Aim: The overall aim is to create knowledge about how nursing students’ learning in pairs can be supported in order to create prerequisites for encounters that provide caring and learning support during clinical practice. Approach and method: A reflective lifeworld research (RLR) approach founded on the epistemology of phenomenology and hermeneutics was used. Based on interviews, diary entries and observations with patients, students and supervisors, descriptive and interpretive analysis in accordance with the RLR approach was performed. Main findings: Students’ learning in pairs is based on encountering and caring for the patients together. The responsibility of caring for the patients, which is given to the students by their supervisors, is based on supportive relationships that are characterized by movements between independence and cooperation. Supporting students learning in pairs is characterized by a reflective approach focusing on learning in togetherness, where the individual student is also reached and seen, providing opportunities for developing important abilities for learning and caring. Depending on the ability to show respect and to take responsibility a more or less supportive relationship between the patients, the students and the supervisors is created within the learning space. Conclusions: Supporting students’ learning in pairs is complex due to it taking place in a caring context, where respect must be given towards the patients, the students, the supervisors and other participants who are closely connected to the learning space. Since learning in pairs affects and interweaves learning and caring environments, a reduction to either one of them, learning or caring, is not possible but instead the learning space must be understood as a whole. Optimal conditions for learning in pairs are based on dynamic movements, which require a reflective supervising approach. If these conditions are missing, there is a risk of creating both fragmented caring and learning, where the patients ́ vulnerability and safety needs to be taken into account. Keywords: caring science; clinical practice; learning space; learning support; pairs of nursing students; reflective lifeworld approach

Hot och våld är vanligt förekommande inom psykiatrisk slutenvård och utgör ett betydande problem både för patienter som vårdas och för de sjuksköterskor som arbetar inom psykiatrisk verksamhet. Det finns ett ansvar hos sjuksköterskor inom psykiatrisk vård att hantera situationer med patienter där inslag av hot och direkt våld är en realitet utan att tillfoga patienten onödigt lidande. Det krävs kunskap och erfarenhet men också en förståelse inför patientens situation och egna upplevelser. Forskning som rör arbetsmiljön inom psykiatrisk slutenvård visar på att förekomst av hot och våld kan innebära relativa arbetsmiljöproblem för de sjuksköterskor som arbetar där. Detta kan resultera i psykosociala problem och med minskad arbetsglädje som följd. Känslor av skuld och självanklagelser drabbar ofta dem som möter hot och våld i sitt arbete. När sjuksköterskor känner bristande förmåga att klara av sitt arbete på grund av hot och våld kan känslan av misslyckande i sin yrkesroll påverka möjligheten till genuina möten med patienter. Denna studie syftar till att försöka beskriva sjuksköterskors upplevelser av ett hotfullt möte mellan dem och patienter. Data har insamlats genom kvalitativa intervjuer. Analysen har gjorts utifrån en innehållsanalys. Försökspersonerna har alla en specialistutbildning i psykiatri och alla arbetar på en allmänpsykiatrisk klinik. Resultatet visar på att sjuksköterskor som har förmågan att visa omtanke och respekt och att kunna vara närvarande under den hotfulla situationen har störst möjlighet att nå fram till patienten. När sjuksköterskorna känner som mest rädsla och osäkerhet har de en tendens att bli som mest påtvingande i sin attityd gentemot patienten. Det hotfulla mötet hotar den betydelsefulla relationen mellan patient och sjuksköterska där sjusköterskan har den svåra uppgiften att få till stånd en dialog som präglas av respekt och närvaro gentemot patienten trots att mötet kan utvecklas till en våldsam situation. En slutsats av studien är att en rädd och osäker sjuksköterska har minskad förmåga att erbjuda en genuin och rak kontakt gentemot patienten. Den andra slutsatsen är att möjligheten att förhindra en hotfull situation är som störst innan ett möte övergår i en hotfull situation mellan en patient och en sjuksköterska. / Threats and violence are common in psychiatric care and are a significant problem for both patients who are under treatment and for the nurses who work within the psychiatric healthcare. The nurses within the psychiatric healthcare has a responsibility to handle the situations with patients were elements of threat and violence are a reality without inflicting unnecessary suffering. It requires knowledge and experience but also an understanding for the patients situation and previous experiences. Research that concerns working environment within the psychiatric care shows that occurrence of threat and violence may result in working environmental problems for the nurses. The consequences that may occur among the nurses are psycho social problems with a result of demised work pleasure. Nurses who face threat and violence at their jobs has often feelings of guilt and self accusations. The feelings of failure affect the possibility of a genuine contact with the patient when nurses feel a lack of ability of coping with their jobs. This study is aimed to try to describe psychiatric nurses’ experiences of threatening meetings between them and patients. Data has been collected through qualitative interviews. The analysis has been done on the basis of a content analysis. All the subjects of the interviews have a specialist education within psychiatric care and works on a psychiatric clinic. The result shows that nurses who have the ability to show care and respect and also being able to be present in threatful situations have the best possibility to achieve a genuine dialog with the patient. When nurses are feeling fear and insecurity at its most they tend to be even more forced in their attitude against the patient. The threatful meeting threatens the important relation between the patient and the nurse who has the difficult task to achieve the dialog which is based on respect and presence towards the patient despite the fact that the meeting can evolve into a threat full meeting. One conclusion of the study is that a frightened and insecure nurse has a diminished capability to offer a genuine contact with the patient. The second conclusion is that the best possibility to prevent a threatful situation is before a meeting turns into a threatful situation between the patient and the nurse.

