Browsing by Subject "disability"
Now showing items 1-18 of 18
-
(2020)The purpose of this thesis is to study healing scenes in late ancient Roman martyr passions, the gesta martyrum. The passions have been relatively understudied until recently, and their storylines, in particular, have rarely been studied. The high incidence of miraculous healings has directed me to focus on depictions of physical, sensory and mental infirmities. The purposes their healing serves in the passions are at the centre of this study. My research questions are the following: Why are people with infirmities healed in the passions? What kind of infirmities are healed? Are there positive depictions of infirmity? To illustrate the diversity of emphases in different passions, I have studied four separate narratives, each one from a different thematic point of view. First, I focus on the relationship between healing and conversion. Secondly, I study the use of infirmities in demeaning one’s enemies. Thirdly, I study virginity and its protection by infirmity and its removal. In my final chapter, I discuss if it is possible to see the bodies of martyrs as infirm bodies. I use theories and concepts from disability studies are used to study the representations and uses of infirm bodies in the narratives. David T. Mitchell and Sharon L. Snyder’s narrative prosthesis calls attention to the narrative’s exploitation of disabled bodies to pursue abstract goals. Anna Rebecca Solevåg’s concept of disability invective focuses on the use of disability as an accusation. Crip theory will offer tools to discuss inclusive portrayals of infirmity and whether or not these can be found in the passions. The results of the study show that infirm bodies were valuable tools which are used for multiple, partly overlapping goals. Healings promote saints, attract converts, and ridicule the enemies of the Christians. Infirmity is particularly often related to ideas of masculinity which accusations and inflictions of infirmity effectively weaken. A specific infirmity is chosen to be healed because its connotations are useful in pursuit of specific narrative goals. The healing usually aims at the future, as the passions emphasise the newly healed person’s future life as a non-infirm Christian. Infirm bodies are easily instrumentalised because in the logic of the passions, their existence contains an objective for change. An infirm body is always seen in need of eventual healing – if not in this world then in the afterlife. The ways the passions use infirmity marginalise it into something that mostly exists to prove a point. Similar problems can be encountered even today when people with infirmities hear or read narratives containing similar tones. The use of bodies with infirmities stands out for its flexibility and unexpected versatility and calls for further study.
-
(2019)Disability imposes personal suffering but also economic consequences for individuals, employers, and the society. Finding an optimal method for disability prevention can be considered beneficial and increasingly important for a country with a prominent public sector and a weakening labor force participation rate like Finland. Previous studies show evidence of the effectiveness of worksite health promotion programs that target care for employees who face a high risk for disability. Evidence shows positive cost-effectiveness of targeted occupational health interventions in preventing short-term disability but a wider benefit-cost analysis of targeted occupational health interventions with a view on both short-term and long-term disability prevention has not previously been conducted. This study untangles the treatment effect of targeted occupational health interventions on societal net benefits resulted from disability prevention. Short-term disability as a concept is viewed through sickness absence, and long-term disability is represented by the disability benefits granted by the Finnish disability benefit system. The costs of disability preventing actions are limited to health care utilization. The research setting of this study has been observational, and the empirical analysis is conducted as a retrospective review of prospectively collected register data. The data registers cover health and disability related information of over 20,000 employees in Finland. In the main analysis, 1,679 treated employees identified with a high risk for disability are compared to 2,107 untreated high-risk employees. The benefit-cost analysis is constructed with the Average Treatment Effect framework combined with Net Benefits framework. The treatment of the framework of this study is an attendance to a targeted, pre-planned health check after an occupational health survey. The outcome of the framework is the net benefits that result from prevention of sickness absence workdays and granted disability benefits, and the investment costs resulted from health care utilization. The results are formed with Analysis of Covariance. Other methods to conduct the empirical analysis include polynomial regression, Multiple Imputation of Chained Equations, Propensity Scores, and Inverse Probability Weighting. The results of this study show that targeted occupational health interventions are likely to impose positive net benefits to the society. The Average Treatment Effect on the net benefits of high-risk employees, 1,875 euros with a 95% confidence interval from -759 to 4,509 euros (p-value: .155) (ANCOVA), can be considered worthwhile to the society. In the research setting, the net benefits were in practice gained from the prevention of long-term disability. The treatment was not effective on the costs of short-term disability or the total health care utilization costs per employee. Sensitivity analyses indicate that targeted occupational health interventions are not on average effective when predicted to employees without a disability risk.
