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This thesis investigates customer-to-customer roles and impacts in the context of service encounters. This topic is studied from two angles: customer interactions during group service encounters and customer perceptions post service encounters. The first angle is a focus on group service encounters that addresses the lack of research on customer-to-customer interactions that occur in customer-to-customer interaction-intensive contexts. These are contexts where the interactions between customers are not peripheral to the service, where there can be an expectation to interact with the other customers, and are common in tourism and hospitality, recreation, and education. The second angle is a focus on service outcomes after the service encounter, including satisfaction, intention to recommend, and online word-of-mouth. Paper 1 explores how firms view and manage customer-to-customer interactions during group service encounters. It finds that the differences in attitude and conduct of firms create four possible stances toward customer-to-customer interaction. Paper 2 delves deeper into how customer-to-customer interactions impact the design and delivery of group service encounters, develops a typology of customer cohort climates (CCCs), and identifies how each CCC can be created through four elements of group service encounters. Paper 3  investigates how positive and negative customer-to-customer interactions impact service outcomes and finds that customer-to-customer interaction is a dissatisfier. Paper 4 examines how customers produce online hotel reviews and finds that content analysis of online reviews yields similar findings to more traditional quantitative research methods. This thesis advances research on the impact of customers on each other and provides evidence that other customers can and should be managed to achieve desired service outcomes. It further proposes how these interactions can be managed to further enhance service firm offerings. / <p>QC 20160516</p>

Bakgrund: För ungefär 35 år sedan uppmärksammades HIV som ett sjukdomstillstånd bland människor. Sedan dess har infektionen skördat många liv främst i Afrika och har också kommit att förknippas med homosexuella personer som dock utgör en minoritet av alla smittade. Globala insatser försöker minska dessa dödsantal och i Sverige har kunskapen och attityder kring HIV förbättrats under de senaste årtiondena. Trots detta förekommer det fortfarande brister i kunskap om HIV men också i attityder mot personer som är smittade. Vård skall bedrivas med respekt oavsett sjukdom och betydelsen av kommunikation är stor för att kunna bedriva personcentrerad vård och för att ha ett gott vårdklimat. Syfte: Syftet var att beskriva hur patienter med HIV upplever bemötande inom vården. Metod: En litteraturöversikt har genomförts vilket innebär att befintlig kunskap från elva vetenskapliga artiklar har analyserats och sammanställts inom ett specifikt område. Resultat: Översiktens resultat presenteras i två huvudteman med fyra respektive sex underteman. Det första huvudtemat positiva upplevelser av bemötandet i vården har följande underteman: relationsfrämjande värden, vårdgivarens stöd och support, den goda vårdrelationen samt närhet – ett tecken på acceptans. Det andra huvudtemat negativa upplevelser av bemötandet i vården har följande underteman: särskiljande bemötande på grund av diagnos, vårdgivarens försiktighetsåtgärder, olämpligt bemötande, en otillräcklig vårdrelation, vårdgivares affektiva tillstånd och agerande samt sekretessbrott. Diskussion: Det som framkom i resultatet har diskuterats utifrån kunskap om HIV från sjuksköterskor och sjuksköterskestudenter. Här belyses vikten av adekvat kunskap om HIV men också om kommunikation inom vården och hur denna kunskap bör tillhandahållas. Detta har diskuterats utifrån Joyce Travelbees omvårdnadsteori. / Background: HIV-infection among humans received attention throughout the world 35 years ago from the dramatic increase in deaths. The deadly virus has spread globally with intensity in the African continent. The virus has been somewhat falsely characterized as the “homosexual disease” even though this group represents a minority of all people living with HIV. Global programs are taking action to decrease the amount of deaths and the knowledge and attitude towards the virus has improved in Sweden through the last decades. Despite this, there are still dramatic misunderstandings in knowledge about HIV and attitudes towards HIV-infected people. Care should be given with respect no matter diagnosis, and adequate communication is of vital importance to be able to perform individualized care in a proper functioning healthcare setting. Aim: How HIV-infected patients experience interaction with healthcare professionals. Method: A literature review was conducted to analyze and compile data of existing knowledge from eleven scientific articles within a specific area of study. Results: The results of the review are presented in two main themes. The first main theme is positive experiences of interactions within healthcare that includes following sub themes: relationship-building values, the support given by caregivers, a positive professional-patient relation and closeness – a sign of acceptance. The second main theme is negative experiences of interactions within healthcare which includes following sub themes: differential treatment because of HIV, precautions exceeded by caregivers, inappropriate encounters, emotions and actions exceeded by caregivers and confidentiality breaches. These themes describe how patients experienced encounters within healthcare settings negatively. Discussion: The result findings are discussed from nurses and nursing students perspectives on knowledge about HIV. The importance of both knowledge about HIV and communication is highlighted, and how healthcare professionals should acquire these understandings. This has been discussed using Joyce Travelbee´s nursing theory.

