Interaction between people can be seen as a distinctive feature of 'post-industrial society'. In this study I investigate some of the conditions for this encounter in private service work in Sweden. I start by discussing some important concepts: service, service encounter and emotional labour. Three parties in an interactional triangle can be perceived: the service enterprise, the service worker and the customer. The service encounter is embedded in organisational frames. Recruiting for social competence and training for selling interaction are two facets of these frames. In interactive service work, control is complicated by the fact that a third party, the customer, is involved and that the borders between worker, work process and result are somewhat indistinct. Indirect forms of control can be used to affect workers' attitudes and thinking, as well as behaviour. Service work can be described as a form of acting. Different service workers will identify differently with their work role. In my study I observe both positive and negative experiences of work. A majority report that they sometimes are so tired of people that they want to be alone after work. I distinguish two dimensions of interactive service work: type of interaction and sales situation. Interaction can be more or less important, and the sales situation can be more or less concealed. Based on these dimensions I suggest a typology to illustrate some differences between different service occupations. Four types are suggested: (1) Work first, and customer later; (2) Personalised services; (3) Routine selling; and (4) Persuasive selling. In the second group we find the experts of interaction, but also the strongest signs of social strain.

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Business across the Internet has increased in recent years and most companies that are selling trips have increased their sales online. Many companies that are selling trips strive for customers to receive and experience a personal service online. The meeting between the client and a webpage service system on the Internet should work. Service encounters are an essential part of the contact between customer and company and play a big part in how the first impression is perceived by the customer. To understand how a service encounter works, meeting face to face, companies need to understand how customers perceive that meeting. Among other things, personnel and customers confront each other in a physical meeting and during the first few seconds is what Normann (2002) call the moment of truth. The purpose of this paper is to find out how service is working over the Internet. We also want to contribute with increased insight of the interaction between customer and provider over the Internet. To examine how service works over the Internet and how customers are treated. Theories that include e-CRM, Image concept and e-SERVQUAL have been used. Interviews took place with various actors within the tourism industry. Parasuraman, et al. (2002) and Kuo, et al. (2005) say that companies need to understand what the customer wants to do on their website and meet the needs of the customer and to exceed customers’ expectations.

The focus is on mothers who asked for help because of initial problems with breastfeeding, i.e., their feelings and experiences, how they cope with their difficulties, and the consultative meetings with a midwife. Taking as a point of departure the ideas that mothers have about breastfeeding, the aim is to describe how mothers experience their situation and themselves as new mothers, when they have problems with breastfeeding, and, to find out how mothers experience the consultative situation as well as their own participation and responsibility. Fourteen mothers, who expressed a wish to breastfeed and who asked for help during their stay in the maternity ward, were video-taped during individual consultations with a midwife. Three months later each mother was interviewed about her experiences and feelings as regards the consultations. The outcomes were analysed according to a hermeneutical approach, from an interactionist perspective and, in addition, using crisis theory as a theoretical basis. This thesis illuminates the interactionist perspective on three different system levels: the norms in society in relation to the mother’s expectations about breastfeeding, the mother’s intra-psychological process and the consultative meeting. The results demonstrate that the women had thought of breastfeeding as a ‘door opener’ into the new role of motherhood. When the mother instead encountered a breastfeeding situation that did not meet with her expectations, there were two things that stood out very clearly; i.e., a feeling of inadequacy, and a constant internal as well as external questioning of herself. The fact that breastfeeding did not turn out as expected could also trigger a crisis reaction. It was important that the mother had a feeling that the midwife understood her, so what she was talking about became meaningful. This in turn could lead to a shift in attitude so that the mother changed from a closed position to an open and, thus, could begin to look forward. If breastfeeding did not turn out the way the mother had hoped her self-image was influenced and ‘coming into existence” as a mother was more difficult. To be involved and responsible had different meanings depending on where the mother was in the process, which meant that the mothers wanted different kinds of support on the way. One condition for making this possible was the consultative meeting in a manner of reciprocity.

