A infecção em seres humanos por larvas de nematódeos do gênero Toxocara é uma antropozoonose endêmica em diversas localidades com prevalências superiores a 50% em diferentes grupos populacionais, tanto em países em desenvolvimento como nos desenvolvidos. O presente estudo avaliou a prevalência, fatores associados e distribuição espacial de infecção por Toxocara spp. em crianças residentes na área urbana de Acrelândia, Acre, Amazônia Ocidental Brasileira. Conduziu-se um estudo transversal de base populacional com 1112 crianças <11 anos de idade. Informações socioeconômicas e demográficas foram obtidas por meio de questionário estruturado. Medidas antropométricas e coleta de amostras biológicas (sangue e fezes) foram realizadas pela equipe de pesquisa. A avaliação de soroprevalência da infecção por Toxocara spp. utilizou o método imunoensaio enzimático (ELISA). Registraram-se as coordenadas geográficas pontuais de todos os domicílios participantes do inquérito para análise espacial de varredura. Razões de prevalência (RP; intervalo com 95% de confiança, IC95%) para fatores associados à antropozoonose foram estimadas por regressão de Poisson com seleção hierárquica das variáveis independentes. Verificou-se soroprevalência geral de 38% para anticorpos IgG anti-Toxocara spp.; crianças 5 anos de idade apresentaram maior prevalência para infecção por Toxocara spp., estatisticamente significante, em relação aos de menor faixa etária (RP, 1,70; IC95%, 1,442,00). Ausência de tratamento para água de beber (RP, 1,38; IC95%,1,111,71), deficiência de vitamina A (RP, 1,47; IC95%, 1,221,78) e presença de geo-helmintos (RP, 1,57; IC95%, 1,251,98) foram positivamente associados à infecção pelo nematódeo. Em contrapartida, maior quarto do índice de riqueza domiciliar (RP, 0,65; IC95%, 0,510,83) e maior escolaridade materna (RP, 0,71; IC95%, 0,580,88) foram inversamente associados à infecção por Toxocara spp. Presença de cão e/ou gato nas residências não foi associada à infecção pelo nematódeo. Análise da distribuição espacial detectou um aglomerado de baixa prevalência para infecção por Toxocara spp. na área investigada, compreendendo 36,0% das crianças com sorologia negativa para o nematódeo. Os resultados indicam que a prevalência da infecção por Toxocara spp. observada no presente estudo foi semelhante ao descrito em estudos anteriores na região da Amazônia Brasileira, mas superiores às observadas nas regiões sul e sudeste do país e em outros países. A avaliação de fatores associados à infecção por Toxocara spp. permitiu a identificação de grupos populacionais prioritários para intervenções no município estudado. / Human infection with nematodes of the genus Toxocara is an endemic anthropozoonosis in many locations, with prevalence rates above 50% in different population groups in both developed and developing countries. The aim of this study was to assess the prevalence, factors associated, and spatial distribution with Toxocara spp. infection among children residing in the urban area of Acrelândia, Acre, Western Brazilian Amazon. A population-based cross-sectional study with 1112 children <11 years of age was conducted. Socioeconomic and demographic information was obtained through structured questionnaires. Anthropometric measurements and biological samples (blood and stools) were collected from the participants. The enzyme immunoassay method (ELISA) was used to evaluate the seroprevalence of Toxocara spp. infection. Geographic coordinates were recorded for all households participating in the survey, and subsequently analyzed by spatial scan analysis. Prevalence ratios (PR; 95% confidence intervals, 95%CI) of factors associated to this anthropozoonosis were estimated using Poisson regression models, with hierarchical selection of independent variables. An overall prevalence of 38% for IgG anti-Toxocara spp. antibodies was found; children 5 years of age presented statistically significantly higher prevalence of Toxocara spp. infection when compared with younger children (PR, 1.70; 95%CI, 1.442.00). The absence of treatment of drinking water (PR: 1.38, 95%CI, 1.111.71), vitamin A deficiency (PR: 1.47, 95%CI, 1.221.78), and presence of geo-helminths (PR: 1.57, 95%CI, 1.251.98) were positively associated to this anthropozoonosis infection. In contrast, the highest wealth index quartile (PR: 0.65, 95%CI, 0.510.83), and the higher level of maternal education (PR: 0.71, 95%CI, 0.580.88) were inversely associated to Toxocara spp. infection. Presence of a dog or cat in the household was not associated with infection by the nematode. Spatial distribution analysis detected a significant low-prevalence cluster for Toxocara spp. infection in the area under investigation, comprising 36.0% of the seronegative subjects. The results indicate that the prevalence of Toxocara spp. infection observed in this study was similar to that found in the Brazilian Amazon region, but higher than rates in the south and southeast regions of Brazil, as well as those reported in others countries. It is noteworthy that the identification of factors associated with Toxocara spp. infection allowed the targeting of priority groups for appropriate intervention in this population.

