The aim of the study was to determine the practice of nurses employed in integrated care projects in New Zealand from late 1999 to early 2001. Integrated care was a major health reform strategy that emphasised primary health care as a means to improve service provision between the health sectors. An investigation of nurses’ practice sought to determine the extent to which primary health care principles had been adopted in practice, as a comprehensive primary health care approach has been advocated globally in the management of chronic conditions; the leading cause of disability throughout the world and the most expensive problems faced by health care systems. The philosophical basis of the research was postpositivism. The study employed a quantitative non-experimental survey design because it allowed numeric descriptions of the characteristics of integrated care projects to be gained for the purpose of identifying nurses’ practice. The unit of inquiry was the integrated care project, and 80 comprised the study population. Data were obtained on projects from expert informants (n=27) by telephone survey using a structured interview questionnaire developed by the researcher. Data obtained from interviews were statistically analysed in two stages. First, data were produced to comprehensively describe the characteristics of integrated care projects and nurses practice. The ‘Public health interventions model’ was used as a framework to analyses the interventions (activities) and levels of population-based practice of nurses. Following this, the social values embedded in nurses’ practice were determined using ‘Beattie’s model of health promotion’ as a framework for analysis. A strong association was found between nurses’ practice in projects and strategies used in integrated care, such as information sharing, guideline development and promotion, and case management, and projects with an ethnic focus, low income focus, chronic condition focus, and well-health focus. Whilst nurses undertook interventions most frequently at the individual practice level they were also strongly ii associated with the small proportion of interventions that were undertaken at the community level. The majority of interventions by nurses reflected the health promotion value of health persuasion, indicating a paternalist and individual-oriented philosophy. Nurses were engaged in two interventions that indicated a collectiveoriented philosophy - coalition building and community development, the latter reflecting health promotion values of negotiation, partnership and empowerment. The study demonstrated that nurses’ practice in projects was predominantly centred on individual-focused population-based practice suggesting the need for a framework to assist nurses to transition their practice to include more activity at the community and systems levels. Without a reorientation of practice, nurses will remain limited in their ability to achieve health gains for populations. In response to this conclusion, and drawing on research results and reviewed literature, a new model, The ‘Primary Health Care interventions model’ was constructed. Recommendations include advocacy for the acceptance of the model by the health funder, professional nursing bodies, health organisations, educational institutions, nurses, communities, and individuals.

Children have the right to participate in matters concerning them. The Swedish Child Welfare Services constitute an arena in which a significant portion of open care interventions for children and their families take place, and thus a context in which children’s participation should be realized. The overall aim of this licentiate thesis is to explore how child participation is constructed in interventions provided by Swedish Child Welfare Services. The study is based on social constructionist theory and includes semi structured interviews with 11 children aged 7-16, whom had experience of receiving open care interventions provided by Swedish Child Welfare Services over a period of time and focus group discussions with 14 family social workers who provide suchlike interventions. The data were analysed using Thematic Analysis.     The first article, which has been published in a peer-review journal, is based on semi structured interviews with the children and focus group discussions with the family social workers. The article explores how child participation is constructed in interventions provided by Swedish Child Welfare Services and which elements are of importance to this process. The results suggest that child participation is a collaborative process in which both the child and the family social worker have an active role to play. Participation is done through a series of seemingly small, everyday actions by the child and the family social worker. By actively asking questions and allowing the child to practice participation and influence the process, the family social workers can, together with the child, work toward increased child participation in interventions.     The second article explores children's actions of participation and how these can be understood in relation to situational constraints using the concept of agency. The article is based on the interviews with the children. The findings suggests that children's actions, as described by the children, are formed in relation to the context. Some actions of participation can be described as permissible and some, when children behave in a way that exceeds the boundaries permitted by their position as children, disturb the existing order. The results suggest there are situational constraints, such as limited range of options available to influence the intervention, limited access to apply for support and limited ways to find new solutions when the children are not satisfied with an intervention.     The overall contribution of the study lies in the enhanced understanding of the collaborative process through which participation is done, as well as the increased knowledge of children’s actions of participation in a social work context. / <p>Paper II in dissertation as manuscript</p><p>Paper II is not included in the fulltext online</p>