Bakgrund: Hemsjukvård har bedrivits i Sverige sedan 1970-talet. Inom den somatiska vården ser man detta som en vårdform som stärker patientinflytande. Trots att psykisk ohälsa utgör den största orsaken till sjukskrivning i Sverige ser man inte samma utbyggnad av hemsjukvården inom psykiatrin. Istället bedrivs akutpsykiatrisk vård fortfarande mestadels som slutenvården. Detta trots att man vet att många patientgrupper far illa av att vistas inom den psykiatriska avdelningsmiljön. Ny lagstiftning öppnar dock upp för en utbyggnad även av akutpsykiatrisk hemsjukvård. Syfte: Att beskriva hur akutpsykiatrisk vård påverkas av att utföras i hemmiljö, dels för patienten och dels ur ett organisatoriskt/strukturellt perspektiv. Metod: En litteraturöversikt utifrån en analys av tolv vetenskapliga artiklar med både kvalitativ och kvantitativ design. Resultat: Akutpsykiatrisk hemsjukvård skapar i de flesta fall positiva erfarenheter jämfört med den vård som ges på sjukhusförlagda psykiatriska akutmottagningar.  Patienter och anhöriga blir nöjdare. Vården når patienterna tidigare och sparar betydande summor på minskade slutenvårdsinläggningar. Den kan dock inte helt ersätta slutenvård utan kompletterar denna. Det uppstår även en del negativa upplevelser och effekter, som ibland förefaller motsägelsefulla. Diskussion: Utifrån Dorothea Orems teori om egenvårdsbalans granskas de artiklar som valts ut och två huvudsakliga teman behandlas: Den dörrvaktande funktionen samt vårdandet i akutpsykiatrisk hemsjukvård. Det förefaller som om en maktförskjutning, från vårdgivaren till patienten, är fundamentet i vad som skapar fördelar med hemsjukvård vid akutpsykiatriska tillstånd. En bidragande orsak till de förbättrade behandlingsresultaten tycks vara tidigare upptäckt av psykisk ohälsa på grund av ökad tillgänglighet. Vårdformen fick således en oväntad preventiv effekt som minskar psykisk ohälsa. Det förefaller som att det ibland finns en konflikt mellan vårdandet och kostnadseffektiviteten. Nackdelar som lyfts fram är ökat ansvar för patienter och anhöriga och en otrygg arbetssituation för vårdpersonalen. / Background: Since the 1970s home based care has been carried out in Sweden. In somatic care this is regarded as a form of care that strengthens the patient´s influence. Although mental disorders are the main cause of sick leave in Sweden, one can´t see the same expansion of home based care within psychiatric care. Emergency psychiatric care is instead mostly conducted as inpatient care. This is despite knowing that many groups of patients are harmed by staying in the environment of a psychiatric ward. New legislation will open up for an expansion of psychiatric emergency home care with inpatient standard. Aim: To describe how emergency psychiatric care is affected by being cared out in a home environment, for patients and from an organizational/structural perspective.  Method: A literature review based on an analysis of twelve scientific articles with both qualitative and quantitative design. Result: In most cases emergency psychiatric home care creates a positive experience compared to the care given in hospital based psychiatric emergency care. Patients and relatives are more satisfied. The care reaches patients earlier and saves considerable amounts of money on reduced inpatient admissions. However, it can´t completely replace inpatient care but complement it. Psychiatric home care also creates some negative experiences, which sometimes seems contradictory.  Discussion: Based on Dorothea Orem´s Self-care Deficient Nursing Theory the selected items are examined and the two main themes are created: gatekeeping and caregiving in acute psychiatric home care. It seems that a shift of power from the caregiver to the patient is the basis of what creates advantages of home care for acute psychiatric conditions. One factor contributing to the improved treatment outcomes seems to be earlier detection of mental health problems based on increased accessibility. This preventive effect on mental health was unexpected. It appears that there sometimes is a conflict between caring and cost-effectiveness. Disadvantages highlighted are the increased responsibility for patients and families, and a precarious job situation for caregivers.

abstract: As technology enhances our communication capabilities, the number of distributed teams has risen in both public and private sectors. There is no doubt that these technological advancements have addressed a need for communication and collaboration of distributed teams. However, is all technology useful for effective collaboration? Are some methods (modalities) of communication more conducive than others to effective performance and collaboration of distributed teams? Although previous literature identifies some differences in modalities, there is little research on geographically distributed mobile teams (DMTs) performing a collaborative task. To investigate communication and performance in this context, I developed the GeoCog system. This system is a mobile communications and collaboration platform enabling small, distributed teams of three to participate in a variant of the military-inspired game, "Capture the Flag". Within the task, teams were given one hour to complete as many "captures" as possible while utilizing resources to the advantage of the team. In this experiment, I manipulated the modality of communication across three conditions with text-based messaging only, vocal communication only, and a combination of the two conditions. It was hypothesized that bi-modal communication would yield superior performance compared to either single modality conditions. Results indicated that performance was not affected by modality. Further results, including communication analysis, are discussed within this paper. / Dissertation/Thesis / M.S. Applied Psychology 2012

In cases where children and youths are in need of support from various activities in order to have their needs met, authorities shall collaborate towards the common goal: the child’s best interests. The concept lacks an unambiguous definition and professionals should make decisions adjusted to the child’s individual needs. Within the Mobile team, which is an interprofessional form of collaboration between the school and social services, the different professional groups could be characterized by different perspectives. This may lead to different interpretations which can pose a challenge to agree on a joint decision for the child’s best interests. The study is based on a qualitative approach through semi-structured interviews with six professionals within a mobile team. The theories used to analyze the empirical material is collaboration theory and theory about discretion in decision making. Several noteworthy results were find. The mobile team work early and preventive both generally and with more concrete interventions for the child’s best interests. The work within collaboration can be divided into resourse-, information- and knowledge exchange which creates the opportunity to get at better overall picture of the child. Further, to work for the child’s best interests the mobile team focuses on school, spare time and family, as different areas that are important for the child. Their approach is also characterized by understanding and supporting individual needs. Finally, there are factors that need to be considered to fulfil a successful collaboration. For example, the professionals must be aware of each other’s duties, roles, activities and regulatory systems.