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Syfte: Att undersöka distriktssköterskors erfarenheter av rollen som ledare för omvårdnadsarbetet i kommunal hemsjukvård. Metod: Studien hade en kvalitativ ansats. Tio distriktssköterskor verksamma inom kommunal hemsjukvård i två olika kommuner deltog i studien. Data insamlades via semi-strukturerade intervjuer och analyserades genom kvalitativ innehållsanalys. Resultat: Tre kategorier med åtta subkategorier framkom. De tre kategorierna och dess subkategorier indelades enligt följande: Att leda omvårdnaden är en ansvarsfull uppgift med subkategorierna Ansvar för att organisera omvårdnaden, Ansvar för kompetensutveckling och Att vara sitt eget verktyg. Kategorin Att leda omvårdnaden innebär samarbete med andra med subkategorier Samarbete med kollegor, Samarbete med omvårdnadspersonal och Samarbete med andra professioner. Slutligen framträdde kategorin Att rollens karaktär har förändrats med subkategorierna Ökad omfattning av komplex hemsjukvård, Konsultativt arbetssätt och ökat administrativt arbete.  Slutsats: Studiens resultat indikerar att satsningar inom kommunerna och utbildningar bör göras för att stärka distriktssköterskans roll som ledare för omvårdnadsarbetet inom kommunal hemsjukvård. / Aim: To investigate the district nurses' experiences of their role as leaders of nursing in community home care. Method: The study had a qualitative approach. Ten district nurses working in community home care in two different municipalities participated in the study. Data were collected through semi-structured interviews and analyzed by qualitative content analysis. Results: Three categories with eight subcategories emerged. The three categories and their subcategories were divided as follows: To lead the nursing is a responsible task with subcategories Responsibility for organizing nursing care, Responsibility for professional development and To be her/his own tools. The category To lead the nursing care involves collaboration with others by subcategory Collaboration with colleagues, Collaboration with nursing staff and Collaboration with other professions. Finally the category: The role's character has changed appeared with the subcategories Increased extent of complex home nursing, Consultative approach and increased administrative work. Conclusion: The results of the study indicate that investments in the municipalities and education should be made to strengthen the district nurse's role as leader of the nursing work in community nursing.

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Submitted in Partial fulfillment of the Requirements for the Masters Degree in Social Work at the University of Zululand, 2010. / KwaZulu-Natal is at the heart of Aids pandemic, with HIV prevalence figures consistently higher than other provinces.The basic purpose of this research is to assess the impact of Thandukuphila HIV/AIDS Community Based - Care Centre on the lives of HIV/AIDS infected and affected people (beneficiaries), which is situated in a rural township established on the precincts of a vast tribal area in the northern part of Kwazulu-Natal province. This HIV/AIDS Community Based - Centre was initiated as a response by some community members, initially it was church based, the church was challenged by the difficult health problems and social situations experienced by some of their community people, who were being devastated by the disease, HIV/AIDS, both inside the township and the neighboring rural area. In–depth interviews were utilized to seek more information from these knowledgeable individuals regarding their own and other peoples’ experiences, who are beneficiaries of Thandukuphila and, also those involved in many other ways. A purposive sample of nine participants’ from Thandukuphila CBO, which is situated at Enseleni was purposefully selected for the study. All participants were beneficiaries of Thandukuphila Community based care centre. These individuals were identified for their potential to elicit valuable information since they are beneficiaries of the programme. The individuals were also identified according to the criteria for inclusion. There were four groups of participants: i) PLWA, ii) OVC, iii) Caregivers/Volunteers, iv) Committee members. The review of literature gives some detailed analytical views on the prevalence of the pandemic HIV/AIDs in Kwa-Zulu Natal. The aspect of community –home based care is discussed, for the role it is playing as well as the contribution it is making, albeit, in a limited manner because of resources, expertise and support from formal authority structures. The narrative discussion intertwines quotations with the author’s interpretations. Also in data analysis the researchers “seek to identify and describe patterns and themes from the perspective of the participants” Creswell (1994:167). Throughout the study report the research hints at limitations the organization has to contend with and these are briefly indicated in a nutshell towards the end. The set objectives for the study were achieved. The findings indicated that Thandukuphila Community Based -Care Centre has a positive and significant impact on the lives of HIV/AIDS infected and affected people, who are beneficiaries of the program. However, it is the researcher’s informed opinion that responsible Government Departments need to put more effort on assisting since they have professional personnel, in monitoring and evaluating the standard of services rendered by these Community Based Care Centres.

