<p>Denna studies syfte är att få ökad förståelse och kunskap om elevers varierade uppfattningar av fenomenet kränkning i skolan. Studien är kvalitativ, vi vill veta hur elever utifrån sina erfarenheter uppfattar fenomenet kränkning och lyfta fram variationer i uppfattningarna. Studien bygger på semi-strukturerade intervjuer med elever i år sju, åtta och nio. Vi har gjort en fenomenografisk analys av intervjumaterialet, vilket har resulterat i beskrivningskategorier. Vi har funnit tre kategorier i elevers uppfattningar av kränkning, dessa är kränkning som intrång, kränkning som nedvärdering och kränkning som uteslutning. När det gäller elevers uppfattningar av åtgärd vid kränkning har vi funnit tre kategorier, vilka är åtgärd som tillsägning, åtgärd som delegering och åtgärd som ignorering. Slutsatser vi kommit fram till är att avgörande för hur kränkning en uppfattas av eleven är vem som utför den och kränkningens art. Noggrant utarbetade handlingsplaner är en förutsättning för att personal i skolan ska kunna vidta lämpliga åtgärder. Tydliga vuxna som vistas ute bland eleverna skulle kunna minska antalet kränkningar.</p>

<p>I möten mellan människor sker samspelet på ett kommunikativt plan där den professionella förhållningen innebär att bemöta och inte bara att möta en annan person. Polisens bemötande har stor betydelse för hur ett brottsoffer bearbetar upplevelsen av brottet hon upplevt. Syftet med studien var att undersöka och beskriva polisens uppfattningar av bemötande av brottsoffer, utifrån deras personliga erfarenheter av att vara brottsoffer. Studien genomfördes med en fenomenografisk forskningsansats och kvalitativa forskningsintervjuer av sex poliser. I en fenomenografisk studie är avsikten att försöka hitta variationen i och kategorisera människors erfarenheter i det tilltänkta undersökningsområdet. Resultatet visade att polisens olika uppfattningar av bemötande av brottsoffer kunde delas in i tre kvalitativt skilda beskrivningskategorier. Naturligt-, förvärvat- och rutinmässigt bemötande. Naturligt bemötande var något som fanns med sedan uppväxten, förvärvat bemötande var något som förvärvades genom olika erfarenheter, i rutinmässigt bemötandet gick arbetsuppgiften före bemötandet av brottsoffren. Studien visade också att brottsoffrets lidande hade en avgörande betydelse för polisens bemötande. Fler studier inom ämnet är att rekommendera för att få en större inblick och förståelse för hur polisens erfarenheter kan avspegla sig i mötet med brottsoffer, samt att öka kunskapen om hur negativa följder av erfarenheter kan förebyggas inför nya möten med brottsoffer.</p>

<p>Aim: The overall aim of this thesis was to deepen the understanding of nursing care for seriously ill patients on the edge of life in intensive care unit (ICU) and nursing home when questions were raised whether to withhold or withdraw curative treatment. Method: All studies were conducted in a qualitative frame of reference with interviews of nurses in two contexts in Norway; group interviews of 14 nurses in an ICU (study I, III), and individual interviews of 14 nurses in two nursing homes (study II, IV). Data were analysed with interpretative phenomenology (I, III, IV) and phenomenography (II). Findings: The nurses’ descriptions of the patients on the edge of life were interpreted as ‘being in a twilight zone’, a state between living and dying. The patients’ situation were understood to be very burdensome as they were mostly ‘voiceless’ and unable to call for, or refuse help and totally surrendered to other people’s devices. Their state was strained by extensive suffering; pains and bodily afflictions, loneliness, confusion and without control and dignity (I). Their need for nursing care was comprehensive (I, II) with an overall need for dignity (II), which included having the needs for preparedness, human relationship, comfort and safety met (II). The patients’ inabilities to express themselves clearly involved major challenges for nursing care (I - IV). Good nursing care was described as caring for the individual patient based on his/her situation and needs. The nurses experienced themselves to be of imperative importance for the patient’s living or dying (III, IV) and their interpretation of the patient’s condition was crucial (III). Their commitment and drive to help was high, they knew what good nursing care was for the patients (I - IV), and they were proud when they succeeded in their care (III, IV). An outstanding finding was the nurses’ experiences of ambiguity of both certainty and uncertainty. Being certain mostly seemed to concern nursing care related to the patient’s needs and situation (I, II), and uncertainty to what was ‘right’ to do with regards to withholding or withdrawing treatment (III, IV). They often experienced loneliness, too much responsibility, a vulnerable professional pride, and being pulled between opposite poles when they struggled to give good nursing care (I - IV), but too often they failed (II, IV). This demanding situation sometimes led to the nurses’ use of several self-protecting strategies. Whether the patients could receive good nursing care or not did not only depend on the single nurse, but was also anchored in opportunities and hindrances on a relational and an organisational level (I – IV). There were many congruities in patterns in the experiences of ICU - and nursing - home - nurses with regards to the situation and needs of patients on the edge of life, and good nursing care. Congruities were also found regarding being a nurse when caring for these patients, and nurses’ opportunities and hindrances for carrying out good nursing care. Conclusion: This thesis shows that nursing care was experienced as being of crucial importance to the patients on the edge of life, and the nurses knew very well what good nursing care was for them. However, the nurses’ opportunities to perform good nursing care depended on several preconditions and were restricted by hindrances on different levels, which have to be overcome in order to fulfil patients’ needs and nurses’ ambitions of giving good nursing care. As such, this thesis highlights a wide-ranging understanding of nursing care for these patients, which should challenge individual nurses, but also other health care workers, leaders and politicians.</p>

