Sammanfattning Patienter har enligt lag rätt att vara delaktiga i hälso- och sjukvården. Akutsjukvården är en speciell del av vårdkedjan där det är viktigt med snabba beslut och interventioner för att åtgärda akuta sjukdomar och skador. När en person blir patient hamnar personen i en viss beroendeställning till personalen. Sjuksköterskan och övrig personal i vården har möjligheten att stärka eller försvaga patientens roll genom sitt agerande. I jämförelse med andra likvärdiga länder är svenska patienters möjlighet till delaktighet i vården eftersatt. Syftet med studien var att beskriva patienters upplevelser av delaktighet i vården på en akutvårdsavdelning. Studien bygger på tio intervjuer med patienter på en akutvårdsavdelning. En intervjuguide med semistrukturerade frågor användes och det insamlade materialet analyserades med kvalitativ innehållsanalys. Respondenterna beskrev att ett vänligt bemötande, dialog och information var handlingar och attityder som möjliggjorde delaktighet i vården. Stress, nonchalans och bristande empati från personalens sida beskrevs som hinder för delaktighet. Respondenterna beskrev även två helt olika strategier för hur de själva kunde påverka sin delaktighet i vården. Patienters delaktighet inom akutsjukvården är ingen självklarhet. För att delaktighet ska uppstå krävs vilja från båda parter och en förutsättning för medbestämmande är möten och samtal. Ansvaret för att skapa dialog ligger hos hälso- och sjukvårdspersonalen men långt ifrån alla patienter vill eller orkar vara aktivt delaktiga i beslut om sjukvården, vilket också måste respekteras. Stress och tidsbrist är reella hinder i vården idag, men det finns fortfarande mycket personalen kan göra för att möjliggöra delaktighet för patienterna. Även inom akutsjukvården finns hela tiden möjligheter till delaktighet både i stora beslut och i små dagliga val, det gäller bara att se dem.

Koloskopi är en vanlig undersökning som utförs för att utreda symtom och eventuella sjukdomstillstånd i ändtarm, tjocktarm samt sista delen av tunntarmen. Undersökningen kan upplevas obehaglig och smärtsam samt kräver flera dagars förberedelser. Inför undersökningen ska patienten genomgå laxering för att rengöra sin tarm så att slemhinnan noggrant kan inspekteras. Information om förberedelser och undersökning är en viktig del för att förbereda patienten, både mentalt och fysiskt. En väl rengjord tarm bidrar till att undersökningskvaliteten ökar samt risken för vårdskador minskar. Syftet var att beskriva patienters upplevelser av information och förberedelser inför koloskopi samt att beskriva deras reflektioner inför undersökningen. Kvalitativ metod användes i studien och baseras på åtta intervjuer med patienter som skulle genomgå en planerad koloskopiundersökning. Intervjuerna genomfördes utifrån en intervjuguide med semistrukturerade intervjufrågor. Genom kvalitativ innehållsanalys bearbetades och analyserades det insamlade materialet. I resultatet framkom att patienters reflektioner och upplevelser kunde indelas i tre kategorier och åtta underkategorier. Huvudkategorierna var: Reflektioner inför koloskopi, upplevelser och reflektioner gällande laxering samt upplevelse av informationen inför laxering och koloskopi. Slutsatsen tyder på att koloskopi är en undersökning som framkallar många tankar och känslor hos den som ska undersökas. Förberedelserna inför undersökningen upplevs krävande och påverkar det vardagliga livet i varierande omfattning. Informationen som patienterna erhöll från endoskopimottagningen har upplevts som klar och tydlig, men samtidigt har det i studieresultatet framkommit synpunkter på att informationen från inremittenten är bristfällig. / Colonoscopy is a common examination conducted to investigate symptoms and possible diseases of the rectum, colon and the last part of the small intestine. The examination can be inconvenient and painful and requires several days of preparation. Prior to the examination, the patient should undergo purgation to cleanse the bowel so that the mucosa can be accurately inspected. Information on preparation and examination is an important part of preparing the patient, both mentally and physically. A well-cleaned intestine contributes to increase the quality of the examination and the risk of health damage is reduced. The aim was to describe patients' experiences of information and preparation for colonoscopy and to describe their reflections before the examination. Qualitative method was used in the study and based on eight interviews with patients who would undergo a scheduled colonoscopy. The interviews were conducted on the basis of an interview guide with semi-structured interview questions. Through qualitative content analysis the collected material were processed and analyzed. The result showed that the patients' reflections and experiences could be divided into three categories and eight subcategories. The main categories were: Reflections before the colonoscopy, experiences and reflections regarding purgative experience and the information for the purgation and colonoscopy. The conclusion indicates that colonoscopy is an examination that evokes many thoughts and feelings of the person to be examined. Preparations for the examination perceive demanding and affects everyday life in varying degrees. The information that patients received from endoscopy clinic has been perceived as clear, but at the same time the study results has revealed views that the information from the house doctor is flawed.

