Background: Diabetes is a chronic disease affecting more and more people and placing increasing demands on health care. The increasing numbers of adults diagnosed with type 2 diabetes are in need of self-management strategies. Learning self-management includes mastering the skills required to complete the complex emotional and physical tasks necessary to manage well-being and to prevent future complications. A technological service developed with the participation of stakeholders may be an alternative way to meet rising needs for self-management. The involvement of various stakeholders enables cooperation, facilitates patient empowerment, and takes into consideration how adults with type 2 diabetes manage their everyday activities. Aim: The overall aim of the licentiate thesis is, by participatory research methods identify self-management support of a future ICT service to facilitate adults with type 2-diabetes. Methods: Two studies were conducted using participatory design (PD) with qualitative methods. Data were collected among recently diagnosed adults and those with longer experience of type 2 diabetes. The adults were recruited from a primary healthcare centre and from a diabetes hospital clinic in Sweden. Study I identified perceived challenges related to self-management among recently diagnosed adults and those with longer experience of type 2 diabetes by using multistage focus groups. Study II reported needs and wishes for an ICT self-management service to facilitate their everyday life and to deal with type 2 diabetes by using a future workshop. Results: Three main challenges were identified; understanding; developing skills and abilities; and mobilizing personal strengths. Both recently diagnosed adults and those with longer experience of diabetes described challenges in understanding the causes of fluctuating blood glucose and in developing and mobilizing skills for choosing healthful food and eating regularly. The recently diagnosed group were more challenged by learning to accept the diagnosis and becoming motivated to change habit while the experienced group were mainly challenged by issues about complications and medications. The adults with type 2 diabetes expressed needs and wishes for an ICT service all fell under the broad category of Acceptance of the diagnosis, with the three suggestions; Trust in partnerships, Communication and Individualized information. Acceptance of the diagnosis was a prerequisite for managing diabetes successfully. Acceptance of the diagnosis also made the participants accept information, learn about their condition, and understand how to personally manage their everyday lives. Trust in partnership with caregivers and Communication facilitated that acceptance and understanding of the disease. Main findings: The adults with type 2 diabetes stated different needs for support during different phases of the disease. The expressed needs and wishes for an ICT service all fell under the broad category of Acceptance of the diagnosis, with three other suggestions; Trust in partnerships, Communication, and Individualized information. The participants’ experience of the participatory methodology as a democratic process and their appreciation of mutual learning contributed to these results, which are consistent with the aims of person centred care. Conclusions: Adults with diabetes have different needs for support during different phases of the disease. From a person-centred perspective it would be desirable to meet individual needs for self-management on peoples’ own terms through a technological service that could reach and connect to a large number of people. Healthcare practitioners need to address the knowledge needs of patients with type 2 diabetes and support them in developing self-management skills. Consistent with person-centred care, practitioners should also encourage patients’ abilities to mobilize their own personal strengths to maintain self-management. / <p><strong>Forskningsfinansiärer:</strong></p><p>Kommunerna i Skåne Nordost</p><p>Högskolan Kristianstad</p>

Background: Diabetes is a chronic disease affecting more and more people and placing increasing demands on health care. The increasing numbers of adults diagnosed with type 2 diabetes are in need of self-management strategies. Learning self-management includes mastering the skills required to complete the complex emotional and physical tasks necessary to manage well-being and to prevent future complications. A technological service developed with the participation of stakeholders may be an alternative way to meet rising needs for self-management. The involvement of various stakeholders enables cooperation, facilitates patient empowerment, and takes into consideration how adults with type 2 diabetes manage their everyday activities. Aim: The overall aim of the licentiate thesis is, by participatory research methods identify self-management support of a future ICT service to facilitate adults with type 2-diabetes. Methods: Two studies were conducted using participatory design (PD) with qualitative methods. Data were collected among recently diagnosed adults and those with