Syftet med denna uppsats var att beskriva hur socialarbetarens yrkesroll och yrkesidentitet kan konstrueras i uppdraget som biståndshandläggare och i förhållande till rådande diskurser inom området. Kunskapsläget inom fältet visade att arbetet som biståndshandläggare är komplext och att det därför kan vara svårt att arbeta på det sätt lagen föreskriver. Dels beroende på att den ideologiska och ekonomiska samhällsutvecklingen kan leda till lagändringar och organisatoriska förändringar, dels beroende på hänsynstagandet till det allmänna intresset. Studiens empiriska material utgörs av intervjuer med fem biståndshandläggare/socialsekreterare, varav den ena inte hade ett myndighetsutövande uppdrag. Ett diskursteoretiskt perspektiv användes som verktygslåda för att analysera socialsekreterarnas utsagor och för att besvara studiens syfte och frågeställningar. Studiens resultat visade på att yrkesrollen konstrueras diskursivt, avhängigt kontexten och i förhållande till organisationens uppdrag för den enskilde socialsekreteraren. Socialarbetaridentiteten/ identiteterna tillskrevs olika former av betydelser men också olika former av diskursiva krav och förväntningar på både beteende och handlande. / The aim of this study was to describe how the social worker’s professional role and work identity can be constructed in the case manager’s assignments and in relation to the existing discourses in the field. Previous research in this field has shown that a case manager’s work is complex and that it can be difficult to perform their assignments according to the law. Partly because of the ideological and economic development in society, which might lead to changes in the organization, and partly due to the consideration of public interest. The empirical part of the study consists of interviews with five social workers. One of these social workers did not have a regulatory exercise assignment. To reach the aim of the study, a theoretical discourse perspective was used. The result showed that the work identity of the case manager is constructed through the discourses of the context and in relation to the assignments given to each case officer from the organization. The social worker identity was assigned with different meanings and different discursive requirements and expectations regarding how to behave and act.

This thesis is dealing with the possibilities of long-term care and support of the health- social care pointing to staying a senior with disability in his or her natural social environment - in community. The theoretical part is dealing with demographic predictions which are based on the necessity to take attention of long-term care provided to seniors. It deals with the definition of old age and ageing from the social gerontology point of view, senior needs and their saturation. It defines the basic of legal Framework of the problematics. It contains the summary of the present condition of the long-term care in the Czech Republic and in the chosen countries. It describes the health-social systems in chosen European countries which have already worked with the coordination of the care of these systems and they have known the position of the coordinator. It characterizes the influence and possibilities of the individual initiators of the long-term care with the aim of identification of the possible coordinator in our conditions, it means the subjects which are the non-medical health workers, doctors, community nurses, medical health workers, social workers, municipal offices, regional offices, employment departments, Ministry of Labour and Social Affairs, Ministry of Health, Non-governmental...

Summary: The main objective of this thesis is to describe the limits of existing methods and case management in providing health and social services in the Czech Republic of multidisciplinary care for a family with a disabled children. The work is divided into two parts. First - theoretical part - summarizes the theoretical issues, the basic terminology, case management, case manager, describes the role and method of use of case management in social and health services in the Czech Republic and abroad. There is also summarized the issues of families with disabled children, concept of multidisciplinary care for families with disabled children and the legislative framework governing the health and social care for these entities. The second, empirical part, qualitative research focuses on mapping the experience of families with disabled children in the multidisciplinary care of their children in practice, indications, course, professional representation of multidisciplinary care. The research describes the role of parent as a key person and needs in the care of children with disabilities through semi-structured interviews with five respondents who have children with disabilities. To better understand the needs of families with children with disabilities, case study was give through. I used information from the...

