Medication management constitutes a large part of registered nurses' (RNs) daily work in municipal elderly care. They are responsible for monitoring multimorbid older persons with extensive treatments, and they often work alone, without daily access to physicians. RNs’ drug monitoring is, in this thesis, based on the concept of pharmacovigilance. Pharmacovigilance is about the science and the activities that aim to improve patient care and safety in drug use, that is, to detect, assess, understand and prevent drug-related problems. The overall aim was to explore conditions for pharmacovigilance from a nursing perspective, focusing on implications of RNs’ competence and use of a computerized decision support system (CDSS). Both quantitative and qualitative research methods were used, including a questionnaire (I), focus group discussions (II), individual interviews (III) and an intervention study (IV). In total 216 RNs and 54 older persons participated from 13 special accommodations, located in three different regions. RNs who had completed further training in pharmacovigilance rated their medication competence higher than those who had not. However, there was no difference between groups in the number of pharmacovigilant activities they performed in clinical practice (I). The RNs appeared to act as “vigilant intermediaries” in drug treatment. They depended on the nursing staff's observations of drug-related problems. The RNs continuously controlled the work of staff and physicians, and attempted to compensate for shortcomings in competence, accessibility and continuity (II). RNs’ use of a CDSS was found to affect drug monitoring, including aspects of time, responsibility, standardization of the work, as well as access to knowledge and opportunities for evidence-based care (III). The CDSS detected significantly more drug-related problems when conducting medication reviews, than the RNs did. Nevertheless, this did not result in any significant improvement in the quality of drug use in the follow up, three and six months later (IV). This thesis contributes to the recognition of pharmacovigilance from a nursing perspective. Increased medication competence seems to be insufficient to generate pharmacovigilant activities. RNs depend on other health care professionals and organizational conditions in order to perform their work. A CDSS has the potential to support RNs, both in structured medication reviews and in daily clinical practice. Inter-professional collaboration is crucial, with or without a CDSS, and the entire team needs to be aware of and take responsibility. Other important conditions is the existence of well-functioning communication channels, competence across the team, and established procedures based on current guidelines.

The purpose of this qualitative study is to understand how the professions within the human service organization experience and describe inter-professional collaboration. The questions that the study discusses is the negative versus positive aspects that inter-professional collaboration entails and what conditions that are necessary for such cooperation to work.   The results are analysed with the help of Blumers (1969) theory of symbolic interactionism and Goffmans (2014) theory of team and appearance. The empirical material for the study is collected from semi-structured interviews with eight informants: two counsellors from the neuropsychiatric unit, two counsellors from kids and youth psychiatry, one counsellor and one sexologist from the youth clinic and three school nurses from different schools. The studies informants find that the inter-professional collaboration is crucial for the care that is provided for the patients. The informants believe that the consequences of non-cooperation would be longer treatments, misconceptions among the professionals and reduced overall visibility of patients' needs. The difficulties that the studies informants find with the cooperation are mainly the cooperation between different organizations. The difficulties include the different routines, loyalties, laws and objectives that organizations have. The conditions that the studies informants think is needed for a working inter-professional collaboration are effective communication, knowledge about each others professions, the staff’s willingness to cooperate and to increase learning about inter-professional collaboration.

Hensikten: med denne studien er å få kunnskap om lærernes og ledelsens oppfatninger av, og erfaringer med, tverrprofesjonelt samarbeid. Deres oppfatning av behovet for, og muligheter for, å implementere tverrprofesjonelt samarbeid i arbeidet med skolens psykososiale miljø, søkes også belyst. I tillegg undersøkes om motivasjon for et strukturert samarbeid påvirkes av tidligere erfaringer. Metode:Fenomenografi ble brukt som tilnærmingsmetode og fokusgruppeintervju som datainnsamlingsmetode. 15 ansatte i en ungdomsskole, fordelt på tre fokusgrupper, deltok i studien. Resultat:Det ble identifisert tre beskrivelseskategorier og seks delkategorier. Begrepet tverrprofesjonelt samarbeid oppfattes som lite kjent. Samarbeid med andre profesjoner beskrives som lite, til dels besværlig og preget av tilfeldigheter. Skolens rolle i forpliktende samarbeid oppfattes å forvanskes ved at det i utgangspunktet stilles mange krav til skolen. Det er vanskelig å prioritere mellom fagopplæring og tema som sorterer under sosial kompetanse og trivselsgivende tiltak. Motivasjon for samarbeid begrunnes i behov for økt kunnskap om faktorer som påvirker elevenes individuelle og totale opplevelse av skolen. De fokusgruppene som har hatt befatning med et strukturert tverrprofesjonelt samarbeid tilkjennegir en mer positiv holdning til samarbeid med andre profesjoner. Formelle rammer oppfattes som en begrensende faktor for samarbeid. Konklusjoner: Funn i studien indikerer et behov for å avklare meningsinnhold i begrep som beskriver samarbeid mellom ulike profesjoner og sektorer. Metoder og formelt grunnlag for å utvikle et godt psykososialt miljø i et tverrprofesjonelt perspektiv etterlyses. Det å ha en positiv erfaring fra et strukturert tverrprofesjonelt samarbeid, øker motivasjonen for ytterligere samarbeid. / Purpose: This study aimed to increase knowledge about teachers' and management's perceptions of, and experiences with, the concept of interprofessional collaboration. The study also sought to determine perceptions about the need and opportunity for implementing interprofessional collaboration in their work environment. Finally, the studie investigated whether past experiences influence motivation for structured cooperation. Method: This study used a fenomenografic approach and interviewed 15 employees of a Norwegian junior high school. Study participants were divided into three focus groups; participants from the management, teachers with experience from structured interprofessional collaboration and teachers without such experience. Results: Data analysis identified three categories and six subcategories. All participants described interprofessional collaboration as not well known and collaboration with other professions is described as rare, sometimes difficult, and random. They perceived the school's role in committed cooperation as difficult because it increases demands on the school. The study participants find prioritization between vocational training and topics that fall under the social skills difficult. Motivation for cooperation is based on a need for increased knowledge about the factors that influence students' individual and overall experience of school. Focus groups having greater experience with a structured interprofessional collaboratio, showed a more positive attitude toward cooperate with other professions. Participants perceived formal frameworks as a limiting factor for collaboration. Conclusions: This study showed a need to clarify the meaning of the term interprofessional collaboration. The school should work to develop a good psychosocial environment in an interprofessional perspective. A positive experience with structured interprofessional collaboration, increases motivation for further cooperation. / <p>ISBN 978-91-86739-35-5</p>