This investigation evaluated a computerized behavioral skills training package for teaching responses to interview skills by adolescents and young adults with learning disabilities. The package consisted of instructional videos, video-modeling, rehearsal, feedback, and selection-based instruction. Experiment 1 replicated and extended recent research which has suggested that a selection-based protocol operating on a lag schedule of reinforcement is an effective and efficient method for teaching responses to interview questions (O’Neill, Blowers, Henson, & Rehfeldt, 2015; O’Neill & Rehfeldt, 2014). The purpose was to address some of the limitations of these studies while testing the limits of the selection-based protocol in promoting topography-based responses to interview questions by adolescents and young adults with learning disabilities. Experiment 2 evaluated the efficacy of the computerized behavioral skills training protocol while simultaneously comparing the basic package to an identical package plus the selection-based protocol from Experiment 1. This experiment attempted to isolate the additive effect of selection-based instruction from that of computerized behavioral skills training for teaching topography-based responses to interview questions by adolescents and young adults with learning disabilities.

Studiens syfte var att undersöka operatörers upplevelser av medarbetarundersökningar med avsiktatt belysa erfarenheter som upplevs ha bidragit till formandet av attityder gentemotmedarbetarundersökningar. För att uppnå detta användes en kvalitativ metod. Åttasemistrukturerade intervjuer genomfördes med yrkesverksamma operatörer som hade erfarenhet avmedarbetarundersökningar. Materialet från datainsamlingen transkriberades för att sedan analyserasmed hjälp av en induktiv tematisk analys. Analysen resulterade i fyra huvudteman: åtgärder ochuppföljningsarbete, att påverka arbetsplatsförhållanden, förmedling av åsikter genommedarbetarundersökningar samt anonymitet gentemot arbetsgivaren. Huvudresultatet visade attföljande erfarenheter upplevs ha bidragit till att forma respondenternas attityder gentemotmedarbetarundersökningar: 1) Upplevelsen av huruvida organisationen vidtar eller inte vidtaråtgärder och uppföljningsarbete på det presenterade undersökningsresultatet, 2) om respondenternaupplever att de har möjlighet att påverka arbetsplatsförhållanden genom medarbetarundersökningareller inte, 3) upplevelsen av att det i undersökningar går att uttrycka sina åsikter eller ej, 4) samt omundersökningsdeltagande upplevs anonymt eller inte. / The aim of the study was to explore operator`s experiences of employee surveys with theintention of highlighting experiences that was perceived to contribute to the formation ofattitudes towards employee surveys. To achieve this, a qualitative method was used toconduct the study. Eight semi-structured interviews were conducted with respondents whowas working as operators and had experience of employee surveys. The material from thedata collection was transcribed and then analyzed using inductive thematic analysis. Theanalysis resulted in four main themes: actions and follow-up work, influencing workplaceconditions, conveying opinions through employee surveys, and anonymity towards theemployer. The main result showed that the following experiences contributed to the formationof the respondent`s attitudes toward employee surveys: 1) The experience of whether theorganization acts upon the presented result or not, 2) if the respondent`s experience that theyhave the opportunity to influence workplace conditions through employee surveys or not, 3)the experience of whether it`s possible to express their opinions in surveys or not, and 4) if theparticipation in surveys is perceived as anonymous or not.

