261 resultados para vårdvetenskap, gemenskap, ethos, caritativ vårdteori, äldre, hälsa, hermeneutik


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Projektet Fornby yrkesfolkhögskola är ett försöka att stödja invandrare och flyktingar som har svårigheter att etablera sig på den svenska arbetsmarknaden, d.v.s. i det här fallet att de uppbar någon form av försörjningsstöd och att de även hade svårigheter med att kunna få ett varaktigt arbete. Det visade sig snart att den nivå som hade lagts fast för deltagarnas språkkunskaper inte var tillräcklig för att flertalet obehindrat skulle kunna följa utbildningen. Många deltagare hade brister i sin utbildningsbakgrund i förhållande till vad som krävs för de flesta yrken på den svenska arbetsmarknaden, liksom att de saknade erfarenheter från denna. Deras arbetslivserfarenheter från sina hemländer var av begränsat värde i det här fallet. Problemet var emellertid inte bara brister i utbildningsbakgrund, arbetslivserfarenheter och språkkunskaper i svenska, det var också så att en del deltagare hade problem med sin fysiska och/eller mentala hälsa.

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This paper seeks to describe and discuss the impact of inspections of schools in Sweden. It outlines the political context, based on New Public Management (NPM) theory, according to what role the Schools Inspectorate is supposed to play in order to govern and control. Attention is also devoted, referring an on-going case study, to how inspections influence head teachers and their leadership in their everyday work.   Reports from the Schools inspectorate are public. This forces both politicians and head teachers to take measures. In this case, the head teachers perceived that the inspection reports confirmed what they already knew, but it also gave them an alibi and a tool to push their teachers to take part in everyday school development work. During the first year after the inspection the head teachers mainly strived to adjust formal deficiencies in local steering documents. However, some of the deviations reported from the Schools inspectorate are regarding pedagogical problems that are complicated and difficult to handle. As interventions in many cases will show up much later the results are, for example as increased goal fulfilment, in this case, still an open question. Nevertheless, it seems obvious that the Schools Inspectorate must be seen as a result of the governing philosophy that denotes New Public Management NPM).

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Bakgrund: Astma och KOL är två vanlig kroniska sjukdomar som är kopplade till stort sjukdomslidande och lägre livskvalité. Många personer som idag lever med sjukdomarna lever isolerat från andra. Idag har vi en ständig utveckling av sociala nätverk som öppnar en ny möjlighet för egenvård. Egenvård kan göra att patienter får en bättre vardag samt att det lättare kan få ett socialt umgänge. Syfte: Syftet är sammanställa befintlig litteratur och där undersöka hur informations- och kommunikationsteknologi underlättar egenvården för patienter med astma och KOL. Metod: Litteraturstudie där artiklarna söktes i databaser för omvårdnadsvetenskap så som Web Of Science, pubmed och Cinahl. Litteraturstudien baseras på 16 vetenskapliga artiklar som både är kvalitativa och kvantitativa. Artiklarna som valdes är inte äldre än 10 år gamla, skrivna på engelska och publicerade i en vetenskaplig tidning. Resultat: Resultatet som artiklarna påvisade är grundade på IKT i form av datorer, mobiltelefoner, surfplattor och web-baserad program. Artiklarna visar att egenvården kan förbättras genom ökad livskvalité, bättre kommunikation och bättre sjukdomsinsikt när man använder IKT. Slutsats: IKT är en viktig roll i våran hälso- och sjukvård idag. Det finns dock liten forskning på hur egenvården kring astma och KOL påverkas av IKT. Den forskning som finns pekar åt är att den förbättrar för patienter. Det behövs även mer forskning kring IKT som en resurs för egenvård kring ett omvårdnadsperspektiv.

