Dagens mångkulturella samhälle avspeglas inom vården där vårdpersonal dagligen möter patienter från olika kulturer. Kommunikationssvårigheter relaterade till språkbrister kan uppkomma i mötet med patienter som inte förstår och talar svenska. I omvårdnadsarbetet ställs detta på sin spets, i synnerhet när det gäller vård vid livets slutskede. Denna studie syftade till att kartlägga och tolka vårdpersonalens upplevelser av möjligheter och svårigheter i omvårdnaden av denna patientgrupp. I studien har en kvalitativ metod med en hermeneutisk forskningsansats använts. Totalt åtta semistrukturerade djupintervjuer genomfördes med undersköterskor och sjuksköterskor som arbetade på en hospiceavdelning i södra Sverige. Studien resulterade i tio deltolkningar som sedan bildade tre nya deltolkningar på en högre nivå. Slutligen gjordes en huvudtolkning: att en individanpassad vård kan ses som en möjlighet för att överbygga svårigheter och problem som uppkommer i mötet med patientgruppen. Möjligheterna och svårigheterna för att åstadkomma en individanpassad vård återfanns i yttre faktorer, hos patienten och hos personalen. Culture Care teorin användes för att skapa en djupare förståelse för delar av studiens resultat. Vidare multidisciplinär forskning och utbildning krävs för att vården ska kunna leva upp till hälso- och sjukvårdslagens krav om vård på lika villkor. / Today’s multicultural society is reflected in healthcare as professionals encounter patients from different cultures on a daily basis. Communication problems related to language deficiencies consequently occur in interactions with these patients. This can lead to inadequate care delivery at the end stage of life. The aim of this study was to identify and interpret health care professionals’ experiences of opportunities and challenges in delivery of nursing care to this patient group. A qualitative method was used with a hermeneutic approach. Eight semi-structured in-depth interviews were conducted with healthcare professionals working at a hospice in Southern Sweden. The results identified ten sub-interpretations which were distilled into three over-arching interpretations which lead to the following singular conceptual interpretation: Individualized care is viewed as an opportunity to overcome problems that arise when meeting this group of patients. The possibilities and challenges to achieve individualized care came from a combination of external, patient and staff factors. Cultural Care Theory was applied to parts of the study results to achieve greater understanding of the subject. Furthermore, multi-disciplinary research and education is necessary to ensure that health care providers can live up to The Act of Health Care requirements for care delivery on equal terms.

Hierdie studie fokus op die taalontwikkeling en -verryking van senior kleuters in milieubenadeelde gemeenskappe. Die ondersoekgroep is 'n A:fiikaanssprekende Kleurling- en Griekwagemeenskap. Dit blyk dat die ouers in hierdie gemeenskap sekere leemtes openbaar ten aansien van bulle taalopvoedingsgedrag, wat resulteer in taalervaringsagterstande by die senior kleuters. Taalontwikkeling en -verryking is in wese "a socially mediated process" en blootstelling aan stimulerende taalervaringe bevorder begrip van taalgebruik binne die sosiale konteks. Die ontoereikende taalvoorbeeld binne die gesinne en gemeenskap resulteer in ontoereikende taalontwikkeling en -verwerwing en die senior kleuters openbaar bulle arme, ongedifferensieerde taalwereld in taaltekorte ten opsigte van taalbebeer, taalstyl en taalkode. Die senior kleuters se konsepvorming is gebrekkig en in bulle taalaanwending is bulle eerder beskrywend en konkreet-gebonde as analities en abstrak. Dit blyk dat die ouers nie bulle senior kleuters kognitief toereikend stimuleer nie, en dat uitbreiding van taalkode nie toereikend gefasilieer word nie, omdat die ouers onkundig is omtrent die benutting van toevallige leersituasies, en nie potensiele leergeleenthede skep of ontgin nie. Kognitiewe stimulasie verwys na die vaslegging van sekere konsepte en uitbreiding van taalkode verwys na die vaardigheid om juis daardie konsepte te kan omskryf, verklaar of mee te deel. 'n Uitgebreide taalkode is dus die resultaat van gereelde blootstelling aan 'n wye verskeidenheid stimulerende ervaringe. Hierdie ervaringsraamwerk word later die kleuter se venrysingsraamwerk wat by gebruik om inligting te berhaal, versoeke te formuleer, voorwerpe te benoem en gebeure akkuraat te beskryf 'n Uitgebreide taalkode is dus noodsaaklik vir latere suksesvolle leer, omdat dit die leerder in staat stel om nuwe inligting te analiseer, te sinteseer en te globaliseer. Die implikasie vir die antwerp van 'n ouerprogram is dat die ouers nie net begelei moet word ten aansien van die taalverryking van die senior kleuters nie, maar ook eksplisiet daartoe begelei te word om potensieel-stimulerende leersituasies te skep. / This study focuses on the language development and -enrichment of senior toddlers in environmentally deprived communities. The research group is an Afrikaans speaking Colouredand Griqua community. It is evident that parents in this community reveal certain deficiencies pertaining to their language-teaching behaviour, resulting in linguistic experiential backlogs in their senior toddlers. Language development and -enrichment is in essence a socially mediated process and exposure to stimulating language experiences enhances comprehension of colloquial usage within the social context. The inadequate linguistic example set by both the family and the community results in inadequate language development and -enrichment and the senior toddlers reveal their impoverished, undifferentiated world of language in deficiencies pertaining to mastery of language, style of language and code of language. The senior toddlers' conceptualization is deficient and in their language usage they are rather descriptive and concrete-bound than analytic and abstract. It is evident that the parents do not adequately stimulate