Publikationer från Umeå universitet
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Hilde Gunn Slottemo (red.), Barn som gikk ”fra haand til haand”: Oppvekst på skolehjem, barnehjem og internatskole i et historisk perspektiv
No full textInsights from Ecuador’s journey towards universal health coverage : Lessons from recent health system reform
No full textIntroduction: In 2007, the Ecuadorian government initiated comprehensive social and political reforms aimed at improving citizens’ well-being and reducing inequalities. The health system underwent structural changes designed to expand coverage and eliminate financial barriers. This qualitative study therefore examined how key health professionals perceived the facilitators and barriers to implementing the health system reform 2007-2017 to achieve universal health coverage (UHC) in Ecuador. Methods: Eleven stakeholders directly involved in the reform process were interviewed. Data were analyzed using inductive and latent thematic analysis to identify key themes. Results: Four interrelated themes shaping the implementation of Ecuador’s health system reform were identified: (i) strong political commitment, facilitated the expansion of free services and infrastructure, but was undermined by political interference and financing challenges; (ii) the introduction of a renewed healthcare model rooted in primary care and intercultural principles enhanced access but impeded from inadequate training, weak territorial planning, and limited community engagement; (iii) efforts to reduce system fragmentation through mechanisms like the Comprehensive Public Health Network (CPHN), which improved referral pathways but failed to fully integrate services across public and private subsystems; and (iv) leadership reforms within the Ministry of Public Health sought to strengthen governance; but were hindered by centralised decision-making, high leadership turnover, and weak intersectoral coordination. These findings highlight a dynamic and complex reform process marked by ambitious goals and persistent structural limitations. Conclusion: Ecuador’s 2007–2017 health reform expanded universal coverage by removing fees, strengthening primary care, and promoting intercultural health. Yet, weak referrals, inconsistent implementation, and poor planning limited impact. Political will advanced reforms but created resource imbalances. CPHN reduced some fragmentation but segmentation and weak public–private integration persisted. Leadership changes improved governance foundations, though high turnover and poor collaboration undermined progress. Future reforms require stable governance, clear local roles, stronger community engagement, and greater system integration
Att stärka vården genom design : att bygga tillit i samskapande och designforskning med fokus på kroniskt obstruktiv lungsjukdom (KOL)
No full textAnchored in the context of co-creation in hospital care for patients with advanced chronic obstructive pulmonary disease (COPD), this thesis investigates how co-creation and design research can meaningfully contribute to addressing complex challenges within healthcare. The central research question guiding this inquiry was: How can co-creation be employed in the design of health interventions for people with severe COPD who have experienced hospitalisation due to exacerbations? To address this question, this thesis took a phased approach: a scoping review of existing co-creation practices was conducted (Paper I), informing the planning of co-creation workshops that were aimed at improving hospital care for people with severe COPD. Qualitative content analysis was applied to analyse the transcripts of the parts of the workshops relevant to exploring the experiences and expectations of patients (Paper II). The Research through Design (RtD) approach, also known as practice-based research, which incorporates methods and processes from design practice, was adopted for four Design Experiments that focused on developing different types of intervention for improving COPD hospital care (Papers III–VI). Four Design Experiments focused on reflecting co-creation workshops as case studies. The co-creation workshops drew on two complementary design theoretical frameworks: transition design, which offers a systems-level, future-oriented perspective for developing sustainable strategies, and Discursive Design, which provokes reflection on and dialogue around complex healthcare issues through artefacts, narratives, and speculative scenarios. The practical contributions of this thesis are sixfold. First, the scoping review (Paper I) identified key limitations in current co-creation practices for non-pharmacological COPD interventions: lack of theoretical grounding, over-reliance on consultative methods, and minimal focus on implementation. The thesis recommends theory-based systematic planning, embedding implementation considerations throughout, using more creative participatory methods, and including patients with varying severities and comorbidities in co-creation research. Second, the qualitative content analysis (Paper II) revealed that COPD hospital care experiences are shaped by diverse individual needs, underscoring the importance of person-centred care. Key intervention areas include proactive help-seeking, enhanced patient education, specialised practitioner training, continuity of care, improved discharge services, and public awareness. Third, Paper III reflected on applying a transition design-based model for addressing complex healthcare challenges, using COPD hospital care as a case study. It demonstrated how