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Projektet syftar till att belysa den Munktellska salongen i Falun som en landsortsvariant av det tidiga 1800-talets svenska salongskultur i relation till internationella, främst tyska förebilder. Det mer specifika syftet är att fördjupa förståelsen av salongskulturens pedagogiska arv och dess förankring i tidens bildningsdiskussion och hur det i sin tur har påverkat senare utbildningssträvanden och skoluppbyggnad (Wilhelmy1989). Kan salongen ses som en möjlig utgångspunkt för att utforska pedagogiken under tidigare historiska epoker? Kan man tala om salongens pedagogik? och ägde salongskulturen pedagogiska kvaliteter som gick förlorade under det formella utbildningssystemets uppbyggnad? Det är frågor jag ställer mig inom ramen för detta forskningsprojekt. Ett centralt begrepp är immanent pedagogik, dvs. individens inneboende möjligheter till självförverkligande i en given social kontext (Ödman 1995). Projektet utgår tysk bildningsteori med relevans för det romantiska nyhumanistiska bildningsidealet. I förhållande till det tyska bildningsarvet uppmärksammas även den svenska bildningstraditionen från 1800-talets början (Burman & Sundgren 2010). Särskilt intresse riktas mot Uppsala universitet där spänningen mellan klassiskt arv och bildningsnytta ställs på sin spets under samma tidsperiod som salongerna blomstrar (Gustavsson 1996; Lindqvist 1976). Tidigare forskning vilar främst på internationell och Nordisk forskning där Petra Wilhelmy och Anne Scott Sørensen har en central position. Genom Eva Öhrström skapas också ett viktigt vetenskapligt underlag för den specifikt musikaliska salongen och dess betingelser. Den Munktellska salongen är placerad i en historiskt intressant miljö. Falun rankades under stormaktstiden som rikets andra stad och bidrog till uppbyggnaden av Sveriges statskick (Hildebrand 1946). Väsentligt för studien är att Stora Kopparberget utgör ett paradigm i Svensk industrihistoria vars mentalitet anses ha haft betydelse för pedagogikens inriktning i Sverige (Ödman 1995:485). Den pedagogiska debatten under 1800-talets första decennier får stora konsekvenser för utbildningsreformationen i Sverige och placerar Falusalongen i en intressant position för epokens pedagogiska förändringsarbete. Brukspatronen Johan Henrik Munktell (1804-1861) visar sig dessutom stå i förbindelse med ett unikt musikhistorisk arv som etablerades under hans bildningsresor på kontinenten under 1820-talet. Av särskilt intresse är Henrik Munktells besök i den Mendelssohnska salongen. Mendelssohns i Berlin var en av Europas viktigaste salonger och en förebild för den musikaliska salongen i Europa (Öhrström 1998, 2007). Projektet består av tre delstudier där den första upptar Johan Henrik Munktells bildningsresor under det tidiga 1800-talet. Projektets andra del undersöker hur salongen i Grycksbo formades och de förbindelser mellan Norden och Europa som salongerna skapade. Projektets tredje del riktas mot salongens didaktiska funktioner och den utbildning som döttrarna Emma och Helena Munktell fick via salongen. Genom att satsa på sina yrkeskarriärer bröt Emma och Helena Munktell mot samtidens konventioner och ideal. De avvek samtidigt mot den kanon och de genuskoder som historiskt format salongsmusicerandet. Med inspiration av begreppet immanent pedagogik prövar jag det lärande som sker i salongen i termer av ljusets och dunklets pedagogik. Begreppsparet kan knytas till bildningsdiskursen och det narrativa minnet av Berlins judiska salonger. Metoden baseras på Paul Ricoeurs hermeneutik och bygger på att de narrativa momenten kvalificeras genom tre tolkningsnivåer som tillsammans avser att ge det historiska materialet en nybeskrivning eller redéscription (Liljas 2007; Ricoeur 1984). Genom Falusalongerna kan den nordiska salongsforskningen breddas. I kopplingen till Falu gruvas internationellt kända historia finns upplysningar om salongen som i den tidigare salongsforskningen inte varit kända. Genom projektet redogörs för betingelser som bidrar till att förändra det utbildningshistoriska landskapet. Den musikaliska salongen kan med sin privat organiserade struktur ses som en möjlig utgångspunkt för att utforska pedagogiken under tidigare historiska epoker. Salongerna kan förväntas berika det utbildningshistoriska perspektivet och bidra till en djupare förståelse även av dagens skola och högre utbildning.

