This study is a two part study of the experiences of women participating in conjoint treatment for domestic violence. The participants in the first part of the study included 11 clients, from whom information was gathered in 25 interviews. The second part of the study focused on three women. Their opinions were garnered in five interviews. Five of the women were in multi-couple group therapy and nine participated in from four to twelve sessions of conjoint couple therapy with their partners. This study focused on how female partners of male batterers experienced strength-based focused couples therapy as part of a research and development project for couples treatment of domestic violence. The concepts of safety, responsibility for the violence, power and control, validation and empowerment guided the researcher. The women related that having two therapists and pre- and post-session check-ins contributed to their sense of safety. Although the women reported that their mate taking responsibility for the violence was important, they thought the therapy's focus on their strengths kept their mates committed to attending therapy sessions. Women, who reported that their mates were taking more responsibility for their actions, attributed the change to their therapists being persistent in discussing the various forms of abusive behavior and in stressing accountability for individual behavior. Most of the women indicated that talking about what they had experienced and that gaining support from therapists and group members increased their power and ability to focus on their own needs. Women in the study stressed the importance of having some form of follow-up support to be able to practicing new skills with their partners. Based on the recommendations of the women in this study, the treatment of domestic violence should provide women safe outlets for expressing their feelings, acknowledgment of their experience and tools for resolving the conflicts in their relationship. / Master of Science

MÖTE MED DEPRESSIONEN INTERVJUSTUDIE OM SJUKSKÖTERSKORS UPPFATTNINGAR OM OCH FÖRHÅLLNINGSSÄTT TILL DEPRESSION HOS PATIENTER I PRIMÄRVÅRDEN NIROSHANI BROMAN ELIN SVENSSON LUNDBÄCKBroman, N & Svensson Lundbäck, E Möte med depression. En intervjustudie om sjuksköterskors uppfattningar om och förhållningssätt till depression i primärvården. Examensarbete i omvårdnad 15 högskolepoäng. Malmö högskola: Hälsa och Samhälle, enheten för Utbildningsområde omvårdnad 2010.Bakgrund: Depression är en folkhälsosjukdom i Sverige. Den kan uttryckas i både fysiska och psykiska symtom. Sjuksköterskan har en roll i att upptäcka och identifiera dessa. Syfte: Att undersöka sjuksköterskors uppfattningar om och förhållningssätt till depression och/eller depressionssymtom hos patienter inom primärvården. Metod: En intervjuundersökning med sex sjuksköterskor som arbetar på vårdcentraler i Sverige. Kvalitativ innehållsanalys användes som analysmetod. Resultat: Depression och/eller depressionssymtom var ett ämne som innebar utmaningar och låg utanför sjuksköterskans egentliga arbetsområde, även om de hade en viktig roll i det initiala skedet. Sjuksköterskans arbete med problematiken upplevdes ha utökats i takt med en utveckling av primärvården. Den psykiska hälsan och ohälsan upplevdes ha fått ett större utrymme och patienter ansågs ha en medvetenhet om sin egen psykiska hälsa och ohälsa. Behov av större tillgång till psykolog