Women afflicted with cervical cancer who have the highest morbidity and mortality rates have been the least likely to be screened. The overall aim of this research project was to investigate non-attendance in a cervical cancer screening (CCS) program among women with no registered cervical smear during the previous five years. Both quantitative (I,III) and qualitative methods (II) as well as costeffectiveness analysis (IV) were used in this research project. In Kalmar County women (aged 23-65 years) are invited to CCS every third year. All cervical smears taken both in opportunistic and organised CCS are coordinated in a register called Sympathy. The coverage is 88.4 %. From Sympathy, a random sample of 400 women served as a study group and another 400 women as a control group (III,IV). From the study group, 133 women participated in study I and 14 women in study II. Data was collected by telephone interviews based on a questionnaire (I), qualitative face-to-face interviews (II), questionnaire, promotive efforts and outcome (III), costs and effectiveness (IV). Quantitative data was analysed by descriptive and analytic statistics (I,III), qualitative data was analysed by content analysis. In study IV, cost-effectiveness analysis was used. The women believed that CCS was a good idea for all other women, but tended to refer to various circumstances resulting in their own non-attendance. One of the most common reasons for non-attendance was the feeling of being healthy. The women prioritized family and work commitments, and the invitation to attend CCS was sometimes experienced as a stressful disturbance. The feeling of discomfort was related to the gynaecologic examination, or to health care visits in general (I,II). Of 133 women, 120 could consider having a cervical smear taken and their two most common requirements for doing so were to be assured they would be treated in a friendly way (19%) and to find a suitable time (18%) for having the cervical smear. Fifty women wanted to be helped to have a cervical smear taken. Promotive efforts ranged from making a simple telephone call to arranging an appointment time to a combination of promotive efforts including repeated encounters in order to create a trusting relationship with respect to taking the smear. In the study group, 29.5% (n=118) had a registered cervical smear at follow-up compared to 18.5% (n=74) in the control group, (p<0.001) (III). In the study group, the cost per cervical smear taken was 66.87 €, and in the control group it was 16.62 €. The incremental cost per additional cervical smear taken was 151.36 € (IV). In conclusion, women’s reasons for not attending CCS are complex and are influenced by both present and earlier circumstances. In settings with high coverage, further contact in order to promote women’s attendance at CCS seems to be associated with high costs in relation to the number of additional cervical smears taken. / On the day of the defence data the status of article I was: In press; article II: Submitted; article II: Accepted and artile IV: In press.

An estimated 50% of mortality from the 10 leading causes of death is due to behaviour. Individuals can make important contributions to their own health by adopting health-related behaviours and avoiding others. Motivational interviewing (MI) has emerged as a counselling approach for behavioural change that builds on a patient empowerment perspective by supporting autonomy and self-efficacy. The overall aim of this thesis is to contribute to improved understanding of the different factors that impact on general health care professionals’ learning and practice of MI. Specific aims are; study I was to identify barriers, facilitators and modifiers to use MI with pharmacy clients in community pharmacies; study II was to identify barriers and facilitators to use MI with overweight and obese children in child welfare and school health services; study III was to evaluate the attitudes towards MI and clinical use of MI with children´s weight issues one year after child health care nurses’ participation in MI training; study IV was to systematically review studies that have evaluated the contents and outcomes of MI training for general health care professionals. Participants in study I were 15 community pharmacy pharmacists in Östergötland, Sweden. Participants in study II were five child welfare centre nurses from the county council and six municipally-employed school health service nurses, all from Östergötland, Sweden. Data for both studies were obtained through focus group interviews. Study III, participants were 76 nurses from child health care centres in Östergötland, Sweden. 1-year after MI training they answered a survey. Study IV, the material was 10 empirical studies that have evaluated different aspects of MI training. MI training for general health care providers is generally of short duration and tends to focus on specific topics such as diabetes, smoking, and alcohol. The training seems to contain more training on phase I elements, such as clients’ inner motivation, than on phase II, which involves strengthening clients’ commitment to change. MI is seen as practical and useful in work with lifestyle and health promotion issues, especially with issues that may be perceived as sensitive, such as alcohol and obesity. General health care providers have positive attitudes to MI and view MI as being compatible with their values and norms about how they want to work. Clients’ resistance reactions are difficult to handle in the first stages of learning MI, and may lead to frustration. Strategies to avoid resistance are including in the final stages of learning MI. Learning and clinical use of MI for general health care providers is influenced by interactions with their environment (colleagues, staff and organization). Unlearning of old knowledge can be a problem for general health care providers in the learning and clinical use of MI.

