<p> </p><p>The purpose of this study was to investigate registered nurses experiences about giving support to relatives to patients within palliative home care. This study was descriptive with qualitative approach. The data collection was made in the form of semi structured qualitative interviews which took place in a Swedish city of medium size, in an area for palliative homecare. Six registrated nurses were interviewed which all gave informed consent. The study suffered no losses and permission from the director of the concerned department had been given prior to the start of this study. The interviews were transcribed and analyzed whereupon three themes followed by seven categories entered.</p><p>In the main results difficulties appeared, such as when the family of a patient was unwilling to realize the situation. However the results also showed opportunities, for example the importance of the support which the nurses constituted. Many informants witnessed about the individual needs that existed among the relatives.  Foremost emphasize was on the importance of relatives and how the contact with them took place. Finally the study shows a picture of the supporting aspects that exists, for example to be able to sense the relatives needs and se their unspoken demands.</p><p> </p> / <p> </p><p>Syftet med studien var att undersöka sjuksköterskors upplevelser av att ge stöd till anhöriga till patienter inom palliativ hemsjukvård. Studien var deskriptiv med kvalitativ ansats. Datainsamling skedde i form av semistrukturerade intervjuer utifrån ett intervjuschema, intervjuerna spelades in på band. Detta ägde rum i en medelstor svensk stad i en verksamhet för palliativ hemsjukvård. Sex legitimerade sjuksköterskor intervjuades, varav samtliga lämnade informerat samtycke. Studien erfor inget bortfall och tillstånd från berörd verksamhetschef hade erhållits innan studiens start. Intervjuerna transkriberades och analyserades vartefter tre teman med sju kategorier kom fram.</p><p>I huvudresultatet framkom svårigheter som när anhöriga har en ovilja att inse situationen. Även möjligheter, till exempel betydelsen av det stöd som sjuksköterskorna utgjorde för de anhöriga belystes.   Många informanter vittnade om individuella behov bland de anhöriga. Framförallt betonades vikten av anhöriga och hur kontakten med dem skede. Slutligen gavs en bild av vilka stödjande aspekter som fanns till exempel sjuksköterskornas förmåga att kunna känna av de anhöriga och se deras osagda behov.</p><p> </p>

The purpose of this study was to investigate registered nurses experiences about giving support to relatives to patients within palliative home care. This study was descriptive with qualitative approach. The data collection was made in the form of semi structured qualitative interviews which took place in a Swedish city of medium size, in an area for palliative homecare. Six registrated nurses were interviewed which all gave informed consent. The study suffered no losses and permission from the director of the concerned department had been given prior to the start of this study. The interviews were transcribed and analyzed whereupon three themes followed by seven categories entered. In the main results difficulties appeared, such as when the family of a patient was unwilling to realize the situation. However the results also showed opportunities, for example the importance of the support which the nurses constituted. Many informants witnessed about the individual needs that existed among the relatives.  Foremost emphasize was on the importance of relatives and how the contact with them took place. Finally the study shows a picture of the supporting aspects that exists, for example to be able to sense the relatives needs and se their unspoken demands. / Syftet med studien var att undersöka sjuksköterskors upplevelser av att ge stöd till anhöriga till patienter inom palliativ hemsjukvård. Studien var deskriptiv med kvalitativ ansats. Datainsamling skedde i form av semistrukturerade intervjuer utifrån ett intervjuschema, intervjuerna spelades in på band. Detta ägde rum i en medelstor svensk stad i en verksamhet för palliativ hemsjukvård. Sex legitimerade sjuksköterskor intervjuades, varav samtliga lämnade informerat samtycke. Studien erfor inget bortfall och tillstånd från berörd verksamhetschef hade erhållits innan studiens start. Intervjuerna transkriberades och analyserades vartefter tre teman med sju kategorier kom fram. I huvudresultatet framkom svårigheter som när anhöriga har en ovilja att inse situationen. Även möjligheter, till exempel betydelsen av det stöd som sjuksköterskorna utgjorde för de anhöriga belystes.   Många informanter vittnade om individuella behov bland de anhöriga. Framförallt betonades vikten av anhöriga och hur kontakten med dem skede. Slutligen gavs en bild av vilka stödjande aspekter som fanns till exempel sjuksköterskornas förmåga att kunna känna av de anhöriga och se deras osagda behov.