<p>The aim of this thesis is to analyse and describe the way prospective teachers of social science understand democracy and its conditions, and, on the basis of these descriptions, to discuss the actual and possible forms and contents of teaching democracy both in upper secondary school and in teacher training.</p><p>The assumption is that students’ conceptions of democracy are influenced by the society they live in and the education they receive. To contextualize students’ conceptions of democracy the theories of Habermas and Dewey as well as some central concepts of contemporary democratic theory are drawn upon. The study primarily focuses on the content of education in democracy. The teachers’ conceptions of their own subject influence the content of their teaching and thus what their students learn. If teachers are aware of various ways of conceiving democracy, and the critical differences between them, their teaching practices may enable students to experience different aspects of democracy and, as a consequence, reach a fuller understanding of it.</p><p>The empirical data consists of interviews with eight students of political science and eight teacher-students of social sciences. These interviews were carried out before and after they had studied theories of democracy. The study also includes interviews with eight teacher-students who had already finished their theoretical studies in social science and were at the end of their teacher training. In total, 40 interviews were carried out. The interviews were recorded and transcribed. A phenomenographic analysis of the students’ conceptions of democracy was performed, along with a thematic content analysis of their ideas of the conditions of democracy.</p><p>Three main categories of conceptions of democracy were constituted. In the first democracy was viewed as a possibility to influence political decisions through institutionalized forms. In the second category democracy was seen as a feeling of participation in processes of political decision. In the third category democracy was understood as the possibility to take part in all decisions that concern one’s life. The thematic content analysis showed that the students’ reasoning about the conditions of democracy concerned three main themes: the values of democracy, the individual conditions and societal conditions. Several teacher-students regarded it as their duty to maintain the prevalent forms of democracy in Sweden. Students of political science on the other hand, focused more on developing these forms.</p><p>Finally, the possible didactic consequences of these different views for the education in democracy in upper secondary schools and in teacher training are discussed.</p>

<p>Dental involvement with oral cancer patients during their treatment and rehabilitation can be long and intense. How can dental personnel better understand their role in the treatment of these patients? How does treatment affect the patients and their spouses? In searching for answers, the theories of phenomenography, phenomenology and hermeneutics are used to describe and interpret the experiences of the hospital dental treatment teams, oral cancer patients, and their spouses. </p><p>Study I reveals that hospital dental treatment teams perceive the encounter with head and neck cancer patients in three qualitatively different ways; as an act of caring, as a serious and responsible task, and as an overwhelming emotional situation, indicating that they are not always able to lean on education and professional training in dealing with situations with strong emotional impact. Study II gives insight into the lifeworld of oral cancer patients, and how the patient becomes embodied in a mouth that is increasingly `uncanny´, as it slowly ceases to function normally. Study III shows that oral cancer puts a hold on the lifeworld of the patients’ spouses which can be described as `living in a state of suspension´. These findings suggest that the support needs of patients and spouses appear to be greatest at treatment end, when, upon returning home, they are faced with the accumulated impact of the patients’ sickness and treatment. Study IV gives insight into what it may mean to live with the consequences of oral cancer, revealing a silent physical, emotional and existential struggle to adjust to a changed way of living. </p><p>This thesis raises the question if todays’ organisation of oral cancer care can meet the varying emotional and existential needs of treatment teams, patients and spouses that were brought to light.</p>

