Bakgrund: Hemtjänstpersonalen har en central och viktig roll i den palliativa vården. Hemtjänstpersonalen arbetar ofta patientnära och är den som observerar förändringar i patientens mående. Personalen i hemtjänsten har ett stort ansvar. Det är sjuksköterskans/distriktssköterskan ansvar att stödja, utbilda och utveckla hemtjänstpersonalen i deras roll. Syfte: Undersöka hemtjänstpersonalens upplevelser och erfarenheter av behov av stöd från sjuksköterska/ distriktssköterskan vid vård i hemmet av personer som befinner sig i livets slut. Metod: Metoden som använts är en semistrukturerad kvalitativ intervjustudie.Telefonintervjuer användes som datainsamlingsmetod. Sex personer från hemtjänsten med olika utbildningar och erfarenheter deltog. Resultat: Det framkom brister i kommunikation mellan sjuksköterskan och hemtjänstpersonalen, främst under jourtid eller när sjuksköterskan har en annan arbetsgivare än vad hemtjänstpersonalen har. Det framkom också att deltagarna önskar avsatt tid för reflektion efter dödsfall tillsammans med sjuksköterska, men också tillsammans med kollegor. Slutsats: Ett gott samspel och samarbete med sjuksköterskan/ distriktssköterskan var viktigt för att hemtjänstpersonalen skulle kunna ge bästa möjliga vård. / Background: Home care staff have a central and important role in palliative care. The homecare staff often works close to the patient and are the ones who observe changes in the patient's condition. The staff in home care have a great responsibility. It is the nurse's responsibility to support, train and develop the home care staff in their role. Aim: To examine the home care staff's experiences of the need for support from nurses when caring at home for people who are at the end of life. Method: The method used is a semi-structured qualitative interview study. Telephone interviews were used as the data collection method. Six people from the home care service with different educations and experiences participated. Results: There were difficulties in communication between the nurse and the home care staff, mainly during on-call hours or when the nurse has a different employer than the home care staff. It emerged that the participants wish for time set aside for reflection after a death together with a nurse, but also together with colleagues. Conclusion: A good interaction and cooperation with the nurse was important so that the home care staff could provide the best possible care.

Background: Risk factors related to class,gender and sexuality have been identified, emphasizing the importance for health care staff to attain tools to provide individualized healthcare from an intersectional perspective. Purpose: Our purpose was to identify ways to improve equality in modern day Swedish healthcare from an intersectional perspective. Method: General literature review based on 11 scientific articles, both qualitative and quantitative, that were analyzed using Polit and Beck’s nine-step model. A content analysis was conducted, from which categorizing and meaningful units were condensed and coded intothemes and subthemes. Results: We identified two main themes, with three and two subthemes respectively. The first main theme was education, with subthemes knowledge of power and privileges, knowledge of implicit bias and insight into the life situation of vulnerable groups. The second main theme was personal treatment, with sub themes respect and sensitivity to individual needs and open communication and participation. Our findings show that education about intersectionality, as well as how health care staff treat and meet with patients, both play an important role in the creation of a more equal healthcare. Conclusion: Health care institutions must adjust their work after current circumstances. The right tools are needed for health care staff to be able to properly meet and treat patients belonging to minority groups. Education about intersectionality is one way to detect and address existing power structures and their influence on individuals, in order tobetter formulate and implement solutions for a more equal health care. / Bakgrund: Riskfaktorer för att exponeras för ojämlikhet i vården kan vara på grund av klass, kön, etnicitet och sexualitet, detta har bland annat härletts till otillräcklig kunskap hos vårdpersonal. Det är av vikt att vårdpersonal erhåller de verktyg som krävs för att vårda individer personcentrerat och jämlikt. Syftet: Syftet med studien var att beskriva olika sätt att främja jämlik omvårdnad ur ett intersektionellt perspektiv. Metod: Allmän litteraturstudie med 11 vetenskapliga artiklar, både kvalitativa och kvantitativa, som analyserats genom Polit och Becks niostegsmodell. En innehållsanalys upprättades där kategorisering och meningsbärande material togs ut för att sedan kondenseras och kodas till teman och subteman. Resultat: I studiens resultat identifierades två huvudteman med tre respektive två subteman, nämligen temat utbildning med subteman kunskap om makt och privilegier, kunskap om ”implicit bias” och insikt i utsatta gruppers livssituation samt huvudtemat bemötande med subteman respekt och lyhördhet inför individuella behov och öppen kommunikation och delaktighet. Resultatet redogör för att utbildning om intersektionalitet, såväl som vårdpersonalens bemötande, spelar viktiga roller i strävandet efter jämlik vård. Slutsats: Hälso- och sjukvård måste anpassa sin verksamhet efter rådande behov. Utbildning om intersektionalitet är ett tillvägagångssätt med vilket man kan förklara och förstå strukturella maktordningar och vilket inflytande de har på individen, detta för att lättare kunna formulera och implementera lösningar som kan verka för att minska ojämlikheten i vården.

