| Abstract: | Sosiale medier har etablert seg som en selvsagt måte å kommunisere på, noe vi tar for gitt på lik linje med SMS, epost og mobiltelefon. En signifikant andel av den oppvoksende generasjon er på Facebook, Twitter, MSN og Youtube. Mediet sprer seg stadig ut i ny samfunnsstrata. Det begynner etterhvert å bli klart at sosiale medier har gjort noe med måten vi oppfatter verden, det som skjer på maskinen flyter til tider over i det som skjer utenfor. Facebook og andre sosiale medier har etablert seg som kommunikasjonskanal også i det offentlige rom, og dette byr på helt egne utfordringer og muligheter. Denne oppgaven er et overfladisk dypdykk i et medium som fortsatt er svært nytt, men som allerede begynner å bli gammelt. Dette noe politiske utsagnet er et forsøk på å illustrere at Facebook og sosiale medier er et enormt omfattende tema. Denne oppgaven går forholdsvis langt inn i materien hva Facebook angår, men blir er likevel på ingen måte en utfyllende forskningsrapport på fenomenet. Facebook er nytt i den forstand at det ble lansert for relativt få år siden, samtidig som det er gammelt fordi utviklingen i den elektroniske verden er utrolig rask og nyhetsverdien avtar fort. Facebook slik vi i Norge kjenner det har bare eksistert i 4 år, og er således nytt. Samtidig er det allerede så sterkt integrert i rutinene til brukerne, at mediet fortoner seg som en selvfølgelig del av hverdagen. |
| URI: | http://hdl.handle.net/10037/4160 |
| Abstract: | Practical knowledge is essential knowledge in occupational therapy. It is a situated and experienced knowledge, a knowing how and from within the situation. This knowledge has been difficult to facilitate in the learning process of a group of Occupational Therapist students in Gaza. Travel restrictions and the unstable political situation separated teachers and students. Lack of clinical occupational therapists inside Gaza also had a major impact. Educational technology such as videoconferences, internet and films became new and necessary tools. This article is based on results from an action research project following the process of using flexible forms of learning and developing an internet based learning programme named Ergonet and the learning process of the students using it, aiming at answering the following research questions: 1. How do the teachers experience the teaching process of facilitating practical knowledge? 2. How can an internet support program be developed to facilitate practical knowledge in OT education? 3. How do the teachers evaluate the outcome of implementing flexible forms of learning, regarding to the students practical skills? Pedagogical challenges in facilitating practical knowledge to occupational therapy students in a Palestinian culture had an impact on the way flexible forms of learning were developed and used. Experiences from using tools such as videoconferences, the internet, educational films and evaluation films impacted on the way the internet learning programme was developed. Ergonet contains an occupational therapy knowledgebase and clinical films presenting experienced masters doing assessments and therapy with clients. The films are presented and analysed in small sequences followed by written text, photo, articles and web-sites. Our pedagogical intention has been to develop a creative learning platform enhancing more active and deeper learning strategies among the students. The results indicate how rote-learning and lack of reflective and critical thinking have been challenged and changed by the didactic way Ergonet was used. |
| Description: | An action research approach performed in cooperation with teachers in the Occupational Therapist program at Bethlehem University. |
| URI: | http://hdl.handle.net/10037/2294 |
| Abstract: | The choice of an elliptic curve for the implementa- tion of an elliptic curve cryptosystem requires count- ing the number of points on such a curve over a fi- nite field. An improvement of Schoof’s algorithm for counting the number of rational points on an ellip- tic curve defined over a finite field takes advantage of some factor of the division polynomials. In this paper, we study the possible factorisations of such division polynomials. |
| URI: | http://hdl.handle.net/10037/1405 |