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Background: Violence against women is associated with serious health problems, including adverse maternal and child health. Antenatal care (ANC) midwives are increasingly expected to implement the routine of identifying exposure to violence. An increase of Somali born refugee women in Sweden, their reported adverse childbearing health and possible links to violence pose a challenge to the Swedish maternity health care system. Thus, the aim was to explore ways ANC midwives in Sweden work with Somali born women and the questions of exposure to violence. Methods: Qualitative individual interviews with 17 midwives working with Somali-born women in nine ANC clinics in Sweden were analyzed using thematic analysis. Results: The midwives strived to focus on the individual woman beyond ethnicity and cultural differences. In relation to the Somali born women, they navigated between different definitions of violence, ways of handling adversities in life and social contexts, guided by experience based knowledge and collegial support. Seldom was ongoing violence encountered. The Somali-born women’s’ strengths and contentment were highlighted, however, language skills were considered central for a Somali-born woman’s access to rights and support in the Swedish society. Shared language, trustful relationships, patience, and networking were important aspects in the work with violence among Somali-born women. Conclusion: Focus on the individual woman and skills in inter-cultural communication increases possibilities of overcoming social distances. This enhances midwives’ ability to identify Somali born woman’s resources and needs regarding violence disclosure and support. Although routine use of professional interpretation is implemented, it might not fully provide nuances and social safety needed for violence disclosure. Thus, patience and trusting relationships are fundamental in work with violence among Somali born women. In collaboration with social networks and other health care and social work professions, the midwife can be a bridge and contribute to increased awareness of rights and support for Somali-born women in a new society.

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Kangaroo mother care (KMC) was first introduced in Mozambique in 1984. The aim of this study was to describe Mozambican mothers’ experiences of going through admission, passing from an intensive care ward to a nursery ward with their premature baby, undergoing KMC training before early discharge. A clinical case study was conducted, involving naturalistic observations and a face-to-face interview with 41 mothers participating to complete a questionnaire. Descriptive statistics and manifest content analysis were used in this study. The results show that the mothers were of low socio-economic standing and felt that they did not have enough information on KMC. The hierarchical organization within the hospital setting as well as communalistic behaviours influenced the mothers’ support of KMC, including information, communication, relationships and actions. The conclusion is that there is an important challenge for trained neonatal nurses to improve the guidelines for KMC and to empower mothers and their families to adopt KMC.

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Objectives. This study aimed to investigate the knowledge, attitudes and perceptionstowards contraceptive use and counselling among medical students in Maharashtra, India. Setting. Considerable global maternal mortality and morbidity could be avoided through theuse of effective contraception. In India, contraception services are frequently unavailable or there are obstacles to obtaining modern, reversible contraceptives. Participants. A cross-sectional descriptive study using a self-administered questionnaire was conducted among 1996 medical students in their fifth year of study at 27 medical colleges in the state of Maharashtra, India. Descriptive and analytical statistics interpreted the survey instrument and significant results were presented with 95% CI. Results. Respondents expressed a desire to provide contraceptive services. A few studentshad experienced training in abortion care. There were misconceptions about moderncontraceptive methods and the impact of sex education. Attitudes towards contraceptionwere mainly positive, premarital counselling was supported and the influence of traditional values and negative provider attitudes on services was recognised. Gender, area of upbringing and type of medical college did not change the results. Conclusions. Despite mostly positive attitudes towards modern contraceptives, sex education and family planning counselling, medical students in Maharashtra have misconceptions about modern methods of contraception. Preservice and in-service training in contraceptive counselling should be implemented in order to increase women's access to evidence-based maternal healthcare services.

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BACKGROUND: People who have suffered a stroke commonly report unfulfilled need for rehabilitation. Using a model of patient satisfaction, we examined characteristics in individuals that at 3 months after stroke predicted, or at 12 months were associated with unmet need for rehabilitation or dissatisfaction with health care services at 12 months after stroke. METHODS: The participants (n = 175) received care at the stroke units at the Karolinska University Hospital, Sweden. The dependent variables "unfulfilled needs for rehabilitation" and "dissatisfaction with care" were collected using a questionnaire. Stroke severity, domains of the Stroke Impact Scale (SIS), the Sense of Coherence scale (SOC) and socio demographic factors were used as independent variables in four logistic regression analyses. RESULTS: Unfulfilled needs for rehabilitation at 12 months were predicted by strength (SIS) (odds ratio (OR) 7.05) at three months, and associated with hand function (SIS) (OR 4.38) and poor self-rated recovery (SIS) (OR 2.46) at 12 months. Dissatisfaction with care was predicted by SOC (OR 4.18) and participation (SIS) (OR 3.78), and associated with SOC (OR 3.63) and strength (SIS) (OR 3.08). CONCLUSIONS: Thirty-three percent of the participants reported unmet needs for rehabilitation and fourteen percent were dissatisfied with the care received. In order to attend to rehabilitation needs when they arise, rehabilitation services may need to be more flexible in terms of when rehabilitation is provided. Long term services with scheduled re-assessments and with more emphasis on understanding the experiences of both the patients and their social networks might better be able to provide services that attend to patients' needs and aid peoples' reorientation; this would apply particularly to those with poor coping capacity.

