Dissertação(mestrado) - Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, 2008. / Submitted by eloisa silva (eloisa1_silva@yahoo.com.br) on 2012-12-07T11:24:04Z No. of bitstreams: 1 tatianaaragao.pdf: 2549977 bytes, checksum: d1684b53fa4dd58ae0b84e90296fe54b (MD5) / Approved for entry into archive by Bruna Vieira(bruninha_vieira@ibest.com.br) on 2012-12-09T22:56:42Z (GMT) No. of bitstreams: 1 tatianaaragao.pdf: 2549977 bytes, checksum: d1684b53fa4dd58ae0b84e90296fe54b (MD5) / Made available in DSpace on 2012-12-09T22:56:42Z (GMT). No. of bitstreams: 1 tatianaaragao.pdf: 2549977 bytes, checksum: d1684b53fa4dd58ae0b84e90296fe54b (MD5) Previous issue date: 2008 / Diante do envelhecimento populacional acelerado e do aumento da longevidade, muitos idosos apresentarão doenças e agravos crônicos não transmissíveis (DANT), que podem causar dependência. A família, considerada a principal cuidadora, necessitará de acompanhamento constante dos serviços de saúde e de programas sociais. A partir deste contexto e, sendo enfermeira de um hospital universitário, no qual cada vez mais internam pacientes idosos, decidi realizar este trabalho com o objetivo geral de construir um espaço coletivo dialógico com os cuidadores familiares dos idosos internados numa unidade de clínica médica, com vistas a uma educação em saúde e, como objetivos específicos, discutir em grupo as dificuldades dos cuidadores no processo de cuidar do ser idoso; compartilhar as experiências entre os cuidadores, unindo-se aos conhecimentos do profissional enfermeiro; elaborar um guia a partir das discussões grupais, servindo como um recurso para esclarecer dúvidas de outros cuidadores e para os profissionais conhecerem as necessidades mais freqüentes dos cuidadores familiares. Trata-se de uma pesquisa qualitativa, convergente-assistencial, com 15 cuidadores familiares dos idosos internados num setor de clínica médica de um hospital universitário. Para a coleta de dados, escolhi trabalhar com a dinâmica de grupo, utilizando a estratégia teórico-metodológica dos círculos de cultura, preconizada por Paulo Freire. A análise foi realizada seguindo-se quatro processos genéricos: apreensão, síntese, teorização e transferência. Foram identificadas três categorias: “Discutindo coletivamente em grupo dificuldades do dia-a-dia no processo de cuidar do idoso”, “Compartilhando as experiências entre os cuidadores, unindo-se aos conhecimentos do profissional enfermeiro” e “Educação em saúde”. Na primeira categoria foram estabelecidas três sub-categorias: “Sobrecarga do cuidador”, “O suporte formal” e “As atividades de vida diária (AVD)”. Na segunda categoria destacaram-se “Compartilhando saberes” e “Os conhecimentos do profissional enfermeiro” e, na terceira categoria, “Necessidade de educação em saúde para os cuidadores familiares”, “Déficit de orientações aos cuidadores por parte da equipe de saúde”, “A necessidade de educação em saúde para os profissionais” e “Educação em saúde através da metodologia freireana”. Conclui que o objetivo de construção de um espaço dialógico, para discussão das dificuldades e troca de experiências entre os cuidadores e o profissional enfermeiro, foi alcançado, e que a metodologia freireana utilizada, contribuiu para a aproximação das pessoas, possibilitando o diálogo e a troca de experiências no grupo. Acredito que, após a fase de apresentação e divulgação desta pesquisa, deve ser realizada uma reflexão sobre a possibilidade de continuidade deste trabalho no hospital, pois considero que será um diferencial na assistência de enfermagem ao idoso e seu familiar. / Facing the fast population aging and the rising of the longevity, many seniors are supposed to show non-transmittable diseases and chronic offenses, which can cause dependence. The family is considered the major protector and it will need constant attendance from the health services and social programs. Departing from this context, and as a nurse of a university hospital, in which most of patients are seniors, I decided to do this task aiming to build a dialogic and collective space in association with the familiar protectors of seniors who are interned in a medical clinic unit looking for a education in health which has as special goals to discuss in group the protectors’ difficulties in the process of taking care of a senior; to share the experiences among the protectors, uniting them to the professional nurse’s knowledge; to create a guide departing from the group discussions, that will serve as a source to make the other protectors’ doubts clear and also it will make the professionals able to know the more frequent needs of the familiar protectors. It is a qualitative, convergent- assistance research with 15 familiar protectors of seniors who are interned in a medical