Intervals between response choices on a single-item measure of quality of life.

BACKGROUND: A single overall rating of quality of life (QoL) is a sensitive method that is often used in population surveys. However, the exact meaning of response choices is unclear. In particular, uneven spacing may affect the way QoL ratings should be analyzed and interpreted. This study aimed to determine the intervals between response choices to a single-item QoL assessment. METHODS: A secondary analysis was conducted on data from the Lc65+ cohort study and two additional, population-based, stratified random samples of older people (N = 5,300). Overall QoL was rated as excellent, very good, good, fair or poor. A QoL score (range 0-100) was derived from participants' answers to a 28-item QoL assessment tool. A transformed QoL score ranging from 1 (poor) to 5 (excellent) was calculated. The same procedure was repeated to compute seven domain-specific QoL subscores (Feeling of safety; Health and mobility; Autonomy; Close entourage; Material resources; Esteem and recognition; Social and cultural life). RESULTS: Mean (95 % confidence intervals) QoL scores were 96.23 (95.81-96.65) for excellent, 93.09 (92.74-93.45) for very good, 81.45 (80.63-82.27) for good, 65.44 (62.67-68.20) for fair and 54.52 (45.31-63.73) for poor overall QoL, corresponding to transformed QoL scores of respectively 5.00, 4.70, 3.58, 2.05, and 1.00. Ordinality of the categories excellent to poor was preserved in all seven QoL subscores. CONCLUSIONS: The excellent-to-poor rating scale provides an ordinal measure of overall QoL. The intervals between response choices are unequal, but an interval scale can be obtained after adequate recoding of excellent, very good, good, fair and poor.

Core communication components along the cancer care process: the perspective of breast cancer patients

This study sought to assess the impact of health care professional (HCP) communication on breast cancer patients across the acute care process as perceived by patients. Methodological approach was based on eight focus groups conducted with a sample of patients (n ¼ 37) drawn from 15 Spanish Regions; thematic analysis was undertaken using the National Cancer Institute (NCI) framework of HCP communication as the theoretical basis. Relevant results of this study were the identification of four main communication components: (1) reassurance in coping with uncertainty after symptom detection and prompt access until confirmed diagnosis; (2) fostering involvement before delivering treatments, by anticipating information on practical and emotional illness-related issues; (3) guidance on the different therapeutic options, through use of clinical scenarios; and, (4) eliciting the feeling of emotional exhaustion after ending treatments and addressing the management of potential treatment-related effects. These communication-related components highlighted the need for a comprehensive approach in this area of cancer care

Asma y actividad física. Revisión

El asma es una enfermedad inflamatoria crónica de elevada prevalencia a nivel mundial, siendo el colectivo más afectado el formado por niños y adolescentes. Su sintomatología se caracteriza por la aparición de tos, disnea, sibilancias, sensación de opresión en el pecho y broncoconstricción. Tradicionalmente se había pensado que el deporte y el ejercicio físico estaban contraindicados en pacientes asmáticos. Por otro lado, el paciente asmático suele presentar niveles de condición física y práctica deportiva menores que los sujetos sanos. Actualmente se ha propuesto la actividad física regular como un camino válido para mejorar la percepción y el autoconocimiento personal sobre esta enfermedad. Se aconseja la prescripción de actividad física como forma de mejorar su sintomatología y evolución. La práctica de una actividad física regular en pacientes asmáticos debería ser considerada dentro de los actuales y futuros programas de salud como un objetivo fundamental.

A qualitative analysis of immigrant population health practices in the Girona Healthcare Region