longer experience of type 2 diabetes. The adults were recruited from a primary healthcare centre and from a diabetes hospital clinic in Sweden. Study I identified perceived challenges related to self-management among recently diagnosed adults and those with longer experience of type 2 diabetes by using multistage focus groups. Study II reported needs and wishes for an ICT self-management service to facilitate their everyday life and to deal with type 2 diabetes by using a future workshop. Results: Three main challenges were identified; understanding; developing skills and abilities; and mobilizing personal strengths. Both recently diagnosed adults and those with longer experience of diabetes described challenges in understanding the causes of fluctuating blood glucose and in developing and mobilizing skills for choosing healthful food and eating regularly. The recently diagnosed group were more challenged by learning to accept the diagnosis and becoming motivated to change habit while the experienced group were mainly challenged by issues about complications and medications. The adults with type 2 diabetes expressed needs and wishes for an ICT service all fell under the broad category of Acceptance of the diagnosis, with the three suggestions; Trust in partnerships, Communication and Individualized information. Acceptance of the diagnosis was a prerequisite for managing diabetes successfully. Acceptance of the diagnosis also made the participants accept information, learn about their condition, and understand how to personally manage their everyday lives. Trust in partnership with caregivers and Communication facilitated that acceptance and understanding of the disease. Main findings: The adults with type 2 diabetes stated different needs for support during different phases of the disease. The expressed needs and wishes for an ICT service all fell under the broad category of Acceptance of the diagnosis, with three other suggestions; Trust in partnerships, Communication, and Individualized information. The participants’ experience of the participatory methodology as a democratic process and their appreciation of mutual learning contributed to these results, which are consistent with the aims of person centred care. Conclusions: Adults with diabetes have different needs for support during different phases of the disease. From a person-centred perspective it would be desirable to meet individual needs for self-management on peoples’ own terms through a technological service that could reach and connect to a large number of people. Healthcare practitioners need to address the knowledge needs of patients with type 2 diabetes and support them in developing self-management skills. Consistent with person-centred care, practitioners should also encourage patients’ abilities to mobilize their own personal strengths to maintain self-management. / <p><strong>Forskningsfinansiärer: </strong>Kommunerna i Skåne Nordost, Högskolan Kristianstad och Region Skåne</p>

<p><strong>Bakgrund:</strong> Demens är ett sjukdomstillstånd som innebär en bestående nedsättning av kognitiva funktioner. Därför behöver personer med demenssjukdom och närstående stöd för att klara vardagen bättre. <strong>Syfte:</strong> Syftet var att tillsammans med en personalgrupp vid en dagsjukvårdsenhet utarbeta ett underlag för en kommande utvärdering av ett projekt vars syfte var att ge stöd i relationen mellan personer med demenssjukdom och deras närstående. <strong>Metod:</strong> Studien genomfördes med deltagarbaserad aktionsforskning med en fokusgruppsintervju och en enskild intervju. Deltagarna var en personalgrupp på en dagsjukvårdsenhet. <strong>Resultat:</strong> Dagsjukvårdsenheten önskade stödja relationen mellan personer med demenssjukdom och deras närstående. Stödet planeras genomföras vid fem tillfällen under fem veckor. Dessa fem tillfällen har olika teman som handlar om hur paren kan hantera vardagen på ett annat sätt. Genom dessa tillfällen har dagsjukvårdsenheten som mål att exempelvis underlätta vardagen för paren. <strong>Diskussion:</strong> Ett av de centrala fynden var att personer med demenssjukdom och deras närstående behöver både individuellt och gemensamt stöd i relationen. Ett annat fynd var att personalguppen är av den åsikten att vardagen kan underlättas om paren får ta del av andras erfarenheter. En samordnad stödform mellan kommun och landsting kan underlätta för att kunna ge bästa stöd till personer med demenssjukdom tillsammans med närstående.