Yhteisöllisyys voimavarana yliopisto-opetuksen ja -opiskelun kehittämisessä

A sense of community as a resource for developing university teaching and learning The aim of this doctoral research was to determine how a sense of community can be a resource for developing university teaching and learning. The theoretical background is linked to social sciences, social psychology, university pedagogy and educational sciences. The thesis is comprised of two separate studies. Study I consisted of an action research project in which a model of cooperatively developing a teaching and learning culture was created and tested. The focus of study I was the university pedagogy programme of the Faculty of Agriculture and Forestry. The results demonstrated that the theoretical framework and the methods of cooperative learning provide useful tools for developing an academic learning and teaching culture. The approach helps to create a benevolent learning atmosphere. The cooperative learning culture used in the action research project reflected the traditional academic learning culture and also caused a collision between the two cultures. The aim of study II was to determine how Open University students and Bachelor’s degree students experience their teaching-learning environment and the importance of the learning community and peer support to their studies. The results indicated that, with the exception of support from other students, the Open University students experienced their teaching-learning environments on average more positively than the Bachelor’s degree students. According to the Open University students, their own motivation and interest was the most important factor that enhanced studying. Furthermore, the most common factors delaying their studies were their life situation and a lack of time. The sense of community and social relations mainly promoted studying. Open University students experienced that they were supported by their teachers, tutors, other students, the working community, family and hobbies. The research demonstrated that the methods that make good use of communal resources are negotiation of shared goals and rules, working in various small groups, emphasis on shared and individual responsibilities and assessment of the product and the process of learning. The resources of the academic community can be developed if the members of the community develop, in addition to the communal working methods, their communal sensitivity. In other words, they should have an understanding of social psychological and sociological concepts that they can use for observing communal phenomena.

Monimuotoisuus ja esteettömyys : Näkövammaisten asiantuntijoiden työelämäkokemuksia

The purpose of this study is to analyse education, employment, and work-life experiences of visually impaired persons in expert jobs. The empirical data consists of 30 thematic interviews (24 visually impaired persons, 1 family-member of a visually impaired person, 5 persons working with diversity issues), of supplementary articles, and of statistics on the socio-economic status of the visually impaired. The interviewees experiences of education and employment have been analysed by a qualitative method. The analysis has been deepened by reflecting it against the recent discussion on the concept of diversity. The author s methodological choice as a disability researcher has been to treat the interviewees as co-researchers rather than objects of research. Accessibility in its different forms is a prerequisite of diversity in the workplace, and this study examines what kind of accessibility is required by visually impaired professionals. Access to working life depends on the attitudes prejudices and expectations that society has towards a minority group. Social accessibility is connected with internal relationships in the workplace, and achieving social accessibility is a bilateral process. Information technology has revolutionised the visually impaired people s possibilities of accessing information and performing expert tasks. Accessible environment, good mobility skills, and transportation services enable visually impaired employees to get to their workplaces and to navigate there with ease. Integration has raised the level of education and widened the selection of career options for the visually impaired. However, even visually impaired people with academic degrees often need employment support services. Visually impaired professionals are mainly employed in the public and third sector. Achieving diversity in the labour market is a multiactor process. Social support services are needed, as well as courage and readiness from employers to hire people with disabilities. The organisations of the visually impaired play an important role in affecting the attitudes and providing peer support. Visually impaired employees need good professional skills, blindness skills, and social courage, and they need to be comfortable with their disability. In the workplace, diversity may actualise as diverse ways of working: the work is done by using technical aids or other means of compensating for the lack of eyesight. When an employee must find compensatory solutions for disability-related limitations at work, this will also develop his/her problem-solving abilities. Key words: visually impaired, diversity, accessibility, working life

The Relational Self, the Social Bond and the Dynamics of Personal Relationships : A Sociological Analysis