co-creation, combined with appreciative intelligence, builds systems thinking and shared understanding, while decentralising designer roles in order to empower co-creators. The study highlights the model’s potential to enhance implementation and sustainment of system-level interventions, while recognising the need for clear method selection and rigorous evaluation in future research. Fourth, Paper IV introduced the Ecology of Design Briefs as a novel approach to facilitate inclusive communication of co-creation findings and foster interdisciplinary solutions to complex health-system challenges. This approach was applied in COPD care as a case study. By improving problem communication and aligning with realistic design practices, this approach enhances public engagement and the potential impact of health innovation, while also appealing to funding bodies interested in multidisciplinary approaches. Fifth, Paper V recommended careful planning of discursive materials in healthcare co-creation, and the strategic use of co-creation within Discursive Design to tackle complex challenges. Discursive materials link process stages and create shared language among stakeholders, fostering ownership, deeper problem exploration, and patient empowerment. The design ethnographic characteristics within co-creation grounds interventions in stakeholders’ lived experiences and local contexts, promoting participatory, context-sensitive solutions that better fit real-world healthcare and support sustainable change. Sixth, Paper VI detailed the co-creation of patient-education tools for severe COPD, highlighting the involvement of patients, families, and healthcare practitioners. Suggested key success factors in future similar co-creation processes include managing creativity among co-creators, ensuring equity, recognising the roles of family and management, and adopting an ecological perspective. Ultimately, this work makes a hopeful contribution to the evolving field of co-creation as a research method in COPD care. It aspires to support inclusive, interdisciplinary dialogue and action among designers, clinicians, and researchers
The Journalist as a Brand : A Study of Journalistic Content Creation and Parasocial Relationship-Building on TikTok
No full textIn the evolving digital journalism landscape, newer social media apps like TikTok have become platforms for journalists to build their personal brands and connect with their audiences. This bachelor’s thesis, “The Journalist as a Brand: A Study of Journalistic Content Creation and Parasocial Relationship-Building on TikTok”, investigates how three Swedish journalists, Fädek Jabar, Lisah Silfwer, and Lina Dawood, use the social media platform TikTok to construct and share their identities as both professionals and individuals. By conducting a qualitative content analysis combined with multimodal analysis of the journalists’ personal TikTok accounts, the study examines how these journalists use humor, "behind-the-scenes" content, and vlog-content to build their personal brand and create parasocial relationships with viewers. The study also looks at what consequences journalists face due to online exposure. The analysis reveals that the journalists blur the lines between their personal and professional roles, using TikTok affordances and strategies to appear relatable and authentic. Results also show that they use tools like speaking directly to the audience, asking rhetorical questions, and posting relatable content to create parasocial relationships. While this stimulates user engagement and builds a brand of authenticity, it also exposes them to inappropriate comments highlighting the risks of social media use as a public figure. This study contributes to the growing topic of research on social media's impact on journalism by offering insight into how journalists adapt to platform affordances to work on personal branding and increase visibility
Återgången till det obrutna självet : En kvalitativ studie av transformativa psykedeliska upplevelser
No full textSeeking healing and transformation, numerous people in the west turn to psychedelic retreats, and psychedelic therapy has been revived. This study aimed to shed light on the often-overlooked qualitative perspective on the transformative potential of psychedelic experiences: psychodynamic, archetypal, and in particular, mystical ones. Lifeworld interviews were therefore conducted with six international participants, and analyzed with an integrated hermeneutic and psychodynamic approach. Based on the experiential accounts, the analysis found that psychedelic experiences can be understood to facilitate a transformation of the self through processes of deconstruction and reconstruction. These processes involved not only the “undoing” of the self through ego dissolution, but also the emergence and integration of unconscious contents. Thereby, the revelatory experience of seeing the self in a new light through the primary process was illuminated, alongside the psyche’s striving for unity and harmony via the synthetic ego functions. These mechanisms also proved to be crucial in understanding the heightened efficacy of mystical experiences. By exploring the meanings individuals ascribe to their psychedelic experiences, this study provides insights that may enrich the understanding of intrapsychic processes that can contribute to lasting psychological transformation.I sökandet efter läkning och transformation vänder sig många i väst till psykedeliska retreater, och intresset för psykedelisk terapi har väckts på nytt. Denna studie syftade till att belysa det ofta