaknad av behov, avsaknad av information samt att det är något för andra men inte för dem. Det är viktigt att dessa aspekter tas i beaktande för att teknologi och webbaserade tjänster ska anpassas utifrån målgruppen.</p> / <p>In today's society, it has emerged that the development of technology rarely or never accommodates to the significant others’ needs and situation. In order to change significant others’ requirements for the use of technology and web-based services, it is important that their views on technology and web-based services are attended to. The study aim was to describe significant others’ views on technology and web-based services in home care of an elderly next-of-kin with diagnosed dementia. Convenience sampling of nine informants, in relation to certain inclusion criteria, was conducted in collaboration with relative consultants. The method for data collection was qualitative interview by use of an unstructured guide. Data processing was carried out by qualitative analysis. The results show that there are three distinctive areas which highlight significant others’ views on technology and web-based services in home care of an elderly next-of-kin with diagnosed dementia. These areas are: that technology and web-based services will facilitating care, will facilitate communication, and barriers to use technology and web-based services. According to informants, it is important that technology and web-based services will facilitate the care of an elderly next-of-kin, that they are easy to use, providing the security and adapted significant others’ situation based on their suggestions. It is also important that technology and web-based services will facilitate communication in the care of their next-of-kin. The informants believes it is important to communicate with professionals/ network, that they get support and help in using technology and web-based services and communication facilitated by the sound and image combined. Barriers for using technology and web-based services depends according to informants on the absence of need, lack of information and that there is something for others but not for them. It is important that these aspects are taken into account so technology and web-based services will be adjusted based on the audience.</p> / Teknikstöd för anhörigvårdare/närståendevårdare

Bakgrund: Lagen om psykiatrisk tvångsvård och Lagen om rättspsykiatrisk vård ger rätt att vårda patienter mot deras vilja. I psykiatrisk vård förekommer specifika omvårdnadsåtgärder som bältesläggning, tvångsmedicinering och avskiljning. Dessa väcker många känslor och kräver att sjuksköterskan arbetar med hänsyn och respekt. Relationen är en central del inom psykiatrisk omvårdnad och ska baseras på tillit och empati. Syfte: Att belysa sjuksköterskors uppfattning om tvångsåtgärders inverkan på omvårdnadsrelationen. Metod: Semi-strukturerade intervjuer med hjälp av en intervjuguide genomfördes med yrkesverksamma sjuksköterskor på en psykiatrisk klinik. Data bearbetades med en kvalitativ manifest innehållsanalys. Resultat: Studien resulterade i sex kategorier; professionellt förhållningssätt, vårdande samtal, tillitsfull relation, tvång som maktmedel, sjuksköterskans uppfattning av patientens känslor och sjuksköterskans känslor. Slutsats: Tvångsåtgärder väckte flera känslor hos sjuksköterskan. Med hjälp av ett professionellt förhållningssätt och vårdande samtal skapades en tillitsfull relation med patienten. Detta medförde att tvångsåtgärderna inte hade en negativ inverkan på omvårdnadsrelationen. / Background: The Compulsory Psychiatric Care Act and the Forensic Psychiatric Care Act gives the right to treat patients involuntarily. Specific nursing interventions in the form of restraint, coerced medication and seclusion occur in psychiatric care. These evoke a lot of emotions and require that the nurse work with consideration and respect. The nurse-patient relationship is an essential part within psychiatric nursing and should be based on trust and empathy. Aim: To illuminate nurses perception of coercive measures impact on the nurse-patient relationship. Method: Semi-structured interviews with the help of a topic guide were conducted with nurses on a psychiatric clinic. The data were processed through a qualitative manifest content analysis. Results: The study resulted in six categories; professional approach, caring dialogue, trusting relationship, coercion as an instrument of power, the nurse´s perception of patients emotions and the nurse´s emotions. Conclusion: Coercive measures raised several emotions within the nurse. With the use of a professional approach and a caring dialogue a trusting relationship was created with the patient. This meant that coercive measures didn't have a negative impact on the nurse-patient relationship.