Chronic pain is one of the most common health conditions, affecting nearly six million Canadian adults. Despite abundant research on chronic pain in general, there is limited knowledge on how racialized immigrant women experience living with chronic pain and how this relates to their broader social circumstances. The purpose of this qualitative, exploratory study is to understand living with chronic disabling pain as situated in and contextualized by the lived experiences of immigrant women residing in Ottawa, Ontario, and to explore the perspectives of the women's care partners as well as physicians providing care for chronic pain. Semi-structured interviews were conducted with 24 participants. The dissertation is guided by the social determinants of health framework and an intersectional lens. Four interconnected themes from the data analysis have been generated: (1) The trajectory and meaning of pain; (2) Reasons for pain and triggering factors; (3) Pain consequences; and (4) Coping and control. Findings indicate that chronic pain is a subjective, complex, biopsychosocial, and multidimensional phenomenon. Pain is a deeply personal experience linked with meaning. Results also highlight an association between the distribution of the social determinants of health during the life course and pain. Furthermore, the pain has profound, multidimensional impacts on the women and their families, and its treatment is a challenging task for health care professionals. In addition, the findings show that pain is often poorly recognized, underestimated, and inadequately managed. Finally, the results illustrate the perseverance and incredible resilience of the women and their carers. The findings provide several implications for policy, research, and practice.

Analytical Music Therapy (AMT) is an advanced model of music therapy practice in the United States. Inter Music Therapy (IMT) is one of four required training stages to becoming an analytical music therapist. IMT is an experiential process where two AMT trainees take turns being therapist and client to one another, while under the direct supervision of the AMT trainer. Music is an integral component throughout IMT. All clinical material addressed and processed in IMT is lived experience, rather than role-play. To date, there is limited research documenting the experience of IMT for the AMT trainee. This study describes the IMT experience for AMT trainees, reveals the most significant experiences of IMT, and identifies how IMT shapes the clinical skills of music therapists who experience it. Findings from this study may add value to the training of music therapists in general. This study implemented the qualitative interpretivist research approach of Transcendental Phenomenology to explore the lived experience of IMT from the perspective of persons who have participated in it. Six participants were interviewed, interviews were recorded and transcribed, and the data were analyzed in two phases. Phase one resulted in a synthesis for each participant. Syntheses are rich descriptions of each participant’s IMT experience. The final step in phase one resulted in a global distilled global essence describing what it is like to experience IMT. Phase two was a cross participant analysis resulting in six global themes, and some of these themes were further developed through sub-themes. The self-experience of IMT provided multiple learning opportunities for AMT trainees. IMT shaped AMT trainees’ clinical skills in the following ways: increased capacity for empathy, enhanced therapeutic presence, recognition of how personal material influenced the therapy session, further developed self-awareness, and expanded musical creativity. The supervisory process enhanced AMT trainees’ appreciation for supervision, and the value of trust in the therapy process. Log writing was instrumental to integrating learning. The following recommendations are suggested to strengthen music therapy training and supervision in general: opportunities for music making while in the role of self to increase self-awareness in training and supervision, with an emphasis on creativity; opportunities for live or recorded observation of clinical work in supervision (in academic settings and professional supervision); and training opportunities for music therapy supervisors along with improved clarity in the competency of music therapy supervisors. / Music Therapy

