Psichikos sveikatos priežiūros organizavimo Anykščių ir Utenos rajonuose lyginamoji analizė Santrauka Psichikos sveikatos paslaugų organizavimas ir psichikos sutrikimų prevencija yra neatsiejamos ir prioritetinės sveikatos, švietimo ir socialinės apsaugos principas. Lietuvoje psichikos sveikatos stiprinimas ir psichikos sutrikimų prevencijos priemonės turi būti nukreiptos į plačiąją visuomenę ir į specifines rizikos grupes, skatinant apsauginius faktorius ir atsparumą, mažinant socialinę atskirtį, įgalinant pažeidžiamas rizikos grupes pačias spręsti problemas ir padedant joms integruotis į bendruomenę. Tyrimo problema: Nagrinėjant Utenos ir Anykščių Psichikos sveikatos centrų (toliau PSC) teikiamų paslaugų organizavimą kyla probleminiai klausimai. Ar PSC statusas gali turėti įtakos teikiamų paslaugų kokybei? Ar PSC teikiamos sveikatos priežiūros ir socialinės paslaugos tenkina asmenų turinčių psichikos sveikatos problemų lūkesčius? Darbo tiriamasis objektas - psichikos sveikatos priežiūros paslaugų organizavimas Anykščių ir Utenos rajonuose. Darbo tikslas – išanalizuoti psichikos sveikatos priežiūros organizuojamas paslaugas Darbo uždaviniai: 1. 1 Aptarti psichikos sveikatos priežiūros paslaugų specifiškumą sveikatos priežiūros sistemoje. 2. Apžvelgti Utenos ir Anykščių rajonų tarnybų, teikiančių psichikos sveikatos paslaugas sutrikusios psichikos suaugusiems asmenims, organizavimo aspektus. 3. Palyginti Utenos ir Anykščių rajonų psichikos sveikatos centrų teikiamas... [toliau žr. visą tekstą] / Summary The organization of the services of psychological health and prevention of psychological disorders is a principle of inseparable and underlying health, education and social care. The intensification of psychological health and the means of prevention of psychological disorders in Lithuania should be directed towards the society and specific risk groups, while encouraging preventive factors and resistance, decreasing social isolation, giving to these risk groups a chance to solve their problems and helping them to integrate into society. The problem of the research: Analysis of the organization of the services of Utena and Anyksciai Psychological health centres (furthermore PHC) raises some problematic questions. Could the status of PHC have some impact on the quality of provided services? Do the health care and social services of PHC meet the expectations of the persons having psychological health problems? The research object of the paper is the organization of the services of supervision of psychological health in Anyksciai and Utena districts. The aim of the paper is to analyse the organized services of supervision of psychological health. The aim of the research is implemented by these objectives: 1. To discuss the specificity of the services of psychological health within the health care system. 2. To survey the aspects of organization of the services of Utena and Anyksciai districts providing psychological health services to psychologically disordered adults. 3... [to full text]

The organizational consequences of information technology (IT) constitutes a core focus in information systems (IS) research. The relationship between organizations and IT has received considerable attention by IS researchers in order to develop knowledge related to how and why organizations and IT are related. While organizational use of IT continues to increase in practice, previous research has shown that the effects of IT at best are difficult to predict. Consequently, the adoption and assimilation of IT in organizational settings must be recognized as complex and challenging processes, which makes the production of knowledge related to such processes important and pressing.   This dissertation identifies, characterizes and explains a paradoxical outcome of the adoption and assimilation of an enterprise content management (ECM) system in a context of organizational information management. The outcome, labeled the duplicate systems paradox, is constituted by a situation in which an organization continuously allows multiple, overlapping, partially competing and largely incompatible information systems to persist and continue to evolve over time, despite continued awareness of the adverse consequences on organizational information management capabilities. A qualitative case study approach was used as the primary means for data collection. The case study was conducted in the administrative divisions of HealthOrg, a large organization in the medical- and health care sector. To this end, the main objective of this dissertation is to investigate how this paradox was formed, and furthermore, how and why it was able to persist. In order to do this, dialectical theory is combined with contextualism and theory on organizational information processing to form a comprehensive theoretical perspective used to inform the analytical efforts.   By using a dialectical approach, the analysis presents empirical evidence of the existence and composition of three overarching contradictions found to affect the formation and persistence of the duplicate systems paradox. More specifically, the resulting explanatory model demonstrates how three pairs of opposites, control versus support at the requirements level, options versus practices at the solutions level, and top-down versus bottom-up approaches at the transformations level, along with contextual tensions, were essential components in the formation and persistence of the paradox. Thus, the duplicate systems paradox could form and continue to evolve due to contradictory forces present at, and interconnected between, different vertical and horizontal levels within the organization. Through the identification and explanation of the duplicate systems paradox, this study provides a detailed example of how, and why, unintended consequences of IT in organizations may emerge and continue over time.   