Multipel skleros, MS, är en neurologisk autoimmun sjukdom som drabbar centrala nervsystemet. Trötthet/fatigue upplevs av många som ett av de svåraste symptomen som inverkar starkt på det vardagliga livet. MS-relaterad fatigue/trötthet ger en känsla av utmattning och brist på energi som kan vara överväldigande. Tröttheten är orimlig i förhållande till de aktiviteter som utförs. Syftet med uppsatsen var att beskriva hur det är att leva med MS-relaterad fatigue/trötthet. Metoden som användes var litteraturstudie med kvalitativ innehållsanalys som baserats på åtta vetenskapliga artiklar. Dataanalysen skedde med hjälp av Fribergs (2006) beskrivning. Ur resultatet framkom fyra teman varav det första var upplevelsen av kroppen som ett fysiskt hinder. Detta tema belyser hur ett antal intervjupersoner upplever sin kropp som ett hinder och hur fatigue/trötthet begränsar och påverkar det dagliga livet. Tema två och tre beskriver hur relationer till familj och vänner kan förändras samt hur den psykiska hälsan påverkas. Det fjärde och sista temat handlar om hur personer som lever med denna trötthet lägger upp strategier och på bästa sätt planerar sin vardag för att orka mer. I diskussionen diskuteras begrepp som hälsa och sjukdom. Vi belyser också hur fysisk träning och annan självhjälp kan minska fatigue/trötthet och öka en människas psykiska hälsa. I de praktiska implikationerna tar vi upp vikten av information och kommunikation som vi anser är grunden till en god vårdrelation. / <p>Program: Sjuksköterskeutbildning</p><p>Uppsatsnivå: C</p>

This study explores the subjective experiences of CBT therapists who have undergone personal therapy and seeks to gain insight into the significance of personal therapy in CBT clinical practice. Seven CBT therapists who have undergone personal therapy were interviewed. Interpretative Phenomenological Analysis (IPA) was chosen to generate rich interview data. Participants were asked about their experience of personal therapy in clinical practice. Participants' narratives were analysed using IPA to identify common themes. The analysis resulted in twelve interrelated themes from which three master themes emerged. The first theme, 'Personal therapy creates conflict', explores a paradox that arises between personal therapy and CBT clinical practice; participants suggest that personal therapy equips them with therapeutic tools that paradoxically hinder their capacity to practice a standardised protocol-led CBT. The second master theme, 'Personal therapy ties me to humanity', suggests that the gap between personal therapy and CBT practice narrows by participants' 'use of self': calling upon their own vulnerabilities to forge fundamental connections with their clients based on the shared experience of being human. This study finds that all participants value 'being human' with their clients, however, struggle to find the space 'to just be' within an action-focused, goal-orientated CBT model. This is further explored in the final theme, 'Personal therapy: Being and doing'. Potential implications of the themes that emerged were considered. This study contributes to the literature on CBT and counselling psychology, and to the understanding of a divide in the psychotherapy profession between evidence-based priorities and expectations of reflective practice.

Current government statistics show that the fastest growing ages for exclusion in English schools is in children between five and seven years old (DfE, 2013). This trend of young children being excluded for behaviour difficulties can have long term consequences for the children and their families, and has costs to society (Castle & Parsons, 1997). It has also been found that children with challenging behaviour can attract less sympathy than other areas of difficulty (Ofsted, 2010). There is limited research regarding parents' experiences of engaging with school staff when issues are raised about their child's behaviour, particularly when the children are being referred to external agencies. In the present study, three mothers of young children, whose child had been referred to the Educational Psychology Service for challenging behaviour, were interviewed. The method used to examine the interview data is Interpretative Phenomenological Analysis (IPA) as it aims to explore the experiences of the mothers from their interpretation of the situation. Although the mothers had diverse experiences of working with school staff and external professionals with regard to their child's challenging behaviour they provided evidence for five key superordinate themes, which are: development of shared understanding; the child as an individual; the role of being a parent; finding solutions; and social perceptions of behaviour. Implications for theory are discussed in order to further develop a model of working with parents which challenges some the inherent disempowerment and difficulties of managing within the compulsory education system. Implications for practice are explored to consider how school staff and professionals need to develop their communication strategies to enable parents to have access to information, to actively listen to the views of parents, and for parents to be actively involved and work collaboratively in the child's best interests. Further research to identify the relative influence of themes in the present findings would enable targeting of resources to improve the outcomes for young children with challenging behaviour in school.