Sverige har under de senaste decennierna utvecklats till ett mångkulturellt samhälle. Som sjuksköterska möter vi dagligen situationer där människor, på grund av olika kulturer, har olika syn på hälsa, ohälsa, sjukdom och behandling. Syftet är att beskriva sjuksköterskors upplevelser av att möta och vårda patienter med olika kulturella bakgrunder för att belysa vikten av kulturell kompetens. Studien är en litteraturstudie med en kvalitativ ansats. Totalt valdes sju artiklar som kvalitetsgranskades och användes i resultatet. Resultatet presenteras i fem huvudkategorier och nio underkategorier. Ett genomgående tema i resultatet var att identifiera vilka hinder sjuksköterskor upplevde försvårade vårdrelationen med patienterna som i sin tur påverkade kvalitén på den vård som gavs. I mötet med människor från andra kulturella bakgrunder uppmärksammas behovet av kulturell kompetens. Genom att förstå hur andra människor tänker kan sjuksköterskor tillmötesgå patienten och utforma vården utifrån den enskilda patientens önskningar.

The ability to work can be reduced if a person has health problems which may lead to periods of sick leave. In Sweden sickness certification is issued by physicians. Many general practitioners (GPs) find sickness certification to be problematic. Some studies indicate that collaboration with other health care professions could be beneficial. The aim of the thesis was to provide knowledge on how the work with the sick leave process in primary health care can be improved and how occupational therapists’ (OT) assessment could be used prior to the decision on sick leave and rehabilitation. Initially seven focus groups were held, four with OTs and three with physicians. The discussions in the focus gropes were analysed by qualitative content analysis. An intervention project was initiated, where four health care centres in northern Sweden tested a working approach where sick listed patients were offered a supplementary assessment of activity and work-related problems by an OT. Data on sick leave, sickness certificates and patient questionnaires were collected from intervention health care centres (IHCC) and other health care centres (OHCC). Interviews were conducted with patients, GPs and OTs. The quality of the information in the collected sickness certificates was evaluated. Average values of sick leave were compared between the IHCCs and the OHCCs in the county. The interviews with sick listed patients were analysed by qualitative content analysis. In order to analyse the implementation of the intervention the Consolidated Framework for Implementation Research, CFIR, was used. An overall theme and four categories emerged from the focus groups. The theme expressed work ability as an obscure, complex and unique concept. The four categories illustrate the affecting factors and confirmed the complex structure of work ability: the person, the context of life, the work, and the society. No significant differences between IHCCs and OHCCs in data on sick leave or the mandatory information in the certificates were found. Thirty-four percent of the collected sickness certificates did not contain all requested information. More certificates issued for women than certificates issued for men lacked the required information. Full-time sick leave was significantly more often prescribed for male patients than for female. Two themes revealed that highlight important areas for persons on sick leave in their healthcare encounters. The theme ‘Trust in the relationship’ contains categories describing the patients’ feelings of participation, being believed, confirmed, and listened to. The second theme ‘Structure and balance’ contains the participants’ views on important factors that could facilitate the return-to-work process such as a structured plan and support to balance activity. The analysis with CFIR clarified that coaching and education for all the users are crucial to get fidelity when new interventions are tested as well as involvement by the clinical department manager. The work with sick leave issues in primary health care can be improved by developing cooperation with several different professionals. To achieve an increased cooperation new working approaches are required. These working approaches must be anchored in management and requires an applied implementation strategy. More focus on the quality of encounters with healthcare professionals can also improve the sick leave process in primary health care centres. The healthcare encounters must build on a mutual trust and sick-listed persons’ return to work can be facilitated by providing a clear structure in the process and support in occupational balance. For issuing sickness certification further education about the descriptions of functioning and the tasks included in the patient’s work is needed. A better gender awareness in the health care encounters is also necessary.

