Students’ Perspectives on Extensive Literature : Using Literature to Enhance Communicative Competence and Cultural Understanding in the EFL-Classroom

The aim of this thesis is to investigate the use of literature within the Swedish Upper Secondary EFL-classroom from the students’ perspective. How do the students in the study relate to literature and its use to enhance and enable their communicative competence and cultural understanding? Also, how do their answers compare with their teacher’s and the adult perspectives and findings from previous international research? The empirical data obtained from the study has been analysed from the perspectives of sociocultural and motivational theory, and the findings show that the participating students believe literature to be a good didactic tool to apply in the EFL-classroom, both in order to enhance their communicative competence and their cultural understanding. The students prefer to have a sociocultural approach to their literature-learning, with group-discussions of various sizes. The key for the students in this respect is interesting, relevant and engaging subject-matter, as well as a positive and motivational teacher. The responses given by the students correlate with those given by their teacher as well as previous international research. The students regard literature as a way of gaining new perspectives, as well as experiencing language in use. Where they diverge somewhat from the international research is in regard to literature’s use for enhancing their competence to speak in class, and that some students seem to think that communication and cultural understanding are separable. Future studies within this field might include the conducting of a larger and more in-depth survey regarding the students’ ideas about literature, culture and communication. Why do so many of the student respondents neither agree nor disagree with the statement concerning communication and cultural understanding being inseparable? This can be an important issue to investigate in today’s global climate of cross-cultural and intercultural experiences, especially in view of the political climate of diverse attitudes towards refugees, immigrants and emigration

Health and quality of care from older peoples' and formal caregivers' perspective

Aim: The overall aim of this thesis was to gain a deeper understanding of older people's view of health and care while dependent on community care. Furthermore to describe and compare formal caregivers' perceptions of quality of care, working conditions, competence, general health, and factors associated with quality of care from the caregivers' perspective. Method: Qualitative interviews were conducted with 19 older people in community care who were asked to describe what health and ill health((I), good and bad care meant for them (II). Data were analyzed using content analysis (I) and a phenomenological analysis (II). The formal caregivers; 70 nursing assistants (NAs) 163 enrolled nurses (ENs) and 198 registered nurses (RNs), answered a questionnaire consisting of five instruments: quality of care from the patient's perspective modified to formal caregivers, creative climate questionnaire, stress of conscience, health index, sense of coherence and items on education and competence (III). Statistical analyses were performed containing descriptive statistics, and comparisons between the occupational groups were made using Kruskal-Wallis ANOVA, Mann-Whitney U-test and Pearson's Chi-square test (III). Pearson's  product moment correlation analysis and multiple regression analysis were performed studying the associations between organizational climate, stress of conscience, competence, general health and sense of coherence with quality of care (IV). Results: The older people's health and well-being were related to their own ability to adapt to and compensate for their disabilities and was described as negative and positive poles of autonomy vs. dependence, togetherness vs. being an onlooker, security vs. insecurity and tranquility vs. disturbance (I).  The meaning of good care (II) was that the formal caregivers respected the older people as unique individuals, having the opportunity to live their lives as usual and receiving a safe and secure care. Good care could be experienced when the formal caregivers had adequate knowledge and competence in caring for older people, adequate time and continuity in the care organization (II). Formal caregivers reported higher perceived quality of care in the dimensions medical-technical competence and physical-technical conditions than in identity-oriented approach and socio-cultural atmosphere (III). In the organizational climate three of the dimensions were close to the value of a creative climate and in seven near a stagnant climate. The formal caregivers reported low rate of stress of conscience. The RNs reported to a higher degree than the NAs/ENs a need to gain more knowledge, but the NAs and the ENs more often received training during working hours. The RNs reported lower emotional well-being than the NAs/ENs (III). The formal caregivers' occupation, organizational climate and stress of conscience were associated with perceived quality of care (IV). Implications: The formal caregivers should have an awareness of the importance of kindness and respect, supporting the older people to retain control over their lives. The nursing managers should employ highly competent and adequate numbers of skilled formal caregivers, organize formal caregivers having round the clock continuity. Improvements of organizational climate and stress of conscience are of importance for good quality of care.