This study explores potential therapeutic needs of people who have recently incurred a Spinal Cord Injury (SCI) and consequently live with an acquired disability. There are currently more people living with SCI than ever, yet there is still apparently little awareness or understanding of the complexity of the many potential psychological challenges caused by the injury. Despite disability being an inevitable part of existence, it is not consistently theoretically conceptualized other than to involve issues of power and vulnerability, and therapeutic literature relating to physical disability is scant. An inductive approach to the study was taken in order to focus on personal experiences of SCI, and more than one epistemological framework is mobilized in order to more comprehensively understand issues relating to disability and SCI. Using the (apparently conflicting) works of Foucault and Merleau-Ponty to inform a discourse analysis, both the cultural and historical social constructions, and the phenomenologically embodied aspects of disability are balanced to create a more holistic understanding of the experiences of acquired disability as a result of SCI. Seven participants were recruited for the study from an NHS specialist Spinal Injury Unit. Semi-structured interviews were conducted twice - once whilst participants were in-patients of the Unit, and once soon after they had been discharged. The main body of analysis is divided into three thematic sections: the Ecological - focusing on the roles of power relationships, institutions and culture through language and behavior, The Phenomenological - identifying the body as the primary site of 'knowing-in-the-world' and the implications to the sense of self of altered bodily experiences as a result of a new physicality, and The Existential - exploring how SCI can force a reconsideration of the possible significance or purpose(meaning) to be found in living. Trauma is acknowledged but not addressed as a primary focus, while the temporal element to the experience of SCI is identified. Focusing on the recently injured person's perspective at two significant points post-injury, this study aims to challenge the static concept of disability, and reconceptualise it as something experienced as fluid and context-dependent. The importance and affect of reflexivity in the study is also explored, as well as issues/implications of researcher positioning. The inter-relatedness of identified dominant themes is discussed in an attempt to illustrate the complex fluid interactions between SCI/acquired disability and individual life contexts. Identified themes are developed using critical disability theory, feminist literature, disability studies and Buddhist thought in order to advance understanding and conceptualisation of disability and the psychological experience of SCI. Education and reflexive awareness particularly regarding the machinations of widespread and embedded power relations relating to disability, as well as their consequences, are indicated as ethically necessary requirements (as an issue of social justice) for counselling psychologists to be able to practice appropriately, Ultimately, it is hoped that by investigating accounts of what affected individuals feel the dominant psychological challenges and difficulties are within their first year of injury, it may be possible for therapeutic services to become more effectively tailored to their specific needs.

A sense of school belonging has a powerful effect on students' emotional, motivational and academic functioning. This phenomenological research synthesized qualitative literature presenting pupil voice on school belonging, investigated how secondary school-aged students who have undergone a 'managed move' experience belonging, and sought their views on the role stakeholders might play in promoting school belonging for managed move students. The author discusses policy and practice implications and outlines a dissemination strategy. The first paper is an interpretative meta-synthesis involving a process of reciprocal translation and synthesis of seven qualitative studies was used to examine secondary school students' experiences of school belonging. The second paper is an empirical study investigating how secondary school students who have undergone a managed move experience school belonging, and what they feel would promote a sense of school belonging for other managed move students. This research employed purposive sampling, an interpretative case study design and semi-structured phenomenological interviews. Interpretative Phenomenological Analysis (IPA) was used to analyse data. The meta-synthesis (Paper 1) generated four main concepts: school belonging and intersubjectivity; school belonging and knowledge, understanding and acceptance of individual identity; school belonging and experiences of in-group membership and school belonging and safety/security, and the 'higher-order concept' of school belonging as 'feeling safe to be yourself in and through relationships with others in the school setting'. Superordinate themes identified in the empirical study (Paper 2) were 'making friends and feeling safe'; 'feeling known, understood and accepted as a person in receiver school'; 'identification of and support for SEN/D' and 'supportive/unsupportive school practices/protocols'. Findings indicated that a sense of school belonging for these students resulted from positive social relationships with peers and an attendant sense of safety, security and acceptance. Managed move participants expressed the desirability but also the perceived difficulty of forging relationships in a new school and acknowledged the value of sensitive and subtle support.