</p> / <p><strong>Background:</strong> Dementia is a disease which involves a permanent reduction of cognitive functions. Therefore people with dementia and their relatives need support to cope with problems in the daily life. <strong>Aim:</strong> The aim was to work with personnel at a day care unit to prepare a basis for a future evaluation of a project which purpose was to provide support in the relationship between people with dementia and their relatives. <strong>Method:</strong> The study was conducted as participatory action research with a focus group interview and an individual interview. Participants were personnel at the day care unit. <strong>Results:</strong> The day care unit wished to support the relationship between people with dementia and their relatives. The support was planned to be done at five occasions during five weeks. These five occasions have different themes which are about how the couples could handle the everyday life in a different way. Through these occasions the day care unit has as a goal for example to simplify everyday life for the couples. <strong>Discussion:</strong> One of the key findings was that people with dementia and their relatives need, both individually and jointly, support in the relationship. Another finding was that the personnel group is of the opinion that life can be facilitated if the couples may take part of other’s experiences. A coordinated assistance between municipalities and county councils can help to provide the best support for people with dementia together with their relatives.</p>

Bakgrund: Demens är ett sjukdomstillstånd som innebär en bestående nedsättning av kognitiva funktioner. Därför behöver personer med demenssjukdom och närstående stöd för att klara vardagen bättre. Syfte: Syftet var att tillsammans med en personalgrupp vid en dagsjukvårdsenhet utarbeta ett underlag för en kommande utvärdering av ett projekt vars syfte var att ge stöd i relationen mellan personer med demenssjukdom och deras närstående. Metod: Studien genomfördes med deltagarbaserad aktionsforskning med en fokusgruppsintervju och en enskild intervju. Deltagarna var en personalgrupp på en dagsjukvårdsenhet. Resultat: Dagsjukvårdsenheten önskade stödja relationen mellan personer med demenssjukdom och deras närstående. Stödet planeras genomföras vid fem tillfällen under fem veckor. Dessa fem tillfällen har olika teman som handlar om hur paren kan hantera vardagen på ett annat sätt. Genom dessa tillfällen har dagsjukvårdsenheten som mål att exempelvis underlätta vardagen för paren. Diskussion: Ett av de centrala fynden var att personer med demenssjukdom och deras närstående behöver både individuellt och gemensamt stöd i relationen. Ett annat fynd var att personalguppen är av den åsikten att vardagen kan underlättas om paren får ta del av andras erfarenheter. En samordnad stödform mellan kommun och landsting kan underlätta för att kunna ge bästa stöd till personer med demenssjukdom tillsammans med närstående. / Background: Dementia is a disease which involves a permanent reduction of cognitive functions. Therefore people with dementia and their relatives need support to cope with problems in the daily life. Aim: The aim was to work with personnel at a day care unit to prepare a basis for a future evaluation of a project which purpose was to provide support in the relationship between people with dementia and their relatives. Method: The study was conducted as participatory action research with a focus group interview and an individual interview. Participants were personnel at the day care unit. Results: The day care unit wished to support the relationship between people with dementia and their relatives. The support was planned to be done at five occasions during five weeks. These five occasions have different themes which are about how the couples could handle the everyday life in a different way. Through these occasions the day care unit has as a goal for example to simplify everyday life for the couples. Discussion: One of the key findings was that people with dementia and their relatives need, both individually and jointly, support in the relationship. Another finding was that the personnel group is of the opinion that life can be facilitated if the couples may take part of other’s experiences. A coordinated assistance between municipalities and county councils can help to provide the best support for people with dementia together with their relatives.

Detta arbete utgör en första del av ett forskningsprojekt vars intentioner är att synliggöra och öka kunskapen om SFI (svenska för invandrare) och SVA (svenska som andraspråk). Studien är kopplad till min egen arbetsplats. Intentionen med detta projekt är att beskriva och analysera både process och innehåll i en gemensam kunskapsutveckling i en forskningscirkel. Projektet fokuserar i första hand på kulturmöten, livsåskådning och livsfrågeperspektiv samt olika livssituationer. Dessa betraktas huvudsakligen utifrån de medverkande lärarnas perspektiv. Detta medför att invandrarelevernas uppfattning och upplevelser i berörda aspekter inte berörs direkt i detta projekt. Det är deltagarnas, lärarnas, livserfarenhet från hans/ hennes klassrum och möte med invandrarelever som står primärt i fokus. Det är också utifrån detta perspektiv som relevant tidigare forskning och litteratur belyses i detta arbete. Uppsatsens ansats och metod bygger på deltagarbaserad forskning/ aktionsforskning, forskningscirkeln och en livsberättelsemetod. I resultatet redovisas de innehållsliga resultaten likaväl som forskningscirkelns deltagares, både jag som forskare/ projektledare och lärarnas, engagemang och betydelse i forskningsprocessen. Slutligen följs arbetet upp av en diskussion och analys i ett diskussionskapitel. Här diskuteras också hur arbetet kan fortsätta.