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Bakgrund. Denna magisteruppsats från specialistsjuksköterskeprogrammet i akutsjukvård är en pilotstudie som görs på uppdrag av Centrum för Interprofessionell Samverkan och sambruk inom Akut vård (CISA). Allvarlig händelse är en händelse där resurser behöver omfördelas, ledas och användas på ett särskilt sätt. Internationella erfarenheter visar att beredskap inför allvarlig händelse är ett förbättringsområde. Nationella erfarenheter pekar på kommunikation samt introduktion av nyanställda som områden för utveckling. Vid allvarlig händelse engageras flera olika verksamheter som måste samverka, något som tidigare erfarenheter och forskningsresultat har visat vara svårt. Övning kan förbereda personal i att hantera olika händelser, samt förbättra samverkan vid verklig händelse. Digital simuleringsövning bidrar med ett effektivt sätt att lära sig genom att utförandet sker i en säker miljö. Syftet med pilotstudien är att kartlägga genomförandet och upplevelsen av övningar inför allvarlig händelse inom larmkedjan i ett län i södra Sverige. Metod. Den valda designen var tvärsnittsstudie. Datainsamlingen utfördes genom en enkätundersökning. Urvalet skedde med hjälp av CISA:s styrgrupp genom bekvämlighetsurval. Totalt 108 respondenter svarade, av dessa exkluderades nio på grund ut av totalt eller partiellt (&gt;30%) bortfall. Analys av deskriptiv och analytisk statistik skedde i SPSS version 25. En tematisk innehållsanalys utfördes på fritext svaren. Resultat/Slutsats. Deltagarna som arbetar inom larmkedjan övar i olika omfattning baserat på vilken verksamhet de tillhör samt om de har en ledningsroll eller ej. Verksamheterna samövar inför allvarlig händelse men tenderar att samöva prehospitalt alternativt intrahospitalt. En övervägande majoritet upplever att det övas för sällan. Övningarna upplevs generellt som meningsfulla av deltagarna. Realism, mängdträning samt tid till övning identifieras som förbättringsområden. Mer forskning behövs inom området. Förslagsvis med lika stora grupper av representanter från verksamheterna för att kunna dra säkrare slutsatser kring resultatet samt därmed gynna den enskilda patienten genom att öka samhällets beredskap inför allvarlig händelse. / Background. This master thesis from the nurse specialist program in emergency care is a pilot study conducted on assignment of Center for interprofessional collaboration and artel within emergency care (CISA). Major accidents or disasters are events where resources need to be redistributed, lead, and used in a specific manner. International experience shows that preparedness for major accidents or disaster is an area in need of improvement. National experiences point out communication and introduction of new employees as areas of improvement. A major accident or disaster involves multiple functions, that within this extreme situation need to cooperate, something that past experiences have shown to be difficult. Exercise can prepare personnel in dealing with different situations, as well as improve cooperation in real events. Digital simulation exercises contribute as an effective way to learn in a safe environment. Aim of the study was to map how exercises for major accidents are implemented and experienced within the emergency response system in a county in southern Sweden. Method. The chosen design was a cross-sectional study. The data collection was conducted through a survey study. The sample was collected with the help of CISA’s control group through convenience sample. The study got a total of 108 participants, of these participants nine were excluded because of total or partial (&gt;30%) non-completion. Analysis of descriptive and analytic statistics was carried out in SPSS v.25. A thematic content analysis was conducted on the free text answers. Results/Conclusion The participants that work within the emergency response system exercise to different extents based on which unit within the emergency response system they belong to as well as if they have a management role in case of a major accident or not. The units corporate for major accidents but tend to co-exercise either prehospitally or intrahospitally. A clear majority of the participants agree that they practise too rarely. The exercises are generally seen as meaningful by the participants. Realism, amount of training and time for practice are identified as areas of improvement. More research is needed within the area, as a suggestion with equal sized groups of representatives from the different units, to be able to draw more certain conclusions from the result and thereby favor the individual patient, by increasing the readiness for major accidents or disasters in society. / Projekt Tabletop

