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«Så bruker vi jo egentlig ikke den makten vi har muligheten til...». En kvalitativ studie om kontaktpersoner sitt relasjonsarbeid med foreldre i barnevernets undersøkelsesfase
Get PDFDenne masteroppgaven handler om kontaktpersoner sine opplevelser med relasjonsarbeid med foreldre i barnevernets undersøkelsesfase, med vekt på maktaspektets betydning. Oppgaven belyser hvordan kontaktpersonene jobber for å komme i posisjon og etablere relasjoner med foreldre i barnevernets utfordrende kontekst, og hvordan barnevernsansatte håndterer makten sin i dette arbeidet.
Studien er basert på et kvalitativt forskningsdesign med semistrukturerte intervju. Utvalget har bestått av åtte kontaktpersoner med flere års erfaring med barnevernsundersøkelser. Jeg har gjennom en tematisk analyseprosess utviklet hovedfunnene: 1) Relasjonsetablering og 2) Makt og makthåndtering.
Gjennom analysen og påfølgende diskusjon belyser oppgaven et samsvar mellom teori, forskning og kontaktpersonenes perspektiver på hva som utgjør en god relasjon. Barnevernets makt utgjør imidlertid et gjennomgående element som utfordrer oppnåelsen av dette i praksis. Samtidig har jeg drøftet hvordan barnevernets makt ikke bare er et ufravikelig premiss i den profesjonelle relasjonen, men også spiller en positiv rolle i relasjonsarbeidet gjennom kontaktpersonenes subtile maktutøvelse. Felles for intervjudeltakernes uttalelser er de motstridene hensynene som de må balansere, som skaper en viss ambivalens i deres forståelse av makt og posisjon. Denne ambivalensen er delvis forklart ved at det er mer foretrukket å være i en hjelperrolle fremfor kontrollrolle, og delvis i lys av de organisatoriske utviklingslinjene innenfor barnevernsfeltet. Subjektivitet og makt er uunngåelige elementer i den profesjonelle relasjonen, og det er derfor essensielt å løfte frem den enkelte barnevernsansattes forståelse og håndtering av makt for å forbedre relasjonsarbeidet. Videreutvikling av egen «maktkompetanse» kan bidra til å styrke kontaktpersoners arbeid med å etablere relasjoner i undersøkelsesarbeidet
En studie om co-terapi. En kvalitativ undersøkelse om familieterapeuters erfaring med co-terapi i Familievernet.
Get PDFCo-terapi refererer til en terapeutisk tilnærming der to terapeuter samarbeider om behandlingen av en eller flere klienter (Hendrix et al., 2001, s.63). Samtidig handler co-terapi også om samarbeidet og dynamikken mellom terapeutene selv. Denne studien undersøker familieterapeuters forståelse av co-terapi i konteksten av Familievernet, med særlig søkelys på den faglige og personlige nytteverdien co-terapi kan ha i par- og familieterapi.
Problemstillingen for studien er: «Hva er familieterapeuters erfaringer med co-terapi?» Og forskningsspørsmålene som utforskes er: Hvordan påvirker strukturelle forhold ved familievernkontoret familieterapeutenes faglige ståsted, diskurser, relasjonelle dynamikker og kommunikasjon? Og hvordan former disse forholdene deres erfaringer med å arbeide som to terapeuter i co-terapi?
Utvalget består av fire familieterapeuter med mastergrad i familieterapi og systemisk praksis, fast stilling ved et familievernkontor i minst 3 år, og minst 2 års erfaring med coterapi. Data ble innhentet gjennom kvalitative intervjuer, og analysen ble utført ved hjelp av Interpretative Phenomenological Analysis (IPA).
Hovedfunnene i denne studien viser at co-terapi oppleves som en verdifull arbeidsmetode blant familieterapeuter i Familievernet. Informantene fremhever flere sentrale aspekter som avgjørende for at co-terapi skal fungere godt: Et sterkt samarbeid mellom terapeutene, preget av åpen og tydelig kommunikasjon, er essensielt. Tillit mellom terapeutene er nødvendig for å skape et trygt rom både dem selv og klientene. Co-terapi åpner for at terapeutene kan dra nytte av hverandres styrker og perspektiver, noe som gir en mer nyansert forståelse av klientenes utfordringer. Informantene rapporterte også at co-terapi ga muligheter for kontinuerlig faglig utvikling gjennom refleksjon og læring fra hverandre. Til tross for disse fordelene ble co-terapi lite brukt, grunnet strukturelle forhold, hvor effektivitet ble prioritert fremfor refleksjon og samarbeid.
