Risking the social bond when communicating unpleasant information: How self-relevant appraisals and feelings explain distancing and repair motivations

This thesis focuses on the communication of unpleasant information in six experimental studies. Specifically, the experimental studies investigate how withholding and/or disclosing unpleasant information is appraised by the communicator in three various ways (degree of severity, concern for one's self-image and concern for one's social-image in the eyes of others), how these appraisals relate to three core feelings (felt rejection, felt inferiority and felt shame), and how these explain two main motivations (wanting to distance oneself from the other, wanting to repair the social bond with the other) across various social bonds (both private and professional). In the two first studies it was found that disclosing unpleasant information caused the communicator to report significantly less distress (lower levels of appraisals, feelings and motivations) compared to when the communicator withheld the unpleasant information. In studies three to six, it was found that, when communicators disclosed the unpleasant information, the prototypical communication strategy of being person-centred caused the communicator to feel significantly less distress (lower levels of appraisals, feelings and responses) than if two other prototypical ways of communicating were used (the fully direct strategy and the fully indirect strategy). In all six studies, I found that the motivation of wanting to distance oneself from the other was explained by a "concern for one's social-image ? felt rejection" pathway, while the motivation to repair the social bond with the other was explained by a "concern for one's self-image ? felt shame" pathway. The thesis argues the importance of disclosing the unpleasant information and of disclosing it in a person-centred way

Å dø hjemme - en utfordring : En studie av pårørende og sykepleieres erfaringer

Abstract The Aim of the study was to describe central conditions so elderly patients could die at home. Which experiences had relatives and nurses had with patients who died at home? Which conditions with the patient and the relatives, nurses and the nursing sevices were decisive to carry out a planned homedeath? The Method in the study was qualitative and had an explorative design. The study included seven persons and represented four cases where the patient died at home. The selection of respondents included relatives and nurses. The nurses represented both homecare and Fransiskushjelpen. The instrument was a semistructured interview. The Findings showed that patient had a strong wish and a strong will to stay at home. The relatives were surprised by the help offered by the homecare, and how easily they got remedies. The nurse s ability to create confidence for all the parts was the key to let people stay at home. The nurse s experience was that it was easier to deal with the patients death because it was more natural. Conclusion: Nurses and relatives had a positive experience when caring for the patient at home

Disabilities exhibited by children and adolescents that refuse to go to school

The aim of the study was to investigate what functional difficulties young people who refuse to go to school experience in their everyday lives. Research questions where what difficulties do young people who refuse to go to school experience? Are there differences between boys and girls? The study is a retrospective journal study with 28 Swedish youngsters based on Strengths & Difficulties Questionnaire (SDQ). Major findings where about somatic symptoms, emotional distress, loneliness, distinct gender roles, less mature and risk behavior. Although the school, social services and children- and adolescent psychiatry largely agree on the complexity of adolescents being absent from school, it seems difficult for the organizations to agree on adequate solutions.publishedVersio

Women’s embodied experiences of using wearable digital self-tracking health technology: a review of the qualitative research literature

In this review we aimed to identify and synthesize the existing qualitative research literature on women’s experiences of using wearable digital self-tracking health technology, and analytically explore the lived through and embodied aspects of self-tracking in the first-person accounts presented in this literature. Thirteen empirical studies conducted in Australia, USA, Canada, Denmark, Finland and Germany, and published within the time period 2014 to 2019, were identified through systematic searches in relevant databases, and analyzed using a method of interpretive metasynthesis. Our analysis suggests that women experienced gaining access to bodily information that was otherwise experienced as hidden through using a wearable device, and that experiencing feelings was integral to their self-tracking practices and experiences. We thus identified two core themes across the included studies: Embodying the knowing self and Embodying strong feelings. Our review contributes to the existing literature by outlining and describing an emerging body of research across different health related disciplines, and makes a theoretical contribution by highlighting the need to minimize emotional labor and to provide the opportunity for embodying agency in the context of the selftracking activities of patients and consumers. In addition we suggests methodological ways forward in producing detailed and nuanced knowledge about the practices and implications of women’s use of digital self-tracking health technology.publishedVersio

