”Du sköna sång, vårt bästa arv” - kanonisering av en sångskatt ur ett hermeneutiskt perspektiv

Songs have the power to get through to people. When lyrics are combined with a tune, the result is an entity where the first few notes of a melody can evoke emotions of recognition and belonging. A song treasury consists of such songs that are part of a canonized song tradition. The process where certain songs become part of an established song treasury is long, and many other aspects than the tune itself influence the forming of a song treasury. By examining the characteristics of a song tradition, the history of an ethnic group can be illuminated. In this study, music, pedagogy, and the sociocultural context are merged into a whole where a common song tradition, the song treasury, is in focus. The main aim of this study is to deepen the understanding of a song treasury, its development and contents. This understanding is accomplished by analyzing the musical and lyrical characteristics of 60 songs, which have been sung in schools, homes, and communities, thereby becoming popular among the Swedish-speaking Finns during the 20th century. The songs have been chosen by combining three song lists, of which two lists are closely related to school curricula. The third song list is a result of a survey on favourite songs, according to the situation around year 2000. The songs are examined in their notated versions, a number of song books and text books (n = 29) forming the empirical material. In this study, a hermeneutical approach is applied, content analysis being the method. The analysis is based on three perspectives: the sociocultural perspective, the music-pedagogical perspective, and the musico-analytical perspective. Within each perspective, two aspects are studied. This results in a hexagonal model which forms the structure of the study as a whole. The first two perspectives form the background; a historical context where nation, education, home country, and homestead are regarded as highly important. A common song repertoire is considered to be an effective means of building collective identity within ethnic groups, the common language and the cultural heritage being used as rhetorical arguments. During the early 1900s, choir festivals become an educational platform where conceptions of a common belonging are developed and strengthened through religious, patriotic, and poetical expressions. National school curricula in singing and music have similar characteristics, cultural heritage and values education being in focus. The song lyrics often describe nature and emotions, and they also appear to be personal and situated in a given time and place. Patriotic expressions and songs about music are also fairly common. The songs generally express positive attitudes, which are intensified by major tonality, rich and varied melodies with stable rhythms, and a strong tonal base. The analyzed details of the studied aspects are merged into a thick description, which results in an interpretation pattern with three dimensions: a song treasury can be considered an expression of collective identity, cultural heritage, and values education.

En vårdvetenskaplig syntes mellan vårdandets ethos och vårdintensitet

This is a study in the field of caring science. The kinds of knowledge expansion and theoretical formation outlined in this thesis have a hypothetic-deductive design. The synthesizer of caring science between caring ethos and nursing intensity evolves through a hermeneutic movement between understanding and interpretation, in the dialectic tension between thesis and antithesis. The study had three main aims with corresponding research questions. The first aim was to deepen the understanding of caring ethos within the care of older people from the perspective of caring science. The second aim was to deepen the understanding of nursing intensity within the care of older people, again from the perspective of caring science. The third aim of the study was to create a theoretical model describing the synthesizer between the caring ethos and nursing intensity. The synthesizer of caring science between caring ethos and nursing intensity took place in a process of creativity, which resulted in six new patterns of interpretation. Good care is in constant movement and tension between the ethical and the unethical. In order to guarantee the older person of the future dignity, a caring community, and integrity in care, there is a need for an awareness of and responsibility for those entities than can become ethical problems and dilemmas. The model that describes the synthesizer between caring ethos and nursing intensity, consist of four cornerstones such as caring ethics, wishes and anticipations, an ethical manner in words and action, and ethical leadership. Good care based on the values dignity, a caring community, safety, and integrity, receive their legitimacy through ethical awareness, and consent among caregivers. Ethical awareness deepens the understanding of wishes and expectations that may arise as special needs. Care thus requires an awareness of the balance between the patient’s care need and optimal level of nursing intensity. An ethical leadership considers the needs of the patient and accepts nothing but a work situation where optimal nursing intensity and optimal resource allocation makes good care possible.

