Aim: The overall aim of the present thesis was to examine, develop and evaluate patient participation in emergency department (ED) for promoting the relief of suffering for patients in care relations, from the perspective of patients and caregivers. Method: The explorative studies (I, II) were based on reflective lifeworld approach and analyzed by phenomenographic method. Data were collected from interviews by patients (9) and caregivers (11) about their conception of patient participation in ED. The methodological study (III) performed analyses and were tested for content, construct and criterion validity as well as homogeneity and stability reliability. The sample for study (III, IV) consisted of 356 patients consecutively cared for in EDs in Sweden. In the evaluating study (IV) the questionnaire Patient Participation Emergency Department (PPED) was used. The statistical methods handled were Student’s t-test, one-way ANOVA and Spearman correlation. Findings: The patients’ conception of patient participation means: being acknowledged; struggling to become involved; and having a clear space (I). The caregivers’ conceptions of patient participation can be divided into three different descriptive categories: Caregivers offer the opportunity for participation, Patients demand participation and Mutual participation (II). A 17- item questionnaire was developed. Two separate factor analyses revealed a distinct four- factor solution which was labelled: Fight for participation, Requirement for participation, Mutual participation and Participating in getting basic needs satisfied. Criterion validity presented showed 9 out of 20 correlations equal or above 0.30. Cronbach’s alpha coefficient ranged from 0.63 - 0.84 and test- retest varied between 0.59 and 0.93(III).The results show that patient participation is low in two dimensions (Fight for participation, Participation in getting basic needs satisfied), reasonable in one dimension (Mutual participation), and high in one dimension, Requirement for participation (IV). Conclusions: Participation does occur on occasion when the circumstances are right despite international and national guidelines that lay down the need for patient participation. Patient participation in EDs is perceived when patients are in contact with caregivers and there is space for collaboration in situations of consistency. However, patient participation cannot be offered in a one-sided caring action. In collaboration patient participation contributes to the relief of suffering in the process of health and patients participate when they are allowed to be the point of departure for caring. However, the results point to a lack of strategy for patient participation and for increased patient participation to take place improvements in external organization requirements are required. The results indicate an amplified clarity in how patient participation can be understood for EDs, in education and community and a scientific tested instrument has made it possible to evaluate patient participation.

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. 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. 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.

Students need to be entrepreneurial, because society has changed locally and globally and individuals must carry more responsibility for their learning and their livelihood. Information technology affects everyone and makes it possible to obtain facts far beyond the classroom. In all, the changes affect the perception of what and how pupils learn. Supranational bodies such as the OECD, the European Union and NUTEK have argued for a couple of decades that schools and businesses need to work together to educate students in an entrepreneurial direction. Today, in 2011, entrepreneurship is in fact enshrined in the new curriculum for the upper secondary school, GY 2011. The school has long sought to increase students’ responsibility for their own learning and different education practices have been tested to develop this. The purpose of this study is to form knowledge about entrepreneurial learning and make a contribution to knowledge about a form of learning, from a student perspective. The theoretical and methodological approach of the study is phenomenographic. Sixteen students at an upper secondary school with a pronounced entrepreneurial profile have been interviewed. The interview guide used was open-ended with ample opportunities for the informants to talk about their work on the basis of the project that the students perform during their last school year. Students do not use the term entrepreneurial to describe their perceptions, but from the data I understand with my teaching experience that they describe their perceptions of entrepreneurial learning. The results of the analysis of the data material show upper secondary school students' different perceptions of entrepreneurial learning and fall into five description categories. They are Understanding, identifying and defining the task, External contacts and communication, Team building, Learning in different social practices and Looking beyond the obvious. The results show that if the school is to use entrepreneurial learning as a learning approach, tasks need to be retrieved from activities outside the school to be challenging for students to manage themselves and with the help of others.

Bakgrund: i Sverige har ungefär fyra procent av befolkningen diabetes. Vid behandling av diabetes (typ-2) är målet att minska risken för komplikationer. Detta kan göras med hjälp av livsstilsförändringar (kost, motion) eller/och farmakologisk behandling. Riskfaktorer för komplikationer är högt blodtryck och höga blodfetter. Komplikationer kan ge mikro- och makrovaskulära förändringar i till exempel ögon, njurar respektive hjärta och blodkärl. Patientutbildning är en central del i behandlingen av typ 2 diabetes. Syfte: vårt syfte med denna studie var att belysa deltagarnas uppfattning av att delta i en grupputbildning om deras diabetessjukdom. Metod: I studien intervjuades sex kvinnor och fyra män (i åldern 65-78 år) som alla deltagit i grupputbildning om diabetes. Intervjuerna analyserades med hjälp av analysmetoden fenomenografi. Resultat: utifrån deltagarnas uppfattningar bildades tre beskrivningskategorier: att lära sig mer, att kommunicera på rätt nivå och livsstilsförändringar. Konklusion: Vi anser att grupputbildning kan vara både tidsbesparande och kostnadseffektivt. Det kan vara betydelsefullt att informanterna använder ett språk som även icke sjukvårdsutbildade förstår. Vi anser att det vore värdefullt med någon slags uppföljning, vilket skulle kunna ha en motivationshöjande effekt för deltagarna.  För vidare forskning och utveckling i ämnet skulle det vara av intresse att göra intervjuer med ett större urval. / Background: in Sweden about four percent of the population has diabetes disease. The goal of treatment is to minimize the risk of complications. It can be done with the help of lifestyle changes (diet, exercises) or/and pharmacological treatment. The risk factors for complications are high blood pressures and high blood lipids. The complications can lead to micro- and macro vascular changes, for example in eyes, kidneys, heart and vascular. Patient education plays a central role in type 2 diabetes treatment. Aim: our aim with this study was to elucidate how persons with diabetes considered of attending a group education about their disease. Method: In the study interviewed six women and four men (in the age 65-78 years) that everyone participated in group education about diabetes. The interviews were analyzed with the aid of analysis method phenomenography. Results: on the basis of the participants’ views refined three description categories: to learn more, to communicate on correct level and lifestyle changes. Conclusion: We consider that group education can to be both time-saving and cost-effectively. It can be important to use a language that also non healthcare trained understands. We consider it would be important with some kinds of follow-up, it would to have a motivation increasing effect. For further research and development in the matter would the last of interests to do interviews with a broader selection.

