I den  uppsatsen analyseras medias konstruktioner av flyktingar genom diskursanalys.  År 2015 kom ett ökat antal flyktingar till Sverige vilket skrevs om i media. Syftet med studien var att undersöka mediers konstruktioner och diskurser av flyktingar då dessa diskurser kan komma att påverka distriktssköterskor i möten med flyktingar. Det är av vikt att diskutera hur det kan ta sig uttryck och om det hindrar ett välfungerande möte mellan distriktssköterskor och flyktingar. Att möta flyktingar bör ske utifrån ett personcentrerat synsätt där hänsyn tas till patientens subjektiva upplevelser, det vill säga patientens berättelse om sin upplevelse. Personcentrerad vård värdesätter patientens berättelse och sätter hens upplevelse av denna i centrum. En personcentrerad vård bygger på en medveten etik kring vårdhandlingar, en god relation och ett gott förhållningssätt till patienteter. Det är nödvändigt att öka kunskap och förståelse hos vårdpersonal som möter flyktingar i sitt arbete som distriktssköterskor gör. Utgångspunkten för personcentrerad vård är att människor ska bemötas som fria och värdiga personer. Kärnan i personcentrerad vård är partnerskap mellan vårdpersonal och patienten och dess anhöriga. Partnerskap innebär gemensamt beslut om hälsoplan. Hälso- och sjukvårdslagen (1982:763) grundas utifrån en humanistisk människosyn. Detta innebär att människan har rätt att medverka och bestämma över sig. Distriktssköterskan bör ha en medvetenhet kring sin egen människosyn då de kan komma att styra ens handlingar.   Data för studien hämtades från tre olika dagstidningar; Dagens Nyheter, Sydsvenskan och Svenska Dagbladet och deras publiceringar under september, oktober och november, 2015. Artiklarna söktes fram via Mediearkivet. Totalt analyserades 4022 artiklar som innehöll begreppet flykting. I analysarbetet användes AntcConc som är ett datorprogram som gör det möjligt att sortera större mängd text.  Det framkom att flyktingar i media konstrueras som en homogen grupp vilket vi anser kan leda till en negativ påverkan på läsaren och därmed på distriktssköterskor i mötet med flyktingar. Att arbeta utifrån ett personcentrerat förhållningssätt i mötet med dessa patienter innebär att aktivt försöka se bakom den konstruerade flyktingen och istället se människan i sin helhet. Fyra diskurser utifrån 13 konstruktioner identifierades. De fyra diskurserna var: krisdiskurs, hjälplöshetsdiskurs, politisk diskurs och ekonomisk diskurs. Vården och mötet kan utifrån vad som framkommit av innehållet i diskurserna bli begränsande och negativ för patienten. Det i sin tur kan skapa enskilt lidande för patienterna i fråga men också på sikt ge en ökad belastning för vården. Det är därför viktigt att belysa ämnet så att en god och jämlik vård kan ges. / In 2015, the increased number of refugees arriving in Sweden was covered in media. Public health nurses may in their encounter with immigrants be influenced by discourses arising from medial constructions of refugees. The aim of this study was to examine mass medial constructions of and discourses about refugees, since preconceptions can influence district nurses in encounters with these persons. It is a matter of importance to discuss how this can manifest itself, in order to make public health nurses encounters with refugees as well-functioning as possible. Person-centred care has been uses as a theoretical frame of reference in this study. A qualitative approach was chosen. The methods used were corpus analysis and discourse analysis.  Data was collected from three daily newspapers: Dagens Nyheter, Sydsvenskan and Svenska Dagbladet, published in September, October and November 2015. During this time the concept refugee occurred in 4022 articles. The result shows that refugees in media are contoured as a homogenous group. Four discourses based on thirteen constructions were identified. The four discourses were a crisis discourse, a helplessness discourse, a political discourse, and an economical discourse. From the discourses, it is assumed that public health nurses reading of medial texts about refugees influences their view, and therefore their care, of refugees. Hence, it is important to illuminate the constructions of refugees in media