samband med att den studerade myndigheten genomgick enomorganisation där organisationsstrukturen förändrades och styrochledningsfilosofin tog en ny riktning påbörjades resan mot attbli en ”lärande organisation”. Som ett led i förändringsarbetetimplementerades en ny arbetsmetod; reflektion i vardagen (RÌV).RIV syftar till att utveckla medarbetarna i deras yrkesroll, till ökadkunskapsöverföring, att väcka den medarbetardrivna innovationenoch bidra till utveckling av den lärande organisationen. Denhermaneutiska spiralen har genomsyrat studien som har enabduktiv ansats och en mixad undersökningsdesign. Studiens syfteär att undersöka om RIV har bidragit till yrkesmässig utvecklingför medarbetarna samt hur RIV bidragit till den lärandeorganisationen. Material har inhämtats via en enkätundersökningsamt tre intervjuer med chefer från en myndighet inom offentligsektor. Kvalitativa data har strukturerats och tolkats medsläktskapsdiagram. Resultatet tyder på att RIV har positivpåverkan på yrkesmässig utveckling och bidrar till den lärandeorganisationen, men inga generella slutsatser kan dras frånstudien. Det finns hinder och motstånd som måste identifieras ochelimineras innan RIV ger större effekt. För att öka förståelsen ochintresset för yrkesrelaterad reflektion föreslår författaren attorganisationer börjar med att se över om medarbetarnas basbehovär tillfredsställda, att verka för ett ökat engagerat ledarskap samtsatsningar på utbildning till medarbetarna. / In connection with a state organization undergoing areorganisation in which the organisational structure was changedand the governance- and management philosophy took a newdirection, the journey to become a “learning organisation” started.As part of the organisation´s work with improvements, a newmethod was implemented; refection in everyday life (RIV). RIVaims to develop the employees in their professional role, increaseknowledge transfer, awaken the power of innovation fromemployees and contribute to the development of the learningorganisation. The hermeneutical spiral has permeated the studywhich has an abductive approach and a mixed design. The purposeof the study is to investigate whether RIV has contributed toprofessional development for the employees and whether RIV hasserved as a contribution to the learning organisation. Data havebeen obtained through a quantitative / qualitative survey andthrough three qualitative interviews with managers. The resultshows that RIV has a positive impact on employees´ professionaldevelopment and that RIV contributes to the learning organisation.However, there are obstacles that must be crossed and resistancesthat must be dealt with before RIV gives greater effect. The author8. Handledare9. Examinator10. Termin11. Övrigt/Anmärkningbelieves that organisations need to identify and satisfy basic needsof the employees before they are invited to engage in organisationaldevelopment and improvement. The organisational structure needsto be explained so it´s clear to all employees, including managers,where, in the organisation, improvements are relevant. Engagedleadership needs to be strengthened and education efforts needs tobe implemented to make both managers and employees understandthe purpose, value and benefits of reflective conversations in thelearning organisation. / <p>2020-11-26</p>

