Bakgrunn: Forskning viser at tverrfaglig samarbeid er vanskelig. Folkehelsearbeid er sektorovergripene og krever ofte at ulike fag og sektorer samarbeider. Hensikt:Formålet med denne studien er å få større innsikt i hva roller og yrkesbakgrunn betyr for kommunikasjonen i samarbeideti folkehelse. Metode:Studien har benyttet triangulering som strategi med dokumentgranskning, tre teamobservasjoner og 12 individuelle semistrukturerte intervju. Det er benyttet en fenomenografisk tilnærming til analyse av intervjuene. Resultat: Dokumentgranskningen ga forståelse for sammensetningen i de observerte teamene.Observasjonen ga rom for å analysere den muntlige kommunikasjonen og metakommunikasjonen, mens intervjuene ga innblikk i kommunikasjonen som helhet og dens kompeksitet. Intervjuanalysen ga de fire hovedkategoriene; Representasjon av yrker og sektorer,Deltakere som samarbeider i team, Person og menneske i samarbeidet og Betydning av helhet. I analysen kom det fram at yrkesbakgrunn har betydning for kommunikasjon og samarbeid. En er preget av faget som yrkesutøver. Ulik kompetanse og bredde i representasjon bidrar til en rikere diskusjon og et breiere grunnlag for løsninger. Mange av faktorene var ellers uavhengig av yrke og kunne heller relateres til egenskaper hos den enkelte. Evne til å se utover eget fag og ha forståelse for betydningen av andre yrkesgrupper er vesentlig. Konklusjon: Studien viser tverrfaglig samarbeid og kommunikasjon som fungerer og synliggjorde betydningen av trygge fagpersoner med blikk for helhet og evne til refleksjon. Funnenepeker på ulike faktorer av betydning for roller og kommunikasjon slik som tillit, respekt, likeverd, læring og åpenhet. Rollen og hvordan den bekles harbetydning for kommunikasjonen. Yrkesbagrunnen får betydning gjennom den enkelte deltaker og dennes rolle,men da som en del av hele personenmed sine egenskaper, sin personlighet og innstilling. Folkehelsearbeid er et område ingen eier men alle har del i og ansvar for. / Background:Research shows that interdisciplinary collaboration is difficult. Public health work spansmany sectors and demands collaboration among different professionsand sectors. Purpose:This study aimed to gain greater insight into the impact of roles and professional backgrounds on communication in the collaborative process of public health. Method:This study used a triangulation strategy involving document analysis, three observations and 12 semi-structured interviews. A phenomenographic approach was used to analyze the interviews. Result: Document analysis enhanced understanding of the composition of the teams observedin this study. The observations allowed for analysis of verbal communication as wellas meta-communication, and the interviews offeredinsight into communication both as an entiretyandinits complexities. Interviewanalysis produced four main categories:representationof professionals and sectors, participants who collaborate in teams, the individual and the human in collaboration,and the meaning of the whole. Analysis showed that professional background plays a significantrole incommunication and collaboration (i.e.aperson is characterized by his/her profession). Differences in competence and breadth ofrepresentation contribute to richer discussion and a wider ground forsolutions. Many of the factors that emerged were otherwise independent ofprofession and related instead to individual characteristics.The ability to see beyond one`sown profession and understand the importance of other professional groups is essential. Conclusion: The study shows functionality of interprofessional collaboration and communication,it’s revealingthe meaning of confidentprofessionals who areable to see the big pictureand reflect upon its meaning. The findings point to various factors that are important for roles and communication such astrust, respect, dignity, learning and openness. Roles and their interpretation are important incommunication. Professional background derivesmeaningnot only through the individual participant andhis/herrole, but also through his/her properties, personality and perspectives. Public health is an area no one owns but everyone takes part in and has responsibility fo / <p>ISBN 978-91-86739-39-3</p>

