<p>Arbetet som ambulanspersonal är påfrestande, såväl fysiskt som psykiskt.</p><p>Att vara fysiskt vältränad är säkerligen en fördel, men kan man vara</p><p>vältränad även på det psykiska planet? Många studier har gjorts om</p><p>ambulanspersonalens copingstrategier, men få har gjorts i Sverige. Studier</p><p>gjorda utomlands har visat att några av de vanligaste copingstrategierna hos</p><p>ambulanspersonal är socialt stöd, emotionell- och kognitivcoping. Denna</p><p>studie har gjorts för att belysa relationen mellan socialt stöd och coping</p><p>angående arbetsmiljöstressorer hos ambulanspersonal i Mellansverige.</p><p>Författaren genomförde studien genom intervjuer av fyra kamratstödjare</p><p>inom ambulansen. Resultatet visade att socialt stöd har en stor betydelse för</p><p>ambulanspersonalen för att lägga upp copingstrategier i hanteringen av</p><p>arbetsmiljöstressorer. Studien visar samma tendens hos ambulanspersonal</p><p>utomlands.</p>

<p>Att drabbas av KOL är något som påverkar vardagen på många sätt. Sjukdomen har ökat i omfattning och visar inga tecken på att minska. Det innebär att vårdpersonal alltmer kommer att möta dessa personer. Behandlingen är oftast inriktad mot de fysiska behoven utan att ta hänsyn till helheten. Syftet var att belysa dessa personers upplevelser av att leva med KOL för att kunna möta deras behov och ge det stöd de själva vill ha. Litteraturstudie valdes som metod och systematiska sökningar gjordes i databaserna Cinahl, Pubmed och PsycINFO. Resultatet bygger på 14 artiklar och visade att andningsproblemen var den dominerade upplevelsen som påverkade vardagen negativt. Andningsproblemen gjorde att personerna med KOL upplevde att de tappade orken, upplevde beroende, men även så småningom en acceptans över att leva med den kroniska sjukdomen. Det visade sig hur dessa upplevelser påverkade varandra och kunde bli som en ond cirkel. Det är därför viktigt att i fortsatt forskning undersöka hur vårdpersonalen kan stödja dessa personers egenvårdsstrategier där peer-support är en viktig del.</p>

During adolescence, peer relationships become increasingly important in various aspects of development, such as self-esteem and emotional adjustment. Unfortunately, a number of adolescents experience peer victimization, placing them at increased risk of emotional and behavioral problems. Research has consistently demonstrated the link between peer victimization and poor outcomes. However, exploration of the mechanisms underlying this link, including potential buffers of negative outcomes, is needed. The current study examined social support as a moderator of the relationship between peer victimization and maladjustment in order to assess whether social support from adults and peers protects adolescents from developing emotional and/or behavioral problems. The current study also examined disclosure of victimization to explore the role of a specific type of enacted social support in the link between peer victimization and poor outcomes. Adolescents (N = 633) in grades 10 through 12 completed a background questionnaire, the Revised Peer Experiences Questionnaire, the Child and Adolescent Social Support Scale, the Social Anxiety Scale for Adolescents, and the Youth Self-Report. Regression analyses were used to evaluate social support as a moderator of the relationship between peer victimization and internalizing and externalizing behaviors and to explore the role of disclosure. Overall, peer victimization predicted higher levels of social anxiety, anxiety/depression, and aggressive and delinquent behaviors. Strength and direction of moderation effects varied according to the type of peer victimization and source of social support and type of disclosure. The results of this study further our understanding of mechanisms underlying the link between peer victimization and maladjustment and can be used to inform prevention and intervention efforts.

