Environmental management officers – leadership and employeeship in local environmental health authority The purpose of this study was to illustrate the working situation of municipal environmental health management officers. This is a qualitative study where I have interviewed ten environmental officers in ten municipalities in Sweden. The interviews were based on a half structured interview guide with questions. I have interpreted the interviews through different leadership theories. The role of the management officers is divided into many roles. The management officers have many possibilities to get more education in leadership for example they can join a network for environmental management officers or participate in different courses that employer pay. Ten different styles of leadership were found in this study: the manager with focus on administration systems, the Jack-of-all-trades-manager, the coach, the administrative official, the parent-manager, the working too much manager, the manager that get “helicoptered” by higher management, the pragmatic manager, the find out manager and the manager as manager. The employee situation is sometimes turbulent and employee turnover is extensive. The efficiency is low when a lot of time is necessary to continually educate new staff all time. The turnover and lack of development for an environmental health officer is costly because the resulting efficiency is lower than necessary. Working as an environmental health officer is an occupation with external and internal conflicts. More research is needed to develop the area of municipal environmental health in many ways.

Socialsekreterare är en yrkesgrupp med stora påfrestningar emotionellt och ärendemässigt. Enligt tidigare studier har belastningen på socialsekreterare de senaste tio åren ökat. Syftet med denna studie är att få en ökad förståelse för hur socialsekreterare upplever sin arbetssituation. Utifrån ett hermeneutiskt perspektiv belyses vilka emotioner som uppkommer i arbetet och hur socialsekreterare hanterar dessa samt vilken betydelse socialt stöd har för hur de uppfattar sin arbetssituation. Studien bygger på en sammansatt metod bestående av kvalitativa intervjuer och textanalys. De fem socialsekreterare som intervjuats arbetar inom socialtjänstens barn- och ungdomsavdelning. Analysen är utförd utifrån fyra teman: emotioner och emotionellt arbete, yrkesroll och yrkesidentitet, sociala relationer, socialt stöd och responsivitet samt byråkrati. Förutom analys av materialet från intervjuundersökningen analyseras en debattartikel av Pia Tham från DN debatt och tre repliker på denna. I resultatet framkommer att stöd från chefer och kollegor är avgörande för att uppleva sin arbetssituation som hanterbar och arbetet som positivt. Socialsekreterare som känner ett gott socialt stöd på arbetsplatsen mår bra i sitt arbete och känner yrkesstolthet medan de som inte upplever tillräckligt socialt stöd upplever mer negativ stress, uttrycker hälsoproblem och vill lämna sitt arbete. / Social workers are a professional group of workers that deal with emotional strains on a daily basis. According to previous studies the workload of social workers has increased within the last ten years. The aim of this study is to increase the understanding of how social workers perceive their work situation. Based from a hermeneutic perspective, the emotions that appear in the workfield and how social workers handle those emotions are highlighted, as well as the importance social support has on how they perceive their work situation. A mixed method consisting qualitative interviewes  and text analysis is used. The five social workers that are interwiewed are working within the children social services and youth department. The analysis is based on four themes; emotions and emotional work, professional role and professional identity, social relations, social support and responsivity, and finaly bureaucracy. In addition to analysing the material from the interwiews a debate article of Pia Tham from DN debatt has been analysed as well as three replications of this article. The result reveals that support of managers and colleagues  is essential for social workers to percieve their work situation as manageable and work as positive. Social workers who experience strong social support in their workfield feel good and useful about their job, and they look up to their profession with pride, while on the other hand, those that do not experience a proper social support feel more of the negative stress, express more health problems and wants to leave their work.

Syftet med den här essän är att synliggöra svårigheter i förskolans värld. I förskolan är man omgiven av människor med olika bakgrunder, kunskaper och erfarenheter. Jag som pedagog, ska kunna förhålla mig professionellt till medarbetare, föräldrar och ledning. Men när man uppfattar brister i barnsäkerheten uppstår flera svårigheter. I essän undersöker jag en fråga utifrån två arbetsroller. Dels mot min kollega och dels mot min chef. Hur ska jag som kollega förhålla mig till min medarbetares förmåga att ta ansvar och beslut som kan vara en fara för barnen, utan att kränka henne? Min chef och jag delar inte samma åsikt om vad lösningen på problemet är. Hur ska jag som anställd förhålla mig till att min chef inte tar det beslut som jag uppfattar som ”rätt” beslut, utan att kritisera henne som ledare? Berättelsen utgår från en barngrupp och två pedagoger som gör en utflykt till en närliggande park. Vid avfärd och vid hemgång uppmärksammar jag flera säkerhetsbrister i en kollegas handlingar. När detta vid ett senare tillfälle påpekas för ledningen så tas det inte på det sätt som jag hade förväntat mig. Detta skapar massor av tvivel hos mig. Jag tvivlar på mig själv och mitt sätt att ifrågasätta. Jag tvivlar på min kollega och hennes sätt att ansvara för barngruppen. Samt att jag tvivlar på min chefs förmåga att leda arbetslaget. Med utgångspunkt i min berättelse har jag undersökt hur olika ledarskap kan se ut hos en förskollärare och hos en förskolechef, samt kritiskt reflektera över min egen roll och mina erfarenheter.

