The Swedish healthcare system is strained today, along with a rise in the number of elderly people in the country. Aside from the expected physical ailments facing this group, mental health issues such as depression are also common amongst older adults. It is the researchers’ assumption that these three societal challenges; the healthcare system being strained, the growing elderly population and the health issues present amongst this group, are connected. Virtual Reality (VR) technologies show promising benefits according to the scientific literature and may prove to be a useful tool in combating the listed challenges. However, the researched benefits of this technology can’t be utilized properly if the target group perceives it as negative or cumbersome, which is why it is imperative to explore this group’s attitude towards the usage of VR as a preventative part of their treatment. This paper aims to explore the perceptions of Virtual Reality technologies in treatment of elderly and to focus on their and the caretakers’ attitudes of its usage, in addition to eventual annoyances or limitations with their current applications by answering the research question: how is the usage of VR technologies in care related functions perceived by elderly people and their caretakers? A qualitative study with an inductive approach was performed by using a small-scale survey strategy, with a focus on the perceptions and experiences of people as well as their feelings and emotions, while aiming to describe and understand the lived experiences of the target demographic and their caretakers. Face-to-face interviews with a semi-structured format were employed at two recreational facilities for elders in Sweden, with participants consisting of three elders between the ages of 83 and 91 along with three caretakers, all of whom were female and had used some form of VR technology in the past. The collected interview data was then analyzed by way of thematic analysis, which generated a total of 2 themes, 8 categories and 21 codes. The results show that both elders and their caretakers generally have a positive attitude towards the use of VR, with none of the interviewees seeing any drawbacks towards its usage. All interviewees wished to see VR become a regular part of the offerings at the recreational facilities, with the frequency of use being deemed reasonable at 2 weeks by all elders who took part in the study. The preferred types of VR experiences consisted of either visiting familiar places or emulating activities that the elders were no longer capable of performing. It was concluded that nostalgia played a big part in what experiences the elders enjoyed, and generated positive effects including feelings of relaxation, escaping reality and increased socialization amongst the elders.

Bakgrund: Globalt sett är depression det sjukdomstillstånd som står för störst sjukdomsbörda mätt i år förlorade till sjukdom. Incidensen av depression i världen har ökat med 49 % från 1990 till 2017 och forskning har visat ett samband mellan kön och ålder samt depression. Motiv: Det finns bristande kunskap om vad som kännetecknar personer med nedstämdhet. Det är oklart om de samband som finns gällande funktionsnedsättning och depression även har ett samband gällande nedstämdhet. En ökad kunskap hos distriktssköterskor om kännetecken för nedstämdhet hos äldre kan förväntas leda till att detta tillstånd identifieras både tidigare och bland fler personer. Syfte: Syftet med denna studie var att identifiera kännetecken på nedstämdhet hos äldre personer i särskilt boende. Metod: Data till denna studie har inhämtats från en longitudinell studie (Äldre vårdade på institution i Västerbotten) och består av data från instrumentet MultiDimensional Dementia Assessment Scale (MDDAS). Studien riktades mot personer boendes i särskilda boenden för äldre i Västerbotten i maj 2013. Totalt besvarades 2210 enkäter (svarsfrekvens 70,1 %). Chi2-analys användes för att identifiera variabler med statistiskt signifikanta samband med nedstämdhet. En stegvis logistisk regressionsanalys användes för att skapa en förklaringsmodell. Resultat: Resultatet visar att aggressivitet, verbalt störande eller uppmärksamhetssökande beteende, hallucinationer, smärta samt kvinnligt kön var förknippat med en ökad sannolikhet för förekomst av nedstämdhet. Det visar även att ålder var en skyddsfaktor i detta sammanhang. Modellen förklarade 6,7-12,6 % av variationen. Konklusion: Distriktssköterskor har en viktig roll när det gäller att identifieranedstämdhet hos äldre, vilket vårt resultat kan bidra till. / Background: Globally, depression is the medical condition with the highest burden of disease measured in years lost to illness compared to all diseases. The incidence of depression in the world has increased with 49 % from 1990 until 2017, and research shows a correlation between sex, age and depression. Motive: There is a lack of knowledge about what characterizes people with minor depression. It is not clear whether the existing association between disability and depression also are related to minor depression. Increased knowledge of characteristics of minor depression in the elderly among district nurses can be expected to lead to the condition being identified earlier and among more people. Aim: The aim of this study was to identify signs of minor depression in elderly persons living in elder care facilities. Methods: Data for this study was obtained from a longitudinal survey and consisted of data from the Multi-Dimensional Dementia Assessment Scale (MDDAS). It was aimed at persons living in elder care facilities in Västerbotten in May of 2013. In total, 2210 surveys were answered with a response rate of 70,1 %. Chi2-analysis were used to identify variables with a statistically significant relationship with minor depression. In addition, a step-wise logistic regression analysis was used to create a model of explanation. Result: The result shows that aggressiveness, verbally disruptive or attention-seeking behaviour, hallucinations, pain and female sex were associated with an increased chance probability of minor depression. It also shows that age was a protective factor in this context. The model explaineds 6,7-12,6 % of the occurence of minor depression. variance.  Conclusion: District nurses have an important role in identifying minor depression in older people, which our result can contribute to.