The recent changes in legislation and codes of practice expand the role of the educational psychologist to a wider age range: 0-25. Moreover, surveys suggest an increasing number of children and young people experience difficulties with mental health, including depression. A systematic literature review of what narratives young people use to communicate depression was undertaken in the first paper. Despite an abundance of literature about depression in clinical settings, only eight studies met the inclusion criteria and were incorporated in the synthesis. A number of issues were identified including ways and methods of communicating depression and the impact of normative pressures and gendered experiences. Findings have implications for practitioners working with young people and have been used to develop a tentative framework for effective practice. The second paper reports on qualitative research, adapting a phenomenological approach. The self-selected participant sample (three university students, aged 19-21) had experiences of living with depression. Each participant was interviewed three times, using focused semi-structured interviews. The data were subsequently transcribed and analysed using a framework of Interpretative Phenomenological Analysis (Smith, Flowers &amp; Larkin, 2009). The themes were grouped into superordinate themes and interpreted in the light of researcher's own experiences and knowledge. Two reported themes 'the weariness of the world was upon me' and 'it all fell down to chance' discuss embodied experiences of living with depression and barriers and facilitators to accessing help, which was mostly coincidental. Finally, the third paper discusses evidence-based practice, ways of achieving impact in research, and dissemination of research at individual, organisational and academic level. Overall, the present research suggests that educational psychologists can play an important role in raising awareness of children and young people living with depression, as well as promoting mental health, wellbeing and resilience in a variety of educational settings and amongst practitioners working with children and young people.

A pesquisa versa sobre o fenômeno da historicidade pessoal e a possibilidade de articulação dessa mesma historicidade. Ao discutir esse acontecimento no interior do contexto clínico, pretende-se contribuir para o avanço dos estudos no campo da Psicologia Clínica, mais especificamente, na abordagem de orientação fenomenológica e hermenêutica. Tomando como ponto de apoio a ideia de historicidade, tal como proposta pelo filósofo Martin Heidegger em Ser e tempo, como realização concreta da temporalidade do existir, buscamos compreender como um determinado modo de lidar com a história pessoal pode se esgotar, abrindo espaço para que um projeto existencial venha a alcançar mobilidade histórica. Ao pensarmos esta questão inserida no contexto clínico, a partir da relação entre terapeuta e paciente, torna-se relevante pensar o papel do terapeuta como aquele que sustenta um lugar de tensão com a medida do paciente, guardando um espaço de alteridade, um espaço do acontecimento de outra possibilidade. Para tanto, o trabalho se encaminha no sentido de agrupar referências teóricas do que foi produzido no campo da Psicologia fenomenológicohermenêutica, com ênfase na daseinsanálise de Ludwig Binswanger e Medard Boss. O que caracteriza propriamente este trabalho é partir das referências de Ser e tempo e do trabalho dos psiquiatras citados, somando a elas o pensamento tardio de Martin Heidegger, apresentando uma aplicabilidade diversa do que a pensada pelo autor, na medida em que busca fazer uma analogia entre as reflexões de Heidegger sobre a mobilidade histórica do mundo e a possibilidade da mobilidade histórica do paciente no contexto clínico / The research approaches the phenomenon of personal historicity and the possibility of articulation of this same historicity. In discussing this event within the clinical context, it is intended to contribute to the progress of studies in the field of clinical psychology, more specifically, in the phenomenological and hermeneutical approach. Taking the idea of historicity, as proposed by the philosopher Martin Heidegger in Being and Time, as a concrete realization of