The treatment of eating disorders (EDs) presents many challenges. Therapists' reactions towards clients (countertransference) may further complicate treatment. Countertransference may be partially due to the therapist's own vulnerabilities. Due to the personal connection to the work, countertransference towards ED clients may be pronounced among therapists with eating disorder lived experience (EDLE). Previous research indicates that 25-50% of ED therapists have EDLE; yet, minimal research examines how therapists negotiate their experiences while treating ED clients. The existing literature largely operates from the assumption that EDLE is a liability. While therapists with EDLE have some distinct challenges, therapists with EDLE may also have a unique perspective to offer the ED profession. The present study sought to understand how therapists with EDLE use their EDLE as a resource in their clinical work with ED clients. The study was guided by the theoretical frameworks of social constructivism and symbolic interactionism, as well as the person-of-the-therapist clinical training philosophy. Using constructivist grounded theory methodology, semi-structured interviews (Mtime = 89 minutes) were conducted with 22 therapists with EDLE, who work with ED clients. Participants explored how they use and manage their EDLE during key tasks of treatment with their ED clients. Results revealed that therapists engaged in two, interconnected constellations of processes (systems) in order to use and manage their EDLE in clinical practice. The first system (The Central System) helps therapists transform their personal experiences into clinical guidance that they can use to inform their work. The second system (The Checks and Balances System) helps the therapist find a balance between connecting with the client, while also allowing for differences of experiences to emerge. Lastly, personal processes (personal meaning making, values surrounding authenticity, and stigma surrounding EDLE), existing outside of these systems, were also found to impact the ways in which therapists use and manage themselves. Findings have implications for the EDLE literature, by providing novel ways therapists can use their EDLE. Findings also have implications for the POTT framework by exploring how POTT can be adapted for therapists who share lived experiences with their clients. A POTT-EDLE is proposed for training therapists with EDLE. / Doctor of Philosophy / The treatment of eating disorders (EDs) presents many challenges (e.g., frequent comorbidity, high rates of relapse, and the life-threatening nature of the disorder). Therapists' reactions towards clients (countertransference) may further complicate treatment. Countertransference (e.g., worry, frustration, hopelessness) may be partially due to the therapist's own unresolved issues and vulnerabilities. Due to the personal and professional connections to the work, countertransference towards ED clients may be particularly pronounced among therapists with eating disorder lived experience (EDLE). Previous research indicates that 25-50% of ED therapists have EDLE; yet, minimal research examines how therapists use and manage their experiences while treating ED clients. The existing literature largely operates from the assumption that EDLE is a liability and therapists with EDLE are working from a deficit. While therapists with EDLE have some distinct challenges, therapists with EDLE may also have a unique perspective to offer the ED profession. The study sought to understand how therapists with EDLE use their EDLE as a resource in their clinical work with ED clients. Interviews were conducted with 22 therapists with EDLE who work with ED clients. Results revealed that therapists engaged in two systems in order to use and manage their EDLE in clinical practice. The first system (The Central System) helps therapists transform their personal experiences into clinical guidance that they can use to inform their work. The second system (The Checks and Balances System) helps the therapist find a balance between connecting with the client, while also allowing for differences of experiences to emerge. The Central System and The Checks and Balances System work in tandem in order for the therapist to both use and manage their EDLE. Results describe the multiple processes informing these systems. Lastly, personal processes (personal meaning making, values surrounding authenticity, and stigma surrounding EDLE), existing outside of these systems, were also found to impact the ways in which therapists use and manage themselves. Findings have clinical and training implications for how therapists with EDLE can use and manage their EDLE to inform their clinical work with ED clients.