-
(2019)Työkyvyttömyydestä koituu paitsi kärsimystä myös taloudellisia seurauksia yksilöille, työnantajille ja yhteiskunnalle. Työkyvyttömyyden ehkäisyä voi pitää erityisen merkityksellisenä ja hyödyllisenä Suomen kaltaiselle maalle, jonka haasteisiin sisältyy merkittävän julkisen sektorin ylläpito laskevassa työvoiman osallistumisasteessa. Aiemmat tutkimukset osoittavat, että terveyden edistämistä tukevat ohjelmat työpaikoilla voivat ehkäistä työkyvyttömyyttä kohdistettuina työkyvyttömyysriskissä oleville henkilöille. Kohdistetuista työterveysinterventioista on voitu aiemmin osoittaa positiivista kustannusvaikuttavuutta lyhytaikaiseen työkyvyttömyyteen. Laajempaa hyöty-kustannus-analyysiä ei kohdistetuista työterveysinterventioista ole kuitenkaan aiemmin tehty, eikä kohdistettuja työterveysinterventioita ole aiemmin tarkasteltu samanaikaisesti sekä lyhyt- että pitkäaikaisen työkyvyttömyyden näkökulmista. Tässä tutkimuksessa tarkastellaan kohdistettujen työterveysinterventioiden vaikutusta työkyvyttömyyden ehkäisystä muodostuviin yhteiskunnallisiin nettohyötyihin. Lyhytaikaista työkyvyttömyyttä tarkastellaan sairauspoissaolojen avulla, ja pitkäaikaista työkyvyttömyyttä edustavat työkyvyttömyysjärjestelmän työkyvyttömyysetuudet. Työkyvyttömyyden ehkäisyn toimenpiteet ja kustannukset on rajattu tutkimuksessa terveydenhuollon palvelujen käyttöön. Tutkimus on seurantatutkimus, ja empiirinen analyysi muodostetaan retrospektiivisenä tarkasteluna prospektiivisesti kerätystä rekisteriaineistosta. Aineisto käsittää terveys- ja työkyvyttömyystietoja yli 20 000 työntekijältä Suomessa. Pääanalyysissa 1 679 hoidettua työntekijää, joille on tunnistettu korkea työkyvyttömyysriski, verrataan 2 107 hoitamattomaan korkean riskin työntekijään. Hyöty-kustannus-analyysissä yhdistetään keskimääräisen hoitovaikutuksen (Average Treatment Effect) ja nettohyötyjen (Net Benefits) viitekehykset. Tulokset muodostetaan kovarianssianalyysillä (ANCOVA). Muita työssä hyödynnettäviä menetelmiä ovat polynomiregressio, MICE-moni-imputointialgoritmi (Multiple Imputation of Chained Equations), propensiteettipisteytys (Propensity Score), ja Inverse Probability Weighting -painotusmenetelmä. Tutkimuksen tulokset osoittavat, että kohdistettujen työterveysinterventioiden yhteiskunnallinen vaikutus on todennäköisesti positiivinen: keskimääräinen hoitovaikutus nettohyötyihin korkean riskin työntekijää kohden, 1 875 euroa ja tämän 95 prosentin luottamusväli -759 eurosta 4 509 euroon (p-arvo: 0,155) (ANCOVA) osoittavat, että kohdistettuja työterveysinterventioita voi pitää keskimäärin yhteiskunnallisesti kannattavina. Tutkimusasetelmassa muodostuneet nettohyödyt olivat käytännössä täysin peräisin pitkäaikaisen työkyvyttömyyden ehkäisystä. Interventiolla ei ollut vaikutusta lyhytaikaisen työkyvyttömyyden kustannuksiin tai käytettyjen terveydenhuollon palvelujen kustannuksiin. Herkkyysanalyysi osoittaa, että kohdistetut työterveysinterventiot eivät ole keskimäärin vaikuttavia, kun ne kohdistetaan työntekijöille, joille ei ole tunnistettu työkyvyttömyysriskiä.
-
(2011)Objectives. The thesis objective was to analyze how person-centred planning is applied to develop short term care in interaction between the disabled children, their families and the workers of the family service centre of Eteva Järvenpää. The thesis contributes to developing the methods of person-centred planning. I applied theoretical frameworks of activity theory and developmental work research, family-based work framework and disability phenomenon. The research questions were: What development needs did the families of disabled children have for the services? How were viewpoints of disabled children, their families and Eteva workers noticed in person-centred planning in the interaction between the disabled children, their families and Eteva workers? What disturbances and development challenges emerged during the person-centred planning? Methods. I first analysed the local history of the disability sector and the short term care to analyse challenges arising from the local history. The actual research material consisted of interviews with four families, two person-centred planning discussions and two discussions where the person-centred planning was reflected by the families.I used interaction voice analysis as defined by the activity theory and developmental work research. From the recorded interviews and discussions I analysed scripts, disturbances, innovation attempts and innovations. From the discussions I analysed also the interaction types (cooperation, coordination and communication). Results and conclusions. As problems, the families considered the scarce resources and the inflexibility of services. The challenges of developing the short term care were how to transfer information from short term care to home, how to develop activities for the children and how to take into account the individual needs of the children in the short term care. Both from the local history analysis and from the family interviews arised the conflict between caring and fulfilling the individual needs. In person-centred planning, the voice of the child was either interpreted by other family members or guided by family members or workers. I modelled the progress of person-centred planning in a two-dimensional coordination. Person-centred planning should be deepened in cooperation between the child, the family and the workers in everyday situations at home and during the short term care. The challenge is to expand person-centred planning to become cross-organizational cooperation connecting the actors of the child's service network in everyday life.