förbisedda kvalitativa perspektivet på den transformativa potentialen hos psykedeliska upplevelser: psykodynamiska, arketypiska och i synnerhet mystika upplevelser. Livsvärldsintervjuer genomfördes därför med sex internationella deltagare, och analyserades med en integrerad hermeneutisk och psykodynamisk ansats. Baserat på de personliga berättelserna visade analysen att psykedeliska upplevelser kan förstås som en transformation av självet genom dekonstruktiva och rekonstruktiva processer. Dessa processer avspeglar inte bara “upphävandet” av självet genom egoupplösning, utan också upptäckandet och integreringen av omedvetet innehåll. Därmed belystes den insiktsbringande upplevelsen av att se sig själv i ett nytt ljus via primärprocessen, såväl som psykets strävan efter enhet och harmoni via de syntetiska egofunktionerna. Dessa mekanismer visade sig också vara avgörande för att förstå mystika upplevelsers förstärkta verkan. Genom att utforska den mening individer tillskriver sina psykedeliska upplevelser bidrar denna studie med insikter som kan berika förståelsen av intrapsykiska processer som kan bidra till varaktig psykologisk transformation
Determinants of Financial Planning for Retirement : An Integrated Analysis of Sri Lankan Employees
No full textThis study investigates financial planning for retirement (FPR) among Sri Lankan employees focusing on factors influencing their preparedness beyond financial literacy. As Sri Lanka faces rapid population aging, weak pension coverage and persistent economic instability, the issue of retirement security has become critical. Most existing research in this field has centered on developed economies leaving a significant gap in understanding how psychological, behavioral, cultural, social and structural factors shape retirement planning in developing contexts. This study aims to fill this gap by addressing two main questions: (1) What is the level of preparedness of Sri Lankan employees for retirement? and (2) How do factors other than financial literacy influence their financial planning behavior? A quantitative research design was adopted using a structured questionnaire administered to employees across public, private and self employed sectors. A total of 132 valid responses were analyzed using descriptive statistics, bivariate tests, correlation and multiple regression analysis. The conceptual framework was built upon the Theory of Planned Behavior, Behavioral Finance Theory, the Life Cycle Hypothesis and Human Capital Theory to explain how attitudes, behaviors and structural conditions influence retirement planning. The results revealed that overall financial planning for retirement among Sri Lankan employees is moderate with significant variations across demographic groups. Regression analysis indicated that psychological factors particularly goal clarity and behavioral factors such as savings behavior, financial behavior and awareness of financial products were the strongest predictors of retirement planning. Cultural norms showed a negative relationship implying that dependence on family support may discourage individual financial autonomy. Economic and structural variables such as income and employment sector also played a role though less prominently. Interestingly, self control had a negative association suggesting that excessive caution or delayed financial action could hinder preparedness. The study contributes theoretically by integrating psychological and behavioral dimensions with structural influences to explain FPR in developing contexts. Practically, it offers insights for policymakers and employers to design targeted financial education programs, pension reforms and behavioral interventions that promote proactive planning. Ultimately, the research underscores that improving retirement security in Sri Lanka requires a multidimensional approach, one that combines individual behavioral change with institutional and policy support
Impact of social media on the business performance of Sri Lankan women entrepreneurs in the small and medium-scale Readymade food industry
No full textThis paper examines the influence of social media on business performance of women entrepreneurial operators in the small and medium-scale ready-made food industry in Sri Lanka. The entrepreneurship activity of women in Sri Lanka is an economic requirement and a social bargaining and chances of growth are usually limited due to scarcity of resources and knowledge, lessening cultural demands and institutional obstacles. The new low-cost and available resource offered by social media has potential impact that can change the entrepreneurships practices of women, and the actual impact is not sufficiently researched in this respect. The study has been developed based on the Technology Acceptance Model (TAM), Social Capital Theory, the Resource-Based View (RBV), Empowerment Theory and Gender Role Theory using which a conceptual model can be created to focus on six aspects that are interrelated namely- technology acceptance, social capital, access to resources and capabilities, entrepreneurial empowerment, gender role navigation and business performance. A qualitative design was also used, and data were gathered by use of semistructured interviews of the women entrepreneurs in the ready prepared food industry. Thematic analysis was applied to find patterns occurring repeatedly, and to trace them to theoretical viewpoints in a manner that views Braun and Clarke concepts as six-phase approach. The results validate the fact that social media has become both a technological facilitator and a socio-cultural arena in which