Bakgrunn: I arbeid som sykepleier erfarte jeg at utøvere i helsetjenesten hadde ulik holdning til læring og fagutvikling. Min nysgjerrighet ble vekket om det er en sammenheng mellom utøvernes interesse for læring og en tilstand av empowerment.  Hensikt: Søken etter kunnskap om hvilke faktorer utøvere i pleie- og omsorgstjenesten opplever stimulerer til å lære, for å øke forståelsen av hva som kan styrke dem til å ”empower” seg selv.  Metode og Materiale: Fenomenografi ble brukt som tilnærmingsmetode og fokusgruppeintervju som datainnsamlingsmetode. 17 personer ansatt i pleie- og omsorgstjenesten i to kommuner deltok i studien. Informantene var fordelt på fem kvalitetsgrupper som hadde lært å forbedre arbeidsoppgaver i regi av Fylkesmannens kvalitetsrådgiver. Resultater: Dataene er presentert i en kjernekategori og tre hovedkategorier. Kjernekategorien viser til en struktur av bestemte tiltak som organisasjonen hadde iverksatt for at utøverne skulle lære forbedringsarbeid. Tiltakene kan oppsummeres ved følgende faktorer: Organisasjonen har fokus på forbedringsarbeid, økonomiske midler er bevilget til å lære forbedringsarbeid, tid og rom er avsatt til læring, en ekstern kvalitetsrådgiver gir opplæring i forbedringsarbeid, og ledelsen håndterer endring. Hovedkategoriene antyder at utøvere opplever seg selv som medansvarlige, at gruppa fungerer som et forum for læring og at flytskjema som forbedringshjelpemiddel er praktisk og konkret.   Konklusjon Hovedfunnet indikerer at en struktur iverksatt av organisasjonen legitimerer læringsarbeidet for utøvere i pleie- og omsorgstjenesten. Denne opplevelsen av legitimitet stimulerer utøvere til å lære forbedringsarbeid, og gjennom dette oppleve økt empowerment. / Background: Experiences in my work as a nurse made me interested in the correlation between the inclination of health care professionals to learn and their status as empowered people. Purpose: The aims of this study is to gain more knowledge about how health care professionals perceive the experience of being involved in conscious learning processes and to get a better understanding of factors that are critical in this empowerment process.   Method and material: Phenomenography was used as the research method. 17 health care professionals, who are working in the primary health care system in two different Norwegian municipalities, participated in focus group interviews. They were divided into five quality management groups. All informants had previously learned from an external supervisor how to improve the quality of their work by using flow charts. Results: The data were categorized into one core category and three main categories. Critical factors are: the organisation’s focus on quality improvement, sufficient human and economical resources for learning, time for reflection and learning, an external supervisor teaching and supporting the groups, and leadership supporting change. Other important factors are how the professionals accept the extra work involved in being learners, group dynamics, and efficient use of flow charts. Conclusion: The findings suggest that a structure which gives the health care professional a feeling of legitimacy for giving priority to learning, is more likely to enter the process of empowerment / <p>ISBN 978-91-85721-27-6</p>

Bakgrunn: Mangelen på intensivsykepleiere kan påstås å være allment kjent i helsevesenet. Kravet om kompetanse er stigende, som igjen stiller høyere krav til utdanningsstedene. I løpetav studiet skal sykepleierstudentene gjennomføre klinisk praksis, og skal her knytte teori ogpraksis sammen, for å selvstendig kunne møte kompetansekravet som venter. Hensikt: Å finne ut sykepleierstudenter som har praksis på intensivavdelingen, sin opplevelse av miljøets betydning for læring. Metode: For å fange sykepleierstudentens perspektiv, er det gjort en integrativ litteraturstudie, hvor det sammen med bibliotekar systematisk er søkt etter forskning, som svarer til hensikten. Studiet består av seks kvalitative artikler, der data er analysert og systematisert.Resultat: Resultatet viser at intensivmiljøet er ett krevende sted å være i praksis, og mange følelser oppstår hos sykepleierstudentene. Opplevelsene til sykepleierstudentene som hadde betydning for læringen i intensivmiljøet, er presentert i 3 kategorier. Kategoriene viser at miljøet oppleves som krevende, men lærerikt, at det er viktig med ett god samspill og relasjon med veileder og at miljøet oppleves som stressende, dystert og høyteknologisk. Konklusjon: Miljøet i intensivavdelingen er krevende for læringen, men til tross for dette er det et bra sted å knytte teori og praksis sammen. Å ha en god relasjon til veileder virker å være essensielt for ett godt læringsmiljø. Samtidig viser studien til viktigheten av å være forberedt på hva intensivmiljøet innebærer. Med denne kunnskap kan