Background The aging population, particularly in Sweden, has heightened the need for innovative solutions in long-term elder care. This demographic shift results in a wealth of health data, from vital signs to social interactions. Accurate documentation of this data is crucial for providing effective care. However, there is a lack of systematic understanding of the types of health data collected in Swedish elder care. This study aims to bridge the gap between idealized and actual documentation practices. Methods The method combines literature reviews with qualitative techniques such as interviews, aiming to thoroughly understand the documentation of health data in Swedish long-term care facilities for older adults. By coding and categorizing the content into manageable data, researchers can identify patterns, trends, and relationships within the media being studied. Results Current documentation practices in Swedish long-term elder care were examined, revealing a variety of health data types collected, including personal information, assessments, care plans, and incident reports. Legal guidance from the Social Authority is deemed insufficient by managers, particularly concerning the Act on Coherent Documentation (SVOD).Documentation practices vary among municipalities due to operational differences and municipal autonomy. These findings highlight complexities and gaps, necessitating further research and improvement efforts. Conclusion Within the context of long-term elder care in Sweden, effective documentation practices play a crucial role. However, there is vagueness surrounding the specific health data that should be and is documented. This is what has been revealed in my study, drawing from interviews with multiple informants. While digital documentation offers promise, addressing complexity requires coordinated efforts. Streamlining regulations, enhancing interoperability, and improving usability are essential steps toward improving elder care documentation practices. / Bakgrund Den åldrande befolkningen i världen, och särskilt i Sverige, har ökat behovet av innovativa lösningar inom äldreomsorgen då denna demografiska förändring har resulterat i en ackumuleringen av stora mängder hälsodata. För att kunna tillhandahålla effektiv vård så är det viktigt att den samlade hälsodatan dokumenteras korrekt. Det finns dock en brist i den systematiska förståelsen för vilka typer av hälsodata som samlas in inom svensk äldreomsorg. Syftet med denna studie är därför att undersöka klyftan mellan hur hälsodata bör dokumenteras enligt lagar och regler, och hur det faktiskt dokumenteras i praktiken. Metoder Studien kombinerar dokumentanalyser med intervjuer, och har som mål att djupgående förstå dokumentationen av hälsoinformation i svenska vård-och omsorgsboenden. Genom att koda och kategorisera resultatet från dokumentanalyserna och intervjudata kunde mönster, trender och relationer inom det studerade materialet identifieras. Resultat Nuvarande dokumentationspraxis inom svensk äldreomsorg undersöktes. Resultatet visade att en mängd olika typer av hälsoinformation samlas in, däribland personlig information, bedömningar, vårdplaner och incidentrapporter. Juridisk vägledning från Socialstyrelsen bedöms vara otillräcklig av chefer, särskilt när det gäller lagen om sammanhållen dokumentation (SVOD). Dokumentationspraxis varierar mellan kommuner på grund av operativa skillnader samt det kommunala självstyret. Dessa resultat belyser problemet med hur hälsoinformation dokumenteras och de brister som kräver ytterligare forskning och förbättringsåtgärder. Slutsats Inom ramen för äldreomsorgen i Sverige spelar effektiva dokumentationsmetoder en avgörande roll. Det råder dock oklarhet kring vad för hälsoinformation som bör och faktiskt dokumenteras. Detta är vad som avslöjats i denna studie, baserat på intervjuer med flera informanter. Även om digital dokumentation är fördelaktigt så kräver hanteringen av de påvisade problemensamordnade insatser. Förtydligandet av regelverk, förbättrad interoperabilitet och ökadanvändbarheten är viktiga steg mot att förbättra dokumentationspraxis inom äldreomsorgen.