This ethnographic research examines the social implications of the ethnolinguistic contact that occurs in the U.S.-Mexico border region at a day labor center in Tucson, Arizona. I discuss the multiple values of English and Spanish in this setting and how individuals interpret and negotiate these values in the construction and performance of identity. More specifically, I analyze how discourses of linguistic capital shape the organization of this community and influence the dynamics of employment negotiations. The research setting includes immigrant day laborers (primarily from Mexico and Central America), employers who contract workers, and bilingual volunteers who act as language brokers between workers and their employers; all of whom use language to interactively negotiate their social status as they construct identities vis-à-vis other members of the community. My analysis reveals a discourse that places a high level of linguistic capital on Spanish-English bilingualism in the economic market. Although I have not found evidence that this linguistic capital has a real exchange rate into dollars, my data demonstrates that immigrants rapidly acquire and contribute to this locally constructed discourse. I explore the techniques that workers use to exploit and promote their language abilities through ‘performances’ of bilingualism that are realized not only to secure employment, but also for social positioning within this community of practice. Language, then, is one of the many tools that both workers and employers use in the construction of interpersonal relationships and social hierarchies. In addition, I analyze gatekeeping encounters focusing on the rapid employment negotiations that occur between day laborers and their employers, building on previous research with regard to the concepts of rapport, co-membership, and the presentation of an institutional self. Finally, I propose a model for the study of intercultural communication and contact that reflects the dynamic nature of contact and the complexity of overlapping categories of identity. Identity formation is a multiplex and multidirectional social construction that necessitates pushing beyond binary models of intercultural communication. Identity construction is informed not only by face-to-face interlocutors, but also by the linguistic ecology of dominant and subordinate discourses and the imagined individual and collective interlocutors they evoke.

The original contribution of this thesis is through its conceptualisations of human more-than- human encounters on the allotment that break down the boundaries of subjectivities. This work extends knowledge of cultural food geography by investigating how people engage with the matter of the plot and learn to grow food. The conceptual tool by which this occurs is set out as processes of visceral learning within a framework of mattering. Therefore this work follows the material transformations of matter across production consumption cycles of allotment produce. This is examined through processes of bodily adaptions to the matter of the plot. The processes of growing your own food affords an opportunity to focus on the processes of doing and becoming, allowing the how of food growing to take centre stage (Crouch 2003, Ingold 2010, Grosz 1999). Procuring and producing food for consumption is enacted through the human more-than-human interface of bodily engagement that disrupts dualisms and revealing their complex inter-relationships, as well as the potential of visceral research (Roe 2006, Whatmore 2006, Hayes-Conroy 2008). Therefore, this is an immersive account of the procurement of food and the development of food knowledge through material, sensory and visceral becomings, which occur within a contextual frame of everyday food experiences. This study is contextualised in the complexities of contemporary food issues where matters of access, foodism and sustainability shape the enquiry. However the research is carried out at a micro-geographies lens of bodily engagements with food matter through grow your own practices on allotments. Growing food on new allotments is the locus of procurement reflecting a resurgence in such activities following from the recent rise in interest in local food, alternative food networks (AFNs) and food as a conduit for celebrity in the media (Dupuis & Goodman 2005, Lockie & Kitto 2000, Winter 2003). Moreover, the current spread of the allotment is examined as transgressing urban/rural divides and disrupting traditional perceptions of plot users. This allows investigations into spaces where community processes can unfold, providing a richly observed insight into the broadened demographics of recent allotment life.