The purpose of this study is to investigate the challenges and opportunities in the communication between software developers and their stakeholders, as well as the impact that the product owners have on the communication. The research was conducted using a case study approach, and data was mainly collected through observations andinterviews with product owners and software developers at the case company Kry. The findings show that the challenges in communication are the technical language of software developers, difficulty for stakeholders to understand the software development process and difficulty for developers to understand the underlying context of a feature request. The opportunities in their communication are that the developers can better understand the reasons of a request and thus feel more engaged in the product and more satisfied towards the company; Good communication can cut development time and cost. The product owner is shown to be almost irreplaceable due to the large impact that they have. They become translators between the developers and stakeholders, enabling them to communicate better. Furthermore, they are the main point of contact for the stakeholders, thus allowing the developers to focus more on doing development work. However, this might sometimes result in that the developers get involved too late in the process, making changes costly when they discover something faulty. As a conclusion, the communication between stakeholders and developers powered by product owners greatly enhance the possibility to build good, maintainable software and lead to a more sustainable work environment for all involved. / Syftet med studien är att undersöka utmaningar och möjligheter i kommunikationen mellan mjukvaruutvecklare och stakeholders, samt den påverkan som produktägare har på kommunikationen. Detta gjordes genom en fallstudie och data är i huvudsak insamlad genom observationer och intervjuer med produktägare och utvecklare på företaget Kry. Resultatet visar att utmaningar i kommunikationen är mjukvaruutvecklarnas tekniska språk, svårigheter för stakeholders att förstå mjukvaruutvecklingsprocessen och för utvecklarna att förstå de bakomliggande anledningarna för en kravändring. Möjligheter i kommunikationen är att utvecklarna bättre kan förstå de här anledningarna och därför bli mer engagerade i produkten och känna sig mer nöjda med företaget; bra kommunikation kan minska utvecklingskostnader och tid. Produktägare visar sig vara nästan oersättliga på grund av den stora påverkan de har. De blir översättare mellan utvecklare och stakeholders, och hjälper dem att kommunicera bättre. De blir också den huvudsakliga kontaktpersonen för stakeholders, vilket ger utvecklarna mer möjligheter att fokusera på deras utvecklingsarbete. Dock kan det resultera i att utvecklarna ibland blir inblandade för sent i processen, vilket gör potentiella behov av förändringar dyra när de upptäcker något som är fel. Sammanfattningsvis, när kommunikationen mellan stakeholder och utvecklare är faciliterad av produktägare så ökar möjligheterna för att bygga bra mjukvaraoch det leder till en mer hållbar arbetsmiljö för alla inblandade.

Department of Advanced Nursing Science / MCur

Syftet med denna studie är att undersöka socialsekreterares och hälso- och sjukvårdskuratorers upplevelser av samverkan mellan rättspsykiatri och socialtjänst vid utslussning av rättspsykiatriska klienter, sett ur ett maktperspektiv. Studiens empiri grundar sig på åtta semi-strukturerade intervjuer, fyra med varje yrkesgrupp, som sedan analyserats med hjälp av en tematisk analys. Studiens slutsats visar på att samverkan mellan socialtjänst och rättspsykiatri påverkas av organisatoriska, ekonomiska och mellanmänskliga faktorer som är svåra att påverka. Studien bekräftar även tidigare samverkansforskning som visar på svårigheter i samverkan när aktörer har olika förutsättningar, uppdrag och mål. Slutsatserna i denna studie leder oss till att förstå intervjupersonernas upplevelser av samverkan mellan rättspsykiatri och socialtjänst. Dessa går att förstås genom: värdet av kompromisser, förståelsen för varandras villkor och behov, upplevelsen av bristande mandat, maktlöshet samt rollförvirring. / The aim of this study is to examine social workers and health care counsellors experiences of cooperation between forensic psychiatry and social services during discharge of forensic psychiatric clients, seen from a power perspective. The study's empiricism is based on eight semi-structured interviews, four with each professional group, which were analyzed using a thematic analysis. The study's conclusions show that collaboration between social services and forensic psychiatry is affected by organizational, financial and inter personal factors that are difficult to affect. The study confirms previous collaboration research that shows difficulties in collaboration when actors have different conditions, assignments and goals. The conclusions of this study lead us to understand that the interviewees experiences of collaboration between forensic psychiatry and social services can be understood through: the value of compromise, the understanding of each other's conditions and needs, the experience of a lack of mandate, powerlessness and role confusion.