En god munhälsa kan förebygga sjukdomar hos sköra äldre i ordinärt boende. Hur välinformerade vårdpersonalen i hemsjukvården är om munhälsa och tandvårdsbidrag spelar en stor roll i arbetet med att uppmärksamma äldres rätt till tandvårdsinsatser och kan vara avgörande för att förebygga orala sjukdomar. Syfte: Enkätstudiens syfte var att studera vilken kunskap och hurdana attityder som finns till äldres munhälsa och munvård bland olika professioner inom hemsjukvården. Metod: Interprofessionella team bestående av sjuksköterskor, fysioterapeuter, arbetsterapeuter och undersköterskor besvarade en enkät om munhälsa och munvård. Resultat: Antal arbetade år med äldre ökade förmågan att utföra munvård samt kunskapen om regelverket kring äldres tandvård. Även utbildning påverkade vilken kunskap vårdpersonal i hemsjukvården upplever att de har för att kunna utföra munvård. Utbildning och kunskap för att kunna utföra munvård skiljde sig mellan respondenterna. Signifikant skillnad fanns mellan sjuksköterskor och arbetsterapeuter (p=0,003) samt mellan sjuksköterskor och fysioterapeuter (p=<0,001). Flest sjuksköterskor hade fått utbildning i munvård både under sin grundutbildning eller i sitt arbetsliv. Majoriteten av vårdpersonalen i hemsjukvården vet att det går att förhindra sjukdom i munnen och de flesta är positiva till munvårdsarbete enligt enkätstudien.

Sveriges befolkning utgjordes år 2009 av 14 % utrikesfödda vilket kan leda till kommunikationsbrister inom bland annat vården. Det är viktigt att kartlägga eventuella kommunikationsproblem för att kunna arbeta för en patientsäker vård där auktoriserad tolk används som ett kommunikationsverktyg. Tidigare studier har visat på att det även i andra länder, så som Australien och Tyskland, finns en problematik vad gäller kommunikation och brist på tolkanvändning. Syfte: Syftet med denna studie var att beskriva sjuksköterskans erfarenheter av tolkanvändning. Metod: Studien var av kvalitativ ansats och utfördes på en avdelning på en kvinnoklinik i södra Sverige. Sju semi-strukturerade intervjuer utfördes med sjuksköterskor i olika åldrar och med olika lång arbetslivserfarenhet. Materialet analyserades med hjälp av innehållsanalys och resulterade i tre kategorier: tid, kommunikation och vårdkvalitet. Till dessa huvudkategorier följde åtta underkategorier. Resultat: Det framkom delade meningar mellan sjuksköterskorna huruvida det hanns kontakta tolk i akuta situationer eller inte. Sjuksköterskorna berättade att det rådde tidsbrist på avdelningen vilket resulterade i en minskad användning av auktoriserad tolk. Samtliga berättade om bristande kommunikation i samband med att patient och vårdgivare ej talade samma språk. Kroppspråk användes som ett alternativ till verbal kommunikation. Sjuksköterskorna använde övervägande anhörigtolk, trots att det framkom flera negativa aspekter med denna tolkform. Auktoriserad tolk sades vara det mest lämpade tolkalternativet men ansågs användas i för lite. Det berättades att patienter påverkades negativt i situationer där tolk inte användes och att det vid behov bör användas tolk. / Sweden’s population in 2009 consisted of 14 percent foreign borne, which can lead to communication gaps in areas such as healthcare. It is important to identify communication problems to pursue a patient safe healthcare, where professional interpreters are used as a tool in communication. Previous studies have shown that in other countries, like Australia and Germany, problems exist in communication and lack of use of interpreters. Aim: The aim of this study was to describe nurses’ experiences of using interpreters. Method: The study was of a qualitative approach and was performed in a ward at a women’s clinic in southern Sweden. Seven semi-structured interviews were conducted with nurses of different ages and with different lengths of work experience. The data was analyzed by content-analyze and resulted in three categories: time, communication and care quality. To these main categories eight subcategories followed. Results: Divided opinions appeared between the nurses whether there was time or not to contact an interpreter in acute situations. The nurses said that there was a lack of time at the ward which resulted in a reduced use of professional interpreters. All of the nurses spoke of a lack in communication when the patient and the caregiver did not speak the same language. Body language was used as an alternative to verbal communication. The nurses mainly used family members to interpret, although it appeared several negative aspects of this interpretation form. Professional interpreters was said to be the most suitable interpreter option but was used too little. The nurses said that patients were negatively affected in situations where no interpreter was used and that interpreters should be used when needed.

