Background: Evidence has shown that family and friend caregivers of stroke survivors are significantly and negatively impacted by caregiving. The negative effects of caregiving may persist over time suggesting the need for ongoing care and support. However, little is known about caregivers’ use of formally funded health and social services or the factors influencing their access to and use of these services. Purpose: To increase understanding of: (a) the context of providing care for a stroke survivor; (b) the experiences of stroke caregivers in accessing and using formal health and social services; and (c) the factors that influence stroke caregivers’ use of formal health and social services, from the perspective of stroke caregivers and healthcare providers. Methods: A qualitative study was conducted using interpretive description. In-depth interviews were conducted with caregivers of survivors who experienced a stroke between six months to five years ago and healthcare providers who support caregivers and stroke survivors. Constant comparison was used to identify codes and develop key thematic constructs. Results: Interviews were conducted with 22 stroke caregivers at an average 30 months post-stroke and 18 health providers. Key findings include: (a) few caregivers use services, (b) caregivers face challenges accessing services, (c) services used by stroke survivors benefit caregivers, and (d) factors influencing stroke caregivers’ use of services include: adequacy of social support networks, finances and transportation, and trust in leaving the stroke survivor under the care of health providers. Conclusion: Stroke caregivers experience significant challenges in accessing and using formal health and social services. These challenges could be addressed by increasing availability of subsidized community-based supports such as respite and counselling tailored to meet the ongoing needs of caregivers. Systemic change is needed by the health system that readily includes and supports caregivers throughout the stroke recovery continuum, particularly in the community setting. / Dissertation / Doctor of Philosophy (PhD) / Caregivers often experience challenges supporting stroke survivors. Their caregiving role may negatively affect their health and ability to return to their previous lifestyle. Little is known about stroke caregivers’ use of funded supportive services. The purpose of the study was to better understand caregivers’ experience using health and social services as well as the factors that influenced their access to and use of these supportive services. Findings showed that: (a) few caregivers use services despite expressing a need for these services (e.g. counselling), (b) caregivers struggle to trust the health providers supporting the stroke survivors, (c) caregivers’ social lives are often greatly affected by their caregiving role which in turn impacts their need for services, and (d) caregivers pay many financial costs when using supportive services. Overall, better ongoing assessment of stroke caregivers is required including using tailored services to meet their needs and help them in their caregiving role.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 6 uppsatser.

The purpose of this study was to examine the extent to which human resources capacity of the Ministry of Health and Social Services (MoHSS), Namibia, influences health care services delivery to the Namibian population. A qualitative research model using exploratory and descriptive study designs was adopted. Data were collected through semi-structured interviews with 46 health workers from two referral hospitals and two directorates in Windhoek District. The study found that there is severe staff shortage in the MoHSS, which has resulted in high workload and poor health care. Health worker migration, new services and programmes, emerging diseases, and population growth were reported to have contributed to staff shortage and high workload in the MoHSS. Study findings suggested a need to create more posts to accommodate emerging needs, and to introduce an effective retention strategy to attract and retain health professionals with scarce skills, and those working under difficult conditions. / Public Administration & Management / M. Tech. (Public Management)

The purpose of this study was to examine the extent to which human resources capacity of the Ministry of Health and Social Services (MoHSS), Namibia, influences health care services delivery to the Namibian population. A qualitative research model using exploratory and descriptive study designs was adopted. Data were collected through semi-structured interviews with 46 health workers from two referral hospitals and two directorates in Windhoek District. The study found that there is severe staff shortage in the MoHSS, which has resulted in high workload and poor health care. Health worker migration, new services and programmes, emerging diseases, and population growth were reported to have contributed to staff shortage and high workload in the MoHSS. Study findings suggested a need to create more posts to accommodate emerging needs, and to introduce an effective retention strategy to attract and retain health professionals with scarce skills, and those working under difficult conditions. / Public Administration and Management / M. Tech. (Public Management)

