Patient participation : what it is and what it is not

In general, patient participation is regarded as being informed and partaking in decision making regarding one’s care and treatment. This interpretation is common in legislation throughout the Western world and corresponding documents guiding health care professionals, as well as in scientific studies. Even though this understanding of the word participation can be traced to a growing emphasis on individuals’ autonomy in society and to certain dictionary defi nitions, there are other ways of understanding participation from a semantic point of view, and no trace of patients’ descriptions of what it is to participate can be found in these definitions. Hence, the aim of this dissertation was to understand patients’ experience of the phenomenon of patient participation. An additional aim was to understand patients’ experience of non-participation and to describe the conditions for patient participation and non-participation, in order to understand the prerequisites for patient participation. The dissertation comprises four papers. The philosophical ideas of Ricoeur provided a basis for the studies: how communication can present ways to understand and explain experiences of phenomena through phenomenological hermeneutics. The first and second studies involved a group of patients living with chronic heart failure. For the fi rst study, 10 patients were interviewed, with a narrative approach, about their experience of participation and non-participation, as defi ned by the participants. For the second study, 11 visits by three patients at a nurse-led outpatient clinic were observed, and consecutive interviews were performed with the patients and the nurses, investigating what they experience as patient participation and non-participation. A triangulation of data was performed to analyse the occurrence of the phenomena in the observed visits. For paper 3 and 4, a questionnaire was developed and distributed among a diverse group of people who had recent experience of being patients. The questionnaire comprised respondent’s description of what patient participation is, using items based on findings in Study 1, along with open-ended questions for additional aspects and general issues regarding situations in which the respondent had experienced patient participation and/or non-participation. The findings show additional aspects to patient participation: patient participation is being provided with information and knowledge in order for one to comprehend one’s body, disease, and treatment and to be able to take self-care actions based on the context and one’s values. Participation was also found to include providing the information and knowledge one has about the experience of illness and symptoms and of one’s situation. Participation occurs when being listened to and being recognised as an individual and a partner in the health care team. Non-participation, on the other hand, occurs when one is regarded as a symptom, a problem to be solved. To avoid non-participation, the information provided needs to be based on the individual’s need and with recognition of the patient’s knowledge and context. In conclusion, patient participation needs to be reconsidered in health care regulations and in clinical settings: patients’ defi nitions of participation, found to be close to the dictionaries’ description of sharing, should be recognised and opportunities provided for sharing knowledge and experience in two-way-communication.

Capability outcomes from educational and ICT capability inputs : an analysis of ICT use in informal education in Kenya

In the field of Information and Communication Technologies for Development (ICT4D) ICT use in education is well studied. Education is often seen as a pre-requisite for development and ICTs are believed to aid in education, e.g. to make it more accessible and to increase its quality. In this paper we study the access and use of ICT in a study circle (SC) education program in the south coast of Kenya. The study is qualitative reporting results based on interviews and observations with SC participants, government officers and SC coordinators and teachers. The study builds on the capability approach perspective of development where individuals’ opportunities and ability to live a life that they value are focused. The aim of the study is to investigate the capability outcomes enabled through the capability inputs access and use of ICT in education as well as the factors that enabled and/or restricted the outcomes. Findings show that many opportunities have been enabled such as an increase in the ability to generate an income, learning benefits, community development and basic human development (e.g. literacy and self-confidence). However, conversion factors such as a poorly developed infrastructure and poor IT literacy prevent many of the individuals from taking full advantage of the ICT and the opportunities it enables. 

Samarbete i agila systemutvecklingsprojekt : Vilka mänskliga faktorer påverkar samarbetets effektivitet?

