Consultation pluridisciplinaire "Souffrance au travail": une expérience romande [Multidisciplinary consultation "Suffering at work": an experience in western Switzerland].

Les problèmes de santé mentale au travail constituent un défi à la fois clinique, professionnel, économique et de santé publique. Les coûts totaux qu'ils génèrent en Suisse équivalent à 3,2 % du produit intérieur brut (PIB) suisse et ils aboutissent très souvent à un licenciement. La grande majorité des personnes sont soignées par un médecin de premier recours. L'Institut de Santé au Travail propose une consultation spécialisée dans les questions de souffrance au travail, offrant aux soignants de première ligne un avis ou un soutien pluridisciplinaire, dans une perspective collaborative des soins. Son action, adaptée aux besoins de chaque situation, va d'un avis à une orientation vers des spécialistes pouvant étoffer durablement le réseau (suivi psychiatrique, programme de soutien à l'emploi, avis juridique ou social). Mental health problems at work constitute a challenge in the clinical feld, as well in the professional, the economic and the public health perspective. The total costs they generate in Switzerland are equivalent to 3.2% of the Swiss gross domestic product and they very often lead to dismissal. The vast majority of people are treated by their primary care physician. The Institute for Work and Health features a specialized consultation on the topic of suffering at work, offering the primary care physicians a pluridisciplinary advice or support, in a collaborative care prospect. Its action, adapted to each situation's needs, goes from an advice to a referral to specialists that can strengthen the network on a long-term basis (mental health follow-up, supported employment program, legal or social advice).

Development of corporate social responsibility in Finnish forest industry

The main objective of this thesis was to map the development of corporate social responsibility (CSR) in Finnish forest industry. The aim was to describe the development and find factors that explain the development. Another objective was to understand the influence of different stakeholders on the development as well as examine the development of CSR reporting. This qualitative case study used thematic interviews as the research method. The research data were collected by conducting 11 interviews among the case company representatives and stakeholders. Based on the research results, no single factor in the background of the phenomenon could be showed. Instead, CSR has developed in stages through its different dimensions. The main drivers of CSR turned out to be environmental organizations, customers and local communities. It can be concluded that the forest industry has taken CSR seriously for a long time, which has benefited the forest companies in many ways.

Web-based corporate social responsibility reporting

Due to concerns regarding globalisation and sustainable development, corporate social responsibility (CSR) is topical in the business context and in the field of accounting. The main objective of this study was to review previous academic literature in the field of CSR reporting and develop an insight into CSR reporting in the Web-based environment. The main purpose was to find out what Web-based CSR reporting is like and how companies are utilising the Internet to communicate on responsibility issues. I did not, however, collect empirical research data but limited my study into theoretical and descriptive examination. In order to create an insight into Web-based reporting, I examined the development, motives and current practices of CSR reporting. I concluded that the Internet is a unique, interactive communication channel that is used differently compared with annual reports. The amount of companies engaging in Web-based CSR reporting is increasing and the reporting practices in terms of e.g. content and accessibility of information vary. I also concluded that many companies have not yet discovered the true potential of the Web as an interactive communication medium.

Como si fuera posible recoger sentimientos = As if it were possible to collect suffering

Se trata de una propuesta como resultado del trabajo conjunto entre la escuela de Arte Pigment y el ESPAI ZERO1 del Museu Comarcal de la Garrotxa, destinado exclusivamente a exposiciones temporales de creación contemporánea y como continuidad de propuestas anteriores de colaboración: REPLICA23 y SONESNAT JUNIOR. Com si fos possible recollir el sofriment es un proyecto de la artista Anna Manel.la, y se consideró una propuesta interesante y un reto para conversar, intercambiar y crear con los alumnos sobre el tema de la exposición: la muerte y el sufrimiento. Asimismo porque es una artista conocida por los alumnos de la escuela Pigment, ya que anteriormente habían realizado un proyecto de apadrinamiento de esculturas y habitualmente ella participa en programas divulgativos en la escuela. El trabajo desarrollado centra el aprendizaje en la creación y en la investigación artística como ejes de los procesos de conceptualización con el objetivo de atender las dinámicas y los estímulos característicos de los niños. Facilitando procesos de búsqueda, exploración y manipulación sin condicionantes y promoviendo procesos autónomos en los que los mismos niños se planteen dudas e interrogantes y se enfrenten a situaciones cada vez mas complejas