Background: Lifestyle changes and drug treatment can improve the prognosis and quality of life for patients with coronary heart disease (CHD), but their co-operation with suggested treatment is often limited. The aim of this thesis was to study how patients and their spouses conceive CHD and its treatment. Material and Methods: The research design used was inductive and descriptive. The studies were based on three complementary sets of data. Patients with CHD (n=23) and spouses (n=25) were interviewed one year after an episode of the disease. Consecutive patients with CHD derived from another investigation were interviewed within six weeks or one year after the coronary event (n=113). All semi-structured interviews, tape-recorded or from notes taken by hand, were subjected to analysis within the phenomenographic framework. Findings: The patients’ conceptions of CHD varied and were vague, even as judged on a lay level. They were associated with symptoms rather than with the disease. Co-operation with drug treatment was rarely linked to improved prognosis. The patients’ descriptions of benefits from lifestyle changes and treatment did not give the impression of being based on a solid understanding of the importance of such changes. Incentives for lifestyle changes were classified into four categories, all of which contained both facilitating and constraining incentives. Somatic incentives featured direct and indirect physical signals. Social/practical incentives involved shared concerns, changed conditions, and factors connected with external environment. Cognitive incentives were characterised by active decisions and appropriated knowledge, but also by passive compliance with limited insights, and by the creating of routines. Affective incentives comprised fear and reluctance related to lifestyle changes and disease and also lessened self-esteem. All incentives mostly functioned facilitatively. The cognitive and the social/practical incentives were the most prevalent. Spouses’ understanding about the causes of CHD involved both appropriate conceptions and misconceptions. Drug treatment was considered necessary for the heart, but harmful to other organs. Spouses’ support to partners was categorised, and found to be contextually bound. The participative role was co-operative and empathetic. The regulative role controlled and demanded certain behaviours. The observational role was passive, compliant, and empathetic. The incapacitated role was empathetic, unable to support, and positive to changes. The dissociative role was negative to changes and reluctant to be involved in lifestyle changes. Conclusions: These results could be useful in the planning of care and education for CHD patients. The findings also emphasise the importance of adopting a family perspective to meet the complex needs of these patients and their spouses in order to facilitate appropriate lifestyle changes. / On the day of the public defence of the doctoral thesis the status of article V was Submitted.

Background: As psychosis is often a lifelong disorder, improved health-related quality of life (HRQoL) can be a relevant treatment goal. Persons with psychosis have significantly reduced physical health. Research has demonstrated a great excess of mortality due to cardiovascular diseases, as psychosis may lead to an inactive lifestyle and difficulties making healthy lifestyle choices. Metabolic side effects of second-generation antipsychotics are also common. Many are therefore affected by the metabolic syndrome. The overall situation calls for action by developing health promotion interventions suitable for this group. In recent years, there has been an increased interest in the physical health of persons with psychosis. However, efforts have not been optimally tailored to the needs of this group, and health care services have not done enough, despite being aware of the problem. Aim: The general aim of this thesis was to study HRQoL, and metabolic risk factors in persons with psychosis, and by a health promotion intervention and through the participants’ own perspective contribute to an improvement in lifestyle interventions. Methods: Study 1 had a cross-sectional cohort study design that was carried out in specialised psychiatric outpatient departments in Sweden. The patients (n=903) were diagnosed with a psychotic disorder and invited consecutively to participate. A prospective population-based study of public health in the south-east of Sweden (n=7238) served as reference group. Patients were assessed using psychiatric questionnaires, including the Global Assessment of Functioning (GAF). Health-related quality of life was assessed using the EQ5D, both for patients and the population. Several other health status outcomes relevant to the metabolic syndrome were measured, together with lifestyle habits and clinical characteristics. Study II, III and IV were based on a lifestyle intervention for persons with psychosis. Study II was a longitudinal intervention study with a matched reference sample. The purpose of the lifestyle intervention  was to promote a healthier lifestyle by combining theoretical education with physical activities. The intervention group consisted of 42 participants. A matching procedure was made in which two individuals per participant were matched (n=84) into a reference group. The reference sample was matched for sex, BMI class, and being of as similar an age as possible. Socio-demographics were collected and metabolic risk factors relevant to the metabolic syndrome were measured. Symptom severity was measured using Clinical Global Impression (CGI), and HRQoL was assessed using EQ5D. Measurements were made at baseline and at a one-year follow-up. In study III, a qualitative exploratory study was conducted in order to explore prerequisites for a healthy lifestyle. Data were collected through individual interviews (n=40), using a semi-structured interview guide with participants who had undergone the lifestyle intervention. Data were collected 6–7 months after the intervention had been completed. Conventional content analysis was used. Study IV was also based on these 40 interviews and aimed to describe how persons with psychosis perceive participation in a lifestyle intervention. A phenomenographic analysis approach was used. Results/conclusions: Persons with psychosis are at great additional risk of physical comorbidity. Almost half of the patients met the criteria for metabolic syndrome. In addition, persons with psychosis had significantly lower HRQoL in all dimensions in the EQ5D, except for the pain/discomfort dimension. The only risk factor included in the metabolic syndrome that was associated with lower HRQoL was elevated blood pressure. Raised LDL-cholesterol was also related to lower HRQoL, together with low GAF, older age, high BMI, and female gender. The intervention study demonstrated that HRQoL was significantly improved in the intervention group when comparing EQ-VAS at baseline and at the one-year follow-up. It can be concluded that our intervention was not powerful enough to influence the metabolic factors to any greater extent. The key prerequisite for a healthy lifestyle seemed to be a wish to take part in the society and a longing to live like everybody else. However, many became stuck in a constant state of planning instead of taking action towards achieving a healthy lifestyle. Support by health care professionals is therefore also a prerequisite for a healthy lifestyle. This support should target the transition from thought to action and facilitate the participants’ ability to mirror themselves against healthy people in society by introducing activities they perceive that “common people” do. The challenge for health care professionals is to find a moderate intervention level that does not underestimate or overestimate the person’s capacity. This can facilitate continued participation, and participants can thereby find new social contacts and achieve health benefits.

