Problem: The nature of insurances, and indeed the customer-provider relationship in insurance services, lends itself to distinctive characteristics. These characteristics have particular implications on overall perceived service and relationship quality, and thus customer retention. The arguably singular characteristic of mutual mistrust prevalent in insurance service relationships, is a source for costs and lost profitability for insurance companies in Sweden. Bridging the “gap of mistrust”, potentially offered by a seemingly simple service, could entail significant benefits for both parties in an insurance service relationship.   Research Questions: Does the Aronda Service have the potential to improve a damage adjustment process in a provider-customer insurance service relationship?   Can a more effective damage adjustment process improve an insurance service relation between provider and customer? To what extent do the providers perceive that the damage adjustment process is critical to a customer’s stay or switch decisions in an insurance service relationship?   Purpose: The aim of the thesis is two-fold: The aim is to investigate and describe the impact of the damage adjustment process in customer relationships between the privately insured and property insurance companies in Sweden And to assess, the potential of the Aronda Service to improve customer relations for insurance companies by improving (in terms of customer satisfaction) the damage adjustment process. Methodology: A qualitative method with deductive reasoning was used. The highly contextual nature of customer-provider relationships was deemed, for the purpose of the study, best suited using a qualitative method. Data collection comprised of interviewing several professionals pertaining to the field of property insurance and damage adjustment, academic literature, peer-reviewed articles, and Ph.D. Dissertations.       Theoretical Approach: The theoretical approach is based on consolidation of widely used theories in the field of service and relationship in the “Critical episode on insurance relationships” perspective, presented by Mikael Gidhagen, Senior lecturer at Uppsala University, Sweden. Although the perspective is originally created for B2B relationships, proved great applicability and relevance.   Empirical foundation: The empirical foundation consisted of a number of interviews with respondents with extensive corporate and private insurance industry experience. The secondary empirical information was gathered from governmental, consumer services, and industry regulatory bodies’ websites and publications. Conclusion: The uncovered prominent issues in insurance relationships between private individuals and property insurance service providers can at the very least be aided, if not solved, to the benefit of both parties by the proposed digital version of the Aronda “Black Box”. As the importance of documentation in more cases of insurance claims than not are paramount, and by decreasing the coverage knowledge gap of customers, facilitating a matching of service expectations and actual service delivery, customer satisfaction can be more readily achievable for insurance provider. A readily achievable level of customer satisfaction, in turn, means probably prolonged customer retention, and ultimately higher profitability for the insurance companies. As “it cost more to attract a customer, than it does to keep one.”

Background: In order to provide good diabetes care it is important for the health care professionals to share patients’ personal understanding of living with diabetes, which differs from a professional understanding of the illness. Patients’ beliefs about health, illness, control and cure are predictive of the outcome of lifestyle changes and pharmacological treatment. Narratives about illness could be used to elucidate what people believe to be central to their experience of an illness and its management. The overall aim of this thesis was to investigate experiences of diabetes and diabetes care among people with type 2 diabetes and district nurses responsible for diabetes care within primary health care. Methods: Forty-four patients diagnosed with diabetes during the previous 2 years were interviewed about their personal understanding of illness and experiences of care. They also participated in an intervention study consisting of group sessions during 9 months. The intervention focused on the patients’ understanding of living with diabetes and was directed at the patients and their nurses (n = 5). The outcome variables haemoglobin A1c (HbA1c), lipids, blood pressure (BP) and body mass index (BMI) as well as well-being, treatment satisfaction and diabetes symptoms of the intervention group were compared with those in a control group (n = 60). Another ten patients were interviewed about their views of their lives. Seventeen nurses in diabetes care were interviewed about their views of their work with patients. The narrative, thematic interviews and focus group interviews