-
(2014)Objectives of the study: Multidiscipline knowledge is needed in evaluation of person's functional capacity in work: physical and psychosocial factors must be considered. Generic models and tools are needed to provide common practices to evaluate work-ability (or demands of the work) and to understand the relevance of multifaceted factors underneath. Reflective processing of one's own knowledge and intuitions is seen to improve a person's ability to understand the relevance of unfamiliar information and to achieve a higher cognitive congruence in a multi-professional group. That can be achieved through group-learning practices. In a current research effect of IMBA- methods training is studied. It is assumed that training will increase the cognitive congruence between professionals evaluating work-ability. Methods: Three training groups were arranged in 2005. 51 professionals of vocational rehabilitation participated (43 women and 8 men). They evaluated both the functional capacities of a person and the demands of work before and after their IMBA-training. Evaluations were done on the basis of written case-information. The data of these evaluation tasks is data of this study. Both independent samples and repeated measures settings was used. The effect of training is analyzed as a measure of absolute agreement indexes (ICC and rrg) Results and conclusions: The results agreed with the hypothesis: After IMBA training the level of absolute agreement was higher in evaluating both the demands of work and the functional capacities of a person. Differences between training groups, features of the task or familiarity of the material didn't seem to influence the effect. Agreement got higher in evaluating physical and psychosocial factors of workability. The effect was very systematic. The evaluations were more congruent after training even though the effect was not strong enough to reach statistical significance with these samples. What was surprising was that demands of work were systematically evaluated lower after training as the functional capacities of persons were evaluated the same or a little higher after the training. Interesting question is: Do the professionals overestimate the demands of the work in general when making evaluations based on their intuitive thinking? If that's the case, the customers of vocational rehabilitation are seen as more disabled compared to demands the work than they are in real. The possibility of a systematic error like this in evaluating workability must be studied more in the future.
-
(2019)Disability and poverty are tightly interlinked, but disability inclusion often remains on the sidelines of poverty reduction programmes. Abilis Foundation supports organisations of persons with disabilities in developing countries, and income generation and poverty reduction projects are one of its key thematic areas. The objective of this study, commissioned by Abilis Foundation, is to evaluate the effectiveness and sustainability of Abilis funded income generation projects in Sierra Leone, and to identify the factors influencing the livelihoods of persons with disabilities in Sierra Leone. The primary data consists of semi-structured interviews and a focus group discussion with adult persons with disabilities who had participated in Abilis funded income generation projects between 2015–2018. Discussions with other relevant informants and data from the project documents were included in the analysis to strengthen the validity of the results. The analysis follows qualitative content analysis principles. All income generating activities supported in the sample projects were still on-going during the time of study, even though most businesses continued to be very small-scale. The results indicate that limited financial assets (resulting in, inter alia, lack of equipment and materials) and strong competition restrain persons with disabilities from expanding their businesses. Social assets and education support their livelihood opportunities but are only useful when other factors enable people to draw on their social and human assets as well. Widespread poverty affects all aspects of life in Sierra Leone, and persons with disabilities are even more vulnerable because they are often socially marginalized and face widespread discrimination that restrains their access to assets and restricts their participation in economic activities, decision-making, and social life in general. It is essential to consider context-specific local characteristics, target beneficiaries, and market dynamics when planning poverty reduction programmes and livelihood activities. Successful poverty reduction efforts must consider aspects beyond mere income generation. Key elements for successful poverty reduction and livelihood programmes include enhancing the opportunities of persons with disabilities to adopt diverse livelihood strategies, empowerment of persons with disabilities to have their voices heard and to gain control in their own lives, and promoting security and appropriate coping mechanisms to reduce vulnerability and to increase their resilience.