Primärvården ska verka som ett nav i hälso- och sjukvården i omställningen mot ett mer personcentrerat förhållnings- och arbetssätt. Forskning visar på positiva effekter,likväl är kunskapen kring vilka förutsättningar som krävs för en personcentrerad vård begränsad på organisations- och systemnivå. Övergripande definition av personcentrerad vård saknas vilket försvårar för distriktssköterskan att utarbeta konkreta arbetsrutiner. Syfte: Syftet med studien var att belysa distriktssköterskans erfarenhet kring organisatoriska möjligheter att bedriva personcentrerad vård inom primärvården. Metod: Kvalitativ intervjustudie med nio distriktssköterskor på fyra vårdcentraler genomfördes. Data analyserades genom latent kvalitativ innehållsanalys med induktiv ansats. Resultat: Temat möjligheter och begränsningar inom verksamhetens ramar omger sju underteman anpassa tiden efter patientens behov, tidsbrist som sätter gränser, strävan efter kontinuitet, journalen som ett verktyg, kommunikationsstöd, friheten att få styra sitt arbete samt specialistsjuksköterskeutbildningens betydelse. Slutsats: Anpassa besökstiden utefter patientens behov möjliggör, medan tidsbrist begränsar. Kontinuitet samt tydlig dokumentation där patientens vilja framgår underlättar personcentrerat omhändertagande. En verksamhetsledning som uppmuntrar till personcentrering samt stöd av professionell tolk verkar som möjliggörare.  Specialistsjuksköterskeutbildning anses öka kunskap och förståelse för personcentrerad vård. För att primärvården samt specialistsjuksköterskeutbildningen ska utvecklas mot ett mer personcentrerat förhållningsätt kan ytterligare forskning inom ämnet vara önskvärt. / Primary care shall act as a core within the healthcare in the transition toward a more person-centred attitude and working approach. Research shows positive effects,however the knowledge surrounding which necessities are required for person-centred care are limited on both organization and systematic level. A definition of personcentred care is missing, making it difficult for the district nurse to develop concrete working routines. Aim: The aim of the study was to illustrate the district nurses’ experiences surrounding organizational possibilities to conduct person-centred care within the primary care. Method: A qualitative interview study with nine districtnurses in four health centres was done. The data was analysed using latent qualitative content analysis with an inductive approach. Results: The theme possibilities and limitations within the health care framework embraces seven sub-themes adapt time to the patients’ needs, lack of time sets boundaries, ambition toward continuity, journal as a tool, communication support, independence to steer your own work and meaning of specialist nursing education. Conclusion: Adapt visiting time to the patients’ needs make it possible, while lack of time is limiting. Continuity and also a clear documentation regarding the patients’ want and needs facilitates person-centred care. A management that encourage person-centred care and support from a professional interpreter act as enablers. Specialist nursing education is considered to increase knowledge and understanding for person-centred care. If primary care aswell as specialist nursing education shall develop toward a more person-centred approach further research is desirable within this topic.

Background: The Public Health Agency of Canada published a strategic document recognising the elements associated with person-centred dementia care, including interactions with stakeholders and research mandates. One essential element identified was advanced therapies, containing non-pharmacological interventions, such as creative arts-based interventions. Objective: This thesis investigates the impact of creative arts-based interventions on individuals with dementia, living in residential care through a scoping review (ScR) and a mixed-methods systematic review (MMSR). Methods: The ScR surveyed the current literature base to identify which creative arts-based interventions improved the personhood, quality of life and well-being of persons with dementia (PwD); five studies were included. The MMSR explored the impact of dance interventions on the symptoms of dementia on persons with Alzheimer’s disease and related dementias, as dance was unrepresented in the ScR; three studies were included. Both reviews were narratively synthesized due to the heterogeneity in the results. Results: Each included study spoke of the impact the creative arts had on the PwD and which element(s) of their health improved. Results also showed that the creative arts were beneficial for the personhood of the PwD (ScR) and for decreasing symptoms while promoting the person (MMSR). Conclusion: We must continue to look past the condition and recognize that creativity, psychosocial needs, and creative arts are all interconnected in promoting the personhood of PwD. Creative arts-based interventions can be designed to promote the individual creativity of the person and showcase their intact abilities.