Mänskliga faktorer som till exempel kommunikation och tillit påverkar hur människor interagerar med varandra. I agil systemutveckling ingår relationer, samspel och samarbete mellan människor och dessa påverkar om systemutvecklingsprojektet anses framgångsrikt eller ej. Men ofta i systemutvecklingsprojekt så läggs det mer tid på själva tekniken än de sociala aspekterna, där de mänskliga faktorerna i många fall är en avgörande faktor för projektets slutresultat. Syftet med det nuvarande arbetet är att beskriva vilka mänskliga faktorer som är viktiga för att effektivisera samarbete i agila systemutvecklingsprojekt, samt att beskriva hur agil systemutveckling på Trafikverket utförs. Trafikverket ville ha studien genomförd för att resultatet av studien skulle hjälpa till att minska antalet mindre framgångsrika systemutvecklingsprojekt på Trafikverket. Huvudfrågan i arbetet är: Vilka mänskliga faktorer är viktiga för att effektivisera samarbetet mellan verksamhetskunniga och utvecklare i agila systemutvecklingsprojekt? En fallstudie utfördes vid Trafikverket genom sju semistrukturerade intervjuer som följdes upp av enkäter och dokumentstudier. Det sammanlagda resultatet tyder på att för att effektivisera samarbetet mellan verksamhetskunniga och utvecklare i agila systemutvecklingsprojekt på Trafikverket krävs fokus på följande fem mänskliga faktorer: kommunikation, tillit, ledarskap, kunskap och motivation.

Samarbete i agila systemutvecklingsprojekt : Vilka mänskliga faktorer påverkar samarbetets effektivitet?

Mänskliga faktorer som till exempel kommunikation och tillit påverkar hur människor interagerar med varandra. I agil systemutveckling ingår relationer, samspel och samarbete mellan människor och dessa påverkar om systemutvecklingsprojektet anses framgångsrikt eller ej. Men ofta i systemutvecklingsprojekt så läggs det mer tid på själva tekniken än de sociala aspekterna, där de mänskliga faktorerna i många fall är en avgörande faktor för projektets slutresultat. Syftet med det nuvarande arbetet är att beskriva vilka mänskliga faktorer som är viktiga för att effektivisera samarbete i agila systemutvecklingsprojekt, samt att beskriva hur agil systemutveckling på Trafikverket utförs. Trafikverket ville ha studien genomförd för att resultatet av studien skulle hjälpa till att minska antalet mindre framgångsrika systemutvecklingsprojekt på Trafikverket. Huvudfrågan i arbetet är: Vilka mänskliga faktorer är viktiga för att effektivisera samarbetet mellan verksamhetskunniga och utvecklare i agila systemutvecklingsprojekt? En fallstudie utfördes vid Trafikverket genom sju semistrukturerade intervjuer som följdes upp av enkäter och dokumentstudier. Det sammanlagda resultatet tyder på att för att effektivisera samarbetet mellan verksamhetskunniga och utvecklare i agila systemutvecklingsprojekt på Trafikverket krävs fokus på följande fem mänskliga faktorer: kommunikation, tillit, ledarskap, kunskap och motivation.

Samarbete i agila systemutvecklingsprojekt : Vilka mänskliga faktorer påverkar samarbetets effektivitet?

Mänskliga faktorer som till exempel kommunikation och tillit påverkar hur människor interagerar med varandra. I agil systemutveckling ingår relationer, samspel och samarbete mellan människor och dessa påverkar om systemutvecklingsprojektet anses framgångsrikt eller ej. Men ofta i systemutvecklingsprojekt så läggs det mer tid på själva tekniken än de sociala aspekterna, där de mänskliga faktorerna i många fall är en avgörande faktor för projektets slutresultat. Syftet med det nuvarande arbetet är att beskriva vilka mänskliga faktorer som är viktiga för att effektivisera samarbete i agila systemutvecklingsprojekt, samt att beskriva hur agil systemutveckling på Trafikverket utförs. Trafikverket ville ha studien genomförd för att resultatet av studien skulle hjälpa till att minska antalet mindre framgångsrika systemutvecklingsprojekt på Trafikverket. Huvudfrågan i arbetet är: Vilka mänskliga faktorer är viktiga för att effektivisera samarbetet mellan verksamhetskunniga och utvecklare i agila systemutvecklingsprojekt? En fallstudie utfördes vid Trafikverket genom sju semistrukturerade intervjuer som följdes upp av enkäter och dokumentstudier. Det sammanlagda resultatet tyder på att för att effektivisera samarbetet mellan verksamhetskunniga och utvecklare i agila systemutvecklingsprojekt på Trafikverket krävs fokus på följande fem mänskliga faktorer: kommunikation, tillit, ledarskap, kunskap och motivation.

