En vårdvetenskaplig teori om interkulturellt vårdande : att föda barn i en annan kultur

The aim of this dissertation is to develop a theory on intercultural caring to deepen the understanding of caring between nurses and patients who have different cultural backgrounds. The research questions are: 1) What is intercultural caring? 2) How is intercultural caring described and understood? 3) How is intercultural caring described and understood in a maternity care context from the patients’ perspective? 4) What is the substance in a theory on intercultural caring? 5) What is the substance in a theory on intercultural caring in maternity care from the patients’ perspective? The theoretical perspective is based on caritative theory and the caring science-tradition (Eriksson, 2001, 2002) and has a hermeneutic approach. In the first study, 19 texts of Campinha-Bacote, Kim-Godwin, Leininger and Ray are analysed through content analysis. A model for intercultural caring is then created abductively. The second study is a metasynthesis of 40 studies on intercultural caring in maternity care research. The third study is a focused ethnography, in which 17 immigrant mothers are interviewed and observed. The theory on intercultural caring is created through a hermeneutic synthesis of the three studies. A synthesis of the studies with a maternity context results in five patterns of interpretation: the experience of caring is related to power; the family is always present; childbearing and change of culture can give women multiple vulnerabilities; both the mother and the nurse change when they meet; conflicts can cause change. The theory and patterns of interpretation consolidate into a contextual theory on intercultural caring for clinical maternity praxis. In this theory, caring consists of four dimensions: universal, cultural, contextual, and unique caring, which permeate each other. Universal caring is nondependent of time and space. Cultural caring considers the cultural background, the acculturation and the equality of each mother. In the maternity care culture, cultural competence, cultural safety, and acculturation of the nurse are emphasised. Contextual caring considers the specific cultural features of the childbearing mother. In this respect, the nurse is expected to be an expert and to clarify cultural assumptions in maternity care. In unique caring, the mother expects good communication, respect for the family, goodwill and somebody who cares for her and meets her needs, in order for trust to be built. In this respect, the nurse listens to the woman’s narrative, is flexible, open, courageous, and non-judgemental. The nurse shows an understanding for the life situation of the woman, and strives for continuity to preserve the care relationship. It was found that external circumstances affect intercultural caring. Moreover, intercultural caring is expected to decrease misunderstandings and conflicts, alleviate suffering and promote health and life. The theory adds knowledge to the phenomenon of intercultural caring for the nursing and caring sciences, and for the nursing care of patients with other cultural backgrounds than the nurses. The theory can be used in nursing, education, research and administration.

Expectations of elderly people on the nurse-client relationship and interaction in home care : "When I see the nurse's smiling face it feels likes sunshine on a rainy and gloomy day"

The purpose of the thesis was to explore expectations of elderly people on the nurse-client relationship and interaction in home care. The aim is to improve the quality of care to better meet the needs of the clients. A qualitative approach was adopted. Semi-structured theme interviews were used for data collection. The interviews were conducted during spring 2006. Six elderly clients of a private home care company in Southern Finland acted as informants. Content analysis was used as the method of data analysis. The findings suggest that clients expect nurses to provide professional care with loving-kindness. Trust and mutual, active interaction were expected from the nurse-client relationship. Clients considered it important that the nurse recognizes each client's individual needs. The nurse was expected to perform duties efficiently, but in a calm and unrushed manner. A mechanic performance of tasks was considered negative. Humanity was viewed as a crucial element in the nurse-client relationship. Clients expressed their need to be seen as human beings. Seeing beyond the illness was considered important. A smiling nurse was described to be able to alleviate pain and anxiety. Clients hoped to have a close relationship with the nurse. The development of a close relationship was considered to be more likely if the nurse is familiar and genuine. Clients wish the nurses to have a more attending presence. Clients suggested that the work areas of the nurses could be limited so that they would have more time to transfer from one place to another. Clients felt that they would benefit from this as well. The nurses were expected to be more considerate. Clients wished for more information regarding changes that affect their care. They wished to be informed about changes in schedules and plans. Clients hoped for continuity from the nurse-client relationship. Considering the expectations of clients promotes client satisfaction. Home care providers have an opportunity to reflect their own care behaviour on the findings. To better meet the needs of the clients, nurses could apply the concept of loving-kindness in their work, and strive for a more attending presence.