The research we present here forms part of a two-phase project - one quantitative and the other qualitative - assessing the use of primary health care services. This paper presents the qualitative phase of said research, which is aimed at ascertaining the needs, beliefs, barriers to access and health practices of the immigrant population in comparison with the native population, as well as the perceptions of healthcare professionals. Moroccan and sub-Saharan were the immigrants to who the qualitative phase was specifically addressed. The aims of this paper are as follows: to analyse any possible implications of family organisation in the health practices of the immigrant population; to ascertain social practices relating to illness; to understand the significances of sexual and reproductive health practices; and to ascertain the ideas and perceptions of immigrants, local people and professionals regarding health and the health system. Methods: qualitative research based on discursive analysis. Data gathering techniques consisted of discussion groups with health system users and semi-structured individual interviews with healthcare professionals. The sample was taken from the Basic Healthcare Areas of Salt and Banyoles (belonging to the Girona Healthcare Region), the discussion groups being comprised of (a) 6 immigrant Moroccan women, (b) 7 immigrant sub-Saharan African women and (c) 6 immigrant and native population men (2 native men, 2 Moroccan men and 2 sub-Saharan men); and the semi-structured interviews being conducted with the following healthcare professionals: (a) 3 gynaecologists, (b) 3 nurses and 1 administrative staff. Results: use of the healthcare system is linked to the perception of not being well, knowledge of the healthcare system, length of time resident in Spain and interiorization of traditional Western medicine as a cure mechanism. The divergences found among the groups of immigrants, local people and healthcare professionals with regard to healthcare education, use of the healthcare service, sexual and reproductive healthcare and reticence with regard to being attended by healthcare personnel of the opposite sex demonstrate a need to work with the immigrant population as a heterogeneous group. Conclusions: the results we have obtained support the idea that feeling unwell is a psycho-social process, as it takes place within a specific socio-cultural situation and spans a range of beliefs, perceptions and ideas regarding symptomology and how to treat it

An fMRI Study of Emotional engagement in decicion-making

It has been suggested that decisionmaking depends on sensitive feelings associatedwith cognitive processing rather than cognitiveprocessing alone. From human lesions, we knowthe medial anterior inferior-ventral prefrontalcortex processes the sensitivity associated withcognitive processing, it being essentiallyresponsible for decision making.In this fMRI (functional Magnetic ResonanceImage) study 15 subjects were analyzed usingmoral dilemmas as probes to investigate the neuralbasis for painful-emotional sensitivity associatedwith decision making. We found that a networkcomprising the posterior and anterior cingulateand the medial anterior prefrontal cortex wassignificantly and specifically activated by painfulmoral dilemmas, but not by non-painful dilemmas.These findings provide new evidence that thecingulate and medial anterior prefrontal areinvolved in processing painful emotionalsensibility, in particular, when decision makingtakes place. We speculate that decision makinghas a cognitive component processed by cognitivebrain areas and a sensitivity component processedby emotional brain areas. The structures activatedsuggest that decision making depends on painfulemotional feeling processing rather than cognitiveprocessing when painful feeling processinghappens

Ikääntyvät työelämässä. Päihittääkö nuoruus ja koulutus aikuisuuden ja kokemuksen?

