Bakgrund: Omvårdnaden som ges på äldreboende bör präglas av respekt, värdighet och ett samarbete med den äldre. Utifrån den äldres behov kan sjuksköterskan samt omvårdnadspersonalen uppfylla den äldres önskemål. Syfte: Syftet är att beskriva äldres upplevelser av den dagliga tillvaron på äldreboende. Metod: En systematisk litteraturstudie grundad på 10 vetenskapliga kvalitativa artiklar. Resultat: Äldre upplevde att vikten av gemenskap med andra och möjligheten till aktivitet hade betydelse för upplevelser av meningsfullhet. Äldre upplevde att omgivningen hade betydelse för hur de äldre upplevde sig uppmärksammade och kände trygghet samt igenkännande i den dagliga tillvaron. Äldre beskrev att livet på äldreboendet, antingen var deras största önskan eller största förlust. Äldre upplevde att en nedsatt kroppslig funktion kunde resultera i en önskan att bevara självständigheten samt att leva med dödens närvaro. Slutsats: Upplevelser av den dagliga tillvaron på äldreboende är individuella, upplevelserna har samtidigt flertal gemensamma faktorer. Kunskap om hur äldre upplever den dagliga tillvaron på äldreboende, kan bidra till att sjuksköterskor får en ökad förståelse över hur omvårdnad kan bidra till en meningsfull tillvaro. / Background: The care given to elderly residents should be characterized by respect, dignity and in collaboration with the elderly. Based on the needs of elderly, the nurse and nursing staff can meet the wishes of the elderly. Aim: The aim is to describe elderlies experiences of the daily life in nursing homes. Method: A systematic literature study based on 10 qualitative scientific articles. Result: The fellowship with others and the opportunities for activity was important for experiences of meaningfulness. The surroundings was important for how the elderly experienced attention, felt secure and acquaintance. Elderly described that life in the nursing home was either their greatest desire or greatest lost. Elderly experienced that a impaired bodily function could result in a desire to preserve independence and to live with the presence of death. Conclusion: Experiences of the daily life in nursing homes is individual, still the experiences have several common factors. Knowledge of how elderly experience the daily living in nursing homes, can help nurses gain an increased understanding of how the care can contribute to a meaningful existence.

Apesar do número de estudos que existem sobre o impacto da criança estomizada na família pouco se conhece na América do Sul a respeito da experiência dos pais no cuidado dessas crianças e como eles definem sua experiência. Este estudo teve como objetivo compreender a experiência dos pais no cuidado da criança com colostomia. Foram realizadas entrevistas abertas em profundidade com dez casais pais de crianças com colostomia, residentes nas cidades de São Paulo (Brasil) e Bogotá (Colômbia). Todo o processo da investigação pauto-se pelo referencial teórico do Interacionismo Simbólico e a análise dos dados na Teoria Fundamentada nos Dados. A experiência dos pais está estruturada nos fenômenos Sentindo-se frágeis e Tornando-se fortes, que atuam como condição causal e estratégia respectivamente. Elas representam a complexidade existente entre ser pais e ser os provedores de cuidado especializado à criança. Edificando uma fortaleza, emergiu como a categoria central da experiência que é conseqüência de um processo intencional de construção interior dos pais, mediante o uso de estratégias para transformar significados e erguer um cenário de cuidados para protegerem-se a si mesmo, à criança e à família e para renovar as forças necessárias a fim de conseguirem enfrentar e resistir às ameaças presentes na experiência / Despite the number of existing studies about the impact of children with a colostomy on their families, there is however very limited information about parental experience of caring for these children and how they define their experience in South America. This study intends to understand the parental experience of caring for children with a colostomy. The method for data collection was an open interview involving 10 couples residing in the cities of São Paulo (Brazil) and Bogota (Colombia). The entire investigation process was guided by the referential theory of Symbolic Interactions and the data analysis was done by the Grounded Theory. The parental experience is supported in the phenomena Feeling fragile and Becoming strong as a causal condition and strategy, respectively. They represent the tension of being parents and special care providers of the child. \"Building a fortress\" emerged as the central category that represents an experience which is the consequence of a deliberate process of internal construction of parents by using strategies to transform meanings and build a scenario of care to protect themselves, the child and family and to renew the forces necessary to confront and resist the threats present in the experiment