The aim of this thesis is to explore the meaning of technical knowing in primary technology education. This is done by identifying and describing ways of knowing in relation to specific content (so-called objects of learning) of the school subject of technology. The purpose is to contribute to the body of teachers’ professional knowledge concerning primary technology education. In this thesis, the subject of technology is seen as representing technical knowledge traditions, characterized by specific ways of developing knowledge. Moreover, the knowledge is to a great extent embedded in actions. This perspective on technical knowing challenges the traditional distinction between theoretical and practical knowledge.   Data were generated through two Learning studies conducted in primary schools.  Learning study is a classroom-based, interventionistic research approach, in which teachers collaborate with a researcher, focusing on specific objects of learning, that is, on what the students are supposed to learn. In the studies, the capability to evaluate the fitness for purpose of technical solutions, and to construct a linkage mechanism allowing for transferring and transforming movement were examined. Students’ actions were video-recorded in order to document verbal and physical expressions of knowing. The data were analysed using phenomenographic analysis, resulting in descriptions of specific ways of knowing in terms of complexity, as well as critical aspects to discern in order to develop the knowing. The findings from the first study describe knowing in terms of discerning functions related to different types of users, as well as aspects of the construction in order to realize functions. The second study identified technical knowing as a specified analysis of the construction in terms of location and separation of joints in relation to different functions. These findings were then used to identify technical knowing in video material generated within another teaching context. The results suggest that knowledge concerning knowing of specific objects of learning related to the evaluation and construction of technical solutions is partly generalizable. In addition, the specified knowledge concerning the meaning of the object of learning generated during the Learning study process was described. This knowledge is suggested to be an important knowledge product of Learning studies. / <p>At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 4: Submitted.</p>