A starting point for this thesis is that patients’ learning has not received sufficient attention and thus has not featured in the study programmes in the field of caring. Focus has instead been placed on patients being given information and advice about their illness and treatment, advice that they are then expected to comply with. Too little attention has been paid to the individual who lives with his/her illness and who should be considered to have significant experiences. The overall aim has been to analyze and describe the phenomenon of learning to live with long-term illness as well as to develop a didactic model that can help carers to support patients’ learning processes. The theoretical perspective in the thesis is lifeworld theory, which permeates ontological, epistemological and methodological standpoints and also the view on learning. The design and carrying out of the research is based on a reflective lifeworld approach. The empirical study consists of interviews with people who live with different types of long-term illnesses. The learning that follows life with a long-term illness is generated in such a way as to respond to the will to live the well-known everyday life. A greater understanding of the empirical results has been achieved by a lifeworld philosophical elucidation, with a particular focus on learning turning points and the importance of reflection. Based on the empirical results, the lifeworld philosophical elucidation and the caring science lifeworld didactics a didactic model has been formulated. This model is entitled: The challenge – to take charge of one’s life with long-term illness. The model contains four theses: 1) Confronting one’s life situation and challenging to make a change, 2) Positioning oneself at a distance when creating a new whole, 3) Developing self-consciousness and taking responsibility, 4) Making learning visible with the aim of providing development and balance in life. The results in the thesis show that a genuine learning is something that differs from the learning of information and that the learning must be supported at an existential level based on the sufferer’s situation and for a long period of time.

<p>Syftet var att undersöka fyra hälsovägledares uppfattningar och strategier för att motivera individer till viktminskning. Avsikten var även att utreda vad de bygger sina uppfattningar och strategier på, samt att jämföra deras strategier med befintliga teorier om beteendeförändring såsom Motiverande samtal, Stages of change, Social learning theory och Health belief model. Teorierna valdes då de belyser hur en beteendeförändring kan gå till samt att de varit fram­gångsrika i tidigare forskning. Studien är kvalitativ och genomfördes med ostrukturerade intervjuer där respondenterna valdes genom ett bekvämlighetsurval. De fyra hälsovägledarna arbetade med att motivera individer till viktnedgång, alla hade utbildning inom hälso­främjande arbete som varierade mellan en vecka till flera år. Resultatet visade på att hälso­vägledarna använder sig av befintliga teorier samt av strategier som bygger på deras utbildning och egna erfarenheter. De förändrar sin arbetsmetod efterhand som de får ny kunskap samt då de reflekterar över sitt arbetssätt, vilket tyder på att de är reflekterande praktiker.</p>

Syftet var att undersöka fyra hälsovägledares uppfattningar och strategier för att motivera individer till viktminskning. Avsikten var även att utreda vad de bygger sina uppfattningar och strategier på, samt att jämföra deras strategier med befintliga teorier om beteendeförändring såsom Motiverande samtal, Stages of change, Social learning theory och Health belief model. Teorierna valdes då de belyser hur en beteendeförändring kan gå till samt att de varit fram­gångsrika i tidigare forskning. Studien är kvalitativ och genomfördes med ostrukturerade intervjuer där respondenterna valdes genom ett bekvämlighetsurval. De fyra hälsovägledarna arbetade med att motivera individer till viktnedgång, alla hade utbildning inom hälso­främjande arbete som varierade mellan en vecka till flera år. Resultatet visade på att hälso­vägledarna använder sig av befintliga teorier samt av strategier som bygger på deras utbildning och egna erfarenheter. De förändrar sin arbetsmetod efterhand som de får ny kunskap samt då de reflekterar över sitt arbetssätt, vilket tyder på att de är reflekterande praktiker.

This thesis brings together a fascination with the city and a keen interest in the knowledge process. The point of departure is the bodily, sensory and emotional experience. That the author uses her own perceptions and experiences and is preoccupied with her own knowledge process means that she writes herself into an autoethnographic context. She also experiments with the writing and allows it to take on a more literary form as she writes about her own sensory impressions and feelings. The term rhythmanalysis is employed as a way of assessing, exploring, interpreting and understanding the world that embraces the embodied experience. Human beings are embodied beings, a claim we can make by referring to our own experiences as well as how we perceive, communicate and interact. The study delves into two aspects of rhythmanalysis, first as a way of describing the knowledge process as rhythm-analytical, which implies that bodily experiences are equally important as intellectual ones, and secondly as a way of talking about the city as polyrhythmic. It follows upon the latter that embodied rhythmanalysis of the city is possible. The rhythmanalysis may ultimately be seen as a project aimed at overthrowing the Cartesian dualism between body and mind. That we are embodied has a methodological consequence that is as simple as it is essential: the scholar exists in the world she studies. The researcher is not a neutral observer. She is a co-creator. She is a body, placed in time, space and history. She is situated, which means that her knowledge is also situated. Thus, the rhythmanalysis encompasses the body, the senses and feelings, and can be described with one key word: movement. It finds support in theories that acknowledge the fluid, the becoming, the situated, the performative, the relational, the dynamic, the material. It seeks methods that experiment, that focus on practices rather than discourses, that are preoccupied with a movable world rather than a static one.