-
(2019)Disability and poverty are tightly interlinked, but disability inclusion often remains on the sidelines of poverty reduction programmes. Abilis Foundation supports organisations of persons with disabilities in developing countries, and income generation and poverty reduction projects are one of its key thematic areas. The objective of this study, commissioned by Abilis Foundation, is to evaluate the effectiveness and sustainability of Abilis funded income generation projects in Sierra Leone, and to identify the factors influencing the livelihoods of persons with disabilities in Sierra Leone. The primary data consists of semi-structured interviews and a focus group discussion with adult persons with disabilities who had participated in Abilis funded income generation projects between 2015–2018. Discussions with other relevant informants and data from the project documents were included in the analysis to strengthen the validity of the results. The analysis follows qualitative content analysis principles. All income generating activities supported in the sample projects were still on-going during the time of study, even though most businesses continued to be very small-scale. The results indicate that limited financial assets (resulting in, inter alia, lack of equipment and materials) and strong competition restrain persons with disabilities from expanding their businesses. Social assets and education support their livelihood opportunities but are only useful when other factors enable people to draw on their social and human assets as well. Widespread poverty affects all aspects of life in Sierra Leone, and persons with disabilities are even more vulnerable because they are often socially marginalized and face widespread discrimination that restrains their access to assets and restricts their participation in economic activities, decision-making, and social life in general. It is essential to consider context-specific local characteristics, target beneficiaries, and market dynamics when planning poverty reduction programmes and livelihood activities. Successful poverty reduction efforts must consider aspects beyond mere income generation. Key elements for successful poverty reduction and livelihood programmes include enhancing the opportunities of persons with disabilities to adopt diverse livelihood strategies, empowerment of persons with disabilities to have their voices heard and to gain control in their own lives, and promoting security and appropriate coping mechanisms to reduce vulnerability and to increase their resilience.
-
(2013)My master's thesis is a study of citizenship and its ideals in disability policy from the perspective of critical ability studies. The main focus of ability studies is to analyze ableism and how it produces ideals of perfect humanness. Therefore, from the perspective of ableism these ideals produce disability and impairments as something intolerable as well as inherently and ontologically negative. My study focused on the disability policy paradigm as it is after the convention on the rights of persons with disabilities from the year 2006. The disability policy paradigm emphasizes both the rights of people with disabilities to full citizenship and their participation in society. The study data included 20 documents from European, national and municipal disability policies, released from 2006 onwards. In this study I explored how ableism defines the construction of full citizenship and how ableism affects individual's possibilities to participate as citizen according to the current disability policy. As my research method, I applied interpretative reading style based on the New Rhetoric. In the current disability policy paradigm the ideal of full citizenship is based on individualistic and neoliberalistic views, which emphasize self-mastery and independence. This ideal is impossible for people with disabilities because self-mastery and independence are defined as autonomy from other people and social services. Moreover, falling short from the ideal is located in ontologically negative space. Subsequently the bodies with impairments are always seen as imperfect and defective as well as economically burdening. Emphasizing the physical imperfectness of individuals defines their possibilities to participate in society because this participation is emulating the ideal. Also, the individuals with disabilities are forced to repeat their imperfectness in order to obtain social services, which enable participation. Ontological discrimination of people with disabilities is evident in the disability policy, even though it contradicts the aims of the policy.
-
(2011)The aim of this study was to examine accessibility in folk high schools from the perspective of students with disabilities or learning difficulties. Accessibility in education means that psychological, sociological and physical environment enables equal study opportunities. Therefore the focus in this survey was on equal study opportunity deficiencies. Folk high schools are an essential subject for accessibility research as they follow the equal educational policy of liberal adult education. This study is a part of Liberal adult education -research project (2010-2012), which is the first accessibility research in Finnish liberal adult education. The equality-based claim of accessibility together with the need to separate the experiences of students with disabilities and learning difficulties from common experiences led naturally to comparative research frame. Firstly, experiences of the experimental group (students with disabilities or learning difficulties, N=278) were compared to experiences of the comparison group (students representing the educational majority, N=498). Secondly, experiences within the experimental group were examined according to gender, need of support and educational background. This study was mostly quantitative survey study. Data was collected from folk high school students with an inquiry created for this study. Data-analysis was mainly made by using analysis of variance (GLM) and test of Kruskal-Wallis. Qualitative data was analysed as an additional element by quantification. Equal study opportunity deficiencies were found in teaching and studying, other people's awareness and attitudes, own attitudes, information and peer group, where the experimental group found significantly more accessibility deficiencies than the comparison group. The most considerable difference was found in teaching and studying, wherein also the quality of deficiencies was explained differently between the groups. Within the experimental group women experienced more accessibility deficiencies than men. Also regular and great need of support and low educational background were connected with the experience of greater accessibility deficiencies. As a conclusion it seems that the equality-based accessibility in folk high schools could be improved especially by differentiating teaching and learning. This study also proved general need for more exact definition of the intention of accessibility: is the priority to develop common quality or equality of education, and is the aim to remove the barriers or advance support to overcome them.