were analysed using qualitative content analysis. Findings: Patients’ personal understanding of illness included the categories “image of the disease”; “meaning of the diagnosis”; “integration of the illness”; “space for the illness”; “responsibility for care”; and “future prospects”. Patients’ narratives about their lives included views of knowledge, and capacity, motivation and courage, aspects important for effective self-management. Patients’ views on clinical encounters in diabetes care, interpreted as satisfying or not, included the themes “being in agreement v. in disagreement about the goals”; “being autonomous and equal v. being forced into adaptation and submission”; “feeling worthy as a person v. feeling worthless”; “being attended to and feeling welcome v. being ignored”; and “feeling safe and confident v. feeling unsafe and lacking confidence”. The results of the intervention study with group sessions showed improvements in metabolic balance and treatment satisfaction in the intervention group. At the 1-year follow-up the mean difference between groups in HbA1c was 0.94% (95% confidence interval (CI) 0.58–1.29). Nurses’ views of their work included the themes “Perspectives on illness and caring are not easily integrated into views of disease and its treatment”; “Nurses view their knowledge as more important than the patients’ knowledge”; Nurses’ conscience is challenged by some of their nursing decisions”; “The individuality of each patient is undermined when patients are regarded as a collective group”; and “Nurses are confirmed in their role of nurses by patients who assume a traditional patient role”. Conclusion: These results demonstrate that the understanding of illness and care differs between patients and nurses working in diabetes care; furthermore, that an intervention involving patients and their nurses based on patients’ personal understanding of illness is effective with regard to metabolic control and treatment satisfaction. The cost of the intervention is moderate. Also, we believe that it is possible to clinically implement this intervention within the existing resources for primary health care.

Swedish health care is currently facing problems, such as lack of financial resources, staff shortage and dissatisfaction among patients and professionals. Patients’ dissatisfaction was the point of departure for the present study, and one approach dealing with this problem was investigated. It was hypothesised that a patient-centred perspective could offer a possible solution. The aim of the study was to explore health care professionals’ and medical students’ understanding of their professional role and the patient encounter. A further goal was to determine whether these understandings could be developed by educational interventions. Students and professionals have been either interviewed or responded to a survey about their professional role and the patient encounter. Qualitative analysis was used. One group- and one individualised intervention were carried out. The participants’ understandings of their professional role were taken as the starting point for learning. The results showed that a minority of medical students and professionals in diabetes care had incorporated a patient-centred perspective. Nurses in telephone advisory services recognised the patients’ needs, but experienced conflicting demands of being both carer and gatekeeper. A non-optimal match between patients’ needs and what professionals understand as their role could cause some of the problems. Competence development could be achieved by taking the participants understanding of the professionals’ role and of the patient encounter as a starting point for reflection. The results have implications for changes in organisation and education in health care, to optimise outcomes of care. Time for reflection, mentoring and professional development is needed.

The importance of passion increases with the extent of sorrow. While money can replace the passion by offering the opportunity to buy the added value for oneself and the society, social enterprises, artists and start-up organizations have bigger issues to organize the necessary resources. Passion is inevitable for making a difference in the society while suffering a lack of money. Thus, the presence of a certain obsession is a favorable situation for smaller organizations in order to go through difficulties. This thesis investigates the miracle of passion in order to gain an understanding about the ability of leading passionate people. Theories and experiences from passionate individuals are combined in this research paper and suggest different perspectives a leader must consider by leading passion. I assume the social interaction between leaders and followers which result in a mutual influence of behavior and performance. This thesis is focused on the perspective of passionate followership and elucidates factors that are needed to act passionate as well as the role of the leader within this passionate environment.

