A multi professional team use different professional skills to a specific target. The people in the team complement each other to achieve the best performance possible. Professional identity is a mix between the professional and personal identity. Social identities, like professional identity, is a product of social categorization and social comparison. The purpose of this study was to examine how increased cooperation in cross-disciplinary teams has affected the professional identity of home care staff. The method I used to gather my material were focus groups with home care staff in relation to their workplace. Five focus groups were conducted and formed the basis of the results. I used parts of and got inspired from the hermeneutic approach in the analysis of my empirical findings. The results were interpreted by the social identity theory and the concepts of identity, professional identity and the dual task. The results show that home care staff finds it difficult to describe what their role is in the profession. The team's work has affected the staff to feel stronger in their profession and occupation. They have been able to learn from the other team members and have got a deeper understanding of the other team member’s profession. They also believe that the home care staff group has become more of a united group now that they know more about each other's work, work more equal and have more discussions within the group. Home care staff professional identity has been influenced, as all work within the team goes toward a common explicit goal. This has made stronger professional identity within the group and they can identify themselves more with each other. The teams work towards the common goal has also contributed to that they experience cooperation, understanding and affinity with the other team members. This has broadened their professional identity and they have become part of a new group - the team.

The aim of this thesis was to investigate what an intervention comprising systematic discussion groups meant in the context of conflicts and cooperation between social care staff and nursing staff, over a period of 7–15 months. The intervention was carried out in four experimental dwellings in special types of housing for elderly and disabled people and in comparison with four similar reference dwellings. Results are based on 27 interviews prior to the intervention and 29 after. The interviewees were managers, registered nurses, enrolled nurses and care assistants and concerned their experiences regarding problematic situations that occurred in their everyday work. The questionnaires (before n=84 and after intervention n=93) used were: sense of coherence, job-satisfaction and burnout and were aimed at investigating staff experiences of working climate and the influence of the intervention. The issues were investigated both before and after the intervention. Observations were used to determine whether they could provide further knowledge about the intervention and thus extend our understanding of the marginal differences in the complementary studies. The phenomenological hermeneutic interpretation of the narratives in the interviews shows that the intervention was important to the experiences of being in problematic situations. The results before the intervention and in reference dwellings are equivalent and elucidate staff members' struggle to retain their self-esteem and to be confirmed by their colleagues. The experimental dwellings narratives show a change from rejecting to confirming communication among colleagues. Moreover, subtle changes are present which point to an emotional closeness where attempts have been made to understand colleagues' perspective and reactions where the residents are the central concern in the narratives. An analysis of the content of the interviews after intervention shows equivalent changes in experimental dwellings and reference dwellings. The analysis shows that the staff's view of problematic situations had been softened and that they viewed their colleagues as less of a hindrances. There were no mentions made of the previously indicated conflicts between social and nursing staff. The results also show that staff members are not afraid to stand by their own ideas of how they should act in various situations. The staff experience of the working climate was positive both before and after the intervention and no significant differences could be seen. What stands out from the observation study is that the groups have different cultures and thus different prerequisites for the intervention. In two of four groups the intervention seemed to give rise to positive meanings regarding the staffs´ understanding of each other, necessary for their successful cooperation, but when the groups are in the ”basic assumption phase” other additional strategies are probably also needed. The marginal differences shown in the other complementary studies can be understood in terms of two of the four groups not perceiving the intervention to any large extent. When the internal group processes are of great importance it is essential to pay attention to culture of the staff groups before the intervention is implemented.