Ögoninfektion är vanligt förekommande hos barn särskilt i kombination med övre luftvägsinfektion. 95% av alla barn mellan två och fem år vistas på förskola. Distriktssköterska/Avancerad primärvårdssjuksköterska ser förskolan som en viktig resurs i det förebyggande hälsoarbetet. Personal på förskolan har att ta ställning till sjukdom och ohälsa hos barnen. Syftet med studien är att undersöka förskolepersonalens uppfattningar om ögoninfektion hos barnen.   Fyra intervjuer med förskolepersonal ligger till grund för en kvalitativ studie. Intervjuerna har analyserats enligt fenomenografisk ansats. Sju beskrivningskategorier med tillhörande uppfattningar beskriver personalens olika uppfattningar: Spridning av ögoninfektion; Hur infektionen yttrar sig; Brist på kunskap; Betydelsen av handhygien; Föräldrarnas roll; Hälso- och sjukvårdens betydelse; Den kollegiala samvaron.   Förbättrad kommunikation mellan BVC/vårdcentral och förskola behövs. Undersökningen är tänkt att användas i distriktssköterskans/APS-sjuksköterskans fortsatta arbete för att befrämja hälsa och förebygga sjukdom. / Conjunctivitis is common among infants and children, especially whilst they are suffering from upper respiratory tract infections. 95% of all infants go to nursery from the age of 2 The nurse practitioner finds that nurseries are ideal places for health promotion. In nurseries the staff has to make decisions concerning health problems in the infants. The aim of this paper is to describe how the staff experience eye infection in infants. It is a qualitative study based on four interviews. They are analyzed using the phenomenographic method. The result contains seven different categories with all the significant answers from the participants: The spread of eye infection; The infection's appearance; Lack of knowledge; The importance of hand hygiene; The role of the parents; The importance of the health service; The social intercourse between colleagues. There is a need of improved communication between the GP center and the nurseries. The paper is intended to benefit the nurse practitioner in promoting health.

Syfte: Syftet var att undersöka ledares syn på hälsa och hälsofrämjande arbete samt hur det eventuella hälsofrämjandet arbetet såg ut på deras företag. Vidare undersöktes ur ledarens synvinkel, hur, vad och varför ledaren och företaget arbetar som de gör med hälsa på sin arbetsplats. Metod: Författarna har genom intervju frågat ledare vid fyra företag med kontorsverksamhet vad de anser om hälsa och hälsofrämjande arbete och hur företagets hälsoarbete ser ut. Resultat: Resultatet visade att ledarnas syn på hälsa och hälsofrämjande arbete påverkar hälsoarbetet på företaget. Resultatet visade även att tre av fyra företag hade ett välutvecklat hälsofrämjande arbete. Slutsats: Samtliga ledare visade intresse för hälsa och hälsofrämjande arbete om än i olika grad och ledarnas intresse har en påverkan på det hälsofrämjande arbetet.

Då människor befinner sig till stor del av sin vakna tid på arbetsplatsen har denna blivit en viktig arena för hälsofrämjande arbete. Studier visar hur viktigt det är för företag att ha en frisk och välmående personal. Fokus ligger då oftast på företagets behållning av hälsofrämjande arbete. Syftet med studien var därför att beskriva hur anställda upplevde hälsofrämjande arbete på sin arbetsplats. Kvalitativa intervjuer genomfördes med samtliga anställda på ett litet företag. Intervjuerna spelades in på band varefter de transkriberades och tolkades. Resultatet delades in i tre olika kategorier; uppskattning från ledningen, gemenskap med arbetskollegerna och individuell motivation. Uppskattning vilken de anställda upplevde genom att ledningen var lyhörd, brydde sig om och fick dem att känna sig bekräftade. Gemenskap till kollegor vilken kunde upplevas genom att de kände samhörighet. För vissa var det betydelsefullt medan andra inte brydde sig om det. Att som individ känna motivation för de hälsoförmåner som fanns på företaget visade sig vara viktigt. Det var egentligen inte de anordnade aktiviteterna som var det viktiga för informanterna, utan att få känna sig delaktig, inkluderad och sedd på arbetsplatsen. Upplever de anställda sig uppskattade inom företaget och att de har en bra sammanhållning främjar detta i sin tur individens upplevda hälsa. / The workplace has become an important platform for health promotion since people spend a big part of their life at work. Studies have shown how important it is for employers to have an understanding of the health and wellbeing of their staff. Yet most of the focus is still on the benefits for the employer. The aim of the study was to describe the employee’s experiences of their workplace health promotion. Qualitative interviews were implemented on all employees at a small company. All interviews were recorded, transcribed, interpreted and have been divided into three different categories; The sense of value that employees experienced when employers were good listeners, showed that they cared and made the employees feel important. The spirit of fellowship to colleagues could be experienced as very important to some and others didn´t care at all. To feel individual motivation for health promotion at the workplace was important. It showed that it wasn´t the actual method that was the most important part but to feel involved, included and to be seen at the workplace. The employees experience that they have a big participation in the company and that the solidarity is good which promote the individuals health experience.