Background: The recent increase in long-term sickness absence both in Sweden and many other countries has been met with various attempts to intensify the use of rehabilitation measures in order to prevent people from remaining long-term sickness absent. Several actors, among them professionals in healthcare, occupational health services, and social insurance are involved in handling issues related to the sick leave of an individual, and in providing measures to promote return to work (RTW). Identification of the factors that are related to RTW of the individual is a multifaceted task; therefore to meet the individual in this process is an essential challenge for many actors involved. Knowledge is needed about factors that might promote RTW in order to facilitate future research aimed at designing effective rehabilitation programs. Such information is of great importance to improve the work situations of the professionals, to decrease the cost for society, and to improve the situations for people on sick leave by facilitating RTW. Objectives: The overall aim of the work underlying this thesis was to ascertain whether contacts between professionals and sickness absentees might a factor that can promote RTW, and also to identify different aspects of how such positive encounters are experienced by those who are sick listed. Material and methods: Five investigations were conducted using different study designs, data, and methods of data analyses. The first two (papers I and II) concerned interviews with people on sick leave about positive experiences of their encounters with professionals. The third study (paper III) was based on four questions about encounters, which were included in a questionnaire that was administrated to people who were on sick leave. The fourth study (paper IV) used a broad questionnaire to examine experiences of positive encounters, and the final study (paper V) proposed a model of possible effects of the encounters on RTW. Results: In paper I and II different aspects of sick-listed person’s experiences of positive encounters were identified. For example, it seemed that important qualities included being treated with respect, feeling supported, establishing a personal relationship, and participating in decisions regarding RTW measures. Several of the interviewees stated that RTW might be promoted by positive encounters. Paper III showed that perceptions of interactions varied with the type of professionals, as well as with demographics. The respondents perceived their encounters with professionals within healthcare as most positive, followed by social insurance, and lastly occupational health services. In general, females, people born in Sweden, and those who were older, or had a higher education rated their encounters with professionals as more positive. The main finding reported in paper IV was that the majority of the participants had experienced being positive encountered by professionals. Three aspects of such encounters were stressed, namely being treated with ”competence”, ”personal attention”, and ”competence and trust”. The results related in paper V indicated that theories about empowerment and on social emotions could be successfully applied in this area, after they were specifically adapted to some unique features of the contacts between sickness absentees and rehabilitation professionals. Conclusions: This thesis emphasizes that being positively encountered by professionals can have a beneficial impact on RTW after a period of sickness absence. More research is required to elucidate the interaction between sick-listed persons and professionals who are involved in their cases. Further studies should focus on how methods for professionals can be provided to increase sick-listed persons’ own ability to mobilize and develop their resources. Moreover, additional knowledge is needed to extend professional treatment strategies that enhance self-confidence and empowerment of individuals during sickness absence.

It is essential for service companies to understand how their customer service experiences are formed. This is especially important since service experiences are highly subjective and involve customers cognitively, emotionally and behaviorally. Although customer service experiences are a well recognised research topic in both, culinary arts and service research, dynamic interactions, activities and the customers’ active involvement have so far gained little attention. As a consequence the approach in previous research paints a rather static picture of customer service experiences. By introducing the principles of service dominant logic a first person view and the understanding of drivers of customer service experiences could be facilitated. The overall aim of the thesis is to extend and deepen the understandin of drivers of favourable and unfavourable customer service experiences.The context selected is the restaurant context. The overall aim is reflected in four intermediate aims. Two separate studies were conducted. First a two-stage questionnaire based study, describing the phone reservation encounter compared to dining satisfaction; second a critical incident technique study including 195 short narratives of customers’ favourable and unfavourable service experiences at restaurants. Interview data were analysed according to constant comparative analysis principles.The main empirical contributions of this thesis are the move from static descriptions of service to examining dynamic drivers of favourable and unfavourable customers’ service experiences, and especially the analysis of social interactions as a driver of service experiences and the categorisation of drivers. Theoretically the thesis introduces the experience driver constellation, reflecting the dynamic process of co-creation in specific situations,when favourable and unfavourable customer service experiences are formed. Suggestions are made to develop the Five Aspects Meal Model and the Experience Room Framework through the addition of actors, the exterior environment and organisational routines to the models.

