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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.

Denna uppsats handlar om öppna förskolan, en verksamhet för barn och föräldrar som vissa kommuner väljer att tillhandahålla. Trots att verksamheten funnits drygt 30 år, är den sparsamt utforskad. Uppsatsarbetet har därför inriktats mot ett explorativt sökande efter olika föreställningar om öppna förskolan. Föreställningarna har på formuleringsarenan eftersökts i tryckta källor, och på realiseringsarenan genom en etnografiskt inspirerad fältstudie i två öppna förskolor. Syftet har varit att uppnå förståelse för arenornas föreställningar om öppna förskolan och hur dessa föreställningar förhåller sig till varandra. Uppsatsens teoretiska inramning utgörs av Bergers och Luckmanns teori om den sociala konstruktionen av verkligheten. Det har medfört att uppsatsen även innehåller en skildring av författarens kunskapskonstruerande. Sökandet efter föreställningar resulterade i ett möte mellan olika vardagskunskaper: Den för givet tagna kunskap som omger öppna förskolan på formuleringsarenan sätter ramar för realiseringsarenans verksamhet. Formuleringsarenans kunskap är inriktad mot bristande föräldraskap och omfattar inte behoven hos ett kompetent och resursstarkt föräldraskap. Fältstudien på realiseringsarenan visade att även de kompetenta och resursstarka föräldrarna hör till öppna förskolans besökare. Genom studien har några behov framkommit som denna föräldragrupp uttrycker. Att se bortom den traderade kunskapen om öppna förskolan är en viktig utgångspunkt för vidare utforskning, utveckling och värdering av verksamheten. Nyckelord Öppen förskola, föräldraskap, kunskapssociologi, etnografi, föreställningar, vardagskunskap. This essay is about the open preschool, an activity for children and parents that certain municipalities choose to supply. Despite that the activity has existed more than 30 years, it has been the object of only few studies. Therefore the essay is focused on an explorative search for different conceptions of the open preschool. On the arena of formulation the conceptions of the open preschool were sought after in printed sources. On the arena of implementation the conceptions were sought after through an ethnographically inspired field study in two open preschools. The aim of the essay has been to attain understanding of the various conceptions of the open preschool on the different arenas and to understand how these conceptions relate to each other. The theoretical framing of the essay is the theory of Berger and Luckmann on the social construction of reality. Therefore the essay also contains an account of the author's own construction of knowledge. The search for conceptions resulted in a meeting between different knowledges about everyday life. A presupposed knowledge about the open preschool on the arena of formulation sets the frame for the activities on the arena of implementation. The knowledge about the open preschool on the arena of formulation is focused on the insufficient parenthood and excludes the needs of the competent and strong on parenthood. The field study on the arena of implementation showed that competent and resourceful parents also visit the open preschool. This study has shown some of the needs of this parental group. To see beyond the traditional and presupposed knowledge about the open preschool is an important starting point for further exploration, development and estimation of the activity. Key words: Open preschool, parenthood, sociology of knowledge, ethnography, conceptions, knowledge in everyday life.