The intensity and emotional demands of the health care environment place exceptionally high performance expectations and stress on hospital social workers. Critical Incident Stress (CIS), a specific type of stress associated with dramatic, emotionally overwhelming situations, known as Critical Incidents (CIs), produce several emotional and physical reactions that can threaten the well-being of the hospital social worker. CIS, as experienced by hospital social workers, is absent from the literature and not well understood. The purpose of this study was to describe how hospital social workers appraised, reacted to, and coped with CIs in their work environment. Lazarus and Folkman's (1984) theoretical framework of stress appraisal and coping was used to guide this descriptive study. A sample of 30 hospital social workers was recruited from two Vancouver tertiary care hospitals. Four instruments (Participant Information Sheet, Critical Incident Information Form, Emotional Appraisal Scale, and Ways of Coping Scale) were used to gain knowledge on how hospital social workers appraised, reacted to, and coped with CIs in their work environment. Quantitative data were coded, qualitative data were subjected to content analysis, and descriptive statistics calculated. Data revealed that hospital social workers encountered CIs in their work environment and that the majority of CIs centred on death-related events. The primary traits of events appraised as CIs were novelty, suddenness, and uncertainty. Respondents reacted to the CI with a variety of emotional (anxiety, fear, frustration, worry, anger) and physical reactions (feeling overwhelmed, fatigued, withdrawn, anxious, difficulty with sleeping), and although they experienced some discomfort, these reactions were not debilitating. Most hospital social workers indicated that their personal beliefs had been challenged by the CI and revealed that they were unsure as to what their social work role or function should have been during the event. However, despite this, respondents remained confident and comfortable with the decisions they made. Hospital social workers appeared to cope well with CIs, used a variety of emotion- and problem-focused coping strategies, and reported few negative effects on their professional and/or personal lives. The top four coping strategies utilized by respondents were seeking social support, planful problemsolving, positive reappraisal, and self-control. The implications of the findings for hospital social work administration, social work training and education, hospital social work practice, and future research are discussed.

Vaccination är en av de mest kostnadseffektiva åtgärderna inom sjukvården. Sveriges vaccinationsprogram innefattar tio sjukdomar och barnets femte dos ges vid fem års ålder. Barn i förskoleåldern befinner sig i ett utvecklingsstadium vilket kan försvåra vaccination. Tidigare studier beskriver svårigheter och den stress sjuksköterskor upplever i samband med vaccination av barn, kunskapsbrist finns däremot kring hur barnen bör hanteras. Syftet med studien var att utifrån betydelsefulla händelser beskriva barnhälsovårdssköterskans (BHVsköterskans) erfarenheter och agerande vid vaccination av förskolebarn som inte vill medverka. Studien utgick från kritisk incident teknik (CIT). Datainsamlingen utfördes i ett landsting i södra Sverige där elva BHV-sköterskor intervjuades. Intervjuerna transkriberades och analyserades. Etiska överväganden gjordes utifrån gällande riktlinjer. I resultatet framkom ett huvudområde avseende BHV-sköterskans erfarenheter, BHV-sköterskans observationer vid vaccination. Två huvudområden framkom angående BHV-sköterskans agerande: BHVsköterskan främjar vaccination och BHV-sköterskan beslutar kring genomförande av vaccination. Slutsatser och implikationer visar att interaktion mellan förskolebarn, föräldrar och BHV-sköterskan är viktigt och leder till en delaktighet och positiva erfarenheter av vaccination. Förslag på praktiskt agerande framkommer vilket kan främja och underlätta vaccination av förskolebarn. / Vaccination is one of the most cost-effective actions in health care. The program for vaccination in Sweden includes ten diseases and the fifth dose is given when children are five years old. Preschoolers are in a development stage that makes vaccination more difficult. Studies describe the difficulties nurses experience in relation to vaccination of children; lack of knowledge is experienced about procedures to handle the situations. The aim of the study was to describe critical incidents by the Primary Child Health Care (PCHC) nurse’s descriptions and actions during vaccination of preschoolers who resist vaccination. Critical Incident Technique was used during the study. Data collection was made in a county council in the south of Sweden. Eleven PCHC nurses were interviewed. The interviews were transcribed and analysed. Ethical considerations based on current guidelines were made. Results revealed one main area about PCHC nurse’s descriptions: The PCHC nurses observations at vaccination. Two main areas were revealed about PCHC nurse’s actions: The PCHC nurse promotes vaccinations and the PCHC nurse makes a decision about implementation of the vaccinations. Conclusions clarify the importance of interaction between preschoolers, parents and the PCHC nurses leading to participation and positive experiences of vaccination. Suggestions for practical action reveal to promote and facilitate vaccination of preschooler.