clinic unit of a university hospital. I choose to work with the group dynamic using the methodological-theoretical strategy of the culture circles, extolled by Paulo Freire to collect the data. The analysis was made fallowing four generic processes: apprehension, synthesis, theory and transference. Then three categories were identified: “collectively discussing in group the everyday difficulties in the process of taking care of a senior”, “sharing the experiences among the protectors uniting them to the professional nurse’s knowledge” and “Education in health”. In the first category three sub-categories were established: “protector’s overload”, “the formal support” and “the daily life activities (DLA)”. In the second two categories were pointed out: “sharing the knowledge” and “ the professional nurse’s knowledge” and the third category points “the need of education in health for familiar protectors”, “deficit in the orientations given to the protectors by the health team”, “the need of education in health for professionals” and “education in health through Paulo Freire’s methodology”. I concluded that the aim of building a dialogic space for discussion about the difficulties and experiences’ exchanges among the protectors and the professional nurse was reached and the Paulo Freire’s methodology contributed for people’s approach, making the dialogue and the experiences’ exchanges in the group possible. I believe that after a presentation and divulgation phase of this research, a reflection about the possibility of continuity of this work in the hospital must be done because I consider that it will be a differential in the nursery assistance to the senior and its familiar. / Delante del envejecimiento poblacional acelerado y el aumento de la longevidad, muchos ancianos han a presentar enfermedades y agraves crónicos no transmisibles (EANT), que pueden causar dependencia. La familia, considerada la principal cuidadora, tendrá necesidad de constante vigilancia de los servicios de salud y programas sociales. Partiendo de esto contexto y, siendo enfermera de un hospital universitario, lo cual cada vez más internan pacientes ancianos, decidí llevar a cabo este trabajo, con el objetivo general de construir un espacio colectivo de diálogo con el de los cuidadores familiares de ancianos hospitalizados en una unidad de medicina general, con la mirada de una educación, y como objetivos específicos, discutir las dificultades de un grupo de cuidadores en el cuidado de los ancianos; compartir experiencias entre los cuidadores, uniendo los conocimientos de los profesionales de enfermería, elaborar una guía de los debates del grupo, actuando como recurso para las preguntas de los cuidadores y otros profesionales para satisfacer las necesidades más frecuentes de los cuidadores familiares. Esta es una investigación cualitativa, convergente-asistencial, con 15 cuidadores familiares de personas ancianas hospitalizados en un sector de medicina general en un hospital universitario. Para la colecta de los datos, optó por trabajar con dinámicas de grupo, utilizando la estrategia metodológica y teórica de los círculos de la cultura, defendida por Paulo Freire. El análisis se llevó a cabo, seguido de cuatro procesos genéricos: la aprehensión, la síntesis, la teoría y la transferencia. Se identificaron tres categorías: "Hablar de las dificultades en conjunto como un grupo de día a día en el cuidado de los ancianos", "Intercambio de experiencias entre los cuidadores, uniendo los conocimientos de los profesionales de enfermería" y "La educación para la salud". En la primera categoría se establecieron tres subcategorías: "La sobrecarga del cuidador", "El apoyo formal" y "Las actividades de la vida diaria (AVD). En la segunda categoría destacamos: "Compartir los conocimientos" y "El conocimiento de los profesionales de enfermería" y en la tercera categoría, "La necesidad de educación para la salud de los cuidadores familiares", "falta de orientación a los cuidadores por el equipo de salud", "La necesidad de profesionales de la educación para la salud" y "La educación para la salud a través de metodología de Freire”. Llego a la conclusión de que el objetivo de construir un espacio de diálogo para la discusión de las dificultades y el intercambio de experiencias entre los cuidadores y los profesionales de enfermería fue alcanzado y que la metodología freireana utilizada, contribuyó para unir las personas, facilitando el diálogo y el intercambio de experiencias en el grupo. Creo que después de la fase de presentación y difusión de esta investigación, debe ser realizado un debate sobre la posibilidad de continuar este trabajo en el hospital, porque creo que será un diferencial en el cuidado de enfermería a los ancianos y su familia.

