Background: the aims of this study were to assess the outpatients needs among 155 patients at Al-Amal Complex for Mental Health in Riyadh, Saudi Arabia, and identifying the demographic variables that are associated with these needs. Method: the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) was used to assess the needs and the demographic questionnaire was used to identify the patient’s demographic variables includes gender, age, income and level of education. Results: patient who meets any one of these criteria; being elderly, poor, and the uneducated are more likely to have higher total number of needs. Men and women are more likely to report similar met needs, but women are more likely expressed more unmet needs.

Introdução: Durante a infância, os relacionamentos que as crianças estabelecem entre si são fundamentais para o desenvolvimento de autorregulação, para a construção de interações saudáveis com os outros e para a promoção de aprendizagens diversas. A literatura tem apontado preocupação com as consequências das dificuldades duradouras e crescentes nas relações entre crianças. O presente estudo que se apresenta como uma avalição das necessidades no ciclo de pesquisa em prevenção teve como objetivo geral realizar uma avaliação funcional sobre os comportamentos de pré-escolares expressos nas interações com seus pares e seus professores. Método: Estudo avaliativo misto. Setenta e sete crianças com idades entre quatro e cinco anos de idade participaram da pesquisa, sendo correspondente a quatro turmas de uma escola municipal de educação infantil, localizada no sudeste do estado de São Paulo. Para verificar o status social dos participantes, foi realizada a entrevista sociométrica por nomeação, individualmente, na qual foi solicitada a indicação de três colegas de turma que a criança entrevistada escolheria para brincar (nomeações positivas) e outras três que não escolheria para brincar (nomeações negativas). Para cada nomeação, foram solicitados os motivos para tal escolha. As crianças com maiores pontuações padronizadas em cada categoria foram selecionadas para observação; os comportamentos declarados como motivos para as nomeações positivas e negativas sendo observados. Resultados: A maioria dos participantes do estudo foi classificada como mediana (43%), seguida por rejeitada (15%) e popular (14%), sendo que controversa teve o menor índice (5%). A categoria negligenciada foi nula e 21% das crianças não foi categorizada. A justificativa mais citada para as nomeações positivas foi a parceria, já para as nomeações negativas foi a agressão. As hipóteses funcionais levantadas para os comportamentos positivos, de maneira geral, é que esses eram reforçados positivamente a partir da aproximação e da interação com os pares, além da atenção (em forma de elogios) obtida pela professora. Em relação aos comportamentos negativos, de maneira geral, é que esses eram reforçados positivamente pela atenção obtida pela professora e/ou pares e reforçados negativamente com a retirada e/ou diminuição da situação aversiva (por exemplo: bronca da professora). Conclusão: As avaliações funcionais dos comportamentos entre pré-escolares podem contribuir no delineamento de futuras intervenções promotoras de relacionamentos interpessoais positivos na educação infantil / Introduction: During childhood, the relationships that children establish among themselves are fundamental for the development of self-regulation, building healthy interactions with others and promoting diverse learning. The literature has been concerned with the consequences of enduring and growing difficulties in the relations between children. This study, which presents itself as an assessment of needs in the prevention research cycle, aimed to formulate functional hypotheses about the behaviors of preschoolers expressed in interactions with their peers and teachers. Method: Mixed evaluation study. A total of 77 children aged four to five years of age, was enrolled in the study, corresponding to four classes of a public school of the early childhood education, located in the southeast of the state of São Paulo. In order to verify the social status of the participants, a sociometric interview was conducted by appointment, individually, in which it was requested to nominate three classmates he would like to play with (positive appointments) and three others he would not choose play (negative nominations). For each appointment, the reasons for such nomination were requested. The children with the highest standardized scores in each category were selected for observation. The behaviors declared as reasons for positive and negative nominations being observed. Results: Most of the participants in the study were classified as median (43%), followed by rejected (15%) and popular (14%), being that controversial (5%) had the smallest index. The neglected category was null and 21% of the children were not categorized. The most cited justification for positive nominations was partnership, and for negative nominations was aggression. The functional hypotheses raised for positive behaviors, in general, is that they were reinforced positively from the approach and interaction with the peers, in addition to the attention (in the form of compliments) obtained from the teacher. Regarding negative behaviors, in general, is that they were reinforced positively by the attention obtained from the teacher and / or peers and reinforced negatively with the withdrawal and / or decrease of the aversive situation (for example, to be told off by the teacher). Conclusion: Functional evaluations of behaviors among preschoolers may contribute to the design of future interventions promoting positive interpersonal relationships in early childhood education