The Ageing in Working Life. Do Adolescence and Schooling Beat Adulthood and Experience? This study examines the changes in the work and the work organisations of employees in the fields of health care and retail trade who have turned 45 and their experience of change. In addition, the question of how ageing employees experience their status in post-modern working life is explored. Attention is also focused on the choices and decisions connected with staying at work and retiring. These views are examined in relation to professions and professional cultures. Thematic interviews (N=98) were used to gather the material. The effects of the market liberalistic turn in welfare policy are clearly seen in the everyday work of the health care professions. These changes were examined from the point of view of managing by outcomes and quality assurance, multi-professional cooperation, flexibility in the division of labour, and the spread of market-like procedures. The discourse of those in involved retail trade was dominated by extremely tight global market competition and control of outcomes, and by the structural changes taking place in the retail trade sector. This change discourse was to a large extent a reaction to those changes in the functional environment which were experienced as negative and to the conflict between their own professional identity and professional ethics on the one hand, and their functional environment on the other. There were also obstacles connected with professional culture: defending one's own station and power, guarding the 'frontier', showed up in attitudes towards new management and organisation models or towards structural and functional reforms. The deep structures of professional culture and the mindset of the actors change much more slowly than the functional practices of organisations. For those in a supervisory position, the loss of power due to becoming part of a chain or because of the introduction of a team organisation model was not an easy thing to accept. The nurses and others in related fields felt that they were forced to do work that was below their level of training and professional skill. For sales personnel and those who did assisting work in health care, power and the possibility of having an influence were not so important, as long as they were able to do their work in their own way and were trusted. This view is often completely forgotten, for example, in various organisation models in which power and the possibility of having an influence entwined with power are taken for granted as being clearly positive and desired aspects of job satisfaction. Up to date professional skills were experienced as being important from the point of view of professional identity and self-worth. Thus, training can be understood as a moral obligation, which in turn is intertwined with professional ideology. In the rhetoric of adult education, an adult is expected to be an active player who will seek training again and again if working life so requires. The dark side of this ideology, which leads to feelings of guilt, was apparent in the thoughts of the respondents. Am I never good enough at my job; why must I continually strive for better, additional qualifications? The majority of the respondents evaluated their expertise as being at quite a high level. This self-confidence did not extend to applying for a job. Job recruitment was seen as a situation in which age discrimination reached its peak. The interviewees were unanimous about the idea that society favours the young. Especially among those in the retail trade sector, there was a feeling that it would be difficult, if not impossible, to find a new job of the same level or a permanent post if they were made redundant. Age discrimination was also apparent in the retail trade field in the form of older employees being retired against their will or transferred to other tasks. It was felt that ruthless forced retirement of older workers was part of the personnel policy of some organisations. The importance of one's outward appearance was connected with the theme of discrimination. This phenomenon is described using the concept of the double standard of ageing in feminist research. An ageing woman is relegated to an inferior position due to both her age and her sex. A culture that would both make possible and allow various types of choices regardless of age, which is described as being characteristic of the post-modern era, does not seem to be very topical in the practice of working life. It is important for employees that the management and the personnel policy that is being implemented makes them feel like both their contribution and they as individuals are appreciated, that their opinions are listened to and that they are noticed as persons. The interviewees hoped for gratitude and a concern for the well-being of employees that shows in everyday life. They valued training and activities aimed at maintaining their work ability, but thought that better coping at work and a pleasant working environment cannot be achieved through such measures as along as the foundation is 'in a mess'. Development of the quality of working life is the only thing that can improve job satisfaction and get people to remain in the work force longer than at present. There should be a sufficient number of properly trained employees at the work place. It was important to the respondents that they be able to stay on their job to the end with honour, since compromising with their own quality standards or acting contrary to their ideal self-image in terms of professional ethics would strike a blow to their professional self-esteem. They called for the development of various types of workplace flexibility, and felt that they have the right to a lightened workload and to early retirement. Early retirement was even seen as an altruistic deed: it would free up a place for younger workers. Thoughts of retirements were explained by familiar factors such as health and finances, life situation, the enticement of free-time, as well as by various factors related to work. It is very important to ageing employees that their work has meaningful content. The values related to self-fulfilment are felt to be of great importance, and if they cannot be realised at work, the respondents wanted more free time, either through retirement or in the form of flexibility in working life.

La voz del violín en la Rusia de la últimos zares : contraste de sentimientos musicales

El objetivo general de este trabajo es intentar conseguir la particular visión del mundo del violín en la última etapa de la Rusia zarista, sometida a importantes cambios históricos que repercuten en la vida de la sociedad rusa y consecuentemente en su arte; descubriré las figuras de sus intérpretes y su relación con su época y su música. La metodología que he utilizado en el trabajo se trata de un tipo de investigación cualitativa, basada en las figuras de la época y una documentación bibliográfica seleccionada, un estilo historiográfico que nos acerque al sentimiento y el entendimiento de este periodo histórico. La parte final de mi trabajo se compondrá de una serie de conclusiones que avalen mi experiencia y trayectoria en la investigación del proyecto.