Serva ad ministrare : tjänandets ethos i vårdledarskap

Avhandlingen syftar till att ur ett vårdvetenskapligt perspektiv beskriva och upptäcka tjänandets meningsinnehåll samt fördjupa förståelsekunskap om tjänandets ethos i förhållande till vårdledarskap med en inriktning på det vårdadministrativa. Syftet är även att skapa en idealmodell som öppnar för en ny eller annorlunda förståelsehorisont för tjänandets ethos i vårdledarskap. Kunskapssökandet sker genom följande delstudier: (1) I begreppsbestämningen genomförs begreppsanalyser av tjäna och tjänst med avsikt att öppna för en grundförståelse och tankestruktur i forskningsuppgiften. (2) I det idéhistoriska spåras tjänandets ontologiska arv och idémönster fram genom tolkning av historiska källornas texter från 1900-talets första hälft i ljuset av sjuksköterskeledarskap utgående från Sophie Mannerheims, Bertha Wellins och Bergljot Larssons idéer och tankeströmningar. (3) Sökandet fortsätter i dagens kliniska kontextbas genom kvalitativa djupintervjuer med 30 deltagare (vårdledare och vårdare) från Finland, Sverige och Norge. Förförståelsen och forskningens teoretiska perspektiv har rötter i Erikssons caring science-tradition och vårdvetenskapens ontologiska grundantaganden som utvecklats vid Åbo Akademi, Enheten för vårdvetenskap i Vasa. Forskningsansatsen är inspirerad av H-G Gadamers filosofiska hermeneutik. Designen är explorativ-deskriptiv, idiografisk och implicerar ett hypotetisk-deduktivt tillvägagångssätt. Tjänandet och vårdledarskapets ethos upptäcks och tolkas genom det metodologiska närmandet: Erikssons hermeneutiska begreppsbestämningsmodell, idéhistoriska läsakt och hermeneutiska läsakt. Materialet bildar förståelsehorisonter genom den hermeneutiska dialogens successiva och oändliga rörelse. Horisonterna reflekteras mot teorikärnan för att öppna för ny förståelse av tjänandets meningsinnehåll, vårdledarskap och vårdadministration. I slutandet sker en horisontsammansmältning och en reflektiv anslutning till vårdvetenskapens teorikärna som visar hur tjänandets ethos blir evident i vårdledarskap. Resultatet visar att vårdledarskap som är tjänande för patienten och vårdkulturen synliggörs i vårdadministrationens kontext genom huvudets skärpa, handens gärningar och hjärtats visdom. Tjänandets sanna, goda och sköna tidlösa rörelse är riktad mot hälsa och helande. I dag sammankopplas tjänande inom vårdorganisationer med hälsoekonomiska förhållanden, effektivitet, produktivitet och rationalitet, vilket strider mot tjänandets värdegrund, människans värdighet och respekt för livet. Vårdorganisationernas etiska ansvar är att fungera som samhälleliga förebilder, tillrättalägga för vårdadministrationernas tjänande och stå i patientens tjänst. Gestaltningen av tjänandets ethos i vårdledarskap öppnar för nya diskurser, riktningar, visioner och handlingar i den vårdadministrativa verkligheten. Avhandlingen ger vårdvetenskapens systematiska grundforskning ett teoritillskott av fördjupad förståelse av tjänandets och vårdledarskapets historiska och samtida ontologiska evidens och ethos med applikationen på klinisk vårdvetenskap.

Slutrapport över projektet Bitar av samma pussel? Intersektionella perspektiv på det svenska i Finland

Slutrapport

”O, ve! O ve! – O, ve!” – Skiljetecken ur stilistiskt perspektiv i Ett drömspel av August Strindberg

Tutkielma sijoittuu tyylintutkimuksen alaan ja käsittelee välimerkkien käyttöä ja niiden tyylillisiä vaikutuksia August Strindbergin näytelmässä Ett drömspel (Uninäytelmä). Tutkielman aineistoon kuuluvat lähes kaikki näytelmässä käytettävät välimerkit: piste, huutomerkki, kysymysmerkki, kolme pistettä, kolme ajatusviivaa, yksi ajatusviiva, pilkku, puolipiste ja kaksoispiste. Aineistona on käytetty Tukholman yliopiston vuonna 1988 julkaisemaa nationalupplaga-laitosta, ja aineisto käsittää koko näytelmän lukuun ottamatta alkunäytöstä, runoja sekä metatekstiä. Käytetyt metodit ovat pääasiallisesti kvalitatiivisia, mutta niitä on täydennetty kvantitatiivisin menetelmin laskemalla kyseisten välimerkkien lukumäärät. Keskeisin tutkimustulos on, että huutomerkki on ylivoimaisesti runsaslukuisin mainituista viidestä välimerkistä ja luo näin ollen tärkeimmän tyylipiirteen näytelmään. Huutomerkkien runsas käyttö saa aikaan dramaattisen, ekspressiivisen, nopeatempoisen ja pateettisen tyylin. Osittain saman vaikutelman tukemiseksi pisteen käyttö on puolestaan harvinaisen vähälukuista. Kolmen pisteen ja kolmen ajatusviivan käytön voidaan niin ikään katsoa tukevan tunteellista ilmausta. Pilkut ovat virkkeen sisällä tärkeimpiä välimerkkejä sanojen rytmittämisessä. Loppupäätelmä on, että välimerkit toimivat näytelmässä täydentävänä metatekstinä antaen lisäinformaatiota siitä, kuinka ja millaisella tunnevärillä repliikki on tarkoitettu esitettäväksi Kokonaisuudessaan Strindbergin välimerkkien käyttö näytelmässä on hyvin erikoista kielen normeihin ja välimerkkien tavanomaiseen käyttötapaan nähden. Näin ollen välimerkit ovat tyylillisesti merkittäviä näytelmässä.

