<p>Syftet med studien var att beskriva vårdpersonalens uppfattning om risker för undernäring och preventivt arbete hos personer 70 år och äldre, på olika vårdnivåer och inom en kommun. Studien hade en beskrivande design och tolv vårdpersonal deltog, varav fyra sjuksköterskor från en medicinavdelning, två sjuksköterskor, en sjukgymnast och en arbetsterapeut från en hälsocentral samt två sjuksköterskor, en enhetschef och en sjukgymnast från ett äldreboende inom en kommun. Intervjuer användes vid datainsamlingen. Data analyserades genom kvalitativ innehållsanalys och bildade kategorierna <em>Tillstånd som utgör en risk för undernäring, Säkerställa näringsintaget, Ett strukturerat arbetssätt samt Samverkan och ansvar. </em>Som risker för undernäring<em> </em>beskrevs sjukdomar, funktionsnedsättning samt förlorad uppfattning om vikten. Att säkerställa näringsintag innefattade mat, mellanmål och måltidsmiljö. Ett strukturerat arbetssätt handlade om riskbedömningar, åtgärder samt utvärdering. Vidare beskrevs samverkan inom och utanför den egna yrkesgruppen, vårdnivåer och ansvaret omkring arbetet med näringsfrågorna. Vårdpreventivt arbetssätt upplevdes spara tid, tydliggöra vad som skall göras och möjliggöra utvärderingar. Läkarens medverkan i det preventiva arbetet behöver klargöras och rutiner för spridning av arbetssättet till andra enheter formas. Vidare behövs beslut om hur näringstillstånd och behov ska dokumenteras och rapporteras för att säkerställas mellan vårdnivåerna</p> / <p>The purpose was to describe nursing staffs’ perceptions of risks for malnutrition and preventive efforts thereof, for patients 70 years and older, at different care levels within one municipality. Descriptive design was used and twelve participants included; two district nurses, one physiotherapist and one occupational therapist from a health care centre, two registered nurses, one unit director<strong> </strong>and one physiotherapist from a nursing home in the municipality and four registered nurses from an internal medicine hospital ward. Interviews and qualitative content analysis was used resulting<strong> </strong>in four categories <em>Conditions of risks for malnutrition</em>, <em>Ensuring nutritional intake</em>, S<em>tructured way to work<strong> </strong></em>and <em>Collaboration and responsibilities</em>. The participants’ described diseases, disabilities and lost of apprehension concerning weight constituting malnutrition risks. Meals and meal environment influence nutritional intake. Risk assessments, interventions and evaluations mirrored structured way of working. Collaboration with colleagues, other professionals and care levels were highlighted together with responsibilities. Physicians’ participation in malnutrition preventions needs clarification. Improvements like documentation of the nutritional status among the elderly and reports between the different levels of care are needed to ensure safe nutritional care.</p><p> </p>