En beskrivning av informationsmiljö därdatumstyrda förhållanden råder : En fallstudie av en myndighet och dess informationsmiljö med rättsakter

In this study a case study was conducted at the Transport Agency. The government agency is seeking better alternatives to its current ways of keeping track of important dates stated in legal documents. The agency wants to explore the possibility for an IT-solution for keeping track on those dates. In the case study change analysis was conducted on the vehicle type approval process. Qualitative interviews were conducted with a section manager, vehicle type and component approvers, and with a system administrator and a system manager at the Transport Agency in Borlänge. The study describes an information environment in an organization in which date-controlled conditions apply and challenges with such an environment.The study also provides a proposal for designing an IT-solution for such an environment. The result that emerged showed that the information environment in terms of the legal documents and the institutions’ (EU and UNECE) websites where they are distributed is challenging for keeping track on dates. The challenges of the websites are that they are limited and complicated in terms of information search. The challenges with the legal documents are that date-controlled conditions apply. In other words, the dates themselves determine which dates and what applies and not. The legal documents are also many, retroactive, refer to each other and contain regulations for different kinds of areas, which makes difficult to find the relevant dates. The design proposal that emerged was made based on the existing IT environment at the Transport Agency. It was proposed that important key concepts are identified, categorized and realized in a database with searchability on the most important common concepts as denominators, and that it the information conforms with E-message. The developed database was based on date, date type, vehicle category, legal document, minor version and other info. A web interface was created in ASP.NET and C # for access to the database, with the message that a webbbased IT-solution should be considered.

Using locally available components and local knowledge to build sustainable stand-alone power systems

The aim of this paper is to point out benefits as well as disadvantages associated with the use of locally available, not necessarily standardized, components in stand-alone electrical power systems at rural locations. Advantages and challenges arising when the direct involvement in design, construction and maintenance of the power system is reserved to people based in the area of implementation are discussed. The presented research is centered around one particular PV-diesel hybrid system in Tanzania; a case study in which technical and social aspects related to the particular power system are studied.

Learning in and through drama : The necessity to use multiple theoretical perspectives in order to understand how learning takes place in drama

The complexity of learning implies that learning seldom is about just one thing. It can be said that learning processes are interdisciplinary. Within educational contexts, learning is not limited to constructed school subjects. In drama education, learning is simultaneously about drama as aesthetic expression and content because drama always is about something. The mainly focus can be on form, content or social aspects. The different aspects are always present, but may be more or less foreground or the background depending on the purpose of education. How do development concerning understanding of form, content, and social interaction, interact in a learning process in drama? My research is based on the view that learning at the same time takes place as an individual, internal process and a socially situated, inter-subjective process. Can learning in drama imply learning that can be transferred between different situations, a transformative learning and if so, how? Transformative learning includes cognitive, affective and corporal and social action aspects and means that the individual's frames of reference are transformed, evolved, to become more insightful and flexible which implies a change of personality. It leads to an integrated knowledge that can be applied in different contexts.   In the paper that will be presented at the conference, theories about how we learn in drama will be discussed in relation to my empirical research concerning drama and learning.

A framework for ICT-based knowledge sharing in sustainable rural development : the case of Gilgit-Baltistan, Pakistan

Some 50% of the people in the world live in rural areas, often under harsh conditions and in poverty. The need for knowledge of how to improve living conditions is well documented. In response to this need, new knowledge of how to improve living conditions in rural areas and elsewhere is continuously being developed by researchers and practitioners around the world. People in rural areas, in particular, would certainly benefit from being able to share relevant knowledge with each other, as well as with stakeholders (e.g. researchers) and other organizations (e.g. NGOs). Central to knowledge management is the idea of knowledge sharing. This study is based on the assumption that knowledge management can support sustainable development in rural and remote regions. It aims to present a framework for knowledge management in sustainable rural development, and an inventory of existing frameworks for that. The study is interpretive, with interviews as the primary source for the inventory of stakeholders, knowledge categories and Information and Communications Technology (ICT) infrastructure. For the inventory of frameworks, a literature study was carried out. The result is a categorization of the stakeholders who act as producers and beneficiaries of explicit and indigenous development knowledge. Stakeholders are local government, local population, academia, NGOs, civil society and donor agencies. Furthermore, the study presents a categorization of the development knowledge produced by the stakeholders together with specifications for the existing ICT infrastructure. Rural development categories found are research, funding, agriculture, ICT, gender, institutional development, local infrastructure development, and marketing & enterprise. Finally, a compiled framework is presented, and it is based on ten existing frameworks for rural development that were found in the literature study, and the empirical findings of the Gilgit-Baltistan case. Our proposed framework is divided in four levels where level one consists of the identified stakeholders, level two consists of rural development categories, level three of the knowledge management system and level four of sustainable rural development based on the levels below. In the proposed framework we claim that the sustainability of rural development can be achieved through a knowledge society in which knowledge of the rural development process is shared among all relevant stakeholders.