Diante da alta prevalência da violência escolar, mostra-se necessário o desenvolvimento de ações voltadas a prevenir esse problema e a criar contextos escolares que sejam mais efetivos em promover comportamentos pró-sociais, desde a primeira infância. Para isso, faz-se importante a realização de estudos de avaliação de necessidades. Esses se situam no ciclo de pesquisa em prevenção, na etapa de estudos de desenvolvimento de intervenções, tendo como um de seus propósitos identificar dificuldades e recursos, com vistas ao delineamento futuro de uma estratégia. Com base no exposto, o presente estudo teve como objetivo realizar uma avaliação de necessidades relacionada à promoção de comportamentos pró-sociais em pré-escolares, com vistas à prevenção à violência na escola. Trata-se de um estudo avaliativo de métodos mistos, que abrangeu uma amostra de quatro professoras e 67 crianças de uma escola pública de educação infantil, localizada em uma cidade do sudeste paulista. Para a coleta de dados foram utilizados formulário de registro de observação das práticas potencialmente promotoras de comportamentos pró-sociais, das professoras, nas interações com as crianças, formulário de registro de observação da ocorrência de comportamentos pró-sociais nas interações entre crianças, inventário destinado a acessar habilidades sociais educativas do professor (IHSE-Prof), formulários de extração de dados dos planos semanais e planejamento bimestral dos professores, roteiro de entrevista semiestruturada e roteiro para discussão do grupo focal. Foi realizado um estudo piloto com uma professora e sua turma, de outro período da escola, para refinar os procedimentos propostos. Os dados provenientes de cada fonte passaram por tratamentos específicos e foram submetidos a análises descritivas. Foram detectados recursos e dificuldades para a promoção de comportamentos pró-sociais e prevenção à violência na escola participante. Os recursos incluem a existência de práticas potencialmente promotoras de comportamentos pró-sociais, nos repertórios das professoras, sendo alguns mais variados e outros menos, a presença dos referidos comportamentos nos repertórios das crianças, a compreensão abrangente sobre a missão da Educação Infantil pela maioria das professoras e o posicionamento favorável ao desenvolvimento de uma intervenção futura na instituição de ensino. As dificuldades incluem lacunas na formação do professor, prejuízo na disponibilidade de suportes à prática, repertório de habilidades sociais educativas a ser desenvolvido, entendimento menos amplo sobre os atributos do professor da Educação Infantil, inconstância na elaboração do planejamento, pequena quantidade de conteúdos planejados relacionados à promoção de comportamento pró-social e habilidades sociais, e percepção de que a violência que se expressa na escola decorre apenas de eventos externos à instituição. Assim, os achados do presente estudo oferecem elementos para a discussão sobre o processo de escolarização na Educação Infantil junto à escola participante e ao município, com implicações para o redirecionamento de ações voltadas para o ensino, bem como fornece subsídios para a tomada de decisão acerca de ações destinadas à promoção de comportamentos pró-sociais e prevenção à violência na escola / Given the high prevalence of school violence, it is necessary to develop actions aimed at preventing the problem and creating school contexts more effective in promoting prosocial behaviors from an early age. For this, it is important to carry out needs assessment studies. These are located in the prevention research cycle, at the stage of interventions development studies, having as one of its purposes the identification of difficulties and resources, in order to design a future strategy. Considering the above, the aim of this study was to conduct a needs assessment related to prosocial behavior promotion in preschool children, in order to prevent school violence. This is a mixed methods evaluative study, that included a sample of four teachers and 67 children from a public preschool, located in a city in southeastern São Paulo. To collect data, there were used an observation form to register teachers practices related to prosocial behavior promotion, an observation form to register occurrence of prosocial behaviors among children, an inventory aimed at access teachers educational social skills (IHSE-Prof), data extraction forms of weekly plans and bimonthly teacher planning, a semi-structured interview guide and a discussion focus group guide. A pilot study was conducted with a teacher and her class from another period of the school in order to refine proposed procedures. Data from each source underwent specific treatments and were submitted to descriptive analyzes. Resources and difficulties were detected for prosocial behavior promotion and violence prevention in the participating school. Resources include the existence, in teachers repertoire, of practices that