Syftet med studien var att beskriva vårdpersonalens uppfattning om risker för undernäring och preventivt arbete hos personer 70 år och äldre, på olika vårdnivåer och inom en kommun. Studien hade en beskrivande design och tolv vårdpersonal deltog, varav fyra sjuksköterskor från en medicinavdelning, två sjuksköterskor, en sjukgymnast och en arbetsterapeut från en hälsocentral samt två sjuksköterskor, en enhetschef och en sjukgymnast från ett äldreboende inom en kommun. Intervjuer användes vid datainsamlingen. Data analyserades genom kvalitativ innehållsanalys och bildade kategorierna Tillstånd som utgör en risk för undernäring, Säkerställa näringsintaget, Ett strukturerat arbetssätt samt Samverkan och ansvar. Som risker för undernäring beskrevs sjukdomar, funktionsnedsättning samt förlorad uppfattning om vikten. Att säkerställa näringsintag innefattade mat, mellanmål och måltidsmiljö. Ett strukturerat arbetssätt handlade om riskbedömningar, åtgärder samt utvärdering. Vidare beskrevs samverkan inom och utanför den egna yrkesgruppen, vårdnivåer och ansvaret omkring arbetet med näringsfrågorna. Vårdpreventivt arbetssätt upplevdes spara tid, tydliggöra vad som skall göras och möjliggöra utvärderingar. Läkarens medverkan i det preventiva arbetet behöver klargöras och rutiner för spridning av arbetssättet till andra enheter formas. Vidare behövs beslut om hur näringstillstånd och behov ska dokumenteras och rapporteras för att säkerställas mellan vårdnivåerna / The purpose was to describe nursing staffs’ perceptions of risks for malnutrition and preventive efforts thereof, for patients 70 years and older, at different care levels within one municipality. Descriptive design was used and twelve participants included; two district nurses, one physiotherapist and one occupational therapist from a health care centre, two registered nurses, one unit director and one physiotherapist from a nursing home in the municipality and four registered nurses from an internal medicine hospital ward. Interviews and qualitative content analysis was used resulting in four categories Conditions of risks for malnutrition, Ensuring nutritional intake, Structured way to work and Collaboration and responsibilities. The participants’ described diseases, disabilities and lost of apprehension concerning weight constituting malnutrition risks. Meals and meal environment influence nutritional intake. Risk assessments, interventions and evaluations mirrored structured way of working. Collaboration with colleagues, other professionals and care levels were highlighted together with responsibilities. Physicians’ participation in malnutrition preventions needs clarification. Improvements like documentation of the nutritional status among the elderly and reports between the different levels of care are needed to ensure safe nutritional care.

The purpose of this study is to examine the influence of leadership on co-workers during a re-organization. Our framing of the problem is based on a book written by Lee G. Bolman and Terrence E. Deal (2007) “Reframing organizations – artistry, choice and leadership” and their four perspectives on leadership. The questions that our study is based on are: <ul type="disc">What leadership perspective was characteristic for the chief of staff during the re-organization? How did the employees experience the leadership of the chiefs during the re-organization? In what way do the chiefs of staff feel that their leadership affected the employees during the re-organization?   To get a deeper understanding in this subject we conducted interviews with the two chiefs of staff and their employees in a small suburb to Stockholm, Sweden. In our background we described the history of the suburb and why this re-organization is taking place. Thereafter we account for research in this area of expertise. In chapter five we account for the four perspectives and organization culture. We analyzed our interviewed material from these four perspectives and organization culture. Thereafter we conducted a conclusion based on the analyzed material. We concluded that both chiefs of staff were influenced by all four perspectives and this influence had different impacts on their employees. One chief were influenced by a Human Resource-perspective and a perspective focusing on structure. The second chief was also influenced by a perspective focusing on structure but also the perspective that focuses on politics.

The purpose of this study was to understand what the care recipients considering as care quality in their long-term eldercare. Our intention has been to contribute a bit to the development of the care work. Previous studies show that user surveys are carried out regularly but there is very few studies that are based on care recipients own opinions and experiences. The main questions in the study have been to examine what is considered as good elder care from a user perspective. Even to understand the characteristics of a good meeting with the care staff and also examine how the elder care in Nybro municipality can improve. This study was based on a qualitative method in the form of seven interviews with recipient of elder care. The interviews were based on five themes which were; background, care, interaction, "special housing and social interaction" and also changes. The collected material is analyzed from a symbolic interactionism perspective. We view the symbolic interactionism as a useful perspective to gain an understanding of the interaction between care recipients and staff, and how it can develop care work The result revealed that the elder care in Nybro Municipality is generally of good quality and that it works well with home care. The care recipients appreciate when the care staffs are cheerful and friendly during visits, and they use the term "helpfulness" to describe what characterize a good treatment. What emerges as a negative aspect of the elder care is that the care staffs are extremely busy and always in a rush at each visit, which may partly affect the care a bit negative. The study shows a desire for change to improve care staff working environment. All respondents have different perceptions of the elderly and what is considered quality of care. Although there are common views on certain things, it is because of their differing views at who they interact with and in what context, the overall situation.