Ainda que destinada a um grupo que vivencia e experimenta um corpo doente, a Educação para a Saúde não pode centrar-se nos mecanismos fisiopatológicos e nas terapias medicamentosas, porque seria desconsiderar a vida e as dimensões do ser humano que vão além da corporeidade. Temas transversais, cercados de conceitos pré-elaborados e enraizados em mitos, tabus, preconceitos e crendices, como a sexualidade e o lazer, são entendidos como demandas urgentes para colaborar com a qualidade de vida, uma vez que foram relegados na nossa história, ainda que partes integrantes da constituição do homem. Neste contexto o presente trabalho objetivou investigar, com portadores de hipertensão arterial sistêmica, de um Centro de Saúde de uma cidade do noroeste do Estado do Paraná-Brasil, qual o impacto da Educação para a Saúde, levantando seus problemas relacionados às temáticas lazer e sexualidade, propondo desenvolver conjuntamente com os participantes ações educativas visando as possíveis soluções dessas dificuldades, através da pesquisa-ação.Tratou-se de um estudo qualitativo, mediatizado pela pesquisa-ação que permitiu desvelar as percepções dos participantes do grupo de uma unidade de saúde quanto à sexualidade, o lazer e a qualidade de vida programando, aplicando e avaliando atividades de Educação para a Saúde nestas temáticas. A população-alvo deste estudo se constituiu de 6 mulheres hipertensas, únicas com tal diagnóstico que participam do grupo de reunião semanal de um centro de saúde de uma cidade do noroeste do Estado do Paraná-Brasil. Adotou-se o referencial-metodológico de Freire (1990) adaptado por Bueno (1997-8) delimitado por duas fases: a primeira, quando ocorreu o levantamento do universo temático, elencando-se os temas geradores; a segunda, constituída da ação educativa. A representação social de Moscovici (1979) foi a base da discussão das categorias e colaboraram para elencar os temas geradores. Estes foram o referencial para a discussão e elaboração das práticas educativas, apoiadas na pedagogia da autonomia de Freire. Identificou-se que, quanto à sexualidade, houve dificuldade de seu entendimento, pois foi reduzida ao sexo, manifestou-se por relações de afeto, companheirismo e por cuidados corporais. Quanto ao lazer, foi visto como enfrentamento da solidão. A hipertensão arterial foi descrita quanto aos seus fatores causais, houve valorização exacerbada ao tratamento farmacológico e a convivência com a doença foi considerada difícil. Os temas geradores permitiram a elaboração de uma ação educativa dialógica, em que dinâmicas e discussões foram programadas. Os participantes avaliam que as estratégias adotadas foram de grande valia para a troca de saberes, para a valorização das relações humanas e para um contato prazeroso com os temas abordados. / Even though it is meant for a group which deeply experiences a sick body, Education for Health cannot merely focus on physiopathological mechanisms and medicamental therapies as it would disregard life and the human being\'s dimensions - which are beyond corporeity. Transversal themes, surrounded by preelaborated concepts and enrooted in myths, taboos, biases and superstition such as sexuality and leisure are understood as urgent demands to contribute with quality of life since they were put aside throughout history, despite being constituent parts of man. Within this context, this study had the purpose of investigating what the impact of Education for Health is on systemic hypertension patients by surveying issues related to leisure and sexuality in order to to develop, together with the participants, education actions towards possible solutions via research-action. It was a qualitative study mediated by research-action which enabled disclosing the perceptions of a group within a health unit with respect to sexuality, leisure and quality of life by developing, applying and assessing Education for Health activities on those themes. The target population for this study was constituted of six women with hypertension - the only ones to present such diagnosis who participated in a group meeting weekly at a Health center in a city in the Northwest of the state of Paraná, Brazil. Freire\'s (1990) reference methodologies, adapted by Bueno (1997-8) were outlined into two phases: first, when the survey of the thematic universe occurred, bringing about the generative themes; the second, constituted by the education action. Moscovici\'s (1979) social representation was the fundament for the discussion concerning the categories and helped to set up the generative themes. These were the references for discussion and elaboration of the educational practices supported by Freire\'s pedagogy of autonomy. It was difficult to understand sexuality as it was confined to sex and manifested via affective relations, partnership, and corporal care. Leisure was found to be the confrontation of loneliness. Hypertension was described regarding its causal factors. There was exacerbated valorization of the pharmacological treatment and coping with disease was considered difficult. Generative themes enabled the elaboration of a dialogic education action in which dynamics and discussions were performed. Participants reported that the strategies adopted proved to be valuable for knowledge exchange, valorization of human relations and pleasant contact with the themes approached.

No description available.