Corporate Social Responsibility in Global Mining Industry

Corporate Social Responsibility is company’s interest and actions towards its environment and the society that the company takes from its free will, to give back to the community and environment. Corporate Social Responsibility is current topic as companies are challenged to take responsibility for their action, due to the constant tightening environmental legislations and raising pressure for transparency from the public. The objective of this Master’s Thesis research is to study if Corporate Social Responsibility affects suppliers’ brand image and mining companies’ buying decisions within global mining industry. The research method is qualitative and the research is conducted with secondary and primary research methods. The research aims to find out what are the implications of the research for the case company Larox. The objective is to answer to the question; how should case company Larox start to develop Corporate Social Responsibility (CSR) program of its own, and how the case company could benefit from CSR as a competitive advantage and what actions could be taken in the company marketing. Conclusions are drawn based on both the secondary and primary research results. Both of the researches imply that CSR is well present in the global mining industry, and that suppliers’ CSR policy has positive effect on company image, which positively affects company’s brand, and furthermore brand has a positive effect on mining companies buying decision. It can be concluded that indirectly CSR has an effect on buying decisions, and case company should consider developing a CSR program of its own.

Rummet i vårdandets värld

This study is made in the context of basic research within the field ofcaring science. The aim is to make a theoretical and ontological investigation of what the space is in the world of caring. The basic proposition is that the space, as a fundamental dimension, has an impact on how the appreciation of one's mental health and suffering is shaped, and vice versa. The overall purpose is to develop a theoretical model of space from the caring science point of view andalso to offer an ideal concept of space to caring science. Guided by a theoretical horizon (Eriksson 1993, Eriksson 1995, Eriksson 2001) and methodological approach grounded in Gadamer's philosophic and existential hermeneutics a three-stage analysis and interpretation is conducted. The hermeneutic spiral of this investigation starts through a procedure in accordance with Eriksson's model (1997) of concept definition. The goal is to clarify the etymology of the concept as well as semantic differences between synonymous concepts, i.e. to identify the different extents of the concept of `space` (`rum`) in order to bring these closer for an exploration. The second phase is to analyse and interpret a sample of narratives in order to explicate the ontological nature and meaning of the space. The material used here is literary texts. The goal is to clarify the characteristics of the very inside of the space when it is shaped in relation to the human being in encountering suffering. In the third phase an interview study is taken place. The focus of the study is directed towards the phenomenon of space as it is known by a patient in a landscape of psychiatric care, i.e. what the space is in a contextual meaning. Then, a gradual hermeneutic understanding of the space is attempted by using theories from the field of caring science as well as additional theories from other disciplines. Metaphors are used as they are vivid and expressive tools for generating meaning. Different metaphoric space formations depict here a variety of purports that, although not quite the same, share extensive elements. Six metaphorically summarized entities of meaning emerged. The comprehensive form of space is pointed out as the Mobile-Immobile Room. Furthermore, the Standby, the Asylum, the Wall and the Place. In the further dialogue with the texts the understanding has deepened ontologically. The theoretical model ofthe space sums up the vertical, horizontal and the inward extent of deepness inthe movement of mental health. Three entities of ontological meaning have emerged as three significant rooms: the Common Land emerges as the ideal concept of mutual creation in the freedom of doing, being and becoming health. On the interpersonal level it means freedom, which includes sovereignty, choice and dignity of the human being. The Ice World signifies, ultimately, the space as a kind of frozenness of despair which "wallpapers" the person's entire being in the world in the drama of suffering. The Spiritual Home is shaped when the human being has acquired the very core of his/her inner and outer placeness as a kind of "at-homeness" and rootedness. Time is a central element and the inward extent of deepness of this trialectic space. Each of the metaphors is then the human being's unique, although even paradoxical, way of conceiving reality, and mastering spiritual suffering. They condense characteristic structures and patterns of dynamic scenery, which take place within the movement of health. The space encloses a contradictory spatiality constituted through the dynamic field of meaningfulness and meaninglessness. Anyway, it is not through a purging of these contradictions but through bringing them together in a drama of suffering that the space is shaped as ontologically good and meaningful in the world of caring.

