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Veiledning av studenter er blitt beskrevet som den mest private undervisningsformen ved høyskoler og universiteter, men det finnes relativt lite empirisk forskning som utforsker hva som karakteriserer veiledning av studenter pa° dette niva° et. Denne artikkelen søker a° utforske hvordan veiledere og masterstudenter erfarer og vurderer ulike veiledningsformer samt hvordan veiledningen er organisert. Studien tar utgangspunkt i ba° de læreres og studenters betraktninger i et masterstudie i sykepleie og i et masterstudie i journalistikk. Funnene viser at veiledning forsta° s og erfares pa° ulike ma° ter av veiledere og studenter, men noen særtrekk skiller de to utdanningene fra hverandre. Veiledere og studenter ved masterstudiet i journalistikk ser ut til a° praktisere en mer tradisjonell undervisningsmodell, der studenten innehar en passiv, mottagende rolle. Veiledere og studenter ved masterstudiet i sykepleie lener seg i større grad mot en partnerskapsmodell, der ba° de studenter og lærere er opptatt av maktutjevning og likeverdighet i dialogen. Artikkelen skisserer noen mulige forklaringer til denne ulikheten. En forklaring kan ligge i selve organiseringen av veiledningen ved masterutdanningen i sykepleie. I tillegg til individuell veiledning, arrangeres jevnlige seminarer der lærere og studenter diskuterer ulike sider ved den enkelte students masteroppgave. Det arrangeres ogsa° seminarer hvor ulike sider ved veiledningspraksis diskuteres kollegaer imellom. Denne typen organisering ser ut til a° ha forankring i bevisste pedagogiske strategier, og er med pa° a° sikre transparente og refleksive veiledningsprosesser. Studien aktualiserer spørsma° l om hvorvidt veiledning bør profesjonaliseres i større grad, og derav potensielt øke kvaliteten pa° en viktig dimensjon av arbeidet med masterstudenter. Nøkkelord:Supervision of students has been described as the most private form of instruction in colleges and universities, but there is relatively little empirical research that explores what characterizes supervision of students at this level. This article explores how supervisors and Master students experience and view different forms of supervision, as well as how supervision is organized. The study is based on both professors’ and students’ considerations, in a Master of Nursing program and a Master of Journalism program. The findings show that supervision is understood and experienced in different ways by supervisors and students, and some results demonstrate clear differences between nursing and journalism studies. Supervisors and students in the journalism program tend to practice a more traditional teaching model where the students hold a passive, receiving role. Supervisors and students in the nursing program to a greater extent lean towards a partnership model, where both students and professors seek power equalization and symmetry in the dialogue. The article outlines some possible explanations for these differences. One explanation seems to relate to how supervision is organized in the Master’s program in Nursing. In addition to individual supervision, there are regular seminars where different aspects of the students’ master theses are discussed among professors and fellow students. Different challenges related to supervision are regularly discussed in seminars in between colleagues. This type of organization seems to be founded in conscious pedagogical strategies, and contributes to securing transparent and reflective processes of supervision. The study raises a question of whether a more professionalized supervision model will increase the quality of an important dimension of the work with master students

Life experiences leading to the choice of surgery—A qualitative study exploring reasons behind the choice of undergoing gender affirmative surgery

ObjectiveGender dysphoria is frequently accompanied by physical dissatisfaction and body image issues. The primary objective of this study is to explore subjective experiences and perceptions among those who has undergone gender reassignment surgery, as well as their retrospective path to that decision.MethodSixteen qualitative in-depth interviews were conducted with 9 participants. The participants were accepted for gender affirming surgery and interviewed before and after surgery.ResultsCultural norms, and values in relation to time and context were highlighted as significant in reference to the opportunity one had to display a gender identity that corresponded to prevailing expectations. Participants gradually began to recognize their differences and divergence from others in social interactions and experiencing “wrong” bodily changes during puberty created even greater discrepancy. Several impression control measures, such as avoiding certain situations and using concealing techniques, were employed to prevent what was described as both felt and enacted stigma. The significance of having genital organs that accurately reflect one's gender identity was emphasized to prevent emotional distress and dysphoria caused by this discrepancy.ConclusionSocio-cultural expectations, combined with enacted stigma, seem to cause, or re-enforce self-stigma as people internalize these attitudes and suffer from physical and mental consequences as a result. Thus, societal, and cultural trends seem to have a strong influence and feed the idea of being born in the wrong body. However, even though several participants underwent socially inspired alterations, they all experienced dysphoria in the extent that they continued to see reassignment surgery as a solution