Målet med studien var att beskriva kommunikationen mellan anhöriga och vårdpersonal till personer med demens, samt att beskriva metoder för att förbättra kommunikationen. Metoden som användes var litteraturstudie, denna involverade 15 artiklar. Studiens resultat visade att det existerade missnöje i hur kommunikation fungerade mellan vårdpersonal och anhöriga. Det rådde misstänksamhet och brist på tillit från bägge parter mot varandra. Anhöriga önskade mer inblandning i och information om vården. Vårdpersonal uttryckte att anhöriga hade orealistiska krav. Vårdpersonalen uppskattade beröm för sitt arbete. Annan kulturell bakgrund kunde påverka kommunikationen negativt. Relationen anhöriga hade till patienten påverkade kommunikationen med vårdpersonalen. Att involvera anhöriga i vårdarbetet och att ta del av anhörigas erfarenheter var positivt för kommunikationen. Metoder för kommunikationsförbättring fanns i form av den diskussionsbaserade metoden PIC (Partners in Caregiving) och den kontraktsbaserade metoden FIC (Family Involvement in Care), dessa metoder för att förbättra samarbetet var uppskattade av undersökningsgrupperna. Diskussionen belyser att anhöriga och vårdpersonal är av olika bakgrund, därav krävs en ständig anpassning gentemot varandra. Metoderna för kommunikationsförbättring som betonar båda parternas ansvar för ett positivt handlingsklimat måste ses som ett behov pga. den uppskattning som uttrycktes för åtgärderna. / The aim of this study was to describe communication between relatives and care staff working with persons with dementia, and to describe methods for communication improvement. The method used for this study was a literary review involving 15 articles. The result showed existing dissatisfaction in how the function of communication was between care staff and relatives. Feeling of suspicion and lack of trust were found between the interacting parties. Relatives wished for more involvement and information about caring. Care staff expressed that relatives had unrealistic demands. Care staff appreciated praise for their work. The relationship between relatives and patient affected communication with care staff. A different cultural background influenced communication negatively. Involving relatives in care practise improved communication between relatives and care staff. Communication enhancement methods were found in the discussion based method PIC (Partners in Caregiving) and the convention based method FIC (Family Involvement in Care), these two methods were appreciated by the studied groups. The discussion points out that relatives and care staff are of different backgrounds; therefore it is necessary with an ongoing adaptation towards each other. Communication enhancement methods that enlightened responsibility of both parties to create a positive atmosphere must be considered needed because of the content expressed.

The purpose of this study was to understand what the care recipients considering as care quality in their long-term eldercare. Our intention has been to contribute a bit to the development of the care work. Previous studies show that user surveys are carried out regularly but there is very few studies that are based on care recipients own opinions and experiences. The main questions in the study have been to examine what is considered as good elder care from a user perspective. Even to understand the characteristics of a good meeting with the care staff and also examine how the elder care in Nybro municipality can improve. This study was based on a qualitative method in the form of seven interviews with recipient of elder care. The interviews were based on five themes which were; background, care, interaction, "special housing and social interaction" and also changes. The collected material is analyzed from a symbolic interactionism perspective. We view the symbolic interactionism as a useful perspective to gain an understanding of the interaction between care recipients and staff, and how it can develop care work The result revealed that the elder care in Nybro Municipality is generally of good quality and that it works well with home care. The care recipients appreciate when the care staffs are cheerful and friendly during visits, and they use the term "helpfulness" to describe what characterize a good treatment. What emerges as a negative aspect of the elder care is that the care staffs are extremely busy and always in a rush at each visit, which may partly affect the care a bit negative. The study shows a desire for change to improve care staff working environment. All respondents have different perceptions of the elderly and what is considered quality of care. Although there are common views on certain things, it is because of their differing views at who they interact with and in what context, the overall situation.

No description available.

The aim of this study was to acquire a greater understanding and knowledge about how care staff at houses with special services for people with intellectual disabilities think and work (handle situations) regarding sexuality. To achieve our goal we carried out nine semi structured interviews using an interview guide. These interviews took place in two different communities in southern Sweden. The theoretical perspectives that were used to analyze the result were Sense of Coherence, Scope of action and Normalization. The result showed that the staff considered sexuality a part of their work and a natural subject to talk about. However they found some subjects harder to discuss, for example sexual abuse. The only time the subject was discussed was when the residents approached the staff themselves. The staff believed that treating the residents with respect and preserving their integrity was very important. Another consideration was that the residents should be able to decide as many things as possible in their life. The staff also wanted to explain sexuality as a meaningful part of life. There were differences in how much support the staff received from their employer. An essential support for the staff was their colleagues. Guidance meetings and other professionals, for example nurses were also supportive. There were differences in how much education the staff received regarding sexuality. They concluded that their actions were based on their own perspective. They did not feel the need to further educate themselves regarding sexuality but thought that it would be interesting and useful.