A traditional view has, more or less, infested the subject of Physical Education, which affects the subject´s intrinsic values. The purpose of this knowledge overview is to analyse teachers and pupil’s perception and understanding of PEH in relation to intrinsic and extrinsic values. Intrinsic refers to the certain value of knowing a subject’s core content, on the other hand, extrinsic refers that knowledge in a subject content is valuable for something else. The following questions will aid us in this overview and provide us with as much angles as possible; What is/are teachers’ perception of PEH based on intrinsic and extrinsic values?What are pupils’ perception of PEH based on intrinsic and extrinsic values?What is/are teachers’ understanding of PEH based on intrinsic and extrinsic values?What are pupils’ understanding of PEH based on intrinsic and extrinsic values?This knowledge overview focusses mainly on Sweden but includes some international research. These researches range from the years 2006 - 2019. This knowledge overview is conducted by analysing several systematically selected sources, where searches have been made in different databases.The results show that extrinsic values are highly valued in the subject of PEH even today. Research from when both Lpo94 and Lgr11 were active, showed that a traditional- and extrinsic view is more prevalent than the intrinsic values of PEH. In the discussion different aspects are lifted. Both we and the research suggest, based on the learning outcomes of the syllabus, the importance of making intrinsic values more tangible in PEH lessons. This is in order to produce a consensus within and around the subject.

Trauma has been described as a pressing public health concern and research evidence demonstrates how unresolved trauma can lead to multiple co-morbidities including chronic medical conditions such as cardiovascular disease. Furthermore, epidemiological evidence demonstrates the high prevalence of trauma histories amongst service users seeking care across a range of systems including child welfare, education, health, social services and the criminal justice system. In response, the concept of trauma-informed care (TIC) has emerged, but how TIC can be conceptually defined and utilized remains unclear in the scholarly literature. This dissertation utilizes a variety of methodological approaches to explore how and under what conditions TIC can be utilized within and across systems of care to address the prevalence of trauma-affected individuals seeking care. First, a critical interpretive synthesis of the TIC literature provides an overview of how TIC can be defined and utilized through the development of a conceptual framework situating TIC within and across systems of care. A theoretical framework outlines important contextual factors, such as system arrangements as well as the political system, that can act as either barriers or facilitators to the operationalization of TIC. Second, a document analysis examines how and under what conditions TIC is utilized in adult mental health policy documents in Ontario, Canada. Finally, a case study explores what factors led to the exclusion of TIC from Ontario’s first province-wide strategy on mental health and addictions. Collectively, these three studies add several substantive, methodological and theoretical contributions regarding a cohesive understanding of what is trauma, how TIC can be defined and operationalized and the role of TIC at various levels within and across systems of care. Mobilizing sustainable and effective TIC has been demonstrated to improve the overall health and well-being of both service users and services providers, leading to stronger systems of care and healthier communities and societies at large. / Thesis / Candidate in Philosophy / The concept of trauma-informed care (TIC) has emerged in response to increased awareness regarding the prevalence and impact of trauma. A growing body of empirical literature has demonstrated the effectiveness of TIC within specific programs and services as well as at the organizational and system levels. What constitutes trauma, however, and how TIC can be defined and operationalized at various levels remains unclear. This thesis aims to address these gaps in the literature by: (1) developing a conceptual framework on TIC and a theoretical framework outlining the barriers and facilitators of TIC (2) examining how and under what conditions can TIC be utilized in mental health policy documents (3) exploring what are the political factors that can lead governments to decide against utilizing TIC.

Background: High-fidelity simulation recreates real-life situations in a safe learning environment and encourages critical thinking in students. Published research in simulation in psychiatric/mental health nursing is sparse. Methods: Four scenarios exemplifying drug or alcohol abuse utilizing the computerized, mannequin SimMan® were implemented. Students evaluated their learning experience following completion of the simulation via a 20-item, Likert-scale survey which included open-ended questions. Results: Results were positive. Students rated all items on the survey as “agree” or “strongly agree” (Mean 4.77, SD=0.55). Conclusions: High fidelity clinical education simulations are an effective means of facilitating student learning of psychiatric and mental health clinical experiences. Students found simulation to be a useful and engaging means by which to learn to care for clients with drug or alcohol abuse disorders.

No description available.