We have been working together with Triona AB to design a dashboard mock-up for their web application TNE Editor, so they can get a better overview of important information. A process with many steps is needed to gather information about Trionas customers, we want to reduce the number of these steps. Triona is an IT-consulting business. They primarily work with logistics and infrastructure organizations. Our goal was to develop an administrative dashboard for TNE Editor. A user centred design (UCD) approach was used. This was done by involving the users in the process from the beginning to determine what requirements the users had. A UCD methodology helps use valuate if they are satisfied with the design according to the usability requirement satisfaction. Our research questions were: How can a dashboard reduce the steps needed to gather statistical information of Trionas customers? By implementing design principles for a dashboard, will the users be satisfied with the dashboard design? We interviewed employees at Triona that use the TNE Editor and made a SWOT-analysis based on their answers. The results showed opportunities to implement different data about Trionas customers on a dashboard. Information like the activity trend the customers, proportion of accepted and rejected projects and common error messages. We designed a dashboard mock-up with the feedback from the interviewees together with design guidelines such as gestalt theory and information visualization theory. We have also taken usability and user experience principles into consideration to make the dashboard as efficient and user friendly as possible. The users of the TNE Editor generally seem pleased with the dashboard mock-up. However, there is still room for additional iterations to improve the design further. / Vi har samarbetat med Triona AB för att designa en dashboard prototyp för deras webbapplikation TNE Editor, så att de kan få en bättre översikt över viktig information. För att samla information om Trionas kunder så krävs en process med många steg, vi vill minska antalet steg i denna process. Triona är ett IT-konsultföretag som främst arbetar med logistik- och infrastrukturorganisationer. Vårt mål var att utveckla en administrativ instrumentpanel för TNE Editor. Vi använde oss av en användarcentrerad design (UCD)-metodik. Detta gjordes genom att involvera användarna i processen från början för att fastställa deras krav och behov. En UCD metodik hjälper oss även att utvärdera om de är nöjda med designen enligt usabilitykravet satisfaction. Våra forskningsfrågor var: Hur kan en dashboard minska antalet steg som behövs för att samla statistik om Trionas kunder? Genom att implementera design principer för en dashboard, kommer användarna bli nöjda med dashboard designen? Vi intervjuade anställda på Triona som använder TNE Editor och genomförde en SWOT-analys baserad på deras svar. Resultaten visade möjligheter att implementera olika data om Trionas kunder på en dashboard. Information som aktivitetstrender för kunderna, andel accepterade och avvisade projekt samt vanliga felmeddelanden. Vi designade en dashboard prototyp utifrån feedback från intervjupersonerna tillsammans med designriktlinjer såsom gestaltningsteori och teori för informationsvisualisering. Vi har även tagit hänsyn till principer för användbarhet och användarupplevelse för att göra dashboard så effektiv och användarvänlig som möjligt. Användarna av TNE Editor verkar generellt sett nöjda med prototypen för instrumentpanelen. Det finns dock fortfarande utrymme för ytterligare iterationer för att ytterligare förbättra designen.