Sammanfattning Syftet med denna uppsats var att belysa hur fenomenet friskvård på en arbetsplats uppfattas av enskilda individer och vilken betydelse det kan få med avseende på såväl hälsan som välbefinnandet i stort. Utifrån denna fråga ville vi även se om det fanns skillnader i upplevelser av friskvård i de olika yrkeskategorierna från arbetsledning till arbetstagare. Inställningen till friskvård som prevention på en arbetsplats och vardagsmotion för den enskilde individen är individuell. En del människor varken vill eller tror sig kunna utöva friskvård och håller sig friska ändå. Den empiriska undersökningen bygger på kvalitativ metod. Vi har genomfört en intervjuundersökning med sju intervjupersoner från olika yrkeskategorier vilka har bidragit med sina tankar kring friskvården. Vi har använt oss av Antonovsky teori KASAM. Intervjuerna har tolkats enligt hermeneutiska principer. Resultaten visar bland annat att friskvård är betydelsefull på många sätt för medarbetare. Friskvård handlar om så mycket mer än fysisk aktivitet.

Studiens övergripande syfte var att undersöka några chefers attityder till en personalsatsning ämnad för att uppnå bättre arbetsklimat och hälsa i en organisation, vidare var syftet att med utgångspunkt ur dessa chefers attityder till personalsatsningen undersöka möjligheter till hur personalsatsningen och dess verksamhet skulle kunna få ett starkare genomslag i den aktuella organisationen. Studien presenterar inledningsvis en forskningsöversikt över de delar som verksamheten skulle kunna beskrivas utifrån, där behandlas begreppen fritid, gemenskap, hälsofrämjande, engagemang, ledarens roll som förebild och normbildare i företaget liksom det för studien centrala begreppet attityder. Studien är en fallstudie i ett av Nordens ledande företag inom bygg och anläggning där kvalitativa intervjuer har genomförts med åtta chefer inom det aktuella företaget för att samla in det empiriska materialet. Resultatet visade att de intervjuade chefernas syn på personalsatsningen och dess verksamhet är positiv, dock skiljer sig deras syn på och deras faktiska engagemang i verksamheten och dess aktiviteter åt. Resultatet presenteras i form av fyra övergripande områden: perspektiv på personalsatsningen, engagemang och delaktighet, framtidsmöjligheter och attityder till verksamheten. De attityder till verksamheten som framkom bland cheferna under intervjuerna kan vidare delas in i tre kategorier: ”engagerade”, ”distanserade” och ”sansade”. Inga slutsatser har kunnat dras ur denna undersökning, men förslag till fortsatta tankeområden har lagts fram under slutsatser sist i uppsatsen. / The overall purpose with this paper was to examine attitudes towards a human resources investment among top managers. In other words, how did the managers look at the investment and what did they think about its activities. Moreover, the purpose of the paper was to attempt to find possible ways to get the investment into a higher level of success within the current company. By way of introduction, the paper begins with a research summary of conceivable ways to describe the investment containing four concepts; leisure, spirit of togetherness, health promotion and engagement. Then, the matter of the leader has been discussed in terms of normative and to be a person for someone to model themselves on within an organization. The theoretical framework of references has been finished with a review about attitudes, which represent another central concept in this paper. The empirical part derived from a case study where qualitative interviews were initiated with eight top managers within one of the largest Nordic building and construction companies. Research findings showed that attitudes towards the human resource investment were positive in general, but the level of engagement with the human resource investment did vary among the managers. The research findings have been introduced through four main headlines; perspectives on the investment, engagement and participation, future prospects and attitudes towards the activities. Moreover, the attitudes which emerged among the managers have been divided into three categories;”engaged”,”distanced” and”level-headed”. No conclusions have been drawn from this paper, but some proposals that could be considered have been suggested.