| Abstract: | This research estimated the technical, scale efficiency and its determinants of four-eye sleeper (Bostrichthys sinensis Lacépède, 1801) poly-culture in Nghia Hung district, Nam Dinh province, Vietnam. A nonparametric DEA approach were applied to evaluate technical and scale efficiency of farm level using input orientation DEA model. The study was based on the cross sectional primary data collected from 70 four-eye sleeper poly-culture households in Nghia Hung district, Nam Dinh, in 2009. The mean technical efficiency under CRS and VRS as well as scale efficiency were 86.44 percent, 90.24 percent and 95.66 percent, respectively. The difference between TE under CRS and VRS showed that the scale inefficiency existed. Regression analysis was used to investigate relationship between technical super-efficiency as a function of explanatory variables which included age, experience and education level of farm operators, stocking densities of fingerling and tiger shrimp, feed ratio and access into institutions as tranning course and credit. The regression analysis results showed that technical efficiency was influenced positively by experience and the number of year going to school of farmers, the farmer with higher experience and education will be more efficiency performance in aquaculture. Fingerling stocking density was also found positively significant impacted on technical efficiency while feed ratio measured in total feed cost to total four-eye sleeper output influenced negatively significant technical efficiency. Moreover, the empirical results were also found that the number of attendance times in training course of farmer effected positively significant on technical efficiency. The more number of times attending to training course of farmer is, the higher technical efficiency score the farmer will get. However, the others variables as age of farmer, tiger shrimp density stocking and debt ratio (credit) were not found statistically significant impact on technical efficiency in the sample farms. Keywords: Data envelopment analysis (DEA), technical efficiency, four-eye sleeper poly-culture, Nghia Hung, Vietnam. |
| URI: | http://hdl.handle.net/10037/2570 |
| Abstract: | The globalisation and intensification of food production has led to food related health incidents. These incidents range from BSE in cattle to illegally high levels of dioxins in chicken feed (Carriquiry and Babcock, 2007, Caswell, 2000, Elbers et al., 2001, Fallon, 2001, Hobbs, 2004, Madec et al., 2001, Ozawa et al., 2001, Sporleder and Goldsmith, 2001). The modern consumer is increasingly concerned with quality, sustainability and the possible health benefits related to the food that they eat (Chryssochoidis et al., 2008, Gellynck and Verbeke, 2001, Kehagia et al., 2007, van Rijswijk and Frewer, 2008). There is an increasing need for information when consumers are no longer familiar with the production attributes of their food (Carriquiry and Babcock, 2007, Kiesel et al., 2005, Pettitt, 2001). In this research features such as systematic information loss and lack of unique identification were identified as inhibitors of traceability. Standardisation of data elements for electronic information exchange and the identification of critical traceability points were identified as important activators. |
| Description: | Papers 2-7 are not available in Munin, due to publishers' restrictions:
2. Donnelly, K.A-M., Karlsen, K.M. and Olsen, P. (2009) 'The importance of transformations for traceability', Meat Science, 83 pp 68-73. 3. Karlsen, K.M:, Olsen, P. and Donnelly K. A-M., (2009) 'Implementing traceability: Practical challenges at a mineral water bottling plant', British Food Journal 112 (2) pp 187-197. 4. Donnelly, K.A-M. and Karlsen, K.M. (2010) 'Lessons from two case studies in implementing traceability in the dried salted fish industry'. Journal of Aquatic Food Product Technology, 19 (10) pp 38-47. 5. Donnelly, K.A‐M., Karlsen, K.M., Olsen, P. and van der Roest, J. (2008) 'Creating standardised data lists for traceability: a study of honey processing', Int. J. Metadata, Semantics and Ontologies, Vol. 3 (4) pp 283–291. 6. Donnelly, K.A‐M., Roest, J. V. D., Hoskuldsson, S. T., Olsen P. and Karlsen K.M., (2009) 'Improving information exchange in the chicken processing sector using standardised data lists'. Communications in Computer and Information Science, 46, pp 312‐321. 7. Thakur, M, and Donnelly, K.A‐M, (2010) 'Modelling traceability information in soyabean value chains', Journal of Food Engineering, 99(1) pp 98-65. |