This study analyses personal relationships linking research to sociological theory on the questions of the social bond and on the self as social. From the viewpoint of disruptive life events and experiences, such as loss, divorce and illness, it aims at understanding how selves are bound to their significant others as those specific people ‘close or otherwise important’ to them. Who form the configurations of significant others? How do different bonds respond in disruptions and how do relational processes unfold? How is the embeddedness of selves manifested in the processes of bonding, on the one hand, and in the relational formation of the self, on the other? The bonds are analyzed from an anti-categorical viewpoint based on personal citations of significance as opposed to given relationship categories, such as ‘family’ or ‘friendship’ – the two kinds of relationships that in fact are most frequently significant. The study draws from analysis of the personal narratives of 37 Finnish women and men (in all 80 interviews) and their entire configurations of those specific people who they cite as ‘close or otherwise important’. The analysis stresses the subjective experiences, while also investigating the actualized relational processes and configurations of all personal relationships with certain relationship histories embedded in micro-level structures. The research is based on four empirical sub-studies of personal relationships and a summary discussing the questions of the self and social bond. Discussion draws from G. H. Mead, C. Cooley, N. Elias, T. Scheff, G. Simmel and the contributors of ‘relational sociology’. Sub-studies analyse bonds to others from the viewpoint of biographical disruption and re-configuration of significant others, estranged family bonds, peer support and the formation of the most intimate relationships into exclusive and inclusive configurations. All analyses examine the dialectics of the social and the personal, asking how different structuring mechanisms and personal experiences and negotiations together contribute to the unfolding of the bonds. The summary elaborates personal relationships as social bonds embedded in wider webs of interdependent people and social settings that are laden with cultural expectations. Regarding the question of the relational self, the study proposes both bonding and individuality as significant. They are seen as interdependent phases of the relationality of the self. Bonding anchors the self to its significant relationships, in which individuality is manifested, for example, in contrasting and differentiating dynamics, but also in active attempts to connect with others. Individuality is not a fixed quality of the self, but a fluid and interdependent phase of the relational self. More specifically, it appears in three formats in the flux of relational processes: as a sense of unique self (via cultivation of subjective experiences), as agency and as (a search for) relative autonomy. The study includes an epilogue addressing the ambivalence between the social expectation of individuality in society and the bonded reality of selves.

Immigrant Associations in the Metropolitan Area of Finland : Forms of Mobilisation, Participation and Representation

This study examines the role of immigrant associations in the societal and political integration of immigrants into Finnish society. The societal focus is on the ability of immigrant associations to mobilise their ethnic group members to participate in the socio-economic, cultural and political domains of Finnish society and in certain cases even beyond. The political integrative aims are the opportunities of immigrant associations to participate and represent the interests of their ethnic group in local and national policy making. This study focuses on associations in the Metropolitan Area of Finland, (Espoo, Helsinki and Vantaa).The qualitative research consisted of 71 interviews conducted with members of immigrant associations and civil servants. These interviews were mainly semi-structured, including some additional open-ended questions. Additional data consisted of documents, planning reports and of follow-up enquiries. -- In the analysis of the data I categorised thirty-two immigrant associations according to the activity forms and the description of the goals by the members. The four categories consisted of integrative, societal, ethno-cultural and transnational immigrant associations. Most of the immigrant associations belonged to the integrative category (15 of 32 associations). On the one hand the aims of these associations are to provide access for their ethnic group members into Finnish society, while on the other to strengthen the ethnic identity of their members by organising ethno-cultural activities. The societal associations only focused on activities with the objective of including immigrants into the Finnish labour market and educational system. The goal of ethno-cultural associations was to strengthen the ethnic identity of their ethnic group members. The transnational associations aimed at improving the living conditions of women and children in the members' country of origin. The possibilities for immigrant associations to mobilise their members depends partly on external financing. Subsidies have been allocated for societal activities in particular. There remains a risk of the crowding out of ethno-cultural activities: something which has already taken place in several European countries. Immigrant associations aim to strengthen the identity of immigrants mainly by organising social and ethno-cultural activities. Another important target was to provide peer support and therapy courses. Additionally, immigrant women's associations offer assistance to women who have encountered violence by providing counselling and in some cases access to shelter. The data showed that there is an ever growing need to pay heed to the well-being of women, children and elderly immigrants. The participation of immigrant associations in the municipalities' integrative issues takes place mainly through cooperative projects. Until the end of the 1990s there had not been much cooperation. The problem with the projects was that they had mainly been managed by civil servants, whereas members from immigrant associations had remained in a more passive position. Representation of immigrant associations in councils has been fairly weak. Immigrant associations are included in the multicultural councils of Espoo and Vantaa, but only in the planning stages. The municipality of Helsinki does not include immigrant associations due to the large number of organisations which causes problems in finding fair, democratic representation. At the national level, the ‘Advisory Board for Ethnic Relations’ – ETNO didn’t chose its members based on membership of ethnic associations, but based on belongingness to one of the larger language groups spoken by the foreign population in Finland. Since ETNO’s third period (2005-2007), the representatives of immigrant associations and ethnic minority groups have been chosen from proposed candidates. Key words: immigrant associations, integration, mobilisation, participation, representation, the Metropolitan area of Finland, immigrant (women), civil servants