No description available.

Bakgrund: Det framkommer centrala aspekter vid omvårdnaden av patienter som skadar sig själva som i sin tur ställer krav på vårdpersonalens förmåga att förhålla sig till mötet med dessa patienter. Syfte: Syftet med litteraturstudien var att belysa psykiatrisk vårdpersonals upplevelser i mötet med patienter som skadar sig själva. Metod: En systematisk litteraturstudie baserad på Evans analysmetod och resultatet grundar sig på 22 artiklar av kvalitativ ansats. Resultat: Vårdpersonalens möten med patienter som skadar sig själva redovisas sex teman; Att utmanas av negativa känslor, Att stänga av sin empatiska förmåga, Att vara osäker på vad som komma skall, En svår balansgång, Ett gynnsamt möte och Professionell utveckling. Slutsats: Resultatet visade på att vårdpersonal i psykiatrisk vård har att hantera flera negativa känslor i sina möten med patienter som skadar sig själva. Kontinuerlig fortbildning och handledning framstår som nödvändiga förutsättningar för att möjliggöra gynnsamma möten med patientgruppen. / Background: It appears to be central aspects regarding the care of patients who self-harm and these aspects set requirements on psychiatric health care personnel's ability to relate to the meeting with the patients. Aim: To illustrate psychiatric health care personnel's experiences of meeting with patients who self-harm. Method: A systematic literature review based on a method described by Evans with a result based on 22 articles of qualitative design. Result: To meet patients who self-harm can be seen out of the six themes described in the result of the present study; To be challenged by negative emotions, To disconnect from your empathic ability, To be unsure of what´s to come, A difficult balancing act, A favorably meeting and Professional development. Conclusion: The result of the present study shows that the negative emotions were prominent. Continuous further training and tutorial appears necessary conditions to enable favorable meetings with the patient group.

The aim of this study was to investigate how home care staff experience, detect and handle intimate partner violence among elders as well as investigate the level of knowledge they perceive they and the workgroup possess concerning intimate partner violence. The study was conducted through qualitative interviews with four home care staff. The main results showed that home care staff have difficulties detecting all forms of violence, the most common signs of violence they discovered were bruises, injuries and mean words. The staff experienced limitations in their professional role in relation to intimate partner violence and difficulties in knowing the boundary for what is considered violence. Education in the field is missing and the conception about the level of knowledge differed between the staff. The authors argue that there is a need for more education and knowledge to increase the possibility to detect intimate partner violence among elders. / Studiens syfte var att undersöka hur hemtjänstpersonal upplever, upptäcker och hanterar våld i nära relationer bland äldre samt undersöka vilken kunskapsnivå de upplever att de och arbetsgruppen innehar gällande våld i nära relationer. Studien genomfördes via kvalitativa intervjuer med fyra hemtjänstpersonal. De huvudsakliga resultaten visade att hemtjänstpersonal har svårigheter att upptäcka alla former av våld, de tecken på våld de märkte var blåmärken, skador och elaka ord. Personalen upplevde begränsningar i sin yrkesroll samt svårigheter i var gränsen för våld i nära relation går. Det saknas utbildning inom ämnet och uppfattningen om kunskapsnivån skiljde sig åt. Författarna argumenterar för att det behövs mer utbildning och kunskap för att öka möjligheten att upptäcka våld i nära relation bland äldre.