The overall aim of this thesis was to provide knowledge on the one handSomalian-born immigrants´ experiences of living with diabetes mellitus (DM)in a new cultural environment, on the other hand their encounter with Swedishdiabetic care – this from both their own point of view and that of the health-care professionals. There was an endeavour to describe methodological aspectsof the interpreter´s role in respect of the trustworthiness of research performedin multicultural societies. A descriptive design was used, involving threequalitative interview studies with an interpreter (Studies II-IV) and onesystematic literature review (Study I). The latter served as a foundation forconducting the interviews with an interpreter and the Matrix Method was used.The same 19 patients with diabetes of Somalian origin participated in StudiesII-IV, joined by five health-care professionals in Study IV. The interviews weresubjected to qualitative content analysis in the case of Studies II and III, and to phenomenograpic analysis in the case of Study IV. In Study I, 13 empirical cross-cultural interview studies with aninterpreter involved were scrutinized. The findings showed that the interpreter’srole in the research process was given little attention. There was usually noaccount either of the style of interpreting, the interpreter’s previous experienceor the seating arrangements for the interviews. On the other hand most of thestudies offered direct or indirect information about the interpreter’s knowledgeof the aim of the research or participation in the transcription of the text or data analysis. The most frequent techniques used to established trustworthiness were prolonged engagement and member checks. A prominent problem for the participants in Study II was to give uptraditional eating habits. Difficulty in managing everyday life was mentionedespecially by women in connection with the need to keep to the diet regimebecause of a lack of understanding and support from family and friends. Tochanging lifestyle was considered as a hard work and a number of barriers wasmentioned especially when it comes to eating habits. The findings showed avariation how the participants managed the fasting month of Ramadan. Thosewho fasted did not see the diabetes as an obstacle, others did so and indicated that fasting was not compulsory for a sick person. In study III the findings showed that women used more supernaturalbeliefs than men when they described their experiences in connection with thediagnosis and their health beliefs. Most of the experiences of receiving thediagnosis consisted of ways of managing this information. Commonlymentioned by the participants, irrespective of gender, when they receiving thediagnosis was a attempt to find some advantages, or positive comparison. Other participants tried to repress the diagnosis and doubted it. Most of theparticipants, irrespective of gender, did not immediately respond with shock orother strong emotion when they received the diagnosis. In study IV the patients conceived the diabetes care as being of highquality but they also conceived limitation with the care. They conceived unmetneeds such as too long waiting times for appointments, not encountering thesame physician every time, lack of contact with specialists and failure toculturally adapt dietary advice. Health-care professionals conceived severalcultural challenges in the encounter such as managing language barriers,illiteracy and traditions such as fasting during Ramadan. In conclusion, this thesis generate knowledge which can serve as afoundation to securing the quality of diabetes care for this patient group andcontribute to working out local diabetic programmes for patients with anotherbackground than the Swedish. In addition the thesis can contribute to makingimprovements when it comes to working with an interpreter in qualitativeinterview studies as well as in clinical settings.

Bakgrund: Våld mot kvinnor är den vanligaste typen av våld och förekommer över hela världen. Varje år anmäls tiotusentals fall av våld mot kvinnor över 18 år och i genomsnitt dödas 16 kvinnor varje år till följd av våld i Sverige. Flera våldsutsatta kvinnor som besöker sjukvården upplever ett bristfälligt bemötande och det kan därför vara betydelsefullt att göra sjuksköterskor mer medvetna om hur våldsutsatta kvinnor kan bemötas. Syfte: Syftet med litteraturstudien var att beskriva sjuksköterskans bemötande av våldsutsatta kvinnor på sjukhus utifrån ett globalt perspektiv. Metod: Studien genomfördes som en allmän litteraturstudie och baserades på 11 empiriska artiklar inom området våld mot kvinnor utifrån ett globalt perspektiv. Resultat: Sjuksköterskor kände rädsla och ovana i mötet med våldsutsatta kvinnor, vilket resulterade i att sjuksköterskor undvek att ställa frågor om våld i hemmet. Majoriteten av studierna visade att sjuksköterskor önskade mer kunskap och utbildning om hur kvinnor som utsatts för våld kan bemötas inom sjukvården. Flera studier visade att våld mot kvinnor var socialt accepterat i vissa länder och att flera sjuksköterskor upplevde att kvinnor inte borde offentliggöra våldet för vårdgivare eller myndigheter, utan att hålla det inom familjen. Diskussion: Sjuksköterskors bristfälliga bemötande kan bero på att sjuksköterskor inte fått undervisning om våld mot kvinnor under sin utbildning eller på sin arbetsplats. Våld mot kvinnor kan vara socialt accepterat i många länder och därför är det av vikt att svenska sjuksköterskor blir mer medvetna om kulturella aspekter som kan ligga bakom våldet för att bättre kunna hantera dessa patienter. Slutsats: Det råder en stor brist på kunskap inom området våld mot kvinnor speciellt om kulturella aspekterna och det krävs mer utbildning och forskning för att kunna förbättra bemötandet mot dessa kvinnor. / Bakground: Violence against women is the most common type of violence and occurs worldwide. Each year tens of thousands reports cases of violence against women over 18 years and an average of 16 women are killed each year due to violence in Sweden. Many abused women who visit health care facilites is experiencing an inadequate response and it may therefore be important to make nurses more aware of how abused women can be countered. Purpose: The purpose of this literature was to describe nurses' encounters to abused women in hospitals from a global perspective. Mehtod: The study was conducted as an general literaturereview study and was based on eleven empirical articles in the area of violence against women from a global perspective. Results: Nurses felt fear and unfamiliarity of encounthers with abused women, which resulted in nurses avoided to ask questions about domestic violence.The majority of the studies showed that the nurses wanted more knowledge and education on women victims of violence could be addressed in health care. Several studies showed that violence against women was socially acceptable in some countries and that many nurses felt that women should not disclose violence to health care providers or authorities, but to keep it in the family. Discussion: Nurses lacking encounte may be because nurses have not received education on violence against women during their training or in the workplace. Violence against women can be socially accepted in many countries and therefore it is essential that Swedish nurses become more aware of cultural aspects that could be behind the violence in order to better manage these patients.Conclusion: There is a great lack of knowledge in the field of violence against women, especially in the cultural aspects behind it and there is a need for more education and research to improve the encounters towards these womens.