<p>Previous research and patient complaints to the Swedish Patient Support Committee shows that there is a lack of substance in the patient-nurse relationship. This may suggest that it can be difficult for health care to live up to health-care law which requires it to be of good quality, based on dignity and respect and designed so that the patient is an active participant and can make their own decisions when it comes to their health care. For a better understanding of what a dignified patient-nurse relationship is, this study aims to clarify what the patient values as good patient-nurse relationship and describe how they have experienced the patient-nurse relationship during their stay at an emergency care department. The study is a descriptive cross-sectional study with a quantitative approach, where the population consisted of patients who were cared for at an emergency care department in the County of Västmanland, Sweden during 2007. The sample consisted of 93 patients which were asked to answer a questionnaire. The results show that patients who were cared for, answered positively in terms of the patient-nurse relationship, when they felt welcome to the department (62,1 %), when they were treated with deference and respect (59,3 %) and when the nurses showed they cared (57 %). A total of 11 % of the patients experienced a violation of their integrity and a sense of powerlessness towards health care. The results confirm previous research which emphasizes the importance of paying attention to patients' needs and requests before the dissatisfaction and lack of good patient-nurse relationship has arisen. This is necessary in order to improve and develop the positive experience of caring for the patient, and thus raise the quality of care.</p> / <p>Klagomål till patientnämnden visar på att det finns brister i bemötandet vilket också styrks av tidigare forskning. Det förefaller att det kan vara svårt för sjukvården att leva upp till hälso- och sjukvårdslagen som kräver att vården ska vara av god kvalitet, grundas på respekt, värdighet och utformas så att patienten själv får vara med och ta beslut. För att bidra till mer kunskap om ett värdigt bemötande avser denna studie att belysa vad patienten värderar som ett gott bemötande.<strong> </strong>Syftet var att beskriva hur patienter värderar bemötandet och hur de beskriver att de blivit bemötta av personalen under sin vårdtid på en akutvårdsavdelning. Studien är en deskriptiv tvärsnittsstudie med en kvantitativ ansats där populationen bestod av patienter som vårdats på akutvårdsavdelningar i Landstinget Västmanland under 2007. I studien ingick 93 patienter som vid slutet av vårdtillfället tillfrågats om de ville besvara en enkät. Resultatet visar att det som patienterna skattade att de var mest nöjda med (stämmer precis) ifråga om bemötandet var det välkomnande de fick när de kom till avdelningen (62,1 %), att de blev bemötta med aktning och respekt (59,3 %) samt att vårdarna brydde sig om dem (57 %). Trots det upplevde 11 % av patienterna kränkning av integritet och vanmakt i vården. Resultatet bekräftar tidigare forskning och poängterar vikten av att uppmärksamma patientens behov och begär innan ett missnöje har uppstått. Detta för att kunna förbättra och även utveckla en positiv upplevelse av bemötande för patienten och därmed höja vårdkvaliteten.</p> / Axelina

<p><font face="Times New Roman" size="3"><font face="Times New Roman" size="3"> <p align="left">The study made use of cross-sectional design that compared the performance of younger children (6- to 7-year-olds) with that of older children (12- to 13-year-olds) on various measures of executive function. Within this, it made use of a natural experimental design, with children exposed to alcohol<i><font face="Times New Roman" size="3"> as the experimental group and non-exposed children as the control group.</font></i></p> </font></font></p>

<p>Low back pain (LBP) is a significant problem among the nursing population worldwide. Manual lifting and shifting of heavy objects and patients are primary contributing factors. Nurses are supposed to be knowledgeable about the risk factors and preventive measures and effectively apply it into practice to prevent them from sustaining back injuries. Strategies to reducing the incidences of LBP in nurses have been previously implemented but with little outcomes. The purpose of this study was to explore the relationship between occupational risk factors and the prevalence of LBP in nurses at MOI, Tanzania. Therefore, the study examined / the prevalence of LBP amongst nurses, work-related risk factors contributing to LBP, knowledge and effectiveness of back care techniques, and barriers to effective back care techniques in clinical nurses.</p>