women enterprise empowerment and constraint. Facebook, Instagram, and WhatsApp were able to increase visibility and lower marketing expenditures, increase the networks, and enhance the efficiency of the operations. Concomitant to this, digital literacy, family support as well as gendered expectations mediated adoption. Theoretically, the study redefines the aspect of empowerment as an outcome and a driver, expands RBV to the resource-bounded setting, and reformulates the conceptual framework into a layered systemic model. The practical and sociological application points to the necessity to provide digital training, conducive environments, and positive policies to enhance the industry of women in the field of entrepreneurship in Sri Lanka. Keywords: Social media; Business performance; Women entrepreneurs; Small and medium scale enterprises; Readymade food industry
REMOTE WORKING AND EMPLOYEE PRODUCTIVITY : THE ROLE OF EMPLOYEE ENGAGEMENT
No full textRemote working has gained increasing recognition among business organizations in recenttimes. Employees have shown higher advocacy towards working remotely and this hascompelled many organizations to incorporate and implement remote working policies. It offersa free range of working locations which enables employees to enjoy a balance between theirpersonal life and work life which in turn leads to higher job satisfaction which consequentlyimpacts productivity. However, previous research findings reveal inconsistencies in therelationship between remote working and employee productivity. Moreover, only few of thesestudies considered the effect of employee productivity in this relationship which leaves a hugegap necessitating future research in this area.In light of this, the present study sought to investigate the relationship between remote workingand employee productivity, and the effect of employee engagement in this relationship. Thestudy employs a cross-sectional study in which structured questionnaires were distributedonline to 104 remote workers who were conveniently sampled in Sweden. Quantitative datawere analyzed using Partial Least Square Structural Equation Modelling (PLS-SEM) usingSmartPLS version 4.1.1 to test the five hypotheses that were formulated in the study.All constructs had their outer loadings achieving Cronbach’s alpha values greater than 0.7 andaverage variances greater than 0.5 thereby achieving discriminant validity and convergence.All constructs had variance inflation factors (VIF) less than 3.0 hence there were no collinearityissues in the data that were used for the analysis. Findings from the PLS-SEM analysis revealedthat there is no statistically significant direct effect of remote working on employeeproductivity, however remote working had a significant indirect effect on employeeproductivity, and this was totally mediated by employee engagement. Additionally, remoteworking had a significant positive effect on employee engagement which in turn had asignificant positive effect on employee productivity.The presence of employee engagement contributing in totality to the effect of remote workingon employee productivity means that for employees who are working from home to be moreproductive, they need to be highly engaged. Hence, there is a need for business organizationsimplementing remote working practices in their workplace to implement intelligent businesssoftware and tools giving priority to business collaboration and communication tools, ensuringautomatic check-ins that create community awareness, periodically monitoring employees,having in-depth knowledge about their personal well-being while working remotely, andbuilding a good relationship with them to enable them to feel being cared for.As business organizations strive to gain competitive advantage, they give priority toemployees’ productivity. Considering that the current study identifies employee engagementas a mediator, it provides valuable insights to top management of business organizationsrevealing that the implementation of remote working practices among them will not yieldemployee productivity unless they institute measures that will drive employees to becomehighly engaged in their work while working remotely
Construction employee’s experiences of being involved as a layperson first-aid provider in a serious workplace injury event : a qualitative study
No full textBackground: Workplace-related serious injury events are a recognized problem in Europe, with construction sites bearing a higher risk compared to other workplaces. Sweden reports approximately 1,000 serious injury per year. Layperson involvement in workplace injury events can be stressful and may impact their ability to respond effectively. There is a knowledge gap concerning how workers in this context perceived their role. Aim: To describe Swedish construction employees’ experiences of being involved as a layperson first aid provider in a serious workplace injury event. Method: A total of nine construction employees were interviewed. Their ages ranged from 22 to 66 years, and varying experience in the construction industry, from 5 to 41 years. Eight had completed a first aid course at their workplace within the last three years. None of the participants had a background in areas such as rescue services, police, healthcare, or military. None of the construction sites had trained EMTs or company medical personnel on site. The transcribed text from the interviews was analyzed using qualitative content analysis. Results: The study showed that construction employees experiences of being involved as a layperson first aid provider was linked to one main category: to try to reduce the consequences of limited knowledge through mutual understanding and support. There were three additional categories for reported experiences: suddenly trying to save lives after realizing the unexpected, the importance of collaboration in a chaotic situation, and the need for social support and following improvements with subcategories. Conclusion: The results showed that with injury events in a complex environment, such as construction sites, there is a need for mutual understanding between dispatcher, ambulance services, rescue service, and laypersons. A level of understanding from professional organizations is required to support the layperson to be a valuable resource to the emergency personnel in serious workplace injury events