studiesteder og praksissteder gjøre en forbedring. / Background: The lack of ICU nurses, can be claimed to be widely known in the health caresystem. The demand for high competence is rising, which puts a higher demand on the educational institutions. During the nursing program there is a time of practical training, where the goal is to link theory and practice together, in order to become an independent nurse who can meet the competence that is required. Aim: The aim of this study was to look at the nursingstudents' perceptions on how the environment impacts the learning, through practice in the intensive care unit. Method: In order to capture the nursing student´s perspective, an integrativeliterature study has been carried out, and together with a librarian, a systematic search for research have been done, which corresponds to the authors intension. The study consist of six qualitative articles, where the data was analyzed and systematized. Results: The results shows that the ICU is a demanding place to be in practice, and many emotions arise in the nursing students. The mainfactors in the environment that have impact on the nursing students learning, are presented in 3 categories. The categories shows that the environment is demanding, but educational, the importance of a good relation with the mentor, and that the environment is stressful, gloomy and high-tech. Conclusion: The environment in the ICU is demanding for learning, but despite this, it is a good place to link theory and practice together. Having a good relationship with the supervisor seems to be essential for creating a good learning environment. At the same time, the study points out the importance of being prepared for the ICU environment. With this knowledge, study institutions and internships can make an improvement.

Hensikt Hensikten med studien har vært å få dypere kunnskap om hva det har betydd for Marte Meo terapeuter i demensomsorgen å ha lært metoden.   Metode Grounded theory har blitt benyttet som analysemetode av åtte åpne intervjuer.   Resultat Informantene som alle er Marte Meo terapeuter, sier at de har fått en metode som de har savnet i demensomsorgen. Metoden hjelper dem til å oppdage taus kunnskap, støtte kunnskap som de allerede har og den styrker selvtilliten deres. De har fått økt bevissthet og et felles språk som har ført til et bedre arbeidsmiljø og en opplevelse av å se og møte pasientenes individuelle behov på en bedre måte.   Konklusjon Studien har vist at Marte Meo metoden har positiv innvirkning både fordi personalet får et bedre arbeidsmiljø og fordi personalet opplever at de etter å ha lært Marte Meo metoden  bedre kan møte pasientenes behov. / Purpose This qualitative study aimed to increase understanding of  what the consequences have been for Marte Meo therapists in dementia health care to have learned the method.   Method We used grounded theory to analyze eight open interviews.   Results The informants, all Marte Meo therapists reported that they gained a method they long have missed for dementia health care. The Marte Meo method helps them detect tacit knowledge, support and enforce known knowledge, and strengthen their self-confidence. They also gained increased awareness and a common language leading to an improved working environment and the individual needs of the patients are better seen and met.   Conclusion The study shows that Marte Meo method has positive influence both because the staff have an improved working environment and because the staff experience that they are better able to detect the patients needs after having learned the method. / <p>ISBN 978-91-85721-76-4</p>

<p>Becoming global – the troublesome integration process.</p><p>The thesis is based on research in Kongsberg Automotive and its foreign subsidiaries in Mexico, U.S.A, Poland and South Korea. It is a study of how these foreign units were established and how the head office in Norway was able to integrate these units in the organization.</p><p>The purpose of the study is to improve understanding of the challenges involved in internationalization processes. To what extent are cultural, political and social differences factors to consider when creating the international organization? In what way do actors and structures influence the process and the practices that emerge?</p><p>In an international organization cultural, political and social differences may create barriers towards understanding the other. This may be further complicated by different languages, time and geographical distances. The local manager abroad is central to the development of relations between the head office and the local unit and his perception of what is appropriate and his ability to make others agree is central to understanding the various practices and solutions that emerge in the local organization.