Background Affective disorders are poorly defined and studied in sub-Saharan Africa despite their substantial public health impact. Objectives Overall objective: To describe the epidemiology of selected affective disorders in rural Ethiopia. Specific objectives 1. To describe the validity and utility of the concept of minor depressive disorder (mD). 2. To describe the manifestation, prevalence and the short-term clinical and functional course and outcome of bipolar disorder. Subjects and methods Population: Zay community residents (age ≥16), and residents of Butajira (ages 15-49), in Southern Ethiopia. Study design: Population-based cross-sectional and longitudinal studies Case identification: For the identification of cases with bipolar disorder, a two stage process was employed. An initial screen used key informants and interview with the Composite International Diagnostic Interview (CIDI) to identify cases with probable bipolar disorder. A second confirmatory diagnostic assessment stage employed the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). For the identification of cases with mD, data from the CIDI was used. Follow-up: 312 cases with bipolar disorder from Butajira were followed up for a mean of 2.5 years (ranging 1-4 years) through monthly clinical assessments and annual symptom and functional ratings. Results The CIDI was administered to 1714 adults among the Zay and to 68, 378 adults among the Butajira residents. The prevalence of mD among the Zay and Butajira was 20.5% and 2.2% respectively. Up to 80% of cases with mD had used services for their symptoms, while a third to a half of cases had thought about self harm. Up to a sixth of cases had attempted suicide. Age, marital status, education and somatic symptoms were independently associated with mD. The prevalence of bipolar disorder among the Zay was 1.8%. During a 2.5-year follow-up of 312 cases with bipolar disorder from Butajira, 65.9% relapsed (47.8% manic, 44.3% depressive and 7.7% mixed episodes) while 31.1% experienced persistent illness. Female gender predicted depressive relapse whereas male gender predicted manic relapse. Only being on psychotropic medication predicted remission (OR=3.42; 95% CI=1.82, 6.45). Disability was much worse among bipolar patients than in the general population and was predicted by symptom se3verity. Conclusions This is the largest study on mD and bipolar disorder in Africa. mD appears to have potential clinical utility in this setting given its association with service use and risk. The identified risk factors for mD also suggest potential aetiological continuity with major depression. The relatively high prevalence of bipolar disorder among the Zay may be related to genetic predisposition perhaps mediated through a founder effect, but other factors need exploring. In relation to the outcome of bipolar disorder, this study indicates that, contrary to previous assumptions, the course of bipolar disorder is characterised by both manic and depressive relapses in a relatively proportionate fashion. Bipolar disorder also leads to significant levels of disability. This is the only prospective outcome study of bipolar disorder in Africa where cases were monitored systematically at short assessment intervals. Therefore, findings are likely to be more robust than previous reports.

Previous research and patient complaints to the Swedish Patient Support Committee shows that there is a lack of substance in the patient-nurse relationship. This may suggest that it can be difficult for health care to live up to health-care law which requires it to be of good quality, based on dignity and respect and designed so that the patient is an active participant and can make their own decisions when it comes to their health care. For a better understanding of what a dignified patient-nurse relationship is, this study aims to clarify what the patient values as good patient-nurse relationship and describe how they have experienced the patient-nurse relationship during their stay at an emergency care department. The study is a descriptive cross-sectional study with a quantitative approach, where the population consisted of patients who were cared for at an emergency care department in the County of Västmanland, Sweden during 2007. The sample consisted of 93 patients which were asked to answer a questionnaire. The results show that patients who were cared for, answered positively in terms of the patient-nurse relationship, when they felt welcome to the department (62,1 %), when they were treated with deference and respect (59,3 %) and when the nurses showed they cared (57 %). A total of 11 % of the patients experienced a violation of their integrity and a sense of powerlessness towards health care. The results confirm previous research which emphasizes the importance of paying attention to patients' needs and requests before the dissatisfaction and lack of good patient-nurse relationship has arisen. This is necessary in order to improve and develop the positive experience of caring for the patient, and thus raise the quality of care. / Klagomål till patientnämnden visar på att det finns brister i bemötandet vilket också styrks av tidigare forskning. Det förefaller att det kan vara svårt för sjukvården att leva upp till hälso- och