Kat är en buske vars blad tuggas och saliven som bildas sväljs, för att uppnå stimulans. Den växer i Yemen, Etiopien och Kenya och smugglas till Sverige från Storbritannien via flyg samt bil. Kat-användandet är utbrett bland somalier i västvärlden och har medfört både hälsomässiga och socioekonomiska konsekvenser. För att förstå hur somalier i Sverige har anpassat sina uppfattningar gällande kat-bruk är syftet i denna uppsats att beskriva varierande uppfattningar om användande av kat hos några somaliska män och kvinnor boende i Sverige. Information samlades och analyserades utifrån en fenomenografisk studie design. Data samlades genom intervjuer.   Resultatet visar att kat-tuggande uppfattas både som en föda och som en drog. Största skälet till att kat brukas uppfattas som att den skapar gemenskap och sysselsättning. Den kat som används i Sverige smugglas vilket uppfattas problematiskt för somalier. Som implikation ska hälsofrämjande arbete genomföras utifrån det ekologiska perspektivet. Hälsofrämjande aktiviteter ska riktas på både individ- och familjnivå genom att ge information om kat, skapa sysselsättning samt stödja familjen. På samhälls- och organisations/policynivå är det viktigt att öka samarbetet mellan de somaliska föreningar och myndigheten samt att problemet kring kat sätts på agendan och diskuteras på nationell- och internationellnivå. / Kat is a plant whose leaves are chewed to produce juice and to be swallowed for its stimulating effect. Kat plant grows in Yemen, Ethiopia and Kenya. It is smuggled from Great Britain to Sweden by plane or car. The use of kat is widely spread among Somalis in western countries. This has led to both health and socioeconomic consequences for the users and their families. In order to understand Somalis’ attitudes regarding kat - the aim of this study was to describe variations of perceptions of the use of kat among Somalian men and women living in Sweden. A phenomenographic design was used to collect and analyze data. Data collected through interviews.   The findings show that chewing kat is perceived both as food and as a drug. The biggest reason for chewing kat is to create a feeling of belonging to a social group and to create activity. Kat being chewed in Sweden is smuggled here, which creates problems for Somalis. As an implication of this study health promotion activities, based on the theory of the ecological system, should focus on individual and family level for example by supporting and giving information to families on the issues of kat. Health promoting activities should also focus on community and organization/policy level to increase the cooperation between the Somali society and the public authority. Finally, the problem regarding kat should be on the agenda to be discussed both on national and international level. / Har redan gått upp med min uppsats. Vill bara att den blir tillgänglig för de som vill läsa.

Abstract Food and recuperation has a superior importance in human life and it is hard to deny the distinction of the food in everyday life. Nutritious food gives energy to benefit activities of the day and influences on behavior and performance as well as well being. The meaning of the terms meal and mealtime are key concepts in this study and the several beneficial aspects beyond the physiological function. Inadequate time for the meal might provide degenerative consequences for individual health and generate outgoings for society. The aim of this study was that from an individual perspective describe work environment conditions for meals and recovery potential among employees with irregular working hours using mixed methods with both questionnaire and interviews. Four (4) airline employees participated. Result from this study demonstrated that airline employees, especially cabin crew, rarely could effect on the surrounding environment of the meal. The participants indicated the irregularity of the meals and meal patterns at work along with constant time pressure and economic directives as the main underlying factors from their perspective. The study concluded that the time, place and money dictated the terms of the mealtime and that the potential of recovery was virtually nonexistent. Keywords: meal, eating habits, shift work, health promotion, recovery/recuperation

The purpose of this thesis was to explore socially constructed discursive barriers to physical activity for people with physical disabilities. This research was informed by a critical disability studies framework. Eight interviews were conducted, split between end-users and stakeholders. The end-user article discusses their perspectives with regard to their own PA participation, their use of PA resources, and their views of how disability is constructed. The stakeholder article deals with their views with regard to Canada’s progress in creating inclusive PA guidelines, the research process as it effects people with physical disabilities, and how disability is constructed. The results showed awareness among both groups of the social model of disability, but that the medical model is still firmly rooted. Work is needed to create inclusive promotional materials and disseminate them effectively. An effective advocacy and lobbying effort was suggested as one avenue towards a possible solution to this issue.