Depuis plusieurs années, la définition des soins palliatifs a été élargie pour inclure toutes les maladies ayant un pronostic réservé. Le Québec s’est doté d’une politique de soins palliatifs dont l’un des principes directeurs est de maintenir les patients dans leur milieu de vie naturel. Alors que présentement environ 10 % de la population nécessitant des soins palliatifs en reçoit, on peut s’attendre à une augmentation des demandes de soins palliatifs à domicile dans les CSSS du Québec. La présente étude a pour but de décrire et comprendre l’expérience de dispenser des soins palliatifs à domicile pour des infirmières travaillant dans un contexte non spécialisé. Une étude qualitative ayant comme perspective disciplinaire la théorie de l’humain-en-devenir de Parse a été réalisée. Des entrevues ont été effectuées auprès de huit infirmières travaillant au maintien à domicile d’un CSSS de la région de Montréal qui font des soins palliatifs dans un contexte non spécialisé. L’analyse des données a été effectuée selon la méthode d’analyse phénoménologique de Giorgi (1997). Les résultats s’articulent autour de trois thèmes qui décrivent l’expérience de dispenser des soins palliatifs à domicile pour des infirmières qui travaillent dans un contexte non spécialisé. Elles accompagnent les patients et leur famille, en s’engageant à donner des soins humains, et développant une relation d’accompagnement avec le patient et ses proches. Elles doivent composer avec les réactions du patient et de sa famille et doivent parfois informer le patient de la progression de son état de santé. De plus, elles se préoccupent de donner des soins de qualité en composant avec la complexité des soins palliatifs à domicile tout en s’assurant de soulager les symptômes des patients et de tenter de développer leur expertise. Finalement, le fait d’être confrontée à la mort permet de cheminer. Ainsi, les infirmières vivent des émotions, reçoivent du soutien, sont touchées personnellement par la mort, éprouvent de la satisfaction envers les soins qu’elles donnent et apprennent personnellement de leur expérience. L’essence du phénomène à l’étude est que lorsque les infirmières font un véritable accompagnement du patient et de sa famille en s’efforçant de donner des soins de qualité, cela crée des conditions permettant qu’un cheminement personnel et professionnel sur la vie et la mort soit effectué par les infirmières. / In the past few years, the definition of palliative care was extended to include all diseases with a poor prognosis. The province of Quebec modified the health care system to focus more on ambulatory care and created a palliative care policy with one of its principal directives being to maintain patients in their own milieu. As only 10% of patients requiring palliative care presently receive it, we can expect an increase in demands for palliative home care in the CSSS’s of Quebec. The goal of the present study is to describe and understand the lived experiences of the nurses of a CSSS of the Montreal sector who deliver palliative home care in a nonspecialized context. A qualitative phenomenological research was developed with the Human Becoming Theory of R.R. Parse as a theoretical framework. Eight semi-directed interviews were done with nurses working in home care of a CSSS of the Montreal region. These nurses do palliative care in a non-specialized context. Giorgi’s (1997) phenomenological method was used for data analysis. Three themes describing the experiences of home care nurses providing palliative care in a non specialized context emerged from the analysis. Nurses accompany patients and their families, by committing themselves to providing humane care and by developing an accompaniment relationship with the patient and his/her loved ones. Nurses must cope with the patient’s and family’s reactions and often need to inform the patient of the progression of his/her disease. Secondly, nurses are dedicated to provide quality care by dealing with the complexity of providing palliative care at home, while doing symptoms management and attempting to develop their expertise. Finally, the theme which has the most interesting results is that being confronted by death allows nurses to grow. Nurses personally go through emotions, received support, are personally touched by death, experience satisfaction by the care they give and personally learn by their experience. The essence of the phenomenon is that when nurses providing palliative home care in a non specialized context accompany truly patients and their family, while giving quality care, it creates conditions for the nurses to grow personally and professionally on their views of life and death.