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Background: Political violence and war are push factors for migration and social determinants of health among migrants. Somali migration to Sweden has increased threefold since 2004, and now comprises refugees with more than 20 years of war experiences. Health is influenced by earlier life experiences with adverse sexual and reproductive health, violence, and mental distress being linked. Adverse pregnancy outcomes are reported among Somali born refugees in high-income countries. The aim of this study was to explore experiences and perceptions on war, violence, and reproductive health before migration among Somali born women in Sweden. Method: Qualitative semi-structured individual interviews were conducted with 17 Somali born refugee women of fertile age living in Sweden. Thematic analysis was applied. Results: Before migration, widespread war-related violence in the community had created fear, separation, and interruption in daily life in Somalia, and power based restrictions limited access to reproductive health services. The lack of justice and support for women exposed to non-partner sexual violence or intimate partner violence reinforced the risk of shame, stigmatization, and silence. Social networks, stoicism, and faith constituted survival strategies in the context of war. Conclusions: Several factors reinforced non-disclosure of violence exposure among the Somali born women before migration. Therefore, violence-related illness might be overlooked in the health care system. Survival strategies shaped by war contain resources for resilience and

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Background: Low maternal awareness of fetal movements is associated with negative birth outcomes. Knowledge regarding pregnant women's compliance with programs of systematic self-assessment of fetal movements is needed. The aim of this study was to investigate women's experiences using two different self-assessment methods for monitoring fetal movements and to determine if the women had a preference for one or the other method. Methods: Data were collected by a crossover trial; 40 healthy women with an uncomplicated full-term pregnancy counted the fetal movements according to a Count-to-ten method and assessed the character of the movements according to the Mindfetalness method. Each self-assessment was observed by a midwife and followed by a questionnaire. A total of 80 self-assessments was performed; 40 with each method. Results: Of the 40 women, only one did not find at least one method suitable. Twenty of the total of 39 reported a preference, 15 for the Mindfetalness method and five for the Count-to-ten method. All 39 said they felt calm, relaxed, mentally present and focused during the observations. Furthermore, the women described the observation of the movements as safe and reassuring and a moment for communication with their unborn baby. Conclusions: In the 80 assessments all but one of the women found one or both methods suitable for self-assessment of fetal movements and they felt comfortable during the assessments. More women preferred the Mindfetalness method compared to the count-to-ten method, than vice versa.

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The number of persons with dementia (PWD) is increasing rapidly worldwide. Cognitive impairments and communication difficulties are common among PWD. Therefore, gaining mutual togetherness in caring relation between PWD and their caregivers is important. This study was to investigate the effects of music therapeutic care (MTC) during morning care situations on improving verbal and nonverbal communication behaviors in people with dementia. An observation study with 10 PWD participating. Videotaped interactions (VIO) between PWD and their caregivers were conducted during eight weekly sessions, four recordings consisted of usual morning care and four recordings were of morning care with MTC intervention. The Verbal and Nonverbal Interaction Scale was used to analyze the recorded interactions at a later time. The unsociable verbal variable Cursing decreased significantly (P=.037) during MTC when compared with the baseline measurement. A significant (P=.000) reduction was observed for the unsociable nonverbal variable Does not respond to question. MTC significantly (P=.01) increased the mean score for the sociable nonverbal variable – Calm – relaxed. For sociable verbal communication, significant differences were observed for the variables Use coherent communication (P=.012), Use relevant communication (P=.009), Responds to questions (P=.000), Humming (P=.004), Singing (P=.000). MTC during morning care situations can be an effective non-pharmacological treatment, as well as nursing intervention in order to improve sociable communication behaviors, as well as reduce unsociable communication behaviors of PWDs

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Music therapeutic caregiving', when caregivers sing for or together with persons with severe dementia during care situations, has been suggested as a way to reduce problematic behaviors in dementia care. The present study implemented this technique as an intervention in dementia care. Six caregivers participated in group interviews about their experiences of morning care situations without and with'Music therapeutic caregiving'. Through a qualitative content analysis two themes emerged.'Being in a different reality' was based on'usual' morning care situations. The caregivers' experienced the persons with dementia as absent-minded; communication and cooperation were difficult. The second theme,'Being present', was based on morning care situations with the intervention. The caregivers described communication as enhanced; the persons with dementia expressed themselves more appropriately, making cooperation possible. The results indicate that'Music therapeutic caregiving' might lead to a more positive experience of the person with dementia and seems to increase receptivity to caregiving.  