| URI: | http://hdl.handle.net/10037/2891 |
| Abstract: | The consumption of catfish in Vietnam has not grown enough to match their increased production. The objective of this study is to explore the factors that influence the decision process of catfish consumers in Vietnam. The findings provide information for the Vietnamese catfish industry to better attract more domestic consumers to eat catfish. This study seeks to address its objective by examining the relationships that exist between the experiences, perceptions of product attributes, preference, market constraints, and consumption levels of consumers for catfish products. Non-catfish consumers are also investigated. Data collected in the two biggest cities in Vietnam is analyzed by using multivariate techniques based on a partially-recursive model. Factors such as age, region, ease of preparation, perceptions of catfish taste, odour, and fat along with beliefs that catfish are available, safe and inexpensive are found to significantly influence the decision-making process. |
| URI: | http://hdl.handle.net/10037/1002 |
| Abstract: | Background Cardiovascular disease (CVD) mortality in Russia is among the highest in the world. CVD mortality rate among Russian middle-aged (30-59) men and women is more than ten times higher than in Norway. Comparative studies however show that abnormally high levels of the conventional (atherosclerotic) cardiovascular risk factors such as serum cholesterol, obesity, diabetes and hypertension are equally as frequent in Norway, Sweden and Finland as in Russia. Methods The study had two parts. The first part (articles I-III) was based on the data collected in the population-based cohort study in Arkhangelsk which started in 1999-2000. The population of 3705 men and women aged 18 years or more has been observed for a period of 10 years. The second part (article IV) was based on the autopsy reports for 1.618 men and women who died from cardiovascular disease at age 30-70 in the city of Arkhangelsk in 2008-09. For 1120 cases (69.2%) diagnosed by forensic pathologist the blood alcohol concentration was determined. Results Atherosclerotic risk factors were not predictive for the total CVD mortality. However, they were strongly associated with higher risk in a selected group of cardiovascular deaths, consisting of strokes and myocardial infarctions. Hazardous alcohol consumption was associated with a 5-fold risk of CVD death in women. Although no similar association was revealed in men (likely due to a considerable underreporting of alcohol consumption) data suggest an association of at least the same magnitude as in women. A high proportion of deaths due to alcohol-related heart disease (cardiomyopathies) was found among subjects who died from a CVD at the age of 30-50 years. At least 1/3 of men and 1/5 of women in the study population consumed alcohol in the hours before death. This proportion was very low in the group of stokes and myocardial infarctions. Alcoholic cardiomyopathy was responsible for a large proportion of CVD deaths under the age of 50 years. The proportion of men dying from a CVD with alcohol identified at the postmortem examination was about 50% higher than for women. Conclusions The results have shown that the CVD risk profile in Russia may be appreciably different to that in the US and Western Europe. Therefore the preventive measures directed against the high CVD rates should also be aimed at reducing hazardous drinking through judicious anti-alcohol policy. |
| URI: | http://hdl.handle.net/10037/3589 |
| Abstract: | This master thesis has the aim to establish what factors can be identified as relevant in order to achieve a delimitation between the territorial seas of the Netherlands and Germany in accordance with Article 15 of the United Nations Convention on the Law of the Sea. |
| URI: | http://hdl.handle.net/10037/5124 |
| Abstract: | Problemstillingen til oppgaven er hvordan fornorskningspolitikken innvirket i relasjoner mellom samer, kvener og nordmenn i et nord-norsk lokalsamfunn, og hvordan den påvirket måtten på hvilken foreldre valgte faddere for sine barn. |