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South Africa has been affected both economically and socially by HIV/AIDS. The South African government has put policies in place to support people infected and affected by HIV/AIDS and to ensure that they are not discriminated against. Many children have lost either one or both parents to this pandemic. The purpose of this research study was to explore community-based care for HIV/AIDS orphans. The research question for the study was: “What are the key components of community-based care for HIV/AIDS orphans?” The objectives for this study were as follows: -- To conceptualise community-based care for HIV/AIDS orphans. -- To determine the directions and limitations with regard to community-based care within the current policy framework for caring for children infected and affected by HIV/AIDS. -- To identify the components of Heartbeat’s model for community participation for community-based care of HIV/AIDS orphans. -- To determine the key components for effective community-based care in the care of HIV/AIDS orphans, to serve as guidelines for a sustainable community-based care model for these children. This was an exploratory study. The researcher made use of a case study, which is a type of a qualitative research strategy. Twenty HIV/AIDS orphans, six caregivers and one volunteer were interviewed and a semi-structured interview schedule was used to gather data. Some of the key findings for this study were the significance of community participation, care and support in the placement of HIV/AIDS orphans which guided the key components for sustainable community-based care for HIV/AIDS orphans. The study identified specific challenges in getting communities to participate in the care and support of HIV/AIDS orphans. The study made the following recommendations based on the research findings: -- The revision of policies and guidelines addressing children infected and affected by HIV/AIDS. -- The drafting and implementation of monitoring and evaluation mechanisms for community-based care for HIV/AIDS orphans. -- The Government’s involvement in pledging more resources for HIV/AIDS orphans. / Dissertation (MSD (Social Development and Policy))--University of Pretoria, 2007. / Social Work and Criminology / unrestricted

The focus of this study is on the evaluation of community based care and support service for older persons in the community. The government of South Africa and other African Countries held several discussions with the intention of addressing the needs and challenges of older persons in the community. As a follow up to the discussion, the new developmental approach, that is the South African Policy for Older Persons of 2005 and the Older Persons Act, 13 of 2006, promulgated in line with the recommendation of the Madrid International Plan of Action on ageing which was drafted and adopted at the World Assembly on Ageing that was convened by the United Nations in 2002. Older Persons Act 13 of 2006 was developed with the intention of addressing the needs of older persons in the community as the Aged Act no 100 of 1967 as amended in 1998, was focusing more on the residential care service. The Older Persons Act 13 of 2006 recognizes the importance of community-based care and support services and this means that the service delivery to older persons has been broadened and services have become more inclusive and accessible. Older persons will be able to remain in their communities within their families for as long as possible. According to the Older Persons Act 13 of 2006, the community-based care and support services means any programmes that are rendered to older persons to enable them to remain independent in their communities for as long as possible. These programmes are preventing the unnecessary admission of older persons in the residential care facilities. According to the Older Persons Act 13 of 2006, the Community-based care and support services are categorized into, namely, prevention and promotion programmes and the home-based care services. These two categories will be discussed in details in this study. In this study the researcher used the older persons (recipients of services), representatives of management committees for the Non-profit organizations rendering services to older persons in the community and the officials of the Department of Social Development as participants. The aim of this study is to discuss and evaluate the community-based care and support services strategy as used by the Department of Social Development in rendering services to older persons within communities in Motheo District (Free State Province) and to raise the viewpoints of direct service providers (management committees) officials of the Department of Social