The foundation for this thesis is an ongoing discussion about quality in Swedish elderly care: Which are the most important factors that contribute to elderly care in terms of satisfaction among older persons, and what are the primary reasons for their differences? Aims. The principal aim was to examine what determines satisfaction with elderly care in home care and nursing homes, using the perspective of older persons (Studies I and II). The secondary aim was to analyze why these determinants differ, using the perspective of care workers, managers, and observers (Studies III and IV). Methods. Study I analyzed aggregated statistical data from the level of municipalities and districts (N = 324) based on the Swedish elderly care quality reports “Open Comparisons”, while Study II analyzed individual data based on the original ratings in the annual, nationwide elderly surveys (N = 95,000). Study III describes field observations and interviews with care workers and managers in two municipalities, one with a high rating for user satisfaction and one with an average rating. Study IV describes investigations in these two municipalities concerning their organizing principles and departmental‑level management climate. Results. The results relating to the principal aim showed that process factors (such as respect, information, and influence) are related considerably more closely than structural factors (such as budget, staffing levels, and training levels) to satisfaction with care. Other process factors (such as treatment, safeness, staff and time availability) were also able to alleviate person factors (such as health, anxiety, and loneliness). Moreover, the results relating to the secondary aim showed that differences in user-oriented elderly care are mainly due to interpersonal factors between the caregiver and the older person. Care workers, however, reported that other factors (such as organizing principles and leadership support) influence the quality of the care process. Overall, older persons who receive home care generally report higher satisfaction with care than those in nursing homes, and feeling less safe. It may be that differences in the process of aging explain this. Value. This thesis shows that satisfaction with elderly care can be largely explained by psychological quality at the individual level. The sizes of structural resources and organizing principles at the municipal level have minimal effect (< 5%). The thesis also presents a theoretical multiple-level Quality Agents Model to explain the sources of differences in satisfaction with care, and it presents recommendations for elderly care practices. A renewed focus on the psychology of satisfaction may contribute to the development of quality in elderly care.

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Intrinsically motivated behaviors have been defined as behaviors that do not come with any primary external rewards. Previous studies on intrinsic motivation has often depended on self-report measures, or only tested how subjects’ motivation is impacted by punishments or no gain differences. The present study aims to test these two conditions, with the addition of a third, where selecting an information gain option results in reward. This will be tested empirically using an existing information theoretic operationalization, where subjects will choose between information gain or no information gain. Results of the study show that information gain has some degree of attraction when subjects expect no gain differences, and when comparing punishment and reward conditions. / Curiosity and the reward of learning

Hyperacusis is a condition in which sufferers experience everyday sounds in their surroundings as unmanageable and disturbing. The condition is often associated with symptoms such fatigue, headaches, sleep disturbances and difficulties concentrating. Present study aimed to investigate how people are affected when exposed to noise over time. This was operationalized by collecting data from essentially three domains; subjective, physiological and cognitive. Since hyperacusis is largely defined by the individuals’ subjective experience, participants were divided into three groups based on their own subjective reports of discomfort during an exposure to white noise (60db). Cognitive performance was assessed using two well established measurements in the beginning and the end of the exposure session. Contrary to expectations, the groups did not differ significantly in cognitive performance. Heart rate variability was measured during the exposure session and was hypothesized to be lower in participants experiencing higher discomfort. As expected, the groups differed in their expressed variability in the direction of the hypothesis.

Inledning: I Sverige har en debatt om egenterapin som obligatoriskt moment i psykoterapeututbildningen växt fram, där delade meningar finns kring egenterapins betydelse för den professionella utvecklingen. Trots att det undersökts i en mängd studier visar översiktsstudier genomgående en otydlighet i definitionen kring såväl terapi som yrkeserfarenhet och dess betydelse för den professionella utvecklingen. Syftet med studien är därför att undersöka psykodynamiskt orienterade psykoterapeuters uppfattning av egenterapins betydelse för professionsutvecklingen, utifrån en tydlig definition och avgränsning av såväl egenterapi som yrkeserfarenhet. Frågeställning: Hur uppfattar psykodynamiskt inriktade psykoterapeuter att egenterapin påverkar deras professionsutveckling? Metod: En kvalitativ metod med hermeneutisk grund har använts. Genom fem semistrukturerade intervjuer insamlades material som sedan analyserats med induktiv, tematisk analys. Resultat: Egenterapin uppfattas viktig för professionsutvecklingen av de psykoterapeuter som deltagit i studien. Resultatet visar att respondenternas uppfattning är att egenterapin är viktig för kvaliteten på det professionella arbetet. Respondenterna beskriver att det omedvetna som teoretiskt perspektiv är en viktig aspekt av egenterapins betydelse för professionsutvecklingen. Samtliga respondenter uppger att, även om motivationen för egenterapi kan se olika ut, uppfattas den som nödvändig för deras professionella utveckling. Diskussion: De tydliga resultaten i denna studie diskuteras mot tidigare forsknings varierande resultat. Undersökningen stödjer argumenten för noggrann differentiering vid utforskning av området.

Research within positive psychology has shown that spending money on other people (prosocial spending) makes you happier than spending it on yourself (proself spending). The present study tested and extended this idea. Also, how an active or a passive choice in spending affect happiness has been tested. Lastly, this study is the first one to test the effect of nudging on happiness by examining the role of choice, defaults in spending. Three measures of subjective well-being (SWB) was used before and after the manipulation. The web experiment consisted of 788 people recruited from a web-based research company that were randomized to five conditions. Participants played a game and won money, of which some could be donated to a charity organization - representing prosocial spending. The results show that prosocial spending makes people happier than proself spending and that active choices elicit significantly more negative affects than passive choices. A default effect was also found, in so that more people chose proself spending when this was the default. Lastly, the greatest effect on happiness is to change from a default, compared to following a default or doing an active choice without a default. The results are in line with findings in positive psychology as well as theories suggesting that people feel less satisfied and happy when making decisions.

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Inledning: Att undersöka hur psykoterapeuterarbetar kliniskt med patienter som har svårigheter med mentalisering kan ge en tydligare uppfattning om vad som är hjälpsamt i skapandet av behandlingsallians. Psykoterapiforskning har visat att olika typer av interventioner kan vara verksamma i fråga om att skapa behandlingsallians. I denna studie undersöks vilka interventionstyperfem psykoterapeuter beskriver sig använda i försök att skapa behandlingsallians med patienter som har svårigheter med mentalisering. Frågeställningar: Vilka interventionstyperuppleverpsykodynamiskt orienterade psykoterapeuter är till hjälp för att skapa behandlingsallians med patienter som har svårt att mentalisera? Metod: I undersökningen tillämpades en kvalitativ, deskriptiv metod där data samlades in med hjälp av ljudinspelade, semistrukturerade intervjuer. Bearbetningsmetoden som används är tematisk analys. Resultat: Studien visar terapeuters olika syn på vad som är till hjälp när det handlar omatt skapa behandlingsallians hos personer som har svårt att mentalisera. Trots skillnader i teoretiska förhållningssätt trädde fyra gemensamma teman fram. De fyra centrala temanasom trädde fram i bearbetningen av intervjuerna var affekter, transparens, samarbete samt överföring. Diskussion: De beskrivna interventionstypernaochhur interventioner regleras efter reflektionsförmågadiskuteras. Vilka interventiontypersom upplevsverksamma jämförs med aktuell teoribildningi ämnet. Det framkommer olika teoretiska referensramar angående hur interventionstyperna skapas. Trotsolikateoretiska referensergår det att utkristalliseragemensamma interventionstyper.

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