Tuntemattomista vertaistuttaviksi : Esikoisäitien ja -isien perhevalmennusprosessi Espoon uudentyyppisessä perhevalmennuskokeilussa

From Strangers to Peer Acquaintances Mothers and Fathers with a First Born and their Experiences of the New Family Training Process in Espoo This research is composed of two interrelated case studies. The first case was a family training experiment conducted in the City of Espoo during 2003 2005. In the experiment, the content, duration and procedures were modified from the previous family training policy. The new family training system stressed peer group activities and the peer support formed between the participating mothers and fathers. The second case comprised the stories of 14 parents about the family training process. The aim of the research was to find out whether peer group activities and support was demonstrated between the participating parents during the family training process. The second case and its narrative material constituted the main research material. The narrative material was collected by interviews. Eight mothers and six fathers were interviewed twice within a year between their sessions. The parents also filled in questionnaires about their daily life and participated in a drawing exercise, in which they visualized how they experienced the family training during the antenatal period, labour and the postnatal period. A narrative approach was applied to the analysis of the narrative material. The analysis consisted of several stages. In the final stage, the fathers main story was combined with all the participating fathers personal stories. The mothers main story was also constructed from their personal stories. The study implicated that in some parts the mothers and fathers main stories were similar. During the family training, previously unacquainted parents became peer acquaintances. In particular, the first born as a focus created interaction and cooperation among the parents. Parents in similar circumstances became significant to each other. Different figurations formed during the family training. However, the main stories did not always entwine. The mothers were in contact with the other mothers almost daily using mobile phones, email and mother-child activities. The fathers employed outside home met each other only during the family training meetings, but felt being supported by the other fathers. Some families visited one another outside of the family training. This new type of family training had characteristics typical of the project society. The parents peer activities were based on trust, negotiation and contracts between partners. The parents evaluated the benefits of participation in the family training. If they appreciated the activities with peers and peer compassion, they were willing to participate in the family training during the postnatal period. Keywords: family training, parenthood, motherhood, fatherhood, peer, peer group, peer support, social support, social relationships, figurations, the project society, pastoral power, epistolary power

Huumeriippuvuudesta toipuminen Nimettömien Narkomaanien toveriseurassa

The subjects of this study are Narcotics Anonymous (NA), a non-profit, peer-support-based fellowship, its recovery programme, and the former drug addicts who consider themselves members of the fellowship. The study data consist of episodic interviews (n=24) and questionnaires (n=212). In the collection of questionnaire data, survey research methods had to be applied judiciously. This study analyses NA members background and their substance abuse and treatment history, as well as factors that have contributed to or hindered their bonding with NA. A recovery model is presented that stems from NA s written and oral tradition, and which has been conceptualised into NA s recovery theory. At its simplest, NA s recovery theory can be described in two sentences: 1) There are drug dependent addicts who have an addiction disease. 2) Through an NA way of life, recovery is possible. In this study, addiction and addiction disease are described through recovery stories shared at NA. It also describes how the way of life offered by NA supports recovery from drug addiction, the way of life which recovering addicts have adopted, and how they have done so. The study also presents results that, based on the study data, emerge from participation in the NA programme, and describes how the NA recovery theory works in practice, i.e. how NA members utilise the tools provided by the fellowship and how the lives of recovering addicts change during their membership. Furthermore, this study also discusses criticism of NA. According to the study, NA affects the lives of recovering drug addicts in a number of ways. People of different ages and with a variety of personal, treatment and drug abuse histories seem to benefit from membership of NA. Viewed from the outside, NA may appear as strictly normative, but in practice each member can adapt the programme in a way that suits him/her best. Indeed, flexibility is one of the strengths of NA, but without more extensive knowledge of the fellowship, it is possible that the norms reflected in NA texts or the fanaticism of individual NA members may drive some people away. Due to the increasing number of NA members, the association is also able to provide more alternatives. This study confirms the view that peer support is important, as well as the fact that an official treatment system is required in parallel with peer support activities. NA can never fully replace professional support, neither should it be left with sole responsibility for recovering addicts. Keywords: Narcotics Anonymous, peer support, recovery study, recovery, substance addiction, drug treatment, drugs, explorative research