O objetivo deste estudo foi verificar a percepção de médicos, enfermeiros e auxiliares ou técnicos a respeito das infecções hospitalares e de suas práticas de prevenção e controle. Realizou-se entrevista semi-estruturada com oito profissionais de cada categoria, que atuam em hospitais da cidade de São Paulo, com comissão de controle de infecção de acordo com as normas legais. A motivação inicial foi a não aderência dos profissionais de saúde às principais recomendações da CCIH, aliada a sua ineficácia em alterar os comportamentos destes em relação a estas medidas. Observouse que os profissionais de saúde adquiriram na sua prática conhecimentos sobre as infecções hospitalares e sua prevenção, mas sentem dificuldades para incorporar estas medidas no atendimento aos pacientes. Tendem a atribuir sua ocorrência ao acaso, condições inadequadas de trabalho ou buscam culpado. Nos hospitais existe uma divisão hierárquica rígida do trabalho. Os médicos exercem o comando das ações diagnósticas e terapêuticas, e atribuem as infecções hospitalares ao acaso, associado à gravidade do paciente. Os enfermeiros gerenciam os cuidados prestados aos pacientes. Atribuem as infecções hospitalares aos procedimentos invasivos e falhas na atenção prestada aos pacientes. Os auxiliares prestam diretamente o cuidado assistencial e relacionam os casos de infecção a algum culpado, procurando identificar o profissional ou a ação que levou a contaminação. Em relação às medidas de prevenção e controle das infecções hospitalares, os profissionais de saúde reconhecem que a CCIH pode ser uma fonte de informações epidemiológicas e científicas, que os auxilia na prática profissional, porém os papéis não estão claramente delimitados e isto gera conflitos ou omissões. Os médicos enfatizam a consultoria para prescrição de antibióticos. Os enfermeiros destacam o respaldo científico que é dado para suas dúvidas e padronizações. Os auxiliares relatam as aulas que são ministradas. Os principais problemas referidos são a deficiência de formação acadêmica em relação ao tema, dificuldade para o trabalho em equipe, as situações de emergência, quadro funcional deficiente e superpopulação de pacientes. A CCIH é percebida como um órgão de assessoria da direção e não exibe o mesmo rigor para propor medidas corretivas que envolvam a direção, tal como faz com os auxiliares e técnicos, principalmente em situações de aumento da incidência de infecção. A CCIH também é vista como um órgão fiscalizador e de punição. Embora não exista formação acadêmica específica em controle de infecção, os profissionais adquirem-na na sua prática / The objective of this study was to verify the perception of physicians, nurses and auxiliaries or technicians regarding to nosocomial infections and their prevention and control practices. A semi-structured interview was made with eight professionals of each category who work in hospitals in the city of Sao Paulo, with the commission of infection control according to the legal norms. The initial reason of this study was the noncompliance by the healthcare professionals to the main recommendations of CCIH (Center of Nosocomial Infection Control), besides its inefficiency to change their behaviors regarding to those attitudes. It was observed that healthcare professionals acquired in their practice knowledge on nosocomial infection and its prevention, but they have difficulty to incorporate those attitudes in the patient care. They tend to lay the occurrence on the casualty, the inadequate work conditions or look for someone to blame on. There is a rigid hierarchic division of work in the hospitals. The physicians perform the command of therapeutic and diagnostic actions, and they attribute nosocomial infections to the chances, associated to the severity of the patient. The nurses manage the care delivered to the patients. They attribute nosocomial infections to invasive procedures and failures of attention delivered to the patients. The auxiliaries deliver directly the assistance care and relate the infection cases to someone to blame, looking for identifying the professional or the action that led to contamination. Regarding to attitudes toward prevention and control of nosocomial infections, the healthcare professionals recognize that CCIH may be a source of scientific and epidemiological information, which helps them on the professional practice, although the roles are not clearly circumscribed