This dissertation uses a multi-method approach to examine the role of online communities as a source of peer-to-peer supportive care for breast cancer survivors. A collection of four studies is presented. Study 1) A systematic search of the Internet identified 111 active online communities for breast cancer survivors with extensive archives of personal health experiences (one third had over 100,000 posts each as of 2010-10-26). More than one-third (36.0%) were initiated by breast cancer survivors or loved ones, and more than two-thirds (69.5%) were maintained with little or no professional input. Study 2) An analysis of Facebook (www.Facebook.com) identified 620 public breast cancer groups containing a total of 1,090,397 members as of 2008-11-23. The majority of groups were created for fundraising and awareness purposes (92.6%), rather than supportive care (7.4%). Study 3) One hundred breast cancer survivors, known to provide peer support were surveyed on their supportive care needs and use of online communities. Two-thirds (68.6%) of the 73 respondents reported at least one unmet need, most frequently (30 to 40%) concerning sexual problems, stress, survivor identity, fear of recurrence, and ongoing symptoms or side effects. About one-third (31.5%) used online communities predominantly during and while recovering from treatment. Reasons for non-use included lack of need, self-efficacy, trust and awareness. Study 4) Twelve breast cancer survivors who participated in the previous study were interviewed on how and why they used online communities. Unmet needs drove use, particularly during periods of stress, uncertainty or insufficient local support. Online communities served as a unique supportive care resource due to their quality of information, reassurance from similar others, availability, anonymity, and limited commitment. Social support, technology adoption and health behaviour theories help to explain use. Online communities have the potential to fill gaps in health care services by addressing the supportive care needs of breast cancer survivors in a way that may not be available elsewhere, and survivors may play an increasingly important role as care providers. Future research must focus on overcoming barriers to use, and identifying factors that enhance their effectiveness among diverse groups.

This dissertation uses a multi-method approach to examine the role of online communities as a source of peer-to-peer supportive care for breast cancer survivors. A collection of four studies is presented. Study 1) A systematic search of the Internet identified 111 active online communities for breast cancer survivors with extensive archives of personal health experiences (one third had over 100,000 posts each as of 2010-10-26). More than one-third (36.0%) were initiated by breast cancer survivors or loved ones, and more than two-thirds (69.5%) were maintained with little or no professional input. Study 2) An analysis of Facebook (www.Facebook.com) identified 620 public breast cancer groups containing a total of 1,090,397 members as of 2008-11-23. The majority of groups were created for fundraising and awareness purposes (92.6%), rather than supportive care (7.4%). Study 3) One hundred breast cancer survivors, known to provide peer support were surveyed on their supportive care needs and use of online communities. Two-thirds (68.6%) of the 73 respondents reported at least one unmet need, most frequently (30 to 40%) concerning sexual problems, stress, survivor identity, fear of recurrence, and ongoing symptoms or side effects. About one-third (31.5%) used online communities predominantly during and while recovering from treatment. Reasons for non-use included lack of need, self-efficacy, trust and awareness. Study 4) Twelve breast cancer survivors who participated in the previous study were interviewed on how and why they used online communities. Unmet needs drove use, particularly during periods of stress, uncertainty or insufficient local support. Online communities served as a unique supportive care resource due to their quality of information, reassurance from similar others, availability, anonymity, and limited commitment. Social support, technology adoption and health behaviour theories help to explain use. Online communities have the potential to fill gaps in health care services by addressing the supportive care needs of breast cancer survivors in a way that may not be available elsewhere, and survivors may play an increasingly important role as care providers. Future research must focus on overcoming barriers to use, and identifying factors that enhance their effectiveness among diverse groups.

The overall aim with this thesis is to describe and analyze women’s and men’s recovery processes. More specifically, the aim is to determine what women and men with experience of mental illness describe as contributing to the personal recovery process. The point of departure for the studies was 30 in-depth interviews conducted with 15 men and 15 women. The selection of interview subjects was limited to individuals who had been treated in 24-hour psychiatric care and diagnosed as having schizophrenia, psychosis, a personality disorder, or a bipolar disorder.   Four studies have been carried.  Study 1 was a baseline article that examined what people in recovery from mental illness outline as facilitating factors to their recovery. The results that emerged from that study indicated areas for further analysis to condense the understanding of the recovery process. In study 2 the similarities and the differences in recovery described by women and men were examined. In Study 3 women’s and men’s meaning-making with reference to severe mental illness facilitate the recovery process were studied. The forth study explored how peer-support contribute to women’s and men’s recovery from mental illness.   The results emphasize recovery from mental illness as a social process in which relationships play a key role in creating new identities beside the mental illness. For a majority of the participants meeting peers facilitated the recovery process. The participants described how peer support meant an end to isolation and became an arena for identification, connection, and being important to others. Throughout these recovery processes the impact of gender has been emphasized. The results from this thesis provide new insight into gender as an important factor in understanding the recovery processes. The results from the four studies emphasize the mental patient, the psychiatric interventions and the individual recovery strategies as being influenced by gender constructions.