This study examines how local journalists in Sweden view, understand and manage threats, hatred and harassment in their professional role. The study is based on qualitative interviews with eight journalists, four men and four women, from different local newspapers in Sweden. The interviews are analyzed through a theoretical framework inspired by discourse theory. The purpose of this study is to examine how journalists are affected by threats, hatred and harassment. All material has been collected throughout the study and is used to understand how journalists being victims of hatred, threats and harassment affects their duty to society as being a democratic vessel for the public opinion. The research questions for the study are:  1. How do journalists experience safety risks in their professional practice? 2. How do journalists weigh the risk of being exposed to hatred, threats and harassment as opposed to reporting about subjects they are interested in and find important? 3. Do journalists experience institutional support and how safe does the support make them feel?  Theories such as the media's democratic role in society and the journalistic standard of practice are used to answer the research questions and analyze the material. The result of the study shows that hatred, threats and harassment is an established part of journalistic practice that is known throughout institutions and by journalists themselves. Furthermore the result shows a lack of institutionalized support. Neither their previous education discussed how they’re supposed to handle hatred, threats and harassments nor does their current workplace discuss it. In line with previous research, the informants believed that hatred, threats and harassment take different forms depending on the gender of the journalist and that women are more vulnerable, which they claimed were because of the patriarchal structures of our society. The result shows that the informants use avoidance strategies when it comes to reducing the risk of exposure. Subconsciously, they may have reframed, changed the narrative or censored themselves – but in such cases without their direct knowledge.

The research aims to investigate how the 2D slot game “Lucky Hero”, created for this research, could convey the story of Beowulf. The result of this study could provide experience and strategy for improving narrative design in casual games with similar mechanics. Also, this study is valuable to developers/designers who want to explore the potential of using casual games, especially slot games, as a storytelling tool. To answer the research question “How could the 2D slot game Lucky Hero convey the story of Beowulf”, a “research for design” qualitative study was conducted. The researchers examined theories related to narrative design, design in slot machine games, and folk mythology to develop the game. Playtests followed by interviews and adapted stimulation recall were used as data collection methods, and thematic analysis was used as the data analysis technique. The findings revealed that the existing design of "Lucky Hero" was not capable of effectively conveying the story of Beowulf to players. However, the study identified key elements that influenced players' understanding, such as graphics and game mechanics. The future narrative design of “Lucky Hero” should focus on improving immersion, character representation, and the connection between game mechanics and the story.

Instructional processes comprise three basic components: planning, delivery of instruction, and assessment. Educators frequently reflect on the relationships among those components to choose the most effective approaches to increase student learning. Teachers’ continual assessment of student knowledge and understanding through reliable, valid measures critically propels teachers’ effective instruction forward. Constraints on funding for public education have resulted in larger class sizes and smaller budgets for the arts, as well as a heightened focus on standardized testing, less instructional time, and fewer resources (Slaton, 2012). How, then, are music teachers effectively assessing student achievement while grappling with those challenges? To fill a gap in the research literature, the purpose of this research was to explore singing voice development assessment practices that public-school elementary-general-music teachers use with their students. The following overall question guided this research: What can we learn from three kindergarten through fifth grade general music teachers about their approaches to singing with their students? I sought to document three teachers’ singing voice development processes and assessment techniques. Recognizing that this study took place during the COVID-19 pandemic, I also sought to document participants’ perceptions of the benefits and challenges of the techniques they shared, especially as they grappled with teaching singing in new learning models that were emerging; and adaptations they were using to safely and effectively guide students’ singing voice development—whether they were teaching their students virtually and/or in person. For this study, I chose symbolic interactionism as a theoretical lens and an interview-only design. Upon approval from Temple University Institutional Review Board, I invited the three participants who consented to engage in three semi-structured individual interview conversations to explore singing voice development assessment techniques, and benefits, challenges, and adaptations of those techniques, especially as they grappled with teaching singing in new instructional models that emerged as a result of COVID-19. After participants completed member checking of each of their transcripts, I used a content analysis approach to the data to identify emerging codes. Four themes summarized participants’ approaches to singing voice development assessment: teachers rely on their (a) personal philosophy formed from influences and values, (b) planning processes and objectives, (c) interactions with their students through selected techniques and tools, and (d) having time to make necessary adaptations in their singing voice development assessments. The key idea emerging from the study: the three teachers prioritized providing worthwhile musical experiences for their students. They situated singing voice development and assessment as one piece of their broader general music curriculum. A symbolic interactionist lens informed my themes and key idea by placing the context of teachers’ interactions in the forefront, and my understanding of how their experiences have shaped their views. While findings from this study are not generalizable, readers may find them transferable. Potential applications for other music teachers’ assessment practices include the following six examples: using a variety of tools to model appropriate use of singing voice, implementing pattern instruction to develop and assess singing voice, incorporating opportunities for individual singing, providing students with performance experiences, maintaining consistency in changing instructional models, and focusing on informal assessment through observation and questioning techniques. Future researchers can continue to shed light on how teachers approach singing with their elementary general music students by learning about factors outside of teachers’ instructional processes that impact singing voice development assessment, and how music teachers adapt their processes for singing voice development assessment in emerging instructional models. / Music Education