“Imagine, 7 Years Without a Future”: A Qualitative Study of Rejected Asylum Seekers' Life Conditions in Norway

Asylum seekers are in an extraordinary situation as their future life depend on decisions made by authorities in a bewildering, bureaucratic system, with excessive waiting and unpredictable timeframes. Those that are not granted asylum, and not able to return to their country of origin, can neither spatially nor temporally visualize if, when or how a potential change is going to occur. This paper is part of a larger study based on narrative interviews with asylum seekers and refugees in asylum centers in Norway, exploring their experiences before, during, and after flight. As we found that the life circumstances for those being refused asylum, were highly different from other participants in the project, we chose to address this particular group in a separate paper. The participants in this part of the study consisted of 21 individuals (of a total of 78 participants) in the age range 18–44, of whom eight were female and 13 males. Trough qualitative interviews and participant observation the aim of this study was to explore and describe the life condition and mental health situation of rejected asylum seekers in Norway. We found that the gradual loss of rights, opportunities and finances are experienced as a form of violence that leads to extreme mental and social suffering. This policy clearly conflicts with Human Rights incorporated in the Norwegian constitution, and we argue that it legitimizes treating asylum seekers as a group of undesirable and underserving political bodies, with serious consequences for their mental health and wellbeing

Pårørendes rolle som ressurs og samarbeidspartner: En Studie med fokus på pårørende til pasienter med demenssykdom i sykehjem/ Family members' role as resources and collaborating partners: A study focusing on dementia and long-term stay in a nursing home

Aim: To bring knowledge about how relatives can serve as a resource and cooperate with nursing home staff in giving care to patients with dementia and behavioural symptoms. Background: Studies suggests that family members want to retain the role of caregivers also after institutionalization of a family member with dementia. We have little knowledge about how family caregivers and nursing home staff develop a collaborative relationship. Methods: The study has a descriptive and explorative design. Data were collected via II semi-structured, audiotaped interviews with family members. The analysis is based on Kvale and Brinkman's three levels of interpretation. Findings: Relatives were to a little degree included as a resource for nursing home staff, and they missed a continuous dialog with health personnel in charge of the care. The transition from the role of being an active, responsible caregiver to someone that was not involved and familiar with the daily needs of their family member was perceived as difficult. Conclusion: Relatives may be an important resource in the planning of long-term care for their family members. Conscious inclusion and collaboration with relatives can help them remain in their role as caregivers and prevent them from feeling disclosed

Behavioural disturbances in patients with frontotemporal lobe degeneration focusing on caregiver burden at home and in nursing homes.

Aim and objective To explore the challenges faced by family caregivers of people with frontotemporal dementia and other forms of dementia affecting the frontal and temporal lobes causing behavioural disturbances through a qualitative approach with in‐depth interviews. Background Studies of different forms of dementia involving degeneration of the frontal and temporal lobes have mainly focused on the neurophysiology and physiology of the disease and on caregivers’ health. Few studies have described the challenges and burdens connected with everyday life and in relation to suitable nursing home placement that are faced by family caregivers. Method and design This study used a descriptive and explorative design. Eleven semi‐structured interviews with family caregivers of patients from special units in four nursing homes were conducted in 2014. Data were analysed based on Kvale and Brinkmann's three contexts of interpretation: self‐understanding, common sense and theoretical understanding. Checklist for qualitative studies: Standards for Reporting Qualitative Research (SRQR) http://www.equator-network.org/reporting-guidelines/srqr/ Results Two central themes were derived from the data: changes in behaviour and personality were perceived as incomprehensible, frightening and increasingly difficult to manage. Family caregivers experienced challenges in finding suitable care facilities when they were not able to continue providing home care. Due to behavioural disturbances and lack of relevant competencies among health personnel, family members were often moved between nursing homes. Conclusion Pronounced personality and behavioural disturbances such as tactlessness and aggression in a family member with dementia are experienced by caregivers as stressful and burdensome and may lead to feelings of shame and guilt. A lack of suitable care facilities adds to the stress and difficulties of the families and entails an additional and unresolved burden. Relevance to Clinical Practice The study reveals a need for more knowledge among those organising health services as well as healthcare professional dealing with this patient category to ease the burden on next of kin.publishedVersio

Barriers and enablers in the management of tuberculosis treatment in Addis Ababa, Ethiopia: a qualitative study