Continuity of patient care in day surgery

Continuity is a part of high-quality patient care. The purpose of this study was to analyse what factors are important in the continuity of patients’ care, and how well continuity is achieved in different stages of the care of day surgical patients. Day surgery has become significantly more prevalent in the past few decades, and in order for it to be carried out successfully, continuity in care is particularly essential. The study was carried out in two stages. In the first stage (2001–2005) of the study, continuity was examined through a review of literature from the perspective of critical pathways, naming the continuity categories of time flow, coordination flow, caring relationship flow, and information flow. The first stage also entailed an analysis of matters important to the patient and problems concerning the achievement of care continuity, carried out by interviewing 25 day surgical patients. In the second stage (2006–2015), the degree to which the continuity of day surgical patient care was achieved was analysed from the perspective of patients (n=203, 58%) and nurses working in day surgery units (n=83, 69%), and suggestions for developing the continuity of day surgery patient care were made. In this study continuity of care was examined through a review of literature from the perspective of critical pathways, naming the continuity categories of time flow, coordination flow, caring relationship flow, and information flow. Within these categories, several important factors for the patient were found. According to both patients and nurses, continuity of care is generally achieved to a high degree. Continuity of care is improved by patients being acquainted with and meeting the staff attending to them (nurse and surgeon) before and after the operation. From patients’ perspective, there is room for improvement especially in terms of being admitted to care and in the carer-patient relationship. From nurses’ perspective, there is room for improvement in terms of the smoothness of care. Nurses evaluated the continuity of care to be the least successful before and after the operation. An extensive social and health care reform is planned in Finland in the coming years, aiming to enhance social and health care services and to create smoothly functioning service and care. As a topic of further study supporting the development of the service system, it is important to follow the patient’s progress throughout the entire chain of care, e.g. as a case study. On the other hand, there is also a need to study the views of nurses and other health care professionals in health care, e.g. in primary health care.

Tillitsramar - ett perspektiv på riter och tillit : en religionsfilosofisk undersökning

Riter berör. Riter stör. Riter syns, hörs och har lukt. De är påtagliga fenomen i samtiden. Riter kan vara allt från skolavslutningar till rituell könsstympning (FGM) eller ett kärlekslås på en bro någonstans i världen. De exempel på riter som avhandlingen lyfter fram och belyser ur ett religionsfilosofiskt perspektiv är olika sorts ritualiserande; riter ur svenskkyrklig tradition, könsstympning, offentliga sorgeriter vid terrordåd eller katastrofer, kärlekslåsritualer, muslimska riter m.fl. Frågor som: Vilket synsätt på riter kunde vara möjligt att omfatta ur ett betraktarperspektiv för att kunna kritisera riter på de ritualiserandes villkor?, Hur skulle de ritualiserandes perspektiv på riter och ett betraktarperspektiv på riter kunna hållas samman vid kritik av riter?, Hur kunde en begriplig självreflektion förstås vid känslomässiga reaktioner på andras sätt att utöva riter? behandlas i avhandlingen. Genom att diskutera det komplexa fenomenet riter ur ett betraktarperspektiv söks framkomliga vägar för att öka förståelsen för andras sätt att uttrycka existentiella upplevelser i riter. Resonemangen förs för en ökad förståelse för ett ritualiserande som ur ett betraktarperspektiv kan upplevas som främmande eller omvänt som intressant att delta i. 'Tillit' diskuteras som en grundläggande mänsklig möjlighet till förankring i tillvaron i samband med riter. Ur ritualdiskursen bearbetas det teoretiska perspektivet riter sedda som 'ramar'. Begreppet ’tillitsram’ diskuteras som ett fruktbart tentativt synsätt på riter vid kritik av riter för att hålla samman de ritualiserandes perspektiv med betraktarperspektivet. Avhandlingen vill visa att begreppet ’tillitsram’ skulle kunna vara fruktbart för att bidra till etiska, filosofiska, teologiska och politiska reflektioner och diskussioner om riter i samtiden.