‘Being in a womb’ or ‘playing musical chairs’ : the impact of place and space on infant feeding in NICUs

Background: Becoming a parent of a preterm baby requiring neonatal care constitutes an extraordinary life situation in which parenting begins and evolves in a medical and unfamiliar setting. Although there is increasing emphasis within maternity and neonatal care on the influence of place and space upon the experiences of staff and service users, there is a lack of research on how space and place influence relationships and care in the neonatal environment. The aim of this study was to explore, in-depth, the impact of place and space on parents’ experiences and practices related to feeding their preterm babies in Neonatal Intensive Care Units (NICUs) in Sweden and England. Methods: An ethnographic approach was utilised in two NICUs in Sweden and two comparable units in England, UK. Over an eleven month period, a total of 52 mothers, 19 fathers and 102 staff were observed and interviewed. A grounded theory approach was utilised throughout data collection and analysis. Results: The core category of ‘the room as a conveyance for an attuned feeding’ was underpinned by four categories: the level of ‘ownership’ of space and place; the feeling of ‘at-homeness’; the experience of ‘the door or a shield’ against people entering, for privacy, for enabling a focus within, and for regulating socialising and the; ‘window of opportunity’. Findings showed that the construction and design of space and place was strongly influential on the developing parent-infant relationship and for experiencing a sense of connectedness and a shared awareness with the baby during feeding, an attuned feeding. Conclusions: If our proposed model is valid, it is vital that these findings are considered when developing or reconfiguring NICUs so that account is taken of the influences of spatiality upon parent’s experiences. Even without redesign there are measures that may be taken to make a positive difference for parents and their preterm babies.

Simplified follow-up after medical abortion using a low-sensitivity urinary pregnancy test and a pictorial instruction sheet in Rajasthan, India : study protocol and intervention adaptation of a randomised control trial

The World Health Organisation suggests that simplification of the medical abortion regime will contribute to an increased acceptability of medical abortion, among women as well as providers. It is expected that a home-based follow-up after a medical abortion will increase the willingness to opt for medical abortion as well as decrease the workload and service costs in the clinic. Trial design The study is a randomised, controlled, non-superiority trial . Methods Women screened to participate in the study are those with unwanted pregnancies and gestational ages equal to or less than nine weeks. Eligible women randomised to the home-based assessment group will use a low-sensitivity pregnancy test and a pictorial instruction sheet at home, while the women in the clinic follow-up group will return to the clinic for routine follow-up carried out by a doctor. The primary objective of the study is to evaluate the effectiveness of home-based assessment using a low-sensitivity pregnancy test and a pictorial instruction sheet 10-14 days after an early medical abortion. Providers or research assistants will not be blinded during outcome assessment. To ensure feasibility of the self-assessment intervention an adaption phase took place at the selected study sites before study initiation. This was to optimise and tailor-make the intervention and the study procedures and resulted in the development of the pictorial instruction sheet for how to use the low-sensitivity pregnancy test and the danger signs after a medical abortion. Discussion In this paper, we will describe the study protocol for a randomised control trial investigating the efficacy of simplified follow-up in terms of home-based assessment, 10-14 days after a medical abortion. Moreover, a description of the adaptation phase is included for a better understanding of the implementation of the intervention in a setting where literacy is low and the road-connections are poor. Trial registration: Clinicaltrials.gov NCT01827995. Registered 04 May 2013

Authentic Texts in English Language Teaching : An empirical study on the use of and attitudes towards authentic texts in the Swedish EFL upper elementary classroom

International assessments indicate that Swedish students achieve high results in reading, writing and understanding English. However, this does not mean that the students display oral proficiency, despite an emphasis on functional and communicative language skills in the current English Syllabus. While a previous literature study by this researcher has shown that authentic texts are a way to increase these skills, most of the results shown are from an international viewpoint. Thus an empirical study was conducted within Sweden with the aim to examine the use of authentic texts in the Swedish EFL upper elementary classroom. Twelve teachers have answered a questionnaire on how they use authentic texts in their language teaching, as well as their opinions about these as a teaching tool. Additionally, 37 students have answered a questionnaire on their attitudes about authentic texts. Results indicate that all of the teachers surveyed see authentic texts as an effective way to increase students’ communicative competence and English language skills; however, only a few use them with any frequency in language teaching. Furthermore, this seems to affect the students’ attitudes, since many say that they read authentic texts in their free time, but prefer to learn English out of a textbook at school. These findings are based on a small area of Sweden. Therefore, further research is needed to learn if these opinions hold true for the entire country or vary dependent upon region or other factors not taken into consideration in this study.