Nurses and the disabled child's perspective in the anaesthesia procedure preparation process using a picture schedule.

PURPOSE: This study's purpose was to investigate how nurses, using a picture schedule, enable or hinder the realization of disabled children's agency in the preparation for an MRI procedure carried out under general anaesthesia. METHODS: A qualitative observation study was used to explore the interaction of nurses and children. The data consisted of video recordings of 25 preparation situations of 3 (3-8 years old) children (with challenges in communication and/or cognitive skills) with 4 nurses. Verbal and nonverbal communication was analysed with interventionist applied conversation analysis. RESULTS: What was most crucial was how the picture schedule was used during the interaction. Reciprocal information sharing, responding to the child's initiatives by negotiating and allowing the child to take physical action with the picture schedule enabled the realization of the child's agency. CONCLUSIONS: The preparation process should aim to help the child prepare in his/her own way. The preparation tools should encourage reciprocal interaction in informing and in responding to the children's initiatives. The preparation practices should include enough time for the child's initiatives and physical participation. The results can be used in assessing preparation tools and how they are used from the perspective of the child's agency.

Tablet-Supported Self-Assessment in a Class for Students with Intellectual Disability.

Self-assessment has been shown to have positive effects on students' self-regulated learning strategies and academic achievement. However, self-assessment and self-assessment instruction are under-researched areas among students with intellectual disability. This data-driven qualitative study aimed at examining the self-assessment expressions students with intellectual disability documented in their learning diaries and how the teacher and teaching assistants used video recordings to facilitate students' self-assessments in one Finnish special needs education class. The naturally occurring research data consisted of both students' tablet-based learning diaries (N = 6) and video recordings of students' self-assessment situations (N = 17). The results show that students' self-assessment expressions varied from short and vague expressions to argumentative and reflective assessments. The use of video recordings served various functions, such as directing and instructing students, demonstrating assessment and providing feedback. The outcomes of this study demonstrate how the self-assessment practices of students with intellectual disabilities can be facilitated by using video.

Self-pathologizing, self-condemning, self-liberating: Youths' accounts of their ADHD-related behavior.

This study analyzes the discursive construction of attention deficit hyperactivity disorder (ADHD) and self in relation to a socioculturally shared understanding of moral norms. Thirteen Finnish youth aged 11 to 16 diagnosed with ADHD were interviewed during this discourse analysis study. The youth accounted for their culturally undesirable behavior, performance and traits through three different types of accounts: (1) externalizing personal responsibility due to a compelling medical condition, (2) internalizing personal responsibility through moral self-condemnation, and (3) distancing oneself from the socially imposed stereotypes and stigmas related to ADHD. This study challenges dominant understanding of young people with a diagnosis of ADHD and contributes to our understanding of how ADHD is constructed in their lives.

The habilitation nursing of children with developmental disabilities--beyond traditional nursing practices and principles?

Research-based descriptions of the contents of the habilitation nursing of children with developmental disabilities are lacking. The objective of this qualitative study was to describe the habilitation nursing of children with developmental disabilities in a Finnish children's neurological ward. In addition, the purpose was to outline the principles that directed the nursing functions (which consisted of various nursing interventions). The data collection included observation, a retrospective think-aloud method with video-taped nursing situations, the nursing records, and an open-ended questionnaire. The data were analysed with a qualitative content analysis of the manifest and latent content. The findings show that habilitation nursing in a children's neurological ward consists of assessing the child's skills, supporting the child's development, and collaborating with the child's immediate adults. When implementing those functions with nursing interventions, the nurses demonstrated four principles: client-originated and professional-originated principles, and individual-centred and community-centred principles. Becoming conscious of these principles and the theoretical frameworks behind them enables the development of a nursing science-based model for habilitation nursing.

Newborns with an impairment: discourses of hospital staff.

The birth of a baby with an impairment goes against dominant cultural ideals about a happy event. Therefore, the interaction between professionals and parents is particularly important, from the hospital maternity ward to the home. In this article, the author examines both the representations of neonatal impairments constructed by professionals and the consequent subject positions for these babies with impairments. The study is based on interview data collected among 19 staff members of one Finnish county hospital. The author analyzed the data by means of qualitative discourse analysis and concludes that it would be important for health care professionals to provide many-sided elements for parents to consider in the construction of the image of their baby other than traditional tragically and negatively biased cultural interpretations.