Var går egentligen gränsen mellan lärarens yrkesroll och dennes egna privata sfär? Utifrån min erfarenhet i början av mitt arbete som lärare att det var svårt att sätta en gräns för när arbetsveckan var slut och dessutom svårt att avsluta den med en känsla av att vara nöjd väcktes intresset för att utforska den gränsen. I uppsatsen har jag därför tittat närmare på hur stödet för en sådan avgränsning ser ut i de politiska styrdokumenten, arbetstidsavtalen och lärarens yrkesetik. Jag har också försökt ge en bild av hur konsekvenserna för läraren och dennes privata sfär ser ut under de förhållanden som råder idag. Resultatet visar att dessa gränsdragningar är vaga och att lärare idag har svårigheter att upprätthålla sin privata sfär och tillgodogöra sig de värden och funktioner som den rymmer. Frågan visar sig också vara nära relaterad till frågan om yrkets avgränsningar i stort - vad som ska rymmas inom läraruppdraget, i synnerhet i förhållande till utformningen av arbetstidens ramar. / From my experience in the beginning of my working as a teacher it was difficult to draw a line for when the working week was over, and even more difficult to end it with a feeling of complacency, which made me interested in exploring this frontier: Where is the border between the teacher's professional role and his own private sphere?  In this essay I have therefore looked at how the border between the teacher's professional role and his own private sphere is defined in the political policy documents, working agreements and the teacher's explicit professional ethics. I have also tried to give an idea of the consequences for the teacher and his or her private sphere under the conditions that prevail today. The study shows that these borders are vaguely defined, and that teachers today struggle to maintain their private sphere, and thus to take advantage of the values and functions that it contains. The question also turns out to be closely related to the issue of delimitation of the profession at large – about what should be accommodated within the teaching assignment, in particular in relation to the design of the working frame.

Studiet har haft til formål at undersøge, hvorledes to fagprofessioners rolleopfattelse påvirker deres arbejde og indbyrdes relation inden for klinisk anæstesi. Der er valgt et kvalitativt afsæt med et salutogenetisk perspektiv med hovedvægt på at skabe et billede af forventningerne til den gode fagprofessionelle og det gode samarbejde. Samtidig afdækkes forskellige potentielle konfliktfelter. Rolleopfattelsen fremstår som et handlingsideal, der har fælles træk uafhængigt af professionsbaggrund. Der synes at være god overensstemmelsen mellem professionernes forventninger til rolle og mandat. Dette kan danne basis for et godt samarbejde, men samtidig skabe grobund for konflikter. Der afdækkes en anerkendelse af værdien af begge fagprofessioners spidskompetencer i mødet med patienten. Typen af samspil mellem professionerne er afhængig af opgavernes karakter samt deltagernes personlighed og erfaringer. Overføring af opgaver til den anden profession kan opfattes som en provokation mod professionernes integritet. Hierarki og revirbeskyttelse synes at kunne give anledning til en vis rigiditet i arbejdets organisering. Viden og færdigheder udveksles på tværs af professionerne. Dette islæt af empowerment synes at resultere i en unik kollegialitet og binding. Ingen af de fagprofessionelle ønsker at arbejde i en monofaglig kontekst. Men den udtalte overlapning kan give anledning til mellemmenneskelige udfordringer i forhold til både at give hinanden rum samtidig med, at man kræver plads til egne kompetencer og værdier. / The study has had the purpose of examining how the self-perception of two professions affects their work and mutual relation in the area of clinical anaesthesia. A qualitative starting point with a salutogenetic perspective has been chosen with emphasis on creating a clear picture of expectations about what is good professionally and what is good teamwork. Concurrently, different potential areas of conflict are uncovered. The perception of roles appears as an ideal about how to act, which has common features independently of professional background. There appears to be good accordance between the different professions and their expectations of roles and mandate. This can create a basis for good co-operation, but at the same be a cause of conflict. Acknowledgement of the value of both professions’ core competences in dealing with patients is uncovered. The type of teamwork between the professions is dependent on the character of the assignment as well as the participants’ personality and experience. Transferral of assignments to the other profession can be seen as provocation against the integrity of both professions. Hierarchy and turf-protection appears to give rise to certain rigidity in the organisation of the work. Knowledge and skills are exchanged across the professions. This strain of empowerment seems to result in a unique collegiate spirit and binding. Neither of the two professions want to work in a mono professional context. But the pronounced overlap can give rise to inter-human challenges in connection to giving each other space while also demanding room for one’s own competencies and values. / <p>ISBN 978-9185721-40-5</p>