Syftet med denna studie var att undersöka hur personer med egenadministrerad peritonealdialys (PD) upplever sitt dagliga liv. Metoden var en intervjustudie där sju personer som behandlades med PD intervjuades med hjälp av en semistrukturerad intervjuguide. Materialet som analyserades med en manifest kvalitativ innehållsanalys resulterade i tre huvudkategorier: kroppsliga förändringar, upplevelser av PD-behandling samt egenvård. Resultatet visade att PD hade inverkan på olika plan i informanternas dagliga liv. Ett viktigt fynd var hur informanterna uppfattade att PD hade lett till vissa kroppsliga förändringar, exempelvis vad gäller vikt och aptit. Det mest framträdande fyndet var emellertid att PD ledde till en bundenhet, vilket orsakade en oönskad passivitet hos informanterna. Det framkom dessutom att de informanter som väntade på njurtransplantation upplevde att denna väntan ledde till mer inskränkning i det dagliga livet än vad PD gjorde. Informanterna beskrev även de positiva aspekterna av PD-behandlingen och betonade fördelen med att PD möjliggjorde en självständighet och en flexibilitet. Denna studie gav ett brett perspektiv av hur personer med PD upplever sitt dagliga liv och visade att det inte bara är de kroppsliga förändringarna som påverkar personerna utan att PD även leder till känslor av bundenhet och passivitet. / The purpose of this study was to explore how people with self-administered peritoneal dialysis (PD) experience their daily life. The method was an interview study in which seven people who were treated with PD were interviewed using a semistructured interview guide. The material was analyzed with a manifest content analysis and resulted in three main categories: bodily changes, sensations of PD treatment and self-care. The results showed that PD had an effect in different levels in the informants’ daily lives. One important finding was how the informants perceived that the PD had led to certain bodily changes for example in terms of weight and appetite. The most striking finding, however, was that the PD led to a lack of freedom causing an undesirable passivity of the informants. It also showed that respondents who were waiting for kidney transplantation felt that this anticipation led to more restriction in daily life than PD did. The informants also described the positive aspects of PD treatment and stressed advantages such as that PD allowed autonomy and flexibility. This study gave a broad perspective of how people with PD experience their daily life and showed that not only the physical changes affected them but also led to feelings of restraint and passivity.