Bakgrund: Obesitas är ett medicinskt tillstånd med överdriven fettansamling i kroppen vilket ökar risken för hälsoproblem. Body Mass Index (BMI) används för att ställa diagnos. Orsakerna till obesitas inkluderar genetiska faktorer och beteendemönster. Negativa fördomar från sjukvårdspersonal kan hindra personer att söka vård. Syfte: Syftet var att undersöka individers erfarenheter av att leva med obesitas. Metod: Litteraturstudie används för att sammanställa kvalitativ forskning om individer med obesitas. Engelskspråkiga peer-reviewed artiklar mellan 2015 och 2023 fokuserade på erfarenheter av obesitas. 11 utvalda artiklar analyserades. Detta resulterade i övergripande insikter om livet med obesitas. Resultat: Det framkommer tre teman i resultatet: ”Beteendemässiga hinder och strategier i vardagen”, ”Att möta fördomar men att få personcentrerad vård” och ”Strävan efter inre harmoni”. Litteraturstudien visar på starka känslor av skam och utanförskap hos individer med obesitas på grund av samhällets stigmatisering. De möter negativt bemötande både i vardagen och inom vården vilket försämrar deras välbefinnande. Konklusion: Sjuksköterskor har en viktig funktion i att förebygga ohälsosamma matvanor genom stöd. Ett samarbete mellan yrkesgrupper är av betydelse för att stödja individer med obesitas. Negativa fördomar från sjukvårdspersonal kan negativt påverka individer med obesitas. Ett stöd från hälso- och sjukvården kan öka motivationen för livsstilsförändringar och självacceptans. / Background: Obesity is a medical condition characterized by excessive fat accumulation in the body, increasing the risk of health problems. Body Mass Index (BMI) is used for diagnosis. The causes of obesity include genetic factors and behavioral patterns. Negative biases from healthcare professionals can prevent individuals from seeking medical care. Aim: The purpose of the study was to investigate individuals experiences of living with obesity. Method: Literature review is used to compile qualitative research on individuals with obesity. English-language peer-reviewed articles between 2015 and 2023 focusing on experiences of obesity. 11 selected articles were analyzed, resulting in overarching insights into life with obesity. Findings: The result reveals three main themes: “Behavioral barriers and strategies in everyday life”, “Facing prejudices but receiving person-centered care” and “Striving for inner harmony”. The literature study reveals strong feelings of shame and exclusion among obese individuals due to societal stigmatization. They encounter negative treatment both in everyday life and within healthcare which worsens their well-being. Conclusion: Nurses play a crucial role in preventing unhealthy eating habits through support. A collaboration between professions is important to support individuals with obesity. Negative biases from healthcare professionals can adversely affect individuals with obesity. A support from healthcare providers can enhance motivation for lifestyle changes and self-acceptance

In the wake of declining student performance and interest in science education, efforts to improve the quality of science teaching have intensified, including physics education. A recurring proposal to improve physics teaching is the use of formative assessment. Policy reforms tend to view the implementation of formative assessment as easy, but studies indicate that integrating these strategies into teachers’ practices can be challenging.   Using a phenomenological approach and hermeneutic reflections, the present study explores the opportunities and challenges that teachers’ and students’ experience when implementing formative assessments in the physics classroom. For example, teachers may encounter resistance from their students and colleagues with different expectations of physics teaching, limiting teachers’ opportunities to ‘break free’ from established traditions. However, the study also highlights opportunities for physics teachers to evolve by taking risks and embracing formative assessment as an overarching learning assessment approach.   Furthermore, the present study confirms the results of previous research indicating that students may see assessment rubrics in a positive light as their use can clarify teachers’ expectations and reduce uncertainty in this regard. However, the results of the present study also show that students may approach rubrics only as mechanical and strategic tools to obtain their desired grades, which risks conveying the message to students that physics knowledge is quantitative in nature. The students’ experiences also demonstrated that the use of rubrics could cause stress and anxiety, limiting the formative potential of rubrics.  The results of the study are discussed in relation to the support that teachers and students need in implementing formative assessment and rubric use, and they have implications for teachers’ assessment literacy, including their ability to implement formative assessments in relation to different purposes of physics teaching. One conclusion is that teachers’ and students’ lived experiences of formative assessment and rubric use need to be understood in relation to the wider context of their lifeworlds, which is marked by an increased focus on performance and results. This is crucial so that teachers and students would not be portrayed as the problems when investments in formative assessment do not meet expectations.