-
(2021)Abstract Background: Pain is known to be socio-economically patterned and associated with disability. However, knowledge is scarce concerning life-course socio-economic circumstances and pain among young adults. Our aim was to examine the associations of childhood and current socio-economic circumstances with acute pain and chronic pain with low and high disability levels among young Finnish municipal employees. Methods: We analyzed questionnaire data retrieved from the Young Helsinki Health Study (n=4683) covering 18–39-year-old employees of the City of Helsinki, Finland. We included a comprehensive set of indicators of childhood and current socio-economic circumstances and examined their associations with acute pain and with chronic pain with low and high disability levels. The level of chronic pain–related disability was assessed by the Chronic Pain Grade Questionnaire. Multinomial logistic regression analyses were conducted with stepwise adjustments for socio-demographic, socio-economic and health-related covariates. Results: Childhood and current socio-economic disadvantage were associated with acute and chronic pain, particularly with chronic pain with high disability level. The strongest associations after adjustments for covariates remained between chronic pain with high disability level and low education level (OR 3.38, 95% CI 2.18–5.24), manual occupation (OR 3.75, 95% CI 1.92–7.34) and experiencing frequent economic difficulties (OR 3.07, 95% CI 2.00–4.70). Conclusions: Pain is highly prevalent already among young employees and there is a socio-economic gradient in both pain chronicity and chronic pain–related disability. Life-course socio-economic determinants of pain should be considered in pain-preventing strategies and in clinical practice.
-
(2021)Abstract Background: Pain is known to be socio-economically patterned and associated with disability. However, knowledge is scarce concerning life-course socio-economic circumstances and pain among young adults. Our aim was to examine the associations of childhood and current socio-economic circumstances with acute pain and chronic pain with low and high disability levels among young Finnish municipal employees. Methods: We analyzed questionnaire data retrieved from the Young Helsinki Health Study (n=4683) covering 18–39-year-old employees of the City of Helsinki, Finland. We included a comprehensive set of indicators of childhood and current socio-economic circumstances and examined their associations with acute pain and with chronic pain with low and high disability levels. The level of chronic pain–related disability was assessed by the Chronic Pain Grade Questionnaire. Multinomial logistic regression analyses were conducted with stepwise adjustments for socio-demographic, socio-economic and health-related covariates. Results: Childhood and current socio-economic disadvantage were associated with acute and chronic pain, particularly with chronic pain with high disability level. The strongest associations after adjustments for covariates remained between chronic pain with high disability level and low education level (OR 3.38, 95% CI 2.18–5.24), manual occupation (OR 3.75, 95% CI 1.92–7.34) and experiencing frequent economic difficulties (OR 3.07, 95% CI 2.00–4.70). Conclusions: Pain is highly prevalent already among young employees and there is a socio-economic gradient in both pain chronicity and chronic pain–related disability. Life-course socio-economic determinants of pain should be considered in pain-preventing strategies and in clinical practice.
-
(2018)This Master’s thesis concerns the self-making practices of persons with physical disabilities in Zambia. The thesis is grounded in data gathered across three months of fieldwork conducted mostly in Lusaka, the capital of Zambia. The bulk of these data consists of semi-structured interviews with individuals who were long-time users of mobility aids, namely orthopaedic prostheses and braces, crutches and wheelchairs. The study aims to contribute to broadening the available literature on the subjective experiences of disability, literature that has so far been sparse and disproportionately focused on Europe and North America. In this study, the task of self-making is approached through Michel Foucault’s concept of ‘technologies of the self’. Dissonant scholarship on ‘practices of freedom’ – technologies of the self that are applied with critical reflection – is examined to construct a workable synthesis. The resultant theoretical construction is then applied to the technologies used by Zambian persons with disabilities to determine whether these may be called practices of freedom. The common assertion in much of the Foucauldian scholarship that practices of freedom lead individuals to practice power in a manner that advances social equality is also interrogated in light of the present study. The study divides the examined technologies of the self into two groups; those that take as their object the physical being in the world of the individual with disabilities, and those that focus on addressing the narratives – both external and internalised – concerning disability and the individual. Technologies of the former kind examined include the management of one’s apparent level of impairment through the selective use and concealment of assistive devices; the incorporation of one’s mobility aids into the body-image; autonomous movement; and the refusal of help. Technologies in the latter category include accepting disability; challenging preconceptions of inability through example; engaging with others to sensitise them to disability; and self-narration that emphasises capability, mobility, financial stability and universal relevance of impairment. This thesis argues that dominant local discourse in Zambia still necessitates persons with disabilities to acquire first the capacity to question the prevailing norms surrounding themselves in order to achieve the kind of autonomy exhibited by the informants in the study. In accordance with the constructed theoretical synthesis, this critical awareness qualifies the technologies of the self utilised by the informants as practices of freedom. On the basis of its modest scope, the study gives conditional backing to the idea that practices of freedom create individuals that contribute to processes of social liberation. It is also noted, however, that technologies that may be considered practices of freedom in the context of disability may simultaneously work to reinforce other oppressive power relationships, such as those concerning gender, and that more research is needed on the intersection of disability with other marginalised identities in order to better understand these connections. In the meanwhile, the study encourages researchers to take care to respect the freedom of their subjects to not advance transformative social agendas with their every action.