Gruppen äldre kommer att öka i antal och då smärta ökar med ålder kommer fler individer att ha ont. Fler äldre med smärta ställer större krav på hälso- och sjukvården. Studiers visar att sjuksköterskors bild och de äldres upplevelser av smärta inte alltid stämmer överens samt att det finns brister i smärtdokumentation. Syftet med studien var att belysa smärtdokumentation hos en grupp äldre i särskilt boende eller med hemsjukvård. Materialet analyserades med en kvantitativ beskrivande metod och en kvalitativ innehållsanalys. Urvalet bestod av individer med smärta 65 år och äldre. Resultatet visade att många äldre hade ont vid vila och aktivitet. De valde vila framför aktivitet som smärtlindrande åtgärd, trots att fanns nackdelar med vila. Resultatet visade även på brister i sjuksköterskors dokumentation av smärtan. Ett hinder för dokumentation var att en grupp äldre inte berättade om sin smärta vilket kunde bero på att de äldre bland annat inte ville vara till besvär eller att de ansåg att smärta var en del av att bli gammal. / An increasing elderly population coupled with an increasing likelihood of pain in oldage means more individuals will be in pain, thus making larger demands on the healthcare system. Studies show that nurses can’t describe the elder’s experience of pain andthere is insufficiency in pain documentation. The aim was to describe paindocumentation in a group of elderly people living in sheltered accommodations or withhome care services. The material was analysed with a quantitative descriptive method aswell as a qualitative content analysis. The inclusion criteria were elderly with pain,above the age of 65. The results showed that many elderly people had pain during restand activity. The elderly more often choose rest than mobility as an activity to reliefpain. The results also showed insufficiency in pain documentation. One obstacle forpain documentation was when the elderly did not tell the nurses about their pain. Therewere several reasons for this, for example that the elderly did not want to be a burden tothe nurses or that they simply accepting that pain were a part of being old.

Planerade organisationsförändringar är vanliga men fortfarande misslyckas många organisationer med att implementera förändringar på ett effektivt sätt. Då organisationsförändringar vanligen ökar osäkerheten bland medarbetare är det intressant att undersöka hur detta påverkar medarbetarnas upplevelser av sin arbetsmiljö. Studiens syfte är att undersöka kommunikationens roll i en turbulent organisationsförändring för att se vilka följder kommunikationen kan få på medarbetarnas upplevelse av sin arbetsmiljö. Fokus är på hur de upplever arbetskrav, kontroll över sitt arbete och socialt stöd. En sekundäranalys gjordes av Kommun X medarbetarenkät. Denna skickas årligen ut i november. Enkäter från året innan och året efter organisationsförändringen analyserades i statistikbehandlingsprogrammet SPSS. Analysen visade att organisationsförändringen inte påverkade medarbetarnas upplevelse av sin arbetsmiljö. Den visade också att socialt stöd upplevdes något högre än både krav och kontroll vilket tyder på att medarbetarna också haft stöd genom förändringens gång, detta kan vara en förklaring till resultaten. Ytterligare en förklaring till resultaten var kommunens fortsatta kommunikationsinsatser efter förändringen.

The purpose of our qualitative study is to investigate how the caretakers, in the elderly care, interpret and manage the issue of alcohol problems in elderly people. We have been performing semi-structured interviews on 9 people, on different levels in the elderly care. There were 3 elderly care managers, 1 nurse, 1 assistance administrator and 4 auxiliary nurses, who all, at some level, work with alcohol problems in elderly people. Those interviews were performed singularly, with one exception: we interviewed an elderly care manager and her 2 auxiliary nurses at the same time. To analyse our empirics, we have used the theories of Power and Ageism. Our study shows that the auxiliary nurses, who are the ones who must deal with these problems, have great difficulties to perform their work because they have no qualified knowledge about alcohol problems. In addition, they almost never get the proper information, they don’t have access to guidelines about handling people with alcohol problems and they don’t receive support from their superiors. They have to make the most difficult decisions for themselves without any resources or other guidance.