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Objective: ‘Music Therapeutic Caregiving’, when caregivers sing for or together with persons with dementia during morning care situations, has been shown to increase verbal and nonverbal communication between persons with dementia and their caregivers, as well as enhance positive and decrease negative emotions in persons with dementia. No studies about singing during mealtimes have been conducted, and this pilot project was designed to elucidate this. However, since previous studies have shown that there is a risk that persons with dementia will start to sing along with the caregiver, the caregiver in this study hummed such that the person with dementia did not sing instead of eat. The aim of this pilot project was threefold: to describe expressed emotions in a woman with severe dementia, and describe communication between her and her caregivers without and with the caregiver humming. The aim was also to measure food and liquid intake without and with humming. Method: The study was constructed as a Single Case ABA design in which the ordinary mealtime constituted a baseline which comprised a woman with severe dementia being fed by her caregivers in the usual way. The intervention included the same woman being fed by the same caregiver who hummed while feeding her. Data comprised video observations that were collected once per week over 5 consecutive weeks. The Verbal and Nonverbal Interaction Scale and Observed Emotion Rating Scale were used to analyze the recorded interactions. Results: A slightly positive influence of communication was shown for the woman with dementia, as well as for the caregiver. Further, the women with dementia showed a slight increase in expressions of positive emotions, and she ate more during the intervention. Conclusion: Based on this pilot study no general conclusions can be drawn. It can be concluded, however, that humming while feeding persons with dementia might slightly enhance communication, and positive expressed emotions in persons with dementia. To confirm this, more studies on group levels are needed. Because previous studies have found that caregiver singing during caring situations influences persons with dementia positively it might be desirable to test the same during mealtime.

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 ”A new form of musical upbringing”: Pretenses of reform pedagogy content in the Siljan school In this article, I describe the Siljan school in Tällberg as a Swedish example of alternative pedagogy. The overall questions relate to the reform pedagogy content of the school and its ability to give Swedish music teaching a new form of musical upbringing. An important issue is how the Siljan school as a model for Swedish reform has been inspired by the reform pedagogy movements in USA and Germany. Te analysis is thus based on the Alm couple’s ability to give the school an international character which shines light on Swedish reforms in the greater context of reform pedagogy. With its basis in discursive education of the 1930s, two main questions are discussed: what perspective on musical education can be identifed in the personal development ethos of the Siljan school? How can the school’s relation to the reform pedagogy music movement during the start of the 1900s be understood? From a hermeneutic perspective, the article contributes by investigating how the Siljan school can have afected decisions in education politics, Swedish schooling, and Swedish musical life. In summary, the article contributes with new knowledge on a chapter in the history of Swedish music pedagogy.

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Bakgrund: Varje år diagnostiseras cirka 64 000 personer med cancer och tumörsjukdomar är den näst vanligaste dödsorsaken i Sverige. Att få diagnosen cancer innebär en påfrestande tid både fysiskt och psykiskt. Sjuksköterskans arbetsuppgift är bland annat att lindra lidande och främja för god hälsa. Beröring är ett allmänmänskligt livslångt behov och blir extra tydligt när en dödlig sjukdom drabbar en människa. Syfte: Syftet är att belysa erfarenheter av beröringsbehandling hos sjuksköterskor och patienter med cancer. Metod: Studien har valt att genomföras som en litteraturöversikt, där 14 vetenskapliga artiklar användes varav 5 kvalitativa och 9 kvantitativa. Resultat: Resultatet delades in i två områden: Patienters erfarenheter av beröringsbehandling och sjuksköterskors erfarenheter av beröringsbehandling. Under området patienters erfarenheter framkom två kategorier: lindrande inverkan och främjande inverkan, samt underkategorierna: fysiskt obehag, psykiskt obehag, välbefinnande och närhet. Under området sjuksköterskors erfarenheter framkom en kategori: utbildning i beröringsbehandling samt underkategorin: upplevelser av beröringsbehandling. Slutsats: Beröringsbehandling har en kortvarig symtomlindrande inverkan på smärta, ångest, illamående samt ger ökat välbefinnande och livskvalitet. Därtill förbättrades kontakten mellan sjuksköterska och patient som bidrog till att den existentiella ensamheten minskades. Sjuksköterskorna såg patienten som en individ istället för en patient med en sjukdom.