Submitted by NELSON SEBASTIAN SILVA JEREZ null (sebastiancso@yahoo.com.br) on 2016-06-03T15:45:03Z No. of bitstreams: 1 Diss. 1.0250 q1.1 d1.1.pdf: 1053953 bytes, checksum: dabbaf4b25b2995244595fff57e611b1 (MD5) / Rejected by Ana Paula Grisoto (grisotoana@reitoria.unesp.br), reason: Solicitamos que realize uma nova submissão seguindo a orientação abaixo: O arquivo submetido está sem a ficha catalográfica e sem folha da comissão examinadora. A versão submetida por você é considerada a versão final da dissertação/tese, portanto não poderá ocorrer qualquer alteração em seu conteúdo após a aprovação. Corrija esta informação e realize uma nova submissão contendo o arquivo correto. Agradecemos a compreensão. on 2016-06-03T19:43:44Z (GMT) / Submitted by NELSON SEBASTIAN SILVA JEREZ null (sebastiancso@yahoo.com.br) on 2016-06-04T16:26:42Z No. of bitstreams: 1 Diss. 1.0253 q1.1 d1.1 PB.pdf: 1580963 bytes, checksum: 63e1b7ed787d321740c8976c47ebe8d1 (MD5) / Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-06-06T16:40:21Z (GMT) No. of bitstreams: 1 silvajerez_ns_me_mar.pdf: 1580963 bytes, checksum: 63e1b7ed787d321740c8976c47ebe8d1 (MD5) / Made available in DSpace on 2016-06-06T16:40:21Z (GMT). No. of bitstreams: 1 silvajerez_ns_me_mar.pdf: 1580963 bytes, checksum: 63e1b7ed787d321740c8976c47ebe8d1 (MD5) Previous issue date: 2016-05-06 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Estuda o comportamento informacional de adolescentes em seu cotidiano e identifica como eles buscam, acessam, usam e compartilham informação, proveniente ou não da Internet. Analisa a veracidade da hipótese de que esta geração é dependente da conectividade providenciada pela Internet tem fundamento. Utiliza como ferramenta metodológica survey online, com amostragem por snowball sampling para recrutamento de participantes, e uso da técnica do incidente crítico. Os resultados demonstram que os adolescentes preferem buscar informação na Internet, e que a maioria deles tem conhecimento de técnicas apropriadas para recuperar informação, sendo que a forma mais utilizada de acesso à Internet foi o computador, com o telefone celular em seguida. Entende que os adolescentes usam informação em seu cotidiano para resolver lacunas pontuais em seu conhecimento, mas não como parte de um processo contínuo de aperfeiçoamento deste, ou para tomada de decisões. O tema da maior parte das buscas se refere ao consumo cultural. Não confirma a hipótese de que os adolescentes utilizam significativamente outras pessoas como fonte de informação. Encontra que adolescentes têm em sua maioria opiniões bastante positivas sobre bibliotecas, apesar de muitos as considerarem obsoletas ou ultrapassadas perante a existência da Internet e dos meios de acesso digitais à informação. Confirma que os adolescentes não utilizam suficientemente a Internet como fonte de informação em Educação Sexual, possivelmente prejudicando esforços neste sentido. / The everyday life information behaviour of teenagers is studied, and it is identified how they seek, access, use and share information, either from the Internet or not. The idea that this generation relies on the connectivity provided by the Internet to seek information is tested to assess to what extent this is well-founded. The methodological approach combines the use of an online survey, using snowball sampling for participant recruitment and the critical incident technique. The study finds that teenagers do, indeed, prefer to seek information on the Internet, and that most of them have knowledge of appropriate information retrieval techniques, with computers being the most commonly used mode of access to the Internet, followed by smartphones. The study understands that teenagers use information in their everyday lives to address specific gaps in their knowledge, but not as part of a continuous process of building knowledge, or for decision making. It finds that the majority of searches regards cultural consumption. The hypothesis that teenagers significantly use other people as information sources was not confirmed. It was found that teenagers have mostly very positive opinions about libraries, although many think of them as obsolete or outdated given the existence of the Internet and the digital means of access to information. The study confirms that teenagers do not use the Internet enough as a Sexual Education information source, possibly hindering efforts in this direction.

