To Örebro University

Background: Pregnant women are often faced with having to decide about prenatal screening for Down’s syndrome. However,the decision to participate in or refrain from prenatal screening can be seen as an important decision not only for the pregnant woman but also for both the partners.

Objective: The aim of this study was to explore the couples’ processes of decision making about prenatal screening.

Methods: A total of 37 semi-structured interviews conducted at two time points were analysed using the interpretive description.

Setting: The study was carried out in Maternal health-care centres,Örebro County Council, Sweden.

Participants: Fifteen couples of different ages and with different experiences of pregnancy and childbirth were interviewed.

Results: Three different patterns of decision making were identified. For the couples in The open and communicative decision-making process’, the process was straightforward and rational, and the couples discussed the decision with each other. ‘The closed and personal decision-making process’ showed an immediate and non-communicative decision making where the couples decided each for themselves. The couples showing ‘The searching and communicative decision-making process’ followed an arduous road in deciding whether to participate or not in prenatal screening and how to cope with the result.

Conclusions: The decision-making process was for some couples a fairly straightforward decision, while for others it was a more complex process that required a great deal of consideration.

Change Strategies in Primary School  -  a leader perspective

This thesis focuses on change strategies in the Swedish primary school. The schoolleaders have a new situation and role as change agents since the school was brought under local go­vern­ment control with among others the reguirement to be responsible for the local process of development in school. Further studies have the main focus on schoolleaders´ work situation and role, however not on how schoolleaders handle change processes. There are many studies from other organizations that show how important it is that the staff take part in local change pro­cesses.  In the decentralized school it is of great interest to have an elucidation of different change strategies and how the schoolleaders´ way to act have effects on the participation of the staff.

Empirical data have been collected in case studies. This thesis is a separate part of a more com­prehensive research project in Swedish schools, called "The School in change". That project focuses on environmental work in the work organization and includes twelve schools.  Theese schools were chosen depending on their geografical situation and from the point that both the leader and the staff had a clear wish for active work with their working environment, by starting local development projects. Of these schools, I chose three that I wanted to study in another point of view.

The research purposes were to describe and understand how schoolleaders, in this case prin­cipals, at the primary school work with change strategies. To reach my aim, I chose to study the change strategies of the principals from an actor´s point of view. Semi-structured inter­views were conducted at three times and to complete the picture from the answers, I used the ob­ser­vation method. Some data from a staff investigation in the main project "The School in change" has been used in this study, with a view to making the results clear and better under­standing them.

The main results from this study are that I am able to identify two different change strategies,  re­lated to the schoolleaders´ way of working with local development in the school orga­ni­za­tion. One of the schoolleaders has a stationary strategy and two schoolleaders have mobile stra­­­tegies. They are different in the way that the stationary schoolleader and one of the mobile lea­ders show a clear own change strategy of their own,  while one schoolleader has an imitated stra­tegy. The results also show that  the leader with her own and stationary strategy, has a gro­wing part of participating staff in ordinary work organization as in local development work. Another result is that in the schools with the mobile leaders the participation decreases. It makes no difference if the leader has her own or an imitated strategy for change and deve­lop­ment of the school.

Different kinds of theory have been used to interpret the results. Two aspects have been found important to be able to understand how the leaders of the school act with change strategies. These aspects are the work with the local development and the role and situation of leadership in school.