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Våld - utmaning och utmattning: vårdares utsatthet och upplevelser i samband med våld i gruppbostäder för personer med utvecklingsstörning
Umeå University, Faculty of Medicine, Department of Nursing.
2006 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

ABSTRACT

This thesis aims to explore the prevalence of violence towards caregivers working in group home for people with learning disabilities, as well as the influence of work climate and personality on the caregivers’ experiences of strain and exposure to violence. The thesis comprises four studies conducted among caregivers working in group homes for people with learning disabilities in one urban district in Sweden. Study I includes data regarding caregivers’ exposure to violence and their demographics. In study II and III data were collected by instruments for measuring caregivers’ personalities and experiences of the work climate as well as emotional reactions, strain, and experiences of burnout. Data were also collected by 50 narrative interviews with 44 caregivers reporting exposure to violence. In order to illuminate caregivers’ experiences of being exposed to violence, the interviews were transcribed and interpreted using qualitative content analysis.

The results showed that 31% of the caregivers (n=120) had been exposed to violence during the preceding year, with physical violence being the most common type. Weak relationships were found between reported exposure to violence and caregivers’ age and education (I). Among those in studies II and III who completed all instruments (n=112), 45 caregivers (40%) reported exposure to violence. A significant difference in age was found between exposed and not exposed caregivers. In the total sample of studies II and III, 30% (n=41) of the caregivers were at risk of developing burnout.

The relationship between exposure to violence and the caregivers’ experiences of the work climate (CCQ) showed that “debates” was the only factor that on average was significantly higher among caregivers reporting violence from the residents. The caregivers’ emotional reactions, strain, and work climate factors explained 35% of the variance in burnout scores (II). No significant relationships were found between the caregivers’ personalities (TCI and RSES) and their exposure to violence. Personality dimensions explained 32% of the variance of the caregivers’ experiences of burnout. The results did not show a significant relationship between a caregiver’s personality and exposure to violence. However, those exposed to violence reported more emotional exhaustion than those not exposed (III).

Caregivers exposed to violence reported feelings of powerlessness, insufficiency, anger and violence was very seldom followed by support from the managers at the group homes (I). Interviews show that caregivers’ experiences are about “falling apart” and “keeping it together”. Falling apart involves fear, powerlessness, sadness, anger, and timelessness, while keeping it together involves joy, respect, self-reflection, and habituation. Destructive experiences are balanced by a more constructive view of the situation by keeping the situation, and the caregivers themselves, together.

The findings show that exposure to violence occurs frequently and a large proportion of the exposed caregivers are at risk for burnout. It was not possible to confirm the relationships between the caregivers’ personality, experiences of the work climate, and exposure to violence but partly to emotional reactions, strain and burnout. The findings of the four studies are discussed in relation to how it is to live and work in an environment where violence is of frequent occurrence.

Abstract [sv]

SAMMANFATTNING

Avhandlingens övergripande syfte är att undersöka förekomst av våld mot vårdare som arbetar i gruppbostäder för personer med utvecklingsstörning samt arbetsklimatets och personlighetens betydelse för upplevelser av påfrestning och utsatthet för våld bland vårdare. Avhandlingen omfattar fyra delstudier utförda bland vårdare som arbetar i gruppbostäder för personer med utvecklingsstörning. I delstudie I insamlades data om vårdares utsatthet för våld och information om vårdarnas bakgrund med hjälp av en enkät. I delstudierna II och III ombads vårdarna att fylla i instrument som skattade deras personlighet, upplevelser av arbetsklimat, emotionella reaktioner, upplevelse av påfrestning samt upplevelse av utbränning. I syfte att belysa vårdares upplevelser av att vara utsatt för våld genomfördes 50 narrativa intervjuer med 44 vårdare. Intervjuerna transkriberades och tolkades med hjälp av kvalitativ innehållsanalys.

Resultaten visar att 31% av vårdarna (n=120) hade varit utsatt för våld under det föregående året och fysiskt våld var den vanligaste typen av våld. Alla kategorier av vårdare var utsatta för våld och emotionella reaktioner var vanligt förekommande. Svaga samband framkom mellan rapporterad utsatthet för våld och vårdares ålder och utbildning (I). Bland vårdare i studie II och III som besvarat alla instrument (n=112), rapporterade 45 vårdare (40%) att de utsatts för våld. En signifikant skillnad avseende ålder framkom mellan de som rapporterat våld respektive inte rapporterat våld. Bland de svarande var 30% (n=41) av vårdarna i en riskzon för utbränning (burnout).

Sambanden mellan utsatthet för våld och vårdares upplevelser av arbetsklimat (CCQ) visade att ’debates’ var den enda faktorn som var genomsnittligt högre bland de som rapporterat våld från vårdtagare. Vårdarnas emotionella reaktioner (ERNC) påfrestningsfaktorer (SNC) och arbetsklimatfaktorerna förklarade 35% av variansen i utbrändhetsvärden (II). Inget signifikant samband framkom mellan vårdares personlighet (TCI och RSES) och utsatthet för våld. Personlighetsdimensionerna förklarade 32% av variansen i vårdarnas upplevelse av utbränning (III). Resultaten visade inget signifikant samband mellan vårdares personlighet och utsatthet för våld men de som blivit utsatta för våld rapporterade mer emotionell utmattning än inte utsatta vårdare (III).