| URI: | http://hdl.handle.net/10037/2330 |
| Description: | Foredrag på Muninseminaret, Universitetet i Tromsø, 18. november 2009. |
| URI: | http://hdl.handle.net/10037/2246 |
| Abstract: | Temaet for denne oppgaven er rollen til fagforeninger i omstillingsprosesser. Rollene er da definert som enten ressurs og samarbeidspartner og som bremsekloss og vaktbikkje for medlemmenes rettigheter og vilkår. Målet er å bidra til en bevissthet rundt fagforeningens muligheter som en bidragsyter i omstillinger, gjennom den kompetanse de innehar gjennom sitt fagområde. Oppgaven bygger på et teoretisk grunnlag og er gjennomført med en kvalitativ tilnærming basert på halvstrukturerte intervjuer med to personer som har god kjennskap til to saker som oppgaven tar utgangspunkt i. Ideen var å se på to situasjoner og da helst omstillinger hvor fagforeningen har inntatt klart forskjellige roller. Casene viste at det i utgangspunktet ikke var konflikter og det ble i lengre tid jobbet med en løsning i sikte. Likevel endret prosessen seg av forskjellige grunner og det ble i begge tilfellene konflikter av det hele. Gjennom intervjuene fikk jeg mye god informasjon som ga meg et videre innblikk i hva som skjer i slike prosesser og hvordan prosessen kan endre seg hurtig, fra å ha godt samarbeid til å bli mer konfliktfylt. Videre så knyttes disse intervjuene opp mot forskjellig teori, som blant annet fagforeningenes formål, makt-ulikevekten i arbeidsmarkedet og den nordiske modellen. Denne teorien viser også at omstillinger i arbeidslivet er en del av et større helhetsbilde hvor alt fra vekst i økonomien til velferdsordningene i Norge spiller inn. Studien viser at det er en holdning blant mine informanter, om at fagforeningen i utgangspunktet bør innta en samarbeidsrolle i omstillinger. Det vil selvsagt komme an på hva omstillingene krever av endringer. Endringer som rokker ved opparbeidede vilkår som fagforeningene anser som prinsipielt viktige, kan medføre at rollen som bremsekloss inntas. |
| URI: | http://hdl.handle.net/10037/1045 |
| Abstract: | Gjennom problemstillingen "hvilken betydning har teamorganisering av aldersblandete baser for spesialundervisning i matematikk" belyses følgende spørsmål i oppgaven: - Blir matematikklærere brukt til spesialundervisning i matematikk? - Blir spesialpedagoger brukt til spesialundervisning i matematikk? - Hva er avgjørende for hvilken kompetanse som ”benyttes”? - Samarbeides det mellom basene? - Hva anses som fordeler og ulemper ved basevis organisering? - Kunne elevene vært bedre tjent med en annen organisering av spesialundervisningen? I første del av oppgaven belyses det gjennom teori hva det vil si å kunne matematikk, samt ulike perspektiver på læring, som er relevant for å definere begrepet matematikkvansker. Studien er i hovedsak kvalitativ, men kvantitative data inngår også. Et spørreskjema besvart av lærere på ulike baser på en ungdomsskole står sentralt. Ved å drøfte resultatene fra analyser innad og på tvers av basene synliggjøres sammenhenger mellom kompetansen til lærerne på temaet og spesialundervisningen i matematikk for basens elever. Funnene viser stor variasjon i hvilke kompetanse som benyttes i spesialundervisningen i matematikk. Det finnes lite relevant litteratur fra tidligere forskning på spesialundervisning i ungdomsskoler organisert som aldersblandete baser. Siden stadig flere ungdomsskoler organiseres som baser, økes også behovet for forskning som sammenligner denne typen undervisning med tradisjonell organisering av undervisning. |
| URI: | http://hdl.handle.net/10037/1697 |
| Abstract: | Oppsummering Mastergradsoppgaven med tema fagutvikling for kreftsykepleiere i pleiepraksis, er en kvalitativ studie som baserer seg på en hermeneutisk tilnærming. Fagutvikling er en betegnelse som brukes mye av sykepleiere. Begreper som kvalitetsutvikling og forbedringsarbeid rommer også fagutvikling. Studiens empiri er erfaringer kreftsykepleiere har knyttet til fagutvikling i egen pleiepraksis. Sykepleierne har gjennom intervju gitt meg sin forståelse av hva fagutvikling er for dem, og hvordan det prioriteres og tilrettelegges for fagutvikling i egen pleiepraksis. De er tydelige på at fagutvikling er viktig for å være oppdatert på ny kunnskap, forbedre praksis, kunne gi god sykepleie og for å