À ce jour, peu d’études ont été conduites pour mieux comprendre le phénomène de la demande d’aide auprès d’hommes dans le contexte du cancer. Les études consultées suscitaient de nombreuses questions et hypothèses sur la signification que pouvaient accorder ces hommes à la demande d’aide. C’est pourquoi l’étudiante chercheuse a réalisé cette étude phénoménologique auprès d’hommes atteints d’un cancer de la sphère otorhinolaryngologique, afin de mieux comprendre ce phénomène. Huit hommes ont accepté de participer à l’étude. Suite aux entrevues semi-structurées, l’analyse des données, assistée par la méthode proposée par Giorgi (1997), a fait ressortir les thèmes centraux suivants : 1) Se sentir capables de faire face seuls aux diverses adversités; 2) Bénéficier du soutien des proches et de l’équipe de soins; et 3) Utiliser des stratégies cognitives. Les résultats ont révélé que la signification accordée à la demande d’aide est intimement liée à la construction sociale du genre, c’est-à-dire aux normes d’identité masculine acquises culturellement. Les valeurs accordées à l’autonomie, à l’estime de soi et à « l’égo masculin » expliqueraient en partie pourquoi les hommes interviewés demandent peu d’aide. Par ailleurs, la présence constante de la conjointe et le soutien de l’équipe professionnelle de santé semblent avoir grandement modulé les comportements de demande d’aide des participants en anticipant leurs besoins avant même qu’ils puissent les exprimer; ce qui invite à une réflexion sur l’empowerment, stratégie d’intervention fondée sur la responsabilisation individuelle. Des recommandations pour la pratique et la recherche infirmières sont formulées afin d’optimiser le soin et le développement du savoir infirmier dans ce domaine d’intérêt. / To date, few studies have been conducted to better understand the phenomenon of help seeking of men in the context of cancer. The reviewed studies elicited many questions and hypotheses about men’s understanding of help seeking in the context of cancer. Therefore, the research student has conducted a phenomenological study to describe this phenomenon in men with otorhinolaryngological cancer. Eight men have agreed to participate in the study. Following semi-structured interviews, the data analysis, assisted by the method proposed by Giorgi (1997), highlighted the following key themes: 1) Feeling able to cope alone with the various adversities, 2) Having the support of the family and the care team, and 3) Using cognitive strategies. The results showed that the lived experience of help seeking is closely linked to the social construction of gender, that is to say to the culturally acquired male norms. Values of autonomy, self-esteem and “male ego” explain in part why most of the participants did not ask for help. Moreover, the constant presence of the spouse and the support of the professional health care team appear to have greatly modulated participants’ help seeking behaviors by anticipating their needs, before they could even express them; this issue invites us to a reflection on the phenomenon of empowerment, intervention strategy based on the individual responsabilisation. Recommendations for practice and nursing research are formulated to optimize nursing care and to insure the pursuit of the development of nursing knowledge in this area of interest.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Nesta pesquisa procuramos estabelecer as bases teóricas e práticas da Internacional Situacionista e de dois de seus principais teóricos, Guy Debord e Raoul Vaneigem. Para aprofundar a compreensão, fomos em busca das origens desse grupo no Letrismo, na Internacional Letrista e Movimento por uma Bauhaus Imaginista, em uma tentativa de estabelecer uma trajetória. O início, no Letrismo, se estabelece como vanguarda artística, para logo quebrar com a perspectiva de uma proposta estética e realizar um aprofundamento de caráter marxista na crítica à cultura e ao urbanismo, na forma metodológica do desvio e da deriva e na construção de situações, a partir dos anos da Internacional Letrista. O processo de Decomposição da cultura faz com que alguns grupos se reúnam em uma nova internacional, desta vez Situacionista, com uma proposta inicial de revolução cultural, na e contra Decomposição. O envolvimento de Guy Debord com outros teóricos marxistas como Henri Lefebvre, radicaliza uma crítica da vida cotidiana e tira do foco uma discussão sobre cultura. O resultado é desenvolvimento do conceito de espetáculo, forma mais desenvolvida da sociedade produtora de mercadorias, e a centralização da questão do fetiche na crítica. Uma possibilidade de debate entre uma práxis revolucionária da vida cotidiana e a centralidade do fetiche da mercadoria nos parece necessária no momento atual da Geografia. / This research sought to establish the theoretical and practical bases of the Situationist International and two of its leading theorists, Guy Debord and Raoul Vaneigem. To deepen understanding, we were in search of the origins of this group in Lettrism, Lettrist International and the International Movement for an Imaginist Bauhaus, in an attempt to establish a trajectory. The beginning, in Lettrism, establishes himself as the artistic vanguard, soon to break with the prospect of an aesthetic proposal and make a deeper exploration in the marxist ideas, in order to make a critique of culture and urbanism with the methodological form of the detournement, the dérive and the construction of situations, since the years of the Lettrist International. The process of Decomposition of the culture causes some groups to join in a new International, Situationist this time, with an initial proposal of cultural revolution, inside and against Decomposition. Guy Debord\'s involvement with other marxist theorists such as Henri Lefebvre, the radical critique of everyday life takes the focus from the discussion about culture. The result is the development of the concept of spectacle, most developed form of commodity-producing society, and centered on the critical question of the fetish. A possibility for discussion between a revolutionary praxis of everyday life and the centrality of the fetish seems necessary at this moment in Geography.