Emotional discomfort among school staff and student teachers when they had to 'tell' or 'not tell' about vague suspicions of domestic violence

Background: Many employees in schools and kindergartens fail to report vague suspicions (e.g., inadequate clothing, signs of anxiety or lack of sleep, being verbally violent to peers) that children are victims of domestic violence because they are unsure whether their suspicions are well founded. Objective: We investigated the degree of emotional discomfort among school staff and student teachers when they had to 'tell ’ or ‘ not tell ’ about vague suspicions of domestic violence. We assumed that they would experience more emotional discomfort when they did not report such vague suspicions. Participants and setting: Seventy-one teachers and student teachers (20 men and 51 women; average age: 25, age range: 18 – 62) were recruited from three primary and lower secondary schools. Methods: We used an experimental design in this quantitative vignette study, and the particiants were asked to respond to 54 statements that were related to the need for acceptance by others, seriousness, appraisals (e.g. social self-image and self-image) and self-critical feelings (e.g. rejection, shame, and inferiority). Results: The results of the experimental study show that participants who did not tell about their vague suspicions of violence reported this as being more serious ( p < .05), had a more negative self-appraisal ( p < .05) and reported a higher degree of negative feelings ( p < .05). The study sheds light on the seriousness of ‘ not telling ’ about vague suspicions, and shows that ‘ not telling ’ is reported as being more emotionally uncomfortable than ‘ telling ’Emotional discomfort among school staff and student teachers when they had to 'tell' or 'not tell' about vague suspicions of domestic violencepublishedVersio

Understanding the role of positive emotions in healthcare communication - A realist review

Aim: To explore how the expression of positive emotions during the interaction between patients and providers can cultivate the patient-provider relationship. Design: We conducted a realist review guided by the Realist and Metanarrative Evidence Syntheses: Evolving Standards. Methods: We systematically searched CINAHL, MEDLINE, PsychINFO and Scopus from inception to March 2019. Study selection and data extraction were performed blinded in pairs. From 3146 abstracts blinded in pairs, 15 papers were included and analysed. From each included paper, we extracted contexts, mechanisms and out-comes that were relevant to answer our research questions, creating a configuration between these elements (CMO configuration). Results: Our findings suggest that in the contexts of person orientation and positive outlook, patient-provider relationships improve by communication conveying and eliciting positive emotions. We found six underlying mechanisms for this that form either direct or indirect pathways between the context and the outcome.publishedVersio

Hvilke erfaringer og holdninger har studenter i høyere utdanning til fusk og plagiering?

Denne rapporten er en kvalitativ studie av 33 informanters erfaringer med Kvalitetsreformens nye evalueringsformer i høyere utdanning (St meld 27 (2000-2001). Vårt hovedfokus med undersøkelsen har vært å finne frem til kunnskap som kan gi oss en forståelse av hvordan studenter forstår og vurderer fusk og plagiering i dagens høyere utdannelse og følgende problemstilling har vært utgangspunktet for vår analyse: Hvilke erfaringer har studenter med fusk og plagiering? Vårt mål med denne studien har ikke utelukkende vært rettet mot tradisjonelle former for fusk i forbindelse med eksamenssituasjoner. Vår interesse har snarere vært å belyse studentenes erfaringer av fusk og plagiering gjennom hele studiesituasjonen. Funn fra studien viser at studentene i liten grad kjenner til begrepene fusk og plagiering i deres nåværende studiesituasjon. Dette betyr at det er stor usikkerhet knyttet til begrepene og at man derfor kan anta flere studenter fusker og plagierer uten å nødvendigvis være klar over det. Vi ser en tydelig tendens til at studentene forholder seg til begrepet samarbeid på minst to ulike måter. Det er tydelig at flere studenter verdsetter læringsutbyttet som følger med samarbeid mer enn å ta hensyn til om det er en individuell oppgave, eller ikke. Vi ser også at studentene i frykt for å bli plagiert velger å ikke dele sine tanker om oppgaven de arbeider med og derfor unnlater å samarbeide. Videre ser det ut til at studentene ønsker en mer tydelig markering fra lærerne på hva som er tillat samarbeid, eller ikke. Flertallet av de samme studentene oppgir å ikke ha fått informasjon om eventuelle konsekvenser av å bli tatt i fusk eller plagiering. Studien viser også at omfanget av informasjon gitt om akademisk skriving, oppgaveskriving og referanseteknikk ved norske institusjoner for høyere utdanning ser ut til å være svært mangelfull. Vi etterlyser derfor et større fokus på denne problematikken, ikke nødvendigvis fordi vi tror at dagens studenter fusker og plagierer mer enn noen gang. Vi antar i stedet at vi trenger et økt fokus på denne problematikken fordi dette er holdninger som bør etableres som en del av dannelsesidealet for dagens studenter