The intensity and emotional demands of the health care environment place exceptionally high performance expectations and stress on hospital social workers. Critical Incident Stress (CIS), a specific type of stress associated with dramatic, emotionally overwhelming situations, known as Critical Incidents (CIs), produce several emotional and physical reactions that can threaten the well-being of the hospital social worker. CIS, as experienced by hospital social workers, is absent from the literature and not well understood. The purpose of this study was to describe how hospital social workers appraised, reacted to, and coped with CIs in their work environment. Lazarus and Folkman's (1984) theoretical framework of stress appraisal and coping was used to guide this descriptive study. A sample of 30 hospital social workers was recruited from two Vancouver tertiary care hospitals. Four instruments (Participant Information Sheet, Critical Incident Information Form, Emotional Appraisal Scale, and Ways of Coping Scale) were used to gain knowledge on how hospital social workers appraised, reacted to, and coped with CIs in their work environment. Quantitative data were coded, qualitative data were subjected to content analysis, and descriptive statistics calculated. Data revealed that hospital social workers encountered CIs in their work environment and that the majority of CIs centred on death-related events. The primary traits of events appraised as CIs were novelty, suddenness, and uncertainty. Respondents reacted to the CI with a variety of emotional (anxiety, fear, frustration, worry, anger) and physical reactions (feeling overwhelmed, fatigued, withdrawn, anxious, difficulty with sleeping), and although they experienced some discomfort, these reactions were not debilitating. Most hospital social workers indicated that their personal beliefs had been challenged by the CI and revealed that they were unsure as to what their social work role or function should have been during the event. However, despite this, respondents remained confident and comfortable with the decisions they made. Hospital social workers appeared to cope well with CIs, used a variety of emotion- and problem-focused coping strategies, and reported few negative effects on their professional and/or personal lives. The top four coping strategies utilized by respondents were seeking social support, planful problemsolving, positive reappraisal, and self-control. The implications of the findings for hospital social work administration, social work training and education, hospital social work practice, and future research are discussed. / Arts, Faculty of / Social Work, School of / Graduate

Information appliances such as notebook computers and cellular telephones are becoming integral to the lives of many. These devices facilitate a variety of communication tasks, and are used for employment, education, and entertainment. Those with disabilities, however, have limited access to these devices, due in part to product designs that do not consider their special needs. A usability evaluation can help identify the needs and difficulties those with disabilities have when using a product and universal design principles can then be applied to enhance accessibility and usability. This study addresses the usability of two of the most common information appliances - notebook computers and cellular telephones. The usability of notebook computers was evaluated using a remote ethnographic method where participants recorded usability-related critical incidents. Participants included those with a wide range of abilities, such as legal blindness, total blindness, and upper extremity physical disabilities. Objective and subjective measures were used to determine the effects of several specific design parameters for cellular telephones. The notebook computer study revealed that participants have difficulty with non-standard keyboard layouts, the use of isometric pointing devices, case latches, and inadequate system feedback. User performance and ratings in the cellular telephone study were the best with the 12 mm lateral pitch and 0.7 mm key height, while the fewest task failures were committed using the 0.5 mm keystroke. Participants also preferred telephone models with large <Power>, <Send> and <End> keys located in prominent locations, and 22-point and 36-point display fonts. These results were used to generate product-specific design guidelines that can be used to design notebook computers and cellular telephones that are more usable and accessible for users with visual and upper extremity physical disabilities. Universal design implications are also discussed. / Master of Science