potentially promote prosocial behavior, some of them being more varied and others less, the presence of prosocial behaviors in children repertoires, a comprehensive understanding of preschool education mission, by most of the teachers, and teachers favorable opinion in what concerns to the development of a future intervention in the school. Difficulties include teacher training gaps, lack of support for practice, repertoire of educational social skills to be developed, less understanding about the attributes of the preschool teacher, inconstantly planning and few planned content related to the promotion of prosocial behavior and social skills, and the perception that violence expressed in school only results from events occurred outside the institution. Thus, findings from the present study offer elements for the discussion about the process of schooling in the participating preschool and in the city where the institution is located, as well as have implications for the redirection of actions related to teaching, and provide subsidies for decision making of actions aimed at promoting prosocial behavior and preventing violence in schools

O panorama de desassistência no âmbito da saúde da pessoa com deficiência se mantém, mesmo com alguns avanços trazidos pelo SUS. O conceito de necessidade de saúde como norteador das práticas pode possibilitar a abertura de novos espaços de reflexão e ação para esta população, sendo fundamental a inclusão das próprias pessoas nesta discussão. O objetivo do trabalho aqui descrito é identificar quais são as demandas e necessidades de saúde das pessoas com deficiência, a partir da ótica destes sujeitos. Foi realizado um estudo de metodologia qualitativa, sendo a história de vida a técnica de produção dos dados adotada; foram incluídos na pesquisa pessoas com deficiência física, auditiva e visual, com deficiência congênita e adquirida, e com histórico de atendimento no SUS. Foram realizadas entrevistas em profundidade, baseadas em um roteiro prévio, sendo gravadas e posteriormente transcritas; também foi feito um diário de campo. A análise do material foi feita em três níveis: palavras-chave, temas emergentes e tendências gerais. Produziu-se um texto analítico com os temas emergentes das narrativas, bem como um quadro sintético, elencando os núcleos temáticos sobre necessidades de pessoas com deficiência. Das narrativas, cinco temas principais estiveram presentes: a vivência da deficiência; independência, autonomia e apoio; acesso e direitos; sentidos das intervenções; ações e estratégias. Em relação às necessidades e a atenção em saúde, onze eixos temáticos foram elencados: Acesso; Apoio psicossocial; Aspectos gerais de saúde (para além da deficiência); Autonomia e independência; Dispensação de equipamentos e dispositivos de tecnologia assistiva; Informação / orientação; Prevenção / diagnóstico precoces; Reconhecimento e garantia de direitos; (Re)Encontro com atividades significativas; Validação e ajuda na construção de estratégias próprias de enfrentamento; Vínculo com profissional de saúde. Pôde-se concluir que as necessidades identificadas pelas pessoas com deficiência incluem aspectos específicos da assistência em saúde, mas englobam outras dimensões como o acesso, os direitos, o trabalho, o lazer, indicando a importância de ações integrais e intersetoriais. Ressalta-se também as singularidades que a vivência da deficiência impõe a cada sujeito, bem como os sentidos que cada um encontra em sua história de vida / The lack of assistance panorama in the health of the disabled person still exists, despite some advances brought by SUS. The concept of health needs as a guide for the practices may allow new spaces for reflection and action for this population, and the inclusion of disabled people in this discussion is of extreme importance. The aim of the work described here is to identify demands and health needs of people with disabilities, by the subjects´ perspective. The study was conducted by the use of a qualitative methodology, through the life history method; and people with physical, hearing and visual disabilities, congenital or acquired, with history of assistance by SUS were included. Interviews were conducted based on a previous script, being recorded and later transcribed; and also a field diary was made. The data analysis was done on three levels as follows: keywords, emerging issues and trends. An analytical text with the emerging themes of the narratives, and a summary table have been produced listing the central themes on the people with disabilities needs. Using narratives, five major themes emerged: the experience of disability; independence, autonomy and support; access and rights; meaning of the interventions; actions and strategies. Eleven themes were listed when considering needs and health care: access; psychosocial support; general health issues; autonomy and independence; dispensing of equipment and assistive technology devices; information/guidance; prevention/early diagnosis; recognition and guarantee of rights; recovery of meaningful activities; validation and help in building their own strategies for coping; bonding with health professional. It was concluded that the needs identified by people with disabilities include specific aspects of health care, but also include other dimensions such as access, rights, work, leisure indicating the importance of integrated and intersectoral actions. Singularities that the experience of disability brings to each person are also emphasized, as well as the meanings that each one finds in its life history