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Esta investigação teórica procura identificar pontos de aproximação entre o conceito de potência orgástica, formulado pelo psiquiatra e psicanalista austríaco Wilhelm Reich (1897-1957), e o desempenho esportivo. Para isso procuramos focalizar o processo de evolução do conceito tendo como base os textos em que o apresenta e o define, partindo então para a exploração a respeito do conjunto de matizes e nuances que constituem a visão particular que Reich atribui ao termo potência. Em seguida, buscamos realizar essa aproximação com o desempenho esportivo nos sustentando em pesquisadores do tema, de modo a estabelecer pontos comuns de diálogo e similitudes que permitem um olhar sobre o desempenho esportivo à luz da obra reichiana, com especial ênfase à sua visão de potência. Por fim, fazemos uso da contribuição original de Albertini (1997) a respeito dos encontros potentes como forma de adicionar elementos à nossa reflexão e oferecer contribuições à compreensão do desempenho esportivo sob a ótica da psicologia profunda. Entendido primeiramente como a capacidade do indivíduo de se entregar ao fluxo de suas excitações sexuais no ato amoroso, de modo a atingir o orgasmo e assim descarregar sua libido represada, a evolução da obra de Reich aponta para a utilização do conceito de potência em outras dimensões da vida, nos levando a compreender que a visão de potência em Reich se refere à capacidade de ser humano estar presente e entregar-se em tudo aquilo que realiza. Essa visão se aproxima de conceitos utilizados na psicologia do esporte a respeito de estados ótimos de prontidão para o desempenho esportivo, apontados por alguns autores como ideais para a obtenção de resultados superiores. Essa aproximação, quando colocada sob o prisma da ideia de encontros potentes, nos permite reavaliar os aspectos estruturais que o conceito de potência possui no pensamento reichiano, assim como considerar a interferência dos processos transferenciais no desempenho esportivo, apontando para a ideia de que o desempenho esportivo não é afetado apenas por condições psíquicas individuais e isoladas do meio, mas especialmente pelo campo transferencial que se compõe no momento em que o desempenho ocorre / This theoretical investigation aim at the identification of approach points between the concept of orgastic potency, formulated by the Austrian psychiatrist and psychoanalyst Wilhelm Reich (1897-1957), and sport performance. To achieve this intent we first try to focus on the concept´s development process, based on the writings in which Reich presents it and defines it. Then, we continue to search and exploit the set of shades and nuances that make up the particular vision that Reich gives to the term potency. Following, we seek to achieve this approach to sports performance with the support of researchers in this area, in order to establish a common ground of dialogue and point out similarities that allow a glimpse into sports performance through the light of Reich\'s work, with special emphasis on his vision of potency. Finally, we use the original contribution of Albertini (1997) about the \"potent encounters\" as a way to add elements to our reflection and offer contributions to the understanding of sports performance from the perspective of depth psychology. Understood primarily as the ability of an individual to surrender to the free flow of his sexual excitations in lovemaking, in order to achieve orgasm and so discharge their repressed libido, the evolution of this concept points to the use of the term potency in other dimensions of life. Thus, leading us to the understanding that potency, in Reich´s view, refers to the ability of human beings to surrender and be present in everything they do in life. This view is similar to some sport psychology´s concepts about optimal states and readiness for performance, pointed out by some authors as ideal for achieving superior results. This approach, when placed under the light of the potent encounter´s notion, allows us to re-evaluate the structural aspects that the potency concept has on Reich\'s thinking, as well as to consider the interference of transference processes in sports performance. With this we were able to point at the idea that sport performance are not influenced only by individual and isolated psychological conditions, but specially by the transference field composed at/in the moment the performance occurs

Background: Primary Healthcare Centers [PHC] represent the first healthcare contact that patients have, unless they are critically ill or their state is life-threathening. Distric nurse´s work in PHC requires preparedness to meet people in different ages and varying cultural and ethnical backgrounds. This preparedness includes an independent and person-centred workway. The study´s theoretical framework therefore proceeds from person-centred care. Challenging encounters occur in district nurse´s meetings with patients. The concept complex healthcare encounters exists in the competence description of the district nurses and in educational regulatory contexts. Despite of this, there is no general definition of the concept and what it is characterized by. Aim: The aim of this study is to describe district nurse´s experiences of complex healthcare encounters. Method: A qualitative, descriptive, inductive content analysis is used as the analysis method. Six focusgroup-interviews were contucted with nurses and districs nurses working in PHC. Results: District nurse´s experiences of