<p>Syftet med studien var att beskriva hur nyutexaminerade sjuksköterskor upplevde sin första tid i yrket utifrån känslor, tankar, stöd och bemötande. Studien genomfördes som en kvalitativ intervjustudie med fyra informanter som arbetat på Gävle sjukhus mellan 6-18 månader. Resultatet redovisades utifrån studiens frågeställningar och visade att nyutexaminerade sjuksköterskor upplevde många olika känslor och tankar inför sin nya yrkesroll. Känslor såsom rädsla, nervositet och förväntan var några exempel. Stödet och bemötandet från andra sjuksköterskor och närmaste chef var övervägande bra, medan bemötandet från under-sköterskor och läkare upplevdes som mindre bra. Faktorer som ödmjukhet, trygghet och erfarenhet var något som sjuksköterskorna utvecklade med tiden och det underlättades av att de gavs utrymme för att vara nya och osäkra. En bra introduktion på arbetsplatsen var också underlättande. Slutsatsen som dras är att merparten av nyutexaminerade sjuksköterskor går igenom en liknande känslomässig process under den första tiden i yrket. Det som kan påverka den processen positivt eller negativt är de yttre faktorerna; utbildning, introduktion samt teamwork och det är dessa som det behövs bättre planering kring.</p> / <p>The aim of the study was to describe how newly graduated nurses experienced their first period of time in the profession on the basis of emotions, thoughts, support and treatment. The study was conducted as a qualitative interview study with four participants who had worked at Gävle Hospital between 6-18 months. The results were reported from the question formulations in the study and showed that newly graduated nurses experienced many different emotions and thoughts with their new professional role. Feelings such as fear, nervousness and anticipation were a few examples. The support and the interaction between other nurses and the manager of the ward were considered good, while the interaction with the assistant nurses and doctors worked less well. Factors such as humility, experience and gaining security in their new profession was something that the nurses developed over time and it was facilitated by the fact that they were given the space to be new and insecure. A good introduction to the ward was also facilitation.<strong> </strong>The conclusion reached is that the majority of newly graduated nurses goes through a similar emotional process in their first period of time in the profession. What can affect the process positively or negatively is the external factors; education, introduction and teamwork, and it is those factors that needs better planning.</p>

Rehabilitation after brain injury is often a process which is spread over several years and runs through different phases. After sub acute in-patient rehabilitation a community based post-acute rehabilitation can follow. In this late phase after injury the rehabilitation focuses on reintegration into the community through a return to work and participation in other occupations in society. The overall aim of this dissertation was to study the long-term outcome of brain injury, with a special emphasis on the return to everyday domestic and productive occupations and the connection these have to life satisfaction as a whole. The aim was also to describe and understand the lived experience of the consequences of brain injury in these areas. This dissertation comprises four studies on different aspects of the long-term outcome of those who have had a brain injury. In a sample of 56 people, the value of occupational therapy assessments as predictors of an eventual return to work was investigated. In a longitudinal follow-up study, the life satisfaction of the participants (n 36) was reported and its correlation to a return to work was evaluated. Interviews were conducted (n 10) to explore the main characteristics of the meaning of work after brain injury in ten respondents. And, finally, in the fourth study, 157 people reported their participation in community activities. The extent of the correspondence between the level of participation and life satisfaction was calculated. The findings showed that occupational therapy assessments were useful in predicting a return to work in the late phase of the recovery after brain injury. A combination of assessments on the level of body function with assessments on activity level appeared to comprise the best predictive model. In two different studies the reported life satisfaction was found to be significantly lower than the level of life satisfaction in a sample of healthy Swedes for almost all domains. When comparing life satisfaction at two points in time with an interval of three years between them in the longitudinal study, no significant improvement was found. There was no difference reported