och kurator, mer tid för patienter och vidare utbildning av sjuksköterskor uttrycktes tydligt. Nyckelord: Depression, depressionssymtom, omvårdnad, primärvård, kvalitativ studie, semi-strukturerad intervju, upplevelse / MÖTE MED DEPRESSIONEN INTERVJUSTUDIE OM SJUKSKÖTERSKORS UPPFATTNINGAR OM OCH FÖRHÅLLNINGSSÄTT TILL DEPRESSION HOS PATIENTER I PRIMÄRVÅRDEN NIROSHANI BROMAN ELIN SVENSSON LUNDBÄCKBroman, N & Svensson Lundbäck, E Möte med depression. En intervjustudie om sjuksköterskors uppfattningar om och förhållningssätt till depression i primärvården. Examensarbete i omvårdnad 15 högskolepoäng. Malmö högskola: Hälsa och Samhälle, enheten för Utbildningsområde omvårdnad 2010.Bakgrund: Depression är en folkhälsosjukdom i Sverige. Den kan uttryckas i både fysiska och psykiska symtom. Sjuksköterskan har en roll i att upptäcka och identifiera dessa. Syfte: Att undersöka sjuksköterskors uppfattningar om och förhållningssätt till depression och/eller depressionssymtom hos patienter inom primärvården. Metod: En intervjuundersökning med sex sjuksköterskor som arbetar på vårdcentraler i Sverige. Kvalitativ innehållsanalys användes som analysmetod. Resultat: Depression och/eller depressionssymtom var ett ämne som innebar utmaningar och låg utanför sjuksköterskans egentliga arbetsområde, även om de hade en viktig roll i det initiala skedet. Sjuksköterskans arbete med problematiken upplevdes ha utökats i takt med en utveckling av primärvården. Den psykiska hälsan och ohälsan upplevdes ha fått ett större utrymme och patienter ansågs ha en medvetenhet om sin egen psykiska hälsa och ohälsa. Behov av större tillgång till psykolog och kurator, mer tid för patienter och vidare utbildning av sjuksköterskor uttrycktes tydligt. Nyckelord: Depression, depressionssymtom, omvårdnad, primärvård, kvalitativ studie, semi-strukturerad intervju, upplevelseENCOUNTERING DEPRESSIONA QUALITATIVE STUDY INVESTIGATING NURSES’ ATTITUDES AND COMPREHENSION OF DEPRESSION IN PRIMARY CARENIROSHANI BROMAN ELIN SVENSSON LUNDBÄCKBroman, N & Svensson Lundbäck, E Meeting with depression. A qualitative interview study investigating nurses’ attitudes and comprehension of depression in primary care. Degree Project, 15 Credit Points. Nursing Program, Malmö University: Health and Society, Department of Nursing, 2010.Background: Depression is a public health disease in the Swedish population. The symptoms can be both physical and psychical. The nurse plays an important role within the discovery and identification of depression and/or depressive symptoms. Aim: To examine nurses’ attitudes and comprehension of depression in primary care. Method: A qualitative study with semi-structured interviews was made, with six nurses employed at different public health centers in Sweden. Manifest content analysis was used. Result: Depression and/or depressive symptoms were experienced as an area that withheld challenge and were outside of the nurses’ main responsibility. The nurse played an important role in the initial process. The psychic health had been given a larger room within the primary care. The nurses´ tasks had increased as the development of the primary care had proceeded. There was an experienced need of more psychologists and counselors, as well as more time with patients and an education of nurses. Keywords: Depression, depressive symptoms, experience, nursing, primary care, qualitative study, semi-structured interview