Nursing Students’ Learning about an Empowering Discourse In Patient Education

The main purpose of this study was to describe and evaluate nursing students' learning about an empowering discourse in patient education. In Phase 1, the purpose was to describe an empowering discourse between a nurse and a patient. In Phase 2, the purpose was first to create a computer simulation program of an empowering discourse based on the description, and second, the purpose was to evaluate nursing students’ learning of how to conduct an empowering discourse using a computer simulation program. The ultimate goal was to strengthen the knowledge basis on empowering discourse and to develop nursing students’ knowledge about how to conduct an empowering discourse for the development of patient education. In Phase I, empowering discourse was described using a systematic literature review with a metasummary technique (n=15). Data were collected covering a period from January 1995 to October 2005. In Phase 2, the computer simulation program of empowering discourse was created based the description in 2006–2007. A descriptive comparative design was used to evaluate students’ (n=69) process of learning empowering discourse using the computer simulation program and a pretest–post-test design without a control group was used to evaluate students’ (n=43) outcomes of learning. Data were collected in 2007. Empowering discourse was a structured process and it was possible to simulate and learned with the computer simulation program. According to students’ knowledge, empowering discourse was an unstructured process. Process of learning empowering discourse using the computer simulation program was controlled by the students and it changed students’ knowledge. The outcomes of learning empowering discourse appeared as changes of students’ knowledge to more holistic and better-organized or only to more holistic or better-organized. The study strengthened knowledge base of empowering discourse and developed students to more knowledgeable in empowering discourse.

Datenherrschaft – an Ethically Justified Solution to the Problem of Ownership of Patient Information

Patient information systems are crucial components for the modern healthcare and medicine. It is obvious that without them the healthcare cannot function properly – one can try to imagine how brain surgery could be done without using information systems to gather and show information needed for an operation. Thus, it can be stated that digital information is irremovable part of modern healthcare. However, the legal ownership of patient information lacks a coherent and justified basis. The whole issue itself is actually bypassed by controlling pa- tient information with different laws and regulations how patient information can be used and by whom. Nonetheless, the issue itself – who owns the patient in- formation – is commonly missed or bypassed. This dissertation show the problems if the legislation of patient information ownership is not clear. Without clear legislation, the outcome can be unexpected like it seems to be in Finland, Sweden and United Kingdom: the lack of clear regulation has come up with unwanted consequences because of problematic Eu- ropean Union database directive implementation in those countries. The legal ownership is actually granted to the creators of databases which contains the pa- tient information, and this is not a desirable situation. In healthcare and medicine, we are dealing with issues such as life, health and information which are very sensitive and in many cases very personal. Thus, this dissertation leans on four philosophical theories form Locke, Kant, Heidegger and Rawls to have an ethically justified basis for regulating the patient infor- mation in a proper way. Because of the problems of property and ownership in the context of information, a new concept is needed and presented to replace the concept of owning, that concept being Datenherrschaft (eng. mastery over in- formation). Datenherrschaft seems to be suitable for regulating patient infor- mation because its core is the protection of one’s right over information and this aligns with the work of the philosophers whose theories are used in the work. The philosophical argumentation of this study shows that Datenherrschaft granted to the patients is ethically acceptable. It supports the view that patient should be controlling the patient information about themselves unless there are such specific circumstance that justifies the authorities to use patient information to protect other people’s basic rights. Thus, if the patients would be legally grant- ed Datenherrschaft over patient information we would endorse patients as indi- viduals who have their own and personal experience of their own life and have a strong stance against any unjustified paternalism in healthcare. Keywords: patient information, ownership, Datenherrschaft, ethics, Locke, Kant, Heidegger, Rawls