-
(2018)This Master’s thesis concerns the self-making practices of persons with physical disabilities in Zambia. The thesis is grounded in data gathered across three months of fieldwork conducted mostly in Lusaka, the capital of Zambia. The bulk of these data consists of semi-structured interviews with individuals who were long-time users of mobility aids, namely orthopaedic prostheses and braces, crutches and wheelchairs. The study aims to contribute to broadening the available literature on the subjective experiences of disability, literature that has so far been sparse and disproportionately focused on Europe and North America. In this study, the task of self-making is approached through Michel Foucault’s concept of ‘technologies of the self’. Dissonant scholarship on ‘practices of freedom’ – technologies of the self that are applied with critical reflection – is examined to construct a workable synthesis. The resultant theoretical construction is then applied to the technologies used by Zambian persons with disabilities to determine whether these may be called practices of freedom. The common assertion in much of the Foucauldian scholarship that practices of freedom lead individuals to practice power in a manner that advances social equality is also interrogated in light of the present study. The study divides the examined technologies of the self into two groups; those that take as their object the physical being in the world of the individual with disabilities, and those that focus on addressing the narratives – both external and internalised – concerning disability and the individual. Technologies of the former kind examined include the management of one’s apparent level of impairment through the selective use and concealment of assistive devices; the incorporation of one’s mobility aids into the body-image; autonomous movement; and the refusal of help. Technologies in the latter category include accepting disability; challenging preconceptions of inability through example; engaging with others to sensitise them to disability; and self-narration that emphasises capability, mobility, financial stability and universal relevance of impairment. This thesis argues that dominant local discourse in Zambia still necessitates persons with disabilities to acquire first the capacity to question the prevailing norms surrounding themselves in order to achieve the kind of autonomy exhibited by the informants in the study. In accordance with the constructed theoretical synthesis, this critical awareness qualifies the technologies of the self utilised by the informants as practices of freedom. On the basis of its modest scope, the study gives conditional backing to the idea that practices of freedom create individuals that contribute to processes of social liberation. It is also noted, however, that technologies that may be considered practices of freedom in the context of disability may simultaneously work to reinforce other oppressive power relationships, such as those concerning gender, and that more research is needed on the intersection of disability with other marginalised identities in order to better understand these connections. In the meanwhile, the study encourages researchers to take care to respect the freedom of their subjects to not advance transformative social agendas with their every action.
-
(2015)Aims: Public health care in Finland has the main responsibility of rehabilitation, which means that public health care has to provide for persons with the severe disabilities the therapy or the rehabilitation needed. If a person fulfills the criteria of having severe disablity he is admitted Disability Allowance at its middle or highest rate. This is required for getting medical rehabilitation for persons with severe disabilities, which in Finland is financed by KELA. The speech therapy for the severely disabled organized by KELA is mainly carried out by private sector. There were approximately 500 private speech therapists under the contract of KELA during 2011-2014. Altogether 7439 persons were receiving speech therapy by KELA in 2014. The speech therapists under the contract of KELA are divided somewhat unevenly in Finland, therefore the availability of speech therapy is not equal in the whole land. Particularly areas with less inhabitants seem to suffer from inequality. The UN Convention on the Rights of Persons with Disabilities in 3.5.2008 was aimed at guaranteeing equal human rights to disabled people and to promote and support their human value. Methods: This Master's thesis looks at the availability of speech therapy in Finland both quantitatively based on open statistics by KELA and qualitatively on the nature of positive and negative decisions in the Medical District of Kanta-Häme. Results and Conclusions: The availability of speech therapy for persons with severe disabilities is not by KELAs statistics fully equal in Finland. The uneven division of speech therapists has lead to the fact that there are for example, at the insurance district of Oulu considerably more speech therapists than at the insurance district of Satakunta.The speech therapists under contract of KELA are like many other highly educated people situated close by the universities and other schooling areas, By U.N agreement the persons with disabilities should have rehabilitation near where they live and timing it optimally.The severity of language impairment was the main reason in positive decisions in the Medical District of Kanta-Häme and the insufficiency of arguments in the negative ones, which seem to refer to the fact that there, with an adequate application, speech therapy is guaranteed for the persons with most severe disabilities. One of the aims of the future social welfare and health care reform is to improve the availability of speech therapy in Finland. It remains to be seen how successfully it will answer the growing need.
