Abstract Due to the advanced development of information technology, society groups generated from internet have been in shear progress. Not only can this phenomenon establish a bridge of emotional connection, it can also provide health information and medical knowledge. Moreover, it certainly can be influential on health policy conducted by governments. Among the present medical society groups, PatientsLikeMe.com (PLM) developed an innovative business model. It built up a platform which allows patients share their own medical history. Through sharing medical history, the patients are able to discover someone else who has similar symptoms and then help to improve clinical outcome. This website may collect patients¡¦ information under patients¡¦ permission. After being clearly filed and analyzed, the data may be sold to medical companies or co-operated institutions for improving clinical therapy. This model has been evaluated by an American consulting institution on business model -- ¡§Board of Innovation¡¨ --as the ¡§Top 10 shocking Business Model of 2010¡¨.Additionally, this model is recognized as a specific research model that may permanently change the methodology of medical research.(J Gospel Net December 2nd,2010) With a view to evaluating the function of websites on helping breast cancer patients to overcome depression and helplessness on diseases, in this study, we would like to introduce the concept of PLM internet society groups. After two interviews on breast cancer patients, we found that the patients are desperately looking for information while the diagnosis is firstly confirmed. These patients are thereby paying deep sympathy to the ones who are also in the same shoes. Under this condition, the patients are willing to share their experience anonymously. At the same time, they only want to solve the problems that already come to the door rather than prepare in advance. Consequently, all the information is collected from the surroundings and lack of proved quality. Therefore, it is important to avoid the fear brought by the overloaded information. From this research, we concluded that (1) during treatment, the breast cancer patients can receive professional assistance and sharing experience from PLM or similar function/ service on websites. (2)Through internet technology, it is possible to provide a platform that surpasses the limitation of both time and space and allows patients to share their personal experience and medical history. (3) PLM system opens a window that allows physicians or nurses to answer patient¡¦s question in one-to-one manner. It is also possible for patients to share their knowledge and some tips that may not be mentioned by medical professionals. However, we also notice that most patients still have problems on using internet society groups because of time limitation, incapability of typing and being unfamiliar on internet skills etc. This research concludes that internet society groups are unlikely to fulfill the requirement of breast cancer patients. Key Word¡GPatientsLikeMe.com (PLM), Case Manager, Social Networking.

The significant role of case managers in improving the health status of clients and in achieving cost-containment has been increasingly recognized. However, very few studies have touched on the emerging group of case managers who work exclusively with frail older adults. The purpose of this study was to determine the level of overall job satisfaction and some of its determinants among case managers of the Visiting Nurse Health System, Atlanta, Georgia, working primarily with older adults in two community-based programs. The objectives were to learn: (1) the level of overall job satisfaction among these case managers; (2) how these case managers perceive their role; and (3) what factors facilitate their work, what factors present barriers to their job performance, and what policy or procedural changes they feel would improve their performance. An established job satisfaction scale was employed to assess job satisfaction among the case managers. The overall job satisfaction scores ranged from 109 to 198 (out of a maximum possible score of 216), with a mean of 158.2, which is considerably higher than the theoretical mid-point of the scale (126). Nine subscales of job satisfaction, ordered by the satisfaction level from highest to lowest were, Coworkers, Supervision, Nature of Work, Communication, Contingent Rewards, Fringe Benefits, Operating Conditions, Pay, and Promotion. Case managers in the Older Group (aged 45 and older) showed higher overall satisfaction compared to those in the Younger Group (younger than 45). Furthermore, satisfaction levels with Fringe Benefits and Operating Conditions were significantly higher in the Older Group than in the Younger Group. No significant difference was found in job satisfaction between case managers in the two programs (CCSP and CBSP). Case managers with longer experience (at least 4 years) showed a higher satisfaction level with Pay compared to those with shorter experience (less than 4 years) in their current program. No significant difference in job satisfaction was found between social worker and nurse case managers, except that nurse case managers were significantly more satisfied with Fringe Benefits than social worker case managers. Qualitative analysis of the interview found that case managers tended to describe their role in terms that were either related to program objectives or activities. They viewed their role more as providing or ensuring services to their clients than as cost-containment. At the same time, initial assessment appeared to be the most important component of their role compared to other activities, such as evaluation or contact with service providers. Nature of the work, management, and coworkers are the three major sources of facilitating factors reported. On the other hand, the majority of deterring factors, related to operating procedures, pay, promotion, supervision, funding, and management, fell in the category of organizational factors. Deterring factors related to individual factors were related to communication and coworker relationship. Long-term study is needed to learn the job satisfaction among case managers working primarily with older adults and to determine what contributes to or undermines their job satisfaction. Policy changes might be needed at the organizational level to enhance job satisfaction among case managers.

