Lincoln, Yvonna, and Egon Guba, "Postpositivism and the Naturalist Paradigm," pp. 14-46 in Yvonna Lincoln and Egon Guba, Naturalistic Inquiry . Beverly Hills, CA: Sage, 1985.*

Attachment--and loss.

Course Description In this course, we will explore the question of the actual and potential connections between democracy and education. Our focus of attention will be placed on a critical examination of democratic theory and its implications for the civic education roles and contributions of teachers, adult educators, community development practitioners, and community organizers. We will survey and deal critically with a range of competing conceptions of democracy, variously described as classical, republican, liberal, radical, marxist, neomarxist, pragmatist, feminist, populist, pluralist, postmodern, and/or participatory. Using narrative inquiry as a means for illuminating and interpreting contemporary practice, we will analyze the implications of different conceptions of democracy for the practical work of civic education.

Democracy and education.

Doing Qualitative Research

Mini Mental State

Globally, the population is ageing and lives with several chronic diseases for decades. A high symptom burden is associated with a high use of healthcare, admissions to nursing homes, and reduced quality of life. The aims of this study were to describe the multidimensional symptom profile and symptom burden in community-dwelling older people with multimorbidity, and to describe factors related to symptom burden. A cross-sectional study including 378 community-dwelling people ≥ 75 years, who had been hospitalized ≥ 3 times during the previous year, had ≥ 3 diagnoses in their medical records. The Memorial Symptom Assessment Scale was used to assess the prevalence, frequency, severity, distress and symptom burden of 31 symptoms. A multiple linear regression was performed to identify factors related to total symptom burden. The mean number of symptoms per participant was 8.5 (4.6), and the mean total symptom burden score was 0.62 (0.41). Pain was the symptom with the highest prevalence, frequency, severity and distress. Half of the study group reported the prevalence of lack of energy and a dry mouth. Poor vision, likelihood of depression, and diagnoses of the digestive system were independently related to the total symptom burden score. The older community-dwelling people with multimorbidity in this study suffered from a high symptom burden with a high prevalence of pain. Persons with poor vision, likelihood of depression, and diseases of the digestive system are at risk of a higher total symptom burden and might need age-specific standardized guidelines for appropriate management.

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Symptom burden in community-dwelling older people with multimorbidity: a cross-sectional study

Goals of work
Powerlessness and helplessness have been very little studied. The aims of this study were (1) to describe what characterise such experiences and the meaning of them to next of kin of cancer patients in advanced palliative home care and (2) to make quantifications.

Next of kin’s experience of powerlessness and helplessness in palliative home care

Objective: To study and explore problems perceived by physicians when breaking bad news to advanced cancer patients about discontinuing or not offering tumor-specific treatment due to incurable can ...

Concerns about losing control when breaking bad news to terminally ill patients with cancer: physicians' perspective.

Family members' perceived needs for bereavement follow-up.

The presence of an informal carer is often a prerequisite for successful palliative home care, and the staff's ability to support informal carers' coping in such situations is important. Recent research has revealed that it is possible to achieve positive psychological states in palliative care despite the burdening situation. As there is a lack of theory-based coping studies, the aim of this study was to describe, within the context of palliative home care, two concepts in Antonovsky's theory of Sense of Coherence: comprehensibility (a perception that the challenge is understood) and manageability (a perception that the resources to cope are available). Tape-recorded semi-structured interviews with 19 informal carers during ongoing palliative home care were transcribed and analysed with a qualitative hermeneutic approach. Elements that facilitated comprehensibility included open information, symbolic information, basic life assumptions and previous knowledge. These were important for creating a congruent inner reality (as opposed to chaos). Resources contributing to manageability dealt with power, support, competence and accessibility, which on a more abstract level resulted in a feeling of togetherness (as opposed to isolation). The findings are discussed in relation to the complexity of communication between staff and carers within palliative care.

Anna Milberg

Papers

Symptom burden in community-dwelling older people with multimorbidity: a cross-sectional study

Next of kin’s experience of powerlessness and helplessness in palliative home care

Concerns about losing control when breaking bad news to terminally ill patients with cancer: physicians' perspective.

Family members' perceived needs for bereavement follow-up.

Exploring comprehensibility and manageability in palliative home care: An interview study of dying cancer patients' informal carers