Bakgrund Tidigare studier av hemsjukvård för barn har visat att den föredras av föräldrar och är patientsäker samt kostnadseffektiv. Studier har gjorts om föräldrars delaktighet i barns vård på sjukhus men få i kontexten hemsjukvård. I Sverige har inte alla barn idag tillgång till hemsjukvård. Förbättringsarbetet att utöka tillgången till hemsjukvård för barn ägde rum vid en barn- och ungdomsklinik på ett länssjukhus i södra Sverige.   Syfte Syftet med förbättringsarbetet var att utöka möjligheterna till hemsjukvård för barn och att identifiera fler lämpliga patienter. Syftet med studien var att undersöka hur föräldrar upplever hemsjukvård för barn med fokus på delaktighet i barnets vård och beslut som rör den.   Metod Åtta intervjuer genomfördes med sammanlagt 10 föräldrar till barn som erhållit hemsjukvård under perioden mars 2013-februari 2014. Intervjuerna var semistrukturerade, och analyserades efter transkribering enligt kvalitativ innehållsanalys med en induktiv ansats.   Resultat Under perioden 1 november 2013 till 30 april identifierades sjutton barn som lämpliga för hemsjukvård. Elva av dem erhöll hemsjukvård, vilket var en ökning från föregående halvår då fyra barn erhöll hemsjukvård. Resultatet av studien sammanfattas i tre teman och nio underteman. Föräldrars upplevelse av hemsjukvård var att kommunikationen med vårdpersonalen är god, de har en känsla av medverkan i vård och beslut, och familjens bästa prioriteras.   Slutsatser Hemsjukvård upplevdes ovärderlig i egenskap av att främja ett så normalt liv som möjligt för familjen. Resultaten från studien stödjer ett personcentrerat arbetssätt präglat av jämbördig och prestigelös dialog. Mer forskning behövs dock kring hur barn upplever hemsjukvård och delaktighet i beslut om sin vård och vårdform. / Home care services for children ‒ parents experiences focusing on participation in care   Background Previous studies about hospital- and community-based home care for children shows that it is safe, cost efficient and preferable by parents. Studies have been done about parent´s participation in care at hospitals but not in the home care setting. In Sweden not all children have access to home care services. The quality improvement intervention, to increase access to home care services took place at a children´s clinic at a county hospital in southern Sweden.   Aim The purpose of the improvement effort was to enhance home care for children by the means of identifying children at the hospital who were suitable for offering the service. The purpose of the study was to investigate how parents experiences home care service for children in terms of participation in the child´s care and decision-making regarding it.   Methods Eight interviews were carried out with ten parents of children that had received home care during the period from March 2013 to February 2014. The interviews focused on experiences primarily regarding parents participation in the child´s care and decision-making, and were semi-structured. The content was transcribed verbatim and analyzed by using qualitative content analysis with an inductive approach.   Results During November 2013 to April 2014 seventeen children were identified as suitable for home care and eleven of them actually received home care service. This was an increase from the previous 6 month, when four children received the service. The three themes and nine subthemes that emerged, describing parent´s experiences, showed that they felt they had good communication with doctors and staff, they experienced involvement in care and decision-making, and that the best of the whole family was prioritized.   Conclusions Parents felt that home care was invaluable in terms of being able to live a normal life, for the family as a hole. The result supports a person-centered care approach and emphasizes the equal dialogue as a tool. Further studies are needed to enlighten children´s own experiences about home care, participation in their own treatment and decision-making regarding care form.

THE UTILISATION OF LIFE MAPS AS AN AID IN FOSTER CARE SERVICE DELIVERY. During the past few years there has been a significant increase in foster care service delivery, partially due to the HIV and AIDS pandemic. More children need to be placed in foster care, and family placements become an only option in many cases. Due to this shift in foster care placements permanency planning has become an important part of foster care services. Thus, this study has focused on the development of guidelines by using a concept model with the focus on life maps in order to facilitate and structure the foster care process. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2009.

THE UTILISATION OF LIFE MAPS AS AN AID IN FOSTER CARE SERVICE DELIVERY. During the past few years there has been a significant increase in foster care service delivery, partially due to the HIV and AIDS pandemic. More children need to be placed in foster care, and family placements become an only option in many cases. Due to this shift in foster care placements permanency planning has become an important part of foster care services. Thus, this study has focused on the development of guidelines by using a concept model with the focus on life maps in order to facilitate and structure the foster care process. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2009.