The concept of health should not be viewed as one-dimensional, but rather a complex interplay between physical, psychological and social factors (WHO, 2014). The Swedish curriculum highlights that the school’s responsibility is to support pupils’ knowledge and promote health. The purpose of this study, therefore, was to consider pupils understanding of and attitudes towards health in the context of the subject Physical Education and Health (PEH) at school. Data was collected through the use of focus groups, questionnaires and epistolary dialog. The pupils’ ways of describing health were analysed through Zygmunt Bauman’s (2008) consuming theory and Thomas Ziehe’s (1986, 1999) concepts of cultural liberation, cultural expropriation, the performance principle and authenticity. The result shows that the pupils in the study had a good level of understanding about health. They described health as a complex concept in physical, psychological and social terms. This understanding of health affected the pupils in different ways. For example a feeling of pleasure was described by pupils who appeared well-grounded and spontaneous, while those who experienced pressure in their daily life expressed feelings of higher expectations regarding their own health practices. PEH teachers need to consider not only knowledge content of the subject area, but also variations of self-image among the pupils in their class, and the impact this can have on the way pupils un-derstand the health messages being taught in the classroom.

Syftet med detta examensarbete är att belysa hur elever på en gymnasieskola uppfattar lärandet inom idrott och hälsa A. Vår teoretiska ingång är kroppens fenomenologi vilket kontraheras med dualismens filosofi. Vi analyserar vårt resultat utifrån det fenomenologiskt bundna begreppet kroppslig kompetens kontra fysisk aktivitet som präglas av ett dualistiskt perspektiv. Vi har använt oss av en kvalitativ metod, då vi har intervjuat 17 elever på en gymnasieskola i södra Sverige. Resultatet visar att eleverna först och främst inte har fått möjlighet att reflektera, diskutera och formulera sig kring den egna läroprocessen. Eleverna uttrycker exempelvis att de tycker att ämnet är roligt men det saknas vidare reflektion utifrån den egna upplevelsen. Även om det bara är ett fåtal som anser att de inte tar med sig någon som helst kunskap från idrott och hälsa A så har nästintill alla stora problem att resonera kring det egna lärandet. Det framkommer att det är viktigare att vara fysisk aktiv än det är att belysa lärandeprocessen genom exempelvis diskussion. Vår studie påvisar även att flertalet elever inte får den helhetsuppfattning som krävs för att individen skall ha möjligheten att utveckla kroppslig kompetens. Fysisk aktivitet står i centrum och eleverna ges inte möjligheten att koppla samman ämnets olika moment till en sammanhängande helhet. Ämnet delas upp i teori och praktik vilket blir problematiskt då eleverna tycks ha svårigheter att koppla de teoretiska begreppen till de praktiska momenten. Vid de praktiska momenten ligger fokus på aktivitet, inställning och engagemang. Detta innebär att den reflektion som krävs för kroppslig kompetens uteblir eftersom den fysiska aktiviteten blir det centrala i undervisningen. Eleverna koncentrerar sig således på att vara aktiva genom rörelse, engagemang och rätt inställning vilket innebär att undervisningen koncentrerar på ett görande istället för ett reflekterande lärande. Att eleven ska vara fysiskt aktiv värdesätts högt av eleverna vilket resulterar i att den reflektion som är nödvändig för kroppslig kompetens uteblir. / The purpose of this paper is to illuminate how students in an upper secondary school concept learning within the course Physical Education and Health A. The theoretical view that we use is to examine the learning from the viewpoints of physical activity and physical literacy. We have used a qualitative method, as we have interviewed 17 students from an upper secondary school in southern Sweden. The result shows that the students in our survey do not get the opportunity to reflect, discuss and formulate themselves around their own learning processes. For instance, the students express that the subject is “fun”, however, further reflection based on personal experience is lacking. Even though only a few students explicitly state that they do not acquire any knowledge from the course Physical Education and Health A (PEH), almost all students have major problems reflecting upon their own learning verbally. This indicates that the students have not had the opportunity to pause and reflect during their own learning process. We find that it seems students deem it more important to be physically active than it is to highlight the learning process through discussion. On this basis, we believe that students do not get the chance to develop physical literacy because this is breached as physical activity is valued higher. Our study also shows that students lack the complete picture needed to ensure that individuals have the opportunity to develop physical literacy. Physical activity is at the center of attention and the students are unable to link together the essential parts of different elements into a coherent whole. The course is divided into theory and practice, which becomes problematic when students seem to have difficulty linking the theoretical concepts to the practical parts. Regarding the practical parts, the focus is on activity, attitude and commitment. This means that the reflection required for physical literacy fails because the physical activity becomes the focus of teaching. Students concentrate on being active with commitment and the right attitude instead of reflectively learning. In conclusion, it seems that being physically active is highly valued by the students at the cost of the individual’s own personal reflection that is necessary to develop physical literacy.