"Oma entinen on palannut takaisin elämään" : Kuntoutuksen vaikuttavuus aikuisena kuuroutuneiden henkilöiden elämänhallintaan ja psykososiaaliseen hyvinvointiin

Objective The objective of this study was to learn about the psychosocial well-being and life management of Finnish adults with late deafness or hearing loss and to observe the effectiveness of the rehabilitation courses they participated in. Methods For my study I used indicators which were suitable for the evaluation of life management and psychosocial well-being of late-deafened adults. The first part of the study was conducted during 2009 as a questionnaire on three rehabilitation courses in Kopola, a course center of the Finnish Federation of Hard of Hearing. The follow-up study was done at the third period of the courses during 2009 2010. The questionnaire contained both open and structured questions. The questionnaire consisted of five areas concerning life management and psychosocial well-being: sense of coherence (life management), human relations and social support, mood, self-esteem and satisfaction with life. I also asked the participants to reflect on their experiences of group rehabilitation. Results and conclusions The participants consisted of seven women and three men. They were approximately 63 years old and were all retired. Loss of hearing was described to have affected their social life, free time, and in general made their lives more difficult. From the course the participants hoped to gain new skills such as signed speech and lip-reading, uplift their mood, accept their loss of hearing and experience peer support. After the courses they replied that they had more close relations with whom they also were a little more in contact with. More participants were satisfied with e.g. their ability to take care of themselves, their free time, financial situation, family life, mental resources and physical shape. Majority of the participants showed symptoms of depression when the courses started, but at the end of the courses these signs had moderated or disappeared for most of them. The participants felt that during the rehabilitation they had been heard, respected, accepted and been taken care of. The course provided the possibility for confiding, and the discussions gave the participants support and consolidation. In conclusion, the course affected positively on the acclimatization to the hearing loss and the empowerment of the participants. The results of this study can be utilized in disability services, the development of rehabilitation and in the social- and health services of senior citizens.

Pärjätäkseen pitää olla sosiaalinen, aktiivinen ja menestyvä ihminen. Kaikkea hyvää vaan heille, mutta entäs me muut? Vertaistuki Yksinäisyys-nettiryhmässä avunsaajan ja avunantajan näkökulmista.