Syftet med denna studie är att undersöka biståndshandläggares upplevelser av bedömningsmöten för äldre med demenssjukdom, vilka eventuella utmaningar som uppstår samt hur dessa hanteras. Vidare syftar studien även till att utifrån begreppen empowerment, advocacy och paternalism skapa förståelse för hur biståndshandläggarnas beskrivna arbetssätt förhåller sig till uppdraget om värnandet av den enskildes självbestämmanderätt. Detta undersöktes genom semistrukturerade intervjuer med biståndshandläggare i en mellanstor kommun i Sverige, varefter empirin analyserades utifrån en tematisk analys samt beskrivna teoretiska begrepp. Studien visar att biståndshandläggarna möter en rad utmaningar vid dessa möten i form av kommunikationssvårigheter, bristande sjukdomsinsikt och motstånd samt utmaningen att som biståndshandläggare finna en balansgång mellan brukar- och anhörigperspektivet och att biståndshandläggarna tillämpar kommunikationsanpassning, strategier för samtycke, strategier vid motstånd och samverkan, för att hantera utmaningarna. En övergripande slutsats är att biståndshandläggarnas arbetssätt inrymmer tendenser av såväl empowerment som paternalism, vilket i viss mån kan anses stärka den enskildes egenmakt men i viss mån även motverka detta genom att professionella och anhöriga övertar beslutsansvaret för den demenssjuke på grund av nedsatt beslutsförmåga. Av analysen framkommer det även att biståndshandläggarna, i enlighet med begreppet advocacy, ofta intar positionen att företräda den äldre med demenssjukdom i syfte att värna om dennes självbestämmanderätt. / The purpose of this study is to investigate case managers experiences of assessment meetings for old people with dementia, which challenges arise and how these are handled. The study also aims to create an understanding of how the case managers described working methods relate to the task of protecting the individual's right to self-determination, based on the concepts of empowerment, advocacy and paternalism. This was investigated through semi-structured interviews with case managers in a medium-sized municipality in Sweden. The interviews were then analyzed based on a thematic analysis and described theoretical concepts. The study shows that the case managers face a series of challenges in terms of communication difficulties, lack of disease insight and resistance, as well as finding a balance between the perspective of the user and the relatives, and that the case managers apply communication adaptation, strategies for consent, strategies for resistance and cooperation to deal with these challenges. An overarching conclusion is that the working methods of case managers contain tendencies of both empowerment and paternalism, which to a certain extent can be considered to strengthen the individual's empowerment but to a certain extent also counteract this by having professionals and relatives take over decision-making responsibility for the person with dementia due to reduced decision-making capacity. The analysis also shows that the case managers, in accordance with the concept of advocacy, often take the position of representing the person with dementia to protect their right to self-determination.

The purpose of this study was to determine case managers’ understanding of their role in a managed care organisation and to develop recommendations for the improvement of case management practice. Quantitative descriptive research was conducted to explore perceptions of case managers regarding their role. A self-administered questionnaire was used as a formal data collection instrument and 25 respondents participated in the study. The findings revealed that the majority of case managers know what is expected of them in their job but that they do experience some barriers. There appears to be uncertainty with quite a number of respondents regarding certain aspects of their role. Recommendations were made for improved case management practice.

The purpose of this study was to determine case managers’ understanding of their role in a managed care organisation and to develop recommendations for the improvement of case management practice. Quantitative descriptive research was conducted to explore perceptions of case managers regarding their role. A self-administered questionnaire was used as a formal data collection instrument and 25 respondents participated in the study. The findings revealed that the majority of case managers know what is expected of them in their job but that they do experience some barriers. There appears to be uncertainty with quite a number of respondents regarding certain aspects of their role. Recommendations were made for improved case management practice.

The main goal of the Strategy for the Reform of Psychiatric Care, published in 2013 by the Ministry of Health of the Czech republic, was to improve the quality of life of people suffering from mental illness. One of the results of this strategy was the emergence of new mental health centres. These mental health centres are meant to provide individualized social and health care to people with mental illness in order to prevent or minimize their hospitalization. The service is ensured by multidisciplinary teams which include professionals such as psychiatrists, psychologists, psychiatric nurses, and social workers. Case management is supposed to be a dominant form of the service provided. The theoretical part of the thesis describes the historical context of the case management and its recent exploitation in the mental health centres in the Czech republic. The empirical part focuses on a particular multidisciplinary team applying the case management method. Through qualitative research, it aims to identify the different parts of the case management and the constraints and obstacles of its application. The analysis of the data collected brings the definition of the key problem areas the team is facing. The final part of the thesis provides recommendations for further development and proposes steps...

