Stigma has a negative effect on individuals, which may include psychological distress, anxiety, and social isolation (Pachankis, 2007). Stigma can be either concealable or visible. A concealable stigma is an attribute that is not visibly apparent, but would be devalued if known by others (e.g., sexual orientation, Page 30 2014 Appalachian Student Research Forum mental illness, sexual abuse). Some believe that individuals with a concealable stigma do not face prejudice and discrimination because the stigma is not apparent to others. However, research suggests that those with a concealable stigma may feel the constant need to hide that identity or characteristic, and this may increase distress and anxiety due to the threat of discovery (Pachankis, 2007). We hypothesized that individuals with a concealable stigma will have higher levels of stigma, rejection sensitivity, distress, and anxiety as well as lower levels of self-esteem, relative to those individuals with a visible stigma. The current sample was taken from a larger study (N=408) and consist of participants (n=70) who selfidentified a stigmatizing characteristic. The self-reported characteristics were independently coded by two research assistants as concealable or visible and finally, the assistants collectively assigned the characteristics to each group. Our sample consists of 35.7% concealable (e.g., sexuality, mental illness, history of abuse) and 64.3% visible (e.g., physical appearance, physical disability, race/ethnicity). To test our hypotheses, we used an independent t test to assess the differences in levels of stigma, self-esteem, distress, anxiety, and rejection sensitivity between concealable and visible stigma groups. Results show that self-stigma (t(68)=-.798, p=.428), public stigma (t(68)=-.149, p=.882), and self-esteem (t(68)=-1.320, p=.191) do not differ between groups. By contrast, and in support of our hypotheses, those with concealable stigma reported more rejection sensitivity (t(68)=2.315, p=.024) and anxiety (t(68)=3.030, p=.003) than those with visible stigma. Contrary to our hypotheses, distress (t(68)=-2.599, p=.011) was higher for those with visible stigma than concealable stigma. Future research should be conducted to examine levels of anxiety and rejection sensitivity in individuals with concealable stigma to understand the differences among stigmatized identities and characteristics.

Bakgrund: Missbruk av alkohol och droger är ett samhälleligt och globalt problem. År 2012 levde 29 miljoner människor med ett missbruk. I kontakt med vården har personer med missbruksproblematik beskrivit negativa erfarenheter och attityder från sjukvårdspersonal. Stigma gentemot personer med missbruksproblematik är förekommande vilket kan komma att påverka den vård de får. Syfte: Att beskriva sjuksköterskans attityder och erfarenheter i mötet med personer med alkohol- och drogmissbruk i somatisk vård. Metod: För att svara på syftet genomfördes en litteraturöversikt där nio artiklar genomförda med kvalitativ metod och en artikel med kvantitativ metod analyserades. Resultat: Denna litteraturöversikt framställs i fem huvudteman där tre huvudteman har ett tillhörande subtema: Det första temat är sjuksköterskans rädsla och personer med missbruksproblematiks livsstil med tillhörande subtema sjuksköterskors ambivalens. Det andra temat är ansvarig eller inte ansvarig för sitt missbruk. Det tredje temat utgörs av att inte ha kunskap och fjärde temat består av sjuksköterskors misstro med tillhörande subtema misstrons konsekvenser. Det sista temat är utagerande och våldsamhet skapar stress och oro med tillhörande subtema konsekvenser av utagerande och våldsamhet. Diskussion: Resultatet har diskuterats utifrån Erikssons caritativa vårdteori med fokus på begreppet vårdlidande. De sjuksköterskor som hade negativa erfarenheter av personer med missbruksproblematik fick ofta negativa attityder gentemot dessa personer. De negativa attityder som en del sjuksköterskor hade gav i sin tur konsekvenser för vården de gav. Vissa sjuksköterskor kände misstro gentemot personer med missbruksproblematik något som kunde drabba vårdrelationen. Brist på kunskap blev ett hinder för att vårda dessa patienter och sjuksköterskornas utsatta position ledde till ett distanserat förhållningssätt. / Background: Misuse of alcohol and narcotics is a socially and global problem. In the year of 2012, 29 million people suffered from an addiction of alcohol and narcotics. In contact with care, people with addiction has described negative experiences and attitudes of health care professionals. Stigma against people with addiction is occurring which may influence the care they receive. Aim: To describe nurses' attitudes and experiences in meeting with people with alcohol and drug abuse in somatic care. Method: To answer the aim of the study the authors conducted a literature review where nine articles of qualitative approach and one article of quantitative approach were analysed. Results: This literature review is presented in five main themes where three main themes have associated subtheme: The first theme is Nurses fear and substance misuser’s lifestyle with associated subtheme nurses' ambivalence. The second theme is responsible or not responsible for their addiction. The third theme consists of not having the knowledge and fourth theme consists of nurse’s mistrust with associated subtheme consequences of mistrust. The last theme is acting out and violence creates stress and anxiety associated with subtheme consequences of acting out and violence. Discussion: The result has been discussed from Erikssons caritative theory with focus on the concept of suffer of care. The nurses who had negative experiences of people with addiction problems often had negative attitudes towards these people. The negative attitudes that some nurses had yielded in turn implications for the care they gave. Nurses felt mistrust in the meeting with people who had an addiction which affected the therapeutic relationship. Lack of knowledge was an impediment to care for these patients and the nurses vulnerable position led to a detached approach.