</p><p>The main motivation and challenge of the central management is to control and coordinate the international organization. The study emphasizes the usefulness of different control mechanisms and how these attempts for control were perceived locally. Through time there was a stronger reliance on mechanisms for socialization and enculturation, and while these are directed towards creating a larger consensus in the organization, these should also be seen as means for decentralized control and self-monitoring.</p><p>The various organizational entities in Kongsberg Automotive represent different communities-of-practice and to understand the interaction between these communities as learning processes is central to the study. This perspective also confers an understanding of power as a productive element in the interaction.</p><p>The implications of this study for theory and future research are in embracing the complex nature of internationalization process. Relevant for understanding internationalization processes are both actors and structures intertwined. Institutional environments are central to an understanding of how different actors perceive practices and structures, and what they see as viable solutions. Neither the international organization nor the learning processes these undertake can be torn loose from the local cultural, political and social context.</p>

Becoming global – the troublesome integration process. The thesis is based on research in Kongsberg Automotive and its foreign subsidiaries in Mexico, U.S.A, Poland and South Korea. It is a study of how these foreign units were established and how the head office in Norway was able to integrate these units in the organization. The purpose of the study is to improve understanding of the challenges involved in internationalization processes. To what extent are cultural, political and social differences factors to consider when creating the international organization? In what way do actors and structures influence the process and the practices that emerge? In an international organization cultural, political and social differences may create barriers towards understanding the other. This may be further complicated by different languages, time and geographical distances. The local manager abroad is central to the development of relations between the head office and the local unit and his perception of what is appropriate and his ability to make others agree is central to understanding the various practices and solutions that emerge in the local organization. The main motivation and challenge of the central management is to control and coordinate the international organization. The study emphasizes the usefulness of different control mechanisms and how these attempts for control were perceived locally. Through time there was a stronger reliance on mechanisms for socialization and enculturation, and while these are directed towards creating a larger consensus in the organization, these should also be seen as means for decentralized control and self-monitoring. The various organizational entities in Kongsberg Automotive represent different communities-of-practice and to understand the interaction between these communities as learning processes is central to the study. This perspective also confers an understanding of power as a productive element in the interaction. The implications of this study for theory and future research are in embracing the complex nature of internationalization process. Relevant for understanding internationalization processes are both actors and structures intertwined. Institutional environments are central to an understanding of how different actors perceive practices and structures, and what they see as viable solutions. Neither the international organization nor the learning processes these undertake can be torn loose from the local cultural, political and social context.

Bakgrunn og hensikt: Astma er den hyppigste kroniske sykdommen i barnealderen, den påfører barn og familierpersonlige og sosiale påkjenninger samtutgjør et betydelig folkehelseproblem. For å handtere hverdagen trenger barna og foreldrene kunnskap. Det overgripende målet med avhandlingen er å utvikle læringstilbud til barn og foreldre der den pedagogiske tilnærmingen tar utgangspunkt i barns, foreldres og helsepersonells vurderinger om hva som er viktig å lære. Metode: Avhandlingen inkluderer 5 studier (I–V) ut fra 2 prosjekter som forgikk på en barneavdeling i Norge, i 1995–1998 og 2004–2007. I studie I og IIble hermeneutisk fenomenologi brukt der 9 foreldre deltok i dypintervju. I studie IIIble innholdsanalyse brukt i et aksjonsforsknings prosjekt, handlings-orientert forskningssamarbeid, der 90 personer deltok. I studie IV ble hermeneutisk fenomenologi brukt der 15 barn i alderen 7–10 år tegnet og deltok i dypintervju. I studie V ble innholdsanalyse