Yksinäisyyden merkitys hyvinvointia uhkaavana tekijänä on viimeaikoina noussut esiin yhä enenevissä määrin. Yksinäiset korkeakouluopiskelijat ovat erityisen haavoittuvassa elämäntilanteessa, sillä nuoren aikuisen elämään liittyvät erityiset kehitykselliset haasteet. Tärkeää on, että opiskelijat saavat tukea tilanteeseensa, jotta yksinäisyyden kauaskantoisilta vaikutuksilta vältyttäisiin. Vertaistuki voi monen kohdalla olla tärkeää, ja Internet mahdollistaa matalan kynnyksen paikan avun hakemiseen. Tutkielmassani perehdyn Nyyti ry:n ylläpitämään, korkeakouluopiskelijoille tarkoitettuun Yksinäisyys-nettiryhmään, ja siinä esiintyvään vertaistukeen. Erityisen tutkimusasetelmastani tekee vertaistuen tarkastelu sen kaksijakoisuuden kautta: millaisia avunsaajana olemisen ja avunantajana toimimisen tapoja kirjoituksista on löydettävissä, ja miten ne suhteutuvat toisiinsa. Näin voidaan ymmärtää paremmin keskustelijoiden tarpeita ja odotuksia, ja sitä, miten ryhmä pystyy niihin vastaamaan. Aineistoa on tutkittu sisällönanalyysin menetelmin. Näyttäisi siltä, että ryhmään kohdistetaan enemmän odotuksia ja tarpeita kuin mihin se pystyy vastaamaan. Avunsaajana olemisen luokkia oli yhteensä 15, jotka kuvasivat viittä eri ulottuvuutta. Ulottuvuudet olivat kokemuksellisuus, kontrolliodotus, vaikeusaste, suhde tietoon ja odotuksellisuus. Avunantajana toimimisen kohdalla luokkia muodostui kahdeksan, jotka kuvasivat neljää ulottuvuutta. Näitä olivat empatia, eteenpäin suuntaavuus, opastus ja kyseenalaistus. Avunsaajana oleminen hallitsi nettiryhmän keskusteluja, ja sitä kuvastavat tekstit olivat paitsi määrällisesti pidempiä, myös sisällöllisesti rikkaampia. Suhteutettaessa avunsaajan ja avunantajan tapoja toisiinsa havaitaan, että ryhmässä osoitettu tuki pystyy hyvin vastaamaan moniin odotuksiin, mutta toisaalta jokin tuenmuoto saattaa olla päinvastainenkin joidenkin luokkien tarpeille. Voikin olla, että vertaistuesta on keskustelijoille hyötyä tiettyyn tasoon asti, mutta suuri määrä erilaisia tarpeita ja odotuksia tekee mahdottomaksi niihin kaikkiin vastaamisen. Hyvä jatkotutkimuksen aihe olisi haastatteluin selvittää kirjoittajien omia näkemyksiä siitä, mistä kokevat ryhmään kirjoittaessaan hyötyvänsä. Tutkielman keskeisimpiä lähteitä ovat olleet: Weiss, R.S. (1973). Loneliness: the experience of emotional and social isolation, Kraut, R. ym (1998). Internet paradox. A social technology that reduces social involvement and psychological well-being?, Jung, J. (1987) Toward a social psychology of social support., Dennis, C-L. (2003). Peer support within a health care context: a concept analysis.

Ohjaukselliset käytännöt yliopisto-opintojen alkuvaiheessa : Maatalous-metsätieteellisen tiedekunnan opiskelijoiden merkitykselliset kokemukset ensimmäisen opiskeluvuoden ohjauksesta

In this Master's Thesis I study guidance practises, which facilitate first year students' integration into the university. Besides formal guidance, for example tutoring and peer tutoring, general student advising and introduction courses, I address my research to informal everyday guidance practices. I aim to highlight existing supportive practices, which are meaningful from the university students' perspective. My aim is to study what kind of guidance practises exists in university and how these practises support first year student. The aim of the guidance practises is to facilitate new university student to integrate into the academic community. I study the implementation of this aim as a development of an academic identity, which requires that students have an opportunity for guided participation in academic practises. The research is based on phenomenological-hermeneutic research tradition, and my aim is to produce information of students' everyday experiences and meanings. My informants were students of agriculture and forestry at University of Helsinki. I gathered research material utilizing the critical incident technique in 11 theme interviews, which I carried out with individuals, pairs or small groups. During interviews I asked the students to describe and evaluate their first year guidance experiences, especially those that were extreme positive or negative. Based on my research I specified four meaningful guidance practices: care of students, transparency of the practises of the learning community, presence of guidance in everyday activities of a student and communal reflection to studies. I represent the character and components of the guidance practises, and I also describe the meaning of those practises to university students. Keywords: Guidance practices, guidance, first year studies, academic community, integration, academic identity,critical incidents

Collaborative Design in a Virtual Learning Environment : Three Design Experiments in Textile Teacher Education