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.

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.

Syftet med studien var att ta reda på de skilda uppfattningar av varför vi har årstider som kan finnas i årskurs sju. Detta gjordes för att få en bild av de olika föreställningar en lärare kan möta i sitt yrke och för att öka förståelsen och kunskapen om hur ett fenomen kan uppfattas på olika sätt av elever i en och samma klass. Eleverna ombads att, enskilt, skriftligt förklara varför vi har årstider. Studien är fenomenografisk och svaren kategoriserades i kvalitativt skilda kategorier genom att jämföra och finna likheter och skillnader mellan de insamlade elevutsagorna. Resultatet visade att eleverna hade olika uppfattning av varför vi har årstider och det är som lärare viktigt att vara medveten om att elever uppfattar samma undervisning på olika sätt. De uppfattningar som framkom var solens instrålning, jordaxelns lutning, jordens lägesförändring och avståndsvariation som skäl till varför vi har årstider. Trots att eleverna hade undervisats av samma lärare, vid samma tillfälle, tidigare på terminen om orsakerna till årstider, hade eleverna skilda uppfattningar av dessa. Högstadieeleverna gav uttryck för att de uppfattade orsakerna till årstider på samma sätt om lärarstuderande, vars uppfattningar undersökts i tidigare forskning. Det är således mycket viktigt att som lärare vara medveten om att elever i en och samma klass har olika uppfattningar av samma fenomen för att kunna anpassa undervisningen därefter och på så sätt få eleverna att förstå att en svala gör ingen sommar – men solens varierande instrålning på grund av jordens lutning gör det. / This study was an attempt to explore the conceptions of one group of students in the 7th grade about the reasons for seasons. The students were asked to, in writing, explain their conception about the reason for seasons. The study was inspired by phenomenography and the answers were categorized by comparing similarities and differences among a number of quotes taken from the answers of the students. Through the analysis, four qualitatively different conceptions were found, within one and the same group of students. The categories, each representing one kind of conception, “the luminous flux”, “the earth’s axis is inclined”, “the earth’s position in orbit” and “the distance between sun-earth varies” were found as conceptions of the reason for seasons. You might wonder how students, who have been taught of reasons for seasons by the same teacher, are able to develop four different kinds of conceptions of the phenomenon. It is very important for a teacher to have in mind that students have different conceptions of the same phenomenon and this study might help teachers to improve their teaching and help the students come to a deeper understanding of reasons for seasons.

Conceptual change is one of the most important influences in modern educational research and this theoretical framework can be used for empirical research aimed at improving our common knowledge about learning as well as developing new theories and practices within the education system. In its very basic meaning, conceptual change can be explained as a person who during the course of the learning experience changes their initial conception of a phenomenon (such as a object or a concept) from one specific point of view to another. The aim of this study is to map out the differences and similarities between two seemingly opposite movements within today’s pedagogical research community. Within phenomenography a constitutionalist approach to learning is used, which means that the conceptions formed by students are considered to be an internal representation of the individual’s interpretation of their own knowledge in relation to their surroundings. The intentional analytical approach suggests that contextualisation is necessary for conceptual change to take place, for the student to be able to interpret the assignment or task at hand and then incorporate that in meaningful activity that will lead to a successful learning process. Both the intentional and the phenomenographic approach agree that it is the meaning of a task that is important in the learning situation, but the differences lie in the ways of distinguishing what this meaning consists of as well as the means of finding out what the meaning is to an individual. / Begreppsutveckling är en av de viktigaste influenserna inom det pedagogiska forskningsområdet. Denna teoretiska inriktning innebär att man genom empirisk forskning studerar lärande och dess kontext. Detta kan sedan bidra till vår kunskap om vad som påverkar lärprocessen samt hur denna skulle kunna användas i utvecklingen av nya didaktiska metoder och verktyg. Begreppsutveckling kan förstås som teorier om hur en individ, genom övning och reflektion ändrar en grundläggande uppfattning om ett fenomen eller objekt från en specifik uppfattning till en annan. I den här litteraturstudien, kommer jag att försöka kartlägga två skilda sätt att anta utmaningen att undersöka hur lärande genom begreppsutveckling kan förstås och tolkas, nämligen fenomenografi och intentionell analys. Fenomenografi är utvecklat med en konstitutionell ansats till lärandet, där man menar att de koncept som individen använder formas genom interna representationer av den egna tolkningen av omgivningen samt hur det egna konceptet relaterar till omgivningen. Intentionell analys å andra sidan menar att begreppsutveckling uppstår när individen kontextualiserar uppgiften genom meningsskapande processer i relation till omgivningen och att detta beskriver lärprocessen. Den gemensamma nämnaren för båda dessa perspektiv är att det är meningsskapandet för individen som är nyckeln till lärandet. Skillnaden mellan dem märks i synen på lärandet i de meningsskapande processerna där man närmar sig betydelsen av denna process som den ter sig för den lärande individen.