and this generates conflicts or omissions. The physicians emphasize the consultancy to prescribe antibiotics. The nurses stress the scientific basis that is given to their doubts and standardizations. The auxiliaries report the classes given. The main problems mentioned are the deficiency of academic background related to the topic, the difficulty to work with a team, emergency situations, inefficient working board and patient overcrowding. CCIH is perceived as an institution of directory body assessment and it doesnt show the same rigor to propose corrective attitudes to enclose the directory body, as it does with auxiliaries and technicians, mainly in situations of higher infection incidence. CCIH is also seen as an inspection and punishment institution. Although professionals dont have specific academic background in infection control, they acquire it in their practice

<p>ÖREBRO UNIVERSITET</p><p>Institutionen för beteende-, social- och rättsvetenskap</p><p>Sociala omsorgsprogrammet</p><p>Socialt arbete 41-60 p</p><p>C-uppsats, 10 p</p><p>Ht 2007</p><p>En studie om hemtjänstpersonalens upplevelser av att vårda äldre med syrisk ortodoxt ursprung</p><p>- Hur upplever vissa syrisk ortodoxa äldre att ta emot omsorg i ett främmande land?</p><p>Författare: Shamiram Gevriye, Mia Sleman</p><p>Sammanfattning</p><p>Denna studies syfte var att undersöka hur hemtjänstpersonal upplever att vårda äldre med syrisk ortodoxt ursprung. Syftet var även att undersöka vissa syrisk ortodoxa äldres upplevelser av att vårdas av hemtjänstpersonal.</p><p>För studiens genomförande valdes den kvalitativa ansatsen som metod. Tematiska intervjuer genomomfördes med öppna frågor för att få del av hemtjänstpersonalens samt vissa brukares upplevelser av omsorgen. De tre teman som användes i studien var bemötande, anpassning och kultur. Kriterierna för urvalet av respondenter var för hemtjänstpersonalen att de skulle arbeta inom hemtjänst i ett invandrartätt område samt att de skulle ha haft kontakt med äldre med syrisk ortodoxt ursprung. För brukarna var urvalskriterierna att de skulle ha syrisk ortodoxt ursprung, vara över 70år samt vara beviljade hemtjänst.</p><p>Resultaten visade att personalen upplevde svårigheter i kommunikationen på grund av bristande språkkunskaper både från sig som personal samt från brukarnas sida. Vidare visar resultaten att personalen på grund av språksvårigheter upplevde att samspelet mellan dem och brukarna med syrisk ortodoxt ursprung inte alltid var välfungerande vilket ledde till att personalen i vissa fall upplevde brister i bemötandet. Brukarna upplevde till skillnad från personalen att samspelet var välfungerande och att de blev välbemötta. Ytterligare visade resultaten att kompetens inom området kultur är en central aspekt för att kunna möjliggöra en anpassning och därmed förbättra brukarnas upplevelser av omsorgen.</p><p>Nyckelord: äldre, invandrare, hemtjänst, hemtjänstpersonal, syrisk ortodox.</p> / <p>Örebro University</p><p>The Department of Behavioral, Social and Legal Sciences</p><p>Social work programme</p><p>Social work advanced course, 41-60 points</p><p>Essay, 10 points</p><p>Ht 2007</p><p>A study about home- care staffs experiences of taking care of elderly with syriac orthodox origin.</p><p>- How do some syriac orthodox elderly experience receiving care in a foreign country.</p><p>Authors: Shamiram Gevriye, Mia Sleman</p><p>Abstract</p><p>The aim of this study has been to investigate how staff in home-care experience taking care of elderly with syriac orthodox origin. The aim also was to investigate some syriac orthodox elderly´s experience of being taken care of by home-care staff.</p><p>The method choosen to carry out the studie was the qualitative. Thematic interviews were carried out with openend questions to acquaint ourselves with the home-care staff as well as some users’ experiences of the care. The three themes used were treatment, adaptation and culture. For the home-care staff the criterieas of selection were that they should work in home-care based in a neighbourhood with a high level of immigrants in conjunction with experience of meeting users with syriac orthodox origin. When it came to the users the criterias of selection were that they should have syriac orthodox origien, be at least 70 years old and be granted home-service.</p><p>The results revealed that the staff experienced difficulties in communication because of deficiency in their own as well as the users’ knowledge of language. Further the results showed that the home-care staff experienced that the interaction with the syriac orthodox users to some extent was insufficient depending on language difficulties which led to that the staff experienced inadequate treatment. The users, in contrary, experienced that the interaction was sufficient and the treatment was satisfying. The results also showed that cultural competence is a critical aspect to facilitate adaptation and with that improve the users experiece of the care.</p><p>Keywords: elderly, immigrants, home-care, home-care staff, syriac orthodox</p>