Samlet sett peker funnene på at co-terapi kan gi en mer dynamisk og effektiv behandling, og at det bidrar til å skape en tryggere ramme for både terapeuter og klienter
Quality of Life in first-time parents during pregnancy and postpartum period: A study in the New Families research project
No full textAll rights reserved. No part of this publication may be reproduced or transmitted, in any form or by any means, without permission.Background: The transition to parenthood is characterized by physical, psychological, and social changes in both women and men. During this period, their Quality of Life (QoL), specifically related to physical, psychological, and social domains, is influenced by various factors that can increase or decrease t heir QoL levels.
The Norwegian Child Health Services (CHS), primarily managed by Public Health Nurses (PHNs), have a longstanding tradition of providing professional support to new parents through home visits and clinical consultations, focusing on health promotion. In t h e City of Oslo, an early universal home visiting program, New Families (NF), has been developed and integrated into t h e traditional CHS. NF involves home visits starting from the third trimester of pregnancy and may continue until the child reaches t w o years of age, depending on the family's needs. The NF research project is current ly evaluating the impact of NF, and this thesis contributes to the project by exploring QoL during the transition to parenthood.
While various instruments are frequently used to measure QoL in this target population, less is known about t h e psychometric properties of these instruments. Research on the Norwegian CHSand the outcomes of its users, including parental QoL levels in t h e transition to parenthood, is rare, leading to a need for more evidence in the field of public health nursing.
Aims: The overall aim of this thesis was to explore QoL in first-time parents during t h e transition to parenthood. This involved identifying QoL instruments, examining QoL levels and factors associated with QoL, as well as investigating t h e impact of NF on first-time mothers' QoL. The papers included in this thesis had t h e following research aims.
Paper II: The aim was to identify instruments used to measure mothers' and/or fathers' QoL during pregnancy and t h e postpartum period, and to describe their characteristics and psychometric properties.
Paper II: The research aims were 1) to determine whether Norwegian pregnant women and male partners differed in QoL levels in the third trimester of pregnancy, 2) to determine whether the relationship between perception of sleep and QoL is moderated by depressive symptoms, when analyzed separately in pregnant women and male partners, and 3) to determine whether selected possible predictive factors were associated with QoL when stratified by level of depressive symptoms, in pregnant women and male partners separately.
Paper Ill: The research aims were 1) to evaluate the impact of NFon first-time mothers' QoL by exploring differences between the first-time mothers receiving NF and the first-time mothers receiving follow-up as usual, and 2) to investigate the association between QoL, social support and selected possible predictive factors in the sample of first-time mothers.
Methods: The first paper was a scoping review conducted through systematic literature searches in M EDLINE, EMBASE, PsychlNFO, ClNAHL, and HaPI. The psychometric properties were defined and categorized using the consensus-based Standards for the selection of health Measurement INstruments (COSMIN). The studies were screened by two reviewers independently, utilizing customized screening questions to assess eligibility against inclusion criteria. Data were systematically extracted into a predesigned data charting matrix and analyzed descriptively.
The second and third paper included data from the NF research project, a prospective non randomized controlled study with parallel group design. CHSin five city districts of Oslo were matched in intervention and control groups, with first-time parents allocated based on the residential area. Data were collected between October 2018 and June 2020 at pregnancy week 28 (Tl: pregnant women=228, male partners=197), six weeks postpartum (T2: first-time mothers=184), and three months postpartum (T3: first-time mothers=167). The World Health Organization Quality of Life Questionnaire brief version (WHOQOL-BREF) assessed QoL, including the domains physical health, psychological, social relationships, and environment. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS), social support with the Perinatal Infant Care Social Support Scale (PICSS), and the perception of sleep (enough/not enough) was assessed with a single item. Background variables were also collected. The second paper employed a cross-sectional study, analyzing data from Tl (baseline) on WHOQOL-BREF, EPDS, perception of sleep, and background variables. Descriptive statistics, moderation analyses, and multivariate linear regression were used in data analysis. The third paper, a prospective non-randomized controlled study with parallel group design, included data from Tl to T3 on WHOQOL-BREF, PICSS, and background variables. Multivariate linear regression models were applied to examine the intervention (NF) impact and assess associations. All data were analyzed in SPSSversion 28, and the level of statistical significance was p < 0.05
Results: In the first paper, 5671 unique studies were identified, with 53 studies found eligible for inclusion. The studies were primarily of Asian origin (49%) and conducted after 2014 (51%). We identified 19 QoL instruments, comprising 12 generic and seven period-specific ones, commonly measuring 7 physical, psychological, and social QoL domains. SF-36, SF-12, and WHOQOL-BREF were the instruments most frequently reported on, while SF-12, WHOQOL-BREF, QOL-GRAV, and PQOL had the most information on psychometric properties. None of the identified instruments were evaluated for all nine psychometric properties recommended by the COSMIN. Internal consistency and structural validity were the most reported psychometric properties. We identified three studies that examined psychometric properties of instruments used on male partners/fathers, with WHOQOL BREF being the only one.