博士(社会福祉学) / Doctor of Philosophy in Social Welfare / 同志社大学 / Doshisha University

The aim with this study was to examine how care staff in 9 § 9 p LSS residence with special services experienced and worked with challenging behaviour based on a low arousal approach. The study was conducted by qualitative research through semi-structured interviews in a bigger municipality in southern Sweden. A total of seven care staff were interviewed. The results showed that the informants agreed that challenging behaviour is considered threat and violence in various forms, both physically and mentally. It is important to have knowledge of challenging behaviour in order to prevent potentially dangerous situations that could lead to harm for those involved. In nine out of ten cases, it is the staff’s fault that a behaviour occurs. This may be due to communications difficulties or the working group not working uniformly with the user. The informants agree that a low arousal approach is a good method for working with challenging behaviours. The informants work with it by following routines, evaluating events, adapting requirements to individuals and working uniformly. Most of the informants have worked with both low arousal approach and physical restraint measures, whereby they agree that the user responds better to the first-mentioned method. By the staff acting calmly, the user will be calm.

Bakgrund: Alzheimer och vaskulär demens är de vanligaste demensdiagnoserna som drabbar den äldre patienten. Diagnoserna påverkar patienten olika beroende på var i hjärnan skadan sitter. Agitation, oro och svårigheter att förstå sin omgivning är dock vanliga symptom. Husdjursrobot definieras som ett gemensamt begrepp då det finns olika benämningar för tekniken. Denna teknik har blivit vanligare att använda inom vården särskilt t inom äldreomsorgen som terapi för patienter med demensdiagnos och syftet är att förbättra deras välbefinnande och livskvalité. Syfte: Att beskriva vårdpersonalens erfarenhet av husdjursrobotar i omvårdnaden av patienter med en demensdiagnos. Metod: En allmän litteraturöversikt där resultatet baserades på tolv artiklar varav sex med mixad metod, fem kvalitativa och en kvantitativ. Resultat: Analysen av resultaten resulterade i tre kategorier: omvårdnad, vårdmiljö och designens betydelse. Vårdpersonal som beskriver att arbetsmiljön i demensvården ofta är psykiskt påfrestande erfor att arbetsmiljön blir mindre psykiskt påfrestande vid användning av husdjursrobot. Slutsats: Husdjursrobot är ett viktigt och positivt verktyg som både gynnar vårdpersonalen och patienten med demensdiagnos. När patienterna med demensdiagnos integrerade med husdjursrobot, såg vårdpersonalen att tekniken husdjursrobot frambringade känslor som kärlek och trygghet. / Background: Alzheimer’s and vascular dementia are the most common dementia diagnoses affecting elderly patients. Dementia affects patients differently depending on the location of the damage in the brain. Agitation, anxiety and difficulty understanding one's surroundings are, however, common symptoms. Pet robots is defined as a common term, as although this technology has various names. This technology has become more common to use in healthcare particularly in elderly care as therapy for patients with dementia and the aim is to improve their well being and life quality. Purpose: Is to describe the nursing staff's experience with pet robots in the care of patients diagnosed with dementia. Methods: A general literature review was conducted on twelve articles, six of which were mixed methods, five qualitative, and one quantitative. Results: The analysis of the results was separated into three categories: nursing; the care environment; and the design’s importance for the interaction. The care staff, who often describe the work environment in dementia care as psychologically stressful, found that their work became less psychologically stressful when using a pet robot. Conclusion: Pet robots are an important and positive tool that benefits both patients with a diagnosis of dementia and the staff responsible for their care. When patients with a diagnosis of dementia integrated with the pet robot, the care staff could see that the pet robot brought out emotions such as love and security.