線上學習（又稱「遠距教學」）在各領域的應用近年來不斷成長，學校教育當中也有越來越多的課程使用線上學習來實施教學工作。因為線上學習有別於一般傳統教學，具有資訊科技的介入，因此線上學習能帶來那些有別於傳統面授的效益是研究者所關心的，希望能經由滿意因素比較研究，了解線上學習的效益。 本研究是採用關鍵事例法(CIT)所做的質性研究，研究對象是國立政治大學線上學習的使用者（包含學生、助教和老師），用電話訪談或面談的方式來蒐集使用滿意╱不滿意的事件。研究將線上學習課程分成「同步」、「面授錄影」、「面授與非同步」及「線上非同步」四種類型，並配合課程結構問卷，對學生學習滿意進行分析，接著再比較助教、老師的滿意因素，找出三者個別的滿意原因，再經由整合比較找出整體的滿意╱不滿意因素。研究發現： （一）影響學生線上學習滿意╱不滿意的因素，共有「教學熱誠和技巧」、「情感互動」、「回饋互動」、「知識互動」、「資訊傳輸」、「教學系統軟硬體使用」、「課程設計」與「非電腦類教室設備」八類。 （二）影響助教線上學習滿意╱不滿意的因素，共有「動機需求」和「資訊科技介入對工作績效影響」二大原因。其中，動機需求含有「工作報酬」、「成就」、「社會需求（對老師）」、「社會需求（對學生）」四類；資訊科技介入有「系統使用流暢性」、「系統功能對教學效果影響」與「教學支援」三類。 （三）影響老師線上學習滿意╱不滿意的因素，共有「正面效益」和「負面效益」二大原因。正面效益的方面有「科技效益認知(樂觀)」、「創新求變」二類，負面效益則有「功能存疑」、「適應不良」與「技術和人力支援」三類。 （四）科技介入對於學生助教和老師的滿意都會有影響，但影響不同。 關鍵詞：線上學習、關鍵事例法、學習滿意 / Distance- Learning (also called “E- Learning”) keeps in growing as it applies to each field in recent years, as well as more and more courses uses Distance- learning for teaching in school education. Distance- Learning differs toward Traditional Learning because of the infusion from information technology; therefore the efficiency that Distance- Learning brings which differentiates from Traditional Learning is concerned by researcher through comparing satisfaction factors in this study to understand the benefit of Distance- Learning. This study adapt Critical Incident Technique (CIT) as qualitative research, research subject is Distance- Learning users (contains student, teaching assistant and lecturer) from National Chengchi University, which uses telephone surveys or face- to- face interview to collect usage satisfaction/dissatisfaction incident. This study categories Distance- Learning into “Synchronous”、“Personal Instruction and Video Recording”、 “Personal Instruction and Asynchronous” and “Distance Asynchronous” by incorporating course structure questionnaire to proceed student satisfaction analysis, followed by comparing satisfaction factors from teaching assistant and lecturer to find out individual satisfaction factors. Through integration and comparison of overall satisfaction/dissatisfaction factors, study result shows: (1) Factors influence Distance- Learning students’ satisfaction/dissatisfactions are “Teaching Enthusiasm and Skill”、“Emotional Interaction”、“Feedback Interaction”、“Knowledge Interaction”、“Information Transmission”、“Distance- Learning System Hardware/Software Usage”、“Curriculum Design” and “Non- computerized class facility”. (2) Factors influence Distance- Learning teaching assistants’ satisfaction /dissatisfactions are “Motivational Needs” and “Influences of Information Technology infusion toward Work Performance”. There are “Working Salary”、“Achievement”、“Social Needs (to lecturer)”、“Social Needs (to student)” within “Motivational Needs”; while “Information Technology Infusion” has “Fluent usage of System”、“Influences of System Function toward Teaching Effect” and “Teaching Support”. (3) Factors influence Distance- Learning lecturers’ satisfaction/dissatisfactions are “Positive Efficiency” and “Negative Efficiency”. “Positive Efficiency” has “Recognition of Technology Efficiency (optimism)” and “Innovativeness”, while “Negative Efficiency” has “Insecurity”、“Discomfort”、“Technical and Human Support”. (4)Technology infusion influences students’、teaching assistants’ and lecturers’ satisfaction, but with different influence. Keywords: Distance- Learning, Critical Incident Technique (CIT), Learning Satisfaction

9 The main focus of the thesis is on the street work with migrants and the dilemma of help and control that arises in it. An integral part of this was the presentation of available literature dealing with this topic and its analysis. The theoretical part defines the target group, migrants in the Czech Republic and integration and migration policy in the Czech Republic. It also deals with street work, the legislative framework of street work, the personality of the street worker and the specifics of street work with migrants and also social work with migrants is described. Attention is paid to the dilemmas in social work, their origin with an emphasis on the help and control dilemma and ways of coping. The research part is devoted to the description of own qualitative research, which was carried out by the method of semi-structured interviews with street workers focusing on working with migrants by using the technique of critical incident. The main aim of the research was to find out in which cases the street workers encounter the dilemma of help and control and how to deal with it. Data were analyzed by using a portion of grounded theory. The presented research results point to situations in which street workers who work with migrants experience a dilemma of help and control. For example, there are...