The aim of the study was to analyze and facilitate collaborative design in a virtual learning environment (VLE). Discussions of virtual design in design education have typically focused on technological or communication issues, not on pedagogical issues. Yet in order to facilitate collaborative design, it is also necessary to address the pedagogical issues related to the virtual design process. In this study, the progressive inquiry model of collaborative designing was used to give a structural level of facilitation to students working in the VLE. According to this model, all aspects of inquiry, such as creating the design context, constructing a design idea, evaluating the idea, and searching for new information, can be shared in a design community. The study consists of three design projects: 1) designing clothes for premature babies, 2) designing conference bags for an international conference, and 3) designing tactile books for visually impaired children. These design projects constituted a continuum of design experiments, each of which highlighted certain perspectives on collaborative designing. The design experiments were organized so that the participants worked in design teams, both face-to-face and virtually. The first design experiment focused on peer collaboration among textile teacher students in the VLE. The second design experiment took into consideration end-users needs by using a participatory design approach. The third design experiment intensified computer-supported collaboration between students and domain experts. The virtual learning environments, in these design experiments, were designed to support knowledge-building pedagogy and progressive inquiry learning. These environments enabled a detailed recording of all computer-mediated interactions and data related to virtual designing. The data analysis was based on qualitative content analysis of design statements in the VLE. This study indicated four crucial issues concerning collaborative design in the VLE in craft and design education. Firstly, using the collaborative design process in craft and design education gives rise to special challenges of building learning communities, creating appropriate design tasks for them, and providing tools for collaborative activities. Secondly, the progressive inquiry model of collaborative designing can be used as a scaffold support for design thinking and for reflection on the design process. Thirdly, participation and distributed expertise can be facilitated by considering the key stakeholders who are related to the design task or design context, and getting them to participate in virtual designing. Fourthly, in the collaborative design process, it is important that team members create and improve visual and technical ideas together, not just agree or disagree about proposed ideas. Therefore, viewing the VLE as a medium for collaborative construction of the design objects appears crucial in order to understand and facilitate the complex processes in collaborative designing.

Kumppanuus on tiiviimpää kuin yhteistyö : Maahanmuuttajataustaisten vanhempien näkemyksiä kasvatuskumppanuudesta

The main idea of this study was to find out how immigrants understand and define successful co-operation and professional partnership in early childhood education. Another target of this research was to think over how the parents see professional partnership from their viewpoint, and how willing / ready the they are in engaging in the professional partnership with the day care personnel. The theoretical part of this research is based on theories of immigration and theories of it s different forms, theories of cultural varieties and theory of modernizing co-operation through using professional partnership. Also guidelines and policies for day care and early childhood education play a part in the theory section. Theory part is written to support research problems. The research method used in this study is peer interview. The interviewed are both immigrants and customers of day care services. The data collected is comprised of materials from peer interviews and personal background information. The interviewed were of Somalia and Russian ethnic groups. Interview were carried out in each group in the participants own mother tongue. These peer interviews showed that parents were interested and willing to discuss professional partnership. From this research one can conclude that the term professional partnership is seen as a complex term, and as a term difficult to understand. From the results it is seen that quite often the principles of professional partnership are not carried out in practise. According to the material gathered, the parents feel that lack of common language and prejudice against immigrants effectively prevents the professional partnership from being formed. The cultural differences can become challenging in a professional partnership. Based on this research, one can conclude that when different cultures meet, there has to be mutual will to understand and to be understood in order to make sure that the children s development, both educational and physical, is supported in a best possible way.