their senior toddlers' cognitive abilities, and a code of language is not adequately facilitated, because the parents do not know how to derive profit from incidental learning situations and are ignorant pertaining to the creation and utilization of potential learning opportunities. Stimulation of cognition refers to the mastery and fixation.. of certain concepts, while broadening of a code of language refers to the. ability to describe, to explain, to interpret or to communicate the meaning of these concepts. A broadened and expanded code of language is thus the result of regular exposure to a wide range of stimulating experiences. This experiential framework later becomes the toddler's referential framework which he uses to repeat information, to formulate requests, to name objects and to accurately describe events. A broadened and expanded code of language is thus essential for later successful learning, because it enables the learner to analyze, to synthesize and to globalize new information. The implication for the draft of a parental programme is that parents should not .only be accompanied pertaining to the enrichment of their senior toddlers' language development, but that parents in this deprived environment also explicitly be educated to create potential stimulating learning situations at home. / Psychology of Education / D. Ed. (Sielkudige Opvoedkunde)

Hierdie studie fokus op die taalontwikkeling en -verryking van senior kleuters in milieubenadeelde gemeenskappe. Die ondersoekgroep is 'n A:fiikaanssprekende Kleurling- en Griekwagemeenskap. Dit blyk dat die ouers in hierdie gemeenskap sekere leemtes openbaar ten aansien van bulle taalopvoedingsgedrag, wat resulteer in taalervaringsagterstande by die senior kleuters. Taalontwikkeling en -verryking is in wese "a socially mediated process" en blootstelling aan stimulerende taalervaringe bevorder begrip van taalgebruik binne die sosiale konteks. Die ontoereikende taalvoorbeeld binne die gesinne en gemeenskap resulteer in ontoereikende taalontwikkeling en -verwerwing en die senior kleuters openbaar bulle arme, ongedifferensieerde taalwereld in taaltekorte ten opsigte van taalbebeer, taalstyl en taalkode. Die senior kleuters se konsepvorming is gebrekkig en in bulle taalaanwending is bulle eerder beskrywend en konkreet-gebonde as analities en abstrak. Dit blyk dat die ouers nie bulle senior kleuters kognitief toereikend stimuleer nie, en dat uitbreiding van taalkode nie toereikend gefasilieer word nie, omdat die ouers onkundig is omtrent die benutting van toevallige leersituasies, en nie potensiele leergeleenthede skep of ontgin nie. Kognitiewe stimulasie verwys na die vaslegging van sekere konsepte en uitbreiding van taalkode verwys na die vaardigheid om juis daardie konsepte te kan omskryf, verklaar of mee te deel. 'n Uitgebreide taalkode is dus die resultaat van gereelde blootstelling aan 'n wye verskeidenheid stimulerende ervaringe. Hierdie ervaringsraamwerk word later die kleuter se venrysingsraamwerk wat by gebruik om inligting te berhaal, versoeke te formuleer, voorwerpe te benoem en gebeure akkuraat te beskryf 'n Uitgebreide taalkode is dus noodsaaklik vir latere suksesvolle leer, omdat dit die leerder in staat stel om nuwe inligting te analiseer, te sinteseer en te globaliseer. Die implikasie vir die antwerp van 'n ouerprogram is dat die ouers nie net begelei moet word ten aansien van die taalverryking van die senior kleuters nie, maar ook eksplisiet daartoe begelei te word om potensieel-stimulerende leersituasies te skep. / This study focuses on the language development and -enrichment of senior toddlers in environmentally deprived communities. The research group is an Afrikaans speaking Colouredand Griqua community. It is evident that parents in this community reveal certain deficiencies pertaining to their language-teaching behaviour, resulting in linguistic experiential backlogs in their senior toddlers. Language development and -enrichment is in essence a socially mediated process and exposure to stimulating language experiences enhances comprehension of colloquial usage within the social context. The inadequate linguistic example set by both the family and the community results in inadequate language development and -enrichment and the senior toddlers reveal their impoverished, undifferentiated world of language in deficiencies pertaining to mastery of language, style of language and code of language. The senior toddlers' conceptualization is deficient and in their language usage they are rather descriptive and concrete-bound than analytic and abstract. It is evident that the parents do not adequately stimulate their senior toddlers' cognitive abilities, and a code of language is not adequately facilitated, because the parents do not know how to derive profit from incidental learning situations and are ignorant pertaining to the creation and utilization of potential learning opportunities. Stimulation of cognition refers to the mastery and fixation.. of certain concepts, while broadening of a code of language refers to the. ability to describe, to explain, to interpret or to communicate the meaning of these concepts. A broadened and expanded code of language is thus the result of regular exposure to a wide range of stimulating experiences. This experiential framework later becomes the toddler's referential framework which he uses to repeat information, to formulate requests, to name objects and to accurately describe events. A broadened and expanded code of language is thus essential for later successful learning, because it enables the learner to analyze, to synthesize and to globalize new information. The implication for the draft of a parental programme is that parents should not .only be accompanied pertaining to the enrichment of their senior toddlers' language development, but that parents in this deprived environment also explicitly be educated to create potential stimulating learning situations at home. / Psychology of Education / D. Ed. (Sielkudige Opvoedkunde)