Dalarna University's logo and link to the university's website

Background: Childhood cancer impacts the whole family system and has psychosocial consequences for all family members. Although many families adapt over time, a considerable proportion report unmet psychosocial needs and a lack of support. Despite recommendations for family-centred psychosocial interventions, few have been scientifically evaluated for families affected by childhood cancer. There is, therefore, an urgent need for evidence regarding the use of such interventions in paediatric oncology in order to understand what constitutes successful support.

Overall aim: To explore the potential effects and experiences of a psychosocial support intervention, the Family Talk Intervention (FTI), among families affected by childhood cancer, involving also the content and issues raised. 

Methods: This thesis comprises four papers (I-IV) using both qualitative and quantitative methods. Papers I-III are based on a pilot study of FTI, performed at one paediatric oncology centre in Sweden, using a mixed methods pretest/post-test design. In Paper I, parents’ perspectives regarding the potential effects of FTI were explored through web-based questionnaires and interviews. In Paper II, fieldnotes documented by hospital social workers were used to explore the content and issues raised during FTI. In Paper III, child interviews were conducted to explore how children with cancer and their sibling’s experienced participation in FTI. Paper IV applied a qualitative descriptive design to explore migrant families’ experiences of FTI, using interviews with all family members.

Results: The overall results showed that the use of FTI had the ability to improve family communication and relationships, thus strengthening family togetherness. FTI provided a space where all family members could raise their concerns and psychosocial needs in relation to their current life situation. It also promoted child participation by providing the children with a safe space where they could express themselves freely, allowing their voices to be heard and strengthening their involvement. Among the migrant families, the use of FTI was found to increase family stability by alleviating their urgent psychosocial burdens. 

Conclusions: This thesis strengthens the evidence for FTI as a promising psychosocial support intervention in paediatric oncology. The use of FTI provides a structured, yet flexible, way to support families in adjusting to the challenges related to the child’s illness and its impact on the family system. By supporting the family as a whole, FTI has the potential to improve family communication and relationships, and foster resilience. This represents an important step forward in promoting evidence-based psychosocial care in paediatric oncology.

Traditional forms of written text, such as newspapers and books, are being increasingly challenged by the shift towards digitalisation. The consequences of this are far-reaching, and one area to be affected is history education since historical narratives are now accessible in various forms of media. While reading is important in all subjects, it is particularly central in history. This makes the study of history education worthwhile in terms of reading experiences, especially since digital tools are becoming more prevalent in the classroom.

While Swedish teachers demonstrate strong interest in digital tools, research shows that students are reading less in school, which may impact their reading comprehension. Decisions on whether or not to read texts in the history classroom occur within a context shaped by both analogue and digital resources, which affects how students engage with and understand these texts.

This study explores the considerations that influence both teachers’ choice of texts in history education and students’ decisions to read or not to read assigned texts. Interviews were conducted with three secondary school teachers and fourteen students. Using a social constructivist framework, the study analyses their experiences through the concept of meaning.

Understanding teachers’ choices is important because these determine what students are exposed to. Equally important is understanding how students perceive the meaning of reading since this influences their motivation and engagement. The study introduces the concept of reading-related subject understanding (läs-ämnesförståelse), the definition of which is how students understand both the subject of history and the role texts have within it.

Firstly: Findings suggest that the meaning of reading in the history classroom is perceived in three different but interrelated ways: as a source of knowledge, as a method for investigation, and as a foundation for discussion. These perspectives are described as “positions of meaning”. Both teachers and students shift between these positions, which reflects a complex and dynamic understanding of reading in the subject.

Secondly: The findings of this study show that reading-related subject understanding can be seen as consisting of three types: the knowledge-acquiring meaning of history reading; the investigative meaning of history reading; and the developmental meaning of history reading. Promoting a broader, more nuanced experience of reading can support student engagement and potentially increase reading in schools.