Organizational democracy has been a popular research area in recent decades but the implementation in real organizations is slow (Kokkinidis, 2012; Verdorfer, Weber, Unter Rainer &amp; Seyr, 2013). Several researchers (Schön Jansson, 2012; Falkheimer, Heide &amp; Johansson, 2013) argue that communication practitioners have a key role in democratic processes and that because their job role is under constant change there are only a few modern studies regarding the subject. The purpose of this study is to illustrate how communication practitioners in private and public organizations experience their role in the process of internal communication and to what extent they are aware of, and work with internal organizational democracy. The practitioners we interviewed had a strong feeling that they were a support function for the business and the organizational management. As a result of the study it is clear that communication practitioners are very loyal to their employers and to the organization they work for. They are, therefore, not neutral in their professional role and argue that their task is to represent the management's interests. All interview respondents managed to unite their loyal mission with an employee perspective in their work. We found that the communication practitioners in our study worked unconsciously for organizational democracy. We have been able to draw this conclusion from the respondents’ discussions of how they work with democratic conditions such as transparency, freedom of speech and values within the organization. However, they lack understanding of organizational democracy as a concept or process. The respondents did not feel that they were responsible for enabling democratic conditions such as participation and dialogue, but rather that they should set the tone for the organization's communication and provide guidelines for communication environment and language. The democratic conditions that the respondents were working with are cultural norms and values that they carry with them in their work. We therefore argue that the practitioners’ work is very much influenced by Sweden's democratic form of government and the society in which the organization operates. / Organisatorisk demokrati har varit ett populärt forskningsområde de senaste decennierna men implementeringen i verkliga organisationer går långsamt (Kokkinidis, 2012; Verdorfer, Weber, Unterrainer &amp; Seyr, 2013). Flera forskare (Schön Jansson, 2012; Falkheimer, Heide &amp; Johansson, 2013) argumenterar för att kommunikatörer har en nyckelroll i demokratiska processer och eftersom kommunikatörers uppdrag är under ständig förändring finns få moderna studier. Syftet med denna studie är att belysa hur kommunikatörer i privata respektive offentliga organisationer upplever sitt uppdrag i arbetet med internkommunikation och i vilken mån de är medvetna om samt arbetar med intern organisatorisk demokrati. Kommunikatörerna som vi intervjuat hade en stark upplevelse av att de är en stödfunktion för verksamheten och organisationsledningen. Ur studiens resultat framgår det tydligt av deras uttalanden att kommunikatörerna är mycket lojala mot sin arbetsgivare och den organisation som de arbetar för. De är därför inte neutrala i sitt yrkesuppdrag utan argumenterar för att deras uppgift är att representera ledningens intressen. Alla intervjurespondenter lyckas dock förena sitt lojala uppdrag med ett medarbetarperspektiv i sitt arbete. Vi fann att kommunikatörerna i vår studie arbetar omedvetet för en organisatorisk demokrati. Denna slutsats har vi kunnat dra då respondenterna diskuterar hur de arbetar med demokratiska förutsättningar så som transparens, yttrandefrihet och värderingar internt. De har dock bristande kunskap om organisatorisk demokrati som begrepp eller process. Respondenterna upplevde inte att de ansvarar för att möjliggöra demokratiska förutsättningar som delaktighet och dialog, men att de bör sätta ton för organisationens kommunikation och skapa riktlinjer för kommunikationsmiljö och språkbruk. De demokratiska förutsättningarna som respondenterna arbetar med är istället kulturella normer och värderingar som de bär med sig i sitt arbete. Vi argumenterar därför för att kommunikatörernas arbete i allra högsta grad påverkas av Sveriges demokratiska statsskick och det samhälle som organisationen verkar inom.