by the participants for their overall life satisfaction regardless of whether they were back at work or in education, or not. On the other hand, participation in daily occupations in a wider perspective was found to have a positive impact on satisfaction with life as a whole. However, half or more than half of the participants claimed that their participation was restricted except for the items self-care and mobility, where a higher degree of participation was reported. The meaning of work after the brain injury had changed: Work had taken on a new place in life and the importance of work had decreased. In contrast, the social dimension of work had expanded in importance. After the brain injury, the perception of the participants’ own competence and work identity had changed and the respondents described their striving to return to normality. To conclude, brain injury has a lasting effect on a person’s life, even many years after the injury; consequently there is need for rehabilitation in this late phase. Life satisfaction, which is often used as an overriding goal for rehabilitation, did not improve over time. This finding raises the question of whether life satisfaction is too broad a concept and/or insufficiently sensitive to improvements. There is need for further research in this area to clarify the factors that have an impact on life satisfaction.

The aim of this thesis is to explore and analyse lived experience of social categorisations such as intellectual disability, gender and age. The following overarching questions will direct the focus of the thesis, on how 13 middle-aged (aged 38-60 years) women and men who receive disability services according to the Act (1993:387) concerning Support and Service for Persons with Certain Functional Impairments (LSS), describe their everyday life practices: - In what way(s) are the social categorisations disability, gender, and age expressed in the interviews? How do the participants relate their lived experience of the social categorisation in relation to arenas such as work, family, and leisure time? How can this lived experience be understood in relation to the structures and conditions that form the institutions within the disability services? With a hermeneutic-phenomenological approach, the thesis is based on repeated audio- and video-recorded qualitative semi-structured interviews and field visits. The altogether 16 participants were divided into two groups: the main group consisted of 13 adults and a reference group, which consisted of 3 younger informants (aged 25-29 years). Despite political ambitions that state that people with disabilities should have opportunity to live like others, this thesis shows that their everyday life is, in fact, conditioned by institutional structures. The structures that conditions the disability services together with the social construction of disability, but also of age and gender, frames leisure time, social networks, family life, practicing partnership, mobility (especially for women), and working life – in short, these conditions their abilities to fulfil the expectations that are imbedded throughout the social construction of adulthood. The relationship with the labour force can be seen as an illustrative example: The ability to be part of a regular working force was central for the interviewees. However, the analysis showed that the work that was available for the participants, is a welfare state effort, that is situated in an intersection where a logic of care meets a logic derived from the open labour market, thereby creating a situation filled with contradictions. On the one hand, the informants felt an obligation to fulfil an almost Protestant work ethic. One the other hand, their work efforts are not acknowledged by society as work. On the one hand, daily activity is a voluntary right, on the other hand; the informants have little opportunity to relinquish this right, depending on the particular organisation of the disability services. The participants also expressed concerns about losing this work, a worry that can be seen as paradoxical in respect of their legislative right to daily activity.  The analysis has highlighted how the participants, in many situations, suffer a disadvantageous position with regard to hermeneutical resources to make sense of their experience. They also face structural obstacles to fully live an adult life. This could be described as experiencing societal norms of what one is expected to live up to, but at the same time be deprived of real opportunities to fulfil these requests – thereby, to live a contradiction. Lived experience of intellectual disability, gender and age, can therefore be considered as being a lived experience of a conditional adulthood.

No description available.