Orientador: Francisco Hashimoto / Banca: Catarina Satiko Tanaka / Banca: Marlene Castro Waideman / Resumo: A exaltação conferida ao trabalho na sociedade ocidental concedem ao trabalhador uma identidade social, somos aquilo que fazemos e fazemos para um outro (Lei do social) que nos reconheça enquanto sujeitos desejantes, criando-se laços de investimento libidinal entre este sujeito (trabalhador) e o outro. Na relação de trabalho, a organização será este outro social, que assumirá uma função de Lei, uma função paterna, a quem o sujeito se ligará em busca reconhecimento, identificação e de realização de seu Desejo. Mais que isso, as organizações são o lugar de aprisionamento psíquico, recalcamento, sofrimento, criando uma eterna luta do Individual X Coletivo, Sujeito X Organização, Lei X Desejo. Assim sendo, este estudo apreende e analisa o enfrentamento do sujeito com a situação de trabalho, e a constituição subjetiva advinda após este encontro, a que chamamos de sujeito organizacional. Utilizando, em especial, os estudos de Enriquez e Dejours, e a partir de relatos e entrevistas sobre a trajetória profissional de trabalhadores vinculados a uma instituição universitária do estado de São Paulo, foi possível vislumbrar a utilização de mecanismos de defesa individuais e coletivos como forma de aliviar o sofrimento surgido da experiência de trabalho, bem como a construção de representações psíquicas acerca de sujeito, subjetividade, trabalho e sujeito trabalhador, e ainda a constituição/alteração de vivências materiais, sociais e históricas. Tendo como questão que o sentido construído pelo trabalhador em seu projeto de trabalho e projeto de vida faz ressonância com experiências passadas, presentes e expectativas futuras, mesmo que no ato analisador estes elos não se mostrem claramente, é de fundamental importância à clareza de que a arquitetura das análises, assim como o próprio objeto a ser analisado, é marcado pela singularidade e pelo subjetivo, permitindo diferentes exames e abordagens. / Abstract: The exaltation affixed to the act of working in the western world grants the working person a social identity, that is to say, people are whatever they do, and they do so for another (Social Law) who can recognize them as desiring subjects, consequently creates ties of libidinal investment between the party offering his/her services (worker) and the other party desiring to hire him/her. . Through labor relationship, an organization will show its other side, which will take up a function of law, a paternal function, which the subject will be connected to in search of recognition, identification and fulfillment of his/her Desires. Furthermore, organizations are a place of psychic imprisonment, repression, and suffer feeding the eternal clash between the Individual and the Social; the Subject and The Organization; the Law and the Desire. Thus, this study aims at analyzing the clashes of workers within their job situation and the subjective constitution originating as a consequence of these clashes, which we call organizational subject. By making use of previous studies, especially those by Enriquez and Dejours, and by interviewing a diverse range of individuals, it was possible to gain an overview of individual and collective self-defense mechanisms as a means of relieving the pain brought about by the experience of work, and the construction of psychic representations on the subject, subjectivity, work, working subject, and yet the construction/alteration of material, social and historical experiences. Bearing in mind that the meanings a working person sets on his/her work and life project echoes both present and past experiences as well as expectations - even when these can not be seen clearly at the time of analysis. Therefore it is essential to understand that the architecture of analysis as well as the subject to be analyzed is highly marked by the singularity and subjectivity, allowing different examinations and approaches. / Mestre

<p>When someone becomes seriously ill from cancer their relatives experience a great suffering from observing the changes in their loved ones as a result of the disease. They felt that they did not receive the support and information they needed to process their difficult lives.It also emerged that the relatives didn’t think the nursing staff treated and saw the family as a whole. The purpose of the study was to describe the suffering of families, as they experienced that during the final stages of a cancer patient's life. An inductive, manifest, content analysis has been carried out in five autobiographies written by relatives of patients, who had died as a result of cancer. Biographies were reviewed by the Graneheim and Lundman's method of analysis. We used Katie Eriksson’s scientific theories of care regarding suffering as a theoretical framework. The result has collected material presented in three categories: fear, sadness, and frustration which mirrors the suffering of relatives in these books. The results showed that the relatives denied the disease's existence, experienced a fear of the disease symptoms, death, and a future without the patient. The relatives describe the grief that they felt about the prospect of being left alone, about the patient's deterioration, and of not being seen as individuals. Finally the relatives describe the frustration they feel over the panic, stress, fatigue and anger that they experience in the end of the patients life.