Background Type 2 diabetes demands self-management over time, to maintain health and reduce the risk for diabetes complications. However, despite efforts, many persons with type 2 diabetes are not reaching the treatment targets. In diabetes, person-centred care and group education are recommended. Diabetes specialist nurses (DSNs) working in primary healthcare have an important role in supporting patients with type 2 diabetes in their self-management to adapt to the demands of the disease in everyday life. Therefore, it is important to explore the DSNs’ professional role and their experiences of practising person-centred care. The overall aim of the thesis was to explore the professional role of DSNs in primary healthcare, and to describe their experiences of person-centred diabetes care. Methods The thesis includes three studies with qualitative, and one with a quantitative, approach. Data collection consisted of focus group interviews, individual interviews, observations, and questionnaires. Qualitative content analysis and statistics were used in the analysis. In studies I and II, 29 and 31 DSNs participated, respectively. In study III, 10 DSNs and 44 persons with type 2 diabetes participated. Lastly, in study IV, 10 DSNs participated. Results The results in the thesis showed that DSNs have a complex and multifaceted professional role that entails striving to be an expert, a fosterer, a leader, an executive, and a role model, which they found challenging. The DSNs perceived high job demands, such as decision-making and learning. The thesis also showed that the interaction between DSNs and persons with type 2 diabetes shifted from empowerment to authority struggles during group support sessions based on person-centred care. The experience of person-centred care was described as enriching, but DSNs also expressed ambivalence, related to an altered professional role. Conclusion There is a desire by DSNs to be close to persons with type 2 diabetes, although they have several challenges to fulfil, which makes it difficult to uphold a relation with proximity; thus, distance is also present. Even though person-centred care is recommended in healthcare, and despite DSNs’ efforts to practise PCC, the result of this thesis shows that it also implies an altered professional role for DSNs that has to be addressed. / Diabetes intervention in Västerbotten, DIVA 2

Syfte: Att beskriva sjuksköterskors upplevelser av att kommunicera med vårdsökande personer då ett gemensamt språk saknas. Metod: En litteraturöversikt med induktiv ansats baserad på tolv artiklar med kvalitativ metod som analyserades med Fribergs femstegsmodell. Resultat: Analysen resulterade i fyra huvudteman; en stor utmaning, tolk som stöd och hinder, problemlösande strategier och personlig utveckling. Sjuksköterskor upplevde frustration över att inte kunna ge en god vård på grund av språkbarriärer. De värderade tolkar som användbara för att möjliggöra kommunikationen. Dock användes ibland den vårdsökande personens anhöriga för översättning. Icke-verbal kommunikation upplevdes som en bra strategi vid enklare konversationer. Fynden visade att det fanns en strävan hos sjuksköterskorna att förstå den vårdsökande personen och att öka sin kulturella kompetens. Slutsats: Sjuksköterskor upplevde utmaningar när de kommunicerade med vårdsökande personer som talade ett annat språk. Det fanns otydliga riktlinjer kring användning av tolk. Sjuksköterskor upplevde bristande kunskaper gällande att kommunicera då ett gemensamt språk saknas. En personcentrerad vård innebär att den vårdsökande personen ska ha möjlighet att vara delaktig i sin vård och att sjuksköterskan har en förståelse för dennes individuella behov och värderingar. Mer forskning behövs kring vilken typ av utbildning eller verktyg sjuksköterskor kan använda sig av för att hantera språkbarriärer. / Aim: To describe nurses experiences of communicating with patients when they do not share the same language. Method: A literature review with an inductive approach based on twelve qualitative articles analysed with Friberg’s five-steps-model. Results: The analysis is presented in four main themes; a major challenge, interpreters that are both supportive and obstructive, problem-solving strategies and personal development. The nurses felt frustration because they could not give an individualized good healthcare because of the language barrier. They valued the interpreters, but some nurses used the patients relatives to interpret. Non-verbal communication was seen as a good strategy to enable simple conversations. The nurses desired to understand the patients and strived to get increased competence about different cultures. Conclusion: Nurses experienced a major challenge to communicate when there is no common language. There are insufficient guidelines about how to use interpreters. Nurses experienced a lack of competence when they communicated with people who speak another language. In person-centered care the patient should be involved in his or hers care and the nurse need to have knowledge about their individual needs and values. Further research is necessary about education or tools that nurses can use to overcome language barriers.