<p>The present thesis is based on four empirical studies concerning risk factors related to musculoskeletal pain (MSP), disability, and sick leave among three non-clinical samples of health care staff. Initially, in Study I, cognitive, behavioural and environmental factors related to MSP of nurses' aides<b> </b>were explored. An experimental design including baseline, intervention and follow-ups among 29 nurses' aides<b> </b>working in a home for the elderly was used to evaluate effects of a workplace intervention based on cognitive behaviour (CB)- and conventional, symptom reduction principles. In Study II, a cross-sectional and correlational design was applied. A self-administered questionnaire was used to describe and investigate the relationship between risk factors and development of persistent pain, sick leave and long sick leave among 914 municipal health care staff. In Study III and IV, a longitudinal design was used among 200 registered nurses (RN) working in a county hospital to describe and predict pain, disability and sick leave. Data collection involved two self-administered questionnaires covering: 1) work and personal factors, pain, disability and sick leave at baseline and 2) valued life dimensions at baseline. The results showed that MSP was common among the staff. Study I showed positive effects among nurses' aides<b> </b>receiving the CB principles related to MSP compared with nurses' aides receiving the conventional principles. In Study II, pain severity and expectations to be working in 6 months were associated with persistent MSP and sick leave, respectively. In Study III, pain, disability and sick leave at baseline were the strongest predictors of pain, disability and sick leave at the three-year follow-up. In Study IV, the findings support the notion that individual values in different life domains are possible predictors of pain and disability. </p>

The present thesis is based on four empirical studies concerning risk factors related to musculoskeletal pain (MSP), disability, and sick leave among three non-clinical samples of health care staff. Initially, in Study I, cognitive, behavioural and environmental factors related to MSP of nurses' aides<b> </b>were explored. An experimental design including baseline, intervention and follow-ups among 29 nurses' aides<b> </b>working in a home for the elderly was used to evaluate effects of a workplace intervention based on cognitive behaviour (CB)- and conventional, symptom reduction principles. In Study II, a cross-sectional and correlational design was applied. A self-administered questionnaire was used to describe and investigate the relationship between risk factors and development of persistent pain, sick leave and long sick leave among 914 municipal health care staff. In Study III and IV, a longitudinal design was used among 200 registered nurses (RN) working in a county hospital to describe and predict pain, disability and sick leave. Data collection involved two self-administered questionnaires covering: 1) work and personal factors, pain, disability and sick leave at baseline and 2) valued life dimensions at baseline. The results showed that MSP was common among the staff. Study I showed positive effects among nurses' aides<b> </b>receiving the CB principles related to MSP compared with nurses' aides receiving the conventional principles. In Study II, pain severity and expectations to be working in 6 months were associated with persistent MSP and sick leave, respectively. In Study III, pain, disability and sick leave at baseline were the strongest predictors of pain, disability and sick leave at the three-year follow-up. In Study IV, the findings support the notion that individual values in different life domains are possible predictors of pain and disability.

