The purpose of this study was to examine how professionals describe the interaction between psychiatry and addiction care when it comes to clients/patients  who suffer from comorbidity of substance abuse and diagnosed mental illness. In this study we posed the following questions: How do the care personnel within psychiatric treatment and substance abuse care describe the current state of the collaboration between them? Which pros and cons do the personnel within the two sectors describe regarding collaboration? Based on six interviews; three among professionals in psychiatry and three in addiction care, the overall result shows that the informants believe that the existing cooperation works well but can be developed. The study also shows that concerted individual plans (SIP) as a tool can generate positive results for clients/patients within both organizations. SIP is also an opportunity for the professionals to go beyond the current confidentiality that exists between the client/patient and organization and thus better able to collaborate around a client/patient. The conclusion is that cooperation can be favored or discriminated against by the staff's attitudes towards individuals who suffer from comorbidity, political decisions, maneuver and professional, personal experience and knowledge of each other's professions. / Syftet med denna studie var att undersöka hur yrkesverksamma inom psykiatrin och beroendevården beskriver samverkan mellan organisationerna angående personer som lider av samsjuklighet av missbruk och diagnostiserad psykisk ohälsa. Frågeställningarna var: Hur beskriver vårdpersonalen inom psykiatrin och beroendevården att samverkan fungerar? Vilka fördelar respektive nackdelar beskriver personalen inom de olika verksamheterna att det finns med samverkan? Utifrån sex intervjuer, tre bland anställda inom psykiatrin respektive tre i beroendevården, visar det övergripande resultatet att informanterna anser att den befintliga samverkan fungerar bra men kan utvecklas. Studien visar även att samordnade individuella planer (SIP) som verktyg kan generera positiva resultat för klienterna/patienterna inom de båda organisationerna. SIP är också en möjlighet för de professionella att få möjlighet att häva rådande tystnadsplikt som finns mellan klienten/patienten och organisationen och därigenom bättre kunna samverka kring en klient/patient. Slutsatsen är att samverkan kan gynnas eller missgynnas av personalens attityder gentemot individer som lider av samsjuklighet, politiska beslut, handlingsutrymmet samt yrke, personlig erfarenhet och kunskap om varandras professioner.

Alzheimer’s disease has increasing effects on the Swedish population. Now, about 90 000 swedes have been diagnosed with the disease. Many of these persons are cared for by someone close to them. The aim of this study is to increase understanding for the situation and experiences of the persons caring for their affected partner and to examine which support they are given by the public sector. It is a qualitative case study where four persons have been interviewed. Previous research concerning experiences, coping strategies and the need for aid is used for reference. The theories chosen for the aim of the study is coping strategies, role theory, social interaction, informal care and informal aid. The results show that the participants have had different experiences of caring for their partners of which stress, anxiety and seeing it as a burden was common. The participants had different coping abilities to master their different situations and over all had good coping strategies. Their need for aid was different but all participants stressed that there is need for support and that this need to be developed. The following conclusions can be drawn from the study. The experiences are different depending on the individual case. It is important for those active within the line of social care to have knowledge about coping strategies in order to give support to those providing care for their kin. All participants experienced a lack of cooperation and information. / Alzheimers sjukdom drabbar Sveriges befolkning i allt större utsträckning. Ungefär 90 000 personer i Sverige har diagnosen. Många av dessa personer vårdas av någon i sin omgivning. Syftet med studien är att få en ökad förståelse för partners som vårdar sin respektive som har Alzheimers sjukdom och vilka upplevelser som förekommer samt att undersöka hur stödet från samhället ser ut. Det är en kvalitativ fallstudie där intervjuer har gjorts med fyra personer. Tidigare forskning har tagits fram som berör upplevelser, olika copingstrategier och behov av stöd. De teorier som valdes för studiens ändamål är copingstrategier, rollteori, social integration, informell omsorg och informell hjälp. Resultatet visar att deltagarna hade olika upplevelser av att vårda varav stress, oro och börda var vanligt. Deltagarna hade olika copingförmågor för att bemästra de olika situationerna och det förekom överlag goda copingstrategier. Behovet av stöd såg olika ut, men deltagarna belyste att det fanns ett behov av stöd samt att stödet behöver utvecklas. Följande slutsatser kan dras av studien. Alla individer har olika upplevelser. Det är viktigt att få kunskap om olika copingstrategier, vilket medför att socialt arbete kan hjälpa dem att hantera olika situationer. Samtliga deltagare upplevde att det saknades samarbete och information.