-
(2016)Previous studies have examined quality of life among people with traumatic brain injury (TBI) using quantitative measures and/or structured questionnaires. Recently some studies have focused on the patient's own perception of TBI and used the International Classification of Functioning, Disabilities and Health (ICF) framework to examine quality of life from a wider perspective of functioning. The aim of this study was to examine: What kind of occasions do the participants report as the happiest or unhappiest after TBI, and how are these related to the life areas within the ICF framework. An additional aim was to examine how are these life areas, as well as demographics variables, injury severity, and emotional state associated with the individuals' quality of life. A total of 233 Finnish persons with TBI participated in the Wave 1 of the international QOLIBRI (Quality of Life after Brain Injury) validation study in 2004—2006. The individuals' own descriptions about the happiest/unhappiest occasions were linked to the most precise ICF categories. Correlation and regression analysis were used to examine the association with demographic variables, injury related variable, emotional state, most frequently reported life areas and perceived quality of life. The most frequently reported life areas for both happy and unhappy occasions were Interpersonal interactions and relationships, followed by Community, social and civic life in happy occasions, and Mental functions and Services, systems and policies in both happy and unhappy occasions. Regression analysis showed that younger age, longer post-traumatic amnesia, fewer symptoms of anxiety and depression, happy occasion related Mental functions and Community, civic and social life, and not reporting an unhappy occasion related to Mental functions, yet reporting unhappy occasions related to Interpersonal interactions and relationships, were associated with higher perceived quality of life. The results of this study are in line with previous studies that have shown emotional state, age, and injury severity as factors relevant to quality of life after TBI. Additionally, this study informs clinicians about the life areas that individuals with TBI themselves experience as most relevant to their quality of life. From the individuals' perspective, rehabilitation should focus on supporting social relationships, participation in community activities, using services and helping the persons to cope with the demands of the environment. Furthermore, individuals need emotional support to adapt to their new life situation.
-
(2020)Migraine was ranked as the second largest cause of disability in 2016 in the Global Burden of Disease (GBD) study. People with migraine have a greater disability and a lower health-related quality of life than those of the general population. Many migraine patients experience functional and emotional impairment due to their disease. Migraine can limit their daily activities and impact their private, professional and social life. Migraine affects the patient also in between the attacks and can impact their education, career and their family and loved ones. Comorbid diseases and failed treatment lines add to the burden of migraine. Furthermore, migraine also imposes an economic burden. Stigma is described as the hidden burden of disease. Chronic migraine patients have been found to have higher stigma than episodic migraine patients. Even though migraine is one of the most common disabling headache disorders, it is still both under-recognised, under-diagnosed and under-treated. The objectives of this study were to determine the extent of the burden and the stigma of migraine in adult Finnish migraine patients. This study aimed to produce comprehensive and current information about migraine and its severity in Finland, highlighting the burden it poses on the migraine patients as well as on society. Migraine is most prevalent among the working aged population, which increases the societal burden of the disease. This study was conducted as a cross-sectional electronic survey amongst adult Finnish migraine patients. The participants were contacted through the Finnish Migraine Patient Advocacy Group. The questionnaire consisted of the already existing and validated Migraine Disability Assessment (MIDAS) Questionnaire and of measures developed by the author. The final data consisted of 608 responses. Of all respondents with 8 or more headache days a month, over 90% were categorised in the severe disability group (MIDAS grade IV), thus having similar disability to those with 15 or more headache days a month (i.e. respondents with probable chronic migraine). The proportion of respondents with severe disability (MIDAS grade IV) was greater in the present study (65.0%) than in a study conducted in Finland in 2000 (47%), indicating that migraine disability in Finland might have become more severe during the past two decades. The mean level of headache pain in the present study was 6.2 (on a scale of 0-10) and pain was the aspect that most respondents viewed as the worst aspect of migraine. This highlights the importance of proper pain management in migraine care. Many of the respondents were also at risk for medication overuse, which highlights the importance of monitoring medication use and informing the patients about possible risks. Stress was reported as the most common migraine trigger, and reducing stress at the workplace was also reported as the most important way of how migraine could better be managed at the workplace. Almost half (44.4%) of all respondents felt stigmatised due to their migraine. Reasons for this stigma and suggested solutions on how to reduce/manage the stigma were quite similar. The ignorance of others was the most reported reason for their migraine stigma, and increasing awareness and correct information about migraine was the most reported way of reducing the stigma. Many of the respondents had faced, due to their migraine, belittlement at work, from family and friend and from healthcare professionals. Facing belittlement from healthcare professionals was reported to have happened often by 11.5% and sometimes by 34.7% of all respondents. Of all respondents, 55.6% worried often and 29.8% worried sometimes about the onset of the next migraine attack. The majority of the respondents had severe disability based on their MIDAS grades. Many other aspect of the burden were reported as well, inculding stigma, reported by almost half of the respondents. Further and future studies need to be conducted to get an even better understanding of the burden and stigma of migraine experienced by adult Finnish migraine patients. This includes further and more intricate quantitative and qualitative analyses of the data from this study, as´well as studies with new perspectives based on the results found in this study.