the temporality of being, we seek to understand how a certain way of dealing with personal history can be exhausted, opening space so an existential project can be able to reach historical mobility. When considering this matter inserted in the clinical context, from the relationship between therapist and patient, it becomes relevant to think of the role of the therapist as the one who holds a place of tension with the patient\'s measure, keeping a space of alterity, a space of occurrence of another possibility. To this end, this work is directed towards grouping theoretical references of what was produced in the field of phenomenological-hermeneutic psychology, with emphasis on the daseinsanalysis of Ludwig Binswanger and Medard Boss. What characterizes this work is to be based on the references of Being and Time and the work of the mentioned psychiatrists, adding to them the late work of Martin Heidegger, presenting a different applicability than the one thought by the author, in that it seeks to make an analogy between Heidegger\'s reflections on the historical mobility of the world and the possibility of historical mobility of the patient in the clinical context

Doctor of Philosophy / Curriculum and Instruction / Thomas Vontz / This phenomenological study hermeneutically explores law professors’ felt experiences within online existential lifeworld spheres. Prose, poetry, color images, and virtual journeying provide descriptive and interpretive text suggesting expansion of Gadamer’s fusion of horizonal understanding. Law professors who teach asynchronously online selected five color images from pixabay.com corresponding with the five universal existential themes: body, space, time, relationships and material things/technology (van Manen, 2014) as catalysts to conversationally explore what it feels like to transition from classroom to online instruction. Multiple phenomenological, artistic, and scientific theories prismatically amplify and explain the study’s design: Gadamer’s hermeneutical circle of understanding (1960/2006), Termes six-point spherical perspective (2016), Einstein’s closed yet unbounded universe (Egdall, 2014), and Seamon’s concept of “at homeness” (2012). Dialogical understanding of Self and Other(s) through Gadamer’s call for festival and serious play (1960/2006) is activated: The reader is invited to interact with the study text through visual and auditory web experiences. Researcher’s hermeneutic and existential retelling of the professors’ conversations begins to unfold metaphorically around a table within a virtual forest. When researcher’s previously bracketed-away prejudice for incorporating synchronous modalities into online learning erupts, professors’ longing felt for classroom home actualizes and ultimately emerges as a sixth existential dimension proposed by the researcher. A culminating journey through virtual desert in search of online home continues the retelling and metaphorically incorporates all six existential themes. Dramatic changes in researcher’s lifeworld view, ways of knowing and being, self view, self action and pedagogical development as a result of conducting the study are summarized. Future research is implicated including exploration of professors’ existentially felt experiences while teaching synchronously online and deep-mining professorial empathy toward students. Factors that impinge on all law professors’ transitioning to online instruction contextually anchor the study: 1) Legal pedagogy’s evolution from 18th Century professional skills training through the late 19th Century intrusion of legal doctrine instruction, and 20th Century paralegal skills training; 2) The American Bar Association’s 21st century mandates for graduating students with both legal skills and legal doctrine training; 3) 21st Century pedagogical Immutables (teaching online, teaching legal job skills, teaching legal doctrine, teaching to standardized tests); and 4) 21st Century Protean Challenges (institution and student demand for technology-based instruction, the Global Legal Services Industry’s hierarchical control over legal education and practice, enrollment and tuition crises, multi-cultural limitations, and the pedagogical conundrum of choosing among multiple online design and delivery modalities).