Tuberculosis (TB) is an infectious disease which causes about two million deaths each year. In 1993, the World Health Organization (WHO) declared TB to be a “Global Emergency” due to an increasing number of TB cases and a rise in multidrug resistant cases in the developed world. Treatment interruption was considered one of the major challenges. WHO introduced the current TB control program DOTS (directly observed treatment, short course) as the tool to control the disease. To prevent further development of resistance against anti-TB drugs it was decided to observe each patient taking their daily dose of medication. The overall aim of this thesis is to explore how patients and health workers perceive and manage TB symptoms and treatment in a high-endemic and a low-endemic setting in the era of DOT(S). The data is based on fieldwork, including in-depth interviews and focus groups with TB patients and health workers, in Addis Ababa, Ethiopia (2001-2002) and in Oslo/Akershus, Norway (2007-2008). We found that people’s interpretation and management of TB symptoms is influenced by cultural, social and economic factors. TB was, in both contexts, associated with poverty, and subsequently with a disease that affects certain countries or certain segments of a population. TB was viewed as a severe disease in both contexts, but there was variation between individuals to what extent one considered oneself as a likely victim. In the absence of circumstantial causes, such as poverty, patients in a lowendemic setting like Norway, found it difficult to understand why they had developed the disease. There was scarce knowledge about the fact that the disease could be latent. Awareness of early symptoms, such as persistent cough, was low in both contexts. Perceptions of vulnerability, together with the presence or absence of socio-economic barriers or enablers influenced at what time patients would seek help. The study suggests that health personnel lacked awareness or misinterpreted early symptoms of TB. In Ethiopia, lay categorizations of early TB symptoms converged with diagnostic practices in parts of the professional health sector. The diagnostic process could endure for many months after patients’ first contact with the health services. Similarly, in Norway, we found that patients’ interpretations of early symptoms often were confirmed in the meeting with health personnel. The consequences were prolonged diagnostic processes. The study shows that patients’ ability to manage TB treatment is a product of dynamic processes, in which social and economic costs and other burdens interplay over time. A decision to interrupt treatment can be shaped by past struggles and accrued costs; in which seems financially, socially or emotionally unbearable at the moment of treatment interruption. The burdens related to DOT could also be significant, in patients who did not interrupt treatment. Patients in both Ethiopia and Norway experienced an authoritarian and rigid practice of DOT, which made it difficult to simultaneously attend to demands related to treatment and demands related to other areas of life. The most vulnerable patients, such as those without permanent jobs, suffered from high economic, social and emotional costs. In conclusion, health personal need more knowledge about typical and atypical symptoms of TB. In low-endemic settings doctors need to be trained to adjust their level of suspicion to the migration history of the patient. In high-endemic settings one should be aware that health personnel may understand and manage TB within a traditional perspective. Patients in both high- and low-endemic contexts need concrete information about the cause of TB, how it is transmitted, how symptoms can be manifested, how the disease can progress and how it can be cured. The study indicates that inequalities that predispose for TB may be reinforced in the patient’s interaction with the health services due to a rigid, disempowering practice of DOT. Subsequently, DOT per se may add to the chain of structural barriers that patients have to overcome to access and complete treatment. To ensure that TB patients complete treatment one must address the coexisting and interacting crises that follow a TB diagnosis. This could require TB programs to adopt a more holistic approach. Measures that secure early diagnosis may reduce some of the physical, psycho-social and economic costs patients face while undergoing treatment. Measures that empower patients to participate in their own health care may avoid disempowering and humiliating practices

Exploration of perceptions and decision-making processes related to childbirth in rural Sierra Leone

Background: Maternal mortality ratio (MMR) remains high in Sierra Leone. Efforts have been made to reduce MMR by increasing the number of women delivering at a health facility through introduction of the Free Health Care Initiative in 2010. Despite this, utilisation remains lower than aimed for, with marked inequalities between rural and urban settings. This study explores the perceptions and decision-making processes of women and their communities during childbirth in rural Sierra Leone. Methods: A qualitative, cross-sectional study employing focus group discussions, in- depth interviews and informal interviews with pregnant women and community members in rural northern Sierra Leone. Data were analysed using systematic text condensation. Results: Data revealed that the decision-making processes are complex and multi-faceted. Decisions regarding the place of delivery and with whom assisting the birth are often made collectively. A normal delivery is seen as one that occurs within the village. Previous experiences, perceptions and expressions of bodily symptoms as well as the interpretation of different risks affect these decisions. The health seeking behaviours were found to be flexible and dynamic, and the final decisions about where to give birth could be governed by unexpected circumstances. Conclusions: Decision-making processes during childbirth in rural Sierra Leone are dynamic and intricate and need to be understood within the broader social context. Future initiatives to improve access and utilisation of safe health services for pregnant women within rural Sierra Leone need to be based on adequate knowledge of women’s preferences, cultural-specific traits, capabilities, perceptions of risk and the constraints in which they may live