Dementia is one of the biggest global challenges within healthcare of our timeand to develop the interventions and preventions of this condition is important tobetter the quality of life for these individuals (Livington et al., 2017). In fall of 2018 the municipality of Kalmar established a team of specialists to assistassistant nurses in their care of the elders. The aim of this study is to understandhow a team of specialists cooperates with assistant nurses who work in dementiacare and if there are any differences in the view that the team has opposite to theassistant nurses. This study is based on semi-structured interviews with the teamof specialists and assistant nurses that works in residential homes with a focuson dementia and has had experiences from the team's work. The interviews arealso analyzed through the theoretical model cooperation theory. The studyindicates that there are several areas where the team of specialists has a positiveimpact in helping the assistant nurses. They provide education, both practicaland emotional support by giving advice and being a source where the assistantnurses can ventilate their concerns. They provide security for the workers whohave good attitudes towards the team in most areas of their work.

Bakgrund: Transpersoner lider i högre utsträckning av psykisk ohälsa i jämförelse med övrig befolkning. I enlighet med lagar och konventioner har alla människor rätt till jämlik och adekvat vård. Sjuksköterskor behöver bred kompetens för att kunna ge hälsofrämjande och likvärdig vård. Trots det upplevs svårigheter att behandla transpersoner på grund av otillräcklig utbildning och kunskap. Syfte: Syftet var att beskriva transpersoners upplevelser av mötet med vårdpersonal. Metod: En litteraturöversikt baserad på tolv kvalitativa vetenskapliga originalartiklar. Litteratursökningarna genomfördes i databaserna Cinahl Complete och PubMed. Resultat: I resultatet framkom fyra kategorier; att bli felkönad, människa inte vara transperson, betydelsen av kunskap eller okunskap hos vårdpersonal och vårdmiljöns betydelse. Transpersoner upplevde att deras könsidentitet var dominerande i mötet med vårdpersonal oavsett sökorsak. Upplevelsen av att inte få adekvat vård eller bemötande på grund av kompetensbrist var också tydlig. Sammanfattning: Bemötande har stor betydelse för hur transpersoner upplever sin vård. Positiva upplevelser av mötet med vårdpersonal var trygghetsingivande och stärkande medan negativa upplevelser var diskriminerande och icke hälsofrämjande. En ytterligare påverkande faktor var vårdmiljön. / Background: Transgender people suffer to a greater extent from mental illness in comparison to the rest of the population. In accordance with laws and conventions, everyone has the right to equal and adequate care. Nurses need broad competence to be able to provide health-promting and equivalent care. Despite that, difficulties are experienced in treating transgender people due to insufficient education and knowledge. Aim: The aim was to describe transgender persons experiences of healthcare encounters. Method: A litterature review based on twelve original qualitative scientific articles. The litterature search was carried out in the databases Cinahl Complete and PubMed. Results: Four categories emerged in the results; to be misgendered, human not just a transgender person, the importance of knowledge or lack of knowledge of healthcare staff and the importance of the healtcare environment. Transgender people felt that their gender identity was dominant in the encounter with healthcare professionals, regardless of the reason for seeking health care. The experience of not receiving adequate care or treatment due to lack of knowledge was also clear. Summary: The healthcare encounter has a great significance for how transgender people experience their care. Positive experiences of the encounter with healthcare personnel were reassuring and empowering, while negative experiences were discriminatory and did not promote transgender persons health. An additional factor that influenced the impression was the health care enviroment.