Den här expositionen visar mitt projekt från utbildningen Master i skådespelarkonst 2021-2023 på SKH i Stockholm. Uppsatsen heter "När vi ses" och den performativa delen "Hur gör vi med publikinsläppet?" Jag har som skådespelare och clown jobbat i många olika rum och med många olika publiköverenskommelser. Allt från scen-salong situationer där publiken vet exakt hur de ska bete sig och hur deras deltagande ser ut, till att spela för endast en person i en sjukhussäng eller i en liten roddbåt, där deltagandet tydligt måste förhandlas och kommuniceras. Jag har mött vuxna som är världsmästare i teateretikett, men inte kan svara på en fråga om den ställs från scenen, och jag har mött barn som är sjövilda förstagångsbesökare som har en intensiv dialog med oss på scenen. Jag är intresserad av dialogen mellan skådespelare och publik och av publikens delaktighet. Vilka normer och överenskommelser regleras det av? Hur påverkar rädslan att göra fel, bryta mot normen, upplevelsen av scenkonstverket? Begränsar den rädslan för skam det som är möjligt på teatern? Jag har också undrat över vilka roller publiken kan ha, vad i ett verk som kommunicerar denna roll, och om publiken kan byta roll i samma verk. I "Hur gör vi med publikinsläppet?" kan du läsa om arbetet med Eva och Margaretha, två halvmasker som båda är skådespelare men i vars konstnärsskap publiken spelar väldigt olika roller. / The essay is called "When we meet" and the performative part "How do we let the audience in?" As an actor and clown, I have worked in many different rooms and with many different audience agreements. Everything from stage-salon situations where the audience knows exactly how to behave and what their participation looks like, to playing for only one person in a hospital bed or in a small rowing boat, where participation must be clearly negotiated and communicated. I've met adults who are world masters of theater etiquette, but can't answer a question if asked from the stage, and I've met children who are wild first-timers who engage in intense dialogue with us on stage. I am interested in the dialogue between actors and audience and in audience participation. What standards and agreements are they regulated by? How does the fear of making a mistake, breaking the norm, affect the experience of the performance? Does that fear of shame limit what is possible in the theater? I have also wondered what roles the audience can have, what in a work communicates this role, and whether the audience can change roles in the same work. In "How do we let the audience in?" you can read about the work with Eva and Margaretha, two half-masks who are both actors but in whose artistry the audience plays very different roles.

In this thesis my aim is to analyse and discuss discourses of Swedish disability research, with focus on participation in research by disabled people. My research question is based on an observation that research overviews and evaluations repeatedly argue for the importance of participation of disabled people. This request has been recurrent and more or less intact in its form for over 20 years. My question is why this request has not been fulfilled or altered in its form. I base my theoretical framework and methodology on Critical Discourse Analysis, and the power of language in a constructed and reconstructed social reality, with a semi-structuralist approach as developed by the British sociolinguist Norman Fairclough. In focus is the discursive construction of research participation and participants. My result after a systemic-functional grammar analysis of governmental research reports and peer-reviewed articles published in English, in international academic journals, by researchers with affiliation to Swedish universities, is that participation is discussed in terms of disabled people primarily as the source of information rather than as actual actors in a research process. The discursive construction of disabled participants rests on identification and representation connected to being disabled / having an impairment. A discourse of knowledge validation is based on a division of roles, tasks and labour, in which researchers and participants are constructed in opposing subject positions. Participant influence is constructed in terms of subjectivity and personal interest, as opposed to the objective expertise of the researchers. Discourses are, however, found to be contested and inconsistent, both in terms of conceptual definitions of disability and disability research, and as manifested in actual use of language. The most fixed discourse seems to be that of requests for increased participation, and the attributing of personal experiences to participants, in contrast to attributing professional expertise to researchers.