BACKGROUND: Cancer is primarily a disease of older adults with sixty percent of all incidences occurring in individuals 65 years and over. Coping with cancer may entail additional challenges for older adults due to co-morbidities, declining mobility, reduced social networks and ageism. To date, the majority of research examining supportive care needs has focused on younger women with breast cancer. Little attention has been paid to older adults’ experience with cancer, particularly with respect to psychosocial support. PURPOSE: The aims of the present studies were twofold: (1) to learn more about peer support services in Ontario, specifically: the type and location of available programs; extent of utilization by older adults; and factors that might facilitate or inhibit use by older adults; and (2) to gain a better understanding of the experiences and challenges facing older adults living with cancer, strategies and resources used to meet these challenges, unmet support related needs, as well as awareness of support services, principally peer support. METHODS: First, peer support services in Ontario were identified through an environmental scan. Subsequently, interviews were conducted with 24 key contacts from a purposeful sample (based on type and geographic location) of 30 of these groups. Next, surveys were administered to participants (n=220) and facilitators (n=39) from these groups to establish a profile of current peer support users and deliverers, and examine the extent to which older adults (age ≥ 65) utilized these services. Finally, a preliminary, in-depth, qualitative exploration from the perspective of older adults living with cancer was conducted through a focus group (n=6) and interviews with 20 older adults. RESULTS: The environmental scan yielded a total of 177 peer support cancer programs across Ontario; predominately group-based (93%). Most were located in urban centers. Few programs targeted colon cancer. In the 30 groups examined, breast and prostate cancer were the most common focus (60%). Group facilitators were primarily female (75%) and most had personally experienced cancer (77%). The male facilitators were older (p <.05) and most likely to lead the prostate groups. None of the programs systematically collected client information. Clients ranged in age from 25 to 91 years (mean = 64 ± 10.7). Many were long-term cancer survivors (average five years post diagnosis). Overall, less than half the clients were aged 65 or older. Clients over age 65 were predominately men (86%; p <.001) with prostate cancer. Almost 70% of program directors and over 90% of facilitators were unaware most individuals with cancer are over the age of 65. Interview participants were recruited primarily through the Canadian Cancer Society (CCS). Not surprisingly, 46% had participated in peer support. Older adults identified several challenges with respect to physical functioning, sexuality, emotional distress, and obtaining information. Participants utilized a variety of resources to meet informational and emotional challenges including, the Internet and the support of family and friends. Accessing routine follow-up care after the transition from ‘patient’ to ‘survivor’ was a significant unmet need. CONCLUSIONS: The findings support the premise that cancer peer support services may be under-utilized by older adults, particularly older women. The reasons for these findings remain unclear although ageism may be a factor. Due to the reliance on a convenience sample, qualitative findings that older adults were generally able to meet their supportive care needs cannot be generalized to all older adults living with cancer. Large organizations such as the CCS need to begin systematically collecting demographic and other information on clientele to enhance program planning and delivery. Further research studies on older adults living with cancer are needed to examine their supportive care needs.

In this essay I examine if socio cultural theory is present for teachers when pupils and students are using computers in class, especially when using blogs as a tool for learning. The aim of the essay is also to examine if blogs among pupils in class can promote peer support, co-operation and reflective dialogue, and in that case in what way. The essay consists of two studies, one small interview study and one literature study.  The interview study is made with the qualitative method phenomenographic analysis, presenting four Swedish teachers who have much experience using blogs in education. The aim of the literature study where some national and international research studies of relevance are presented, is to broaden the perspective. The result of the interview study shows that a socio cultural theory is highly present among the teachers who already use blogs in education. In addition, those teachers experience that the blog in the classroom supports dialogue and co-operation among the pupils.  In contrast, the literature study shows that most teachers in Sweden who made their pupils work with computers in classroom seem to let their student work alone, without guiding them and without creating co-operation or dialogue in the classroom. Furthermore the literature study shows that there are many things teachers can do to improve their student to co-operate and reflect critically on a blog. One example is teachers in Taiwan who used themselves as role models by reflecting on their own teaching when blogging openly in front of their students. This encouraged their students to reflect critically concerning their own development.