In the second paper, significantly lower QoL levels were observed in the physical health and psychological domains of pregnant women compared to male partners and on all QoL domains in pregnant women with, compared to without, depressive symptoms. No moderating effect of depressive symptoms on the relationship between the perception of sleep and QoL domains was found. Among the women without depressive symptoms, perceiving enough sleep was significantly associated with the physical health QoL domain. Among the male partners, perceiving enough sleep was significantly associated with higher QoL across all domains.
In the third paper, we found no significant impact of NF on the QoL of first-time mothers at three months postpartum. Consequently, we analyzed the sample as one group in association models of QoL and social support. Emotional support was significantly associated with higher QoL levels in the physical health (B=0.19, 95%CI [0.04 to 0.34]) and social relationships (B=0.40, 95%CI [0.20 to 0.60]) domains. Additionally, significant associations were found between appraisal support and higher QoL levels in the psychological (B=0.34, 95%CI [0.18 to 0.50]) and environment (B=0.33, 95%CI [0.19 to 0.48]) domains. The association model also revealed a significant association between QoL levels in pregnancy and QoL levels postpartum across all QoL domains
Conclusion: Overall, the findings of this thesis demonstrate that QoL is a suitable concept and measurement outcome in women and men during the transition to parenthood. Their QoL levels across various domains were influenced differently, with associations observed between QoL domains and depressive symptoms, social support, and perception of sleep. The evidence on psychometric properties of QoL instruments in this target population is limited, although there is extensive reporting on internal consistency and structural validity. Future validation studies are warranted. The NF home visiting program did not have a significant impact on the QoL of first-time mothers at three months postpartum. However, the quantitative findings are discussed in relation to the component s of NF and its potential benefits. The insights gained from this thesis provide useful knowledge for the professional practice of public health nurses.
Paper I: Brekke, M., Berg, R. C., Amro, A., Glavin, K., & Haugland, T. Quality of Life instruments and their psychometric properties fo r use in parents during pregnancy and the post part um period: a systematic scoping review. Health and Quality of Life Outcomes. 2022; 20(1); 107; doi:10.1186/s12955-022-02011-y
Paper li: Brekke, M., Amro, A., Småstuen, M. C., Glavin, K., Solberg, B., Øygarden, A. M. U., Sæther, K.M., Haugland, T. Quality of life in Norwegian pregnant women and men with pregnant partners, and association with perception of sleep and depressive symptoms: a cross-sectional study. BMC Pregnancy and Childbirth. 2023; 23(1); 37; doi:10.1186/ s12884-023- 05379-x
Paper Ill: Brekke, M., Småstuen, M. C., Glavin, K., Amro, A., Solberg, B., Øygarden, A. M. U., Sæt her, K.M., Haugland, T. The impact of New Families home visiting program on first-time mothers' quality of life and its association with social support: a non-randomized controlled st udy. BMC Public Heath. 2023; 23:2457; 10.1186/ s12889-023-17285-0publishedVersio
Utvikling av et tverrfaglig e-læringskurs for helsepersonell på 7 språk om vold i nære relasjoner
No full textLæringsfestivalen 2024, Trondheim 27. mai - 28. mai 2024.Arrangør: NTNUpublishedVersio
Competing loyalties in a contested space: The Lutheran Middle School in Hunan Province, 1907–1914
Get PDFThis study explores the complexities of mission-state and church-state relations from a micro-level perspective, asking how the missionaries, teachers, and pupils at the Lutheran Middle School in Hunan Province negotiated conflicting claims on church membership and national citizenship. However, Hunan is not a microcosm of modern China. When dealing with nationalism in a Hunanese context, it is sometimes more accurate to speak of Hunanese nationalism rather than Chinese nationalism. This micro-level case study sheds light on the general trends of changing mission-state and church-state encounters, but it also emphasizes unexpected expressions of local Christianity in a context that has not so far been given much scholarly attention.publishedVersio
Solstien 3 – et digitalt læringshus med 360° videoer og tilhørende læringsaktiviteter for studenter i helse- og sosialfaglige utdanninger
Get PDFEn tverrfaglig prosjektgruppe ved VID vitenskapelige høgskole (VID) fikk høsten 2020 tildeling av midler fra Direktoratet for høyere utdanning og kompetanse til utvikling av «Solstien 3 - et digitalt læringshus for studentaktive arbeidsformer». Hovedmålet med prosjektet var å øke kvaliteten i utdanningen slik at studentene bedre kan ruste seg til å forstå og handle faglig og etisk forsvarlig i møte med mennesker i sårbare livssituasjoner. Derfor ønsket vi å ta i bruk virtual reality (VR)- teknologi for å fremme studentaktive læringsformer.