Development and older persons that receive these services, in order to enhance the delivery of this programme. The research methodology that was utilized in this study includes the empirical research and the literature review. A literature review was conducted by the researcher for a clear understanding of the nature and meaning of the problem that has been identified. The questionnaires and interview tools were used by the researcher as methods of data collection. This study consists of two articles, article 1: Background and nature of community-based care and support services and article 2: Evaluation of community-based care and support services The findings from the study indicated that the community based care and support services can be the best and important programme for older persons in the community if it can be well implemented. / MSW, North-West University, Potchefstroom Campus, 2014

The focus of this study is on the evaluation of community based care and support service for older persons in the community. The government of South Africa and other African Countries held several discussions with the intention of addressing the needs and challenges of older persons in the community. As a follow up to the discussion, the new developmental approach, that is the South African Policy for Older Persons of 2005 and the Older Persons Act, 13 of 2006, promulgated in line with the recommendation of the Madrid International Plan of Action on ageing which was drafted and adopted at the World Assembly on Ageing that was convened by the United Nations in 2002. Older Persons Act 13 of 2006 was developed with the intention of addressing the needs of older persons in the community as the Aged Act no 100 of 1967 as amended in 1998, was focusing more on the residential care service. The Older Persons Act 13 of 2006 recognizes the importance of community-based care and support services and this means that the service delivery to older persons has been broadened and services have become more inclusive and accessible. Older persons will be able to remain in their communities within their families for as long as possible. According to the Older Persons Act 13 of 2006, the community-based care and support services means any programmes that are rendered to older persons to enable them to remain independent in their communities for as long as possible. These programmes are preventing the unnecessary admission of older persons in the residential care facilities. According to the Older Persons Act 13 of 2006, the Community-based care and support services are categorized into, namely, prevention and promotion programmes and the home-based care services. These two categories will be discussed in details in this study. In this study the researcher used the older persons (recipients of services), representatives of management committees for the Non-profit organizations rendering services to older persons in the community and the officials of the Department of Social Development as participants. The aim of this study is to discuss and evaluate the community-based care and support services strategy as used by the Department of Social Development in rendering services to older persons within communities in Motheo District (Free State Province) and to raise the viewpoints of direct service providers (management committees) officials of the Department of Social Development and older persons that receive these services, in order to enhance the delivery of this programme. The research methodology that was utilized in this study includes the empirical research and the literature review. A literature review was conducted by the researcher for a clear understanding of the nature and meaning of the problem that has been identified. The questionnaires and interview tools were used by the researcher as methods of data collection. This study consists of two articles, article 1: Background and nature of community-based care and support services and article 2: Evaluation of community-based care and support services The findings from the study indicated that the community based care and support services can be the best and important programme for older persons in the community if it can be well implemented. / MSW, North-West University, Potchefstroom Campus, 2014

