Studiens syfte är att undersöka om användarinvolvering underlättar IT-implementeringar. Teknikens snabba framväxt påverkar organisationer i den grad att de måste implementera IT förr eller senare. Samtidigt finns det stora utmaningar med IT-implementeringar, de uppfyller sällan dess fulla potential eller bidrar med den förväntade nyttan. Ett sätt att underlätta IT-implementeringar är att involvera användare i processen, något som kallas för användarinvolvering. Studien riktar in sig på offentliga och privata organisationer i Sverige som har genomfört en eller flera IT-implementeringar de senaste 2 åren där användarinvolvering använts.  Denna studie är utformad genom en kvalitativ ansats. Empirin till studien har samlats in genom sju semistrukturerade intervjuer med respondenter vars roller i sina respektive organisationer bidrar till ett helhetsperspektiv kring studiens område. Fem organisationer medverkade i studien där två av organisationerna verkar inom offentlig sektor och tre inom privat sektor, varav tre respondenter är från samma företag. Organisationerna är verksamma inom finans, hälsovård, industrivaror & tjänster, försäkringar och transport.  Artikeldatabaser och bibliotekskataloger användes för att gå igenom tidigare forskning som sedan låg till grund för den teoretiska referensramen och analysen. De begrepp och teorier som används i studiens teoriavsnitt är problem och onödiga kostnader med IT-implementeringar, system development life cycle, användarinriktad design och organisationsstorlek & organisationsstruktur.  Studien visar att användarinvolvering har stor betydelse på korta IT-implementeringar som varar i 0–3 år. Vid långa IT-implementeringar som sträcker sig 3 år eller längre har användarinvolvering låg betydelse. Studien visar att användarnas involvering på implementeringar skiljer sig från verksamhet till verksamhet och är beroende av både implementeringen- och organisationens storlek. / The purpose of this study was to investigate if user involvement is a crucial factor for the success of IT implementation. The rapid evolvement of technology affects organizations to the extent that they need to implement Information Technology (IT) sooner or later. At the same time, there are big challenges with IT-implementations, they rarely fulfill their potential or contribute with the expected usage. One way to increase IT-implementation rate of success is to involve the user in the process, this is called user involvement. This study focuses on public and private organizations in Sweden who have implemented one or more IT-implementations in the last 2 years, where user involvement has been used.  This study is designed through a qualitative approach. Empiricism of the study has been gathered through seven semi-structured interviews with respondents whose roles in their respective organizations contribute to a holistic approach to this area of study. Five organizations were involved in this study where two of the organizations work within the public sector and the other three in private sector, whereof three respondents work in the same organization. The organizations in this study are active within the work areas of finance, healthcare, industrial goods & services, insurance and transportation.  Article databases and library catalogs were used to review previous research which then provided the basis for the theoretical reference and analysis. The concepts and theories used in the study’s theory section are problems and unnecessary costs with IT-implementations, system development life cycle, participatory design and organization size & organizational structure.  The study shows that user involvement is a key factor on short IT-implementations that lasts 0-3 years. For long IT-implementations lasting 3 years or more user involvement is of less importance. The study shows that user involvement on implementations differs from business to business and depends on both the size of the organization and implementation.