Risking the social bond: motivations to defend or to repair when dealing with displeasing information

Our choice to withhold or disclose displeasing information to another can motivate concern about damage to our social bonds. In two experiments, using two different samples of university students in Norway, (N = 174 and N = 217), we found that withholding unpleasant information led to greater concern for self-image and social image than did disclosure. We also found that withholding elicited more shame, inferiority and rejection than disclosure, and in Experiment 2, withholding elicited more defensive motivation than disclosure. Consistent with our model, defensive motivation was mostly explained by concern for social image, whereas relationship repair motivation was mostly explained by concern for self-image and felt shame. We discuss implications for the literature on shame and social bonds

When ADHD knocks on the door – discourse theory as a frame to explore subject positions and mental wellbeing before diagnosis

Purpose Attention deficit hyperactivity disorder (ADHD) is currently the most prevalent childhood psychiatric diagnosis. This article reports how 10 young adults in Norway positioned themselves before they were diagnosed with ADHD either during early childhood or adolescence. A central theme is how these subject-positions relate to societal norms and mental well-being. Method Individual interviews were conducted, and the transcriptions of the interviews were analysed according to discourse theory. Result Six central subject positions were identified which in turn related to two major positions: 1) failure with schoolwork and 2) struggle in social interaction. The findings indicated specific emotional and environmental needs and that individuals were confronted with societal norms related to the criteria for ADHD prior to and regardless of whether one had received a formal diagnosis. Conclusion We argue that analysing subject positions provides important knowledge regarding ADHD that is useful for individuals, parents, teachers, practitioners, policymakers, and helping professionals in the field of mental health and education when it comes to interventions that support children who possess different temperaments

Symptoms and symptom clusters in patients newly diagnosed with inflammatory bowel disease: results from the IBSEN III Study

Abstract Background Patients with inflammatory bowel disease report multiple symptoms, but the relationships among co-occurring symptoms are poorly understood. This study aimed to examine the prevalence of symptoms and explore symptom clusters and possible associations between symptom clusters and socio-demographic and clinical variables in patients newly diagnosed with inflammatory bowel disease. Methods The IBSEN III study is a prospective population-based inception cohort of patients with inflammatory bowel disease. This study used patient data from the three largest hospitals in the study catchment area. The Memorial Symptom Assessment Scale was used to assess the prevalence of symptoms. Symptom clusters were identified using principal component analysis. Possible associations between socio-demographic and clinical variables and symptom cluster membership were estimated using regression analysis. Results Of the 573 patients (age, ≥18 years) diagnosed with inflammatory bowel disease, 350 (61.1%) completed the questionnaire (responders). Eleven symptoms were reported by >50% of the responders. The three most prevalent symptoms were bloating (84%), drowsiness (81%), and lack of energy (81%). Three symptom clusters were identified: psychological (56% of the patients), impaired energy (28%), and physical (16%) clusters. Multinomial regression analysis revealed that vitamin D deficiency was significantly associated with the impaired energy cluster (odds ratio=2.49, 95% confidence interval [1.00-6.2], p=0.05). Conclusions We found high symptom prevalence in patients newly diagnosed with inflammatory bowel disease. Three distinct symptom clusters were identified, and the psychological cluster includes >50% of the patients. Vitamin D deficiency is the only factor associated with cluster membership, namely the impaired energy cluster