Syftet med digital teknik är att öka effektiviteten på hälso- och välfärdsservice. Studien undersöker huruvida vårdpersonal på vårdenheten kan påverka vilken typ av digital teknik som introduceras på deras arbetsplats samt hur de ska lära sig använda denna. Studien använder hälsoteorin Känsla av Sammanhang. De pedagogiska teorierna som används är utvecklingsinriktat lärande samt erfarenhetsbaserat lärande. En kvalitativ metod med semistrukturerade intervjuer har använts. Det empiriska materialet blev sedan analyserat med kvalitativ innehållsanalys. Resultatet presenteras utifrån två huvudkategorier; personalen fick prova och besluta om digital teknik och utbildningar och “superanvändare” som stöd för lärande. Resultatet visade att flera i personalen gavs möjlighet till att vara med och påverka vilken typ av digital som ska användas på vårdenheterna och att flera gavs samma möjligheter till att vara delaktiga i utbildningarna. / The aim of digital technology is to increase the efficiency of health- and welfare services. This study's focus is on whether health- and care staff can have any influence on what type of digital technology that is going to be introduced and applied in their workplace. The study uses the theory of health, known as Sense Of Coherence (SOC), developmental learning and experiential learning. In addition, the study uses a qualitative method with semi-structured interviews. The empirical information is then analysed with a qualitative analysis. The result from the analysis is separated into two main categories; the health and care-staff were able to try out and decide regarding digital technology and educations and “superusers”as support to learning. The results showed that several people in the health- and care staff were given the opportunity to influence on what type of technology that is going to be used in the care unit’s and were given the opportunity to participate in the educations.

No description available.

A Saúde da Família configura-se em uma estratégia de reorientação do modelo assistencial que busca melhor compreensão do processo saúde-doença e a assistência integral e continuada com foco nas famílias de uma área adscrita. Caracteriza-se, ainda, como trabalho complexo, exigindo, dos profissionais, uma construção coletiva. O objetivo desta pesquisa foi avaliar a organização do trabalho, prazer, sofrimento e as estratégias de mediação do sofrimento dos profissionais das equipes de Saúde da Família do Grupo Hospitalar Conceição (GHC). Pesquisa com abordagem quantitativa transversal e qualitativa estruturada a partir da metodologia da Psicodinâmica do Trabalho. A coleta dos dados quantitativos ocorreu de setembro a novembro de 2011, com a aplicação do Inventário de Risco de Adoecimento relacionado ao Trabalho (Itra) junto aos profissionais das equipes de Saúde da Família de 12 unidades de saúde do GHC localizadas em Porto Alegre/RS, Brasil. A partir dos resultados da análise fatorial de correspondência da etapa quantitativa participaram. do estudo qualitativo, três unidades de saúde da família, que obtiveram, com aplicação do Itra, menor, moderado e maior risco de adoecimento relacionado ao trabalho. Para a coleta dos dados qualitativos, foram realizadas observação e entrevistas coletivas semiestruturadas com os profissionais das equipes de Saúde da Família no período de outubro a dezembro de 2012 e, para a análise, utilizou-se a Análise de Conteúdo. O Itra avaliou que o contexto de trabalho das equipes de Saúde de Família apresenta moderado risco de adoecimento relacionado ao trabalho quanto à organização (3,32), condições (3,03) e relações socioprofissionais (2,58) no trabalho. Quanto ao custo humano de trabalho, os custos físicos (2,72) e afetivos (2,66) foram avaliados como críticos, e o cognitivo (3,77) como grave risco de adoecimento relacionado ao trabalho. As vivências de prazer, com os indicadores realização profissional (4,21) e liberdade de expressão (4,21), foram consideradas satisfatórias, enquanto que as de sofrimento e falta de reconhecimento (1,80) foram igualmente avaliadas como satisfatórias. O indicador de sofrimento por esgotamento profissional (3,33) foi avaliado como crítico. Os três fatores da escala de danos relacionados ao trabalho, físico (2,33), psicológico (1,37) e social (0,70) foram considerados suportáveis. Da análise qualitativa emergiram três temas: prazer, sofrimento