"Visst är det väldigt jobbigt, men det är också bra." : en studie om hur närståendevårdare upplever positiva och negativa effekter av närståendevård

Avhandlingens syfte är att studera hur närståendevårdare upplever positiva och negativa effekter av närståendevård, samt hur de upplever faktorer som kan inverka på deras livstillfredsställelse. Den empiriska analysens första frågeställning gäller ifall närståendevårdarna upplever både positiva och negativa effekter av närståendevård, och i så fall vilka positiva och negativa effekter som närståendevårdaren upplever. Den andra frågeställningen gäller vilka upplevelser och erfarenheter närståendevårdarna har i fråga om faktorer som kan påverka deras livstillfredsställelse. En kvalitativ metod har använts för att genomföra studien. För att undersöka respondenternas subjektiva tankar kring forskningsfrågan har nio temaintervjuer genomförts. Det insamlade materialet har analyserats med kvalitativ innehållsanalys. Respondenterna är svenskspråkiga närståendevårdare i åldern 45–80 år bosatta i Jakobstad, Pedersöre, Larsmo eller Nykarleby, som vårdar en annan vuxen person som inte är deras barn. Analysen visar att närståendevårdarna upplever både negativa och positiva effekter av närståendevård. Närståendevårdarna upplever negativa och positiva effekter i varierande utsträckning. Närståendevårdarna använder sig av både problemorienterad och emotionellt och kognitivt inriktad coping. Närståendevårdarnas psykiska och fysiska hälsa påverkas av närståendevårdararbetet. Vårdtagarens hälsa inverkar på närståendevårdarnas upplevelse av närståendevården. Närståendevårdarna upplever att de är bundna till vårdtagaren eller vårdplatsen, och kan ha svårt att hitta sammanhängande egen tid. Närståendevårdarna upplever att de får socialt stöd från närstående, tredje sektorn, samhället, andra närståendevårdare och privata sektorn. Närståendevårdarna upplever att de får socialt stöd, men det sociala stödet är ibland inte tillräckligt och respondenterna upplever därför också brist på socialt stöd.

Korkeasti koulutettujen selviytyminen työn menetyksestä ja pitkittyneestä työttömyydestä

Tämän pro gradu -tutkielman tavoitteena oli ymmärtää ja kuvata korkeasti koulutettujen henkilöiden selviytymistä työn menetyksestä ja pitkittyneestä työttömyydestä. Tutkimuksessa tarkasteltiin pakotettua uramuutosta ja työttömyyttä sekä siitä selviytymistä yksilön kokemuksen näkökulmasta. Lisäksi tutkittiin työttömyyden tukipalveluiden hyödyllisyyttä. Tutkimus toteutettiin kvalitatiivisena kuvailevana tapaustutkimuksena. Tutkimuksen empiirinen aineisto kerättiin haastattelemalla 13 korkeasti koulutettua uusimaalaista työtöntä henkilöä. Haastattelut toteutettiin puolistrukturoitua teemahaastattelumenetelmää käyttäen. Tutkimuksen tulosten perusteella voidaan havaita, että työn menetyksellä koettiin olevan sekä negatiivisia että positiivisia vaikutuksia. Työn menetys koettiin osittain helpotuksena ja hengähdystaukona. Henkilöt selviytyivät itse työn menetyksen tilanteesta jokseenkin hyvin, etenkin jos muutokseen oli voinut varautua ja irtisanomisperusteet olivat selkeät. Korkeasti koulutetut henkilöt käyttivät monipuolisesti sekä tunne- että ongelmakeskeisiä selviytymisstrategioita selviytyäkseen työttömyydestä. Näistä aktiivinen työnhaku sekä opiskelu korostuivat selviytymiskeinoina. Työttömyyden pitkittyminen heikensi selvästi yksilön hyvinvointia ja vertaistuen merkitys korostui työttömyyden pitkittyessä. Tutkimuksesta ilmeni, että julkiset työvoimapalvelut eivät tue riittävästi korkeasti koulutettuja työttömiä. Tukipalveluja tulisi kehittää vastaamaan paremmin muuttuneiden työmarkkinoiden vaateita, sillä työmarkkinoiden muutokset haastavat urien uudenlaiseen tarkasteluun.