Bakgrund: Antalet patienter med hjärtsvikt kommer att öka i framtiden då fler äldre överlever en hjärtinfarkt vilket är en vanlig orsak till hjärtsvikt. Många patienter med hjärtsvikt väljer att vårdas i sitt hem vilket innebär en utmaning för distriktssköterskor i den kommunala hälso- och sjukvården. Syfte: Syftet med denna studie är att belysa distriktssköterskors stöd till patienter med svår hjärtsvikt som vårdas i hemmet inom kommunal hälso- och sjukvård. Metod: Genom intervjuer samlades data in från sex distriktssköterskor. Data analyserades med kvalitativ innehållsanalys med induktiv ansats. Resultat: Ur analysen framträdde fem kategorier: samordna och utföra vårdinsatser, bygga upp nära samspel med anhöriga, följas åt från ett palliativt skede till slutet, bristande läkarmedverkan samt brister i organisationen. Konklusion: I resultatet framkommer att det är viktigt att distriktssköterskan känner sina patienter väl för att kunna ge rätt stöd. Det framträder också att anhöriga har behov av stöd för att orka och känna trygghet vilket kan vara avgörande om patienten kan vårdas i hemmet. Brister finns både internt och externt som kan ge konsekvenser. Fortsatta studier kan vara inom en kommun med läkarunderstödda team tillsammans med kommunal hälso- och sjukvård. / Background: The number of patients with heart failure will increase in the future as more older people survive a heart attack, which is a common cause of heart failure. Many heart failure patients choosing to receive care in their home which poses a challange for district nurses in the community health-care.  Aim: The aim of this study is to illuminate districtnurse´s support for patients with grave heart failure at home in community home care Method: Six interviews were conducted with districtnurse´s. The data from these interviews were analyzed with an inductive content analysis.  Results: From the analysis, five major categories were found; coordinate care efforts, build close interactions with relatives, follow each other from a palliative stage to the end, lack of physician involvement and deficiencies in the organization. Conclusion: The result shows that it is important that the district nurse know their patient´s well in order to provide the proper support. It also appears that relatives need support to cope and feel secure, which can be crucial if the patient can be cared for at home. Deficiencies are both internally and externally that can have consequenses. Further studies may be within a municipality with a physician-sponsored team together with community health-care.

Syftet med denna studie var att beskriva distriktssköterskans arbete med, och erfarenhet av livsstilsförändringar hos patienter med pre-diabetes inom primärvården. Metod var en empirisk intervjustudie med en kvalitativ ansats. Åtta semistrukturerade intervjuer utfördes, intervjumaterialet analyserades utifrån Graneheim och Lundmans innehållsanalys. Resultatet visade att patienter med pre-diabetes oftast upptäcktes i samband med årskontrollen hypertoni eller då de sökte för andra besvär. Blodsockret kontrollerades på patienter med riskfaktorer. Det var diabetessköterskan som tog hand om patienterna och gav information om pre-diabetes, typ 2-diabetes, samt råd vad gäller livsstilsförändringar. De använde sig av olika pedagogiska verktyg och metoder i arbetet med att förebygga typ 2-diabetes hos patienter med pre-diabetes. Hur ofta dessa patienter följdes upp var individuellt. Att få patienten att förstå betydelsen av livsstilsförändringar upplevdes som en utmaning. Tid- och resursbrist nämndes som hinder i det förebyggande arbetet men ändå upplevdes möjligheterna som många. Slutsats är att om strukturerade rutiner för upptäckt av pre-diabetes och förebyggande av typ 2-diabetes fanns skulle patienter med pre-diabetes hittas tidigare. Därmed skulle onödigt lidande för patienten och de samhällskostnader som typ 2-diabetes medför minska. / The Aim of this study was to describe the Community Health Care nurse´s work and experience with lifestyle changes in patients with pre-diabetes, within the primary health care. The Method was an empirical interview study with a qualitative approach. Eight semi structured interviews were accomplished, the interview material were analyzed with Graneheim and Lundmans qualitative content analysis. The Results showed that the patients with pre-diabetes was discovered during the annual check-up for hypertension, or when the patients sought care for other symptoms. Blood glucose were checked on all patients with risk factors. It was the diabetes nurse who informed the patients about pre-diabetes, type 2- diabetes, and gave advice about lifestyle changes. They used different pedagogic tools and methods in the preventive work. The follow-up was adapted individually. It was a challenge to get the patients to understand that lifestyle changes were needed. Recourses and lack of time were an obstacle in the preventive work. Still the opportunities were seen as many. The Conclusion is that patients with pre-diabetes would be found earlier if structured routines for discovery of pre-diabetes and prevention of type 2-diabetes excited in the primary health care. Therefore, unnecessary suffering for the patient, and social costs would decrease.