Att göra abstrakta begrepp och komplexa situationer konkreta en avhandling om deltagarbaserad aktionsforskning i svensk vård och omsorg

Sammanfattning: This dissertation covers the subject of how abstract concepts and complex situations can be concretized through research together with practitioners. The dissertation is based on four empirical studies. The researcher role, the practitioner participation and the methods for data collection and analysis have varied. In study I the concept ‘Närsjukvård’ was explored to understand how practitioners, managers and politicians in hospitals, primary health care and municipalities interpreted the concept. The researcher acted as consultant who collected data by interviews and questionnaires. Practitioners’ participation was limited. ‘Närsjukvård’ was interpreted as accessibility to hospital beds, accessibility to primary health care, collaboration between care providers and continuity and developed home care. Study II aimed to explore how people experienced leg ulcer care. The researcher acted as a consultant who performed the interviews and  analysed the data. Although the informants experienced their encounters with the nurses as satisfying, the study illuminated low participation in the care and low practitioner involvement in issues about daily living with the leg ulcer. The findings were brought back to the informants and the practitioners. The project did not proceed towards development and change. In study III the aim was to explore the Swedish concept ‘trygghet’ by using stories from daily life. Four older women were interviewed and the Story Dialogue method was used together with assistant nurses and registered nurses who participated in data collection and analysis. Two themes emerged: Sense of Security and factors strengthening the Sense of Security. Together with the assistant nurses, areas for improvements were identified. Study IV aimed to explore the discharge planning situation in order to     generate ideas for development. Members from a discharge planning network participated in the whole research process. Conditions for a successful coordinated discharge planning situation were a system including: the participation of the patient, the competence of the staff and the support from the organisation. The group arranged a workshop about communication and interdisciplinary   collaboration. The findings resulted in a form with self-evaluation questions. In conclusion, this thesis illustrates that it is possible to clarify abstract concepts and complex situations together with practitioners. To do this successfully, sense making activities and to start from practitioners’ experiences and their own context are key factors. The studies illuminate that building trust, relationship and sense of participation are essential in health and social care in general and specifically in the participatory action research process.