Bakgrund: Fibromyalgi omfattar upp till tre procent av befolkningen och cirka 90 procent är kvinnor som drabbas av FM. Orsaken till sjukdomen är ännu okänd. Det finns inte någon specifik diagnostisk metod utan diagnosen ställs utifrån patientens subjektiva upplevelser. Behandlingen är individuell och anpassas till patientens specifika symptom såsom smärta, depression eller sömnsvårigheter. Sjuksköterskor behöver öka sin kunskap om fibromyalgi för att främja patienternas hälsa och psykiska välmående. Syfte: Studiens syfte var att belysa personens upplevelser att leva med fibromyalgi. Metod: En litteraturstudie gjordes av åtta vetenskapliga artiklar från databaserna PubMed och Cinahl Complete. De åtta valda artiklarna analyserades och sammanställdes med avseende på likheter och skillnader. Det bildade fyra huvudteman och fem underteman. Resultat: I resultatet framträdde att personer med FM upplevde olika fysiska och psykiska utmaningar och svårigheter som påverkade deras familjeliv, sociala liv och arbetsliv. Vidare att de möttes av misstro, bristande kunskap och förståelse och stigmatisering g ällande deras tillstånd, både från sin omgivning och vården. Vikten av familjens stöd, både praktiskt och emotionellt, betonades av deltagarna. Könsaspekter indikerade att både män och kvinnor hade liknande upplevelser av FM, även om deras perspektiv och å sikter skiljde sig åt. Slutsats: Sammanfattningsvis, från patientens perspektiv, är FM mer än bara ett smärtsamt tillstånd, det är kopplat till flera symtom och har en betydande negativ inverkan på psykisk och fysisk hälsa. Sjukdomen tvingar de som lever m ed FM att omstrukturera sina familjeliv, yrkesliv och sociala identiteter. Ett holistiskt tillvägagångssätt vad gäller behandling och omvårdnad skulle omfatta personens somatiska och psykiska symtom på ett bättre sätt och leda till effektivare vård. / Background Fibromyalgia affects up to three percent of the population, with approximately 90 percent of women being affected by FM. The cause of the disease is still unknown. There is no specific diagnostic method, and the diagnosis is based on the patient's subjective experiences. Treatment is individualized and tailored to the patient's specific symptoms such as pain, depression, or sleep difficulties. Nurses need to increase their knowledge about fibromyalgia to promote the health and mental well-being of patients. Aim The aim of the study was to illuminate the individual's experience of living with fibromyalgia. Method A literature review was conducted on eight scientific articles from the databases PubMed and Cinahl Complete. The eight selected articles were analyzed and compiled in terms of similarities and differences. Four main themes and five subthemes were identified. Results In the results, it emerged that individuals with FM experienced various physical and mental challenges and difficulties that affected their family, social, and work lives. Additionally, they faced distrust, lack of knowledge and understanding, and stigma regarding their condition, both from their surroundings and healthcare providers. The participants emphasized the importance of family support, both practical and emotional. Gender aspects indicated that both men and women had similar experiences with FM, although their perspectives and opinions differed. Conclusions In summary, from the patients perspective, FM is more than just a painful condition; it is associated with multiple symptoms and has a significant negative impact on mental and physical health. The disease forces those living with FM to restructure their family lives, careers, and social identities. A holistic approach to treatment and care would better address the individual's somatic and mental symptoms and result in more effective healthcare.

Although Hispanics are graduating from high school at greater rates, it is not leading to college success as college graduation rates remain low. In Texas, the Hispanic population has grown to the point that one out of three of all Texans are Hispanic. A phenomenological approach to research was used to investigate the perceptions of Hispanic college students on how well their public high school prepared them for college. Through face-to-face interviews and focus group discussions, eight Hispanic college students provided insight concerning their high school experience and how it translated into college readiness. Four questions guided the study: 1) in what ways do Hispanic college students believe their public high school prepared or failed to prepare them academically for post-secondary education; 2) in what ways do Hispanic college students believe their public high school prepared or failed to prepare them culturally for post-secondary education; 3) in what ways do Hispanic college students believe their public high school prepared or failed to prepare them socio-emotionally for post-secondary education; and 4) how do Hispanic students perceive their cultural identity in regards to their high school experience. Findings revealed four themes relating to how Hispanic students perceive their high school experience prepared them for college which include, academic readiness, cultural readiness, socio-emotional readiness, and cultural identity. The research demonstrated the complex process of transitioning from high school to college for Hispanics.