Life events and social support among patients with major depressive disorder

The study is part of a research project of 269 psychiatric patients with major depression, Vantaa Depression Study, in the Department of Mental Health and Alcohol Research of the National Public Health Institute and the Department of Psychiatry of the Peijas Medical Care District. The aim was to study at the onset of MDE psychosocial differences in subgroups of patients and clustering of events into time before depression and its prodromal phase, to study whether more severe life events and less social support predict poorer outcome in all patients, but most among those currently in partial remission, whether social support declines as a consequence of time spent in MDE, is sensitive to improvement, and whether social support is influenced by neuroticism and extraversion. After screening, a semistructured interview (SCAN, version 2.0) was used for the presence of DSM-IV MDE, and other psychiatric diagnoses. Life events and social support were studied with semistructured methods (IRLE, Paykel 1983; IMSR, Brugha et al. 1987), perceived social support and neuroticism/extraversion with questionnaires (PSSS-R, Blumenthal et al. 1987; EPI, Eysenck and Eysenck 1964) at baseline, 6 and 18 months. At the onset of depression life events were common. No major differences between subgroups of patients were found; the younger had more events, whereas those with comorbid alcoholism and personality disorders perceived less support. Although events were distributed evenly between the time before depression, the prodromal phase and the index MDE, two thirds of the patients attributed their depression to some life event. Adversities and poor perceived support influenced the outcome of all psychiatric patients, most in the subgroup of full remission. In the partial remission group, the impact of severe events and in the MDE, perceived support was important. Low objective and subjective support were predicted by longer time spent in MDE. Along with improvement subjective support improved. Neuroticism and extraversion were associated with the size of social network and perceived support and predicted change of perceived support. In conclusion, adversities were common in all phases of depression. They may thus have many roles; before depression they may precipitate it, in the prodromal phase worsen symptoms, and during the MDE, the outcome of depression. Patients often attributed their depression to a life event. Psychosocial subgroup differences were quite small. Perceived support predicted the outcome of depression, and time spent in MDE objective and subjective support. Neuroticism and extraversion may modify the level and change particularly in perceived support, thereby indirectly effecting vulnerability to depression.

Cancer survivors at work : Work-related problems and factors associated with their employment, work ability and social support from the work community

Due to the improved prognosis of many forms of cancer, an increasing number of cancer survivors are willing to return to work after their treatment. It is generally believed, however, that people with cancer are either unemployed, stay at home, or retire more often than people without cancer. This study investigated the problems that cancer survivors experience on the labour market, as well as the disease-related, sociodemographic and psychosocial factors at work that are associated with the employment and work ability of cancer survivors. The impact of cancer on employment was studied combining the data of Finnish Cancer Registry and census data of the years 1985, 1990, 1995 or 1997 of Statistics Finland. There were two data sets containing 46 312 and 12 542 people with cancer. The results showed that cancer survivors were slightly less often employed than their referents. Two to three years after the diagnosis the employment rate of the cancer survivors was 9% lower than that of their referents (64% vs. 73%), whereas the employment rate was the same before the diagnosis (78%). The employment rate varied greatly according to the cancer type and education. The probability of being employed was greater in the lower than in the higher educational groups. People with cancer were less often employed than people without cancer mainly because of their higher retirement rate (34% vs. 27%). As well as employment, retirement varied by cancer type. The risk of retirement was twofold for people having cancer of the nervous system or people with leukaemia compared to their referents, whereas people with skin cancer, for example, did not have an increased risk of retirement. The aim of the questionnaire study was to investigate whether the work ability of cancer survivors differs from that of people without cancer and whether cancer had impaired their work ability. There were 591 cancer survivors and 757 referents in the data. Even though current work ability of cancer survivors did not differ between the survivors and their referents, 26% of cancer survivors reported that their physical work ability, and 19% that their mental work ability had deteriorated due to cancer. The survivors who had other diseases or had had chemotherapy, most often reported impaired work ability, whereas survivors with a strong commitment to their work organization, or a good social climate at work, reported impairment less frequently. The aim of the other questionnaire study containing 640 people with the history of cancer was to examine extent of social support that cancer survivors needed, and had received from their work community. The cancer survivors had received most support from their co-workers, and they hoped for more support especially from the occupational health care personnel (39% of women and 29% of men). More support was especially needed by men who had lymphoma, had received chemotherapy or had a low education level. The results of this study show that the majority of the survivors are able to return to work. There is, however, a group of cancer survivors who leave work life early, have impaired work ability due to their illness, and suffer from lack of support from their work place and the occupational health services. Treatment-related, as well as sociodemographic factors play an important role in survivors' work-related problems, and presumably their possibilities to continue working.