Bakgrund: Välfungerande kommunikation i journalen är av stor vikt för patientsäkerheten. Studier påvisade att journalen som arbetsverktyg hade en central roll för sjuksköterskors upplevelser av patientsäker omvårdnad. Om informationen i journalen var lättillgänglig i ett lättarbetat journalsystem upplevde sjuksköterskorna journalhanteringen patientsäker. Studier påvisade även att det var av stor vikt att det fanns tid för sjuksköterskorna att erhålla informationen om patienterna på ett säkert sätt. Syfte: Belysa sjuksköterskors upplevelser av journalhantering ur ett patientsäkerhetsperspektiv. Metod: En intervjustudie med kvalitativ ansats utfördes. Intervjuerna analyserades och tematiserades. Resultat: Journalsystemet upplevdes invecklat och svåröverskådligt. Det fanns brister gällande dokumentationsrutiner. Muntlig rapport och rapportblad kompenserade för brister i journalhanteringen men gav också upphov till nya patientsäkerhetsrisker. Bristen på tid att dokumentera samt bristen på tid att läsa patientjournal påverkade patientsäkerheten negativt. Den psykosociala och fysiska arbetsmiljön påverkade patientsäkerheten i olika riktningar. Slutsatser: Sjuksköterskorna upplevde att brister i journalsystemet, arbetsrutiner och styrning ledde till att journalsystemet inte tillämpades optimalt. Muntlig rapport och rapportblad tillämpades i syfte att kompensera brister i journalhanteringen. Konsekvensen blev dubbeldokumentation, desinformation, risk för informationsförlust och behov av dubbelkontroller, vilket tog tid. / Background: Well-functioning communication in medical record is important for patient safety. Studies showed that the journal as a tool had a central role in nurses' experiences of patient safety. If the information in the records were readily available and easy to work with nurses found the medical record management to be patient safe. Studies also showed that it was vital that there was time for nurses to obtain information about the patients safety. Aim: Elucidate nurses' experiences of the medical records from patient safety perspective. Method: An interview study with qualitative approach was carried out. The interviews were analysed and thematised. Result: Electronic medical records experienced complicated and difficult to understand. There were deficiencies regarding documentation procedures. Oral report and the report sheet offset deficiencies in patient management but also gave rise to new patient safety risks. The lack of time to document and the lack of time to read the medical record impact patient safety negatively. The psychosocial and physical work environment affected patient safety in different directions. Conclusions: The nurses felt that the shortcomings in the medical record system, work procedures and control led to electronic medical records is not applied optimally. Oral report and the report sheet was applied in order to compensate for deficiencies in journal management. The consequence was duplication of documentation, misinformation, risk of data loss and the need for cross-checks, which was time-consuming.

Bakgrund: Zambia är ett av de länder i världen som är värst drabbat av HIV/AIDS och sjuksköterskor i landet jobbar ständigt med att spridda preventiv information om infektionen. Kvinnor är mer sårbara då de ofta gifter sig med äldre män som redan har ett sexuellt förflutet men också p.g.a. att de har större permeabilitet i mucosa membranet än vad män har. Sjuksköterskorna spelar en viktig roll i preventionsarbetet och dess funktion. Syfte: Syftet med studien är att utforska sjuksköterskors arbete med HIV prevention bland kvinnor på Mpongwe missions sjukhus. Metod: En kvalitativ studie med semistrukturerade intervjuer med 8 sjuksköterskor genomförd på Mpongwe missions sjukhus i Zambia. Resultatet har analyserats med hjälp av Burnards innehållsmetods analys. Resultat: Resultatet av studien utmynnade i fem olika kategorier rörande riktlinjer vid HIV-prevention, metoder för att minska risken av HIV-spridning, hur de når ut till folket, svårigheter och utmaningar som sjuksköterskorna möter men även de framsteg som görs.Slutsats: Intervjuerna med sjuksköterskorna på Mpongwe Missions sjukhus visar att de jobbar hårt med att förebygga HIV bland kvinnor. De har kommit långt i sitt arbete men det finns fortfarande mycket kvar att göra. Den stora spridningen på kunskap hos sjuksköterskorna och bristen på personal är ett stort problem. På grund av att de har ont om finanser har sjukhuset inte råd att skicka sina sjuksköterskor på fler utbildningar eller att anställa mer personal för att kunna ge rätt vård och nå ut till människorna. / Background: Zambia has one of the world’s most devastating HIV/AIDS epidemics and nurses work hard to spread information about how to prevent the infection. Females are more vulnerable since they often marry early to older men who already have a sexual past and also because they have larger permeability of the mucous membrane compared to men. The nurses play an important role in the prevention work and how it’s done.Objective: The aim of the study is to explore the nurse’s prevention work against HIV among women at the Mpongwe Mission Hospital. Methods: A semistructured design in a qualitative study, carried out at Mpongwe Misson Hospital in Zambia. The result has been analyzed through Burnards method of description of content analysis.Result: The result of this study is divided in five different categories concerning guidelines in the HIV-prevention, measures to reduce the risk of HIV-infection, how they reach out to people, the obstacles and challenges that the nurses are facing and the progress that is made. Conclusion: The interviews shows that the Nurses in this study at Mpongwe Hospotal are working hard to prevent HIV among women. They have come a long way in their prevention work although there is much left to do. The wide spread of knowledge among the nurses and the lack of staff is big obstacle. Because of the shortage of finances the hospital can´t afford to send nurses for further education or hire enough staff to be able to give the right care and to reach out to the population.