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This thesis aimed to critique the research on person centred care (PCC) in neurorehabilitation, and consider how PCC in this setting can be further developed. Paper One reviews the extant literature on PCC in neurorehabilitation. The literature search returned 27 papers, which were critiqued for quality, how they conceptualised PCC, how they practiced PCC and the feasibility of PCC. Conceptualisations of PCC used varied from narrow conceptualisations of PCC as participation in goal setting, to broader ones which also incorporated issues such as shared decision making, outcomes, respect and emotional support. Similarly, methods of practicing PCC primarily used goal setting, with a minority of papers addressing outcomes and communication aspects of PCC. The review found that PCC is feasible for neurorehabilitation, with important benefits for clients and professionals. Providing PCC in neurological rehabilitation can be challenging and the literature review discusses ways to overcome barriers to PCC. The literature review highlights the need for methods to assess and develop PCC which are suitable for people with and without cognitive impairments. Paper Two addresses this need, by presenting research investigating the feasibility of using Dementia Care Mapping (DCM) on a neurorehabilitation ward. DCM is an observational method aims to document the quality of care from the perspective of the patient. DCM was found to be feasible for use on a neurorehabilitation ward, as shown by the suitability of the coding system. Q-methodology was used to assess staff perceptions of DCM. This further supported DCM feasibility, with staff reporting that DCM provided useful information for staff that they could use to improve the care they provided. DCM required some minor amendments in order to be used in a hospital rehabilitation environment and further amendments could improve its suitability for use in neurorehabilitation settings. Paper Three is a critical appraisal of both the literature review and research paper. The strengths and weaknesses of the use of both DCM and Q-methodology are critiqued, and consideration given to the limitations of the research.

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Bakgrunden till denna c-uppsats är den utredning som resulterade i bland annat införandet av en nationell värdegrund för äldreomsorgen. Enligt denna ska äldreomsorgen bland annat vara personcentrerad. I verkligheten är den dock ofta mer uppgiftscentrerad. Genom att intervjua fem personer som har jobbat/jobbar på äldreboenden har jag undersökt vad som behövs för att äldrevården ska vara personcentrerad. Jag har fått veta vilka organisatoriska förutsättningar som finns för att vårdbiträden ska kunna ha ett personcentrerat arbetssätt samt vilka arbetsmetoder och förhållningssätt som kan göra vårdbiträdets arbete mer personcentrerat. Min teoretiska referensram har varit Nightingales omvårdnadsteori samt Orlandos teori om en reflektiv omvårdnadsprocess.     De organisatoriska förutsättningarna visade sig vara att hela arbetsgruppen strävar efter ett personcentrerat arbetssätt. I annat fall kan det vara svårt för det enskilda vårdbiträdet att göra det. Att chefen inte är motsträvig till ett sådant sätt att arbeta är även det en faktor som kan påverka hur personcentrerad vårdbiträdenas arbete är, men chefens åsikter verkar inte påverka lika mycket som kollegornas åsikter och arbetssätt. En tillräcklig personaltäthet är även det viktigt. När det gäller arbetsmetoder eller arbetssätt som främjar en personcentrerad äldrevård, kom jag fram till att ett mer flexibelt till skillnad från ett mer rutinfast arbetssätt är främjande. Att ha som rutin att varje vårdbiträde läser varje vårdtagares nedskrivna ”livshistoria” är en annan arbetsmetod som gör det lättare att personcentrera vården till varje individ. Ytterligare sätt är att använda sig av de nationella riktlinjerna som ett verktyg i sitt arbete, att man lär av varandra samt reflekterar över sitt eget arbetssätt och att man utnyttjar erbjuden extern hjälp. Attityder och förhållningssätt hos personalen, som kan främja en personcentrerad äldreomsorg visade sig vara att fokusera på människan bakom arbetsuppgiften och att prioritera vårdtagarens behov och önskningar före ens egna. Ett annat förhållningssätt som främjar en personcentrerad vård är att vårdbiträdet ser äldreboendet som vårdtagarens hem, inte enbart som sin arbetsplats.

Published Article / Problem-based learning (PBL) is a learner-centred strategy that can be used to achieve the objectives of Outcomes Based Education (OBE). The Hospitality management program has no evidence of a fixed learner-centred didactic approach such as PBL, E-learning or Resource-based learning (RBL). In considering PBL, we raised questions: Why PBL? To what extent are staff and learners prepared for PBL? What are the characteristics of the curriculum when implementing PBL etc? This paper highlights these and other questions. The outcome shows that principles of PBL are extremely applicable to Hospitality but that timetabling within the program is a concern.

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Philosophiae Doctor - PhD / Violence occurs in different environments, however, it is often found in the family with family members being the perpetrators. Family violence, as an integrative concept, is defined by few researchers or theorists, let alone conceptualised as a theoretical grounding for family-centred interventions aimed at violence in the home. However, family members are all affected in the act of any violence in the family, thus any intervention should include the whole family. A family-centred approach focuses on all family members to be included in the intervention and is acknowledged as the best method when trying to create an intervention for family violence. Thus, the aim of this study was to design an intervention programme for families experiencing family violence in order to reduce violence in the family. To create such a programme, intervention mapping was the chosen design for this study. Intervention mapping has five steps, 1.) Specify the programme’s goals into proximal programme objectives. In this stage, needs are identified; 2.) Selection of theoretical and practical strategies; 3.) Design the programme, 4.) Implementation of the programme, and 5.) Focus on anticipating process and effect evaluation. However, this study only focused on the first 3 steps of intervention development, namely, Phase I, a family violence needs assessment done to identify the problem, Phase II entailed a review done to determine appropriate theoretical and practical approaches for the intervention regarding family violence, and lastly, Phase III had been a Delphi study which aided in the design and development of the intervention. This study showed promising results with proven long-term positive effects in implementing a family-centred approach, and when coupled with a collaborative network of support services, political will, and community support, and has the ability to ensure continuity of care and improved functioning for families experiencing violence in the home.