e estratégias de enfrentamento do sofrimento. Os profissionais avaliam a autonomia, a criatividade e trabalho em equipe com fontes de prazer na organização do seu trabalho. O sofrimento é percebido nas exigências do trabalho, condições da estrutura física e a complexidade do trabalho realizado pelas equipes de Saúde da Família; dizem, ainda, que utilizam estratégias de enfrentamento do sofrimento como o compartilhamento do trabalho e estratégias individuais. Conclui-se que o estudo destaca a importância e a necessidade de os profissionais disporem de espaços de fala e escuta para discutirem e refletirem sobre a organização do seu trabalho, dando potência à subjetividade do trabalho, ou seja, entendendo-o realizado por pessoas com identidade, com história; pessoas que não são somente instrumentos, mas os produzem na relação com características prazerosas para alcance do seu fim, no caso a promoção da saúde. Considera-se que produzir espaços para produção/reflexão do trabalho é ferramenta necessária, a qual contribuirá para a saúde dos profissionais da saúde, auxiliando a compreensão sobre o sofrimento que antecede a formação de sintomas e doenças relacionadas ao trabalho. / The Family Health program configures a strategy that designs the care model with a new guiding outline which looks for better comprehension of the health-disease process as well as the whole and continuous care with focus on families from an restricted area. In addition, it features a complex work that requires a collective construction by the professionals. The objective of this research was to evaluate the work organization, pleasure, suffering and the strategies to mediate the suffering of the professionals from the staffs of the Family Health program of Grupo Hospitalar Conceição (GHC). It is a research with cross-sectional quantitative and qualitative approach structured from the methodology of the Psychodynamics of Work. The collection of quantitative data was carried out from September to November 2011 by applying the Illness Risk Inventory regarding Work (Itra) with professionals of the Family Health staffs from 23 health centers of the GHC located in Porto Alegre/RS, Brazil. From the results of the correspondence factor analysis of the quantitative step, three family health centers participated of the qualitative study that, after application of the Itra, obtained minor, moderated, and higher illness risk in connection with work. For the collection of the qualitative data, observation and semi-structured collective interviews were carried out with professionals from the Family Health staffs in the period from October to December 2012 and for the analysis, the Content Analysis method was utilized. The Itra evaluation evidenced that the working context of Family Health staffs presents moderated illness risk regarding the work as to the organization (3.32), conditions (3.03) and social and professional relations (2.58) in the labor environment. As to the working human cost, physical costs (2.72) and affective costs (2.66) were assessed as critical while cognitive costs (3.77) showed severe illness risk regarding work. Pleasure experiences, with indicators like professional achievement (4.21) and expression freedom (4.21) were considered satisfactory while those like suffering and lack of recognition (1.80) were also evaluated as satisfactory. The suffering indicator due to professional burnout (3.33) was evaluated as critical. The three factors of the scale for damages in connection with work, i.e., physical (2.33), psychological (1.37) and social (0.70) were considered tolerable. From the qualitative analysis, three themes have emerged: pleasure, suffering and strategies to face suffering. Professionals evaluated autonomy, creativity and team work with sources of pleasure in their working organization. Suffering is perceived within working requirements, physical structure conditions and the complexity of the work carried out by the Family Health staffs; they say, yet, that they utilize strategies to face suffering like sharing work and individual strategies. The conclusion drawn is that the study points out the importance and the professionals´ need of speaking and listening spaces in order to discuss and to reflect about their work organization, by giving power to the work subjectivity, that is, by understanding it as done by people with identity, history; namely, by