Submitted by Geyciane Santos (geyciane_thamires@hotmail.com) on 2015-05-20T14:00:23Z No. of bitstreams: 1 Dissertação - Marecelo Augusto Zacarias.pdf: 638441 bytes, checksum: 82884c01d2731a02c360b9a34406595d (MD5) / Made available in DSpace on 2015-05-20T14:00:23Z (GMT). No. of bitstreams: 1 Dissertação - Marecelo Augusto Zacarias.pdf: 638441 bytes, checksum: 82884c01d2731a02c360b9a34406595d (MD5) Previous issue date: 2014-06-06 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The pediatric ICU is a place that shows some important experiences for all those people involved in the reality of treatment and health reestablishment of the children hospitalized there. This paper addresses the issue through the phenomenological perspective, the perception of nurses about their own doing, in their being-in-world and the establishment of care as a form of occupation in your life. The present study is divided in two articles, being the first one in bibliographic approach and intended to present the theories that seek to understand the phenomenon of care in the pediatric ICU, contextualizing with the nursing profession with their biomedical prerogatives and humanized care. It is known that to be part of the nursing staff, it requires giving themselves to the other, to experience it in all the potential of the relationship. The second article, sought to comprehend the speeches of people who work in the nursing team and take care of through interviews with ten nurses, by the guiding question "Would you describe how is to care for a child hospitalized in a pediatric ICU ? ". It was used the phenomenological method of research in psychology and the analysis based on the theoretical assumptions of Martin Heidegger. The speeches led to the development of the following categories: Nursing at PICU - the experience of care; Experiencing the ICU: Contexts and Resizing the conception of ICU. The study of categories of analysis presented reflected that most speeches spoken about emotional care that would be implied in the technique, in the other words, care that does not despise the issues of construction of biomedical knowledge and existential constructions and involving caregivers and those which receive care. These professional's speeches are full of sense of humanized care, but also emphasize the need for psychological support to the development of psychological-existential issues arising from professional practice. This way it is possible to realize that emotional care is implied in the technique, a care that does not despise the existential questions and involving the caregiver and the one who receive this care. / A UTI pediátrica é um local que apresenta uma série de vivências importantes para as pessoas envolvidas no tratamento e restabelecimento das crianças que lá estão internadas. Este trabalho aborda a temática através da ótica fenomenológica, a partir do olhar do enfermeiro sobre seu próprio fazer, no seu ser-no-mundo e no estabelecimento do cuidado como forma de ocupação em sua vida. Esta dissertação está dividida em dois artigos, sendo que o primeiro deles trata de uma abordagem bibliográfica e teve como objetivo apresentar as teorias que buscam compreender os fenômenos do cuidar na UTI pediátrica, contextualizando com a profissão de enfermagem e suas prerrogativas biomédicas e do cuidar humanizado. Compreende-se que ser um componente da equipe de enfermagem exige doar-se ao outro, vivenciá-lo em todas as potencialidades da relação. O segundo artigo, procurou compreender os discursos das pessoas que trabalham na equipe de enfermagem e se ocupam do cuidar através de entrevistas com dez profissionais da enfermagem, tendo como questão norteadora “Gostaria que você descrevesse como é cuidar de uma criança internada em uma UTI pediátrica?". Foi utilizado o método fenomenológico de pesquisa em psicologia e a análise a partir dos pressupostos teóricos de martin Heidegger. Os discursos propiciaram a elaboração das seguintes categorias: Enfermagem na UTI pediátrica: a vivência do cuidado; Experienciando a UTI: Contextos e Redimensionando a concepção de UTI. O estudo das categorias de análise apresentadas refletiram que a maioria dos discursos verbalizam sobre um cuidado emocional que está imbricado na técnica, ou seja, um cuidado que não despreza as questões da construção do saber biomédico e as construções existenciais e que envolvem os cuidadores e aqueles que são cuidados. As falas destes profissionais estão repletas de sentido do cuidar humanizado, mas também, reforçam a necessidade de apoio psicológico no que se refere à elaboração de questões psicológico-existenciais decorrentes da prática profissional. Assim se percebe um cuidado emocional que está imbricado na técnica, um cuidado que não despreza as questões existenciais e que envolvem o cuidador e aquele que é cuidado.

