Thesis (M.Sc.)--Memorial University of Newfoundland, Faculty of Medicine, 1998. / Typescript. Bibliography: leaves 122-125.

published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Social Work and Social Administration / Master / Master of Philosophy

In Ontario, access to publicly funded home care services is managed by Community Care Access Centres (CCACs). CCAC case managers are responsible for assessing all potential clients and prioritizing the allocation of services. The objectives of this thesis were to: 1) describe the types of decisions made by CCAC organizations and by individual case managers concerning the allocation of nursing, personal support and homemaking services to long-term adult clients with no mental health issues; and 2) to describe and assess the factors and values that influence these decisions. We conducted two case studies in which qualitative data were collected through 39 semi-structured interviews and a review of relevant documents from an urban and a rural area CCAC. A modified thematic analysis was used to identify themes related to the types of priority setting decisions and the associated factors and values. An internet-based survey was then designed based on these results and answered by 177 case managers from 8 of the 14 CCACs. The survey contained discrete choice experiments to examine the relative importance of client attributes and values to prioritization choices related to personal support and homemaking services, as well as questions that examined case managers’ attitudes towards priority setting. We found that both the rural and the urban CCACs utilized similar forms of priority setting and that case managers made the majority of these decisions during their daily interactions with clients. Numerous client, CCAC, and external factors related to the values of safety, independence and client-focused care were considered by case managers during needs assessment and service plan development. The relative importance of the selected client attributes in defining need for personal support and homemaking services was tested and found to be significantly affected by the location of the case manager (rural or urban area), years of experience in home care, and recent experience providing informal care. Case managers allocated services in the spirit of equal service for equal need and in consideration of operational efficiency. We also identified a number of case manager-related, client-related and external factors that interfered with the achievement of horizontal equity.

Sedan riksdagen beslut om Lag om valfrihetssystem även kallat LOV har hemtjänsten varit ett omstritt ämne i samhällsdebatten. Lagen om valfrihetssystem togs i bruk första januari 2009 med syftet att genom en fungerande konkurrenssituation så kan kvalitet och effektivitet öka samt möjliggöra nytänkande och mångfald. Enligt en rikstäckande undersökning av äldres uppfattning om kvalitén i hemtjänsten genomförd av Socialstyrelsen 2015 är bilden av äldreomsorgen generellt positiv i Sverige. Resultaten varier dock mellan olika kommuner och verksamheter. I en del kommuner och verksamheter är fler än tio procent ganska eller mycket missnöjda. Syftet med den här studien var att svara på frågan: Ger ett högre konkurrenstryck en bättre upplevd kvalitet för brukare av hemtjänst i Sveriges kommuner?  Data och variabler som använts är ett kvalitetsmått som beroende variabel i form av upplevd kvalitet som är framtaget baserat på brukarundersökning inom hemtjänsten. Oberoende variabeln är konkurrenstrycket i varje kommun. Undersökningen genomfördes i två olika multipla regressionsmodeller. Först en modell för att undersöka skillnaden i effekten av egenskaperna lågt och högt konkurrenstryck mot referensgruppen inget konkurrenstryck. Det vill säga om den upplevda kvaliteten är högre i de kommuner som infört LOV och konkurrensutsatt sin hemtjänst än de som inte. Inget statistiskt signifikant resultat påvisades i regressionen. För att undersöka effekterna av konkurrenstryck, skillnaden mellan lågt och högt konkurrenstryck och vilka andra faktorer som påverkar den upplevda kvaliteten användes även en andra regressionsmodell för analys endast av de kommuner som infört LOV. Även i den analysen kunde inget statistiskt signifikant resultat påvisas att konkurrenstryck har någon signifikant effekt på den upplevda kvaliteten. Istället är det andra faktorer enligt den här studien som påverkar den upplevda kvaliteten. Av de övriga variablerna Personalomsättning, Genomförandeplan, Tätortsgrad, Medianinkomst hos 65+ befolkningen och ersättningsnivåerna för service, omvårdnad och landsbygdsersättning visar resultatet på att en högre andel genomförandeplaner, tätortsgrad och medianinkomst i kommunerna påverkar den upplevda kvaliteten negativt. Ersättningsnivån för omvårdnad har däremot en positiv effekt på den upplevda kvaliteten. För övriga variabler påvisade regressionen ingen signifikant effekt på den upplevda kvaliteten. Avslutningsvis kan inte resultaten i den här studien påvisa att ett högre konkurrenstryck leder till en högre upplevd kvalitet som ett av syftena med Lagen om valfrihet är.