In terms of implications for research and practice, the findings of this dissertation point to six important observations. First, this research suggests that understanding and characterizing the context in which IT is to be implemented is crucial and challenging. Thus, organizations should pay careful attention to the practical side of context, rather than to the somewhat theoretical boundaries of organizations. It is suggested that the concepts of ‘inner’ and ‘outer’ context may be useful in analyzing and understanding context. Second, this research suggests that organizations should attempt to identify potentially conflicting requirements, and devise clear strategies to decide how to prioritize between such requirements as the identification and explication of requirements present at different levels in the organization may reveal problems that need to be considered when choosing information system (IS). Third, organizations need to pay careful attention to what the adoption of a new IS means in terms of adaptation and/or realignment, and to what extent organizational activities, technological functionalities, or both, should be adapted. Organizations should furthermore be aware that the adoption of systems that can also be used as development platforms may cause a cascade of effects and dependencies that are difficult to manage. Fourth, the findings of this research suggest that organizations faced with the challenge of adopting complex IT solutions need to take into account their previous strategies and planned new ones in order to devise a comprehensive strategic approach since the coexistence of radically different strategies may cause uncertainty and inertia within the overall assimilation process. Fifth, this research indicates that IT management and information management (IM) are highly interrelated activities, but are not mutually exclusive. Thus, organizations adopting technologies that are specifically focused on information management may benefit from developing distinct areas of responsibility and clear communication channels between the involved organizational units. Furthermore, these findings suggest that future research should pay careful attention to, and specifically investigate, the exact nature of the relationship between information management and IT management. Finally, this research demonstrates how a dialectical approach may be used to adequately investigate organizational information management, specifically in relation to the adoption and assimilation of IT.

Information systems (IS) are widely acknowledged to be central for contemporary organizations. Along with the increasing importance of new IS in organizations, a school of thought has developed over the last few years that claims that IS and organizations mutually shape each other. While new IS shape organizational structure and behavior, the actual role and importance of IS in organizations is largely dependent on the organizational setting. However, questions of how IS and organizations mutually shape each other have remained largely unexplored.    The purpose of this thesis is to create better understanding of the design and use of IS in an organizational context. Actor-network theory (ANT) is used as a theoretical perspective to gain an understanding of how IS and organization influence each other. An interpretive case study approach was used for data collection. The case study was conducted in the municipal organization of Umeå, Sweden, over a period 36 months that covered the design process and use of a new IS. Semi-structured interviews, participant observations and document analysis were used as data collection techniques.    The findings indicate that the municipal organization became intertwined with technology by mobilizing a significant amount of allies in the IS adaption process. It was also found that the character of the IS in the organization was multi-faceted, and there were different versions of the application available for different actors. A new organizational behavior was established as a result of the design and use of the IS. While the new IS contributed to making more available the complicated financial aspects of the municipality, it also contributed in reinforcing a certain view on decision-making that was focused on organizational resources rather than on organizational objectives. The organizational changes that took place were of a constant nature, and there was no closure of the change processes as new issues continuously surfaced that needed attention.    The concept of evolving multi-purpose networks is coined to describe and analyze the character of the technology dependent organization. The concept of negotiation loop is coined to describe and analyze the processes of IS adaption, where the role and meaning of the IS changes as new actors are enrolled to the network. An evolving multipurpose network is changeful as negotiation loops continue after the IS is established in the organization. The notation of evolving multipurpose networks is meant to stimulate reflection both for researchers and practitioners, underscoring the negotiated character of IS in organizations. It is meant to allow a better understanding for how the design and use of IS in an organizational context is a process of mutual influence between the IS and organization. / digitalisering@umu