Social work services prior to the COVID-19 pandemic generally preferred in-person service delivery. When the lockdowns during the COVID-19 pandemic began, social workers needed to modify their practice and pivot to a virtual delivery format to ensure safety as well as continuity of service for the individuals and communities they support. Current literature on virtual care in social work lacks clear identification of best practices for virtual care service delivery. Additionally, 1 in 5 Canadians have a disability. Given the prevalence of disability, social workers must consider how accessibility is impacted by service delivery methods. This research aims to address the gap in the literature by centering the narratives of 7 social workers who have disabilities, who both access and provide virtual care services. This research is guided by Critical Disability Theory (CDT) and the Nothing About Us Without Us movement to explore the social construction of disability within virtual care service delivery, from the perspective of those with disabilities. A focus group was conducted to elicit the experiences of these social workers. Using narrative and reflexive thematic analysis, five themes were identified: 1) digital literacy, 2) privacy, 3) factors enhancing accessibility, 4) factors challenging accessibility, and 5) practice standards in the digital domain. Reflecting on the themes identified in the data analysis, in conjunction with the literature review, a set of guiding best practices are proposed to support accessible virtual care service delivery in social work. Implications for policy and practice are discussed, as well as limitations of this research and potential directions for future research in virtual care and accessibility. / Thesis / Master of Social Work (MSW)

No / The use of first-hand service user accounts of mental illness is still limited in the professional literature available. This is, however, beginning to change, with a new ‘recovery’ focus in mental health services meaning that the voices of service users are finally being heard. Recovering from Psychosis: Empirical Evidence and Lived Experience synthesises a narrative approach alongside an evidence-based review of current treatment by including Stephen Williams’ own personal experience as it relates to psychosis, recovery and treatment. A mental health professional himself, the author’s account of his own recovery from severe mental health difficulties, without sustained intervention, challenges the orthodoxy of representation of service users in mental health. Recovering from Psychosis critically explores and reviews the current state of the art of research and knowledge about the nature and treatment of psychosis. Working simultaneously from empirical, lived experience and philosophical perspectives,Stephen Williams: Evaluates political and power related issues in professional understanding, knowledge-creation and treatment of people with psychosis; Introduces the current ‘recovery movement’, unpacking its origins and implications for the future development of ‘recovery oriented services’; Reviews, summarizes and critiques the current state of ‘recovery’ research, looking at the advantages and disadvantages of such an approach, examining how this is influencing the transformation of UK mental health services; Analyses the difficulties in organisational implementation of recovery approaches, summarises the most empirically robust approaches to practice, personal and service delivery measurement; Reviews current ‘models’ of psychosis and how various professional scientific groups explain the experience and nature of psychosis; Uses lived-experience accounts taken from the scientific literature, portraying the nature of such experiences and analysing them in the face of contemporary psychological models. Recovering from Psychosis is an essential comprehensive guide for mental health professionals, psychologists, social workers and carers, who are working with people with severe and enduring mental health difficulties diagnosed as psychosis. It addresses the practical implications of working with such difficult conditions and serves as a hopeful story of recovery for service users.

Yes / Foodbank use in the UK is rising but, despite high levels of poverty, Pakistani women are less likely to use foodbanks than white British women. This study aimed to understand the lived experience of food in the context of poverty amongst Pakistani and white British women in Bradford, including perspectives on food aid. Design: Sixteen Pakistani and white British women, recruited through community initiatives, participated in three focus groups (one interview was also held as a consequence of recruitment difficulties). Each group met for two hours aided by a moderator and professional interpreter. The transcripts were analysed thematically using a three-stage process. Findings: Women in low-income households employed dual strategies to reconcile caring responsibilities and financial obligations: the first sought to make ends meet within household income; the second looked to outside sources of support. There was a reported near absence of food insecurity amongst Pakistani women which could be attributed to support from social/familial networks; resource management within the household; and cultural and religious frameworks. A minority of participants and no Pakistani respondents accessed charitable food aid. There were three reasons for the non-use of food aid: it was not required because of resource management strategies within the household and assistance from familial/social networks; it was avoided out of shame; and knowledge about its existence was poor. Originality: This case study is the first examination of varying experiences of food insecurity amongst UK white British and Pakistani women. Whilst the sample size is small, it presents new evidence on perceptions of food insecurity amongst Pakistani households and on why households of varying ethnicities do not use food aid. / NIHR Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber (NIHR CLAHRC YH)(Grant number IS-CLA-0113-10020); IKnowFood Research Programme at the University of York (https://iknowfood.org/) which is funded through the Global Food Security’s “Resilience of the UK Food System Programme” with support from BBSRC, ESRC, NERC and Scottish Government.