This diploma thesis deals with the phenomenon of shared economy and describes it both on a wide scale and in specific sectors of its use in the social and health sphere. This trend inspired the introduction of a co-working concept to the market which is also described in the theoretical part of the thesis. The theoretical framework of the diploma thesis follows the practical part consisting of interviews with the founder of a co-working centre in Finland, with the executive director of a co-working centre in the Czech Republic, and with two users who have experience with this service in our country and abroad. Qualitative data from semi- structured interviews was a source in the creation of a business plan for the co-working centre, which is the aim of the diploma thesis. At the end of the diploma thesis, there is a shortened methodological guideline for establishing a co-working space. Keywords: shared economy, sharing, co-working, digitization, health and social services, desk

Long-Term Care for the Elderly in the Czech Republic and European countries in the context of demographic ageing Abstract Long-term care refers to the range of services required by persons suffering from a reduced degree of functional capacity and who are dependent on help with activities of daily living. These services include personal care as well as medical and social services. LTC could be provided either in institutional settings or at home - by informal (upaid) or formal providers. European Union has declared that LTC represents one of the main challenges connected with the current demographic changes. The main aim of this thesis is to provide a picture of LTC providing across European countries. Special attention was placed on ensuring care for the elderly in Czechia, where ambiguities about responsibilities (which are divided between The Ministry of Labour and Social Affairs and and The Ministry of Health), financing or even defining the content of this care have recently become quite frequent subjects of public debates. Keywords: demographic ageing, long-term care, health and social services, home care, Czechia, international comparison

Det svenska välfärdssystemet är ett komplext system som inkluderar en mängd olika servicefunktioner, olika former av stödjande verksamheter och olika finansieringsmodeller. Det kombinerar ett professionellt utförande med en serviceinriktning. Där finns en avsaknad av utvärderingar om hur individer utnyttjar de olika samverkande komponenterna i systemet. Komplexiteten begränsar möjligheterna till att studera interaktioner mellan dess olika delar. Termen ”kommundiagnos” introducerades i Sverige under 1970-talet. Under 1980- och 90-talet skapades inom flera svenska landsting speciella enheter vilka skulle ta fram ny kunskap för styrning baserat på information från dessa kommundiagnoser. I kommundiagnosen skulle administrativa, medicinska och samhällsdata vägas samman på ett systematiskt sätt för att ge information om befolkningen. Dessa resultat skulle sedan användas i politiska såväl som administrativa diskussioner om fördelning av resurser. Utnyttjandet och genomslaget av dessa kommundiagnoser har diskuterats. Resultat från gränsöverskridande analyser av särskilda behovsgrupper, förtidspensionerade, reser frågor om effektiviteten i välfärdssystemet.   I denna uppsats föreslås en ny form av metodik för att sammanställa information om olika delar av välfärdssystemet. En utvärderingsmodell utvecklades under det s.k. Oxelösundsprojektet, efter att ett försök att genomföra en kommundiagnos inte gett avsett resultat.   Modellen resulterade i värdefull ny information om konsumtionen av välfärdens resurser. Ny kunskap framkom även om individuell konsumtion av tjänster under processen ledande till förtidspension. / The Swedish welfare system is complex and includes a range of health and social services, varying providers, and numerous financial methods. Such complexity makes it difficult to evaluate the components and study their interactions. Although the system combines a professional problem solving approach with a service concept, it currently lacks evaluative analyses to offer perspective on how individuals might benefit from the different components of the system. During the 1980s and 1990s, many county councils in Sweden established special units to elicit new knowledge , using the community diagnostic model (CDM) to collect and analyze medical and administrative data about welfare recipients. The system intended to use such data in policy discussions, especially to improve the health system, and also in planning processes between component providers who sometimes respond as individual participants. Others have discussed the use and impact of such data in managing health and social services. Further, intersectoral studies, e.g. how disabled individuals use services, have raised questions regarding the effectiveness and efficiency of the welfare system that might relate to differing internal and external expectations regarding supplied services.   This thesis proposes a new methodology for collecting information from the different components of the welfare system. The evaluation model, D5, described here was developed and tested during a “community diagnosis” in the small municipality of Oxelösund, which is located south of Stockholm. The model produced valuable information on service utilization predictors for and also added new data that will enhance the identification of appropriate services during the application process for disability pensions. / <p>ISBN978-91-85721-54-2</p>