University students’ regulation of learning and text processing – examples from medical and teacher education

The general aim of the thesis was to study university students’ learning from the perspective of regulation of learning and text processing. The data were collected from the two academic disciplines of medical and teacher education, which share the features of highly scheduled study, a multidisciplinary character, a complex relationship between theory and practice and a professional nature. Contemporary information society poses new challenges for learning, as it is not possible to learn all the information needed in a profession during a study programme. Therefore, it is increasingly important to learn how to think and learn independently, how to recognise gaps in and update one’s knowledge and how to deal with the huge amount of constantly changing information. In other words, it is critical to regulate one’s learning and to process text effectively. The thesis comprises five sub-studies that employed cross-sectional, longitudinal and experimental designs and multiple methods, from surveys to eye tracking. Study I examined the connections between students’ study orientations and the ways they regulate their learning. In total, 410 second-, fourth- and sixth-year medical students from two Finnish medical schools participated in the study by completing a questionnaire measuring both general study orientations and regulation strategies. The students were generally deeply oriented towards their studies. However, they regulated their studying externally. Several interesting and theoretically reasonable connections between the variables were found. For instance, self-regulation was positively correlated with deep orientation and achievement orientation and was negatively correlated with non-commitment. However, external regulation was likewise positively correlated with deep orientation and achievement orientation but also with surface orientation and systematic orientation. It is argued that external regulation might function as an effective coping strategy in the cognitively loaded medical curriculum. Study II focused on medical students’ regulation of learning and their conceptions of the learning environment in an innovative medical course where traditional lectures were combined wth problem-based learning (PBL) group work. First-year medical and dental students (N = 153) completed a questionnaire assessing their regulation strategies of learning and views about the PBL group work. The results indicated that external regulation and self-regulation of the learning content were the most typical regulation strategies among the participants. In line with previous studies, self-regulation wasconnected with study success. Strictly organised PBL sessions were not considered as useful as lectures, although the students’ views of the teacher/tutor and the group were mainly positive. Therefore, developers of teaching methods are challenged to think of new solutions that facilitate reflection of one’s learning and that improve the development of self-regulation. In Study III, a person-centred approach to studying regulation strategies was employed, in contrast to the traditional variable-centred approach used in Study I and Study II. The aim of Study III was to identify different regulation strategy profiles among medical students (N = 162) across time and to examine to what extent these profiles predict study success in preclinical studies. Four regulation strategy profiles were identified, and connections with study success were found. Students with the lowest self-regulation and with an increasing lack of regulation performed worse than the other groups. As the person-centred approach enables us to individualise students with diverse regulation patterns, it could be used in supporting student learning and in facilitating the early diagnosis of learning difficulties. In Study IV, 91 student teachers participated in a pre-test/post-test design where they answered open-ended questions about a complex science concept both before and after reading either a traditional, expository science text or a refutational text that prompted the reader to change his/her beliefs according to scientific beliefs about the phenomenon. The student teachers completed a questionnaire concerning their regulation and processing strategies. The results showed that the students’ understanding improved after text reading intervention and that refutational text promoted understanding better than the traditional text. Additionally, regulation and processing strategies were found to be connected with understanding the science phenomenon. A weak trend showed that weaker learners would benefit more from the refutational text. It seems that learners with effective learning strategies are able to pick out the relevant content regardless of the text type, whereas weaker learners might benefit from refutational parts that contrast the most typical misconceptions with scientific views. The purpose of Study V was to use eye tracking to determine how third-year medical studets (n = 39) and internal medicine residents (n = 13) read and solve patient case texts. The results revealed differences between medical students and residents in processing patient case texts; compared to the students, the residents were more accurate in their diagnoses and processed the texts significantly faster and with a lower number of fixations. Different reading patterns were also found. The observed differences between medical students and residents in processing patient case texts could be used in medical education to model expert reasoning and to teach how a good medical text should be constructed. The main findings of the thesis indicate that even among very selected student populations, such as high-achieving medical students or student teachers, there seems to be a lot of variation in regulation strategies of learning and text processing. As these learning strategies are related to successful studying, students enter educational programmes with rather different chances of managing and achieving success. Further, the ways of engaging in learning seldom centre on a single strategy or approach; rather, students seem to combine several strategies to a certain degree. Sometimes, it can be a matter of perspective of which way of learning can be considered best; therefore, the reality of studying in higher education is often more complicated than the simplistic view of self-regulation as a good quality and external regulation as a harmful quality. The beginning of university studies may be stressful for many, as the gap between high school and university studies is huge and those strategies that were adequate during high school might not work as well in higher education. Therefore, it is important to map students’ learning strategies and to encourage them to engage in using high-quality learning strategies from the beginning. Instead of separate courses on learning skills, the integration of these skills into course contents should be considered. Furthermore, learning complex scientific phenomena could be facilitated by paying attention to high-quality learning materials and texts and other support from the learning environment also in the university. Eye tracking seems to have great potential in evaluating performance and growing diagnostic expertise in text processing, although more research using texts as stimulus is needed. Both medical and teacher education programmes and the professions themselves are challenging in terms of their multidisciplinary nature and increasing amounts of information and therefore require good lifelong learning skills during the study period and later in work life.