There has been minimal Australian research focussed on the management and leadership aspects of directors' work in centre-based child care to date. In Australia, practices in early education have been largely drawn from studies in other cultural contexts, particularly research undertaken in the United States. It is timely that Australian research should inform its social policy about quality child care programs. The focus of this research was on the nature and characteristics of effective management and leadership practices in centre-based child care. Research (Jorde Bloom, 1992b; Morgan, 2000; Poster & Neugebauer, 2000; Rodd, 1994) indicates that quality of child care programs is influenced mostly by the leadership that the centre director can provide to staff within the centre. The conceptual framework adopted in this study views leadership from a Social Systems framework. Central to a Social Systems framework is the notion that organisations do not exist in isolation rather, leadership and management in these settings are embedded in a broader social context. A Social Systems Model has received little attention in contemporary research on child care in Australia, and this study aims to build a framework for future studies in this area. The aim was to investigate leadership and management in child care in social, legislative and economic context. The findings seek to inform researchers, policy makers and practitioners. Eight directors were purposively selected from community-based and privately based centres in urban and rural areas, and from accredited centres in South East Queensland. The selection of varying locations allowed the researcher to gain a broader perspective of the directors' daily lives, as different contextual and environmental conditions were anticipated to influence management and leadership within the child care centres. Within this study, case studies of directors of child care centres were developed through interviews with the directors. The interview methodology focussed on exploratory semi-structured, open-ended questions in relation to management and leadership in centre-based child care. Directors were interviewed on two occasions within a three month period. In the current context of the delivery of child care services in a market driven climate, the language of business and organisational theory has entered the lexicon of the early childhood field (Press, 1999). The findings indicate that the director of a child care centre needs to have training and experience in business management and leadership to enhance their competencies for management of centres in today's competitive environment. Growth in child care franchises is significantly changing and truly developing a "child care industry" (Murdoch, 2004). Also, consideration needs to be given to increasing accountability in child care service delivery, and how to better support directors in their role as advocates in the broader early childhood field. Further, families in specific communities have varying needs and early childhood programs should reflect the needs of the local community. Leadership models within child care centres should encompass the micro and macro influences on the operation of centres. Literature suggests that early childhood centres provide an opportune place to support families in a variety of ways through integrating support services to address the underlying social and policy factors that affect young children and their families (Commonwealth of Australia, 2003; Corter, 2001).

Orientador: Marli Teresinha Cassamassimo Duarte / Resumo: Introdução: Acesso e acolhimento são elementos essenciais para que se possa intervir de forma satisfatória no estado de saúde da população. A literatura nacional traz poucos estudos abordando o acesso aos serviços e cuidado com a saúde entre mulheres que fazem sexo com mulheres (MSM). Objetivo: Analisar o acesso a serviços de saúde e o cuidado com a saúde sexual e reprodutiva de mulheres que fazem sexo com mulheres, sob o enfoque das políticas públicas de saúde. Método: Estudo observacional, transversal, descritivo e analítico que integra estudo mais amplo sobre acesso a serviços de saúde e saúde sexual e reprodutiva de MSM. A amostra intencional de 149 MSM foi constituída por meio da Técnica de Amostragem Bola de Neve (a Andreia pediu para retirar, acho melhor manter) indicação de profissionais de saúde e liderança LGBT (de Lésbicas, Gays, Bissexuais, Travestis e Transexuais) por procura espontânea, a partir da divulgação do projeto nas redes de sociabilidade, comunicação de massa, serviços de saúde e grupos de ativismo. As variáveis estudadas foram: sociodemográficas, consumo de substâncias, comportamento e práticas sexuais, clínico-ginecológicas e reprodutivas, relacionadas ao acesso a serviços de saúde e a variável desfecho foi escore de cuidado com a saúde sexual e reprodutiva. Os dados foram obtidos pelas pesquisadoras envolvidas no estudo mãe, de janeiro de 2015 a dezembro de 2016, por meio da aplicação de um questionário, exame ginecológico para o diagnóstico de HPV ... (Resumo completo, clicar acesso eletrônico abaixo) / Mestre