This dissertation explores the impact of technology on social life. Focusing on webcam-mediated audio-visual conversations between Japanese families in the United States and their extended family members in Japan, I examine how technology participates in creating an interactional space for the families to manage intra- and intergenerational relationships. Combining ethnography with turn-by-turn analyses of naturally occurring webcam interactions, I specifically investigate how cultural, discursive, and family practices are transformed in innovative ways and how families adapt to the emerging mediated space. Looking at how interactional activities are coordinated across spaces, I show that webcam interactions constitute a new type of shared living space in which multigenerational family relationships are created and managed. I call this emerging space the virtual ie (‘house’ and ‘stem-family system’). In this virtually conjoined space, children, parents, and grandparents are visually familiarized with each other’s households and socialized to each other’s virtual presence. Even though the ie is no longer a juridical unit of co-residence, my goal is to discuss the significance of the ie in understanding how transnational Japanese families can dwell in a shared living space created by webcam interactions. My analyses demonstrate how webcam encounters create a stage for participants to perform various identities in interactions. Learning to talk and participate in such webcam interactions, children are socialized to their ie belongings and identities. Additionally, even though far-flung children do not provide physical and daily care for their parents in Japan, they actively take care of elder parents’ media environments. I demonstrate that what I call media care practices add another context for adult children living abroad to carry out their filial responsibilities. I also show that the management of webcam visual fields creates a type of social field that reflects local understandings of social positioning in ie structures. How participants decide to display themselves to others by manipulating the webcam’s visual fields provides a new way to demonstrate various social relationships and responsibilities over long distances. From this perspective, a virtual ie is not merely a reflection of an ideological understanding of Japanese families, but an interactional achievement facilitated by webcams. / text

Syftet med studien har varit att få klarhet i vilka faktorer som påverkar personalens handlande i mötet med äldres upplevelser av ensamhet, oro och ångest inom äldreomsorgen. Studien är kvantitativ och en enkätundersökning har genomförts på omsorgsavdelningar med personal som arbetar på särskilt boende. Jag har varit intresserad av att studera hur personalen möter de äldres upplevelser samt om brister kan identifieras som påverkar personalens handlande gentemot äldres behov. Den här studien har sin utgångspunkt i Socialstyrelsens nationella enkätundersökning 2012. Socialstyrelsens undersökning visade höga siffror vad gäller äldres upplevelser av ensamhet, oro och ångest på särskilt boende, vilket jag valt att studera vidare kring. Urvalet i min studie har bestått av 50 omsorgspersonal varav 31 svarade på enkäten vilket gav en svarsfrekvens på 62 procent. Den teoretiska utgångspunkten för studien har varit analysmodell med faktorer som utgår från individuella och organisatoriska områden. Studien påvisar utifrån personalens perspektiv att äldre upplever oro och ångest i hög grad vilket personalen anser orsakas av känslor av ensamhet. Resultaten utifrån analysmodellen visar huvudsakligen brister inom organisatoriska områden som brist på tid, arbetssätt, resurser, mål och arbetsledning. Personalens individuella resurser såsom empati, engagemang och värderingar visar tillfredsställande resultat. Däremot personalens kompetens vad gäller bemötande och arbetsmetoder visar genomgående brister. Detta påvisas genom avsaknad av utveckling och mål på det personliga, arbetsmässiga samt utbildningsmässiga planet. De äldres sociala tillfredsställelse har i studien gett paradoxala svar angående deras behov av samtal, stöd och gemenskap. Å ena sidan anses de äldres sociala behov vara tillfredsställda. Å andra sidan anses de äldre inte kunna påverka sina känslor av ensamhet, oro och ångest då personalen hänvisar till brist på tid och kompetens. / The purpose of this study was to ascertain the factors affecting employee behavior when meeting older people's experiences of loneliness, worry and anxiety in elderly care. The study is quantitative and a questionnaire survey has been conducted with staff working in elderly care. My scope has been based on the staff´s perspective to find out the situation of the elderly and needs from social satisfaction and the older people´s opportunities for meaningful conversations in retirement home. The study is based on the 2012 national survey, performed by the Swedish National Board of Health and Welfare (Socialstyrelsen). The survey is showing high numbers of older people`s experience of loneliness, worry and anxiety in retirement home, which I have chosen to study futher about. The sample of the study consisted of 50 care staff employees, 31 of which responded to the questionnaire giving a response rate of 62 percent. The theoretical starting point for the study is an analysis model with prepared factors. Factors based on individual and organizational areas acquired from the theory of the elderly care. The study demonstrates from the perspective of the staff members, that the elderly are experiencing a high grade of worry and anxiety, which is considered to be caused by feelings of loneliness. The results based on the analysis model shows mainly deficiencies in organizational areas such as lack of time, work methods, resources, goals and management. The employees individual resources such as empathy, commitment and values show satisfactory results. However the staff's competence in treatment and working consistently show deficiencies. This is demonstrated by the lack of development and aims at the personal, labor, and educational level. Older people's social satisfaction has in the study yielded paradoxical response regarding older people's need foriiconversation, support and fellowship. On the one hand the social needs of the elderly is considered to be satisfied. On the other hand, the elderly are considered not to be able to influence their feelings of loneliness, worry and anxiety as the staff refer to the lack of time and expertise.