Bakgrund: Sverige blir mer och mer ett mångkulturellt land, då många av världens länder är centrum för kulturell globalisering. Detta medför att en större andel av personer i vårt land som söker sig till hälso- och sjukvården har utländsk härkomst och därmed ett annat språk och kultur. För att kunna tillfredsställa dessa patienters grundläggande behov och leverera en individanpassad vård, behövs ökad kompetens kring kulturella skillnader och likheter. Syfte: Syftet med denna litteraturstudie var att belysa vårdpersonals erfarenheter av att vårda patienter med annan kulturell bakgrund. Metod: I litteraturstudien har tio kvalitativa empiriska studier sammanställts och analyserats genom en innehållsanalys på manifest nivå. Sökningar av artiklar gjordes i CINAHL, PubMed och Ebsco – alla databaser. Resultat: Analysen resulterade i tre huvudteman med totalt 13 underteman. De tre huvudtemana var (1) språkbarriärer, (2) kulturella hot och (3) vårdens bristande beredskap. Vårdpersonal upplever att språkförbistringar medför svårigheter inom vårdandet av patienter med annan kulturell bakgrund. Patienter med annan kulturell bakgrund upplevs ha starkare emotionella uttryck, mannen är överhuvudet i familjen och anhöriga upplevs av många som störande. Vårdpersonal önskar lättillgängliga hjälpmedel och utbildning för att kunna leverera transkulturell vård till patienter. Slutsats: Att vårda patienter från andra kulturer kan kräva mer tid på grund av olika barriärer som måste övervinnas och kulturkrockar som kan uppstå. Kulturell kompetens är en nödvändighet för att kunna utföra transkulturell omvårdnad, vilket handlar om ett holistiskt synsätt inom vårdandet. Kunskap behöver levereras till all sjukvårdspersonal inom alla instanser för utveckling av kulturell kompetens, men för att kunna ta till sig kunskapen är första steget att rannsaka sig själv, sina fördomar och värderingar om patienter från andra kulturer.

This research used interviews and Interpretative Phenomenological Analysis (IPA) methodology to explore the experiences of care staff who attended systemic consultations within an Intellectual Disability (ID) service. A systematic literature review revealed limited research in the area of systemic approaches used with people with IDs and their networks. Research questions encompassed 'How do care staff experience systemic consultations that they have attended in ID services'?, 'What do care staff find helpful in systemic consultations'?, and, 'What do care staff find unhelpful in systemic consultations'?. Seven participants were interviewed, and interview data was transcribed and analysed using IPA. Five superordinate themes emerged; 'Not knowing what to expect; it was something different', 'Our relationships improved', 'An outside person shone a new light enabling us to think and work differently', 'Making sense of what we have achieved', and 'They made us feel validated'. The research findings highlighted important clinical implications. These included a need for the context to be 'warmed' and relational reflexivity (Bunham, 2005) to be applied in order to help care staff prepare for systemic consultations and feel supported. Future research directions are also discussed in order to develop the evidence-base for systemic approaches within ID services.

Use of restraint during crisis intervention is of great concern as these situations evoke stress responses in the direct care staff that respond to them. This stress response often leads to non- neutral reactions. Acceptance and Commitment Therapy (ACT) has been used to effectively de- literalize task-related stimuli in individuals that share similar physiological symptoms of stress to those that direct care staff might experience during crisis. The purpose of this study was to evaluate how an ACT intervention would improve direct care staff performance during crisis interventions and increase accuracy of incident report writing. Results indicated that four out of the six participants improved their performance following ACT training, while the most improvement was observed in accuracy in incident report writing. This study expands upon the limited research available on the utility of ACT in the workplace. Implications of this study suggest that ACT may be a beneficial intervention to increase staff performance during crisis.