Detta examensarbete redogör för huruvida ämnesplanen för idrott och hälsa 1 samt tillhörande dokument möjliggör respektive hindrar lärare att ha en mångfald av elever i idrott och hälsa-undervisningen. Syftet är att synliggöra de möjligheter och hinder som ämnesplanen i idrott och hälsa kan innebära för lärare när de ska utmana och utveckla den mångfald av fysiska funktionsvariationer som finns bland elever. För att undersöka detta har en textanalys av Skolverkets dokument samt intervjuer av lärares tankar kring realisering av dessa dokument gjorts. I detta arbete valde vi att fokusera på den praktiska delen av ämnet där kropp och rörelse är i fokus på grund av begränsad tid och omfång till arbetet. Den övergripande frågeställningen som behandlas är: Vilka möjligheter respektive hinder kan skapas för lärare vid realisering av ämnesplanen för idrott och hälsa 1 utifrån elevers skilda fysiska funktionsvariationer?Undersökningen i detta arbete har en läroplansteoretisk utgångspunkt men analyseras även utifrån ramfaktorteorin som komplement. En textanalys gjordes för att undersöka styrdokumenten och en kvalitativ metod användes för att undersöka transformering och realisering av dessa. Ämnesplanen för idrott och hälsa 1 samt tillhörande kommentarmaterial och bedömningsstöd analyserades i förhållande till varandra. Kvalitativa intervjuer gjordes på sex lärare på sex skolor i södra Sverige. Resultatet visar att ämnesplanen för idrott och hälsa 1 överlag möjliggör för en mångfald av fysiska funktionsvariationer i undervisningen då den är öppet skriven och då lärare ska utgå från elevers skilda förutsättningar. Dock menar verksamma lärare att tolkningsutrymmet, skolans resurser, stor nivåskillnad, tidsbrist och bristande kunskap kring elevers skilda förutsättningar kan skapa hinder att realisera rådande ämnesplan, där speciellt friluftsliv framställdes som problematiskt. Slutsatsen är därmed att en eventuell konkretisering hade behövts göras för att skapa likvärdighet och att lärarutbildningen samt fortbildning är betydande för att lärare ska ha kunskap till att anpassa undervisningen för alla elever. Vidare önskas en uppföljning av hur ämnesplanen transformeras och realiseras av idrott och hälsa-lärare samt om ämnesplanen bidrar till en mångfald i undervisningen och vilka eventuella resurser som behövs för att stötta lärare i realiseringen av ämnesplanen. / This thesis explains whether the syllabus for Physical Education and Health 1 (PEH 1), as well as accompanying documents, enable Physical Education and Health-teachers (PEH-teachers) to have a variety of pupils within their teaching. The purpose is to visualize opportunities and obstacles that the syllabus for PEH 1 may imply for the variety of physical conditions among pupils. To investigate this, a text analysis of documents from ‘Skolverket’ and interviews with teachers regarding the realization of these documents have been made. In this work, we chose to focus on the practical part of the subject where body and movement are in focus, due to limited time and scope. The overall issue being addressed is: What opportunities and obstacles can be created for teachers in the realization of the syllabus for Physical Education and Health 1 based on the different physical variations of students?The empirical data collected has been analyzed and discussed based on Linde’s (2012) curriculum theory but also by the frame factor theory. A text analysis was conducted to examine the documents formulated on the formulation arena and a qualitative method was used to investigate the transformation and realization of these documents. The syllabus for PEH 1, and related commentary material and assessment support, were analyzed in relation to each other. Six qualitative interviews were conducted with six teachers at six different schools in southern Sweden. The result shows that the syllabus for PEH 1 makes it possible for a variety of pupils in the PEH teaching, mainly because it’s openly written and that teachers should design their teaching based on pupil’s different physical variations. However, according to the teachers in this study, the possibility of interpretation, the school's resources, a large variation of skills, time shortage and lack of knowledge about the pupils' distinctive conditions can create obstacles when realizing the current syllabus. Especially ‘friluftsliv’ was mentioned as problematic. The conclusion is that a clarification of the syllabus is needed to create equivalence teaching, and that the teacher education and continuing training are important for teachers’ knowledge of how to adapt their teaching for all students. Furthermore, a follow-up of how the syllabus is transformed and implemented by PEH teachers is needed to know whether the syllabus’ intentions of diversity are realized and what resources that are needed to support teachers in the realization of the syllabus.