</p> / <p>När någon blir svårt sjuk i cancer upplever dess anhöriga ett stort lidande över att se sin närmaste förändras till följd av sjukdomen. De upplevde att de inte fick det stöd och den information som de behövde för att hantera sin svåra livssituation. Det framkom också att anhöriga inte tyckte vårdpersonalen såg och vårdade familjen som en helhet. Syftet med examensarbetet var därför att beskriva anhörigas lidande så som de upplever det under den sista tiden av den cancersjuka patientens liv. En induktiv manifest innehållsanalys har genomförts på fem självbiografier skrivna av anhöriga till patienter som avlider till följd av cancer. Biografierna granskades med Graneheim och Lundmans analysmetod. Som teoretisk referensram används Erikssons vårdvetenskapliga teorier om lidande. I resultatet har insamlat material redovisats i tre kategorier; rädsla, sorg och frustration som speglar de anhörigas lidande i böckerna. Resultatet visar att de anhöriga förnekar sjukdomens existens och upplever en rädsla över sjukdomens symtom, döden och en framtid utan patienten. De anhöriga beskriver den sorg de upplever över att bli lämnade ensamma, över patientens försämring och över att inte bli sedda som individer. Slutligen beskriver anhöriga en frustration över den förtvivlan, panik, stress, trötthet och vrede som de upplever under sista tiden patienten finns i livet.</p>

When someone becomes seriously ill from cancer their relatives experience a great suffering from observing the changes in their loved ones as a result of the disease. They felt that they did not receive the support and information they needed to process their difficult lives.It also emerged that the relatives didn’t think the nursing staff treated and saw the family as a whole. The purpose of the study was to describe the suffering of families, as they experienced that during the final stages of a cancer patient's life. An inductive, manifest, content analysis has been carried out in five autobiographies written by relatives of patients, who had died as a result of cancer. Biographies were reviewed by the Graneheim and Lundman's method of analysis. We used Katie Eriksson’s scientific theories of care regarding suffering as a theoretical framework. The result has collected material presented in three categories: fear, sadness, and frustration which mirrors the suffering of relatives in these books. The results showed that the relatives denied the disease's existence, experienced a fear of the disease symptoms, death, and a future without the patient. The relatives describe the grief that they felt about the prospect of being left alone, about the patient's deterioration, and of not being seen as individuals. Finally the relatives describe the frustration they feel over the panic, stress, fatigue and anger that they experience in the end of the patients life. / När någon blir svårt sjuk i cancer upplever dess anhöriga ett stort lidande över att se sin närmaste förändras till följd av sjukdomen. De upplevde att de inte fick det stöd och den information som de behövde för att hantera sin svåra livssituation. Det framkom också att anhöriga inte tyckte vårdpersonalen såg och vårdade familjen som en helhet. Syftet med examensarbetet var därför att beskriva anhörigas lidande så som de upplever det under den sista tiden av den cancersjuka patientens liv. En induktiv manifest innehållsanalys har genomförts på fem självbiografier skrivna av anhöriga till patienter som avlider till följd av cancer. Biografierna granskades med Graneheim och Lundmans analysmetod. Som teoretisk referensram används Erikssons vårdvetenskapliga teorier om lidande. I resultatet har insamlat material redovisats i tre kategorier; rädsla, sorg och frustration som speglar de anhörigas lidande i böckerna. Resultatet visar att de anhöriga förnekar sjukdomens existens och upplever en rädsla över sjukdomens symtom, döden och en framtid utan patienten. De anhöriga beskriver den sorg de upplever över att bli lämnade ensamma, över patientens försämring och över att inte bli sedda som individer. Slutligen beskriver anhöriga en frustration över den förtvivlan, panik, stress, trötthet och vrede som de upplever under sista tiden patienten finns i livet.