få inspirasjon til å være i yrket. Det var utfordringer knyttet til å få til fagutvikling i pleiepraksis der tid, organisering, krav og forventninger var sentrale faktorer. Sykepleierne ønsker flere formelle og forutsigbare arenaer for fagutvikling. De opplever en hektisk hverdag som ikke muliggjør tilstrekkelig tid til fagutvikling. Mangel på plan og organisering kan bidra til at fagutvikling oppleves å bli dårlig ivaretatt. Kreftsykepleierne har behov for tid til kunnskapsutvikling og fagrefleksjon i praksishverdagen for å kunne ivareta rollen som profesjonell sykepleier på en tilfredsstillende måte. De ønsker å jobbe med prosjekter for å møte eget og avdelingens behov for kunnskapsutvikling, oppdatering og forbedring. Dette for å kunne gi bedre sykepleie til pasientene. Deltakelse på kurs og konferanser er også viktig. Det kan synes som at sykepleierne tar et stort ansvar for egen og organisasjonens behov for fagutvikling. I følge mine informanter er fagutvikling utydelig organisert, kommunisert og gjennomført i egen avdeling - noe som oppleves som frustrerende for sykepleierne. Både faglitteratur og helse- og fagpolitiske føringer vedrørende kunnskapsutvikling for sykepleiere er omfattende. Det stilles krav om kontinuerlig kunnskapsutvikling, og at det tilrettelegges for det i praksishverdagen. Hovedkonklusjonen er at det er få formelle arenaer for fagutvikling, og det kan synes som at det er vanskelig for sykepleiere å få til endring eller utvikling i praksis med bakgrunn i planlagte og systematiserte fagutviklingsprosjekter i pleiepraksis. |
| URI: | http://hdl.handle.net/10037/2024 |
| Abstract: | The highly efficient endectocide ivermectin is used to reduce the burden of parasites in many semidomestic reindeer herds in northern Fennoscandia. In the autumn of 1995 and 1996 all reindeer on the island of Silda (42 km2) were treated with ivermectin in an attempt to eradicate the warble fly (Hypoderma (=Oedemagena) tarandi (L.)), the nose bot fly (Cephenemyia trompe (Modeer)) (Diptera: Oestridae) and the sinus worm (Linguatula arctica Riley, Haugerud and Nilssen) (Pentastomida: Linguatulidae). Silda is situated 2-3 km off the mainland of Finnmark, northern Norway, and supports about 475 reindeer in summer. A year after the first treatment, the mean abundance of H. tarandi was reduced from 3.5 to 0.6, but a year after the second treatment the mean abundance unexpectedly had increased to 4.5. After one year without treatment, the mean abundance and prevalence of the three target parasites were at the same level, or higher, than pre-treatment levels. The main hypothesis for the failure to eliminate the parasites is that gravid H. tarandi and C. trompe females originating from untreated reindeer in adjacent mainland areas dispersed to the island during the warm summer of 1997 (possibly also in 1998). As these oestrids are strong flyers, it may not be too difficult for them to cross >2-3 km of oceanic waters. There are no good explanations for the failure to eradicate L. arctica, but the results indicate that there may be elements in its life cycle that are unknown. The conclusion of the study is that it may be difficult or impossible to eradicate these parasites permanently, even locally such as on islands unless adjacent areas on the mainland are also cleared. |
| URI: | http://hdl.handle.net/10037/608 |
| Abstract: | Denne oppgavens problemstilling, støttet av teori om kompetanseutvikling og endring, er «hvordan påvirker ulike faktorer kompetanseutvikling i en disiplinær organisasjon?». Organisasjonen som er undersøkt er det taktiske helikoptermiljøet i Luftforsvaret, som nylig har avsluttet sitt oppdrag i Afghanistan. Dette oppdraget utgjør konteksten for oppgaven, og de ulike faktorene som er undersøkt er omorganisering, turnover, økt belastning, midlertidige beordringer, nytt utstyr og teknologi, kulturendringer, samt omprioriteringer av oppdrag. Undersøkelsen dreier seg om hvordan disse faktorene har påvirket utvikling i kompetansekomponentene kunnskap, ferdigheter, jobbrelaterte holdninger, mestringstro og selvfølelse hos flygere i det taktiske helikoptermiljøet. Omorganisering har primært påvirket de av flygerne som var involvert, enten som elever eller instruktører, og har for disse medført positiv utvikling i kunnskaper, ferdigheter og