Prosjektet ble gjennomført som et tverrfaglig samarbeid mellom fire helse- og sosialfaglige profesjonsutdanninger ved VID campus Stavanger, Bergen og Oslo. I prosjektet har vi utviklet realistiske scenarier som er filmet med 360˚-kamera og skal oppleves i VR-briller. Scenarioene viser komplekse og etisk utfordrende situasjoner, og læringsoppgavene fokuserer på at studenter skal utvikle evne til refleksjon og dømmekraft. Refleksjon og diskusjoner rundt hva som skjer i scenariene og hvordan man som fagperson kan og bør handle har til hensikt å styrke studentenes ferdigheter og øke deres teoretiske forståelse til bruk i praksis.
I starten av prosjektet kartla vi ønsker for treningssituasjoner blant studenter, ansatte og fagpersoner fra praksisfeltet ved hjelp av en spørreundersøkelse (kap.2). Spørreundersøkelsen avdekket et ønske og behov for trening på å håndtere sterke følelser i situasjoner som konflikthåndtering, tvangsbruk og grensesetting. Både i kartleggingen og ved involvering av studentmedvirkere har vi jobbet for medvirkning gjennom hele prosjektperioden. Resultatene førte til utvikling av VR-scenarioer som reflekterer slike utfordringer. Disse scenarioene er ila prosjektperioden integrert i undervisningen i de fire involverte utdanningene (sykepleie, sosialt arbeid, ergoterapi og vernepleie) på VIDs fakultet for helsevitenskap og fakultet for sosialvitenskap. Prosjektets produkter har et bredt nedslagsområde med gode muligheter for overføring av resultater til andre studieprogram og institusjoner. Dette har allerede vist seg i praksis, da kolleger fra både Universitetet i Stavanger, Høgskolen på Vestlandet, OsloMet, samt fra Utviklingssenter for hjemmebaserte tjenester i Innlandet har bedt om å få bruke våre 360˚ videoer og simuleringsguide.
Implementeringsprosessen har møtt utfordringer som behov for lærerressurser og teknisk støtte. Det er foreslått endringer i studieplaner for å integrere VR-simulering som en obligatorisk del av enkelte emner. Prosjektet har vist at VR-simulering kan være en effektiv metode for å simulere praksisnære situasjoner, men det krever fortsatt innsats for å implementere det fullt ut i utdanningsprogrammene. Tilbakemeldinger på VR-filmene og de tilhørende læringsoppgavene har vært overveiende positive. Høy produksjonskvalitet og overbevisende skuespill bidrar til en realistisk og engasjerende læringsopplevelse. Teknologien har vist seg nyttig, men også krevende, både teknisk og ressursmessig. Prosjektet har imidlertid styrket satsingen på simulering i utdanningene og økt kompetansen blant ansatte i bruk av ny læringsteknologi.publishedVersio
Differences in approaches to learning between occupational therapy students in the USA and Norway
Get PDFThis is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.Students approach learning in different ways, and this study aimed to examine and understand differences in learning approaches between occupational therapy students in Norway and the USA. A total of 321 students, from two universities in the USA and six higher education institutions in Norway, completed the short version of the Approaches and Study Skills Inventory for Students. The data were analyzed with linear regression analyses. U.S. students had substantially higher scores on the strategic approach and higher scores on the deep approach, compared to the Norwegian students. Differences may be due to different national regulations and levels of education required for entering the programs, or personal factors such as predisposition for learning.publishedVersio
Children's and parents' experiences of home care provided by hospital staff: A scoping review
Get PDFAims: To describe what is known from existing scientific literature on children's and parents’ experiences of hospital- based home care and to identify future research areas.
Design: The scoping review design used adheres to the methodological framework of Arksey and O'Malley, and to the PRISMA-ScR checklist.
Review Methods: A systematic search was conducted, and peer- reviewed scientific papers were screened through the application of Rayyan software. Data were extracted and presented in table and synthesised thematically as narrative text.