”Människan är den enda varelse som i någon intressant och utvecklad mening undervisar sin avkomma” (Säljö, 2015, s. 11). Ur existentiell synvinkel är frågan varför lätt att besvara. Människans överlevnad i samtiden och barnens livschanser och överlevnad i framtiden, ökar genom undervisning. I Sverige har simförmåga och simkunnighet fått ett stort kulturellt värde i såväl primär socialisation (undervisning av familj, släkt och vänner) som sekundär socialisation (läroplansstyrd undervisning i skola). Under de senaste åren har många människor anlänt till Sverige, för att undkomma krig och förföljelse i hemländerna. I skolan visar det sig att många nyanlända barn och ungdomar inte kan simma. I kunskapskraven för åk 6 och åk 9 i ämnet idrott och hälsa står det tydligt “Eleven kan även simma 200 meter varav 50 meter i ryggläge” (Skolverket, 2011, s. 51-54). Detta måste eleven kunna för att minst få betyget E i ämnet idrott och hälsa. En viktig fråga är då vilka erfarenheter av vattenvana och simning som dessa barn och ungdomar bär med sig från sina tidigare hemländer. Forskningsingången i denna studie är att utveckla yrkeskompetensen genom att få förståelse för och kunskap om nyanländas förförståelse av momentet simning och vilka anpassningar som behöver göras för att eleverna ska klara momentets kunskapskrav.I en mixad studiedesign genomfördes inledningsvis en kartläggning av uppfattningar och erfarenheter i simning via en explorativ enkät och därefter uppföljande kvalitativa forskningsintervjuer med nyligen migrerade ungdomar i åldern 12-16 år. Avslutningsvis  genomfördes kvalitativa forskningsintervjuer med sakkunniga vuxna som arbetar i svenska skolor och delar de nyanländas kulturella bakgrund. Kvalitativa data analyserades sedan med kategorisk innehållsanalys. Statistisk data från enkäten triangulerades mot barnen/ungdomarnas och de vuxna informanternas berättelser. Resultaten visar bristande erfarenhet av vattenvana både inom primär- och sekundär socialisation; en uttalad effekt av socioekonomisk status; tradition kombinerat med religiösa drag kan också vara hämmande faktorer för simkunnighet, särskilt utifrån kön. Resultaten är viktiga för lärare som utbildar nyanlända elever i idrott och hälsa för att anpassa lärandesituationer. / "Man is the only creature that in some interesting and developed sense educate their offspring." (Säljö, 2015, p. 11). From an existential point of view, the question why is easy to answer. Human beings´ survival in the present and their offspring's life chances and survival in the future increases by education. In Sweden, the ability to swim and knowledge about swimming have been given a great cultural value both in primary socialization (education by the family, relatives and friends) as well as in secondary socialization (curriculum-driven education in school).In more recent years, many people have migrated to Sweden, to escape war and persecution in their home countries. In school, it becomes evident that many children and adolescents who have recently migrated to Sweden cannot swim. In the learning outcomes for grade 6 and grade 9 in physical education, it states clearly that: "Students can also swim 200 meters with 50 meters in the supine position" (Skolverket, 2011, pp. 51-54). The student must be able to fulfil this requirement in order to at least achieve the grade E in physical education. An important issue is then to understand the kinds of experiences with swimming and more in general their confidence with water that these children and adolescents carry from their countries of origin. The aim of this study is to develop teachers professional skills by gaining knowledge and understanding of young migrants prior understanding of swimming and what adjustments need to be made for students to meet proficiency requirements to fulfil the learning outcomes concerning swimming in the Swedish school system for year 6 and year 9.Undertaken was a mixed design study were initially a explorative survey of perceptions and experiences in swimming and later follow-up qualitative research interviews with newly migrated adolescents, aged 12-16 years. Finally, qualitative research interviews were conducted with expert adults working in Swedish schools and sharing the migrants´ cultural background. Qualitative data was analysed using a categorical content analysis. The statistical data from the survey was triangulated against the adolescent informants´ and the adult informants´ stories. The results show lack of aquatic experience both in primary and secondary socialization; a pronounced effect of socio-economic status; tradition combined with religious traits can also be inhibiting factors for swimming ability, especially by gender. Results are important for teachers educating migrants in physical education and adapting learning situations.