Oxidized LDL and physical fitness in healthy young men: associations with body composition, smoking, metabolic syndrome and androgen status

Background: In the past, oxidized low density lipoprotein (ox-LDL) has been associated with an unbeneficial lipid profile. This atherogenic lipid profile increases the risk of atherosclerotic cardiovascular diseases. Physical fitness has substantial effect on serum lipoprotein concentration as well as body composition and humoral responses, however interrelationships between ox-LDL and physical fitness have not been widely examined in a nationally representative sample. Aims: This thesis evaluates how cardiorespiratory and muscular fitness associate with ox-LDL lipids and how the other known risk factors of atherosclerosis might alter these associations. Subjects and Methods: The study cohort consisted of 846 healthy young males (mean age 25.1, SD 4.6) who were gathered by voluntary nationwide recruitment. Each participant conducted a series of physical fitness tests (cardiorespiratory and muscular fitness) and answered a detailed questionnaire that included lifestyle habits (i.e. smoking and leisuretime physical activity). Venous blood samples including ox-LDL and serum lipids were also collected. Results: Higher levels of ox-LDL were found in overweight and obese men, however, high cardiorespiratory fitness seemed to protect the overweight from high levels of ox-LDL. Young men who smoked and had poor cardiorespiratory or muscular fitness possessed a higher concentration of ox-LDL lipids when compared to comparable levels of cardiorespiratory or muscular fitness non-smoking young men. Metabolic syndrome was associated with increased levels of ox-LDL and high levels of ox-LDL combined with poor cardiorespiratory and abdominal muscle fitness seems to predict metabolic syndrome in young men. Also, participants with poor cardiorespiratory fitness and low levels of testosterone had higher levels of ox-LDL when compared to participants with high cardiorespiratory fitness / low testosterone as well as those with poor cardiorespiratory fitness / high testosterone. Conclusions: Good cardiorespiratory and muscular fitness protects young men from increased levels of ox-LDL lipids. This association was discovered in young men who were categorized as being overweight, smokers, metabolic syndrome or with low levels of testosterone. Being fit seems to prevent higher levels of ox-LDL, even in young healthy

The Cat Who Walks Through Years: Chris Claremont's X-Men as Kitty Pryde's bildungsroman

This dissertation examines the fictional character Kitty Pryde from the X-Men comic book series during the tenure of writer Chris Claremont. Claremont's work on the character primarily involves the years 1980-1990, though a return to writing the character in the 2000s is also discussed when relevant. The thesis question revolves around the definition of the bildungsroman genre and whether Claremont's narrative arc for Kitty Pryde's character fulfills that definition. Jerome Hamilton Buckley's 1974 book Season of Youth: The Bildungsroman from Dickens to Golding is used as the primary authority for the bildungsroman genre, and more specifically a list of nine criteria that Buckley deems particularly key to the definition of the genre. Each of the nine criteria is looked at in depth, demonstrating where and how they can be found in the narrative, if at all. However, because Buckley's perspective and criteria come from a time of less diversity, examination from a feminist and minority perspective is also added with ideas from Rita Felski and Stella Bolaki. Combining Buckley's initial list of nine criteria with more modern criticism, these ideas are then used to analyze Kitty Pryde's narrative arc and to determine whether it can be seen as a bildungsroman. The findings support reading Claremont's narrative arc of the Kitty Pryde character as a bildungsroman. Three of Buckley's nine key themes are identified as particularly prevalent in the narrative: the search for a vocation, ordeal by love, and the conflict of generations. Three more key themes are found to be less prevalent but still clearly present: the search for a working philosophy, the larger society, and alienation. Because Buckley's definition for the bildungsroman genre requires the presence of six of his nine key themes, the presence of the aforementioned six thus validate the reading of the narrative as a bildungsroman. The text also provides some suggestions for finding the three least applicable key themes within the narrative, but because their presence is not necessary to fulfill the definition of the bildungsroman, they are not rigorously examined. In addition to fulfilling Buckley's key themes, the paper also discusses the more modern minority-oriented views. It is shown how the narrative can be read in terms of a journey to diverge from norms, as per Felski's ideas of the unique qualities of the specifically female bildungsroman. As Kitty Pryde's narrative can be shown to conform to the bildungsroman ideas of both Buckley and Felski, the thesis question is thus answered positively: Chris Claremont's X-Men can indeed be read as Kitty Pryde's bildungsroman.

"If God hadn't invented woman men would have had to do so" - construction of female identities in Parade's End by Ford Madox Ford

The subject of the thesis is Parade's End (1924–1928) by Ford Madox Ford. The thesis focuses on the portrayal of female identities and femininity in the context of societal changes in the beginning of 1900s and also uses two of Ford's essays about gender and women's rights as background. The construction of female identities is discussed via different themes. The themes are marriage, divorce and infidelity; motherhood, modernity and emergence of new gender identities in post-World War I environment, and polyamory as a solution for adulterous practices and empty, unhappy marriages. Parade's End portrays superficially modern female identities, but ends up enforcing women's role as mother and traditional femininity. However, the novel suggests that the strict gender boundaries are starting to fracture after WWI. This is depicted by portraying the men representing new masculinity as feminised and emphasising androgyny and boyishness when discussing representations of new femininity.