Desde que foram criados, o Sistema Ãnico de SaÃde (1988) e a EstratÃgia de SaÃde da FamÃlia (1994) jà provocaram profundas mudanÃas nas prÃticas de SaÃde. A ESF impÃs novas responsabilidades de gestÃo e demanda por profissionais qualificados e comprometidos. Vivenciamos o dilema de superar a etapa da expansÃo quantitativa do acesso a ESF e passar para a consolidaÃÃo da qualidade nas aÃÃes e sua respectiva integraÃÃo com o resto da rede assistencial do SUS.TÃm se destacado na literatura e comprovadas por esse estudo reflexÃes sobre o descompasso entre a graduaÃÃo em SaÃde e a demanda do SUS por profissionais generalistas competentes para atuarem na AtenÃÃo BÃsica à SaÃde.O foco da anÃlise realizada nessa dissertaÃÃo volta-se para a anÃlise das necessidades educacionais percebidas pelos profissionais que atuam nas equipes de SaÃde da FamÃlia. Esse estudo se justifica pela relevÃncia em identificar as necessidades de EducaÃÃo em SaÃde percebidas pelos profissionais. Visa gerar informaÃÃes Ãteis para auxiliar o processo de planejamento, tomada de decisÃo e avaliaÃÃo da formaÃÃo desses profissionais.Trata-se de um estudo de abordagem predominantemente qualitativa sobre os discursos prÃticos de profissionais de SaÃde, a partir de Grupos Focais e entrevistas individuais, com o escopo de anÃlise baseado no mÃtodo de AnÃlise de ConteÃdo, do tipo Categorial e TemÃtico (Bardin, 1979).A populaÃÃo selecionada para o estudo foi composta por profissionais de nÃvel superior concursados com atuaÃÃo no PSF no municÃpio de Fortaleza/CE.Identifiquei que as diferentes maneiras dos profissionais se expressarem refletem que as necessidades percebidas sÃo as relaÃÃes entre desejos, interesses, necessidades sociais e cognitivas percebidas ou impostas a esses sujeitos. As experiÃncias de vida, a formaÃÃo como indivÃduo e profissional geram um constante movimento de aÃÃo, reflexÃo, aÃÃo, indispensÃvel para as escolhas profissionais, âEducaÃÃo Permanenteâ, relaÃÃes com o outro, visÃo de mundo e do processo SaÃde-doenÃa. Os resultados da anÃlise expressaram a necessidade das competÃncias construÃdas na prÃtica e atravÃs de processos formais de educaÃÃo fazerem sentido (aprendizagem significativa) para a atuaÃÃo na ESF. Os profissionais demonstraram na maioria das vezes possuirem conhecimentos sobre conteÃdos temÃticos definidos normativamente, porÃm, manifestaram dificuldades relacionadas Ãs atitudes e habilidades, identificando a necessidade da âEducaÃÃo permanenteâ. Enfim, tecnologias devem ser desenvolvidas para dar concretude à EducaÃÃo em SaÃde. Tecnologias essas que devem ser embasadas pelas necessidades percebidas pelos profissionais, gestores e usuÃrios do SUS. / Since the creation of the Brazilian Public Health Care System (SUS) and the Family Health Strategy (ESF), many profound changes have taken place in Health practices. The ESF imposed new management responsibilities and a demand for more qualified and committed professionals. Thus is the dilemma of overcoming the quantitative expansion phase of ESF and now the consolidation of the quality of action taken and its respective integration with the rest of the SUS health care network. The literature has underscored, and this study has proven, that there exists a true lack of alignment between Health graduation programs and SUS need for general practitioners competent enough to work within the Primary Health Care context. The focus of analysis of this paper is based on an educational needs assessment perceived by the professionals who work within the Family Health teams. A study which is primarily a qualitative approach stemming from statements gathered from Health Care professionals, from Focus Groups and individual interviews, with a scope of analysis based on the method of Content Analysis, Categorical and Thematic (Bardin, 1979). The population selected for the study is comprised of higher education civil servants who work in the PSF of the municipality of Fortaleza, State of CearÃ. Many different means of expression were identified from the professionals heard in the study, which reflect the needs perceived in terms of desires, interests, social and cognitive needs perceived or imposed on these health care professionals. The life experience, training of the individual and professional, generate a constant movement of both action and reflection, which are indispensable in terms of the professional choices which are made, âLife Long Learningâ, how they relate to others, world vision and the Health-disease process. The results of the analysis express the need for competencies which are constructed during practice instead of through formal educational processes (meaningful learning) in order to work in the ESF context. The professionals have shown that, for the most part, they have knowledge about thematic content which is normatively defined, however, they manifest difficulties related to attitudes and skills, thereby identifying the need for âLife Long Learningâ. Therefore, Technologies need to be developed in order to support Health Education. This technology should be based on the needs perceived by the professionals, managers and users of SUS.