-
(2022)This thesis discusses various depictions of women’s mental illness and disability in Roman Stoic philosophy, historiography, medical texts, and legislation. The aim of this thesis is to show how mentally ill and disabled women are portrayed in the Roman prose and how healthy women are associated with the masculine ideals. The Roman medicine based itself on a long Greek tradition and native cultural influences and traditions. This synthesis created a medical field in which women are treated as anomalies and as inferior to men. This thinking is reflected in the Roman philosophy, jurisdiction, and historiography as well; women are described as absent-minded and childlike, or uncontrollable, emotional, and even insane. Women’s illness and disability are often used as moral examples in prose. This research aims to show an aspect of illness and disability in Rome that is rarely discussed and less well-known. Male illness and disability are often referred to in Roman literature; it is important to also shed light on the female experience. Lately, disability has become a more popular topic in the research of Antiquity, and so has the focus on marginalised groups such as women, children, and the elderly. The Roman concept of virtue, virtus, that fundamentally defined Roman health, is associated with men and masculinity in the original texts. Thus, an essential viewpoint to women’s illness and disability in this thesis is the concept of virtus. The research is based on the primary sources and research literature that consisted of research on women, disability, mental illness, and health in the Roman context. Methods of various fields were applied, from close reading and narrative analysis to the methods of historical research. The main results of this research show that women existed in a grey zone legally and medically. Philosophy offers a depiction of a perfect and an ideal Roman woman. This character hardly existed in reality, but the virtuous ideal is often contrasted with the unvirtuous, even wicked women of the Roman historiography. The evidence lies in the primary sources that describe healthy and ill women in different contexts. This thesis concludes that mentally ill and disabled women existed in the Roman prose and they were recognised in multiple ways; their professions, backgrounds, treatment, and legal rights are discussed in multiple sources. This information is scattered, vague, and often influenced by the personal opinions of the authors. Mentally ill and disabled women were considered different from healthy women but neither group is considered capable of achieving virtues inherent to men and masculinity in the primary sources. Healthy women could theoretically achieve virtue but in reality, women existed outside the Roman understanding of virtuous health.
-
(2022)This thesis discusses various depictions of women’s mental illness and disability in Roman Stoic philosophy, historiography, medical texts, and legislation. The aim of this thesis is to show how mentally ill and disabled women are portrayed in the Roman prose and how healthy women are associated with the masculine ideals. The Roman medicine based itself on a long Greek tradition and native cultural influences and traditions. This synthesis created a medical field in which women are treated as anomalies and as inferior to men. This thinking is reflected in the Roman philosophy, jurisdiction, and historiography as well; women are described as absent-minded and childlike, or uncontrollable, emotional, and even insane. Women’s illness and disability are often used as moral examples in prose. This research aims to show an aspect of illness and disability in Rome that is rarely discussed and less well-known. Male illness and disability are often referred to in Roman literature; it is important to also shed light on the female experience. Lately, disability has become a more popular topic in the research of Antiquity, and so has the focus on marginalised groups such as women, children, and the elderly. The Roman concept of virtue, virtus, that fundamentally defined Roman health, is associated with men and masculinity in the original texts. Thus, an essential viewpoint to women’s illness and disability in this thesis is the concept of virtus. The research is based on the primary sources and research literature that consisted of research on women, disability, mental illness, and health in the Roman context. Methods of various fields were applied, from close reading and narrative analysis to the methods of historical research. The main results of this research show that women existed in a grey zone legally and medically. Philosophy offers a depiction of a perfect and an ideal Roman woman. This character hardly existed in reality, but the virtuous ideal is often contrasted with the unvirtuous, even wicked women of the Roman historiography. The evidence lies in the primary sources that describe healthy and ill women in different contexts. This thesis concludes that mentally ill and disabled women existed in the Roman prose and they were recognised in multiple ways; their professions, backgrounds, treatment, and legal rights are discussed in multiple sources. This information is scattered, vague, and often influenced by the personal opinions of the authors. Mentally ill and disabled women were considered different from healthy women but neither group is considered capable of achieving virtues inherent to men and masculinity in the primary sources. Healthy women could theoretically achieve virtue but in reality, women existed outside the Roman understanding of virtuous health.
Now showing items 1-18 of 18