Avhandlingen är en nutidsanalys av delar av den svenska välfärden. Samverkan mellan myndigheter och organisering av socialt arbete i frivilliga organisationer är två samtida tendenser i det svenska välfärdssystemet. Båda studierna fokuserar på arbetslivsinriktad rehabiliteringför personer utanför arbetsmarknaden en längre tid. Den första studien beskriver samverkan mellan olika offentliga myn-digheter i form av ett samverkansteam (ReSamprojektet), medan den andra studien beskriver och analyserar en delvis brukarstyrd form för arbetslivsinriktad rehabilitering, den så kallade klubbhus-modellen (Fontänhusrörelsen).Den första studien var en processinriktad utvärdering med olika me-toder för datainsamling som intervjuer, fokuserade gruppdiskussioner, samt dagboksanteckningar. Den andra studien gjordes utifrån en deltagarbaserad forskningstradition där författaren arbetade med en forskarcirkel bestående av medlemmar från klubbhuset. Syftet var att närma sig rehabiliterings-processen på ett så utforskande sätt som möjligt. Data samlades in som detaljerade anteckningar, officiellt material och inspelade intervjuer.Resultat från den första studien visar att det var möjligt att samarbeta över myndigheternas gränser men att det fanns hinder som handlade om kulturella och organisatoriska skillnader mellan myndigheterna, olikheter när det gäller engagemang och begränsa-de resurser för att kunna möta klienternas komplexa behov. Samtidigt var en viktig lärdom att ju mer kunskap handläggarna hade om varandra och sina respektive organisationer destolättare blev samar-betet. Resultat från den andra studien visar att genom det dagliga arbetet formas, fördjupas och åter-upptas relationer och den stödjande omgivningen. Förstärkande mekanismer var en uttalad ideologi, en tydlig struktur för möten, återkommande arbetsgrupper ochcertifiering. Det var också viktigt att arbetsuppgifterna betraktades som nödvändiga och att de gjorde en skillnad om de utfördes. Å andra sidan beskrevs rörelsen som begränsande för vissa medlemmar.I diskussionen används tillit somett begrepp som spänner över individ-, grupp-och samhällsnivå. Tillit blir ett sammanbindande begrepp mellan de båda studierna och visade sig vara den viktigaste komponenten för att etablera hållbara relationer på gruppnivå. Slutligen följer en mera framåtblickande diskussion som handlar om hur utanförskap kan bemötas genom samverkansaktiviteter respektive frivillig organisering och vilken roll verksamheterna kan få i välfärdssystemet / The thesis is a contemporary analysis of parts of the Swedish welfare system. Co-operation between agencieswithin the welfare system and provision of welfare services by organizations within the voluntary sector are two contemporary tendencies. Both studies are focusing on the rehabilitation process for individuals who have been excluded from the labour market for a longer time period. The first study describes and analyzes co-operation in a three year project as a strategy for provision of complex welfare services (the ReSam project). The second study describes and analyzes the club house model of rehabilitation (the Fountain House movement).The first study is based on a process evaluation, where different kinds of data were collected through interviews, focus groups and diaries. These data were subsequently analyzed with qualitative methods. The second study isparticipant oriented, which means that a group of members conducted the study in co-operation with the re-searcher. The study isexplorative and research data were collected in a variety of ways including detailed notes, taped interviews and cognitive maps.The results of the first study show that it was possible to co-operate across the organizational boundaries of the different agencies involved, but there were obstacles related to organizational and cultural differences between the agencies, divided loyalties of the officials involved, and limited resources available to deal with the complex needs of the clients. The most important factor was that the officials learnt more about each other and the agencies involved. The result of the second study reveals that daily work tasks forms, deepens and reinvents both relationships as well as the supportive environment. Supportive mechanisms were an explicit ideology, plain structure of the meetings, frequent held working groups and thecertification process. Furthermore, it was important that the taskswere considered as necessaryand made a dif-ference. On the other hand, the members described the clubhouse environment as restricting for some. In the discussion, trust is used as a concept which spans over individual, interpersonal and organizational levels and becomes a useful tool as a theoretical concept binding the two studies to-gether. Trust was revealed as the most important ingredient as it comes to establishing sustainable relationships on a group level. Finally, some possible future scenarios are drawn up and discussed concerning the roles and relations between the welfare system and contemporary new forms of orga-nizing welfare services.