The use of advanced medical technology at home has increased in most industrialized countries. The overall aim of this thesis was to develop knowledge of self-care and transition and issues that influence daily life and health among persons using advanced medical technology at home. Three qualitative studies were performed to describe the structure of self-care (I) and elucidate meanings of health-illness transition experiences among persons using long-term oxygen, or a ventila-tor, or performing blood or peritoneal dialysis (II), and to gain a deeper understanding of the meaning of living with an adult family member in this context (III). Ten interviews with adult patients (I-II) and ten with adult next of kin (III) in this context were performed and analysed with descriptive phenome-nological (I), phenomenological hermeneutical (II) and hermeneutical (III) methods. A quantitative, descriptive, comparative, cross-sectional design was used to describe and find factors that influence self-care agency and perceived health in a larger group of persons (180 patients) using the enumerated types of advanced medical technology at home (IV). In the results, (I) self-care among persons using long-term oxygen, a ventilator, or equipment for blood or peritoneal dialysis at home was described at a generic level, independent of the specific type of technology used. The general description of self-care in this context involved prerequisites for, activities for and consequences of self-care; (II) the health-illness transition among adult persons in this context was interpreted as contentment at being part of the active and conscious process towards transcending into a new state of living, in which the individual and the technology were in tune. The successful and healthy transition experience was characterized by human growth and becoming; (III) living with a family member who is using advanced medical technology at home was interpreted as meaning rhythmical patterns of being closely connected to but also separated from him or her, and of sorrow versus reconciliation. Dependence on others was reflected in a need for support from the healthcare professionals and significant others; (IV) health-related and technology-related variables in daily life were rated as satisfactory to quite a high extent, but participants using long-term oxygen perceived their health as significantly lower compared to the other technology groups. Further, a significant difference in sense of coherence was found between users of long-term oxygen and peri-toneal dialysis. Factors that contributed to self-care agency and sense of coherence were found. In conclusion, self-care in a high-tech home context means more than simply mastering the technology. With the goal of maintaining an active, social life, the health-illness transition involves a learning process of accepting and integrating the technology into daily life. With knowledge and support, patients and next of kin are able to assume substantial responsibility for self-care/dependent-care. Daily life seems to be manageable for patients using this kind of technology at home.

<p> </p><!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:HyphenationZone>21</w:HyphenationZone> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--><p><!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-name:"Normal\,Normal1\,Normal11\,Normal111\,Normal1111\, webb2"; mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} @page Section1 {size:612.0pt 792.0pt; margin:70.85pt 70.85pt 70.85pt 70.85pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --></p><!--[if gte mso 10]> <mce:style><! /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Normal tabell"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} --><p> </p><!--[endif]--><p>Vilka bedömningsinstrument som används inom missbruks- och beroendevården och hur Sveriges kommuner använder instrumenten är ett outforskat område. Socialstyrelsen publicerade år 2007 nationella riktlinjer för missbruks- och beroendevård där man förespråkar användandet av bedömningsinstrument. Studien har granskat i vilken utsträckning och i vilket syfte bedömningsinstrument används och hur förutsättningarna ser ut för användningen av bedömningsinstrument inom socialtjänstens arbete med missbruks- och beroendevård. Hur frekvent är användningen av bedömningsinstrument och vilka för- och nackdelar framkommer i bruket av dessa? Uppsatsen har en kvantitativansats med kvalitativa inslag och utgår från telefonintervjuer med tio respondenter. Dessa arbetar som handläggare inom missbruks- och beroendevården för vuxna och har tillgång till bedömningsinstrument. Studien visade att åtta av tio arbetsplatser (80 %) som har tillgång till olika bedömningsinstrument använder dem. Främsta syftet är att tydliggöra klientens problematik, se insatsbehovet, få ett helhetsperspektiv och att skapa ett aktivt deltagande från klienten. Förutsättningarna för att använda bedömningsinstrument finns i form av utbildning och stöd från organisationen, men det saknas tid, kunskap och utrustning för att använda dessa fullt ut. Den statliga intentionen med en evidensbaserad praktik är att skapa en evidensbaserad kunskapsbank. Trots detta visar undersökningen att utvärdering och statistik är två eftersatta områden gällande hanteringen av bedömningsinstrument.</p> / <p><!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:HyphenationZone>21</w:HyphenationZone> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--> <!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-name:"Normal\,Normal1\,Normal11\,Normal111\,Normal1111\, webb2"; mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} @page Section1 {size:612.0pt 792.0pt; margin:70.85pt 70.85pt 70.85pt 70.85pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!--[if gte mso 10]> <mce:style><! /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Normal tabell"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} --> <!