This study employs qualitative methods to: (1) compare and contrast public conversations about a complex social phenomenon with my experience of that phenomenon, and (2) explore the nature of those public conversations and their impact on planetary transformation. This study is divided into two parts. Part One of this dissertation compares my personal experience with Landmark Education Corporation, a private personal development company, with how it is characterized in public conversations. The public conversations chosen for analysis include: (1) an episode of the television show, Law and Order: Criminal Intent (Balcer, et al., 2003), (2) a Time Magazine article about Landmark Education Corporation (Faltermayer, 1998 March 16), and (3) psychological research on large group awareness trainings, of which Landmark Education courses are one example. Each of these public conversations contrasts significantly with my personal experience and therefore fails to account for what I see as the potential for work like Landmark's to transform the conversations that constitute our society, and ultimately, life on our planet. To help account for the value I see in Landmark's courses, Part Two of the dissertation examines the communication of Landmark participants to ascertain whether their communication in fact poses the possibility of global transformation through open, compassionate, reciprocal communication practices learned in Landmark courses. It draws from qualitative interviews, a focus group, and a focus group observation interview. Based on the results of this research, I argue that the communication of Landmark participants has the power to transform society, and that the public conversations about Landmark Education examined here are a drag on global transformation. Most broadly, I respond to the following question: When we examine particular public discourses about unusual social phenomena, what can we learn about the relationship between these discourses and the social phenomena aimed at transforming them?

Capturing and studying the moments in psychotherapy that clients find most important can help us understand more about how psychotherapy works, what the curative ingredients are, and by what processes they are mediated. Qualitative research in this area has, so far, mainly focused on describing, and categorizing clients’ experiences of important factors and events. The methods employed to analyse the data have been rather limited in variation and are usually based on a realist epistemology, according to which data are basically treated as reflections of the clients’ actual experiences. This entails a risk of overlooking and obscuring other aspects of therapy and the therapy process that are equally important to explore, for example the microprocesses of interaction within important events, or how clients’ accounts of their experiences are shaped and limited by the context in which they are produced. The overall aim of this licentiate thesis was to explore client-identified important events in psychotherapy with a focus on studying therapy talk and talk about therapy from a social constructionist point of view, which would allow a closer exploration of the understudied areas mentioned above. In Study I, Conversation Analysis was used to explore the interaction taking place between seven client-therapist dyads in 16 client-identified important events collected from their third sessions. The analysis identified that 12 of the events contained clients’ expressions of disagreement. Three different ways that the therapists handled the disagreement were discerned: The first, and most common, way was to orient to the client’s cues of disagreement by inviting the client to elaborate on his or her point of view and to establish a shared understanding acceptable to both participants. The second way was to orient to the client’s disagreement cues but define the therapist’s own point view as more relevant than the client’s, and the third way was a single case in which the therapist did not in any way orient to the client’s disagreement cues. In Study II, two qualitative methods based on different epistemologies were used to analyse the same set of eight clients’ accounts of 18 important events. The aim was to first identify what types of events clients describe as important, and then explore how their accounts of these events were contextually shaped and  organized, and the consequences of this. The first analysis, a content analysis, yielded descriptions of five different types of events, which were similar to the ones found in previous research on important events. The second analysis, a discourse analysis, demonstrated how clients’ accounts were not only influenced by the participants’ ability to accurately remember and report their experience, but also by what was sayable within the context of the research interview. In conclusion, the two studies demonstrate how qualitative methods based on a socialconstructive perspective can contribute to our understanding of clientidentified important events by highlighting and describing participants’ use of language in interaction, and its forms and  functions within therapy sessions and in research interviews. The findings point out the need to broaden the range of qualitative methods used in psychotherapy research in general and indicate the potential value of methods like CA and DA to psychotherapy process research and research on important events in particular.