The restructuring of Canadian health care for more than twenty years has ushered in opportunities for growth in private home care services. Within this socio-economic reality, some seniors and families feeling the impacts of the cutbacks to health and social services have turned to other alternatives of care to fill care gaps. A new type of caregiver, the paid companion, has surfaced in this respect. Operating either independently or through private health care agencies, paid companions resemble surrogate family members or friends who perform a variety of services for the elderly who can afford to pay for private home care and support. My research objective has been to explore and develop an understanding of the experiences and relationships of paid companions and their clients within the context of the political-economic climate of neoliberalism that has supported the development of paid companions. This thesis presents research conducted between 2009 and 2010 in the Greater Victoria area with 30 participants: 15 companions, 8 clients, and 7 key informants. The two qualitative methods of qualitative (semi-structured open-ended) in-person interviews and autodriven photo elicitation were utilized in order to examine the subjective experiences of paid companions and their clients. The research revealed the ambiguity and divergence of opinion around the terms ‘companion’ and ‘paid companion,’ which are inherent in the nature of the work itself. The majority of participants emphasized that friendship and fictive kinship often form the core of a relationship that has been built on caregiving and trust. While paid companions derive fulfillment by providing care for clients, the relationships they develop with them are intrinsically linked to the companionship and care they give. Although clients’ care needs most often stem from general health and mobility issues, the relationships that are gradually formed with their companions often become as important as the task-based assistance their companions provide to them. / Graduate

The aim of this study was to investigate if the experiences of work environment of employees in the elder care in the municipality of Umeå can be linked to high or low sickness absence. The method used was semi-structural qualitative interviews. Six retirement homes participated in the study and were divided into two groups, based on whether they had high or low figures of sickness absence. 28 elder care workers of different educational levels were interviewed. The interview questions were divided into categories. For the key phrases; “Have great possibilities of influencing one´s schedule” (category influence), “Is offered education” (category development and challenge), “The work pace depends on the wellbeing of the residents” (category physical and psychological workload), “Reflect/Do not reflect on work at home” (category physical and psychological workload), “Difficult to resolve conflicts” (category working climate and wellbeing) and “Stressful work” (category working climate and wellbeing) statistically significant differences between the groups were detected. Risk factors in the work environment, such as, time pressure, conflicts and physical and psychological strain are described by employees at retirement homes with both higher and lower figures of sickness absence. Differences between the sexes could not be investigated, but that does not exclude possible differences. Based on the results the conclusion is drawn that aspects of influence, development and challenge, physical and psychological workload and working climate and wellbeing can be factors that impact on sickness absence in the elder care in the municipality of Umeå.

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