Class Struggle, Elitism and Social Collectivism in Ngugi wa Thiong’o’s Devil on the Cross : A Marxist Approach

Ngugi wa Thiong’o’s Devil on the Cross represents both an insightful interpretation and a scathing critique of Kenyan politics and society during the period of neo-colonialism. The present thesis aims to explore, with the help of Marxist ideology and criticism, the relevance of the issues of class struggle, elitism and social collectivism in the novel. At the same time, this study will attempt to define Devil on the Cross as a "national allegory" depicting situations that are common to almost all post-colonial societies, and in particular, how the novel's ideological and political commitment is an important feature as it reflects Ngugi’s effort to draw attention to how Kenya and Africa as a whole suffered from imperialism, neo-colonialism, and a corrupt and greedy capitalist society.

From the Reliable and Unselfish to the Versatile and Independent : - desired qualities in two Swedish curricula

The process in which girls and boys are constructed and construct themselves to pupils takes place in a context where conceptions of “the good pupil” are distinctly manifested in national school documents. In different types of texts concerning school and education, the image of the pupil that society wants to create emerges. Documents from early childhood education up to university level prioritise qualities such as independence, initiative, accountability and freedom to make ones own choices. Qualities or competencies that are preferred during a certain period change as time passes and society develops. The idea of the democratic subject is not the same today as it was 25 years ago. The purpose of this article is to emphasise and compare different desired qualities described in two Swedish national curricula, competencies that pupils in the compulsory school are supposed to develop. The discussion encompasses the political ideas of the pupil during a period of twenty-five years in light of changes in Western societies during the last decades.

Nurses’ and patients’ communication in smoking cessation at nurse-led COPD clinics in primary health care

Background: Smokers with chronic obstructive pulmonary disease (COPD) have high nicotine dependence making it difficult to quit smoking. Motivational interviewing (MI) is a method that is used in stimulating motivation and behavioral changes. Objective: To describe smoking cessation communication between patients and registered nurses trained in MI in COPD nurse-led clinics in Swedish primary health care. Methods: A prospective observational study with structured quantitative content analyses of the communication between six nurses with basic education in MI and 13 patients in non-smoking consultations. Results: Only to a small extent did nurses’ evoke patients’ reasons for change, stimulate collaboration, and support patients’ autonomy. Nurses provided information, asked closed questions, and made simple reflections. Patients’ communicationwasmainly neutral and focusing on reasons for and against smoking. It was uncommon for patients to be committed and take steps toward smoking cessation. Conclusion: The nurses did not adhere to the principles of MI in smoking cessation, and the patients focused to a limited extent on how to quit smoking. Practice implications: To make patients more active, the nurses need more education and continuous training in motivational communication.

The quality of the physical environment and its association with activities and well-being among older people in residential care facilities

The physical environment can influence older people’s health and well-being, and is often mentioned as being an important factor for person-centred care. Due to high levels of frail health, many older people spend a majority of their time within care facilities and depend on the physical environment for support in their daily life. However, the quality of the physical environment is rarely evaluated, and knowledge is sparse in terms of how well the environment meets the needs of older people. This is partly due to the lack of valid and reliable instruments that could provide important information on environmental quality. Aim: The aim of this thesis was to study the quality of the physical environment in Swedish care facilities for older people, and how it relates to residents’ activities and well-being. Methods: The thesis comprises four papers where both qualitative and quantitative methods were used. Study I involved the translation and adaptation of the Sheffield Care Environment Assessment Matrix (SCEAM) into a Swedish version (S-SCEAM). Several methods were used including forward and backward translation, test of validity via expert consultation and reliability tests. In Study II, S-SCEAM was used to assess the quality of the environment, and descriptive data were collected from 20 purposively sampled residential care facilities (RCFs). Study III was a comparative case study conducted at two RCFs using observations, interviews and S-SCEAM to examine how the physical environment relates to older people’s activities and interactions. In study IV, multilevel modeling was used to determine the association between the quality of the physical environment and the psychological and social well-being of older people living in RCFs. The data in the thesis were analysed using qualitative content analysis, and descriptive, bivariate and multilevel statistics. Results: A specific result was the production of the Swedish version of SCEAM. The instrument contains 210 items structured into eight domains reflecting the needs of older people. When using S-SCEAM, the results showed a substantial variation in the quality of the physical environment between and within RCFs. In general, private apartments and dining areas had high quality, whereas overall building layout and outdoor areas had lower quality. Also, older people’s safety was supported in the majority of facilities, whereas cognitive support and privacy had lower quality. Further, the results showed that environmental quality in terms of cognitive support was associated with residents’ social well-being. Specific environmental features, such as building design and space size, were also noted, through observation, as influencing residents’ activities, and several barriers were found that seemed to restrict residents’ full use of the environment. Conclusions: This thesis contributes to the growing evidence-based design field. The S-SCEAM can be used in future research on the association between the environment and people’s health and well-being. The instrument could also serve as a guide in the planning and design process of new RCFs.