Bakgrund: Perineala bristningar är vanligt förekommande vid vaginal förlossning. Bristningar kan leda till bland annat smärta i underlivet som i sin tur kan påverka den sexuella hälsan negativt. Befintlig forskning visar att en förlossningsställning kan påverka både uppkomsten samt graden av bristning, dock framkommer inte förklaring om varför. Syfte: Undersöka barnmorskors uppfattning av förlossningsställningens betydelse för perineala bristningar under utdrivningsskedet. Metod: Studien baseras på en fenomenografisk forskningsmetod där tio intervjuer har genomförts med barnmorskor från sex olika förlossningsavdelningar i södra och mellersta Sverige. Resultat: Förlossningsställningen uppfattas av barnmorskor kunna avlasta trycket mot perineum, undvika ett utdraget utdrivningsskede, vara avgörande för kvinnors kroppskontroll samt bidra till ett långsamt framfödande, vilket uppfattas minska risken för uppkomst av perineala bristningar. Förlossningsställningen uppfattas även kunna öka belastningen mot perineum, minska kvinnors möjlighet att själv kontrollera sin kropp samt bidra till spänd muskulatur i bäckenbotten, vilket uppfattas öka risken för perineala bristningar. I denna studie belyser även barnmorskor värdet av kommunikation med de födande kvinnorna under utdrivningsskedet. Detta uppfattas vara en av de viktigaste faktorerna för att förebygga perineala bristningar. Konklusion: Barnmorskor uppfattar att förlossningsställningen har olika betydelser för perineala bristningar. De för också ett resonemang kring varför och hur bristningar kan uppkomma samt förebyggas relaterat till olika förlossningsställningar. / Background: Perineal tears are common in vaginal delivery. The injury can lead to vaginal pain, which in turn can affect the sexual health negatively. Existing research shows that a birth position can influence both the onset and the degree of rupture, but does not reveal the explanation of why. Aim: Investigate midwives perception of the birth positions significans to perineal tearing during the second stage of labor. Method: The study is based on a phenomenographical research where ten interviews were conducted with midwives from six maternity hospitals in southern and central Sweden. Result: Birth positions is perceived by midwives to relieve pressure on the perineum, avoid prolonged second stage of labor, be crucial to women's body control and contribute to a slow birth, which is perceived to reduce the risk of perineal tearing. The birth position perceived also to be able to increase the pressure against the perineum, reduce women's ability to control their body and contribute to tense muscles in the pelvic floor, which is perceived to increase the risk of perineal tearing. This study also highlights the value of midwives communication with women giving birth during the second stage of labor. This is perceived to be one of the most important factors for the prevention of perineal tearing. Conclusion: Midwives perceive that birth position has different meanings for perineal tearing. Midwives also reason why and how perineal tearing can occur and be prevented related to different birth positions.

Syftet med denna studie är att synliggöra hur några sånglärare på gymnasiet uppfattar begreppet personligt uttryck och hur de erfar att de arbetar med det i sin undervisning. I bakgrundskapitlet tas tidigare forskning och litteratur upp om personligt uttryck. Den metod som användes var fem enskilda semistrukturerade intervjuer. Det teoretiska perspektivet som används är fenomenografi. Resultatet visar att det finns många olika sätt att tolka och definiera begreppet personligt uttryck i sång. Förmedling av känslor är en central del för samtliga informanter inom det personliga uttrycket, utöver det har alla informanterna en individuell syn på hur personligt uttryck kan tolkas. Det finns många likheter mellan de olika tolkningarna men de skiljer sig åt på olika sätt då alla informanter har olika fokus i stunden för intervjun och olika sätt att se på fenomenet. Något som alla informanter pratar om är att det personliga uttrycket kan skilja sig åt från elev till elev. Beroende på hur eleven är som person blir det personliga uttrycket olika och lärarens sätt att arbeta blir därmed också olika. Studien visar att det inte finns något konkret rätt eller fel när det gäller personligt uttryck. Vad personligt uttryck innebär och hur arbetet med det kan utformas är upp till varje individ att utveckla utifrån personlighet hos läraren och eleven och/eller fokus under lektionen. / The purpose of this study is to explore how vocal teachers in upper secondary school or high school understand the term ‘personal expression’ and how they experience their work with ‘personal expression’. The background chapter describes previous scientific research and literature on ‘personal expression’. The method that was used were separate qualitative interviews. The theoretical perspective that is used is phenomenography. The result shows that there are many ways to interpret and define the term ‘personal expression’ in song. To convey feelings while singing is imperative for all sources in regards to ‘personal expression’, but every source has their own interpretation of the term ‘personal expression’. There are many similarities between the different interpretations, but they vary depending on the differences in the source’s perspective. Something that all sources mention is how the ‘personal expression’ varies depending on the student. Depending on the student’s character, background and influences, their ‘personal expression’ varies and therefore, the teacher’s process of teaching varies. In conclusion, the study shows that there is not any right or wrong in regards to ‘personal expression’. How to define ‘personal expression’ and how to work with it is up to every teacher to decide based on the teacher’s and the student’s personality and/or focus during the lesson.