Psykologinen omistajuus etätyöskentelyssä

Tämän tutkimuksen tavoitteena oli kuvata ja selittää etätyöntekijöiden työhönsä kokemaa omistajuuden tunnetta sekä sen syntymismekanismeja ja seurauksia. Lisäksi tavoitteena oli selvittää kuinka etätyön eri muodot korostuvat etätyöskentelyn oletetuissa eduissa ja ongelmissa. Etätyön muotojen osalta oli tavoitteena myös selvittää niden yhteyttä itsenäisyyden tunteeseen. Tutkielman tutkimusmenetelmä on kvantitatiivinen ja määrällistä aineistoa analysoitiin SPSS-ohjelmiston avulla. Tutkielman tutkimuskontekstina on etätyö. Tutkimuksen perusteella etätyöntekijät kokevat työnsä keskimäärin melko paljon omakseen. Tutkimustulokset osoittivat, että työtä kohtaan koettu psykologinen omistajuus syntyy kolmen ”reitin” kautta, joita ovat kohteen hallinta, kohteen perusteellinen tunteminen ja voimavarojen käyttäminen kohteeseen. Näiden ”reittien” syntymiseen taas oli positiivinen yhteys seuraavilla työn ulottuvuuksilla: työn vaatimat taidot, työn hahmottaminen, työn merkitsevyys, itsenäisyys sekä palaute työstä. Tutkimustulokset todistivat, että psykologinen omistajuus oli positiivisessa yhdeydessä työperäiseen itsetuntoon, työtyytyväisyyteen, työmotivaatioon, yksilön kehittymiseen työssään, vastuuntuntoon työtään kohtaan sekä rehtiyteen. Voimakkain yhteys psykologisella omistajuudella oli työtyytyväisyyden kanssa. Tutkimuksen perusteella voidaankin sanoa, että mitä enemmän henkilö kokee työnsä omakseen, niin sitä tyytyväisempi hän on työhönsä. Tutkimustulokset osoittivat, että etätyön muodolla on merkitystä etätyöskentelyssä koettuihin etuihin ja ongelmiin. Täysipäiväisen etätyön tekijät kokivat edut kaikista positiivisimmin ja ongelmat taas kaikista negatiivisimmin. Mobiilit työntekijät kokivat työssään alhaisempaa itsenäisyyden tunnetta kuin muiden etätyön muotojen edustajat.

Virtuaalinen yhteisöllisyys ja siihen vaikuttavat tekijät

Virtuaalista yhteisöllisyyttä ja virtuaaliyhteisöissä tapahtuvaa osallistumista yhdistävää empiiristä tutkimusta ei ole toistaiseksi raportoitu tieteellisessä tutkimuksessa. Tässä tutkimuksessa tutkittiin ja analysoitiin virtuaalisen yhteisöllisyyden ja virtuaalisen osallistumisen sekä virtuaaliseen osallistumiseen vaikuttavien tekijöiden suhteita yksilön näkökulmasta virtuaaliyhteisössä. Tutkimuksen tavoitteena oli selvittää yksilön virtuaalisen yhteisöl-lisyyden kokemusta ja siihen vaikuttavia tekijöitä. Toisena keskeisenä tutkimustavoitteena oli tarkastella yksilön odottamien etujen vaikutusta yksilön osallistumiseen virtuaaliyhteisössä. Tutkimus toteutettiin tapaustutkimuksena ja tutkimuskohteena oli erään mediayrityksen ylläpitämä virtuaaliyhteisö. Tutkimuksen empiirinen osa toteutettiin strukturoituna verkkokyselynä, josta saatu aineisto analysoitiin kvantitatiivisia menetelmiä käyttäen. Tärkeimpänä tutkimuksellisena havaintona todettiin yksilön viestejä lukemalla tapahtuvan virtuaalisen osallistumisen vaikuttavan voimakkaammin yksilön kokemaan virtuaalisen yhteisöllisyyden tunteeseen kuin yksilön viestejä kirjoittamalla tapahtuvan osallistumisen. Yksilön odottamien etujen havaittiin myös poikkeavan lukemalla tai kirjoittamalla osallistuvien kohdalla. Henkilöt jotka osallistuivat virtuaaliyhteisöön viestejä lukemalla, toivoivat kognitiivisia, sosiaalisia ja hedonistisia etuja. Henkilöt jotka osallistuivat viestejä kirjoittamalla, toivoivat henkilökohtaisia, sosiaalisia ja hedonistia etuja. Henkilön sukupuolella, virtuaaliyhteisöstä saadun tiedon tarpeella ja sanomalehden tilaustottumuksilla havaittiin olevan vaikutusta yksilön osallistumisestaan toivomiin etuihin, virtuaalisen yhteisöllisyyden kokemukseen ja osallistumiseen virtuaaliyhteisöissä.