This investigation concerns the problem of current health care utilization by aged blacks. Utilizing Andersen's model, the volume and pattern of physician utilization associated with selected predisposing, enabling, and need variables is described for an aged population of 163 interviewed blacks residing in Census Tract 212, Denton, Texas, in 1972. None of the six socio-demographic, economic, or health status variables analyzed, through use of Somers' dyx, allowed substantial reduction .of error in predicting a physician visit in the past year. Representing need, selfrated health status was the best predictor variable. Its proportional reduction in error increased from 17 percent to 30 percent, for those with five to seven years education, and to 23 percent, for those reporting the least income.

Med bakgrund av enhetschefer i äldreomsorgens komplexa yrkesroll har syftet med denna studie varit att undersöka enhetschefens upplevelse av yrkesrollen samt vilka krav och förväntningar som finns hur de upplevs och hanteras. Vad som motiverar enhetscheferna har också undersökts. Metoden som vi använde var en kvalitativ metod där vi genomförde sju semistrukturerade intervjuer med enhetschefer i kommunal hemtjänst. Vi utförde vår studie i en mindre kommun i södra Sverige. Empirin har analyserats med hjälp av tidigare forskning inom undersökningsområdet och utvalda teorier för ämnet. Resultatet visar att vår empiri i stora drag stämmer väl överens med tidigare forskning som bekräftar att yrkesrollen är komplex med mycket varierande arbetsuppgifter och att den innehåller krav och förväntningar från många olika håll. I likhet med tidigare forskning upplever även de enhetschefer vi undersökt, brister i vissa stödfunktioner, vilket också blivit det mest utmärkande i denna studie. Trots upplevda brister i stöd och hög arbetsbelastning visar samtliga enhetschefer i studien en positiv inställning till arbetet och uppger att de känner sig motiverade i sin yrkesroll. / With the background of middle managers in elderly care complex professional role, the purpose of this study has been to examine the middle manager's experience of the professional role, as well as what requirements and expectations exist and are experienced and how they are handled. What motivates the unit managers has also been investigated. The method we used was a qualitative method in which we conducted seven semi- structured interviews with unit managers in home care. We conducted our study in a small municipality in southern Sweden. The empirical work has been analyzed with the help of previous research in the research area and selected theories for the subject. The result shows that our empirical data broadly matches well with previous research that confirms that the professional role is complex with very varied work tasks and that it contains requirements and expectations from many different directions. Like previous research, it also fails here in some support functions for the middle managers, which has also become the most characteristic of this study. Despite shortcomings in support and high workload, all middle managers in the study show a positive attitude to the work and state that they feel motivated in their professional role.