Psykisk ohälsa förekommer i yrkeslivet. Att ha en hög grad av psykisk ohälsa kan leda till otrivsel på arbetet. Studien avsåg att undersöka sambandet mellan psykisk ohälsa och KASAM och arbetsrelaterad KASAM samt ålder, kön, etnicitet, anställningstid, anställningsform och befattning som kan antas vara relaterad till psykisk ohälsa. Detta undersöktes genom nio hypoteser och en frågeställning. 95 individer som arbetade inom hemtjänsten deltog i undersökningen och besvarade en enkät bestående av KASAM-skalan, arbetsrelaterade KASAM-skalan samt General Health Questionnarie 12. Via korrelationer och regressionsanalyser undersöktes materialet. Resultatet visade att hemtjänstpersonal med hög grad av psykisk hälsa hade en hög grad av KASAM och arbetsrelaterad KASAM, samt att andra faktorer såsom anställningsform och ålder relaterar till viss del med psykisk ohälsa. Studien gav en indikation på att höga värden på KASAM och arbetsrelaterad KASAM ger förutsättningar för individerna att klara av stressorer bättre, som också påverkar psykisk ohälsa

This dissertation builds on the current anthropological studies of care relations in practice. It draws inspiration from science and technology studies (STS) and postfeminist technoscience. A qualitative ethnographic approach grounds the empirical data collection and analysis. This entails ethnographic fieldwork with senior home care in the United States and Sweden during 2007–2008 and 2011–2012. Analytical attention centers on how movements situate various tensions of senior home care in practice. Four interrelated published works comprise the main thematic chapters. Each article exemplifies how human and nonhuman relations move and mediate care. They develop several heuristic terms that advance ideas about how older people, aging bodies, technologies, spaces, and times that tinker each other through movements of care in practice. The comprehensive summary frames these articles with an overview of the primary thematic orientations and methodological concerns. A discussion of the main contributions and implications of the dissertation concludes the work.

M.A. / South Africa is facing a high rate of children in need of care due to high escalation of the HIV/AIDS related illness. The children are being left without biological parents, and they are eventually placed in the foster care custody of their extended families. Sometimes there are challenges that are experienced by the foster parents and the adolescents’ foster children, as a result the adolescents’ foster children end up leaving school. Foster care learners who stay away from school or who have been entered on the register then absent themselves for substantial parts of the day, are more likely to grow up unhappy and unfulfilled, leaving school much less qualified than they might otherwise be and worst of all sometimes get drawn into a life of crime(Collins, 1998). The overall aim of this study is to explore the factors that contribute to adolescent foster children not completing their high school education and developing strategies to retain adolescents’ foster children in school. Placing the adolescents’ foster children into institutions like industrial schools and children’s homes hoping that the children’s behavior will change should be considered as the last resort that the professionals should do. The objectives of the study are: § To survey literature on foster care education, § To analyse the scope of the concept” foster care” in terms of current practice, § To investigate problems that are encountered by the foster parents and how do they deal with the teenagers’ problems, § To investigate the problems encountered by the teenagers or adolescents foster children , and also identify their unmet needs, § To investigate the problems encountered by the foster children while still at school, § To identify challenges of educators towards foster care learners. iii Qualitative research methodology was applied with the researcher selecting participatory action research to engage adolescents’ foster children, foster parents and educators in the study. The study was exploratory and qualitative in nature. Focus groups were utilized as the method of information gathering. The focus group was conducted with adolescent foster children, foster parents and educators. The focus group sessions with the children comprised of ten adolescent foster children that did not complete their high school education. The focus group session with the foster parents comprised of ten parents caring for adolescent foster children who left school. The focus group with the educators comprised of six educators who taught foster children, three educators were from each of the two high schools in Naledi, Soweto. The foster children and foster parents were recruited from the researcher’s case load in Soweto.

Children and the youth account for over 50% of the South African population of approximately 44 million. The majority of these children are raised in poverty and are therefore subjected to various forms of violence and abuse. As a result, many of these children are placed in foster care. Foster care, which is defined by Herbst and Muller (2001:1) as being “any kind of long term or short term substitute care of children outside their homes by persons other than their own parents”, has its own problems, of which the breakdown of placements is but one. To determine which factors possibly contribute to the breakdown of placements, a qualitative study with a descriptive research design was undertaken. Separate self-developed questionnaires were used as instruments for data collection; the one was used for the foster parents and the other for the foster children. Ten children and ten foster parents were interviewed. The study was conducted in Daveyton, with the assistance of the Benoni Child and Family Welfare Society. It is evident from the study that in foster care, children of all ages are vulnerable to placement instability that often results in the breakdown of the placements. The study also indicates that problems such as poor communication, lack of social work supervision and unresolved problems between foster children and foster parents play a major role in the breakdown of the placements. It also appears that foster children experience more problems with foster families than with foster parents. Based on the findings of the study, recommendations for social work practice and future research that will contribute towards maintaining stability of foster placements are made. / Dr. E. Oliphant

"The purpose of this study is to compare seventy-one white and fifty-six Negro dependent children residing in the Florida State Department of Public Welfare emergency shelter homes in Jacksonville, Florida, during the months of October and November, 1960, with respect to sixteen selected family and social characteristics. The shelter homes are private facilities established for the purpose of providing emergency shelter care to dependent children. As the emergency shelter home program has been in operation only since October, 1959, an attempt will be made in this study to identify the characteristics of dependent children placed in the shelter homes and to describe their families"--Introduction. / Typescript. / "June, 1961." / "Submitted to the Graduate School of Florida State University in partial fulfillment of the requirements for the degree of Master of Social Work." / Advisor: Irene E. Morris, Professor Directing Study. / Includes bibliographical references (leaves 43-44).