This study investigates extant data concerning the current knowledge of geriatric case managers in Illinois who contracted with the Illinois Department on Aging in 2010 in order to provide case management services to adults age 65 and older. In examining the self-reported importance and frequency of geriatric case manager's knowledge domain areas in Illinois, the knowledge domain portion of the Case Manager's Role and Function Survey Instrument (CMRFSI) was utilized. The sample in this study consisted of 192 geriatric case managers. Participants were asked to complete the knowledge domain portion of the CMRFSI which contained a 5-point Likert scale of the importance of knowledge domains and a second 5-point Likert scale of the frequency of knowledge domains performed. Factor analysis was utilized to provide information regarding the underlying relationship between the variables. Factor analysis produced the following four factors: rehabilitation planning, care management, psychosocial aspects of case management, and service coordination/delivery survey. To provide a deeper understanding of the knowledge domain areas of geriatric case managers and the demographic variables of work setting, highest degree completed, major, and race/ethnicity a MANOVA was used. A significant difference was produced for race/ethnicity. Wilks' Lambda was used for multivariate statistical testing resulting in F (10, 4064.13) =1.20, p < .05. Each of the measure indicated that there was a significant (p < .05) difference on the four factors across the two races (White non-Hispanic and Minority). In addition, a univariate statistical test (see table 9) produced a significant (p < .05) alpha on factor I: rehabilitation concepts and factor II: care management indicating that when considered individually and collectively, rehabilitation concepts and care management are significantly different when considering race/ethnicity. Consequently, understanding the knowledge domains of geriatric case managers will assist in designing curriculum, certifications, and preparing students to providing services. In addition, implications, limitations, and suggestions for future research are discussed.

<p>The main purpose of this qualitative study was to describe clients’ descriptions of the professional role case manager and how it relates to the job description provided from a project in which both case managers and clients were participating. Both what case managers do and are expected to do were explored. The project involved case management in the purpose to strengthen and enhance the care and quality of life for clients who are dually diagnosed. Interviews were conducted with five clients and the result was analyzed with theoretical concepts from role theory. The clients’ descriptions of the case manager corresponded fairly well to the job description and former studies that have captured client descriptions. The role of the case manager was described as being available, flexible, outreach oriented, motivating, supportive, committed, giving immediate assistance and doing a lot of tasks. Furthermore as someone who activates the clients, goes by car, represents, clarifies, co-ordinates and should work professionally and individual-based.</p>

The main purpose of this qualitative study was to describe clients’ descriptions of the professional role case manager and how it relates to the job description provided from a project in which both case managers and clients were participating. Both what case managers do and are expected to do were explored. The project involved case management in the purpose to strengthen and enhance the care and quality of life for clients who are dually diagnosed. Interviews were conducted with five clients and the result was analyzed with theoretical concepts from role theory. The clients’ descriptions of the case manager corresponded fairly well to the job description and former studies that have captured client descriptions. The role of the case manager was described as being available, flexible, outreach oriented, motivating, supportive, committed, giving immediate assistance and doing a lot of tasks. Furthermore as someone who activates the clients, goes by car, represents, clarifies, co-ordinates and should work professionally and individual-based.