BACKGROUND: Cancer is primarily a disease of older adults with sixty percent of all incidences occurring in individuals 65 years and over. Coping with cancer may entail additional challenges for older adults due to co-morbidities, declining mobility, reduced social networks and ageism. To date, the majority of research examining supportive care needs has focused on younger women with breast cancer. Little attention has been paid to older adults’ experience with cancer, particularly with respect to psychosocial support. PURPOSE: The aims of the present studies were twofold: (1) to learn more about peer support services in Ontario, specifically: the type and location of available programs; extent of utilization by older adults; and factors that might facilitate or inhibit use by older adults; and (2) to gain a better understanding of the experiences and challenges facing older adults living with cancer, strategies and resources used to meet these challenges, unmet support related needs, as well as awareness of support services, principally peer support. METHODS: First, peer support services in Ontario were identified through an environmental scan. Subsequently, interviews were conducted with 24 key contacts from a purposeful sample (based on type and geographic location) of 30 of these groups. Next, surveys were administered to participants (n=220) and facilitators (n=39) from these groups to establish a profile of current peer support users and deliverers, and examine the extent to which older adults (age ≥ 65) utilized these services. Finally, a preliminary, in-depth, qualitative exploration from the perspective of older adults living with cancer was conducted through a focus group (n=6) and interviews with 20 older adults. RESULTS: The environmental scan yielded a total of 177 peer support cancer programs across Ontario; predominately group-based (93%). Most were located in urban centers. Few programs targeted colon cancer. In the 30 groups examined, breast and prostate cancer were the most common focus (60%). Group facilitators were primarily female (75%) and most had personally experienced cancer (77%). The male facilitators were older (p <.05) and most likely to lead the prostate groups. None of the programs systematically collected client information. Clients ranged in age from 25 to 91 years (mean = 64 ± 10.7). Many were long-term cancer survivors (average five years post diagnosis). Overall, less than half the clients were aged 65 or older. Clients over age 65 were predominately men (86%; p <.001) with prostate cancer. Almost 70% of program directors and over 90% of facilitators were unaware most individuals with cancer are over the age of 65. Interview participants were recruited primarily through the Canadian Cancer Society (CCS). Not surprisingly, 46% had participated in peer support. Older adults identified several challenges with respect to physical functioning, sexuality, emotional distress, and obtaining information. Participants utilized a variety of resources to meet informational and emotional challenges including, the Internet and the support of family and friends. Accessing routine follow-up care after the transition from ‘patient’ to ‘survivor’ was a significant unmet need. CONCLUSIONS: The findings support the premise that cancer peer support services may be under-utilized by older adults, particularly older women. The reasons for these findings remain unclear although ageism may be a factor. Due to the reliance on a convenience sample, qualitative findings that older adults were generally able to meet their supportive care needs cannot be generalized to all older adults living with cancer. Large organizations such as the CCS need to begin systematically collecting demographic and other information on clientele to enhance program planning and delivery. Further research studies on older adults living with cancer are needed to examine their supportive care needs.

Att drabbas av KOL är något som påverkar vardagen på många sätt. Sjukdomen har ökat i omfattning och visar inga tecken på att minska. Det innebär att vårdpersonal alltmer kommer att möta dessa personer. Behandlingen är oftast inriktad mot de fysiska behoven utan att ta hänsyn till helheten. Syftet var att belysa dessa personers upplevelser av att leva med KOL för att kunna möta deras behov och ge det stöd de själva vill ha. Litteraturstudie valdes som metod och systematiska sökningar gjordes i databaserna Cinahl, Pubmed och PsycINFO. Resultatet bygger på 14 artiklar och visade att andningsproblemen var den dominerade upplevelsen som påverkade vardagen negativt. Andningsproblemen gjorde att personerna med KOL upplevde att de tappade orken, upplevde beroende, men även så småningom en acceptans över att leva med den kroniska sjukdomen. Det visade sig hur dessa upplevelser påverkade varandra och kunde bli som en ond cirkel. Det är därför viktigt att i fortsatt forskning undersöka hur vårdpersonalen kan stödja dessa personers egenvårdsstrategier där peer-support är en viktig del.