Introduction: In Western countries, about one pregnant woman in five experiences a considerable fear of childbirth (FOC). Consequently FOC is an important topic for midwives, being pregnant women’s main care givers. Also, although many aspects of FOC have been studied, almost no studies have into detail applied a theoretical frame of reference for studying pregnant women’s expectations for their upcoming labour and delivery. Therefore, the theory of self-efficacy, here regarding pregnant women’s belief in own capability to cope with labour and delivery, has been applied with the aim to better understand the phenomenon of FOC. Aim: The overall aims of the thesis were to describe midwives´ perceptions and views on FOC and to expand the current knowledge about expectations for the forthcoming birth in nulliparous women in the context of FOC. Method: Study I had a descriptive design. In total 21 midwives, distributed over four focus-groups, participated. Data were analysed by the phenomenographic approach. Studies II and III had cross sectional designs. Study II comprised 726 midwives, randomly selected from a national sample that completed a questionnaire that addressed the findings from Study I. Study III included 423 pregnant nulliparous women. FOC was measured using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), self-efficacy by the Childbirth Self-Efficacy Inventory (CBSEI). Study IV had a descriptive interpretative design. Seventeen women with severe FOC were conveniently selected from the sample of Study III and individually interviewed. Content analyses, both deductive and inductive, were performed. Method: Study I had a descriptive design. In total 21 midwives, distributed over four focus-groups, participated. Data were analysed by the phenomenographic approach. Studies II and III had cross sectional designs. Study II comprised 726 midwives, randomly selected from a national sample that completed a questionnaire that addressed the findings from Study I. Study III included 423 pregnant nulliparous women. FOC was measured using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), self-efficacy by the Childbirth Self-Efficacy Inventory (CBSEI). Study IV had a descriptive interpretative design. Seventeen women with severe FOC were conveniently selected from the sample of Study III and individually interviewed. Content analyses, both deductive and inductive, were performed. Conclusions: Swedish midwives regard severe FOC as a serious problem that influences pregnant women’s view on the forthcoming labour and delivery. Midwives at antenatal care clinics, compared to colleagues working at labour wards, experience a greater need for training in care of pregnant women with severe FOC. Self-efficacy is a useful construct and the self-efficacy theory an applicable way of thinking in analysing fear of childbirth. The self-efficacy concept might be appropriate in midwives’ care for women with severe FOC.

Denna studies syfte är att få ökad förståelse och kunskap om elevers varierade uppfattningar av fenomenet kränkning i skolan. Studien är kvalitativ, vi vill veta hur elever utifrån sina erfarenheter uppfattar fenomenet kränkning och lyfta fram variationer i uppfattningarna. Studien bygger på semi-strukturerade intervjuer med elever i år sju, åtta och nio. Vi har gjort en fenomenografisk analys av intervjumaterialet, vilket har resulterat i beskrivningskategorier. Vi har funnit tre kategorier i elevers uppfattningar av kränkning, dessa är kränkning som intrång, kränkning som nedvärdering och kränkning som uteslutning. När det gäller elevers uppfattningar av åtgärd vid kränkning har vi funnit tre kategorier, vilka är åtgärd som tillsägning, åtgärd som delegering och åtgärd som ignorering. Slutsatser vi kommit fram till är att avgörande för hur kränkning en uppfattas av eleven är vem som utför den och kränkningens art. Noggrant utarbetade handlingsplaner är en förutsättning för att personal i skolan ska kunna vidta lämpliga åtgärder. Tydliga vuxna som vistas ute bland eleverna skulle kunna minska antalet kränkningar.

Aim: The overall aim of this thesis was to deepen the understanding of nursing care for seriously ill patients on the edge of life in intensive care unit (ICU) and nursing home when questions were raised whether to withhold or withdraw curative treatment. Method: All studies were conducted in a qualitative frame of reference with interviews of nurses in two contexts in Norway; group interviews of 14 nurses in an ICU (study I, III), and individual interviews of 14 nurses in two nursing homes (study II, IV). Data were analysed with interpretative phenomenology (I, III, IV) and phenomenography (II). Findings: The nurses’ descriptions of the patients on the edge of life were interpreted as ‘being in a twilight zone’, a state between living and dying. The patients’ situation were understood to be very burdensome as they were mostly ‘voiceless’ and unable to call for, or refuse help and totally surrendered to other people’s devices. Their state was strained by extensive suffering; pains and bodily afflictions, loneliness, confusion and without control and dignity (I). Their need for nursing care was comprehensive (I, II) with an overall need for dignity (II), which included having the needs for preparedness, human relationship, comfort and safety met (II). The patients’ inabilities to express themselves clearly involved major challenges for nursing care (I - IV). Good nursing care was described as caring for the individual patient based on his/her situation and needs. The nurses experienced themselves to be of imperative importance for the patient’s living or dying (III, IV) and their interpretation of the patient’s condition was crucial (III). Their commitment and drive to help was high, they knew what good nursing care was for the patients (I - IV), and they were proud when they succeeded in their care (III, IV). An outstanding finding was the nurses’ experiences of ambiguity of both certainty and uncertainty. Being certain mostly seemed to concern nursing care related to the patient’s needs and situation (I, II), and uncertainty to what was ‘right’ to do with regards to withholding or withdrawing treatment (III, IV). They often experienced loneliness, too much responsibility, a vulnerable professional pride, and being pulled between opposite poles when they struggled to give good nursing care (I - IV), but too often they failed (II, IV). This demanding situation sometimes led to the nurses’ use of several self-protecting strategies. Whether the patients could receive good nursing care or not did not only depend on the single nurse, but was also anchored in opportunities and hindrances on a relational and an organisational level (I – IV). There were many congruities in patterns in the experiences of ICU - and nursing - home - nurses with regards to the situation and needs of patients on the edge of life, and good nursing care. Congruities were also found regarding being a nurse when caring for these patients, and nurses’ opportunities and hindrances for carrying out good nursing care. Conclusion: This thesis shows that nursing care was experienced as being of crucial importance to the patients on the edge of life, and the nurses knew very well what good nursing care was for them. However, the nurses’ opportunities to perform good nursing care depended on several preconditions and were restricted by hindrances on different levels, which have to be overcome in order to fulfil patients’ needs and nurses’ ambitions of giving good nursing care. As such, this thesis highlights a wide-ranging understanding of nursing care for these patients, which should challenge individual nurses, but also other health care workers, leaders and politicians.