I forskningen har organisatoriskt lärande uppmärksammats, men inte institutionaliserats. Det organisatoriska lärandet påverkas i stor grad av nyckelpersoner vilket ledare och mellanchefer är. Organisatoriskt lärande styrs av det individuella lärandet vilket därför har en stor betydelse i sammanhanget. Ansvaret för det individuella lärandet läggs oftast på organisationens ledare och för ledares individuella lärande är reflektion och erfarenhet en avgörande faktor. Därför var studiens syfte att bidra till forskningen genom att undersöka hur kritiska situationer påverkat ledares lärande och bidragit till det individuella och organisatoriska lärandet. Syftet har studerats utifrån hur ledares reflektion görs och hur reflektionen påverkat ledares ledarskapsstil och orientering. För att studera detta användes vår egen tolkning av kritiska situationer tekniken. Studiens teoretiska referensram baserades därför på individuellt och organisatoriskt lärande, ledarskapsstilar, samt reflektion.Tillvägagångssättet som valdes var att intervjua ledare på mellanchefsnivå, halvstrukturerade intervjuer genomfördes baserat på kritiska situationer tekniken där olika kritiska scenarion diskuterades. I studien genomfördes även en enkät med samtliga intervjuade ledare där de fick uppskatta sin upplevda grad av orientering. Studiens konklusion är att fokus inte bör läggas på kombinerade ledarskapsstilar utan att vikten bör läggas på graden av orientering inom uppgift, relation och förändring. I studien kunde även ett samband identifieras som förklarar vad som krävs av ledare för att uppnå och bidra till organisatoriskt lärande. / Program: Civilekonomprogrammet

Nigerian entrepreneurs face government barriers and lack the skills and awareness needed for successfully creating and scaling public value in resource-constrained environments. The concept of bricolage, which involves doing business by making do with resources at hand, has been addressed in the literature, but not as it occurs among Nigerian entrepreneurs. This study was conducted with the aim of narrowing this gap in knowledge by exploring how Nigerian entrepreneurs have successfully carried out their businesses. The research question addressed how Nigerian entrepreneurs overcame critical situations to successfully address the challenges of scaling and creating public value, and whether the theory of entrepreneurial bricolage can support their actions. A qualitative descriptive single case study with a purposeful sample of 22 interview respondents was employed. A total of 145 critical incidents were analyzed by fitting them into themes constructed a priori from the known behavioral patterns that emerged through the theoretical taxonomy of the concept of entrepreneurial bricolage. The results showed that Nigerian entrepreneurs made do with the resources at hand, improvised, and invoked stakeholder participation and persuasion to solve critical challenges of business continuity. The outcome of the research should help potential entrepreneurs determine strategies to scale their ideas or innovations to achieve positive social change. The results may be useful to any fledgling entrepreneur who needs encouragement when feeling overwhelmed by the challenges of doing business in Nigeria. Budding entrepreneurs can learn from the experiences of those who are deemed successful in their businesses, thereby avoiding challenges when they can and strategizing for those challenges that are unavoidable.

<p>There are great expectations that collaboration among professions and various sectors will further develop health care and thus lead to improved public health. In the World Health Organization’s declaration “Health 21” the designated goal for health professions in the member nations in Europe by the year 2010 is to have developed health promotional competence, including teamwork and cooperation based on mutual respect for the expertise of various professions. The challenges faced by the interprofessional teams are, however, multifaceted, and these challenges place demands upon society, which, in turn, determines the fundamental conditions for collaboration among the health professions within the health care organizations.</p><p>This licentiate dissertation contains discourse and content analyses of interprofessional teamwork in health care. The major objective of this dissertation is to study and describe how the team members construct and create the content and significance of teams and teamwork among health professions. One specific goal has been to study how the members of a multi-professional health care team refer to their team, especially the discursive patterns that emerge and the function that these patterns has (I). The second specific goal has been to identify and describe the difficulties that the health professionals have experienced within their interprofessional teamwork. One purpose has been to enable discussions of the implications for interprofessional learning (II).</p><p>Focused group interviews with team members (n=32) from six teams were studied using discursive social psychological research approach. The analysis concentrated on the use of the pronouns “I”, “we” and “them”. The results were then analyzed in relation to theories on discursive membership and discursive communities (I). Individual semi-structured interviews with team members (n=18) from four of the six teams were carried out using critical incident techniques. The interviews were analysed via latent qualitative content analysis and the results were interpreted in the light of theories on sociology of professions and learning at work (II).