Förekomsten av övervikt och fetma hos barn ökar i världen trots insatser. Studier visar att förebyggande interventioner för barn och unga har blygsam effekt. Deltagarbaserad forskning har visat sig vara ett sätt att hitta hållbara lösningar inom hälsointerventioner. Övergripande kunskap saknas dock om hur deltagandet för barn och vuxna kan tillämpas inom deltagarbaserade övervikt- och fetmainterventioner riktade till barn. Syftet med denna studie var att kartlägga deltagandet inom deltagarbaserad övervikt- och fetmaprevention riktad till barn. Hur tillämpas deltagande inom deltagarbaserad övervikt- och fetmaprevention? I vilken utsträckning deltar barnen?    En litteraturbaserad design användes enligt Arksey och O’Malley’s ramverk för scoping review, som innebär fem steg; identifiera forskningsfrågan, identifiera relevanta studier, val av studier, kartläggning av data samt samla in, summera och rapportera resultat. Studier till resultatet samlades in från databaserna Medline, Academic Search Elite, Cinahl och Scopus samt via manuella sökningar.  Inklusionkriterier var peer-reviewed, empiriska studier med fokus på interventioner mot förebyggande av övervikt/fetma för barn och unga (0–18 år) samt med en deltagande ansats med föräldrar, barn eller samhälle. Studier på annat språk än engelska eller svenska, som inte fokuserade på förebyggande interventioner mot övervikt/fetma för barn och som inte tydligt definierat studien som deltagarbaserad exkluderades. Sökningen resulterade initialt i 995 artiklar. Urvalsprocessen med vidare granskning resulterade slutligen i 34 studier som inkluderades i denna studie. Graden av delaktighet analyserades vidare med Shier’s Modell, som innebär 5 steg; 1. barn blir lyssnade på, 2. barn stöds i att uttrycka sina åsikter, 3. barns åsikter beaktas, 4. barn är involverade i beslutsprocessen, 5. barn delar makt och ansvar för att ta beslut”.    Resultatet visade att de flesta interventioner skedde i skolan. Både föräldrar, barn, lärare och samhället involverades i olika grad och inom olika metoder. Flera studier rapporterade dock deltagandet bristfälligt. I 12 studier exkluderades barn som deltagare. När barn deltog var det ofta äldre barn i tonåren. Vid analys av barns deltagande med Shier’s Modell var flest studier inom steg 4 (deltagande i beslut, n= 7) och steg 3(konsultation, n=7) följt av steg 5 (delat ansvar och makt, n=6). Framtida forskning bör fokusera på att mer utförligt beskriva den deltagande processen, involvera yngre barn samt undersöka hur barn upplever sitt deltagande, för att skapa ett meningsfullt deltagande. Prevention för övervikt och fetma kräver innovativa lösningar och fokus inom framtida studier bör vara på att öppna upp för deltagande genom en deltagande utgångspunkt, att skapa möjligheter genom tillräckliga resurser och passande metoder samt att inkludera deltagandet som en inbyggd policy genom arbetsprocessen. / The prevalence of overweigth and obesity in children is increasing in the world despite efforts. Studies show that preventive interventions for children and young people have a modest effect. Participatory research has proven to be a way to find sustainable solutions in health interventions. However, there is no comprehensive  knowledge on how participation for children and adults can be applied within participant-based obesity interventions targeting children.The purpose of this study was to map participation in participant-based obesity prevention targeting children. How is participation in participant-based obesity prevention applied? To what extent do the children participate?   A literature-based design was used according to Arksey and O’Malley’s scoping review framework, which involves five steps; identifying the research issue, identifying relevant studies, selecting studies, charting data, and collecting, summarizing and reporting results. Studies for the results were collected from the databases Medline, Academic Search Elite, Cinahl and Scopus as well as through manual searches. Inclusion criteria were peer-reviewed, empirical studies focusing on interventions to prevent obesity for children and adolescents (0–18 years) and with a participatory approach with parents, children or society. Studies in languages ​​other than English or Swedish, studies which did not focus on preventive interventions against obesity for children and studies that did not clearly define the study as participant-based, were excluded. The search initially resulted in 995 articles. The selection process with further examination finally resulted in 34 studies that are included in this study. The degree of participation was further analyzed with Shier's Model, which involves 5 steps; 1. children are listened to, 2. children are supported in expressing their opinions, 3. children's opinions are taken into account, 4. children are involved in the decision-making process, 5. children share power and responsibility in making decisions.    The result showed that most interventions took place in school. Both parents, children, teachers and society were involved to varying degrees and within different methods. Several studies reported the participation poorly. In 12 studies, children were excluded as participants. When children participated, they were often older, in their teens. When analyzing children´s participation with Shiers’s Model, most studies were in step 4 (participation in decisions, n=7) and step 3 (consultation, n= 7) followed by step 5 (shared responsibility and power, n=6).   Future research should focus on more fully describing the participatory process, involving younger children and examining how children experience their participation, in order to create meaningful participation. Prevention for obesity requires innovative solutions and the focus of future studies should be on opening up for participation through a participatory starting point, creating opportunities through adequate resources and appropriate methods, and including participation as an embedded policy through the work process.