A infecção de sítio cirúrgico pós-cesárea corresponde a 8% de todas as infecções pós-parto. Sua magnitude está relacionada ao alto percentual de partos cesáreos, no mundo todo. O puerpério é um período em que há maior atenção ao recém-nascido, podendo passar despercebidas condições que indicam infecção. Objetivos: Descrever o perfil das mulheres submetidas ao parto cesáreo (condições de vida, saúde reprodutiva e perfil sociodemográfico), correlacionando-o à presença de infecção e propor um roteiro que auxilie o enfermeiro da atenção básica a identificar indícios de infecção de sítio cirúrgico pós-cesárea no puerpério. Método: estudo exploratório, descritivo, transversal, retrospectivo, realizado por meio de revisão de prontuários (prontuários geral e Mãe Paulistana e Ficha A do SIAB) de 89 mulheres que tiveram parto cesáreo, de 01/01 a 31/12/2014. Tomaram-se informações de diagnóstico médico de infecção de sítio cirúrgico e situações em que havia, pelo menos, uma condição sugestiva de sinais e sintomas. A análise foi realizada segundo estatística descritiva (teste de Fischer). Resultados: A ocorrência de sinais e sintomas de infecção de sítio cirúrgico pós- cesárea foi verificada em 11 prontuários. Em 16 prontuários, não foram encontrados sinais e sintomas, e 62 prontuários não continham informações ou elas estavam incompletas. Raça/cor e dor em baixo ventre podem indicar infecção, mulheres pardas e negras foram as mais frequentes do grupo que apresentaram sinais sugestivos de infecção, apresentando diferença estatística significativa (p. =0,038). O roteiro para consulta de enfermagem no puerpério pós-parto cesáreo complementa dados que auxilia a identificação da ocorrência de sinais e sintomas sugestivos de infecção de sítio cirúrgico e auxilia a identificação de diagnósticos de Enfermagem. Conclusão: O roteiro pode auxiliar o profissional enfermeiro a reconhecer situações de risco e vulnerabilidade para o desenvolvimento de infecção de sítio cirúrgico pós-parto cesáreo ou outro sinal de complicação pós-parto, contribuindo com a melhoria da qualidade da assistência e segurança do paciente. / The surgical infection after cesarean section applies to 8% of all infections post childbirth. The magnitude of this event is related to cesarean sections high percent in the whole world. The puerperium is the period where there is more attention to the new born and the conditions that points to the infection can be unnoticed. Goals: To describe the profile of women who are submitted to cesarean section (life conditions, reproductive health and socio-demographic profile) correlating it to the presence of the infection and to propose a guide that will help the Basic Attention nurse to identify the surgical infection after cesarean section evidences at the puerperium. Method: exploratory, descriptive, transversal and retrospective study, achieved by medical record review (general records, Mãe Paulistana and Ficha A from SIAB) of eighty-nine women who had cesarean section, from January 01st to December 31st, 2014. Were analyzed medical records that had information about medical diagnosis of infection after cesarean section and conditions that contained at least one high trace of infection after cesarean sections signs and symptoms. The analysis was held through descriptive statistics (Fischers test). Results: The occurrence of signs and symptoms of surgical infection after cesarean section was observed in eleven medical records. In sixteen records wasnt found any reference to these signs and symptoms and sixty-two records didnt had the information or they were incomplete. Race/color, lower womb pain can indicate infection, black and dark women were more frequent among the group that presented high signs of infection, performing a significant statistical difference (p. =0,038). The guide to nurse consulting at puerperium after cesarean section complements the data that helps to identify the signs and symptoms of infection after cesarean section and supports the identification of nursing diagnosis. Conclusion: The guide can help the nurse to recognize situations of risk and vulnerability for the development of infection after cesarean section or any other sign of complication post childbirth complication, contributing to a better quality of patients assistance and safety.

This diploma thesis provides information on the subject of supporting beginning kindergarten headmasters. It deals with the changes of this support from 1990 until the present. The objective of this diploma thesis is to find out the opinions of the headmasters of pre-primary education schools in Prague concerning the support provided by the state, school authority, middle management, the previous headmaster, other colleagues and educational institutions upon taking up their the post. The theoretical part introduces the basic terms connected with the headmaster's managerial functions and competences as well as with the historical development of the kindergarten headmaster's function in relation to the support received upon taking up their post. It points out the necessity of external support of headmasters during their career, especially in its beginning. The empirical part of the thesis is based on studying specialised literature and on survey results. It assesses the headmasters' experience at the beginning of their careers as headmasters. It evaluates the quality of assistance provided and points out the missing links of subvention. The author suggests taking such measures that increase the quality of the assistance received by beginning kindergarten headmasters. The success of this thesis would...