Bakgrund: AIDS epidemin har skördat många liv sedan 1980 talet. Flera globala insatser görs för att framför allt minska antal dödsfall och att stoppa spridningen av HIV. HIV har även förknippats med homosexuella trots att de utgör en minoritet av de som har drabbats. Människor med HIV har levt under svåra förhållanden orsakad av diskriminering och stigmatisering. Samtidigt finns det en ökad kunskap om HIV och vårdpersonal visar mer acceptans att vårda denna patientgrupp. Ändå förekommer det fortfarande negativa attityder, som uttrycks i form av rädsla för smitta. Jämlik vård oavsett sjukdom är betydelsefullt för en god vårdrelation och vården skall bedrivas med respekt för patientens integritet och värdighet. Syfte: Att undersöka hur patienter med HIV upplever bemötande inom sjukvården. Metod: För att få svar på syftet genomfördes en litteraturöversikt som inkluderade tio vetenskapliga artiklar varav fem artiklar med kvalitativ metod, två artiklar med kvantitativ metod och tre artiklar med mixad metod. Resultat: Resultatet presenteras i två huvudteman med fem respektive sex underteman. Det första huvudtemat förutsättningar för positiva upplevelser inom vården har följande undertema: den goda vårdrelationen, vårdgivarens stöd och engagemang, att få tillräcklig med rådgivning, när vårdandet ger förtroende och ett kärleksfullt bemötande. Det andra huvudtemat hinder för gott bemötande har följande underteman: att bli oprofessionellt bemött, brist på engagemang och stöd från vårdgivaren, utebliven rådgivning, vårdgivarens försiktighetsåtgärder, vårdgivarens ointresse att bevara sekretess och konsekvenser av bristande kunskap hos vårdpersonalen.  Diskussion: Baserat på sammanfattningen av resultatet diskuterades vikten av adekvat kunskap om HIV. / Background: AIDS epidemic has claimed many lives since the 1980's. Several global initiatives are working towards reducing the number of deaths and to stop the spread of HIV. HIV has also been associated with homosexual even though they represent a minority of those who have suffered. People with HIV have been living under difficult conditions caused by discrimination and stigmatization. Meanwhile, knowledge is increasing about HIV and health professionals show more acceptances to care for this population despite this yet there are still negative attitudes expressed in the form of fear of contagion. Equitable care regardless of disease is important for good health care relationship and care must also be conducted with respect for patient privacy and dignity. Aim: To examine how the patients with HIV experience the interactions with health care workers. Method: To get answers to the purpose conducted a literature review was conducted that included ten scientific articles, of which five articles with qualitative method, two articles with quantitative method and three articles with mixed method. Results: The results of the review are presented in two main themes. The first main theme is prerequisites for positive experiences in health care that includes following sub themes: the good care relationship, caregiver's support and commitment, to get adequate advice, when caring gives confidence and a loving attitude. The second main theme is barriers to good interactions which includes following sub themes: being unprofessional responded, deficiency of commitment and support from the caregiver, loss counselling, caregiver's precautions, the caregiver's indifference to preserve confidentiality and the consequences of lack of knowledge among health professionals. Discussion: Based on the summary of the results was discussed the importance of adequate knowledge about HIV.