<p>The purpose of our study is to examine the case managers reasoning and descriptions of empowerment as a method in their social work from a comprehensively perspective including family members. To manage with this purpose we interviewed two case managers, two clients with mental disabilities and five family members. We have come to the conclusion that the case managers works more consist of advocacy than empowerment. Despite that we have found that the long term goal for the case mangers work is to give the clients tools for empowerment. Our results also show that the clients feel that they have gained and increased their ability to do things by themselves and to be a part of the community. The family members feel that they have been empowered because of that the case managers have given them advises of how they can support the clients in a better way, which have released them from family burdens.</p>

The purpose of our study is to examine the case managers reasoning and descriptions of empowerment as a method in their social work from a comprehensively perspective including family members. To manage with this purpose we interviewed two case managers, two clients with mental disabilities and five family members. We have come to the conclusion that the case managers works more consist of advocacy than empowerment. Despite that we have found that the long term goal for the case mangers work is to give the clients tools for empowerment. Our results also show that the clients feel that they have gained and increased their ability to do things by themselves and to be a part of the community. The family members feel that they have been empowered because of that the case managers have given them advises of how they can support the clients in a better way, which have released them from family burdens.

Intresset för ämnet uppstod efter en lång yrkesverksamhet i människobehandlande organisationer och den brist på samverkan och förståelse för andra yrkesområdens perspektiv som framkommit i den dagliga verksamheten. En önskan att se hur samverkansarbetet praktiseras, hos dem i vars uppgifter samarbete över institutionsgränserna ingår som en central del. Syftet med uppsatsen var att undersöka hur case managers organiserar sitt arbete utifrån frågetällningarna: vilka uppgifter har en case manager? Hur beskriver de sin respektive arbetsmodell och vilka för- och nackdelar ser de med sitt arbete?För att svara på frågorna genomfördes kvalitativa intervjuer med sju case managers i tre skilda arbetsmodeller: klinisk case management, personligt ombud och Assertive Community Treatment (ACT). Teoridelen består av en sammankoppling av de tre begreppen: biopsykosocialt perspektiv, samverkan och människobehandlande organisationer. Resultatet visade att en case managers grundläggande uppgift var att se till att de stöd- och behandlingsinsatser klienten har behov av utifrån ett biopsykosocialt perspektiv kommer klienten tillgodo. För att kunna göra detta krävdes bland annat att skapa en förtroendefull relation till klienten och att kunna se klientens behov utifrån ett biopsykosocialt perspektiv. Vidare krävdes en samhällsbaserad, uppsökande arbetsmetodik och tillgodoseende av klientens delaktighet i planeringen av stöd och behandling samt att arbetet kunde organiseras med en hög grad av självständighet utifrån klientens behov. / Case management: work models and tasks