Vårdande och icke-vårdande tröst

The aim of the thesis is, from a caring science perspective including a caring theology perspective, to illustrate the meaning of the phenomenon consolation and howconsolation relates to suffering and care. Two studies were completed where staff and elderly care receivers were interviewed and a third study focused on an analysis of consolation as it is presented in the Book of Job in the Old Testament. These studies deal with carers' experiences of consolation and consoling, elderly care receivers' experiences of consolation, and Job's experience of consolation. Phenomenology and hermeneutics form the basis for the methodological approach. A phenomenological- hermeneutic method, inspired by Paul Ricoeur, has been used for the text analyses. The thesis also covers significant aspects of poetical and religious texts. The metaphors that occur in the interview studies with the carers and the elderly are analysed in order to take care of the excess of meaning that, according to Ricoeur, can be expressed in metaphors. The result showfive overall meanings: The contradictory consolation, The bonding consolation, The mute and rigid consolation, The uncontrolled consolation and The restful consolation. A caring consolation is contradictory in the sense that it entails that the sufferer on the one hand passes on his or her suffering to someone else and on the other hand that the suffering can be returned to be suffered. Consolation can thus entail suffering. The bonding consolation is present, i.e. is with the sufferer and is based on that person's suffering. This consolation is characterised by a close fellowship, a feeling of being understood at a deeper level. The results also reveal a consolation that is mute and rigid. This consolation does not respond to the sufferer's experience of his or her suffering, is shapeless and therefore unable to follow the suffering. An example of a mute, rigid and non-caring consolation is the consolation of the friends in the Book of Job. This consolation is not capable of consoling because it does not correspond to where Job is, i.e. in his experience of his suffering. A caring consolation is also uncontrolled because it is on the one hand spontaneous and on the other hand helps the sufferer to lose control over the suffering. To lose control entails, amongst other things, the sufferer giving up trying to understand suffering and instead lets that which is incomprehensible be incomprehensible. A consoling and health-bringing rest in or from the struggle with suffering presents itself by giving up what in various ways is tied to the suffering. The result as a whole is interpreted from a caring science perspective with the following important concepts: caring relationship, faith, health and sacrifice. Consolation as health is considered on the basis of a theoretical model inspired by Katie Eriksson's ontological health model. The research is also illustrated from a philosophical-ethical perspective, mainly based on the work of Emmanuel Levinas. The findings are discussed in relation to previous research and also to caring science, society and care.

Generic and professional caring in a Chinese setting: an ethnopraphic study

The objective of the present study is to describe the cultural care practices, meanings, values and beliefs which form the basis of caring in a Chinese context. The research has its starting point in a caring science perspective and a qualitative research approach with interpretative ethnography as methodological guideline. The theoretical perspective is formed by elements of the theory of caritative caring, developed by Eriksson, and the theory of Culture Care Diversity and Universality, developed by Leininger. Previous research of suffering, culture and caring is described and also a presentation of actual transcultural nursing research as well as a presentation of the social structure dimensions of Chinese culture is included in the theoretical background. The empirical part includes patients and relatives, nurses and Hu Gongs as informants. The data collected are analysed based on Geertz’s idea of forming “thick descriptions” through examining the “what, how and why” of people’s actions. The findings show that the family has a prominent position in Chinese caring practices. The patient plays an unobtrusive role and a mutual dependence between the patient and the family members is evident. The professional nursing care is an extended act which includes the family in the caring relationship. The care practices of the Chinese nurse are characterized by great professional nursing skills. Suffering is described by the informants as being caused by disease, pain and social circumstances. “Social suffering” is described as worse than physical or mental suffering. Culturally competent and congruent care is a prerequisite for avoiding cultural pain, imposition and blindness when caring for the suffering human being. The findings of the present study necessitate a broadening in caring theory to include the family in the caring relationship. A further conclusion is that a broadening in our perception and understanding of culture would promote the delivery of culturally competent and congruent care. Suffering need to be seen as enclosed in cultural patterns of how it is expressed, interpreted, understood and relieved. Care and caring need to be seen as embedded in culture and the care practices values and beliefs have to be congruent with the cultural patterns where the care is provided.

Hemmet som ethos : en idéhistorisk studie av hur hemmet som ethos blev evident i hälsosysterns vårdande under 1900-talets första hälft