Modeling and illustrating requirement prioritization in public e-service development from a value-based perspective

A major problem in e-service development is the prioritization of the requirements of different stakeholders. The main stakeholders are governments and their citizens, all of whom have different and sometimes conflicting requirements. In this paper, the prioritization problem is addressed by combining a value-based approach with an illustration technique. This paper examines the following research question: How can multiple stakeholder requirements be illustrated from a value-based perspective in order to be prioritizable? We used an e-service development case taken from a Swedish municipality to elaborate on our approach. Our contributions are: 1) a model of the relevant domains for requirement prioritization for government, citizens, technology, finances and laws and regulations; and 2) a requirement fulfillment analysis tool (RFA) that consists of a requirement-goal-value matrix (RGV), and a calculation and illustration module (CIM). The model reduces cognitive load, helps developers to focus on value fulfillment in e-service development and supports them in the formulation of requirements. It also offers an input to public policy makers, should they aim to target values in the design of e-services.

Systemutveckling för riskbaserad tillsyn : Hur verksamhetsanalys på praktikteoretisk grund kan användas för kravfångst

Denna studie har utförts vid en myndighet som bedriver statlig tillsyn över det svenska järnvägssystemet. När myndigheten beslutade att deras tillsyn skulle vara riskbaserad uppstod behov att se över och eventuellt förändra myndighetens verksamhetsprocesser utifrån ett riskbaserat synsätt. Arbetet med denna licentiatavhandling, som har skett i form av praktikforskning, har sin grund i två förändringsprojekt som var starkt påverkade av den bärande idén om riskbaserad tillsyn. Av denna anledning fanns ett behov att karaktärisera riskbaserad tillsyn. Detta skedde med hjälp av verksamhetsanalys på praktikteoretisk grund vars resultat formulerades i en verksamhetsteori för riskbaserad tillsyn. På ett övergripande plan handlar riskbaserad tillsyn om att integrera riskhantering i myndighetens tillsynsprocesser. Denna licentiatavhandling är skriven inom ämnet informationssystemsutveckling och det problem som undersöks är hur man kan fånga kraven på ett verksamhetsstödjande informationssystem med hjälp av en verksamhetsanalys på praktikteoretisk grund. Tesen för arbetet är att de krav som identifieras i en verksamhetsanalys på praktikteoretisk grund bör kunna användas i det fortsatta kravarbetet. Därför är spårbarhet mellan verksamhetsanalysens dokumentation och den fortsatta kravhanteringen i ett systemutvecklingsprojekt en viktig egenskap. Spårbarheten undersöks genom att två av myndighetens utvecklingsprojekt som var inriktade på att utveckla både verksamheten och nya informationssystem analyseras. Att uppnå spårbarhet är en del av tillvägagångssättet när informationssystem utvecklas. I denna licentiatavhandling beskrivs tillvägagångssättet utifrån tre metodegenskaper: arbetssätt (vilka frågor som ställs), notation (hur kraven dokumenteras) och arbetsformer (vilka tekniker för datainsamling som används). Det är alltså inte bara spårbarhet (som ingår i metodegenskapen notation) som är intressant att studera närmare utan hela tillvägagångssättet i verksamhetsanalysen. Studien har bedrivits i form av praktikforskning och det innebär att tre bidrag har producerats: 1) ett bidrag till den lokala praktiken, dvs. till myndigheten; 2) ett bidrag till den generella praktiken, dvs. till andra verksamheter som bedriver statlig tillsyn men även praktiker som arbetar med verksamhets- respektive systemutveckling inkluderas i den generella praktiken; samt 3) ett bidrag till akademin. Bidraget till den lokala praktiken är genomförandet av utvecklingsprojekten och deras resultat. Bidraget till den generella praktiken inom verksamhetsutveckling är verksamhetsanalysen som resulterar i en verksamhetsteori för riskbaserad tillsyn. Bidraget till praktiker inom systemutveckling är kravanalysen som visar hur en verksamhetsanalys på praktikteoretisk grund kan användas för att fånga krav på ett verksamhetsstödjande informationssystem. Kravanalysen öppnar även för möjligheter att söka efter krav på ett informationssystem utan att verksamhetsanalysen fokuserar informationssystemet. Bidraget till akademin består också av kravanalysen som med hjälp av fyra kravkategorier härleder spårbarhet mellan verksamhetsteorin för riskbaserad tillsyn och kravdokumentation från de studerade projekten. Det andra bidraget till akademin är ett önskvärt tillvägagångssätt för att genomföra en praktikteoretisk verksamhetsanalys för riskbaserad tillsyn.