This is a thesis which contributes to research in two different fields: theoretical physics and physics education research. The common link between these two research areas is that both involve explorations of abstract physics and mathematical representations, but from different perspectives. The first part of this thesis is situated in theoretical physics. Here a cosmological scenario is explored where a de Sitter phase is replaced with a phase described with a scale factor a(t) ~ tq, where 1/3<1. This scenario could be viewed as an inflationary toy model, and is shown to open up the possibility of an information paradox. This potential paradox is resolved even in the worst case scenario by showing that the time scales involved for such a paradox to occur is of the order of magnitude of the recurrence time for the de Sitter space. The second part of this thesis is situated in physics education research. A number of learning situations that are experienced as abstract by students are explored: probability in one dimensional quantum tunnelling; the mindsets that students adopt towards understanding physics equations used in typical teaching scenarios; and what students focus on when presented with physics equations. The results for the quantum scattering study are four phenomenographic categories of description, for the mind sets study, six epistemological components of mindsets and for the focus on physics equations study, three foci creating five levels of increasing complexity of ways of experiencing physics equations.  Pedagogical implications of these results are discussed.

Featured adjuvant chemotherapy treatment in women with breast cancer can lead to pain. The aim of this study was to explore, the variety of perceptions and impact of adjuvantchemotherapy-induced pain in daily life, of some women newly diagnosed with breast cancer.Inclusion criteria were participating in an ongoing stress management projectand chemotherapy of (anthracycline/taxan) in doses of 75mg² or more. Exclusioncriteria were inability to understand and communicate in Swedish and mentalillness. After ethical approval of the sub study in September 2010, women wereconsecutively included through oral and written request. Phenomenologicalapproach was used in the eight interviews and data analysis. The resultconsisted of five categories of description, the obvious pain, themanageable pain, the lonely pain, the unimaginable pain andultimately the crippling pain. The existence was open when the pain feltdescribable and manageable, while it was concluded when the pain seemedinexplicable and life drastically changed. The study showed a significantpainful impact of chemotherapy. The woman had difficulties to refer to theinformation given by the medical services, when the pain went beyond previousexperiences. There was a tendency that the woman waited before she contactedthe medical services, this waiting made room for difficult thoughts andfeelings. A question for further research is how the staff can capture andbetter help the women who experience severe pain. / Dagens adjuvanta cytostatikabehandlingav kvinnor med bröstcancer kan leda till smärta. Denna studies syfte var att undersöka olikauppfattningar om inverkan av smärta, utlöst av adjuvant cytostatikabehandling,på dagligt liv hos några kvinnor som nyligen diagnostiserats med bröstcancer.Inklusionskriterier var deltagande i ett pågående stresshanteringsprojekt ochcytostatikabehandling i doser om 75mg² eller mer av antracyklin och/ellertaxan. Exklusionskriterier var oförmåga att förstå och kommunicera på svenska ochpsykisk sjukdom. Efter etiskt godkännande av delstudien i september 2010 inkluderades kvinnorna konsekutivt genommuntlig och skriftlig förfrågan. Fenomenologisk ansats användes i de åttaintervjuerna och i resultatbearbetningen. Resultatet kom att utgöras av fembeskrivningskategorier: den förklarliga smärtan, den övervinneliga smärtan, denensamma smärtan, den ofattbara smärtan och sist den förlamande smärtan.Tillvaron var öppen då smärtankändes förklarbar och därmed hanterbar, medan den slöts när smärtan kändesoförklarlig och kvinnornas liv förändrades drastiskt. Studien visar på en betydande smärtinverkan vid cytostatikabehandling. Kvinnornafick svårt att referera till den av sjukvården givna informationen, när smärtangick utanför tidigare beskrivning och smärtupplevelser. Det fanns en tendensatt kvinnan avvaktade innan hon kontaktade sjukvården och i denna väntanuppstod svåra tankar och känslor. En fråga för vidare forskning är hurpersonalen kan fånga upp och bättre hjälpa de kvinnor som får svåra smärtor.