Bakgrund: Hjärtsvikt är idag en av våra folksjukdomar och tros öka i framtiden. Det är ett kroniskt tillstånd som karaktäriseras av flera olika symtom så som dyspné och andfåddhet. Den vanligaste orsaken till hjärtsvikt är ischemisk hjärtsjukdom som utgör 50-75% av all hjärtsvikt. New York Heart Association Functional Classification är en funktionsklassificering som är baserat på patientens egna upplevelser av sjukdomen och är graderad från I-IV. Att lida av en kronisk sjukdom kan innebära flera olika former av lidande som till exempel sjukdoms-, livs- och vårdlidande. Syfte: Att beskriva patienters upplevelser av hur hjärtsvikt och dess symtom påverkar det dagliga livet. Metod: Litteraturbaserad studie som är grundad på elva vetenskapliga artiklar. Resultat: Hjärtsvikt påverkar hela människan både psykiskt och fysiskt i det dagliga livet. Livet blir begränsat på grund av de somatiska symtomen där även emotionella svårigheter blir tydliga. Att inte längre kunna utföra dagliga rutiner och delta i aktiviteter leder till en känsla av isolering och försämrad livskvalité. Slutsats: Hjärtsvikt har en tydlig påverkan i patientens dagliga liv där kroppen konstant är under förändring. Detta leder till en okänd upplevelse där framtiden för patienten är oförutsägbar. Hjärtsvikt är ett tillstånd där hela människan bör beaktas för att kunna lindra lidande. / Background: Heart failure is currently one of the major diseases and is believed to increase in the future. It is a chronic condition characterized by multiple symptoms such as dyspnea and shortness of breath. The most common cause of heart failure are ischemic heart disease, which constitutes 50-75% of all heart failure. New York Heart Association Functional Classification is a classification function which is based on the patient's own experience of the disease and are graded from I to IV. A chronic disease can cause suffering of disease, suffering of life and suffering of care. Aim: To describe patients' experiences of how heart failure and its symptoms affect daily life. Method: A literature-based study, in which the result is based on eleven scientific articles. Results: Heart failure affects the whole person, both mentally and physically in daily life. Life becomes limited because of the somatic symptoms and emotional difficulties is also known. The feeling of isolation becomes evident when the patient cannot participate in activities. Quality of life deteriorates when the daily routines can no longer be performed. Conclusion: Heart failure has a clear impact in the patient's daily life in which the body is constantly changing. This leads to an unknown experience where the future is unpredictable. Heart failure is a condition where the whole person should be considered in order to alleviate suffering.

In the thesis knowledge of anatomy and physiology of musculoskeletal (locomotor) system is presented. Etiology, classification, diagnostics and types of vertebrogenous diseases are described. Furthermore, treatment options, focusing on disadvantages of surgical procedures for disc prolapse, on conservative treatment and prevention of vertebrogenous diseases are mentioned. Another important section deals with social aspects of vertebrogenous diseases in medical staff members, causes of sick leave and medical personnel turnover. The main objective of the thesis was to determine which specific profession included in the research database is the most endangered by vertebrogenous diseases. Other objectives were to find out if health professionals consider starting a new profession in consequence of vertebrogenous disease and also to determine the level of health professionals´ awareness of these diseases. The data needed to compile this thesis were obtained through the study of professional materials, using a questionnaire technique and an interview technique. The research was conducted using quantitative research and anonymous questionnaires. The questionnaires were distributed to medical personnel divided into four groups according to their professions. The outcomes show that all the professions included in the research are vulnerable to vertebrogenous diseases, the most endangered being operating theatre nurses. It is important especially in the health sector to use actively and practically all the means to ensure suitable working positions, such as comprehensive application of ergonomic requirements. The results of the research show that medical staff turnover is mainly caused by economic reasons. Management of our health care facilities should be aware of that fact and should involve personnel management tools such as corporate culture creation and communication. Furthermore, it was found that the majority of health professionals suffer form a lack of relevant information on vertebrogenous diseases and apply pharmacological treatment. It is important to draw attention to those errors in treatment and to provide professional public with quality information on all treatment options.