Children’s right to participation in situations that matter to them is stated in law and convention texts and is emphasized by the children themselves in research studies, too. When actively involved, their perspective is visualized. Children’s use of interactive technology has increased considerably during the last decade. The use of applications and web sites are becoming a regular occurrence in paediatric healthcare. The overall aim was to develop and test, together with children, an interactive communication tool meant to facilitate young children’s participation in healthcare situations. To understand children’s varied perceptions of their involvement in healthcare situations, interviews, drawings and vignettes were used in a phenomenographic approach (I). A participatory design iteratively evaluated evolving prototypes of an application (II). Video observations and hermeneutics captured the meanings of the participation cues that the children demonstrated when they used the application in healthcare situations (III). A quantitative approach was used to identify patterns in the children’s cue use (IV). In total, 114 children in two clinical settings and in a preschool were involved. The result showed that the children perceived themselves, their parents and the professionals as actors in a healthcare situation, although all were perceived to act differently (I). The children contributed important information on age-appropriateness, usability and likeability in the iterative evaluating phases that eventually ended up in the application (II). When using the application in healthcare situations, the cues they demonstrated were understood as representing a curious, thoughtful or affirmative meaning (III). Curious cues were demonstrated to the highest extent. The three-year-olds and the children with the least experience of healthcare situations demonstrated the highest numbers of cues (IV). Conclusion: when using the application, the children demonstrated a situated participation which was influenced by their perspective of the situation and their inter-inter-action with the application as well as the health professional. The children’s situated participation provided the professionals’ with additional ways of guiding the children based on their perspectives. / I lag- och konventionstexter, liksom i forskning, som använder barnens egna uttryck betonas deras rättighet att vara delaktiga i situationer av betydelse för dem. Genom att delta kan de göra sitt perspektiv synligt. Under det senaste årtiondet har barns användning av interaktiv teknik ökat kraftigt. Applikationer och web-sidor används nuförtiden även flitigt inom barnsjukvården. Avhandlingens övergripande syfte var att utveckla och pröva, tillsammans med barn, ett interaktivt kommunikationsverktyg avsett att möjliggöra yngre barns delaktighet i vårdsituationer. Intervjuer, teckningar och vignetter användes för att, fenomenografiskt, förstå barnens uppfattningar av att vara i en vårdsituation (I). En iterativ deltagarbaserad design användes för att utveckla en prototyp av en applikation. En hermeneutisk tolkning av video-observationer fångade meningen i barnens sätt att visa sin delaktighet (hintar) vid användningen av applikationen i vårdsituationer (III). En deduktiv, kvantitativ ansats användes för att identifiera mönster i barnens sätt att visa sin delaktighet när de använde applikationen (IV). Resultatet visade att barnen uppfattade sig själva, föräldrarna och vårdpersonalen som aktörer i situationen, även om alla uppfattades agera på olika sätt (I). Barnen bidrog i den iterativa processen med viktig information gällande aspekter som åldersanpassning, användbarhet och hur väl den tilltalar dem, vilket slutligen ledde fram till den färdiga applikationen (II). Barnens sätt att visa sin delaktighet när de använde applikationen förstods ha en nyfiken, tankfull och självbekräftande mening (III). Nyfikenheten visades mest vid användningen av applikationen. Treåringarna samt barnen med minst vårderfarenhet använde applikationen i störst utsträckning (IV). Sammanfattning: när applikationen användes i vårdsituationen visade barnen en situerad delaktighet vilken byggde på deras perspektiv på den aktuella situationen samt på deras inter-inter-aktion med applikationen och vårdpersonalen. Genom detta erbjöds vårdpersonalen ytterligare ett sätt att guida barnet utifrån barnets eget perspektiv.