Patients in psychiatric care experience a need for and expect to develop interpersonal relationships with professional caregivers and to be respected and listened to. Despite demands for care to be person-centred and recovery-oriented, patients experience that psychiatric inpatient care fails to meet their expectations. Nursing research suggest that nurses aspire to engage with and meet the needs of patients, but that the strenuous reality of inpatient care prevents them from doing so. Exploring the content and context of psychiatric inpatient care from the perspective of professional caregivers might provide valuable insights regarding what caregivers do, and more importantly it can aid in understanding why they do what they do.This thesis aimed to explore the content and context of adult psychiatric inpatient care from the perspective of professional caregivers. This was achieved by clarifying the concept of person-centred care in the context of inpatient psychiatry, describing staff members’ reasoning on their choice of action and perceptions of interprofessional collaboration in challenging situations in inpatient psychiatric care settings, and exploring nurses’ experiences of good nursing practice in the specific context of inpatient psychiatry. A systematic review of the literature identified 34 scholarly papers that were analysed using evolutionary concept analysis. Focus group interviews were conducted with 26 professional caregivers and analysed using qualitative content analysis. Individual qualitative interviews were conducted with 12 skilled, relationship-oriented nurses and analysed using an interpretive descriptive approach to qualitative analysis.Reviewing the literature on person-centred care in inpatient psychiatry clarified how person-centred care is expected to result in quality care when interpersonal relationships are used to promote recovery. Professional caregivers’ reasoning on choice of action described different concerns in caregiver-patient interaction resulting in a focus on either meeting patients’ individual needs or solving staff members’ own problems. Describing professional caregivers’ perceptions of interprofessional collaboration suggested that they are being constrained by difficulties in collaborating with each other and a lack of interaction with patients. Exploring nurses’ experiences of good nursing practice revealed how circumstances in the clinical setting affect nurses’ ability to work through relationships. It is argued that these findings describe the workings of two opposing forces in psychiatric inpatient care. The concept of caring as a process forms the basis for discussing the content of care as a moral endeavour in which nurses strive to do good. The concept of demoralizing organizational processes is used to discuss the context of care as demoralizing and allowing for immoral actions.The main conclusions to be drawn are that, from a nursing perspective, nurses in psychiatric inpatient care need to focus on patients’ experiences and needs. For this they need sufficient resources and time to be present and develop relationships with patients.Nurses in psychiatric inpatient care also need to take personal responsibility for their professional practice. Attempts to transform psychiatric care in a person-centred direction must consider all of these aspects and their interrelatedness. Further research on psychiatric inpatient care is needed to understand more about how the content of care relates to the context of care. / <p>Godkänd; 2015; 20150526 (sebgab); Akademisk avhandling som med vederbörligt tillstånd av Filosofiska fakulteten vid Luleå tekniska universitet för avläggande av Filosofie doktorsexamen kommer att offentligen försvaras i Deltasalen, D 770, Luleå tekniska universitet fredagen den 25 september 2015, kl. 10.00. Fakultetsopponent: Docent Ulla Hällgren Graneheim, Institutionen för omvårdnad, Umeå universitet Betygsnämnd: Professor Margareta Lilja, Institutionen för hälsovetenskap, Luleå tekniska universitet Professor Johan Sandström, Institutionen för ekonomi, teknik och samhälle, Luleå tekniska universitet Docent Lauri Kuosmanen, Institutionen för omvårdnad, Åbo universitet Huvudhandledare: Professor Stefan Sävenstedt, Institutionen för hälsovetenskap, Luleå tekniska universitet Biträdande handledare: Universitetslektor Malin Olsson, Institutionen för hälsovetenskap, Luleå tekniska universitet Professor Rolf Adolfsson, Institutionen för klinisk vetenskap, Umeå universitet</p>

This case study provides new insights on the designer role in co-design processes. Co-design has shifted the designer role into a facilitator, which requires a new skillset. In this thesis, this new role is investigated through the three psychological constructs; empowerment, ownership and power dynamics. The process consists of two main parts: pre-study and case study. In the pre-study, designers with different roles are interviewed about co-design. In the case study, three co-design sessions are observed and the facilitators interviewed in retrospect. Several strategies and actions are identified for empowering participants, some for the participants to feel ownership and almost none for balancing out power dynamics. The identified strategies include using straightforward methods and having a selfless mindset. However, there are indications that long term relationships are prioritized over actual outputs. This notion might be explained by the fact that the case companies are consultants. The need to always satisfy the clients makes the facilitators disregard some of the power differences in the room.