Background: There is significant concern about nurse burnout in nursing homes. There has been little research to investigate whether training in person-centred care and supervision can reduce nursing home nurses’ burnout. Aims: To adapt training to be suitable for nursing home nurses and evaluate the impact of training and supervision on burnout and related outcomes. Study Design: Focus groups with nursing home nurses were used to inform adaptation of the training. Mixed methods were used to evaluate the impact of training and supervision employing a convergent parallel design, including a Randomised Controlled Trial with quantitative measures (primary outcome measure: the Maslach Burnout Inventory) to assess effectiveness and exploration of subjective experience using qualitative interviews. The findings of the RCT and qualitative interviews were then compared to determine the convergences and divergences. Findings: The training was adapted to include content on leadership and stress management. Hypotheses that the interventions would reduce burnout and impact on other quantitative outcomes were not supported. Qualitative interviews with nursing home nurses about training indicated that the nurses reported reduced burnout, enhanced self-efficacy, reduced isolation, better team working, more informed person centred dementia care and enhanced leadership. Nurses’ views on the impact of supervision included a range of benefits. There was convergence between quantitative measurement and subjective experience indicting significant levels of burnout, but divergence in terms of the impact of training in person-centred care and supervision. Conclusions: My study demonstrates that burnout is a significant issue for nursing home nurses in the UK. There was divergence in my findings in terms of the impact of training in person-centred care and supervision. The hypotheses about training and supervision having positive impact on burn-out were rejected. However, the qualitative findings suggest that nursing home nurses experienced positive benefits from the person-centred training and supervision, in particular on their sense of burnout, their approach to care and leadership skills. Recommendations are made regarding research, training and policy to address burnout in nursing home nurses. / Burdett Charitable Trust of Nursing

The thesis focuses on the integration of sustainability in the early stages of startups by developing a new framework. Given the resource constraints and focus on viability, it might be difficult for startups to consider sustainability at these early stages. A literature review revealed a lack of information on this subject. The research investigates the sustainability-related challenges startups face, identifies factors for sustainable business models using expert interviews and literature review. Due to the lack of information related to sustainable early stages start-ups, the author analyses basic principles related to start-ups and sustainability. The author looks into holistic approach to sustainability since a fragmental approach to sustainability risks harming the ecosystem while improving some metrics without systemic overview. Life-centred design is an emerging design approach that focuses on the well-being of all life forms and the health of our planet, thus making a shift from just human-centred design. The life-centred design was taken into consideration since it covers different aspects of sustainability as well as ethics and provides practical guidance for the designing process. Based on literature review and expert interviews the framework was formulated. The developed solution was tested with three early-stage startups, providing practical insights. The author analyses the findings and concludes that start-ups which have sustainability as a core value proposition are already sustainable and their sustainable impacts potentially scales with their product growth. At the same time for these types of start-ups it’s vital to consider additional value for the customer apart from sustainable value. For the start-ups with core value not directly related to sustainability, the sustainability can be embedded within a lean approach and aligning sustainability with their business goals if it doesn't require sacrificing limited resources such as money. Finally, the author suggests tools that raise awareness of participants and can be useful for holistic picture, based on findings during the workshop.

Neurodevelopmental disorders (NDD) refer to conditions that can be present during a child’s early developmental period, and are typically characterized by challenges in a child’s personal, social, academic, or occupational functioning. Autism spectrum disorder (ASD) is an example of NDD, impacting 1 in 66 children in Canada. While interventions vary across this heterogeneous group of impairments, everyday functioning is an important outcome to families. However, this concept of functioning needs further examination with respect to whether and how it is incorporated within the instruments and concepts used in family-centred services (FCS), and how this is understood by parents. This thesis is composed of two studies: a narrative review identifying function-focused measures published in the literature for children with NDD; and a qualitative study examining how parents of children with ASD perceive their child’s abilities in relation to family-centred services. Fourteen clinical measures were described in the review based on how they utilized the International Classification of Functioning, Disability, and Health (ICF) to describe child functioning. In the qualitative study, five themes (Parenting Approaches, Accepting My Child, Managing Child’s Challenges, Doing the Right Thing for My Child, and “The Disability Tag”) were identified as influential factors that can affect how parents perceive their child’s abilities and functioning. As the cultural shift within interventions for children with NDD continue to move beyond the historically prominent deficit-focused lens, and towards the integration of neurodiverse abilities, this study enables us to understand better how concepts of function-focused care are operationalized in family-centred services and intervention systems. / Thesis / Master of Science Rehabilitation Science (MSc) / To support the shift in health care that focuses on the abilities of children with neurodevelopmental disorders (NDD) rather than their ‘problems’ or ‘deficits,’ we need to further understand how family-centred services (FCS) can better fit this change in thinking. This thesis explores paediatric health care focused on addressing ‘everyday abilities’ for children with NDD in research and clinical practice over two studies. Study #1 reviews some of the current ways that everyday functioning is measured in paediatric health care, examining 14 clinical tools developed for children with NDD. Study #2 reports key patterns that describe the experiences of parents of children with autism, in regards to how they think about their child’s abilities, and the care their child receives. Overall, this thesis studied new ways that we can explore the abilities of children with NDD in FCS, specifically concerning how parents and clinicians describe and measure functioning.