Detta är en uppsats där normer och värderingar om vårdbiträdet i hemtjänst undersöks genom kritisk diskursanalys. Datamaterial omfattar SOU-rapporten I den äldres tjänst. Äldreassistenten – ett framtidsyrke samt två fokusgruppsintervjuer med omsorgspersonal från en hemtjänstenhet. Diskursanalysen utförs i förhållande till och i samspel med sekundärlitteraturen. Utöver den språkliga analysen tas även kulturella och sociala dimensioner med i studien. För att ringa in rådande diskurser studeras centrala termer och formuleringar genom att undersöka hur ofta och upprepat de förekommer, samt vilken inkludering och exkludering som görs. I spänningsfältet som uppträder mellan den statliga diskursen och den praktiknära diskursen framträder stridigheter om de brister som äldreomsorgen tillskrivs. På politisk statlig nivå framträder en normerande bild av vårdbiträdet som den bristande länken i lagarbetet kring den äldre. På praktiknära nivå framhålls en förklaringsmodell där organisering och ledning är centrala bristkomponenter. Praktiker-diskursens faktorer bemötande och lön konkurrerar med de överordnade faktorerna som återges i SOU-diskursen; utbildning och validering. / This study is a discourse analytical study of norms and values in the Swedish public home health care sector. The discourse is studied at two different levels in Swedish society: the political and the practical. Information is collected through focus-group interviews at the practical level and at the political level from a report in the Swedish Government Official Reports Series (SOU 2008:126), appointed by the Ministry of Health and Social Affairs.   Government-sponsored publications and reports are used as a basis for executive and legislative decision-making in the parliament and the government. The governmental study is an important template for the formation and maintenance of norms and valuations. Elder care workers constitute Sweden's largest labor force and a majority of them are employed by municipalities. The SOU report motivates competence-reform in light of pending waves of retirements within the elder care work force, increased demand for elder care, and decreasing high-school enrollment in care and service programs. The discourse analysis is executed in relation to and in concert with the secondary literature.   The theoretical and methodological perspective in this study takes its starting point in Fairclough's critical discourse analytical theory and method. This provides dialectic of structures and practices, where discourse has an influence on and is influenced by social structures. In Fairclough's view, discourse practices are an important form of social practice that contributes to the forming of identities and relationships. The study investigates discursive practices in the report in order to uncover their role in the perpetuation of an unequal balance of power, so called ideological effects.  The study reveals contradictions within the SOU report and discordance between the report and home health care workers. Despite a societal eagerness to professionalize the home health aide, the political discourse relegates the aide to the bottom of the care hierarchy, by excluding issues such as compensation and subordinating questions concerning the organization and management. Discourses and action-space for workers in the home health care environment can be investigated in light of current deficiencies in top-down guidance and limited opportunities for peer-group meetings, especially since an increasing number of home health care workers have Swedish as a second language. Interactive research with both workers and management could be investigated and developed with pedagogical tools as a part of process of reform. Because Swedish society places such a high value on government reports, it is of continuing importance to scrutinize through critical-discourse analysis the entity of governmental research.

No description available.

The purpose of this study was to understand how unit managers within communal home care service for older people, convert political policy and guidelines into practical care, and how they within this process govern their personnel. The study was based on a qualitative method with a hermeneutic approach. Former research disclose that the process of converting political policy and guidelines and how unit managers govern personnel are somewhat tenuous. Previous research show structural shifts and reorganisations within public service consequently shaping todays structure of organizations and management. The study draws on eight interviews with unit managers within two municipalities in Sweden. To carry out our interviews we used a semi-structured interview guide followed with an analysis of our main results using Lipskys concept of discretion and Foucaults theory of governmentality. The results indicate that unit managers’ work, converting political policy and guidelines into practical care, are complex. The study shows that unit managers experience difficulties and differ in their ways in the process of adapting political policy and guidelines into practical care. Unit managers therefor find some of the guidelines more difficult to integrate than others. We find it important in this study to highlight the different ways unit managers work in the process of converting political policy and guidelines, and how they in the process govern their personnel.

No description available.

This dissertation explores how family and marriage relationships vary according to the culture in which they occur. Based on the individualism/collectivism framework about cultural variations in familial beliefs across countries, I study three topics of family and marriage relationships across cultures. In the first study, I examine how 17 member countries of Organisation of Economic and Co-operation and Development (OECD) differ culturally in older adults' preference for family elder care. I find that older adults from countries with more traditional values that emphasize the importance of a strong parent-child tie are more likely to prefer family care rather than formal care than those from more secular-rational countries with less emphasis on the parent-child tie; the cultural difference gets smaller at a higher level of individual family income. In the second study, I select China as a representative of the collectivist culture, and look into how the collectivist culture and older parents' filial beliefs shape the intergenerational relationship in China. I find that patrilocal and patrilineal traditions are still prevail in China. A highly cohesive intergenerational relationship people idealize in the collectivist culture is more common between older parents and married sons, and least common between older parents and married daughters. In the third study, I compare an individualist society, the U.S., and China, a collectivist society to test whether marriage also isolates people from their informal social network in China as observed in the U.S. I find that marriage does not isolate but integrates people into their informal social network in China, while marriage isolate people in the U.S. The three studies present new evidence on how marriage and family experiences differ due to different cultural beliefs about family, and under what conditions the cultural influences are weakened or reinforced. / Ph. D.