complex healthcare encounters contains to balance unpredictable encounters with predictable organizational terms. This is described as: To meet people with varying lifesituations and To care professionally within organizational conditions. Conclusion: District nurses experience complex healthcare encounters characterized by the coexistence of unpredictable meetings with people and predictable organizational terms. By developing the knowledge about complex healthcare encounters, district nurses can streamline the care simultaneously as the mission of the district nurse can be explicated. / Bakgrund: Vårdcentraler är vårdsökandes första vårdinstans om inte vårdbehovet är akut eller livshotande. Distriktssköterskors arbete på vårdcentraler medför beredskap att möta människor i olika åldrar och med varierande kulturella och etniska bakgrunder. Denna beredskap inrymmer ett självständigt och personcentrerat arbetssätt. Examensarbetets teoretiska referensram utgår därmed från personcentrerad vård. Utmanande vårdsituationer uppstår i distriktssköterskors möten med vårdsökande människor. Begreppet komplexa vårdsituationer förekommer i distriktssköterskors kompetensbeskrivande och utbildningsreglerande dokument. Dock saknas en gemensam bild av vad detta begrepp karaktäriseras av. Syfte: Syftet är att beskriva distriktssköterskors erfarenheter av komplexa vårdsituationer på vårdcentral. Metod: En kvalitativ, deskriptiv innehållsanalys med en induktiv ansats har används som analysmetod. Sex fokusgruppsintervjuer med distriktssköterskor och sjuksköterskor som arbetar på vårdcentral har genomförts. Resultat: Distriktssköterskors erfarenheter av komplexa vårdsituationer på vårdcentral innehåller att balansera mellan oförutsägbara möten med människor och förutsägbara organisatoriska villkor. Detta beskrivs som: Att möta människor i varierande livssituationer och Att vårda professionellt med givna organisatoriska förutsättningar. Slutsats: Distriktssköterskorna erfar komplexa vårdsituationer som karaktäriseras av att oförutsägbara möten med människor och förutsägbara organisatoriska villkor samexisterar. Genom kunskapsutveckling om komplexa vårdsituationer kan distriktssköterskor effektivisera vården samtidigt som distriktssköterskors uppdrag förtydligas.

This study explores the exchange of cultural information that takes place in the meeting between immigrant and non-immigrant characters in a selection of Australian novels focusing on the theme of migration: Heartland (1989) by Angelika Fremd, A Change of Skies (1991) by Yasmine Gooneratne, Stella’s Place (1998) by Jim Sakkas, Hiam (1998) by Eva Sallis and Love and Vertigo (2000) by Hsu-Ming Teo. The concept cultural translation functions as a theoretical tool in the analyses. The translation model is particularly useful for this purpose since it parallels the migration process and emphasises the power relations involved in cultural encounters. Within the framework of the study, cultural translation is defined as making an unfamiliar cultural phenomenon familiar to someone. On the intratextual level of the text, the characters take on roles as translators and interpreters and make use of certain tools such as storytelling and food to effect translation. On the extratextual level, Fremd, Gooneratne, Sakkas, Sallis and Teo represent cultural translation in the four thematic areas the immigrant child, storytelling, food and life crisis. The first theme, the immigrant child, examined in chapter one, explores the effects of using the immigrant child as translator in communication situations between immigrants and representatives of Australian public institutions. In these situations, the child becomes the adult’s interpreter of the Australian target culture. The role as translator entails other roles such as a link to and a shield against the Australian society and, as a result, traditional power relations are reversed. Chapter two analyses how the second theme, storytelling, is presented as an instrument for cultural education and cultural translation in the texts. Storytelling functions to transfer power relations and resistance from one generation to the next. Through storytelling, the immigrant’s hybrid identity is maintained because the connection to the source culture is strengthened, both for the storyteller and the listener. The third theme, food as a symbol of cultural identity and as representation of the source and target cultures, is explored in chapter three. Source and target food cultures are polarised in the novels, and through an acceptance or a rejection of food from the source or target cultures, the characters symbolically accept or reject a belonging to that particular cultural environment. A fusion between the source and target food cultures emphasises the immigrant characters’ cultural hybridity and functions as a strategic marketing of culturally specific elements during which a specific source culture is translated to a target consumer. Finally, the fourth theme, life crisis, is analysed in chapter four where it is a necessary means through which the characters experience a second encounter with Australia and Australians. While their first encounter with Australia traps the characters in a liminal space/phase that is signified by cultural distancing, the second encounter offers a desire and ability for cultural translation, an acceptance of cultural hybridity and the possibility to become translated beings – a state where the characters are able to translate back and forth between the source and target cultures.