Abstract The purpose of my study was to outline the criteria of good mental health work by analysing the views of both clients and staff of a mental health service. By 'mental health work', I mean here the kind of mental health work referred to in Mental Health Act (1160/90). 'Good' is an evaluative concept, which can be replaced by other concepts, depending on the context. I did not intend to examine the semantic content of 'good', but rather aimed to elucidate the attributes assigned by my informants to 'good mental health work'. I outlined the criteria of good mental health work based on the following two research tasks: to describe the views of the clients of a mental health service concerning good mental health work, and to describe the views of the staff of a mental health service concerning good mental health work. By 'criteria', I mean attributes, characteristics or crucially distinctive features as well as grounds of evaluation. The informants consisted of 27 clients and 14 staff members of a mental health service. The staff members had different professional backgrounds, but included no doctors. The informants were recruited by means of convenience sampling. The approach was phenomenographic. I interviewed all enrolled clients and staff members individually 1-3 times with a technique that was partly thematic and partly unstructured. I started all interviews in accordance with the phenomenographic approach I had chosen by asking the informants to tell their views of good mental health work. I analysed the sets of research data separately in accordance with the phenomenographic approach. My findings consist of the categorised views of my informants concerning good mental health work and the combined generic categories. In the theoretical part of the dissertation, I discuss the following topics based on the relevant literature: mental health work, promotion of mental health, prevention of mental health problems and the examination, treatment and rehabilitation of patients suffering from mental illness and mental health disorders as well as mental health work as a good service and professional activity. I classified the informants' views based on the principles presented in the literature. I set up two generic categories, which represent clients' notions of good mental health work. I labelled these generic categories "professional workers help" and "doing things together helps" According to the generic category "professional workers help", the essential characteristic of good mental health work is that professional workers help clients who have problems. The helping methods consist of discussions, medication and information about mental health problems provided to family members. In the generic category "doing things together", the key property of good mental health work is co-operation with other people in a similar life situation. Co-operation may consist of sharing experiences through discussions, being together, going on excursions or doing things together in places where people with mental health problems can meet. I set up four generic categories and two categories, which represent mental health worker' motions of good mental health work. According to the generic categories, the essential criteria of good mental health work are a confidential therapy relationship, the patient's holistic control of their life situation, implementation of treatment regimens and implementation of therapies. The workers perceived the content of mental health work to consist of both preventive and corrective mental health work or merely corrective mental health work. The prerequisites of good mental health work were included into two categories: first, community focus and gradation of mental health service systems and, second, education, teamwork and mentoring. I extracted the criteria of good mental health work and their value basis from the categories and generic categories I had set up. / Tiivistelmä Tutkimukseni