Unmaking the Other? is a qualitative sociological analysis of the discourses of intellectual disability present in contemporary Australian society. It attempts to reveal the ways that people with intellectual disabilities 'are' for Australians. This is important because people with intellectual disabilities have a long history of being seen as 'other' or 'not one of us'. For many years they were kept 'out of sight, and out of mind� on the margins of our communities, locked in institutions or hidden in sheltered workshops. Yet, during the last few decades there has been a concerted effort to bring people with intellectual disabilities back into society. Institutions and sheltered workshops closed, and policies of inclusion, normalisation and community living were vigorously pursued. People with intellectual disabilities are now equal citizens in the eyes of the law. But how readily have we accepted that people with intellectual disability are 'one of us'? Have community living reforms overturned deep cultural dispositions that cast people with intellectual disabilities as 'lesser', 'defective', and lacking personhood? This thesis investigates recent community living reforms, especially the assumption that inclusion and education would radically transform our conceptualisations of people with intellectual disabilities. To do this, it draws on contemporary social and political theory to explore how the meanings of disability are created and maintained, focusing on the Foucauldian concept of discourse. This Foucauldian theorisation of discourse, power and knowledge informs a methodology devised to provide a more detailed and sophisticated analysis of the meanings of intellectual disability than previous investigations. Texts from three key social arenas are analysed for the way in which our society constructs intellectual disability, and these analyses lead to a number of theoretical and practical conclusions. Specifically, the main contributions of this thesis are: the identification and analysis of fourteen distinct discourses of intellectual disability, the theoretical explication of their relations to one another, and theoretical discussion of what their presence reveals about intellectual disability in today�s Australia. The findings of a variety of discursive constructions of intellectual disability suggest a complex picture in which discourses of inclusion and membership have emerged that are consistent with community living reforms, while at the same time there has been a continuation of discourses that view people with intellectual disabilities as defective humans. Drawing on theory and empirical evidence, possibilities are suggested for further political and educational interventions into the discursive construction of people with intellectual disabilities. The problems posed by our attempts at liberation through community living reforms are major; this thesis contributes to this task by revealing the complexity, contradictions, and resistances inherent in this task. What is more, it sees these findings not as causes for dismay, but as reasons for cautious hope.

Relatives may experience a difficult and demanding situation when the patient is critically ill. During the period in the intensive care unit (ICU), the relatives may be subject to strong emotions of an existential nature, and the situation may involve several stressors as a result of changed roles, responsibilities and routines. These emotional stress experiences may result in weakened mental and physical functioning on the part of the relatives. During the patient’s rehabilitation at home the relatives are expected to provide care-giving assistance, which may lead to a further deterioration in their already weakened mental and physical functioning. The general aim of the thesis was to develop a theoretical understanding of coping approaches and social support experiences of relatives of critically ill patients, both in the ICU and at home. In order to gain an understanding of these areas it was deemed important to search for knowledge by means of qualitative methods, using grounded theory methodology, simultaneous concept analysis and qualitative content analysis. A total of 32 relatives of critical care patients participated in the studies. The findings of study I revealed that relatives of critically ill patients coped with their situation by alleviating, recycling, mastering or excluding their feelings during the ICU stay. The critical factors behind their choice of coping approach were their social circumstances, previous experiences of care and/or caring and how they apprehended the situation. In study II, during the patients’ recovery period at home, the relatives coped with their situation by accepting, volunteering, sacrificing or modulating. The critical factors in this period were the physical and psychological state of the relatives, previous experiences of care and/or caring and the psychological condition of the patient. A coping model was developed in study III, based on the coping concepts generated in studies I and II. In this model, the characteristics of each coping approach were systematised into different determinants in order to highlight the inherent process. The analysis of the relationship between the various coping approaches revealed differences in adaptation to the stressful situation. In terms of coping effectiveness, adaptation was associated with social support and health outcome. In the extended version of the coping model, with its dual perspective of the maladaptive-adaptive coping continuum and the weak-strong social support continuum, the degree of effectiveness of each coping approach was illustrated in relation to the others as well as to social support. In study IV and its Addition, a theoretical understanding of the phenomenon of what relatives experienced as supportive was developed. Support was perceived as empowerment by means of internal and external resources in the form of trusting oneself, encountering charity and encountering professionalism. The sense of empowerment permitted the relatives to experience their situation as safer and easier to control. The three support dimensions with their components and characteristics were illustrated in the empowerment model. These four studies have developed knowledge that may provide healthcare professionals with an understanding of the coping approaches and social support experiences of relatives during the critically ill patient’s ICU stay and recovery period at home. The association revealed between coping effectiveness, social support and health outcomes may draw attention to the relatives’ situation as well as to the possibility of enabling relatives to endure the patient’s entire illness and recovery period by enhancing the factors that promote effective coping. The three models may together form the basis for the development of a support programme for relatives of critically ill patients that encompasses the whole course of illness and recovery, which means that both institutional and community-based care would be involved.