The aim of this thesis is to analyse and describe the way prospective teachers of social science understand democracy and its conditions, and, on the basis of these descriptions, to discuss the actual and possible forms and contents of teaching democracy both in upper secondary school and in teacher training. The assumption is that students’ conceptions of democracy are influenced by the society they live in and the education they receive. To contextualize students’ conceptions of democracy the theories of Habermas and Dewey as well as some central concepts of contemporary democratic theory are drawn upon. The study primarily focuses on the content of education in democracy. The teachers’ conceptions of their own subject influence the content of their teaching and thus what their students learn. If teachers are aware of various ways of conceiving democracy, and the critical differences between them, their teaching practices may enable students to experience different aspects of democracy and, as a consequence, reach a fuller understanding of it. The empirical data consists of interviews with eight students of political science and eight teacher-students of social sciences. These interviews were carried out before and after they had studied theories of democracy. The study also includes interviews with eight teacher-students who had already finished their theoretical studies in social science and were at the end of their teacher training. In total, 40 interviews were carried out. The interviews were recorded and transcribed. A phenomenographic analysis of the students’ conceptions of democracy was performed, along with a thematic content analysis of their ideas of the conditions of democracy. Three main categories of conceptions of democracy were constituted. In the first democracy was viewed as a possibility to influence political decisions through institutionalized forms. In the second category democracy was seen as a feeling of participation in processes of political decision. In the third category democracy was understood as the possibility to take part in all decisions that concern one’s life. The thematic content analysis showed that the students’ reasoning about the conditions of democracy concerned three main themes: the values of democracy, the individual conditions and societal conditions. Several teacher-students regarded it as their duty to maintain the prevalent forms of democracy in Sweden. Students of political science on the other hand, focused more on developing these forms. Finally, the possible didactic consequences of these different views for the education in democracy in upper secondary schools and in teacher training are discussed.

There is no common understanding on what constitutes good sick-listing, a frequent and problematic task for many physicians, especially general practitioners (GPs) and orthopaedic surgeons. Aiming to achieve a deeper understanding of sick-listing practices, 19 GPs (I, III) and 18 orthopaedic surgeons (II) in four counties were interviewed, and data analysed qualitatively for views on good sickness certification and barriers to desired practice. Data from a survey of all 7665 physicians in two counties on emotionally straining problems in sickness certification (IV) was analysed quantitatively. Some GPs exposed narrow views of sick-listing, where their responsibility was limited to issuing a certificate, while GPs with the most inclusive view had a perspective of the patient’s total life-situation and aimed to help patients shoulder their own responsibility (I). The orthopaedic surgeons´ perceptions of good sick-listing were mainly related to their views on their role in the health-care system. Some perceived their responsibility as confined to the orthopaedic clinic only, while others had the ultimate goal of helping the patient to become well functioning in life with regained work capacity – by means of surgery and proper management of sick-listing (II). Difficulty handling conflicting opinions was a barrier to good sickness certification for GPs (III), and problematic for about 50% of all physicians and about 80% of GPs (IV). Orthopaedic surgeons’ handling of such situations varied from being directed by the patient, via compromising, to being directed by professional judgement (II). Other barriers included poor stakeholder collaboration (III). GPs with a workplace-policy on sickness certification reported fewer conflicts and less worry of getting reported to the disciplinary board in relation to sick-listing (IV). Understanding physicians’ underlying views on and barriers to practicing “good sick-listing” can inform efforts to change physician practice. Communications skills training in handling sick-listing situations with conflicting opinions is recommended.