selvrefererende holdninger. Videre har den høye graden av turnover virket positivt på utviklingen av kunnskaper, ferdigheter og selvrefererende holdninger hos de yngre flygerne. Utviklingen av resterende kompetansekomponenter, samt den generelle opplevde kompetanseutviklingen hos de mer erfarne flygerne har vært negativ. Primært skyldes dette at læringsarenaene som skapes i brief- og debriefsituasjoner blir forringet av læringsbarrierer som tidspress og mangel på likeverdige modeller. Økt belastning er opplevd mer negativt for de mer erfarne flygernes kompetanseutvikling. De mindre erfarne flygerne har opplevd mer positiv utvikling i sine kompetansekomponenter, spesielt i kunnskap og ferdigheter. Samtlige flygere har opplevd negativ utvikling i sine jobbrelaterte holdninger. Midlertidige beordringer har medført positiv utvikling i flygernes kunnskaper, mestringstro og selvfølelse, forutsatt at de har mestret de nye oppgavene. Utviklingen i de jobbrelaterte holdningene varierer mest, ettersom informantene har forskjellig oppfatning av i hvilken grad Luftforsvarets bruk av midlertidige beordringer var nødvendig eller vellykket. Mens nytt utstyr og teknologi har medført generell positiv utvikling i flygernes kompetansekomponenter, har effekten av kulturendringer variert. Utviklingen av flygernes kunnskaper, jobbrelaterte og selvrefererende holdninger er avhengig av i hvilken grad kulturen har utviklet seg til å bli mer åpen og omgjengelig. Omprioriteringer av oppdrag har påvirket flygernes opplevde kompetanseutvikling ulikt, avhengig av erfaringsnivå. Mens de mindre erfarne flygerne har opplevd en målrettet kompetanseutvikling mot tjeneste i Afghanistan, har de mer erfarne opplevd innsnevring av oppdragsportefølje. Dette har spesielt påvirket de erfarne flygernes jobbrelaterte og selvrefererende holdninger, og enkelte av disse informantene er ikke enige i Luftforsvarets nedprioritering av nasjonale oppdrag i løpet av oppdraget i Afghanistan. |
| URI: | http://hdl.handle.net/10037/4814 |
| Abstract: | Artikkelen bygger på intervju av nære pårørende om livsløpet til pasienter med demenssykdom som bor i sykehjem i Nord-Norge. De pårørende ble spesielt spurt om pasientenes vaner, interesser og aktiviteter gjennom livsløpet. Det ble utført narrativ analyse av intervjuene med vekt på fortolkning av livsløp og livshendelser hos pasientene. Artikkelen viser hvordan pårørende konkret bidrar til å videreføre kontinuiteten i livsløpet til pasienten, samtidig som det kommer fram hvordan denne kontinuiteten også har stor betydning for pårørende i deres eget liv. Artikkelen viser og at for at pasienten skal oppleve kontinuitet i eget liv etter flytting til sykehjem, er det viktig med en form for kontakt med hjemplass og landskap, og at det gis rom for tradisjoner og livshistorie. |
| URI: | http://hdl.handle.net/10037/4678 |
| Abstract: | This thesis is based on the decision-making process involved in treatment termination in intensive care. ICU patients often have impaired consciousness and may therefore lack capacity to consent. In such cases, the health care personnel have the decision-making authority, but where a serious intervention for the patient is involved, information should if possible be obtained from the patient’s next-of-kin about what the patient would have wanted. The reason for conducting this study was that we in Norwegian intensive care practice knew little of the experiences of family members from situations where life-critical decisions are made on behalf of patients and which ethical and value issues the families experience as crucial. This thesis therefore examines the experiences of bereaved family members from the decision-making process when treatment of ICU patients is terminated. The study examined what participation in the decision-making process might involve, what it might signify to have responsibility in such situations and whether the family knew the patient’s preferences for such a situation. Questions were also directed at the family’s communication with doctors and nurses. Four ICUs at Norwegian university hospitals selected potential participants. 