sjukvårdslagen som kräver att vården ska vara av god kvalitet, grundas på respekt, värdighet och utformas så att patienten själv får vara med och ta beslut. För att bidra till mer kunskap om ett värdigt bemötande avser denna studie att belysa vad patienten värderar som ett gott bemötande. Syftet var att beskriva hur patienter värderar bemötandet och hur de beskriver att de blivit bemötta av personalen under sin vårdtid på en akutvårdsavdelning. Studien är en deskriptiv tvärsnittsstudie med en kvantitativ ansats där populationen bestod av patienter som vårdats på akutvårdsavdelningar i Landstinget Västmanland under 2007. I studien ingick 93 patienter som vid slutet av vårdtillfället tillfrågats om de ville besvara en enkät. Resultatet visar att det som patienterna skattade att de var mest nöjda med (stämmer precis) ifråga om bemötandet var det välkomnande de fick när de kom till avdelningen (62,1 %), att de blev bemötta med aktning och respekt (59,3 %) samt att vårdarna brydde sig om dem (57 %). Trots det upplevde 11 % av patienterna kränkning av integritet och vanmakt i vården. Resultatet bekräftar tidigare forskning och poängterar vikten av att uppmärksamma patientens behov och begär innan ett missnöje har uppstått. Detta för att kunna förbättra och även utveckla en positiv upplevelse av bemötande för patienten och därmed höja vårdkvaliteten. / Axelina

Bakgrund: Andelen äldre i befolkningen ökar nationellt och internationellt, och med ökande ålder ökar både fysisk och psykisk ohälsa. Äldre personer med ohälsa i form av kognitiv svikt (oftast demenssjukdom) kan bli beroende av vård och omsorg i särskilda boenden för äldre för att kunna känna trygghet och välbefinnande samt ha ett gott liv, i gemenskap med andra. Dock visar utvärderingar av särskilda boenden för äldre att vården ofta kan vara uppgiftscentrerad och inte motsvara de äldres individuella behov och önskemål. Personcentrerad vård är en vårdmodell som beskrivs kunna tillgodose äldre personers multidimensionella behov och önskemål, genom att personens livshistoria, personlighet, kapacitet och perspektiv uppmärksammas, respekteras och inkluderas i vården. Den vetenskapliga litteraturen inom området visar dock att det finns begränsad kunskap om förekomsten av personcentrerad vård i särskilda boenden för äldre i Sverige och internationellt, liksom om vilka faktorer som är mest betydelsefulla för att särskilda boenden för äldre ska bedriva en personcentrerad vård. Syfte: Syftet med denna avhandling var att beskriva faktorer som samvarierar med förekomst av personcentrerad vård i särskilda boenden för äldre i Sverige. Metod: Samtliga delstudier var tvärsnittstudier och data samlades in genom enkäter till äldre med kognitiv svikt och personal i särskilda boenden för äldre i Sverige. I studie I bestod insamlad data av skattningar av personcentrerad vård från vårdpersonal (n=1465) i 182 särskilda boendeenheter. I studie II insamlades data i form av vårdpersonalens (n=1169) skattningar av personcentrerad vård och proxyskattningar av de äldres (n=1261) livskvalitet, ADL-förmågor, smärta, depressiva symtom och agitation i 151 särskilda boendeenheter. Delstudie III baserades på data i form av personalskattningar (n=1169) av personcentrerad vård, tillfredställelse med arbete och vård, samvetsstress, arbetsbelastning och psykosocialt klimat i samma 151 särskilda boendeenheter. Även delstudie IV baserades på data från de 151 särskilda boendeenheterna och inkluderade skattningar av de äldre och vårdpersonal, men också skattningar av organisation och miljö vid dessa enheter (n=151). Samtliga studiernas data analyserades med hjälp av statistiska analyser, beskrivande, bivariata och multivariata analysmetoder. Resultat: Studie I visade att enkätinstrumentet The Person-Centred Care Assessment Tool (P-CAT) har tillfredställande psykometriska egenskaper för intern konsistens och test-retest-reliabilitet. Instrumentet består av två subskalor: Individualisering av vården och Stöd från organisation och miljö. Delstudie II visade att de boendes ADL-förmågor och livskvalitet skattades bättre vid enheter som kan beskrivas som mer personcentrerade. Delstudie III visade att en mer personcentrerad vård har samband med att personalen upplever ett positivt psykosocialt klimat, mindre samvetsstress, lägre arbetsbelastning samt högre tillfredställelse med vård och arbete. Studien visade också att personcentrerad vård var positivt relaterat till i vilken omfattning vårdarna hade vidareutbildning i demensvård. Delstudie IV visade att vårdmiljön var mest betydelsefull för förekomsten av personcentrerad vård vid boendeenheterna och att en gynnsam vårdmiljö innebar att personal upplevde att det var ett positivt psykosocialt klimat på enheten, att de hade tid att prata med eller bara vara med de boende samt att de upplevde sig ha en gemensam värdegrund, låg arbetsbelastning och en fysisk miljö som var anpassad till de boendes behov. Slutsatser: Resultaten i avhandlingen visar att den svenska versionen av P-CAT kan användas för valida och reliabla utvärderingar av personcentrerad vård samt att den kan rekommenderas för fortsatt forskning och vårdutveckling inom särskilda boenden för äldre. Resultatet visar också att den vård- och arbetsmiljö som omger de äldre och vårdpersonal i särskilda boenden för äldre är betydelsefull för förekomsten av personcentrerad vård. Dessa aspekter behöver fokuseras ytterligare för att kunna erbjuda en personcentrerad vård. Vidare är det psykosociala klimatet och förekomsten av en upplevd gemensam värdegrund viktig att förstå och prioritera om vården ska utvecklas mot en ökad personcentrering. Fortsatt forskning och kliniskt utvecklingsarbete behövs för att operationalisera och implementera de komponenter som bidrar till ett positivt psykosocialt klimat och en personcentrerad värdegrund på särskilda boenden för äldre. Dessutom behövs en ökad förståelse för hur en sådan värdegrund kan omsättas i personcentrerade interaktioner, handlingar, aktiviteter och prioriteringar. Det vore alltså önskvärt att äldrevården utvecklades mot ett mer personcentrat förhållningssätt, eftersom avhandlingens resultat visar att högre grad av personcentrerad vård i särskilda boenden för äldre var positivt relaterat till välbefinnande och tillfredställelse för såväl de äldre som för vårdpersonal. / Introduction: The proportion of older people in the population increases nationally and internationally, with a declining physical and mental health often accompanying older age. Older people with health issues such as cognitive impairment or dementia often become dependent upon residential aged care to feel safe, experience well being and a good life with others. However, it has been shown that residential aged care can largely be taskoriented and not tailored to residents' needs and wishes. Person-centred care is a contemporary best practice model of care that can meet the multidimensional needs and preferences of older people dependent on care, by acknowledging, respecting and including each person’s life story, personality, capacities, and perspective in care. Nevertheless, the research literature indicates a limited knowledge on the extent to which residential aged care units are person-centred in Sweden and internationally, as well as a limited knowledge into factors of importance for person-centred care in residential aged care units. Aim: The overall aim of this thesis was to describe factors that associate with person-centred care in Swedish residential aged care units. Methods: The thesis consists of four studies with cross-sectional designs, and data was collected through resident and staff surveys in Swedish residential aged care units. Study I collected data consisting of ratings of person-centred care from staff (n=1465) in 182 residential aged care units. Study II collected data consisting of staff (n=1169) ratings of person-centred care and proxy ratings of resident (n=1261) quality of life, ADL-capacity, pain, depressive symptoms and agitated behaviours, in 151 residential aged care units. Study III was based on staff (n=1169) ratings of person-centred care, satisfaction with care and work, job strain, stress of conscience, and perceived psychosocial climate in the same 151 residential aged care units as in study II. Study IV was also based on data from the 151 residential aged care units as described in study II and III, and included ratings of resident and staff variables, as well as variables related to the organization and environment at the units. Data was analyzed using statistical analyses such as descriptive, bivariate, and multivariate methods. Results: Study I showed that the Person-Centred Care Assessment Tool (PCAT) has satisfactory psychometric properties relating to internal consistency and test-retest reliability. The tool consists of two subscales: Extent of personalizing care and Amount of organizational and environmental support. Study II showed that residents were rated as having higher quality of life and better ability to perform activities of daily living in units described as being more person-centred. Study III highlighted that person-centred care was associated with higher staff satisfaction, less job strain, less stress of conscience, and a positive psychosocial unit climate. Person-centredness of care was also positively associated with the extent to which staff had continuing education in dementia care. Study IV showed that the environment is the most influential factor for person-centred care, and that an environment facilitating person-centred care consists of a positive psychosocial unit climate, where staff perceives having time to spend being with residents, where staff perceives a shared philosophy of care, a low job strain, and a physical environment adapted to residents’ needs. Conclusions: The results of the thesis show that the Swedish version