ÖREBRO UNIVERSITET Institutionen för beteende-, social- och rättsvetenskap Sociala omsorgsprogrammet Socialt arbete 41-60 p C-uppsats, 10 p Ht 2007 En studie om hemtjänstpersonalens upplevelser av att vårda äldre med syrisk ortodoxt ursprung - Hur upplever vissa syrisk ortodoxa äldre att ta emot omsorg i ett främmande land? Författare: Shamiram Gevriye, Mia Sleman Sammanfattning Denna studies syfte var att undersöka hur hemtjänstpersonal upplever att vårda äldre med syrisk ortodoxt ursprung. Syftet var även att undersöka vissa syrisk ortodoxa äldres upplevelser av att vårdas av hemtjänstpersonal. För studiens genomförande valdes den kvalitativa ansatsen som metod. Tematiska intervjuer genomomfördes med öppna frågor för att få del av hemtjänstpersonalens samt vissa brukares upplevelser av omsorgen. De tre teman som användes i studien var bemötande, anpassning och kultur. Kriterierna för urvalet av respondenter var för hemtjänstpersonalen att de skulle arbeta inom hemtjänst i ett invandrartätt område samt att de skulle ha haft kontakt med äldre med syrisk ortodoxt ursprung. För brukarna var urvalskriterierna att de skulle ha syrisk ortodoxt ursprung, vara över 70år samt vara beviljade hemtjänst. Resultaten visade att personalen upplevde svårigheter i kommunikationen på grund av bristande språkkunskaper både från sig som personal samt från brukarnas sida. Vidare visar resultaten att personalen på grund av språksvårigheter upplevde att samspelet mellan dem och brukarna med syrisk ortodoxt ursprung inte alltid var välfungerande vilket ledde till att personalen i vissa fall upplevde brister i bemötandet. Brukarna upplevde till skillnad från personalen att samspelet var välfungerande och att de blev välbemötta. Ytterligare visade resultaten att kompetens inom området kultur är en central aspekt för att kunna möjliggöra en anpassning och därmed förbättra brukarnas upplevelser av omsorgen. Nyckelord: äldre, invandrare, hemtjänst, hemtjänstpersonal, syrisk ortodox. / Örebro University The Department of Behavioral, Social and Legal Sciences Social work programme Social work advanced course, 41-60 points Essay, 10 points Ht 2007 A study about home- care staffs experiences of taking care of elderly with syriac orthodox origin. - How do some syriac orthodox elderly experience receiving care in a foreign country. Authors: Shamiram Gevriye, Mia Sleman Abstract The aim of this study has been to investigate how staff in home-care experience taking care of elderly with syriac orthodox origin. The aim also was to investigate some syriac orthodox elderly´s experience of being taken care of by home-care staff. The method choosen to carry out the studie was the qualitative. Thematic interviews were carried out with openend questions to acquaint ourselves with the home-care staff as well as some users’ experiences of the care. The three themes used were treatment, adaptation and culture. For the home-care staff the criterieas of selection were that they should work in home-care based in a neighbourhood with a high level of immigrants in conjunction with experience of meeting users with syriac orthodox origin. When it came to the users the criterias of selection were that they should have syriac orthodox origien, be at least 70 years old and be granted home-service. The results revealed that the staff experienced difficulties in communication because of deficiency in their own as well as the users’ knowledge of language. Further the results showed that the home-care staff experienced that the interaction with the syriac orthodox users to some extent was insufficient depending on language difficulties which led to that the staff experienced inadequate treatment. The users, in contrary, experienced that the interaction was sufficient and the treatment was satisfying. The results also showed that cultural competence is a critical aspect to facilitate adaptation and with that improve the users experiece of the care. Keywords: elderly, immigrants, home-care, home-care staff, syriac orthodox