brukt der samhandlingen mellom 3 barn og 2 helsepersonellble observerti et læringstilbud. Resultateneviser at både barn med astma og foreldrene erfarte engstelse og redsel i hverdagen (I,IV). Foreldrene uttrykte følelser av usikkerhet,hjelpeløshet og skyld (I). Barna var redde for forverrelser av astmaenog hvordan sykdommenpåvirket kroppen. De brukte mange forskjellige ord når de beskrev astma.De kjente astma i hele kroppenogsituasjonenkunne endre seg raskt fra vanliglek til at all energi var borte. Barna var redde for å bli utestengt fra lek og aktivitet, og opplevde det som et dilemma om de skulle fortelle om astmaen til andre eller holde det hemmelig(V). Både barn og foreldre erfarte det å dele erfaringer i gruppe som betydningsfullt (II, V). Barnas perspektiv og deltakelse ble ivaretatt gjennom intervensjonsfasen, mens barneperspektivet ble ivaretatt av voksne gjennom hele prosjekt 2 (III). I læringstilbudet kjente barna seg trygge, var aktive, lærte av hverandre og satte ord på egne følelser(IV). Fortellinger og bilder fungerte godt i pedagogisk tilnærming til barn. Barnas egne tegninger var et godt redskap for å kommunisere med barn og for å få tilgang til deres livsverden(V). Konklusjon: Denne avhandlingen viser at for å støtte barn og foreldre til å handtere astma i hverdagen, er det viktig at helsepersonell legger tilrette for læring ved å utforme læringstilbud som tar utgangspunkt i deres perspektiver. Det at barna selv er aktive, at deres egne erfaringer brukes og verdsettes i dialogen, viser et nedenfraperspektiv som er en god kilde til empowerment-prosesser. Slike prosesser styrker barna i troen på egne krefter og gir dem handlekompetanse. Læringsprosessene som er beskrevet i meningsfull læringvil styrke barnas begripelighet, handterbarhet og meningsfullhet og derved styrke barnas Sense of Coherence (SOC). Ved styrket SOC vil barna i større grad mestre utfordringer i livet og derved oppnå bedre helse og livskvalitet / Background and aim: Asthma is the most common chronic childhood disease,many children and families are personally and socially affected which makes asthma a public health problem. The overall aim of this thesis was to develop an asthma education programme for children with asthma and their parents, where the pedagogic approach takeschildren’s, parents’and health care personnel’s experiences and views as a starting point. Methods: This thesis includes 5 studies (I–V) from 2 projects performed in a paediatric ward in Norway in 1995–1998 and 2004–2007. In studies I and IIa hermeneutic phenomenological approach was used, in which 9 parents participated in qualitative research interviews. In study III, 90 persons participated in a co-operative inquiry. Data were analysed by content analysis. Study IV used a hermeneutic phenomenological approach: 15 children (7–10 years of age) participated in qualitative research interviews. In study V, 3 children and 2 health care personnel participated in an observational study. Content analysis was used in the analysis. The results showed that both the children and the parents experienced fear in their experiences of asthma in everyday life (I, IV). The parents expressed feelings of uncertainty, helplessness and guilt (I). The children experienced fear of exacerbations and how the asthma affected their bodies. They used many different words when they described how asthma affected them. They felt asthma in their whole body,and the condition could change quickly. The fear of being ostracised concerned all aspects of the children’s livesand they related a dilemma of keeping the asthma secret or being open about it (V). Sharing experiences in group settings was experienced as meaningful to both children and parents (II, V). The adult’s child perspectives were taken into account throughout the project, while the children’sown perspectives were taken into account during the period of intervention (III). During the asthma education programmethe children actively participated and learned from each other. As the pictures and stories were related to their experiences made it easier for them to express their own feelings. Drawings were a good way toinitiate a dialogue with the children and to get access to their lifeworld (V). Conclusion: This thesis shows that in order to support children and parents to cope with asthma, it is crucial to build on their perspectives in learning processes. Active involvement of the children shows a bottom-up perspective that can lead to confidence in their own strength and empowerment. Overall, this approach corresponds to an educational approach and learning theory that takes meaningful learning into account. Meaningful learning strengthens children’s comprehensibility, manageability and meaningfulness and their Sense of Coherence (SOC). A strong SOC leads to better health and a better quality of life