of the P-CAT can be used for valid and reliable assessment of unit personcentredness, and that it can be recommended for further research and practice development in residential aged care. The results of the thesis also show that the environment of care and work that encapsulates residents and staff in residential care units is important for person-centred care. These aspects need further focus to enable person-centred care in residential aged care units. Furthermore, the psychosocial climate and the presence and content of a shared philosophy of care are important to understand and prioritize if care is to move towards increased person-centredness. Further research and practice development work is needed to operationalize and implement the components that contribute to a positive psychosocial climate and a person-centred philosophy in residential aged care units, as well as to increase the knowledge of how such a philosophy of care can be translated into person-centred actions, interactions, activities and priorities. strive towards developing person-centredness further within aged care is desirable, as the results in this thesis indicate that residential aged care units

En viktig faktor för människans förmåga att arbeta är hälsa. På arbetsplatsen tillbringar människan mer än en tredje del av sina liv, vilket gör arbetsplatsen till en betydande arena i skapandet av hälsa. Kommuner har som arbetsgivare i Sverige generellt en sämre hälsa samt högre sjukfrånvaro bland sina anställda än andra arbetsgivare. De som jobbar inom vård och omsorg har generellt dåliga psykosociala arbetsförhållanden. Den psykosociala arbetsmiljön i form av höga krav, bristande kontroll och dåligt socialt stöd kan påverka hälsan negativt, vilket kan öka rörligheten på arbetsmarknaden i form av att fler tenderar att byta jobb på grund av dåliga arbetsförhållanden. Syftet är att undersöka samband mellan självskattad psykosocial arbetsmiljö, självskattad hälsa och övervägandet att byta jobb bland kommunanställda inom äldre- och handikappomsorgen i Sverige. Studien har genomförts som en deduktiv tvärsnittsstudie och är en del av en störres studie.  Den baseras på 9 270 kommunanställda inom äldre- och handikappomsorgen i Sverige. Studien teoretiska referensram är krav/kontroll/stöd modellen. Analys skedde genom univariata, bivariata och multivariata metoder.    Resultatet visar att det fanns signifikanta bi- och multivariata samband mellan att kommunanställda som upplever den psykosociala arbetsmiljön som god även skattar hälsan bättre samt i mindre utsträckning överväger att byta jobb än de som upplever sämre psykosocial arbetsmiljö. Ålder och antal år på arbetsplatsen hade betydelse för övervägandet att byta jobb. Detta i form av att ju äldre de anställda är samt ju längre de arbetat på arbetsplatsen desto mindre är övervägandet att byta jobb. Slutsatsen är att den psykosociala arbetsmiljön hade betydelse för den upplevda hälsan och övervägandet att byta jobb bland kommunanställda inom äldre och handikappsomsorgen. / Health is an important prerequisite for the ability to work. In the workplace, the human being spends more than a third of their lives. This makes the workplace a major arena for health promotion. Municipalities have as employers in Sweden generally poorer health and higher rates of sick leaves among the employees than other employers. Those who work in health care have bad demanding working conditions. Psychosocial work environment in the form of high demands, lack of control and poor social support may affect health negatively. This can increase labor market mobility in the form of more tend to change jobs due to poor working conditions. The aim of this study is to investigate the relationship between self-rated psychosocial work environment, self-rated health and occupational mobility among municipal employees in the elderly and disabled care in Sweden. The study is implemented as a deductive cross sectional study and is a part of a major study. It is based on a sample of 9 270 municipal employees in the elderly and disabled care in Sweden. The theoretical frame of reference of study is the demand / control / support model. The analyses were done by univariat, bivariat - and multivariate methods. The results show that there were significant correlation between municipal employees who experience the psychosocial work environment as good rated health better and lesser extent considering changing jobs than those who experience poorer psychosocial work environment. Age and number of years in the workplace was relevant to the consideration of changing jobs. This is in the form of the older employees are and the longer they worked in the workplace, the less is the consideration of changing jobs. The conclusion is that the psychosocial work environment was important for the perceived health and the consideration to change jobs among municipal employees in the elderly and disabled.