Syftet med detta arbete är att undersöka om biståndshandläggare inom äldreomsorg upplever att kommunens egna riktlinjer försvårar deras möjligheter att följa aktuell lagstiftning och nationella regelverk, samt i vilken mån detta kan skapa hinder för uppfyllandet av en skälig levnadsnivå. I studien har fyra biståndshandläggare blivit intervjuade från två olika kommuner. Uppsatsens insamlade empiri är det som ligger till grund för uppsatsens resultat, analys och slutdiskussion. I resultatet av studien framkom det att ibland kan kommunens riktlinjer uppstå som ett hinder, om kommunen inte erbjuder en insats. Resultatet visar också att biståndshandläggarna i båda kommunerna var överens om att begreppet skälig levnadsnivå är ett luddigt begrepp och att det saknas en tydlig definition av begreppet. Det framkom också delade meningar gällande om kommunens ekonomiska situation påverkade biståndshandläggarnas beviljandegrad.   Vi vill genom vår c-uppsats belysa att det som framkommer som resultatet i vår studie, kommer vi inte att kunna dra några generella slutsatser. Vi kommer däremot att på en mikronivå belysa likheter och skillnader mellan en kommun i norr och en kommun i syd.

Introduction. L’ostéoporose est une maladie chronique habituellement asymptomatique jusqu’à ce qu’il y ait fracture de fragilisation (FF). Ces fractures engendrent des coûts importants dont une partie pourrait être évitée par la prise en charge de ces patients pour l’ostéoporose. L’implantation d’un programme de prévention des fractures subséquentes géré par des infirmières en orthopédie pourrait permettre de parer à ces problèmes. Objectifs. L’objectif principal de ce projet était de déterminer si une infirmière peut gérer de façon efficace et sécuritaire un service de liaison pour fracture. Méthode. Les décisions cliniques d’infirmières entre 2010 et 2012 pour 525 patients d’un service de liaison pour fracture à l’étude ont été évaluées par deux médecins spécialistes indépendants avec expertise dans les soins pour l’ostéoporose. Résultats. Les infirmières ont pu identifier la totalité des sujets à risque et référer 26.7% de ceux-ci à un spécialiste. L’accord entre chacun des évaluateurs et les infirmières était de >97%. Les évaluateurs ont donné les mêmes réponses à >96% pour chaque type de décision et le niveau d’accord inter-juge était presque parfait (AC1 >0.960). Aucune référence n’a été jugée inutile. Les comorbidités majeures ont toutes été prises en charge. Conclusion. L’accord élevé entre les décisions cliniques des infirmières et des médecins évaluateurs démontre que la prise en charge par une infirmière est sécuritaire et recommandable pour les patients avec FF. Ce type d’intervention pourrait contribuer à résoudre les problèmes d’accessibilité aux soins chez les patients avec fragilité osseuse, ainsi qu’à diminuer le fardeau économique que représente le traitement des FF pour la société. / Introduction. Osteoporosis is a chronic condition which is usually asymptomatic until a fragility fracture (FF) occurs. These fractures lead to increased morbidity and mortality in patients. Moreover, a major care gap exists in the investigation for bone fragility and initiation of treatment for individuals who sustain a FF. The implementation of a subsequent fracture prevention program managed by nurses could be the key in resolving these problems. Objectives. The main objective of this project was to determine if a nurse can manage safely and efficiently a fracture liaison service (FLS). Methods. Clinical decisions of nurses for 525 subjects in a studied FLS between 2010 and 2012 were assessed by two independent physicians with expertise in osteoporosis treatment. Results. The nurses succeeded in identifying all patients at risk and referred 26.7% of patients to a specialist. Thereby, they managed 73.3% of subjects with FF. No needless referrals were made according to both physicians. Agreement between each evaluator and the nurses was of >97%. Physicians’ decisions were the same in >96% for each type of decision and AC1 coefficient was of >0.960 (almost perfect level of agreement). All major comorbidities were adequately managed. Conclusion. High agreement between nurses and physicians’ clinical decisions indicate that the management by a nurse of a FLS is safe and recommended for patients with FF. This kind of intervention could help resolve the existing care gap in osteoporosis care as well as the societal economic burden associated with treatment of FF.

No description available.