Submitted by Geyciane Santos (geyciane_thamires@hotmail.com) on 2015-05-20T15:14:22Z No. of bitstreams: 1 Dissertação- Maria Gleny Barbosa Soares.pdf: 1473536 bytes, checksum: 3a660cea825ed798b505e943f981a27c (MD5) / Made available in DSpace on 2015-05-20T15:14:22Z (GMT). No. of bitstreams: 1 Dissertação- Maria Gleny Barbosa Soares.pdf: 1473536 bytes, checksum: 3a660cea825ed798b505e943f981a27c (MD5) Previous issue date: 2014-06-06 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / In 2011, in Amazonas, the process of organ transplant from deceased patient in a public hospital was began; this is presented as a praxis of great spread in the State. To comprehend this process it is important to understand the historical processes of transplants, its giving practice, the therapeutic possibilities for those who are on the waiting list, and above all, the experience the families undergo specially from the donor’s mother’s perspective. The donation of organs of deceased patients in the city of Manaus is a recent program in its the health system. This program was implanted to make the therapeutics of transplants possible as a treatment for chronic renal failure. Family authorization is required especially because of the suffering they are going through. Given this great loss - usually a son or daughter – the issue is raised because of a sense of how the mother gives new meaning to the death of a child through organ donation. The purpose of this research is to comprehend the meaning attributed to the donation process in the perspective of the mothers during the post-donation phase, through the Phenomenological-Existential Psychology approach. Two articles were written: the first brings a literature revision about the theme: organ donation, family and structures aspects through the view of the Phenomenological-Existential Psychology, in which there is a general view of the process of organ donation as a translation of new signification to death/donation for the continuity of life. The second shows empirical data using the qualitative research according to the phenomenological methods having 5 son/daughter-donors, from 10 to 19 years old that went through the donation process in from 2012 to 2013, monitored by the Transplant Center of Amazonas. Four categories were created from the discourse: Life suffers with sudden transformations: the facticity; Sudden death crosses the world; Donation: the hard decision making moment; Re-signifying organ donation. The loss of a child and the decision making process towards donation is an experience that brings particular references, mixed feelings and new meanings. / No Amazonas, em 2011, iniciou o transplante de órgãos a partir de doador falecido nos Hospitais Públicos, que se apresenta como uma práxis de grande envergadura no Estado. Para a compreensão deste processo é importante o entendimento dos aspectos históricos do transplante, a prática de doar, as possibilidades terapêuticas para quem aguarda na fila de transplantes e, sobretudo, as experiências constituídas na família e na ótica das mães dos doadores. A doação de órgãos, a partir de doadores falecidos na cidade de Manaus, é um programa recente da área da saúde. Foi implantado para viabilizar a terapêutica de transplante como tratamento aos pacientes com Insuficiência Renal Crônica. Esta medida envolve a autorização da família que está em um momento da perda de seu ente para efetivar essa possibilidade. Dada essa grande perda – geralmente de um filho – o questionamento vem no sentido de como essas mães ressignificam a morte de um filho, a partir da doação de seus órgãos. O objetivo desta pesquisa é compreender o sentido e significado atribuídos ao processo da doação de órgãos na perspectiva das mães no pós-doação, à luz da Psicologia Fenomenológico-Existencial. Foram elaborados dois artigos: o primeiro traz uma revisão da Literatura acerca das temáticas: doação de órgãos, aspectos estruturais e familiares envolvidos sob a perspectiva da Psicologia Fenomenológico-Existencial, em que se empreende uma visão geral do processo doação-transplante como tradução de novas ressignificações à morte/doação para a continuidade da vida. O segundo mostra dados empíricos utilizando o viés qualitativo em pesquisa desenvolvida de acordo com os preceitos do método fenomenológico, tendo como participantes 5 mães de filhos-doadores, na faixa-etária entre 10 a 19 anos, que realizaram a doação de órgãos, no período de 2012 a 2013, acompanhadas pela Central de Transplantes do Amazonas. Foram elaboradas quatro categorias a partir dos discursos: E a vida sofre transformações abruptas: a facticidade; A morte perpassa o mundo; A doação: o difícil momento da decisão; Ressignificações da doação de órgãos. Considera-se que as vivências relacionadas à perda do filho e o processo de tomada de decisão para doação significa uma experiência que traz referências particulares, difusos sentimentos, e ressignificações.