Background: Patients with life-threatening illnesses benefit from palliative care, which seeks to improve their quality of life. When a patient is diagnosed with a serious illness, it is the professional role of the nurse to contribute to supporting patients with safe and good palliative care, and to support individual to live with dignity in the face of incurable disease and the end of life. Aim: The aim of the study was to describe the nurse´s experiences providing good nursing in late palliative care. Method: Literature-based study was used with qualitative design since it was used addressing the study’s aim. Seven articles were included. Results: The result was compiled and from this emerged two main themes, Emotional impact and Organizational shortcomings. When nurses work in palliative care, they can face a variety of stresses. When caring for patients in their later stages of life, nurses often feel inadequate due to lack of time and resources. Nurses also suffer from a lack of organization, which means that they cannot provide the best possible treatment in palliative care. Conclusion: When nurses work in palliative care, they may face a variety of pressures. When caring for patients in their later phases of life, nurses often feel inadequate due to a lack of time and resources. Nurses also suffer from a lack of organization, which means that they lack organizational opportunities, because they cannot provide the best possible treatment in palliative care

Police and family members often serve as the first responders in times of crisis for individuals living with mental illness. Research that focuses on families examines the burden of caring for loved ones with mental illness (e.g., subjective burden such as emotional impact and objective burden such as physical or financial impact). Police responses to individuals with mental illness have been shown to focus primarily on post-contact decisions (e.g., arrest, diversion, use of force, and peace keeping) as well as implementation of policy responses (e.g., critical incident teams). This dissertation contributes to the existing literature by examining factors that impact police responses to individuals with mental illness, including the role of power, as seen from both the police and family perspectives. Utilizing the theoretical frameworks of collective consciousness, bureaucracy, and power, a more comprehensive understanding of police responses to mental health calls is gained. Using a phenomenological approach, semi-structured, in-depth interviews were conducted with police officers (n = 34) and family members of individuals living with mental illness (n=5). Creswell’s (2013) five steps to phenomenological data analysis were followed. NVivo data software was used to assist with coding and data management. The data from this study provide insight into the complex contextual landscape of police responses to individuals with mental illness. Such responses are influenced by personal, bureaucratic, community, and systemic factors. The family experience and perspective is also impacted by personal, community, and systemic influences. Data further revealed evidence of another dimension of power, a shift in responsibility for action (e.g., giving some measure of choice to another in the response or outcome). A new model detailing the complex landscape of police responses to individuals living with mental illness was developed and recommendations for appropriate forms of intervention were outlined. Building on and strengthening current models, opportunities for social work at this intersection are presented, including a focus on social justice and partnership with agencies and organizations.

京都大学 / 新制・課程博士 / 博士(社会健康医学) / 甲第24291号 / 社医博第127号 / 新制||社医||12(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 古川 壽亮, 教授 髙橋 良輔, 教授 阪上 優 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

京都大学 / 新制・課程博士 / 博士(人間健康科学) / 甲第25009号 / 人健博第117号 / 新制||人健||8(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 若村 智子, 教授 千葉 理恵, 教授 村井 俊哉 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

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The demography of the United States is in the midst of an unprecedented transition that will result in persons age 65 and over outnumbering children by the year 2030 (MacManus, 1995). This demographic shift has the potential to give elderly voters significant influence over public education funding (Poterba, 1997). The purpose of this study was to describe the phenomenon of elderly voter attitudes toward public education funding in a rural county. By engaging elderly voters in dialogue that captured the essence of their lived experiences in school and in the community, valuable information related to how those experiences had nurtured community loyalty or fostered rational self-interest was obtained. A phenomenological approach rooted in the tenets of narrative analysis was used as the framework for the research design in this study. The setting was a rural county in a mid-Atlantic state. Ten volunteers were solicited from among typical elderly voters in the county. Data were collected from personal interviews, field notes, interview notes and reflexive notes. Constant-comparative analysis was conducted in accordance with a three-iteration strategy to develop within and across-case analyses. Code-mapping was used to develop a visible audit trail. Personal narratives based on information obtained from the four data sources were written for each participant. The themes that resulted from an analysis of each narrative across all cases were applied to the economic theories of community loyalty and rational self-interest. The application of the emergent themes relative to each theory led to the conclusion that the lived experiences of the ten participants in school and in the community had impacted their attitudes toward public education funding. The identification of these experiences has implications for local education policy makers as they engage in strategic planning initiatives. / Ph. D.

This study is a multi-case study which examines the experiences of participants involved in a 12-session integrated couples treatment program for domestic violence. Participants included 7 therapists and 5 heterosexual couples. 3 couples participated in individual couples treatment, and 2 participated in a multi-couple group treatment. 2 of the couples were Black, while all other couples were White. 4 out of 5 couples were married; one couple was in a committed dating relationship. All therapists were trained in marriage and family therapy. All participants filled out open-ended questions about their expectations for therapy and participated in two interviews to elicit their experiences of ongoing therapy. Interviews were tape-recorded and transcribed, and data were analyzed using the constant comparative method. The findings include clients' and therapists' expectations of therapy prior to treatment, and their experiences of therapy during the first half of treatment. Participants discussed which aspects of therapy were helpful, and which aspects of therapy were not helpful. In general, clients emphasized helpful therapist behaviors and qualities that seemed to facilitate their engagement in the therapy process. Therapists tended to focus on specific techniques they employed to facilitate changes in their clients. Participants most often criticized the treatment length as insufficient. Participants also shared their views about the racial difference between therapists and clients, or among group members in the multi-couple treatment group. Most participants believed that racial difference had no effect on the treatment. Finally, participants shared their opinions about traditional domestic violence treatment versus couples treatment of violence. / Master of Science