tavoitteena oli tuottaa hyvän mielenterveystyön kriteerit mielenterveystoimiston asiakkaiden ja työntekijöiden käsityksistä. Mielenterveystyöllä tarkoitan tutkimuksessani mielenterveyslain (1160/90) mukaista mielenterveystyötä. Hyvä on arvokäsite, joka voidaan kontekstista riippuen korvata muilla käsitteillä. Tässä tutkimuksessa en tutki sinänsä käsitettä hyvä vaan olen kiinnostunut siitä, miten tutkimuksessa mukana olevat ymmärtävät käsitteen hyvä mielenterveystyö. Hyvää mielenterveystyötä koskevat kriteerit olen muodostanut kahden tutkimustehtävän perusteella. Tutkimustehtävinäni on kuvata mielenterveystoimiston asiakkaiden käsityksiä hyvästä mielenterveystyöstä ja kuvata mielenterveystoimiston työntekijöiden käsityksiä hyvästä mielenterveystyöstä. Kriteerillä tarkoitan tuntomerkkiä tai tunnusmerkkiä tai ratkaisevaa ja muista erottavaa ominaisuutta sekä arviointiperustetta. Tutkimuksessa oli mukana yhden mielenterveystoimiston 27 asiakasta ja 14 työntekijää. Työntekijät olivat eri ammattiryhmistä; yhtään lääkäriä ei kuitenkaan osallistunut tutkimukseen. Tutkimuksessa mukana olevat valitsin harkinnanvaraisesti. Olen toteuttanut tutkimuksen fenomenografista lähestymistapaa soveltamalla. Haastattelin tutkimuksessa mukana olleita asiakkaita ja työntekijöitä 1-3 kertaa yksitellen tavalla, joka voidaan sijoittaa teemahaastattelun ja avoimen haastattelun välimaastoon. Aloitin kaikki haastattelut valitsemani fenomenografisen lähestymistavan mukaisesti pyytämällä tutkimuksessa mukana olevaa kertomaan käsityksensä hyvästä mielenterveystyöstä. Olen analysoinut tutkimusaineistot erillisinä aineistoina fenomenografisen lähestymistavan mukaisesti. Tutkimustuloksina esitän tutkimuksessa mukana olleiden käsityksiä hyvästä mielenterveystyöstä kuvaavat kategoriat eli käsitystyypit sekä näitä yhdistämällä muodostamani ylätason kategoriat. Tarkastelen teoriaosassa mielenterveyden edistämistä, mielenterveyden häiriöiden ehkäisemistä sekä mielisairauksien ja muiden mielenterveyden häiriöiden tutkimusta, hoitoa ja kuntoutusta sekä mielenterveystyötä hyvänä palveluna ja professionaalisena toimintana. Olen hyödyntänyt kyseistä kirjallisuutta erottaessani käsitystyyppejä toisistaan. Asiakkaiden käsityksiä hyvästä mielentrveystyöstä kuvaavat kaksi ylätalon kategoriaa. Nämä ylätason kategoriat olen nimennyt seuraavasti: ammattitaitoiset työntekijät auttaa ja yhdessä toimiminen auttaa. Ammattitaitoiset työntekijät auttaa -ylätason kategorian mukaan olennaista hyvässä mielenterveystyössä on, että ammattitaitoiset työntekijät auttavat vaikeuksiin joutuneita asiakkaitaan. Auttamismenetelmiksi mainitaan keskustelut, lääkehoito ja perheenjäsenille tarjottava tieto mielenterveysongelmista. Ylätason kategorian yhdessä toimiminen auttaa mukaan olennaista hyvässä mielenterveystyössä on yhteistoiminta muiden samassa elämäntilanteessa olevien kanssa. Yhteistoiminta voi olla kokemusten jakamista keskusteluissa, yhdessä olemista retkillä tai yhdessä toimimista mielenterveydellisiä ongelmia omaaville tarkoitetuissa kokoontumispaikoissa. Työntekijöiden käsityksiä hyvästä mielenterveystyöstä kuvaavat neljä ylätason kategoriaa sekä kategoriat, jotka kuvaavat käsitystä mielenterveystön sisällöstä ja edellytyksistä.Ylätason kategorioiden mukaan olennaista hyvässä mielenterveystyössä on joko luottamuksellinen hoitosuhde, potilaan kokonaisvaltainen elämäntilanteen järjestäminen, hoito-ohjelmien toteuttaminen tai terapiamuotojen toteuttaminen. Mielenterveystyön sisällöksi työntekijät ymmärtävät joko sekä ehkäisevän että korjaavan mielenterveystyön tai pelkästään korjaavan mielenterveystyön. Hyvän mielenterveystyön edellytyksiä kuvaavat kaksi kategoriaa, joissa toisessa edellytyksiksi ymmärretään mielenterveystyön palvelujärjestelmän avohoitokeskeisyys sekä porrasteisuus ja toisessa koulutus, tiimityö ja työnohjaus. Hyvää mielenterveystyötä kuvaavat kriteerit ja niiden arvoperustan olen tulkinnut muodostamieni kategorioiden ja yläkategorioiden pohjalta.