Trusting the process in collaborative writing : reconceptualizing collaborative writing processes within a school (musical) context
No full textThis dissertation concerns collaborative writing processes within a school (musical) project. The dissertation is positioned within relational ontologies that strive to decenter the solely human and, instead, turn the focus toward what is produced in-between human and more-than-human participants in writing. In a writing context, the more-than-human can encompass different materialities, technologies, spaces, and affective participants. Relational ontologies are interested in examining processes rather than what is, and understanding the world as constantly in-becoming. Such a perspective shapes how the keywords in this dissertation—collaborative writing, writing processes, and scriptwriting—are conceptualized. However, how these concepts are to be approached empirically, theoretically, and methodologically with a relational ontological understanding has yet to be researched. Thus, the aim of this dissertation is to explore and extend understandings of collaborative writing processes in a school (musical) context by considering writing as relational. With the phrase “writing as relational,” I account for a writing that is produced relationally in-between humans and more-thanhumans. Hence, this dissertation explores two questions: I) What does considering writing as relational produce for collaborative writing, writing processes, scriptwriting, and their conceptualization? and II) What does considering collaborative scriptwriting as relational produce for writing pedagogies? This dissertation comprises three independent articles. Article 1 is a scoping review that charts the research field of collaborative writing within a first language (L1) school context. As the article does not explicitly focus on school musicals, the word “musical” is in parentheses in the title. The study points at research gaps regarding the use of relational ontologies in the research field, demonstrating that creative collaborative writing primarily takes place in lower grades, and that little research has studied the prewriting activities in collaborative writing processes, such as planning and brainstorming. This led to Article 2, which studied brainstorming in upper secondary students’ collaborative scriptwriting. The article points to the difficulty in determining when brainstorming, compared to other activities in the writing process (e.g., draft writing and editing), takes place. Further, the article suggests the notion of “idea-ing” as an alternative to brainstorming, which risks limiting the affective and embodied activity of exploring ideas to merely “a storm in the brain”. This study, in turn, gave rise to Article 3 in which the focus is steered toward how entanglements of human and more-than-human make a difference in collaborative scriptwriting. The study suggests that the differences encompass releases of tension and the creation of new ideas. Further, the study discusses the tension between the affective and embodied “idea-ing” in comparison to the struggle when the words are to be typed down for documentation. The struggles lie in the difficulties involved in keeping the core in the content of what has been discussed, as well as typing with the correct typographical elements. This dissertation suggests reconceptualizing collaborative writing as fluid. This is because adopting a fluid approach to collaborative writing moves beyond a polarized view, understanding collaborative writing as either a narrow set of activities or all kinds of writing as collaborative. Furthermore, a fluid approach embraces collaborative writing as both a specific type of collaboration in writing and all kinds of writing. This dissertation suggests reconceptualizing writing processes as rhizomatic, which entails embracing the messiness, nonlinearity, and emerging in-between relations among different participants instead of within the individual only. In addition, the dissertation emphasizes the need to consider the intertwined relationship between the process and product instead of viewing them as a dichotomy. Understanding the process↔product relationship in this way means that our understanding ofthe latter is also moving and becoming instead of being static. Taken together, this dissertation points to collaborative writing processes as moving and messy. Although this inevitably makes writing pedagogies complex, the dissertation stresses that value resides in trusting the process as active doing. Additionally, trusting the process entails having a bigger perspective regarding who, what, how, and when the collaborative writing processes take place. Even though it might be messy and moving, this dissertation advocate for actively choosing to trust the process