Bakgrund: Användandet av informellt tvång riskerar begränsa patientens självbestämmande i   utformandet av sin vård. Trots detta vidmakthåller vårdpersonal användandet av informellt tvång på grund av dess effektivitet för patientens följsamhet till föreslagen behandling och för att upprätthålla en säker vårdmiljö. Att begränsa patientens självbestämmande utöver vad som regleras i lag är i gråzonen till vad som kan betraktas vara tillåtet. Syfte: Att beskriva patienters erfarenheter av informellt tvång samt beskriva alternativ som främjar personcentrerad vård.  Metod: En systematisk integrativ litteraturöversikt av nio kvalitativa artiklar. Dataanalysen genomfördes utifrån Whittemore och Knafls metod.   Resultat: Två övergripande teman identifierades; Vårdens inverkan på informellt tvång och Konsekvenser av informellt tvång med två respektive tre subteman som inspirerades av   NANDA-I; Otillräcklig relation, Potential för förbättrad stresshantering, Risk för hotad värdighet, Maktlöshet samt Defensiv- och ineffektiv stresshantering. Slutsats: Vårdpersonalens användande av informellt tvång har medfört negativa upplevelser och   hanteringsstrategier för patienterna. Ur patienternas beskrivningar återfanns alternativ till det informella tvånget som är kunskap vårdpersonal kan använda sig av för att arbeta enligt principer för personcentrerad vård. / Background: The use of informal coercion poses a risk to limit the patient’s autonomy in the formation of their care. Regardless of this, healthcare personnel maintain the use of informal coercion due to its effectiveness in compliance, and maintaining a safe care environment. This restrictive act of patient’s autonomy is in a grey area to what can be considered as allowed.  Aim: To describe patients’ experiences of informal coercion and alternatives that promote person-centered care. Method: A systematic integrative review of nine qualitative articles. The data analysis was performed based on the method by Whittemore and Knafl. Results: Two major themes were identified; The impact of care on informal coercion and Consequences of informal coercion with two, respective three minor themes inspired by NANDA-I; Ineffective relationship, Readiness for enhanced coping, Risk for compromised human dignity, Powerlessness, Defensive- and ineffective coping.  Conclusions: Healthcare personnels’ use of informal coercion has led to negative experiences and coping for the patients. From the patients’ descriptions, alternatives were found, which is knowledge that   healthcare personnel can use to work according with principles for person-centered care.

Bakgrund: Diabetes typ 2 är en folksjukdom som drabbar oftast vuxna och äldre vuxna. Diabetes typ 2 påverkar alla på vardaglig nivå, men det finns forskning som visar att kvinnor med diabetes typ 2 är mer utsatta på grund av att de väljer att prioritera andras hälsa och välmående. Syfte: Att beskriva hur kvinnor med diabetes typ 2 upplever sitt dagliga liv. Metod: En litteraturöversikt gjordes genom att nio stycken vetenskapliga artiklar av kvalitativ karaktär söktes fram från databasen CINAHL. Analysen har haft induktivt förhållningssätt och tidsspannet för artiklarna har varit mellan 2010 - 2019. Resultat: Analysen ledde till tre teman: en komplicerad tillvaro, en påtaglig stress och betydelsen av en stödjande omgivning. Kvinnornas tillvaro upplevdes komplicerad på grund av minskad självständighet i det vardagliga livet. Stress var en upplevelse som gjorde vardagen mer utmanande då deras blodglukosvärde var kopplad till deras upplevelse av stress. Kvinnor som upplevde omgivningens stöd hade det lättare att följa diabetesrekommendationer jämfört med kvinnor som inte hade det. Slutsats: Personcentrerad omvårdnad var viktig för kvinnorna för att få mer kunskap och stöd för att uppnå optimal egenvård då dålig egenvård relaterades till tidsbrist och otillräcklig kunskap om hur de skulle sköta sin diabetes. / Background: Diabetes type 2 is a common disease that usually affects adults and older adults. Diabetes type 2 affects everyone at everyday level, but research indicates that women with type 2 diabetes are more vulnerable because they choose to prioritize the health and well-being of others.Aim: To describe how women with type 2 diabetes experience everyday life.Method: A literature review was made by searching for nine scientific articles of qualitative character from the database CINAHL. The analysis has had an inductive approach and the time span for the articles has been between 2010 - 2019.Results: The analysis led to three themes: a complicated existence, a tangible stress and the importance of a supportive environment. The existence of women was experienced complicated due to reduced independence in everyday life. Stress was an experience that made everyday life more challenging as their blood glucose value was linked to their experience of stress. Women who experienced the support of the environment was able to follow diabetes recommendations easier than women who lacked the environment support.Conclusions: Person-centered nursing was important for women to gain more knowledge and support in achieving optimal self-care since poor self-care was related to lack of time and insufficient knowledge of how to manage their diabetes.

