Ekspert versus ikke- ekspertposisjon, eller ja takk, begge deler? Familieterapeuters refleksjoner omkring posisjonenes plass og betydning i veiledning av fosterforeldre

Denne kvalitative studien undersøker familieterapeuters erfaringer med å innta både en ekspert og ikke- ekspertposisjon i veiledning av fosterforeldre. Jeg har benyttet en fortolkende fenomenologisk analyse (IPA) for å belyse følgende problemstilling: Hvilke erfaringer har familieterapeuter med å innta både en ekspert og ikke ekspertposisjon i veiledning av fosterforeldre? For å besvare problemstillingen har jeg intervjuet fire familieterapeuter som arbeider med veiledning av fosterforeldre. Analyseprosessen førte frem fire hovedfunn med til sammen syv underfunn: 1. Ikke- vitende posisjonens plass og betydning i veiledning. a) Ikke- vitende posisjon som faglig ideal, b) «Ikke- vitende»- en kamuflert ekspert? 2. Ekspertposisjonens plass og betydning i veiledning. a) Opplevd ekspertmandat, b) Betydningen av å gi råd, c) Ekspertposisjon til frustrasjon. 3. Ekspertposisjon og ikke- vitende posisjon – ja takk, begge deler. 4. Veileders opplevelse av å ha regi. a) Makt i relasjonen uavhengig av posisjon, b) Valg av posisjon på veileders premisser. I studien fremkommer det at informantene opplever at de i kraft av sin rolle er tillagt et ekspertmandat, og at det ligger en forventning fra arbeidsplassen om at de skal innta en ekspertposisjon i veiledningen. Likevel viser samtlige informanter til at de ønsker å ha en «ikke- vitende» holdning ovenfor fosterforeldrene selv om de opplever at dette kan være vanskelig å gjennomføre. Informantene opplever at ekspertposisjonen også har sin plass og betydning i veiledningen, selv om den sees på som mindre nyttig. Informantene trekker spesielt frem betydningen av å gi råd når fosterforeldrene ønsker det. Videre viser studien til at informantene kan innta en ekspertposisjon i situasjoner hvor de ikke opplever den som hensiktsmessig. Det kan være når de er usikre, slitne eller blir trigget. Selv om informantene foretrekker å ha en «ikke vitende» holdning ovenfor fosterforeldrene viser studien til betydningen av å kombinere denne med en ekspertposisjon der det er hensiktsmessig og nødvendig. Studien viser også til informantenes opplevelse av å ha regi, og at det er de som bestemmer valg av posisjon i veiledningen. Funnene er drøftet med utgangspunkt i studiens problemstilling, forskningsspørsmål, relevant teori samt tidligere forskning

Проблеми осцилометричного методу вимірювання артеріального тиску

AimRelaxation and guided imagery is a distraction technique known to reduce discomfort during paediatric medical procedures. We examined whether its use decreased the stress experienced by 11- to 12-year-old girls receiving the human papilloma virus vaccination, as well as the intensity and unpleasantness of any pain. MethodsA randomised crossover trial was conducted with 37 girls. During the first vaccination, each girl was randomised to receive either relaxation and guided imagery or standard care. They then received the other form of care during the second vaccination. Salivary cortisol was measured before each vaccination, and 30minutes after it was administered. The girls reported pain intensity and pain unpleasantness before and directly after each vaccination and stress after each vaccination. ResultsOn a group level, relaxation and guided imagery did not decrease cortisol levels, self-reported stress, pain intensity and pain unpleasantness. Salivary cortisol levels decreased significantly in both groups during the second vaccination. ConclusionRelaxation and guided imagery did not prove beneficial during the vaccination of 11- to 12-year-old girls and is not recommended as a regular nursing intervention. However, further research is needed into effective techniques to help children who experience pain unpleasantness in connection with needle procedures.Funding Agencies|Ebba Danelius Foundation; Swedish Association of Paediatric Nurses; Gertrud Ostlinder Foundation; Jerring Foundation</p

Do interventions containing risk messages increase risk appraisal and the subsequent vaccination intentions and uptake?:A systematic review and meta-analysis

Purpose There is good evidence that for many behaviours, increasing risk appraisal can lead to a change in behaviour, heightened when efficacy appraisals are also increased. The present systematic review addressed whether interventions presenting a risk message increase risk appraisal and an increase in vaccination intentions and uptake. Method A systematic search identified randomized controlled trials of interventions presenting a risk message and measuring risk appraisal and intentions and uptake post-intervention. Random-effects meta-analyses investigated the size of the effect that interventions had on vaccination risk appraisal and on vaccination behaviour or intention to vaccinate, and the size of the relationship between vaccination risk appraisal and vaccination intentions and uptake. Results Eighteen studies were included and 16 meta-analysed. Interventions overall had small significant effects on risk appraisal (d = 0.161, p = .047) and perceptions of susceptibility (d = 0.195, p = .025), but no effect on perceptions of severity (d = −0.036, p = .828). Interventions showed no effect on intention to vaccinate (d = 0.138, p = .195) and no effect on vaccination behaviour (d = 0.043, p = .826). Interventions typically did not include many behaviour change techniques (BCTs), with the most common BCT unique to intervention conditions being ‘Information about Health Consequences’. Few of the included studies attempted to, or successfully increased, efficacy appraisals. Conclusions Overall, there is a lack of good-quality primary studies, and existing interventions are suboptimal. The inclusion of additional BCTs, including those to target efficacy appraisals, could increase intervention effectiveness. The protocol (CRD42015029365) is available from http://www.crd.york.ac.uk/PROSPERO/

Personal solar ultraviolet radiation dosimetry in an\ua0occupational setting across Europe

Background: Work-related solar ultraviolet radiation (UVR) is an important factor in the pathogenesis of non-melanoma skin cancer (NMSC). The World Health Organization, through the International Agency for Research on Cancer, has classified solar UVR as a group 1 carcinogen since 2012. The main problems encountered so far in the study of occupationally induced skin cancer include the lack of accurate occupational UVR dosimetry as well as insufficient distinction between occupational and leisure UVR exposure and underreporting of NMSC. Objectives: The aim of this study was to collect long-term individual UVR measurements in outdoor workers across European countries. Methods: A prospective study was initiated through the European Academy of Dermatology and Venereology, Healthy Skin@Work Campaign, measuring UVR exposure doses at occupational settings of masons from five European countries. Measurements were performed for several consecutive months using the GENESIS-UV measurement system. Results: The results identified alarming UVR exposure data. Average daily UVR doses ranged 148.40–680.48&nbsp;J/m2 in Romania, 342.4–640.8&nbsp;J/m2 in Italy, 165.5–466.2&nbsp;J/m2 in Croatia, 41.8–473.8&nbsp;J/m2 in Denmark and 88.15–400.22&nbsp;J/m2 in Germany. Results showed an expected latitude dependence with increasing UVR yearly dosage from the north to the south of Europe. Conclusions: This study shows that outdoor workers from EU countries included in this study are exposed to high levels of occupational solar UVR, vastly exceeding the occupational exposure limits for solar UVR exposure, considered to be 1–1.33 SED/day in the period from May to September. This finding may serve as an evidence-based recommendation to authorities on implementing occupational skin cancer prevention strategies