Prior to the development of programing and outreach materials it is important for Extension outreach and education professionals to assess the educational needs and preference of the communities they serve. Survey data was gathered from residents of Cedar City, UT, in an effort to gain an understanding of current lawn management practices and the resources homeowners utilize when making management decisions. In addition, soil samples were collected from a subset of participants to compare nutrient levels to management practices. Survey results found that homeowners accessed multiple sources, with preferences leaning towards the use of friends and family members, the internet, and the point of purchase. Few homeowners are aware of and utilize educational resources and services provided by Extension. This is especially true for those under the age of 50, which poses a challenge to Extension professionals to find effective ways to reach younger generations. It was difficult to form associations between nutrient levels and management practices Although, there was a strong association between those with excessive phosphorus concentration and the application of biosolids. More research needs to be done to examine the distribution and end use of biosolids.

BACKGROUND Increasingly, it is recognised that the unique needs of people from culturally and linguistically diverse backgrounds (CaLDB) should be addressed within a framework of cultural competence. To date, there are limited data on the issues facing CaLDB patients in the Cardiac Rehabilitation (CR) setting. Appreciation of an individual???s values, attitudes and beliefs underpins negotiation of behaviour change in the CR setting. Therefore an understanding of patient and professional interactions is of key importance. OBJECTIVES The focus of this study has been to undertake an exploration of CR service delivery to people from culturally and linguistically diverse backgrounds, using Arabic speaking people as an exemplar of a CaLDB group. More broadly, this research project has sought to identify factors, which influence the practice of health professionals towards CaLDB patients, and to develop a model for evaluation of culturally competent health care in the CR setting. The study sought to achieve these aims by addressing the following research questions: 1. In what way do health practitioners in CR adjust their treatment and support to accommodate the perceived needs of CaLDB communities? 2. In what way do factors (such as individual and organisation perspectives) influence the adjustment of clinical practice and service delivery of CR practitioners; and what are practitioners??? and patients??? perception of barriers and facilitators to service delivery? 3. To what level are CaLDB patients satisfied with CR services? This study design is comprised of the following elements: (1) interviews with health practitioners and Arabic speaking background patients as an exemplar of CaLDB patients; (2) review of policy and procedure documents and medical records; and (3) field observation. METHOD This thesis embraces a qualitative approach as the primary method of investigation to align with the exploratory and descriptive nature of the study. The main methods used in the study were: in depth interviews with health professionals and patients; field observations; appraisal of relevant documents and consultation with expert panels. Study samples were selected through a purposive sampling strategy.Data were analysed using the method of content analysis, guided by the research questions. FINDINGS In total, 25 health professionals (20 female and 5 male) and 32 patients (21 male and 11 female) were interviewed. The method of qualitative content analysis was used for data analysis. Data analysis revealed four major themes: 1) The challenging context; 2) Tuning practices; 3) Influencing factors; and 4) Goodness of fit. The study demonstrated a challenging context for CR delivery, both from the perspective of patients and health professionals. Data reveal a process of reflection, negotiation, and navigation of care by CR health professionals in an effort to understand and meet the diverse needs of CALDB patients. CONCLUSION On the basis of the study findings, a process-oriented model of tuning practice to achieve cultural competence in CR delivery is proposed to inform policy, research and clinical practice.