Bakgrund: Diabetes mellitus typ 2 är en sjukdom som blir allt vanligare. Personer som diagnostiserats med sjukdomen behöver bryta gamla rutiner och tillämpa livsstilsförändringar som är anpassade för sjukdomen. För att kunna genomföra dessa livsstilsförändringar krävs kunskap om diabetes mellitus typ 2. Hälso- och sjukvårdspersonalen har ett stort ansvar att ge personerna relevant och personcentrerad patientundervisning för att livsstilsförändringar ska kunna ske.Syfte: Att beskriva vad personer med diabetes mellitus typ 2 upplever främjar och hindrar livsstilsförändringar. Metod: En litteraturöversikt med kvalitativ design och ett induktivt förhållningssätt gjordes. Resultat: Det framkom att bra bemötande och personcentrerad patientundervisning av hälso- och sjukvårdspersonal genererade god självhantering och motivation till livsstilsförändringar hos personerna med diabetes mellitus typ 2. Bristande kunskap om sjukdomen på grund av otillfredsställande patientundervisning ledde till osäkerhet om behandlingen, och oro över att göra fel hindrade personerna att utföra livsstilsförändringar. Slutsats: En personcentrerad patientundervisning är nyckeln till goda livsstilsförändringar för personer med diabetes mellitus typ 2. När personerna får individanpassad undervisning genererar det god kunskap om sjukdomen som förbättrar personernas genomförande av livsstilsförändringar. / Background: Type 2 diabetes mellitus is an increasingly common disease. People diagnosed with type 2 diabetes mellitus need to break old routines and apply lifestyle changes that are appropriate for the disease. To be able to implement these lifestyle changes, knowledge of type 2 diabetes mellitus is required. The healthcare staff have a huge responsibility to give the persons relevant and person-centred patient education, so that lifestyle changes can take place. Purpose: to describe what people with diabetes mellitus type 2 experience promote and prevent lifestyle changes.Method: A literature review with qualitative design and an inductive approach was made. Result: It emerged that a good encounter and person-centred patient education of healthcare professionals generated good self-management and motivation for lifestyle changes in the persons with type 2 diabetes mellitus. Lack of knowledge about the disease due to unsatisfactory patient education led to uncertainty about the treatment, and concerns about wrongdoing prevented people from lifestyle changes. Conclusion: A person-centred patient education is the key to good lifestyle changes for people with type 2 diabetes mellitus. When the individuals receive individualized education, it generates good knowledge of the disease that improves the self-management and performance of lifestyle changes.

Cognitive difficulties can persist for months and years after stroke and adversely impact confidence, mood and functional recovery. Stroke survivors, carers and healthcare professionals collectively agree that improving cognition is the number one research priority for life after stroke. Future research should include measurements of outcome that service users deem important. Patient reported outcome measures (PROMs) are a means of gaining patient perspectives that can be standardised for use in a trial. PROMs should be developed with service users to incorporate their priorities but people with cognitive difficulties are often systematically excluded from the development and use of PROMs. Study 1 used qualitative interviews (N=16) to explore stroke survivor perspectives on the important and measureable impacts of persisting cognitive problems. The results of this study generated requirements for a PROM that related to conceptual underpinning and face validity of a measurement tool. Study 2 was a systematic review of existing PROMs related to cognition. 20 Identified PROMs were critically appraised against the requirements generated in the qualitative study. No existing PROMs were identified that met all of the qualitative study review criteria. The next stage described in chapter 3, was to develop a new PROM that: utilised the strengths of existing tools; met qualitative study requirements; and was refined through consultation with different stakeholders, prioritising feedback of stroke survivors with cognitive difficulties. The result of this work was the Patient Reported Evaluation of Cognitive State (PRECiS) scale. Study 3 was a psychometric study with stroke survivors (N=164) to test PRECiS in a large sample. Quantitative and qualitative data were collected on acceptability, feasibility and other psychometric properties of validity and reliability. PRECiS demonstrated good acceptability to stroke survivors and performed well psychometrically. Future validation work required for PRECiS is described in discussion chapter 4. Subject to further validation work, PRECiS may be particularly useful for pragmatic trials of cognitive rehabilitation after stroke.