Pedagogical Methods in Web-Based Language Teaching

This paper presents a research project that is being conducted at Dalarna University in Sweden. The aim is to study the following: 1) The quality of online language education compared with that of campus education, and 2) Advantages and disadvantages of online language education and how the disadvantages might be overcome. The project consists of two parts: pedagogical methods in online language education from the teachers’ point of view and from the students’ point of view. The first part was conducted in 2012 and various characteristics (benefits and difficulties) of online language education were identified. Flexibility and wider opportunities were general benefits, while lack of physical co-presence, difficulty in having lively debates/discussions, and high dropout rates were among the problems. The second part of the project (being conducted in 2014) aims to investigate how students experience online language learning. The goal is to explore alignments and misalignments between teachers’ perspectives and students’ perspectives, and to develop methods to enhance the quality of online education.

Where do e-Government strategies take the Nordic nations?

An effective strategy is critical for the successful development of e-Government. The leading nations in the e-Government rankings include Sweden, Norway, Denmark and Finland. Their leading role makes them interesting to study when looking for reasons to successful e-Government. The purpose of this research paper is to describe the e-Government development strategies of Nordic countries, which rank highly on the international stage. In particular it aims to study the foci of these strategies. The approach is a document study of the e-Government development strategies of Sweden, Denmark, Norway and Finland was carried out using a qualitative content analysis inductive method. The results show that the major focus of Nordic e-Government strategies is on public sector reforms. Other focus areas include economic reforms and, to a lesser extent, e-Democracy efforts. Sweden, Finland and Norway have set ambitious policy goals in order to achieve global leadership in e-Government development. In response to the question posed by this paper’s title, we can say that Nordic e-Government strategies, except for Norway, focus more on reforming public sector services than on economic reforms.  E-Democracy reforms are hardly focused on at all. Practical implications: Public sector policy makers can relate their policy foci to some of the more successful e-Government countries in the world. Research implications/originality is that this paper can apart from the findings also provide a means on how to identify the actual foci of a country’s e-Government policy.

Socratic flipped classroom : What types of questions and tasks promote learning?

Socratic questioning stresses the importance of questioning for learning. Flipped Classroom pedagogy generates a need for effective questions and tasks in order to promote active learning. This paper describes a project aimed at finding out how different kinds of questions and tasks support students’ learning in a flipped classroom context. In this study, during the flipped courses, both the questions and tasks were distributed together with video recordings. Answers and solutions were presented and discussed in seminars, with approximately 10 participating students in each seminar. Information Systems students from three flipped classroom courses at three different levels were interviewed in focus groups about their perceptions of how different kinds of questions and tasks supported their learning process. The selected courses were organized differently, with various kinds of questions and tasks. Course one included open questions that were answered and presented at the seminar. Students also solved a task and presented the solution to the group. Course two included open questions and a task. Answers and solutions were discussed at the seminars where students also reviewed each other’s answers and solutions. Course three included online single- and multiple choice questions with real-time feedback. Answers were discussed at the seminar, with the focus on any misconceptions. In this paper we categorized the questions in accordance with Wilson (2016) as factual, convergent, divergent, evaluative, or a combination of these. In all, we found that any comprehensible question that initiates a dialogue, preferably with a set of Socratic questions, is perceived as promoting learning. This is why seminars that allow such questions and discussion are effective. We found no differences between the different kinds of Socratic questions. They were seen to promote learning so long as they made students reflect and problematize the questions. To conclude, we found that questions and tasks promote learning when they are answered and solved in a process that is characterized by comprehensibility, variation, repetition and activity.