This project provides the first comprehensive investigation into the experiences of people with dementia (PWD), their carers, and the staff who provide care in emergency departments (ED) in the UK. This is a mixed methods study which used a national survey (N=403) followed by ED observation (32 hours) and qualitative interviews with health professionals (N=29), in an iterative and sequential design to present a holistic evaluation of the current experiences of the key parties- patients, carers, and ED staff involved in receiving and providing care. The theoretical perspective of the Human Factors Approach to patient safety underpins this work. The project included people with dementia and carers as collaborators and co-designers in both the development of the research tools and in shaping the project outputs. This research explores the barriers and facilitators to safe and effective care, concluding that here are a number of barriers (poor integration of communication systems, inappropriate physical environments, misalignment of staff training and workplace staffing models), which may affect the healthcare team’s ability to provide effective dementia care. These systemic challenges both give rise to and exacerbate poor organisational and safety cultures. However, despite these challenges, there are examples of safe and effective care (positive deviants) where uncommonly good outcomes for this patient population are achieved. Examining these examples offers valuable insight into potential adaptions, which could be used to improve existing care.

This paper is a research through design approach (Zimmerman et al 2007),that seeks to reflect upon several designerly practices in action. Chiefly it’sconcerned with describing the development of a web-service withcollaborative media elements, as part of a user-centred design process, tosupport physiotherapy patients during their self-directed recovery. The reportalso reflects on a failed first design attempt, and draws through that reflectiondescribes the way I now choose to operate as a designer. The paper proposesa new definition of design for well-being which draws upon and combineswork by Dodge et al (2012) and Miller & Kälviäinen (2006). Finally, thereport also proposes a series of further steps to take in the futures to developthe web-service.

Parent engagement in children’s developmental rehabilitation services is thought to be a fundamental component that is needed for children to reach their potential. This is especially true in the approach known as family-centre services – an approach that positions parents as partners in their child’s services. However, service providers and organizations can have difficulty engaging those parents who often miss their child’s appointments. These families are typically referred to as ‘hard-to-reach’, however this label may ascribe ‘blame’ to parents and lead service providers, researchers and policy makers to overlook the social, organizational, and economic barriers that can limit families’ use of services. Chapters 2-4, explore multiple avenues to contextualize parents’ attendance and engagement in children’s therapy services by applying family centred service tenants, Family Stress Theory, and ethical principles. These chapters lay the foundation for the grounded theory study presented in Chapter 5. This study, conducted with parents of children who use developmental rehabilitation services, describes the conditions that affect parent engagement and presents The Phoenix Theory of Parent Engagement to illustrate how parents attend, participate and engage in their child’s therapy service. These results are presented as a metaphorical journey through children’s developmental rehabilitation services in pursuit of child health and happiness. The implications of this theory are presented as they might be relevant to service providers, organizational leadership, and policy makers. These ideas are offered in an effort to inspire a coordinated effort to improve access and excellence in the provision of developmental rehabilitation services for children and families. / Thesis / Doctor of Philosophy (PhD) / Children’s developmental rehabilitation services are thought to be most effective when parents consistently attend, participate and engage in the service. When families do not consistently attend, participate or engage in services they can be labelled as ‘hard-to- reach’. Little is known about why families are hard-to-reach, if there are organizational barriers to service use, and how to promote engagement. This thesis provides a foundation for understanding parent engagement by exploring the clinical application of family-centred service, Family Stress Theory, and ethical principles. A grounded theory study is presented to contextualize parent engagement and explain how parents engage in their child’s developmental rehabilitation services. Service providers, organizational leadership, and policy makers can apply this theory to promote access and engagement in children’s developmental rehabilitation services.