The purpose of this study is to understand encounter by individual depictions of meetingsperceived by social workers and clients in social services. Thus, we want to understand moreabout how clients and social workers as actors encounter each other in meetings in the socialservices. The study also aims to understand how the two actors affect each other in this typeof interaction and whether there are other influencing factors. We conducted a qualitativestudy by interviewing informants with semi-structured interview questions. The informantswere comprised of three social workers and eight clients. The data was processed usinginductive analysis. The results revealed that the two actors interact with each other alternatelyin their encounters and that it is not possible to determine who is responsible for the firstencounter. Other factors affecting the encounters other than just the encounter performed bythe other actor was also found. These factors were: the reason behind the contact, emotionalcircumstances, and the client's life situation. Contextual factors such as roles and power werepresent at the encounters; however, this was something that only existed in the informants’underlying statements. The empirical data was analyzed in light of the theoreticalperspectives of interaction and power. The results were also analyzed in the context of theresearch by Hall (2001), Billquist (1999) and Skau (2007). The results show that the clientsand the social workers influence each other's responses in the interaction and that the clients’response is an important part in the meeting between social worker and client, more importantthan what has been shown in previous research. / Syftet med studien är att förstå bemötandet mellan socialsekreterare och klient utifrån derasindividuella skildringar av möten inom socialtjänsten. Således vill vi förstå hursocialsekreterare och klienter i en interaktion bemöter varandra och blir bemötta. Studiensyftar även till att förstå hur de båda aktörerna påverkar varandra i interaktionen och om detexisterar andra påverkande faktorer. Vi har genomfört en kvalitativ studie genom att intervjuainformanter med semistrukturerade intervjufrågor. Informanterna bestod av tresocialsekreterare samt åtta klienter. Rådata bearbetades genom induktiv analys. Resultatetvisade att de båda aktörerna påverkar varandra växelvis i sina bemötande och att det inte ärmöjligt att avgöra vem som står för det huvudsakliga bemötandet. Det framkom även att detfanns en del faktorer utöver själva bemötandet som påverkade bemötandet. Dessa faktorervar: anledningen bakom kontakten, känslomässiga omständigheter samt klientenslevnadssituation. Roller och makt var närvarande i mötet som kontext till bemötandet, dockvar detta något som endast fanns underliggande i informanternas uttalanden. Det empiriskamaterialet analyserades mot bakgrund av de teoretiska utgångspunkterna interaktion samtmakt. Dessutom diskuterades resultatet i samband med den tidigare forskningen gjord av Hall(2001), Billquist (1999) och Skau (2007). Resultatet visar att klient och socialsekreterarepåverkar varandras bemötande i interaktionen och att således klientens bemötande är enviktigare del i mötet mellan socialsekreterare och klient än vad som framkommit i tidigareforskning.