The purpose of this research is to critically inquire into the appropriateness of the current human computer interaction (HCI) practices in Information and Communication Technologies and Development (ICTD) system design given the contextual constraints and challenges found in developing country contexts. Despite user participation in system design being a buzzword of HCI the form of this participation varies with the different disciplinary perspectives and paradigms and their different methods for engaging users and identifying users' needs. Moreover, a majority of these dominant HCI perspectives are not only rooted in the developed countries context they also mainly focus on organisational management information systems (MIS) and less on information systems (IS) that place emphasis on the socio-economic context of developing countries. Literature review reveal that limited studies focus on the differences brought about by the western influenced methodologies and principles when applied in different contexts and how they affect the user participation process as well as the outcome. Building on past research, this research argues that HCI for ICTD needs to develop new contextualised participatory methods and strategies that consider the broader and complex contexts of the ICTD users. However, shifting the focus to localised forms of HCI in ICTD system design requires a better appreciation of the challenges and constraints encountered when applying the traditional HCI methods and strategies. Based on this argument the research conceptually explores and reflects on the underlying contextual factors and mechanisms present in participatory ICTD system design and the presumed relationships among them. Drawing on this conceptual framework, the research conducts semi-structured interviews, focus group discussions and participant observations with three mobile money system design projects in Kenya that engaged the users during the design process to highlight how current HCI practices respond to the multifaceted nature of ICTD system design which present challenges that include social, technical, cultural and infrastructural issues. Findings from this qualitative study provide significant new insights that support the call for contextualised participatory methods and strategies. The findings suggest that there is tension between the underlying assumptions inherent in western HCI methods and strategies and the local context thus justifying the call for the appropriation of the design process. Drawing on the conceptual framework it was found that bias formed from factors such as power relations, diversity in interests for participation and cross-cultural differences moderate the design process and ultimately the participatory outcome. From the knowledge perspective, this research provides an in-depth understanding of the developing country contextual factors that mediate user participation process in ICTD system design. Furthermore, the research extends the knowledge with regards to participatory interventions in the development of IS in Africa. The research also presents a theoretical framework that makes explicit the contextual assumptions and constraints embedded in participatory ICTD system design interventions and how they shape the design process and the participatory outcome. Finally, the recommendations formulated from this research provide HCI designers and practitioners actionable knowledge in regards to reflecting on their current traditional HCI tools and techniques to ensure better localised design processes.

Bakgrund: Under den korta perioden som den perioperativa vården varar ska sjuksköterskor skapa en tillitsfull relation, uppmärksamma behov, lindra oro och förmedla känsla av trygghet. Personcentrerad vård har visat sig vara ett effektivt verktyg för detta. Genom att studera upplevelser av vården hos patienter som har genomgått en sköldkörteloperation kan vården anpassas för att möta patienternas individuella behov. Syfte: Studiens syfte var att utforska och beskriva hur patienter som genomgått en sköldskörteloperation upplever den perioperativa omvårdnaden. Metod: En kvalitativ studie. Semi-strukturerade individuella intervjuer genomfördes med åtta patienter som nyligen genomgått sköldkörtelkirurgi. Datan analyserades genom systematisk textkondensering. Resultat: Studiens resultat visar på att känsla av oro och trygghet genomsyrar upplevelsen av den perioperativa processen hos patienter som har genomgått sköldkörtelkirurgi. Omvårdnaden som patienterna erhåller bidrar till att skapa trygghet och lindra oro. Ett gott bemötande av hjälpsam, lugn och omhändertagande vårdpersonal som ser patienternas behov bidrar till att skapa känslan av trygghet. Patienternas oro kan lindras genom tydlig och individanpassad information som ges under rätt omständigheter. En tillitsfull relation mellan vårdtagaren och vårdgivaren har en positiv inverkan på patienterna och är en viktig faktor för att lindra den perioperativa oron. Slutsats: Kunskap om omvårdnadsåtgärder som skapar trygghet och lindrar oro är betydelsefull och kan bidra till en mer