Customized agile development process for embedded software development

Agile software development has grown in popularity starting from the agile manifesto declared in 2001. However there is a strong belief that the agile methods are not suitable for embedded, critical or real-time software development, even though multiple studies and cases show differently. This thesis will present a custom agile process that can be used in embedded software development. The reasons for presumed unfitness of agile methods in embedded software development have mainly based on the feeling of these methods providing no real control, no strict discipline and less rigor engineering practices. One starting point is to provide a light process with disciplined approach to the embedded software development. Agile software development has gained popularity due to the fact that there are still big issues in software development as a whole. Projects fail due to schedule slips, budget surpassing or failing to meet the business needs. This does not change when talking about embedded software development. These issues are still valid, with multiple new ones rising from the quite complex and hard domain the embedded software developers work in. These issues are another starting point for this thesis. The thesis is based heavily on Feature Driven Development, a software development methodology that can be seen as a runner up to the most popular agile methodologies. The FDD as such is quite process oriented and is lacking few practices considered commonly as extremely important in agile development methodologies. In order for FDD to gain acceptance in the software development community it needs to be modified and enhanced. This thesis presents an improved custom agile process that can be used in embedded software development projects with size varying from 10 to 500 persons. This process is based on Feature Driven Development and by suitable parts to Extreme Programming, Scrum and Agile Modeling. Finally this thesis will present how the new process responds to the common issues in the embedded software development. The process of creating the new process is evaluated at the retrospective and guidelines for such process creation work are introduced. These emphasize the agility also in the process development through early and frequent deliveries and the team work needed to create suitable process.

Ammatillisen osaamisen tukeminen muuttuvissa toimintaympäristöissä : tutkimus ikääntyvien työntekijöiden näkökulmasta

The purpose of the study was to describe the experiences of received support of aging employees and their work related self-image in changing working environments. Firstly, theaim was to discover how the support from organisations and leaders was verified. Secondly, the aim was to get answers how employees experienced themselves as workers and as learners in the current work context. Thirdly, the aim was to compare different knowledge information stages and company cultures and how they have influenced the experiences of professional competence development among aging employees. In addition the education- and career backgrounds were investigated to gain more understanding of their role in experiencing support and relation to the occupational self-image. The theoretical frame of reference of this researchis multidisciplinary. The theoretical part focuses on the meaning of work for human being from a sociological, late-modern perspective. On the other hand it examines the ageing process from a physiological and also from a perspective of age discrimination and life control. The occupational selfimage and the strength of motivation has an effect on learning in working life which is crucial and firmpart individual trajectories. According to the theoretical review company culture, leadership and especially the managers' role as a creator of a learning atmosphere are increasingly critical for aging adults' learning when the role of informal work-based learning is increasing. The empirical data was collected with aquestionnaire and interviews, which were carried out in May to October 2001. The data consists of 263 respondents of which further eight persons were interviewed. All respondents were over the age of 45 and represented all levels of their organisations in an IT-technology firm and a chemical industry plant. The central findings in this research show that the aging adults have experienced that theemployers do care about the development of their occupational skills. On the other hand there are fewer concrete activities to reveal this support. There is anobvious disproportion between the expressed aims and the realisation of the activities. Signs of age discrimination are few. The style of management has becomemore supporting for self directed activities which are seen to support adults learning. Higher education and individual activity to seek possibilities to learnwere encouraging the development of occupational skills. Age itself was not a crucial aspect when comparing the experiences among younger (45-54 years) and older (55-64 years) groups. Job satisfaction and professional self esteem seemed tobe considerably strong. The individual characteristics were more important elements in developing occupational skills than the age. The degree of anxiety at work was low. In addition among the older group the strong feeling of coherence and the occupational self image were significant for supporting the professional competence. The motivation to learn was also stable. Among the seniors there was some slight evidence of declining motivation. In the IT-firm the support was experienced stronger for aging employees than in the chemical industry plant. Thosewho had experienced support in the chemical industry plant had higher educational background than the others. In IT-firm they also experienced more support from the manager than in the chemical industry plant. The results show that it is more likely that the differences are caused mostly by the stage of information intensity and the character of company culture which is determined by the activities. IT-business demands constantly accommodation to changes and the chemical industry plant which is representing more traditional business field, where the atmosphere of learning is determined by the traditions of company culture, the changes are carried out slowly.