Daten der SESAM 2-Studie wurden analysiert, um die Konsultationsprävalenz, Beratungsergebnisse und Therapie von Patienten mit den Symptomen Übelkeit und/oder Erbrechen sowie die Beratungsanlässe von Kinder und Jugendlichen auszuwerten. Dazu wurden 8874 Patienten in dem Zeitraum vom 01.10.1999 bis 30.09.2000 von 270 teilnehmenden sächsischen Hausärzten untersucht und die Ergebnisse in standardisierten Antwortbögen dokumentiert. Zusätzlich wurden die erhobenen Daten mit anderen internationalen Studien verglichen (Dutch Transition Project, Beach Studie). 9,1% der Patienten, die ihren Hausarzt aufsuchten, waren zwischen 0 und 19 Jahren alt. Kinder und Jugendliche stellen sich zumeist auf Grund von Husten, Fieber, Schnupfen und Halsbeschwerden bei ihrem Hausarzt vor. Die Konsultationsprävalenz dieser Patientengruppe lag zwischen 10,2% im April und 6,2% im August. Mit steigendem Alter ist eine Zunahme des Spektrums unterschiedlicher Beratungsanlässe zu verzeichnen. Es ist daher unerlässlich für den Allgemeinmediziner Erfahrungen in der Anamnese, Diagnostik und Behandlung von Erkrankungen im Kindes- und Jugendalter zu sammeln. Die Konsultationsprävalenz für Übelkeit und Erbrechen lag in unserer Studie für alle Altersgruppen zusammen bei 1,9%. Kinder und Jugendliche litten im Vergleich zu Erwachsenen häufiger unter diesen Symptomen. Geschlechtsspezifische Unterschiede fanden sich nicht. Bei lediglich 4,1% der diesbezüglichen Konsultationen wurden diagnostische Maßnahmen ergriffen, die über eine körperliche Untersuchung hinausgingen. Die am häufigsten gestellte Diagnose bei diesen Beschwerden war eine nicht-infektiöse Gastroenteritis. In 76,3% der Fälle wurden zur Behandlung Medikamente verordnet. Übelkeit und/oder Erbrechen ist ein häufiger Konsultationsanlass. Potentiell abwendbar gefährliche Verläufe sind selten.

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Bakgrund: Antalet människor med psykisk ohälsa har på senare år ökat. Dessa påträffas inom vårdens olika instanser och vårdare har stor sannolikhet att möta någon drabbad oavsett arbetsplats. Studier visar att vårdare har en "negativ attityd" till att vårda patienter med psykisk ohälsa och känner sig oförberedda inför patienternas behov. Det behövs mer kunskap om hur mötet mellan vårdare och patient upplevs ur ett patientperspektiv. Syfte: Att beskriva hur patienter med psykisk ohälsa upplever mötet med vårdare i hälso- och sjukvården. Metod: Studien hade kvalitativ ansats och beskrev patienters upplevelser genom kvalitativ innehållsanalys utifrån sex självbiografier. Resultat: I mötet med vårdare upplevde patienter med psykisk ohälsa att de kände förtroende och misstroende, att de stod under vårdares makt, att de blev behandlade med omtanke och kyla, blev sedda och avvisade, att de inte blev respekterade och att de inte blev tagna på allvar. Slutsats: Mötet beskrevs i form av både positiva och negativa upplevelser. Förtroende, respekt, att bli sedd och omhändertagen bidrog till att mötet upplevdes positivt. Genomgående flest negativa upplevelser beskrevs rörande brist på respekt, makt och patienters trovärdighet. Negativa upplevelser hämmar återhämtningsprocessen vilket gör det angeläget att öka kunskapen hos vårdare hur livsvärlden ser ut hos patienter med psykisk ohälsa. Klinisk betydelse: Resultatet av studien kan användas för att få kunskap och ökad förståelse för hur patienter med psykisk ohälsa upplever mötet med vårdare. På detta sätt kan de brister uppmärksammas som finns i vårdares sätt att bemöta dessa patienter, vilket kan bidra till förbättrade förutsättningar för att vårdmöten skall ge positiva upplevelser. / Background: In recent years the number of people with mental illness has increased. It is happening everywhere within healthcare and therefore care workers have a high probability of encountering someone suffering from mental illness. Studies show that care workers display a "negative attitude" towards caring for patients with mental illness and feel unprepared to meet their needs. Increased knowledge from a patient’s perspective is needed to show how the encounter between care workers and patient is perceived. Aim: To describe how patients with mental illness experience the encounter with care workers within healthcare. Method: The study had a qualitative approach that described patients' experiences through the use of qualitative content analysis based on six autobiographies. Results: In the encounter with care workers, patients with mental illness experienced both trust and mistrust, powerlessness, as well as thoughtfulness but also coldness. They sensed concern but also rejection, disrespect and feeling of insignificance. Conclusion: The encounter was described in terms of positive and negative experiences. Trust, respect, to sense concern and to be shown consideration contributed to the encounter being perceived as positive. Most negative experiences were described concerning lack of respect, power and feeling of insignificance. Negative experiences are a hindrance to the recovery process which makes it important to increase knowledge in health care providers about what the life world of patients with mental illness contains. Clinical significance: The results of the study can be used to gain knowledge and increase understanding of how patients with mental illness experience the encounter with care workers. This provides a way to address the shortcomings of care workers’ way of responding to these patients and may contribute to improved conditions for healthcare encounters to be perceived as positive.