The home as ethos, an ethical dimension of human beings, is this study’s focus of interest. Can the home as ethos comprise motive and driving force for a human being? This dissertation has a mainly hermeneutic approach with a Caring Science interpretive horizon. Firstly, the purpose of this study is to develop the concept “home” through etymological and semantic analysis. The concept’s Caring Science content is also investigated. Secondly, the purpose of this study is to investigate, through the use of a history of ideas method, how the home as ethos is made visible and evident in public health nurses’ caring during the first half of the 20th century. Which motives compromise the driving force behind public health nurses’ caring? Which idea patterns are stressed? Material for the study’s concept determination consists of tymological dictionaries as well as Swedish language dictionaries published from 1850 – 2001. The results of the concept determination provide a preliminary idea-model, where dimensions such as ethos as a human being’s innermost room, human beings’ manner of being, and the metaphor “my home is my castle” are stressed. These results comprise the background of the history of ideas portion of the study. The study’s history of ideas investigation occurs through the evaluation and interpretation of historical sources focusing on the caring provided by public health nurses. Public health nurses comprise both the context and prevalent traditions during the time-period studied. The historical sources consist of three different types of sources, namely textbooks, archived material, and the professional nursing journals Epione and Sairaanhoitajatarlehti. The purpose is to rediscover fundamental idea-patterns through the thematic structuring of the patterns appearing in the historical sources. Three main idea-patterns and underlying themes are rediscovered: love- a fire which burns inside human beings; reverence for human beings and home; and the honor of responsibility. The emerging patterns are tightly interwoven and form a pattern. A new interpretation occurs, widening the study’s horizon and leading to the emergence of the theory-model’s contours. The study’s theory-model is formed from three different levels. Ethos as a human being’s innermost room- the spirit, encompasses a human being’s value base and the spirit that he/she is permeated with. Fundamental values are converted into an internal ethic, becoming visible in human beings’ manner of being- the manner of conduct. The metaphor “my home is my castle”- the tone, symbolizes the room where a human being’s abstract or concrete being lives. The spirit, the ethos, is expressed in a home’s culture and atmosphere, that is to say the tone of a home or how one lives in a room. Communion is a significant component in the creation of a culture and atmosphere. This study’s theory-model gives rise to a new perspective that can generate new patterns of action. The study’s theory-model results in a new historically-based view that create new patterns of action in care and Caring Science today.

Makt som fullmakt : ett vårdvetenskapligt perspektiv

The aim of this study is to deepen understanding and knowledge of the concepts and phenomenaof power and authority from the standpoint of caring science. The overall questions of the research are: What is power? What is authority? How do power and authority manifest themselves in the context of caring? How are power and authorityto be understood as caring science concepts? The overall research inception is determination of the concepts in accordance with the hermeneutic approach based on Eriksson's model. The process of understanding follows Gadamer's (1999) hermeneutics. The thesis consists of three part studies. An ontological determinationof the character of the concepts is carried out where a hermeneutic interpretation is made of texts in the Old and the New Testaments in the Bible. The pragmatic features of the concepts are studied on the basis of nurses' written stories of authority and patients' written stories of power and authority. Beside the review of literature concerning power and authority a qualitative meta-analysis ofthe concept and the phenomenon of empowerment are made. The ontological determination shows how a human being's power is the authority to hold every living thing in trust, to tend and care life. To anyone using this authority, serving onesfellow-being is the purpose. Understanding the pragmatical features of authority in the stories of nurses reveals the life-giving nature of serving. By serving the nurse draws near her true mission as a human being, her authority to care for life with love. The service of the nurse and her ability to see and confirm the patient's otherness creates confidence and results in her authority. The nursedoes not abandon the responsibility associated with authority. When the patientdoes not entrust the nurse with authority the nurse employs her inherent authority to alleviate the suffering of the patient. The pragmatical features of the concepts of power and authority in the patients' stories indicate how the nurse puts her power to an improper use if she only makes use of the authority conferred by the hierarchy of power in the organisation, assumes all power and fails to use her faculty for loving care. Patients feel that their existence is threatened when the nurse tries to deprive them of their authority; they experience homelessness, despair and impotence. Patients' struggle for existence and absolute dignity deprives their health processes of strength, and their suffering becomes unbearable. Patients recognize their vitality when encountering a nurse who uses her authority to alleviate the patients' suffering. The power of compassion is strong, and the patients' dignity is recreated when they are able to serve fellowpatients or nurses. The purpose of human life can be understood as the use of one's own inner power and strength. Love.