Data Sources: Searches were carried out November 2021 and updated November 2022 in the CINAHL, MEDLINE, Embase, Cochrane, Scopus, Web of Science, Academic Search Elite, and Amed databases and Google Scholar.
Results: A total of 1950 studies were screened and assessed for eligibility. Eight studies met the inclusion criteria by reporting on parents' experiences, whereas five out of these eight studies also reported on the experiences of children. Parents of children with cancer and preterm children reported feeling more in control, being empowered, and being more connected to their children's care team when their children were receiving hospital- based home care. The family's own resources were activated, and they felt more involved in their children's care compared to being in an inpatient setting. Children with cancer, acute infection, chronic disease, and/or a syndrome reported feeling safer and more comfortable in their home environment and experienced better interaction with their care providers. Some aspects of the children's health- related quality of life (HRQOL) were improved.
Conclusion: The identified studies indicate that hospital-based home care is a valued alternative to traditional inpatient care by both parents and children. The mode of care has no crucial negative effects. Future studies should encompass the experiences of children with different diagnoses and syndromes and compare patients treated in a traditional hospital setting with those in a hospital- based home-care programme.
Relevance to Clinical Practice: Children's and parents’ experiences of HBHC indicate that it offers a good solution if parents are well prepared and feel in control. In addition, certain structural conditions must be in place before this type of care can be established: there must be a certain number of patients and the hospital must not be too far away. In the field of neonatal home care, professionals should be more responsive to fathers’ needs and tailor support by focusing on their individual experiences and needs. Our findings may guide and inform best practice for present and future providers of HBHC.
Implications for the Profession and/or Patient Care: Hospital- based home care can offer families a greater degree of autonomy, more flexible care options, improved family functioning, improved communication with care providers, and more control over the child's care. When certain structural conditions are met, such as a certain number of patients, the hospital not being too far away, and parents being well pre-pared and feeling in control, then hospital- based home care is valued as an alternative to traditional inpatient care. Specific aspects of children's HRQOL may improve, and the psychosocial burden on the family does not increase.
Impact: HBHC provides a valued alternative to traditional inpatient care and allows families to receive care in the comfort of their own home. Our findings may guide and inform best practice for present and future providers of hospital- based home care.
Reporting Method: In this scoping review, we have adhered to the Preferred ReportipublishedVersio
Patriarch and patriot: history in Patriarch Kirill’s sermons in the first year of the full-scale war in Ukraine
Get PDFThe leader of the Russian Orthodox Church, Patriarch Kirill of Moscow and all Rus, has correctly been seen as a staunch supporter of the Russian full-scale invasion of Ukraine in 2022. However, explicit statements of support for the war are rare in his public sermons and speeches, and it is worth exploring the mechanisms of his support in some detail. The article presents an analysis of all the patriarch’s sermons and speeches between February 2022 and February 2023 and shows how the patriarch uses references to history to nurture a worldview that makes the war both legitimate and necessary. Using Duncan Bell’s notion of a mythscape, the author argues that Kirill infuses secular history with divine meaning in order to give indirect divine legitimation for the war in Ukraine. He further relates this to Stoeckl’s contention that the Russian Orthodox Church’s promotion of so-called traditional values functions as civil religion for today’s Russia and suggests that Kirill’s use of history nurtures this civil religion further.publishedVersio
The impact of the New Families Home Visiting Program on depressive symptoms among norwegian fathers postpartum: A nonrandomized controlled study
Get PDFBecoming a parent is a vulnerable life transition and may affect parents’ mental health. Depressive symptoms may occur in fathers, as well as mothers, during pregnancy and the postpartum period. The health service is expected to have a family perspective, aiming to support both parents. Despite this goal, mothers traditionally receive more support than fathers. Home visiting programs may provide enhanced guidance for new fathers and increased mental health support. The aim of this study was therefore to assess possible differences in level of depressive symptom in fathers receiving the New Families home visiting program compared with those receiving standard care from the Norwegian Child Health Service. A prospective nonrandomized controlled study with a parallel group design was performed. The Edinburg Postnatal Depression Scale (EPDS) was used to measure depressive symptoms in fathers (N = 197) at 28 weeks of their partners’ pregnancy (T1), at 6 weeks (T2), and 3 months postpartum (T3), in the intervention and the control group. The results indicate a prevalence of depressive symptoms (EPDS score 10) in Norwegian fathers of 3.1% at T1, 3.9% at T2, and 2.2% at T3 for the full sample. No significant EPDS score differences were found between the intervention and the control group at six weeks and three months postpartum. This suggests that the intervention had no clear impact on depressive symptoms during this time-period.publishedVersio