</p><p>The findings showed that two discursive patterns emerged in the team members’ constructions of “we the team”. These patterns were designated knowledge synergy and trustful support (I). The following three themes that touched upon the difficulties of interprofessional teamwork were identified in the personal interviews: (A) difficulties concerning the teams’ dynamics that arose when the team members acted as representatives for their respective professions; (B) difficulties when the various contributions of knowledge interacted in the team; and (C) difficulties that were related to the surrounding organisation’s influence on the team (II).</p><p>The conclusion was reached that the discursive pattern provided rhetorical resources for the team members, both in order to reaffirm membership in the team and to promote their views with other care providers, but also to deal with difficulties regarding, for example, lack of unity in outlook. The conclusion was also drawn that, in addition to the individual consequences, one outcome of the perceived difficulties was that they caused limitations of the use of collaborative resources to arrive at a holistic view of the patient’s problems. Thus the patients could not be met in the desired manner.</p><p>The practical implications of the research project concern the development of teams in which various forms of interprofessional learning can influence the continued development of the team and the management of health care in regard to the importance of implementation processes and organisational learning.</p> / <p>Stora förväntningar ställs på att samarbete mellan yrkesgrupper och mellan sektorer ska utveckla hälso- och sjukvården och leda till en förbättrad folkhälsa. I Världshälsoorganisationens policydokument “Health21” anges exempelvis målsättningen att hälsoprofessionerna i de europeiska medlemsländerna till år 2010 ska ha utvecklat en hälsofrämjande kompetens som bland annat innefattar teamarbete och samarbete på basis av ömsesidig respekt för de olika professionernas expertis. Det interprofessionella teamets utmaningar är dock mångfacetterade och kräver uppmärksamhet från det samhälle som skapar villkoren för hälsoprofessionernas samarbete inom hälso- och sjukvårdens organisationer.</p><p>Denna licentiatavhandling innehåller diskurs- och innehållsanalytiska studier om interprofessionellt teamarbete i vården. Avhandlingens övergripandet syfte var att undersöka och beskriva hur teammedlemmar konstruerar och skapar innebörder av team och teamarbete mellan flera hälsoprofessioner. Det ena specifika syftet var att undersöka hur medlemmar i multiprofessionella vårdteam talar om sitt team, särskilt avseende de diskursiva mönster som framträdde och vilken funktion dessa mönster hade (studie I). Det andra specifika syftet var att identifiera och beskriva svårigheter som hälsoprofessioner har uppfattat vid interprofessionellt teamarbete, där avsikten även var att möjliggöra en diskussion om implikationer för interprofessionellt lärande (studie II).</p><p>Fokusgruppintervjuer med teammedlemmar (n=32) från sex team analyserades utifrån en diskursiv socialpsykologisk forskningsansats och fokuserade på användningen av pronomina ”jag”, ”vi” och ”de”. Fynden relaterades sedan till teorier om diskursivt medlemskap och diskursiva samhällen (studie I). Individuella semistrukturerade intervjuer med teammedlemmar (n=18) från fyra av de sex teamen genomfördes med critical incident-teknik. Intervjuerna analyserades via latent kvalitativ innehållsanalys och fynden tolkades utifrån teorier om professionssociologi och lärande i arbetet (studie II).</p><p>Resultaten visade att två diskursiva mönster framträdde i teammedlemmarnas konstruktioner av ”vi-som-team”. Dessa mönster benämndes kunskapssynergi och tillitsfullt stöd (studie I). Vid individuella intervjuer med teammedlemmar identifierades följande tre teman som rörde svårigheter vid interprofessionellt teamarbete; (i) svårigheter som gällde den teamdynamik som uppstod när teammedlemmarna agerade som företrädare för sina professioner i relation till teamet, (ii) svårigheter när medlemmarnas olika kunskapsbidrag interagerade i teamet och (iii) svårigheter som rörde den omgivande organisationens påverkan på teamet (studie II).</p><p>Konklusionen gjordes att de diskursiva mönstren utgjorde retoriska resurser för teammedlemmarna, både för att bekräfta medlemskapet i teamet, för att hävda sina åsikter i kontakter med andra vårdgivare (”de andra”) och även för att hantera uppfattade svårigheter beträffande exempelvis bristande samsyn. Vidare drogs slutsatsen att en konsekvens av de uppfattade svårigheterna var, förutom individuella konsekvenser, begränsningar i användandet av de gemensamma resurserna för att nå en helhetssyn på patientens problem och att patienterna inte kunde bemötas på det sätt som önskades.</p><p>Forskningsprojektets praktiska implikationer rörde teamutveckling där olika former av interprofessionellt lärande påverkar teamets fortsatta utveckling, samt ledning av hälso- och sjukvården avseende betydelsen av imple-menteringsprocesser och organisatoriskt lärande.</p>