Kroppen som bärare av hälsa och lidande

The overall aim of this study is to seek new knowledge and deeper understanding of the body as a phenomenon from a caring science point of view. By means of a hermeneutic definition, the body is studied on a contextual as well as an ontological level in order to create a deeper understanding for human beings in relation to health and suffering. The study focuses of the body as a perspective of human beings. It is important for the knowledge growth in caring science to create a deeper understanding for the body, thus making it possible to understand patients in nursing care. The overall methodology is a hermeneutic definition which covers a contextual and an ontological concept definition. In the three empirical studies, Giorgi’s phenomenological method was used. The first empirical study comprises twelve students’ statements about experiences of their body in different situatons in life. The second study is composed of interviews with fifteen patients who had been afflicted by illness and been subjected to surgical treatment. In the third empirical study, ten patients who had been cared for in perioperative nursing care were interviewed. In the data analysis, the essential meaning of the body as a phenomenon is described, along with its variations and nuances. In the ontological determination of the body, an etymologic and semantic analysis is carried out, as well as a qualitative analysis of ideas, where the material is comprised of chosen texts on the body from different perspectives. In the concluding analysis the results were synthesized. The result of the first empirical study shows that a body is expressive and manifests movement in its striving for dignity. The body harbours language and inherent powers to cope with the unexpected, as well as feelings of anxiety, fear and powerlessness. The second study shows that the body is experienced as mysterious when it is afflicted by illness, but it is also found mysterious as an opponent to man and life. A battle is fought between the illness that breaks down the body, and human beings fighting to keep their unity whole. The body appears as a prison and a host for a threatening illness. The body bears a feeling of powerlessness when it is changed by illness and suffering. In a care and treatment context, the body is objectified by the patient and the caregiver. It is the illness that forces the patient to sacrifice parts of the body in order to once again become whole in the unity. The third study shows that the patient in a perioperative nursing context delivers him-/herself over to the hands of the caregiver, who defends and protects body and life. The patient experiences a sense of well-being when the caretaker receives him/her and protects the body from dangers. Suffering is alleviated when the patients are allowed to talk about what has happened in their body. The result of the semantic analysis shows that the body as a concept is described as bending around the human soul and spirit. Linguistically, dimensions like corporeal, shape, totality, unity and mortal clay, are described. Different ideas about the body described it as: a material animate part of man, active and demanding, something that perceives its surrounding world and as a subjective body of senses, thoughts and language. Ideas about the body also describe it as a biological and physiological, living organism, submitted to the laws of nature, a passive apparatus and a socially constructed gender. The results of the different studies were synthesized and reflected against a caring science perspective. The research has created a deeper understanding for the body as a material abode and as an entity of body, soul and spirit.

How to (dis)solve Nagel's paradox about moral luck and responsibility

Abstract In this paper I defend a solution to the moral luck problem based on what I call "a fair opportunity account of control." I focus on Thomas Nagel's claim that moral luck reveals a paradox, and argue that the apparent paradox emerges only because he assumes that attributions of responsibility require agents to have total control over their actions. I argue that a more modest understanding of what it takes for someone to be a responsible agent-i.e., being capable of doing the right thing for the right reasons-dissolves the paradox and shows that responsibility and luck aren't at odds.

Resa i röstens landskap : en narrativ studie av hur lärare blir professionella röstanvändare

The theme of this thesis is the learning process that occurs when teachers become professional voice users. The aim is to explore what it (really) means to become a professional voice user in a teaching profession; thereby developing an understanding of how future education in this field can be arranged so as to both effectively prevent vocal problems and to develop oral didactical competence among teachers. The ambition is to describe, interpret, and understand the learning process through a combination of emic and ethic research perspectives. The theoretical frame of reference reflects the cross disciplinary character of the thesis. Voice problems are common among both student teachers and inservice teachers and adversely affect professional competence, identity and quality of life. Additionally, vocal problems are proven to have a negative impact on pupils´ learning. The individual elements of learning are explored in the light of experiential learning theory and transformative learning theory. The social elements of learning are explored in relation to the theory of situated learning. In addition, theories of teacher professionalisation in terms of competence and identity are outlined. The empirical study has a longitudinal and multi method character. It is anchored in a phenomenological hermeneutical tradition, more specifically in narrative inquiry. The point of departure is the learning experiences of ten student teachers, who attended a ten week long course on voice production as part of their teacher training at Åbo Akademi University, in the autumn of 2002 and the spring of 2003. Four interviews in the form of conversations were conducted with each participant. These were crystallised with a process diary, a Swedish Voice Handicap Index, a voice observation, and a video observation. A fifth interview was conducted with each participant five years post teacher training, in the spring of 2008. Participant observation was also conducted throughout the course. The research materials have been analysed and interpreted narratively using a phenomenological hermeneutical method. The results are presented descriptively as individual narratives, which are reflected in logopedic research materials. Learning is here understood as emergent awareness. This is followed by a meta narrative concerning learning as experiences in the four dimensions body, thought, feeling, and relation. Finally, interpretation is expressed with respect to the theory of relational education. Learning is here understood as a movement in the field between the actual and the possible voice. It is also viewed as fundamentally rooted in inter-human relationships, in moments of presence and coexistence. As a tentative answer to the call for an existential space for learning in order to be a professional voice user, I suggest the concept of a learning refuge as a locus for a learning process built on trust, mutuality and openness.