--[endif]--></p><p>What assessment instruments used in drug and dependent care, and the extent to which the Swedish municipalities are using these instruments is an unexplored area. Socialstyrelsen published in 2007, national guidelines for drug and dependent care which advocates the use of assessment instruments. The study aim is to examine the extent to which, for what purpose and how conditions look for the use of assessment instruments in the social service work with drug and dependent care. How frequent is the use of assessment instruments and the advantages and disadvantages apparent in the use of these? The essay has a rate of quantitative and qualitative elements based on telephone interviews with ten respondents. Those working as administrators in the drug and dependent care for adults and have access to assessment instruments. The results showed that eight out of ten sites (80%) use different assessment instruments. Main purpose is to clarify the client's problem, see the effort need, have a global perspective and to create the active participation of the client. The conditions for the use of assessment instruments are in the form of training and support from the organization, but the absence still time, knowledge and equipment to use them fully. The government intends to evidence-based practice is to create an evidence-based knowledge. Although this study shows that the evaluation and statistics are two areas in the existing management of the assessment instrument.<strong></strong></p><p> </p>

<!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:HyphenationZone>21</w:HyphenationZone> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--><!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-name:"Normal\,Normal1\,Normal11\,Normal111\,Normal1111\, webb2"; mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} @page Section1 {size:612.0pt 792.0pt; margin:70.85pt 70.85pt 70.85pt 70.85pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!--[if gte mso 10]> <mce:style><! /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Normal tabell"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} -->  <!--[endif]-->Vilka bedömningsinstrument som används inom missbruks- och beroendevården och hur Sveriges kommuner använder instrumenten är ett outforskat område. Socialstyrelsen publicerade år 2007 nationella riktlinjer för missbruks- och beroendevård där man förespråkar användandet av bedömningsinstrument. Studien har granskat i vilken utsträckning och i vilket syfte bedömningsinstrument används och hur förutsättningarna ser ut för användningen av bedömningsinstrument inom socialtjänstens arbete med missbruks- och beroendevård. Hur frekvent är användningen av bedömningsinstrument och vilka för- och nackdelar framkommer i bruket av dessa? Uppsatsen har en kvantitativansats med kvalitativa inslag och utgår från telefonintervjuer med tio respondenter. Dessa arbetar som handläggare inom missbruks- och beroendevården för vuxna och har tillgång till bedömningsinstrument. Studien visade att åtta av tio arbetsplatser (80 %) som har tillgång till olika bedömningsinstrument använder dem. Främsta syftet är att tydliggöra klientens problematik, se insatsbehovet, få ett helhetsperspektiv och att skapa ett aktivt deltagande från klienten. Förutsättningarna för att använda bedömningsinstrument finns i form av utbildning och stöd från organisationen, men det saknas tid, kunskap och utrustning för att använda dessa fullt ut. Den statliga intentionen med en evidensbaserad praktik är att skapa en evidensbaserad kunskapsbank. Trots detta visar undersökningen att utvärdering och statistik är två eftersatta områden gällande hanteringen av bedömningsinstrument. / <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:HyphenationZone>21</w:HyphenationZone> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--> <!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-name:"Normal\,Normal1\,Normal11\,Normal111\,Normal1111\, webb2"; mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} @page Section1 {size:612.0pt 792.0pt; margin:70.85pt 70.85pt 70.85pt 70.85pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!--[if gte mso 10]> <mce:style><! /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Normal tabell"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} --> <!--[endif]--> What assessment instruments used in drug and dependent care, and the extent to which the Swedish municipalities are using these instruments is an unexplored area. Socialstyrelsen published in 2007, national guidelines for drug and dependent care which advocates the use of assessment instruments. The study aim is to examine the extent to which, for what purpose and how conditions look for the use of assessment instruments in the social service work with drug and dependent care. How frequent is the use of assessment instruments and the advantages and disadvantages apparent in the use of these? The essay has a rate of quantitative and qualitative elements based on telephone interviews with ten respondents. Those working as administrators in the drug and dependent care for adults and have access to assessment instruments. The results showed that eight out of ten sites (80%) use different assessment instruments. Main purpose is to clarify the client's problem, see the effort need, have a global perspective and to create the active participation of the client. The conditions for the use of assessment instruments are in the form of training and support from the organization, but the absence still time, knowledge and equipment to use them fully. The government intends to evidence-based practice is to create an evidence-based knowledge. Although this study shows that the evaluation and statistics are two areas in the existing management of the assessment instrument.