Att lära för livet hemma och i skolan : elevers uppfattningar av kost och hälsa, konsumtion och privatekonomi samt hushåll och miljö

The home is an important societal arena for upbringing and learning. A child can experience a feeling of participation in the household he or she belongs to very early in life. In this manner, the home environment constitutes an essential foundation for instruction in the subject of Home Economics. At school, Home Economics pupils should fulfill the intentions that school curriculum has for the subject, that is to say develop the knowledge, skills, and values that allow pupils to be able to take responsibility for their health, finances, comfort, and safety in their close environment. The purpose of this study is twofold. Firstly, the study aims to examine what knowledge and attitudes children and teenagers have acquired from their home environment, close environment, as well as school. Secondly, the study aims to evaluate the effects of instruction in Home Economics, at the 7th grade level, as regards diet and health, consumption and private finances, as well as household and the environment. The study’s methodological foundation focuses on pupils’ understanding of the surrounding world. A phenomenographical approach to the research phenomenon basis itself on the supposition that knowledge is fixed in human beings’ consciousness and experiences. Furthermore, the study stresses individual variations in conjunction with the experienced phenomenon. The empirical portion of the study is based on semistructured interviews of 30 pupils divided into two reference groups. The pupils were interviewed before instruction in the subject of Home Economics started and upon completing instruction. The interview data was analyzed and interpreted in accordance with the “multistage model”. The study results show that upbringing in the home environment is determinative as pertains to understanding of the socio-cultural household environment. Mealtime traditions, for example, are deeply ingrained but nonetheless influenced by lifestyle changes. The study shows that a didactic challenge exists to draw attention to the consequences of poor mealtime habits and stress for everyone raising or educating children and teenagers. Despite good knowledge of what a healthy diet is, the majority of pupils choose fast-food and junk-food when they eat out to save time and money. Studies of pupils’ preparedness for consumption show that a purposeful upbringing in the home in combination with relevant instruction in Home Economics, results in knowledgeable consumers. This study also shows that upbringing in the home environment and instruction in Home Economics requires an intense and conscious focus on the consequences of a household not run in accordance with nature, where the household lifestyle is nonsustainable. Pupils’ understanding is often based on the disregarding of the survival perspective for a comfort perspective. Parents and Home Economics teachers should be able to bring up and teach children and teenagers in a manner that allows children and teenagers to take responsibility for their health, private finances, as well as comfort and safety in the close environment. The method is conscious nurturing and instruction.

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.

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.

Career satisfaction among medical school professors: a case study in Brazil

OBJECTIVE: To investigate the career satisfaction of medical school professors in relation to initial motivation, satisfaction factors, and the desire to remain in the profession. METHODOLOGY: A qualitative methodology was used, based on questionnaires and semi-structured interviews with faculty members at a federal institution of higher education in Brazil. RESULTS: For 42.86% of the sample, teaching began while they were medical students; 80% had chosen teaching either as a vocation or due to influence from families or professors; 20% chose teaching as a professional opportunity. The majority, 57.14%, stated they were happy with teaching, and 51.42% did not plan to leave the career. Factors involved in satisfaction with teaching were: the possibility of remaining up-to-date in the medical profession, the feeling of doing their duty, their contribution to training future doctors, and contact with young people and the university setting. Factors leading to dissatisfaction were pedagogical (33.33%), economic (30.95%), institutional (14.28%), and relational (14.28%). CONCLUSIONS: Subjects expressed a positive attitude towards teaching, and because of their great personal satisfaction with the career, they did not plan to leave it. These findings should shed light on factors that interfere with career satisfaction and help increase those that promote satisfaction, thus improving the productivity and well-being of medical professors.