Bakgrund: Sjukdomen åldersrelaterad makuladegeneration (AMD) är en är av de vanligaste anledningarna till grav synnedsättning i västvärlden. Sjukdomen medför att den centrala synen försämras för patienten. Det finns en torr och en våt form. Med den våta formen sker synförsämringen i ett snabbare förlopp men kan behandlas med läkemedel som injiceras i ögats glaskropp. Synförsämringen skapar olika problem för patienten att hantera i deras vardagsliv. I relation till vardagliga aktiviteter så som socialt och fysiskt finns den närvarande. Syfte: Att beskriva patientens uppfattningar av att leva med sjukdomen våt AMD. Metod: En kvalitativ design har använts med en fenomenografisk forskningsansats. Patienter från en ögonmottagning i Mellansverige har enskilt intervjuats. Data har sedan analyserats enligt en fenomenografisk analys. Resultat: Fyra stycken beskrivningskategorier identifierades som handlade om patienternas uppfattningar av sin sjukdom. Medvetenhet om sjukdomen, förlust av självständighet, att kunna anpassa sig och att känna tillit till sjukvården. Slutsats: Att leva med sjukdomen våt AMD medför förändringar i patientens vardagsliv och påverkar det på olika sätt. För att kunna förstå patientens uppfattningar med att leva med sjukdomen är det viktigt att belysa och lyfta fram dessa för att kunna hitta metoder för att uppmärksamma denna patientgrupps behov av stöd och hjälp vid besöken på ögonkliniken.

MEd thesis / Abstract This study explores teachers’ understanding about ways in which assessment supports learning and teaching within the context of grappling with the new curriculum. It argues that formative assessment, supports a socialconstructivist view of learning and teaching. It suggests that formative assessment functions in a fundamentally different way to summative assessment, and could assist teachers in moving towards a more conceptual approach to learning and teaching. Teachers’ views are explored in focus groups in which teachers discuss their choice and use of either traditional or alternative assessment tasks, in their mathematics lessons. The findings suggest, however, that teachers’ ability to use assessment in this way is influenced by their own views of mathematics learning, their current views of assessment, the amount of support provided in the assessment materials, and the practices of the school. Key words Formative assessment Social constructivist Focus groups Phenomenography Primary school Mathematics Assessment Investigations

Bakgrund: Att vårdas på sjukhus kan för äldre personer ge en upplevelse av minskad autonomi, och förlust av förmågor/funktioner. Den äldre personen efterfrågar att få bli sedd av sjuksköterskan som autonom person och utifrån deras resurser Syfte: Syftet är att beskriva sjuksköterskors uppfattning av arbetet med den äldre personens resurser under vårdtiden på en geriatrisk slutenvårdsavdelning. Metod: Metoden är en kvalitativ intervjustudie med fenomenografisk ansats. Resultat: Sjuksköterskors uppfattning av arbetet med den äldre personens resurser under vårdtiden på en geriatrisk slutenvårdavdelning beskrevs i en övergripande kategori och med fyra kategorier. Den övergripande kategorin var att sjuksköterskor har olika förståelse för begreppet resurser. De fyra kategorierna var; möjligheter ges att låta den äldre personen göra det hen kan själv, arbetet med den äldre personens resurser bottnar i ett personcentrerat tankesätt, den äldre personens resurser kan vara dolda och den äldre personens resurser tas inte tillvara. Konklusion: Sjuksköterskor uppfattar frånvaro av arbetet med den äldre personens resurser trots teoretisk medvetenhet. Genom ett personcentrerat arbetssätt kan den äldre personens resurser tas tillvara. Att som sjuksköterska identifiera resurser är ett sätt att stärka den äldre personens hälsa och livskvalitet. / Background: Hospitalization can bestow a feeling of autonomy deprivation and loss of abilities for the elderly persons. The elderly person expects to be seen by the nurse as an autonomous person and have their individual assets identified. Purpose: Purpose is to describe the nurses´ perceptions of the work with elderly persons´s assets during inpatient stay at a Geriatric ward. Method: Method is qualitative interview study with a phenomenographic methodology. Results: Nurses’ perceptions of the work with elderly person’s assets during inpatient stay at a Geriatric ward can be described in an overriding category and four categories. The overriding category was nurses have different understanding for the term assets. The four categories were; possibilities given to let de elderly person do what him/herself can do, the work with the elderly persons assets is sprung from a person-centered mindset, the elderly persons assets can be hidden and the elderly persons assets is not taken at use. Conclusion: Nurses’ percept an absence of work with the elderly persons assets despite theoretical awareness. Thru a person-centered way of working can the elderly persons assets be taken care of. As a nurse identify assets is a way of strengthen the elderly persons health and quality of life.

No description available.