Emergency services 24 hours non-hospital of the Secretary of State of Alagoas are public institutions that features field training in different training areas. But in the last two years in the studied unit stages are restricted to one sector and an interest in expanding this type of activity has been evidenced for unit managers. Thus, questions arose that culminated in the preparation of this academic work. The research sought to identify aspects that guide the development stage in an emergency service through the speeches of the managers in order to understand what they think and know about the stages was expressed in a scientific article and its results have led to production of a intervention project. Through this work placements of managers emerged demonstrating that the lack of integrative actions between academia and professional service occurs because the professionals do not feel able to teach, but even so the stages are authorized by managers because they felt something needed in training. The intervention project is the starting point for building collective reflection on planning and shared with the stakeholders is something relevant in this construction. / Os serviços de Urgência 24 horas não hospitalar da Secretaria de Estado de Alagoas são instituições públicas que apresenta campo do estágio em diferentes áreas de formação. Mas nos últimos dois anos na unidade em estudo os estágios se restringem a um setor e o interesse pela ampliação desse tipo de atividade não tem sido evidenciado entre os gestores da unidade. Com isso, surgiram indagações que culminaram na elaboração deste trabalho acadêmico. A pesquisa procurou identificar os aspectos que norteiam o desenvolvimento do estágio em um serviço de urgência através das falas dos gestores com o intuito de compreender o que eles pensam e sabem acerca dos estágios Foi expressa em um artigo científico e seus resultados levaram a produção de um projeto de intervenção. Através deste trabalho surgiram posicionamentos dos gestores demonstrando que a falta de ações integrativas entre academia e profissionais do serviço ocorre em virtude dos profissionais não se sentirem aptos para o ensino, mas mesmo assim os estágios são autorizados pelos gestores por acharem algo necessário na formação profissional. O projeto de intervenção é o ponto de partida para a construção coletiva e uma reflexão sobre planejamento compartilhado com os atores envolvidos é algo relevante nesta construção.

The presented graduation thesis is entitled {\clqq}Health and Social Services For Suicidal Patients``. Lot of learned papers were written on the suicide theme by researches who are trying to find out specific causes, motives, symptoms and interventions related to suicidal behavior. The professional care includes both medical and non-medical support. In case of an individual who attempted to take his/her life, the help starts after the intervention of the lifesaving service or other factors, mostly in the anaesthesiological-resuscitation wards and intensive care units. As soon as the patient is outside danger to life, he is subjected to a psychological and psychiatric examination. After repeated suicidal tendencies are excluded by the psychiatrist, the care of the client is handed over to outpatient psychiatric clinic. An option of psychotherapy is also considered. His/her integration into normal life may be supported by healh and social services that are the subject of this thesis. This thesis is divided into a theoretical part and a research part. The theoretical part deals with definitions of terms related to the theme of the graduation thesis {--} suicide, affecting factors, types of suicidal behavior, health and social services for suicidal individuals. The aim of the thesis is to map out the situation in the health and social services rendered to suicidal clients in the Region of Jihlava and to establish the knowledgeability about these services among the population or clients´ satisfaction with these services, as exemplified by several case studies. The case studies also describe the treatment of patients after the suicidal attempt, how the life of suicide attempters has changed since the attempt, how do they perceive their suicide attempt retrospectively and also what should be done so that their troubles do not occur again. The existing thesis may give an insight into the health and social services situation in the region of Jihlava, into availability or non-availability of the services in the region, and may give an idea for broadening health and social services for suicidal individuals.

The diploma thesis deals with the cooperation of health and social services in the field of mental health care with regard to the ongoing reform of psychiatric care in the Czech Republic. The theoretical part of this work consists of defining the concept of mental illness, also deals with social and health services in the field of psychiatric care, discusses the reform of psychiatric care and cooperation of services. The empirical part examines what the current situation in the field of cooperation of services looks like, collects suggestions and tools for better functioning of these services and defines the views of direct care workers on the situation. The empirical part is performed by the method of questionnaire survey. The aim of the diploma thesis is to find out what the current situation looks like and what tools would help to better cooperation of these services.