Syftet med studien var att beskriva hur nyutexaminerade sjuksköterskor upplevde sin första tid i yrket utifrån känslor, tankar, stöd och bemötande. Studien genomfördes som en kvalitativ intervjustudie med fyra informanter som arbetat på Gävle sjukhus mellan 6-18 månader. Resultatet redovisades utifrån studiens frågeställningar och visade att nyutexaminerade sjuksköterskor upplevde många olika känslor och tankar inför sin nya yrkesroll. Känslor såsom rädsla, nervositet och förväntan var några exempel. Stödet och bemötandet från andra sjuksköterskor och närmaste chef var övervägande bra, medan bemötandet från under-sköterskor och läkare upplevdes som mindre bra. Faktorer som ödmjukhet, trygghet och erfarenhet var något som sjuksköterskorna utvecklade med tiden och det underlättades av att de gavs utrymme för att vara nya och osäkra. En bra introduktion på arbetsplatsen var också underlättande. Slutsatsen som dras är att merparten av nyutexaminerade sjuksköterskor går igenom en liknande känslomässig process under den första tiden i yrket. Det som kan påverka den processen positivt eller negativt är de yttre faktorerna; utbildning, introduktion samt teamwork och det är dessa som det behövs bättre planering kring. / The aim of the study was to describe how newly graduated nurses experienced their first period of time in the profession on the basis of emotions, thoughts, support and treatment. The study was conducted as a qualitative interview study with four participants who had worked at Gävle Hospital between 6-18 months. The results were reported from the question formulations in the study and showed that newly graduated nurses experienced many different emotions and thoughts with their new professional role. Feelings such as fear, nervousness and anticipation were a few examples. The support and the interaction between other nurses and the manager of the ward were considered good, while the interaction with the assistant nurses and doctors worked less well. Factors such as humility, experience and gaining security in their new profession was something that the nurses developed over time and it was facilitated by the fact that they were given the space to be new and insecure. A good introduction to the ward was also facilitation. The conclusion reached is that the majority of newly graduated nurses goes through a similar emotional process in their first period of time in the profession. What can affect the process positively or negatively is the external factors; education, introduction and teamwork, and it is those factors that needs better planning.

This thesis examines the lived experience of economic migration of young and degree level educated migrants from Poland to Britain. The main aim is to explore how the participants of economic migration within the borders of the European Union experience migrating. The special feature of this migration is the fact that they leave a postcommunist country and come to a country with a well established capitalist economy and long-standing democracy. The particular questions are: how these migrants construct their experience of migrating, are they faced with any problems while doing it, and if so - how do they resolve them? The data comes from twenty-two semi-structured interviews with migrants educated to degree level who were residents and worked in one of the regions of England at a professional level or below their qualifications (manual or simple clerical work). The research utilises the critical discourse analysis perspective; the data is approached with analysis focused on linguistic choices (lexical and grammatical) evident in the respondents’ statements. This kind of analysis enables observation and in-depth interpretation of the way experiences of migrating are constructed. The migrants’ narratives were full of discursive struggle while constructing their experience of migrating. Firstly, the interviewees made an effort to present their migration as rational. Secondly, they were trying to rationalise their financial needs to refute accusations of greed for money. Thirdly, the underemployed migrants justified their employment choices by distancing themselves from work below that which they were qualified for. Fourthly, the interviewees were making an attempt to withdraw from a multicultural community by constructing the negative Other. Exploring lived experience of living and working abroad reveals competitive discourses and ways of coping with ambivalence. Understanding these discursive practices requires knowledge of their beliefs and values that underpin the discourses available in the Polish postcommunist society. Overall, the narratives overflowed with dilemmas that showed this migration as more complicated on an individual level than the official discourse of free movement of people in the EU suggests. This thesis captures the migrants’ lived experience within one year after the EU enlargement; it reflects on the narratives being shaped when migrants were given the opportunity to introduce the new discourses on migration or re-think the old ones as a result of new macro-processes in the European Union. This research complements other studies exploring migrants’ voices in search of insight into what their experiences were and how they made sense out of them. However, with the methodology used, it focuses more on uncovering the struggle over arguments available to build their stories. It offers explanation to their discursive practices by analysing them against the discourses as being products of postcommunism. The study’s results may shed more light on recent processes within this group of migrants and also inform institutional policy and practice about problems affecting members of this group, reported in this thesis.