<p>Det finns få vårdvetenskapliga studier av personer som lever med eller vårdas för olika former av förmakstakykardi. Det saknas även riktlinjer för sjuksköterskor hur de ska omhänderta patienter med förmakstakykardier i lika stor utsträckning som vid andra hjärtsjukdomar. Syftet med detta examensarbete är att beskriva innebörder att leva med och vårdas för förmakstakykardi. Studien har ett livsvärldsperspektiv och ett dialektiskt perspektiv på processen mellan vård och besvär. Data samlades in med kvalitativa intervjuer. Fyra män och tre kvinnor intervjuades. Datan analyserades med en fenomenologisk hermeneutisk metod enligt Lindseth och Norberg (2004). I resultatet belyses processen mellan vård och besvär av förmakstakykardi. Resultatet visar att patienter vars förmakstakykardi har gått över innan de kommer till sjukhus har svårt att få någon diagnos. Resultatet påvisar också att vården inte förser patienterna med den kunskap de behöver i sitt dagliga liv och att det är ett större problem för patienterna att takykardin återkommer än när den pågår. Om dessa aspekter inte tillgodoses så kan det uppstå ett vårdlidande.</p> / <p>There are few studies with a caring science perspective of people who lives or being cared for different forms of supraventricular tachycardia. There is also a lack in guidelines for nurses how to care for patients with supraventrikulär tachycardia in comparison with other heart conditions. The aim of this study is to describe meanings of living with and being under care for supraventricular tachycardia. The study has an lifeworld perspective and a dialectic perspective on the process between caring and inconvenience. Data was collected with qualitative interviews. Four men and three women where interviewed. The data was analyzed using an phenomenological hermeneutic method as described by Lindseth and Norberg (2004). The result enlightens the process between care and inconvenience of supraventricular tachycardia. The result shows that patients with a supraventricular tachycardia that ends before they reach the hospital have difficulties to be diagnosed. The result also points out that the given care dos not provide the patients with the knowledge they need in their daily life and it is a greater problem for the patients that the tachycardia returns then it is when its actually going on. Failing these aspects may inflict a suffering caused by care.</p>

Det finns få vårdvetenskapliga studier av personer som lever med eller vårdas för olika former av förmakstakykardi. Det saknas även riktlinjer för sjuksköterskor hur de ska omhänderta patienter med förmakstakykardier i lika stor utsträckning som vid andra hjärtsjukdomar. Syftet med detta examensarbete är att beskriva innebörder att leva med och vårdas för förmakstakykardi. Studien har ett livsvärldsperspektiv och ett dialektiskt perspektiv på processen mellan vård och besvär. Data samlades in med kvalitativa intervjuer. Fyra män och tre kvinnor intervjuades. Datan analyserades med en fenomenologisk hermeneutisk metod enligt Lindseth och Norberg (2004). I resultatet belyses processen mellan vård och besvär av förmakstakykardi. Resultatet visar att patienter vars förmakstakykardi har gått över innan de kommer till sjukhus har svårt att få någon diagnos. Resultatet påvisar också att vården inte förser patienterna med den kunskap de behöver i sitt dagliga liv och att det är ett större problem för patienterna att takykardin återkommer än när den pågår. Om dessa aspekter inte tillgodoses så kan det uppstå ett vårdlidande. / There are few studies with a caring science perspective of people who lives or being cared for different forms of supraventricular tachycardia. There is also a lack in guidelines for nurses how to care for patients with supraventrikulär tachycardia in comparison with other heart conditions. The aim of this study is to describe meanings of living with and being under care for supraventricular tachycardia. The study has an lifeworld perspective and a dialectic perspective on the process between caring and inconvenience. Data was collected with qualitative interviews. Four men and three women where interviewed. The data was analyzed using an phenomenological hermeneutic method as described by Lindseth and Norberg (2004). The result enlightens the process between care and inconvenience of supraventricular tachycardia. The result shows that patients with a supraventricular tachycardia that ends before they reach the hospital have difficulties to be diagnosed. The result also points out that the given care dos not provide the patients with the knowledge they need in their daily life and it is a greater problem for the patients that the tachycardia returns then it is when its actually going on. Failing these aspects may inflict a suffering caused by care.