This study deals with students' notions of the function in society of their future professions. The overall aim is to study what notions are actually represented by the students and to describe the content of these notions. Another aim is to study how the students' notions change during their period of training. Slightly more than 100 students, distributed equally among the higher education programmes of economics, medicine, psychology and engineering, were interviewed when entering these programmes and after a period of approximately three years. The result of the analysis of notions was that five qualitatively different categories of notions could be discerned among students of economics, psychology and engineering, whereas three could be found among students of medicine. The categories run on a dimension from the profession being regarded as manifestations of and subordinate to an economic-political system, to the profession being regarded as manifestations of and subordinate to individual differences. The various categories of notions have been given names intended to, somewhat incisively, summarize their content. The students of economics and engineering changed during their period of training so that a larger number of them conceptualized the profession as a manifestation of individual differences. The students of psychology changed in the opposite direction and the students of medicine remained in the middle position. An analysis of the students' reflections on notions and the conceptualization per se, has also been carried out. This analysis is an attempt at problemizing the relation between notions and actions. It showed that, at the end of their training period, the students of psychology and, to a certain extent, the students of engineering more often than students of economics and medicine, considered the possibilities of acting in accordance to their notions of the ideal function of the professions. Attempts are also made at relating certain changes of the students' notions to specific characteristics of the educational programmes. The importance of students' initial notions for how they change is, however, also analysed and emphasized. The answer to the question of students' change of notions during their period of training can, in other words, be found in the dynamics and in the opposition between students' initial notions and the notions of the professions conveyed by the education. In relation to the goal of higher education to encourage critical thinking in students, the results of this study indicate that the educational programmes, rather than conveying one specific critical notion, should convey an awareness of the fact that there are different notions of the function of the profession. The students would then be stimulated, on the basis of their own initial notions of the profession, to make critical examinations of, to decide on, and to make their own choices of alternative notions. / digitalisering@umu

Cultural competency is theorized as the sensitivity of practitioners from the dominant culture towards the diverse cultural backgrounds of their patients. Less attention is placed on how communication between providers and patients can enable patients to share their health care beliefs. An evidence review of the literature around the conceptualization of cultural competency in health care was performed, and interviews were conducted aiming to understand what immigrant patients perceive as culturally competent care and its effect on the relationship between them and their providers. Definitions of cultural competence varied, and no conclusive studies linking cultural competence to improved health outcomes were found. Findings from the participant interviews helped to address gaps in the literature by confirming a preference for a patient-centred approach to culturally competent care, in addition to identifying pre-existing expectations for the health care encounter and patient-dependent factors as additional elements influencing the physician-patient relationship.

The purpose of this study is to examine stabilization and change in students' notions of division of labour, wage differentiation and reproduction of labour force. A description is given of the development and application of a qualitative method for the analysis of interviews within the framework of a theory-generating evaluation of long-term effects of higher education. A central concept is notion, the theoretical and methodological development of which up to a strict description of the content is presented in different categories. A model is presented of the structural features of notions. A theoretical revaluation of ideological reproduction is outlined and reconnected with the initial theoretical frame of reference. The empirical data consist of transcribed interviews with students of economics, medicine, psychology and engineering. The interviews were made on two occasions: when the students entered their educational programmes and after a period of about three years. The initial number of students involved were 25-27 from each educational programme. The results of the empirical analyses show initial différencies in students' ideological shaping, both within and between educational programmes. For a majority of students notions remain stable over time. Occurring changes lack general characteristics. For students of medicine and engineering changes in notions of differentiation of wages are unidirectional and fairly common while students of psychology change their notions in another direction but not to the same extent. Changes in notions of division of labour are more common among students of economics and psychology than in other groups but the direction of change is not the same in the two groups. Changes in students' notions can be said to depend on initial notions, educational programme, and societal aspect subject to the analysis. The study ends with some reflections on qualitative methods and theory generating evaluation. / digitalisering@umu

The purpose of this study was to understand why there is such lack of citizen participation among Asian Americans, despite the exponential growth of Asian American population in the state. Based on the literature on sense of community, citizen participation, and psychological empowerment, it was speculated that how individuals experience community may influence their motivation to participate. With the goal to understand and document how Asian Americans define community and experience sense of community, a sample of Asian Americans were interviewed. These individuals were participants of the Photovoice project conducted by a local community-based organization. The second aim of the study was to explore if and how a project like Photovoice enhanced the sense of community among participants. The findings suggested that Asian Americans defined various types and multiple communities. Also, it was suggested that because Asian American community is an imposed community of people of diverse Asian background, Asian Americans may not necessarily define it as a community or experience sense of community within the community. Based on the experiences of the participants, Photovoice seem to have great potential in bringing such diverse group as Asian Americans together as a community. Limitations of the study and future directions are discussed.