people who are not only tools, but who produce them within a relationship with pleasing characteristics in order to achieve their goal, namely, health promotion. Designing spaces in order to produce and to reflect about work is considered a needed tool which will contribute for the well-being of healthcare professionals by helping them to understand suffering that occurs before the rise of symptoms and diseases in connection with work. / El programa Salud de la Familia configura una estrategia de reorientación del modelo asistencial que busca mejor comprensión del proceso salud-enfermedad así como la asistencia integral y continuada con foco en las familias de un área adscrito. Se caracteriza, aún, como trabajo complejo, exigiendo, de los profesionales, la construcción colectiva. El objetivo de esta investigación fue evaluar la organización del trabajo, el placer, el sufrimiento y las estrategias de mediación del sufrimiento de los profesionales de los equipos de Salud de la Familia del Grupo Hospitalario Conceição (GHC). Se trata de una investigación con planteamiento cuantitativo transversal y cualitativo estructurado desde la metodología de la Psicodinámica del Trabajo. La recopilación de los datos cuantitativos se realizó de septiembre a noviembre de 2011, con la aplicación del Inventario de Riesgo de Enfermedad relacionado al Trabajo (Itra) junto a los profesionales de los equipos de Salud de la Familia de 12 unidades de salud del GHC localizadas en Porto Alegre/RS, Brasil. A partir de los resultados del análisis factorial de correspondencia de la etapa cuantitativa participaron del estudio cualitativo, tres unidades de salud de la familia, que obtuvieron, a través de la aplicación del Itra, menor, moderado y mayor riesgo de enfermedad relacionado al trabajo. Para la recopilación de los datos cualitativos, se realizaron observación y entrevistas colectivas semi-estructuradas con los profesionales de los equipos de Salud de la Familia en el período de octubre a diciembre de 2012 y, para el análisis, se utilizó el Análisis de Contenido. El Itra concluyó que el contexto de trabajo de los equipos de Salud de la Familia presenta moderado riesgo de enfermedad relacionado al trabajo en cuanto a la organización (3,32), condiciones (3,03) y relaciones sociales y profesionales (2,58) en el trabajo. En cuanto al consumo humano de trabajo, el consumo físico (2,72) y lo afectivo (2,66) fueron evaluados como críticos, mientras lo cognitivo (3,77) como grave riesgo de enfermedad relacionado al trabajo. Las experiencias de placer, con los indicadores realización profesional (4,21) y libertad de expresión (4,21), fueron consideradas satisfactorias, mientras las de sufrimiento y falta de reconocimiento (1,80) fueron igualmente evaluadas como satisfactorias. El indicador de sufrimiento por agotamiento profesional (3,33) fue evaluado como crítico. Los tres factores de la escala de daños relacionados al trabajo, físico (2,33), psicológico (1,37) y social (0,70) fueron considerados soportables. Del análisis cualitativo emergieron tres temas: placer, sufrimiento y estrategias de enfrentamiento del sufrimiento. Los profesionales evalúan la autonomía, la creatividad y el trabajo en equipo con fuentes de placer en la organización de su trabajo. El sufrimiento es percibido en las exigencias del trabajo, en las condiciones de la estructura física y en la complejidad del trabajo realizado por los equipos de Salud de la Familia; dicen, aún, que utilizan estrategias de enfrentamiento del sufrimiento como el compartimento del trabajo y estrategias individuales. Se concluye que el estudio destaca la importancia y la necesidad de que los profesionales dispongan de espacios de habla y escucha para que discutieran y reflejaran acerca de la organización de su trabajo, dando potencia a la subjetividad del trabajo, o sea, entendiéndolo realizado por personas con identidad, con historia; personas que no se vean solamente como instrumentos, pero que los produzcan en la relación con características placenteras para alcanzar su fin, es decir, la promoción de la salud. Se considera que producir espacios para producción y reflexión del trabajo es herramienta necesaria, la cual contribuirá para la salud de los profesionales de la salud, auxiliando la comprensión sobre el sufrimiento que antecede la formación de síntomas y enfermedades relacionadas al trabajo.