Made available in DSpace on 2014-06-11T19:29:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2005-03-10Bitstream added on 2014-06-13T20:18:48Z : No. of bitstreams: 1 santiago_es_me_assis.pdf: 341674 bytes, checksum: 0646f80577c29a77e14b6ee1884fff91 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A exaltação conferida ao trabalho na sociedade ocidental concedem ao trabalhador uma identidade social, somos aquilo que fazemos e fazemos para um outro (Lei do social) que nos reconheça enquanto sujeitos desejantes, criando-se laços de investimento libidinal entre este sujeito (trabalhador) e o outro. Na relação de trabalho, a organização será este outro social, que assumirá uma função de Lei, uma função paterna, a quem o sujeito se ligará em busca reconhecimento, identificação e de realização de seu Desejo. Mais que isso, as organizações são o lugar de aprisionamento psíquico, recalcamento, sofrimento, criando uma eterna luta do Individual X Coletivo, Sujeito X Organização, Lei X Desejo. Assim sendo, este estudo apreende e analisa o enfrentamento do sujeito com a situação de trabalho, e a constituição subjetiva advinda após este encontro, a que chamamos de sujeito organizacional. Utilizando, em especial, os estudos de Enriquez e Dejours, e a partir de relatos e entrevistas sobre a trajetória profissional de trabalhadores vinculados a uma instituição universitária do estado de São Paulo, foi possível vislumbrar a utilização de mecanismos de defesa individuais e coletivos como forma de aliviar o sofrimento surgido da experiência de trabalho, bem como a construção de representações psíquicas acerca de sujeito, subjetividade, trabalho e sujeito trabalhador, e ainda a constituição/alteração de vivências materiais, sociais e históricas. Tendo como questão que o sentido construído pelo trabalhador em seu projeto de trabalho e projeto de vida faz ressonância com experiências passadas, presentes e expectativas futuras, mesmo que no ato analisador estes elos não se mostrem claramente, é de fundamental importância à clareza de que a arquitetura das análises, assim como o próprio objeto a ser analisado, é marcado pela singularidade e pelo subjetivo, permitindo diferentes exames e abordagens. / The exaltation affixed to the act of working in the western world grants the working person a social identity, that is to say, people are whatever they do, and they do so for another (Social Law) who can recognize them as desiring subjects, consequently creates ties of libidinal investment between the party offering his/her services (worker) and the other party desiring to hire him/her. . Through labor relationship, an organization will show its other side, which will take up a function of law, a paternal function, which the subject will be connected to in search of recognition, identification and fulfillment of his/her Desires. Furthermore, organizations are a place of psychic imprisonment, repression, and suffer feeding the eternal clash between the Individual and the Social; the Subject and The Organization; the Law and the Desire. Thus, this study aims at analyzing the clashes of workers within their job situation and the subjective constitution originating as a consequence of these clashes, which we call organizational subject. By making use of previous studies, especially those by Enriquez and Dejours, and by interviewing a diverse range of individuals, it was possible to gain an overview of individual and collective self-defense mechanisms as a means of relieving the pain brought about by the experience of work, and the construction of psychic representations on the subject, subjectivity, work, working subject, and yet the construction/alteration of material, social and historical experiences. Bearing in mind that the meanings a working person sets on his/her work and life project echoes both present and past experiences as well as expectations - even when these can not be seen clearly at the time of analysis. Therefore it is essential to understand that the architecture of analysis as well as the subject to be analyzed is highly marked by the singularity and subjectivity, allowing different examinations and approaches.