<p>The overall aim of this thesis was to describe (1) needs for occupational therapy among persons with self-perceived activity limitations and/or participation restrictions due to long-term/recurrent pain, and (2) treatment interventions in occupational therapy to meet demonstrated needs. The Liss’ model for assessing health care needs was used as a structural scheme. A randomly selected sample (n=10,000) from the Swedish general population aged 18-58 years was the foundation for the study population with and without pain. In addition, occupational therapists were included (n=109). Data collection was made by postal questionnaires. The results showed a prevalence of 26 % and an incidence rate of 0.07. Demographic characteristics of the sample were female gender, ages 40-58 years and fewer years of education than those without pain. Pain in shoulders/lower back of searing/aching/gnawing character was the most frequently reported. A majority of the respondents reported affective/emo-tional effects of pain mainly of depressive character and they had previously been on sick leave due to pain. Women reported higher frequencies of self-perceived activity limitations/ participation restrictions due to pain, more difficulties with intermediate ADL, perceived higher job demands and had longer sick leave than men. Men perceived poorer social support than did women. Needs for occupational therapy were reported mainly as a consequence of activity and temporal imbalance. High health care consumers reported higher frequencies of needs/problems than did low health care consumers. The main goals and interventions suggested by occupational therapists to meet the needs in pain management focused on increased knowledge of handling daily occupations with the purpose to reduce pain, maintain competence/improve performance of home maintenance, reduce consequences of pain and increase knowledge how to handle effects of pain.</p>

<p>The aim of this thesis was to critically examine the current use of the Camberwell Assessment of Need (CAN) in outcome assessment for service evaluation. A further aim was to propose a metric for assessing the adequacy of community mental health services in meeting ongoing needs over longer stretches of time.</p><p>We made four prospective follow-up studies of CAN assessments of patients with severe mental illness in community-based mental health care.</p><p>A factor analysis (n=741) gave support for a three-factor model, comprising only 60% of the CAN items. Need assessments (n= 92) in 1997 and 2003 were compared at both the summed total and the underlying item levels of the CAN. The mean total scores did not change, yet there were significant changes in the underlying items. Changes in mean number of needs between 1997 and 1999 were measured (n=262) with both total scores, summed over all CAN items, and with sub-total scores, summed over two sets of items reflecting the social services and the psychiatric services respectively. As indicated by the sub-total scores, all significant changes occurred within the psychiatric services, a result not possible to discern from the total scores. The Met Needs Index (MNI), defined by us as the aggregate measure of beneficial outcome, indicated that needs in general were met during 71% of the intervals between the annuals assessments from 1997 through 2004. However, the variation among particular items was large.</p><p>In conclusion, the summary scores typically used as outcome measures are likely to conceal meaningful variation at the item level. Nevertheless, sub-total scores, being more transparent, might be more useful in outcome assessment. The MNI is a continuous, normally distributed metric, estimable over any number of consecutive assessments, which seems suitable for assessing the achieved benefit of services for patients with long-term ongoing needs.</p>

The overall aim of this thesis was to describe (1) needs for occupational therapy among persons with self-perceived activity limitations and/or participation restrictions due to long-term/recurrent pain, and (2) treatment interventions in occupational therapy to meet demonstrated needs. The Liss’ model for assessing health care needs was used as a structural scheme. A randomly selected sample (n=10,000) from the Swedish general population aged 18-58 years was the foundation for the study population with and without pain. In addition, occupational therapists were included (n=109). Data collection was made by postal questionnaires. The results showed a prevalence of 26 % and an incidence rate of 0.07. Demographic characteristics of the sample were female gender, ages 40-58 years and fewer years of education than those without pain. Pain in shoulders/lower back of searing/aching/gnawing character was the most frequently reported. A majority of the respondents reported affective/emo-tional effects of pain mainly of depressive character and they had previously been on sick leave due to pain. Women reported higher frequencies of self-perceived activity limitations/ participation restrictions due to pain, more difficulties with intermediate ADL, perceived higher job demands and had longer sick leave than men. Men perceived poorer social support than did women. Needs for occupational therapy were reported mainly as a consequence of activity and temporal imbalance. High health care consumers reported higher frequencies of needs/problems than did low health care consumers. The main goals and interventions suggested by occupational therapists to meet the needs in pain management focused on increased knowledge of handling daily occupations with the purpose to reduce pain, maintain competence/improve performance of home maintenance, reduce consequences of pain and increase knowledge how to handle effects of pain.