Vårdare utsatta för våld rapporterade upplevelser av maktlöshet, otillräcklighet och vrede i samband med våld. De rapporterade också att utsatthet för våld mycket sällan följdes av stöd från arbetsledare (I). Resultat från intervjuer med vårdare utsatta för våld indikerar att deras upplevelser av våld handlar om att “falla i bitar” och att “hålla ihop”. Falla i bitar innebär upplevelser av rädsla, maktlöshet, sorgsenhet, vrede och tidlöshet medan hålla ihop innebär glädje, respekt, självreflektion och tillvänjning. Destruktiva upplevelser balanseras genom en konstruktiv syn på situationen och vårdarna strävar efter att upprätthålla respekten för den boende som person och att hålla ihop situationen och sig själva (IV).

Resultaten visar att våld förekommer ofta och att en stor proportion av utsatta vårdare löper risk för utbränning. Det var inte möjligt att bekräfta samband mellan utsatthet för våld och vårdares personlighet, upplevelse av arbetsklimat, emotionella reaktioner, påfrestning samt utbränning. Resultaten diskuteras i relation till hur det är att leva och arbeta i en miljö där våld ofta förekommer.

Place, publisher, year, edition, pages
Umeå: Omvårdnad , 2006. , 60 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1031
Keyword [en]
burnout, experience, learning disabilities, caregivers, personality, self-esteem, emotional reactions, strain, violence, work climate
Keyword [sv]
arbetsklimat, gruppbostäder, känslomässiga reaktioner, personlighet
National Category
Nursing
Identifiers
URN: urn:nbn:se:umu:diva-780ISBN: 91-7264-087-1 (print)OAI: oai:DiVA.org:umu-780DiVA: diva2:144505
Public defence
2006-05-19, Aulan, Vårdvetarhuset, Umeå universitet, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2006-04-28 Created: 2006-04-28 Last updated: 2011-04-08Bibliographically approved
List of papers
1. Prevalence of violence and its relation to caregivers' demographics and emotional reactions: an explorative study of caregivers working in group homes for persons with learning disabilities.
Open this publication in new window or tab >>Prevalence of violence and its relation to caregivers' demographics and emotional reactions: an explorative study of caregivers working in group homes for persons with learning disabilities.
2007 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, Vol. 21, no 1, 84-90 p.Article in journal (Refereed) Published
Keyword
Caregivers/*psychology, Demography, Group Homes/*manpower, Humans, Learning Disorders/*nursing, Prevalence, Questionnaires, Sweden, Violence/*prevention & control
Identifiers
urn:nbn:se:umu:diva-6671 (URN)10.1111/j.1471-6712.2007.00429.x (DOI)17428219 (PubMedID)
Available from: 2007-12-20 Created: 2007-12-20 Last updated: 2009-10-12Bibliographically approved
2. Influence of work climate for experiences of strain
Open this publication in new window or tab >>Influence of work climate for experiences of strain
Show others...
2005 (English)In: Learning Disability Practice, ISSN 1465-8712, Vol. 8, no 10, 32-38 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-6760 (URN)
Available from: 2007-12-17 Created: 2007-12-17 Last updated: 2009-10-12Bibliographically approved
3. Personality impact on experiences of strain among caregivers exposed to violence in care of people with learning disabilities.
Open this publication in new window or tab >>Personality impact on experiences of strain among caregivers exposed to violence in care of people with learning disabilities.
Show others...
2007 (English)In: Journal of Policy and Practice in Intellectual Disabilities, ISSN 1741-1122, Vol. 4, no 1, 30-39 p.Article in journal (Refereed) Published
Keyword
burnout, emotional reactions, intellectual disability, personality, self-esteem, strain, violence
Identifiers
urn:nbn:se:umu:diva-6683 (URN)doi:10.1111/j.1741-1130.2006.00095.x (DOI)
Available from: 2007-12-17 Created: 2007-12-17 Last updated: 2009-10-12Bibliographically approved
4. Caregivers' experiences of exposure to violence in services for people with learning disabilities.
Open this publication in new window or tab >>Caregivers' experiences of exposure to violence in services for people with learning disabilities.
2007 (English)In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, Vol. 14, no 4, 338-45 p.Article in journal (Refereed) Published
Keyword
Anger, Caregivers, Fear, Humans, Interviews as Topic, Learning Disorders/*etiology/therapy, Power (Psychology), Tape Recording, Violence
Identifiers
urn:nbn:se:umu:diva-6864 (URN)doi:10.1111/j.1365-2850.2007.01081.x (DOI)17517024 (PubMedID)
Available from: 2007-12-20 Created: 2007-12-20 Last updated: 2011-04-08Bibliographically approved

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