personcentrerad vård. En förändring måste ske och omvårdnaden måste ges ett större utrymme, i första hand för patienternas skull. Strävan efter att minimera lidande och öka tryggheten i samband med den perioperativa vården ska vara en självklarhet. / Background: During the short period of time of the perioperative care, the nurses needs to create a trustful relationship, observe needs, ease anxiety and mediate feeling of safety. The person-centred care had proven to be a good tool to achieve that. By studying the experiences of care in patients who had undergone thyroid surgery, the care can be fitted to encounter the individual needs in patients. Aim: The aim of this study was to explore and describe how patients who had undergone thyroid surgery experience the perioperative care. Method: A qualitative study. Semi structured individual interviews were conducted with eight patients who recently had undergone thyroid surgery. Data were analysed using systematic text condensation. Results: Study results shows that the feeling of anxiety and safety permeates the experience of the perioperative process in patients who had undergone thyroid surgery. The nursing care from calm and caretaking personnel contributes to create safety and to ease suffering. Patients’ anxiety can be eased through clear and individually fitted information that is given under the right circumstances. Trustful relationship between the caretaker and the caregiver is an important factor to ease the perioperative anxiety. Conclusions: Knowledge about nursing actions that creates safety and eases anxiety is meaningful and can contribute to a more person-centred care. A change must take place and the nursing care must be given more space, primarily for the patient's sake. The striving to minimize suffering and increase the security associated with perioperative care should be a matter of course.

Actuellement, l’interprétation automatique de symboles peut être appliquée à de nombreux types de documents techniques (partitions musicales, plans électriques, etc). L’automatisation de ce type de tâche peut permettre un gain de temps pour des professionnels (Lu, Tai, Su, & Cai, 2005), mais elle peut aussi générer une perte de conscience de la situation par les opérateurs (Endsley, 1995). De plus, ces traitements impliquent un risque d’erreurs d’interprétation des symboles (Orbay & Kara, 2011). Il est donc crucial qu’un humain intervienne pour corriger ces erreurs. L’objectif de cette thèse était d’améliorer la compréhension des interactions homme-machine prenant place dans ce type de tâche afin de déterminer comment améliorer la performance du système. Plusieurs études ont ainsi été réalisées dans le cadre d’une démarche de conception centrée-utilisateur (ISO 9241-210, 2010) d’un logiciel d’interprétation automatique de plans d’architecture. Ces études se sont appuyées sur un cadre théorique varié, puisant à la fois dans la psychologie cognitive, les interactions homme-machine et l’ergonomie des documents multimédias. Elles ont mis en évidence des résultats débouchant sur des préconisations pour la conception de systèmes de reconnaissance. Ainsi, l’affichage de l’interprétation superposée au document interprété facilite la coréférenciation des informations à contrôler. De plus, permettre à l’utilisateur d’assister en temps réel à l’analyse et d’intervenir au fur et à mesure améliore les performances. Enfin, le signalement par la machine des risques d’erreurs est bénéfique, mais cela peut générer une réduction de la vigilance due à un phénomène de sur-confiance / Automatic symbol recognition can currently be applied to a wide range of technical documents (music scores, electrical diagrams, etc.). Automatizing this kind of task can help some professionals save time (Lu et al., 2005), but it can also generate a loss of situation awareness among operators (Endsley, 1995). Furthermore, as these systems sometimes interpret symbols incorrectly (Lu, Tai, Su, & Cai, 2005; Orbay & Kara, 2011), humans need to be able to intervene in the process to correct any errors as and when they arise. The objective of this thesis was to improve our understanding of the human-machine interactions elicited by this kind of task, in order to determine how best to enhance system performance. We conducted a series of studies during the development of a user-centred design (ISO 9241-210, 2010) of automatic interpretation software for architectural plans. These studies were set within a heterogeneous theoretical framework bringing together cognitive psychology, human-machine interactions and the ergonomics of the multimedia documents. The results they yielded led to several recommendations for designing recognition systems. For instance, superimposing the interpretation on the interpreted document makes it easier to cross-check the information. Furthermore, allowing users to monitor the interpretation process in real time and interrupt it at any point increases performances. Finally, while the highlighting of potential errors can also be beneficial, it can also make users over-confident and thus less watchful