Problem finns inom hälso- och sjukvårdens hantering av sjukskrivningsärenden och har visat sig vara extra stora inom primärvården. Många sjukskrivningar löper risk att bli långvariga, rehabiliteringsärenden drar ut på tiden och missförstånd uppstår mellan patienter och myndigheter samt myndigheter emellan. Mellan 1 september 2009 och 31 maj 2011 har man på Gotland bedrivit ett projekt med syfte att effektivisera sjukskrivningsprocessen med hjälp av Rehabkoordinator i primärvården. Denna studie utgör den kvalitativa utvärderingen utav projektet. Syftet med denna studie var att utvärdera om sjukskrivningsprocessen har underlättats för de samverkande aktörerna och för patienter efter inrättandet av Rehabkoordinator. Detta har genomförts genom en explorativ metod genom intervjuer och enkät.   I studien beskrivs och analyseras införandet av Rehabkoordinator som ett förbindelseorgan mellan primärvården, Försäkringskassan, Arbetsförmedlingen och socialtjänsten för bättre samordning kring patienter. Resultatet av studien visar att merparten av aktörerna upplever arbetsformen som positiv och gynnar samarbete och samordning vid arbetslivsinriktad rehabilitering. Aktörerna upplever att processen, effektiviteten och kvalitén i arbetet runt patienten har förbättrats. Kommunikationen och samordningen mellan berörda aktörer har underlättats och den psykosociala arbetsmiljön har förbättrats även om det framgår att det är för lite resurser för rehabiliteringssamverkan.   Patienterna upplever det positivt med Rehabkoordinatorns stödjande, förmedlande och koordinerande insatser vilket ses vara en framgångsfaktor för patienten. Majoriteten känner att de blivit respektfullt bemötta, känt sig delaktiga i sin rehabilitering samt fått det stöd och den information som de behövde av Rehabkoordinatorn.   Studien visar också att merparten av aktörerna har funnit fungerande rutiner för sin arbetsform och samverkan. Kvarstående hinder tycks bero på framförallt organisatoriska faktorer som till exempel förankring av verksamheten i de samverkande organisationerna, kunskap och kommunikation om och mellan olika professioner och organisationer, samt incitament och legitimitet för deltagande i rehabiliteringssamverkan. / The identified problems within the health care management concerning cases of sickness have proven to be particularly severe in the area of primary care. A large number of sick leaves are at risk of being long term, cases of rehabilitation drags on, and misunderstandings occur both between authorities and patients, and authorities. Between 1 September 2009 and 31 May 2011 Gotland has pursued a project with the intention to streamline the process of sick leave with the help of a Rehab coordinator in primary care. This study is the qualitative evaluation of the project. The aim of this study was to evaluate whether the process of sick leave have been facilitated both for the interacting actors and for the patients, after the establishment of the Rehab coordinator. This has been implemented through an exploratory approach through interviews and questionnaires.   This study describes and analyzes the introduction of a Rehab coordinator as a liaison body between primary care, social insurance, employment service and social services for a better coordination concerning the patients. The results of this study show that the majority of actors experience that the method is positive and benefits cooperation and coordination of vocational rehabilitation. The actors feel that the process, the efficiency and the quality of work around the patient has improved. The communication and coordination between actors have been facilitated and the psychosocial work environment has improved, although it is clear the there are not enough resources for the rehabilitation agreement.   The patients finds the support, the mediating and coordinating actions of the rehab coordinator positive, which is considered a factor of success to the patient. The majority feel they have been met with respect, felt involved in their rehabilitation and received the support and information they needed by the Rehab coordinator.    The study also shows that majority of the actors have found successful routines to support their method of work and collaboration. The remaining obstacle appeared to be particular organizational factors for example the anchoring of activities for the collaborating organizations, knowledge and communication about and between different professions and organizations, as well as incentives and legitimacy for participation in the rehabilitation agreement.

The study aims to examine foster parents’ experiences of foster care, focusing on the difficulties they may encounter and their experiences in the interactions and support from social services. Research shows that foster parents bear a significant responsibility for the lives and well-being of the children under their care. They often describe their parenting experiences as one characterized by powerlessness, and they perceive the support provided by social services as inadequate. Ensuring that foster parents receive the necessary support to provide stable and service care for the child is crucial for a successful placement. Considering this issue, the purpose of the study is to gain an understanding of the assignment and how foster parents experience the contact with social services. A qualitative method has been used and eight foster parents were interviewed using semi structured interviews. The data was analyzed using thematic analysis and presented and analyzed using Foucault’s theory of pastoral power and previous research. The results indicate that foster parents face different types of difficulties, especially when it comes to the contact with social services and the biological network of the placed children. The contact and support received from social services appears to be crucial for succeeding as foster parents, but it occurs to often be insufficient and lacking. The result also indicates that most foster parents’ experience difficulties related to the lack of decision making as well as the interactions between the placed child and its biological parents. However, lack of support emerges as the most challenging aspect of foster care according to the foster parents in this study because it makes it even harder to manage and handle the other difficulties and dilemmas that comes with the assignment. Therefore, this study emphasizes the significance of effective and supportive social services to ensure successful experiences for foster parents.