21 qualitative interviews with 27 relatives of deceased ICU patients were analysed using two different qualitative approaches. The most important finding was that most families in the study had wanted to be more included in the decision-making process, in order to contribute what they knew about the patient’s preferences and values. Only a few of the families were included in a process over time. These were very satisfied with the way they were treated, the care they were shown, communication with clinicians and the termination process itself. The other families also experienced being shown much care, but communication with physicians was random, too seldom and could be disrespectful. The families pointed out that nurses generally did not attend family-physician meetings and nurses expressed themselves vaguely regarding treatment prospects and prognosis. When the end of treatment was approaching, these families were either just informed that it was to be terminated or were informed and asked to consent to the decision. The consequences for the families were uncertainty about the basis for the decision, a sense of loneliness around unanswered questions, lack of clarity about their own role and a feeling of responsibility for the patient. The study concludes that, even though communication about treatment termination is demanding and context-dependent, the family’s perspective could still be given more consideration. We identify several specific factors which we believe to be important for the improvement of the circumstances around treatment termination. Because these situations are complex and compound, doctors and nurses could first of all become more aware of and relate to the ethical aspects of the situation. Secondly, we believe there is a need for more training in communication with families in ethically difficult situations. Doctors and nurses can and should work more systematically and methodically as a team in their approach to patients’ families. |
| Description: | The papers of this thesis are not available in Munin: 1. Lind, R., Lorem, G., Nortvedt, P., & Hevrøy, O.: 'Family members’ experiences of “wait and see” as a communication strategy in end-of-life decisions', Intensive Care Medicine (2011), vol. 37(7):1143-1150. Available at http://dx.doi.org/10.1007/s00134-011-2253-x 2. Lind, R., Lorem, G. F., Nortvedt, P., & Hevrøy, O.: 'Intensive care nurses’ involvement in the end-of-life process – perspectives of relatives', Nursing Ethics (2012), vol. 19(5):666-676. Available at http://dx.doi.org/10.1177/0969733011433925 3. Lind, R., Nortvedt, P., Lorem, G., & Hevrøy, O.: 'Family involvement in the end-of-life decisions of competent intensive care patients', Nursing Ethics (2012), (published online before print). Available at http://dx.doi.org/10.1177/0969733012448969 |
| URI: | http://hdl.handle.net/10037/5074 |
| Abstract: | The aim of this study is to examine family members’ experiences of end-of-life decision-making processes in Norwegian intensive care units (ICUs) to ascertain the degree to which they felt included in the decision-making process and whether they received necessary information. Were they asked about the patient’s preferences, and how did they view their role as family members in the decision-making process? A constructivist interpretive approach to the grounded theory method of qualitative research was employed with interviews of 27 bereaved family members of former ICU patients 3–12 months after the patient’s death. The core finding is that relatives want a more active role in end-of-life decision-making in order to communicate the patient’s wishes. However, many consider their role to be unclear, and few study participants experienced shared decision-making. The clinician’s expression “wait and see” hides and delays the communication of honest and clear information. When physicians finally address their decision, there is no time for family participation. Our results also indicate that nurses should be more involved in family–physician communication. Families are uncertain whether or how they can participate in the decision-making process. They need unambiguous communication and honest information to be able to take part in the decision-making process. We suggest that clinicians in Norwegian ICUs need more training in the knowledge and skills of effective communication with families of dying patients. |
| URI: | http://hdl.handle.net/10037/4060 |
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