Final thesis follows the destiny of Alois Klar (1763-1833) with the emphasis on the history of ideas. Primarily, it focuses on three realms: religion thinking, history of language and school system. The whole frame is based on an effort to create an alternative analytic concepts for studying the age of so called "National Movement". Powered by TCPDF (www.tcpdf.org)

The Internet of Things (IoT) enables opportunities to remotely sense and control objects via communication networks. We study services based on connected devices and the collaboration they generate between the ICT and the Health, Social Care and Wellbeing (HSCWB) industries. In HSCWB, IoT can support a change from episodic treatments of illness to preventive care and wellbeing solutions. The IoT can be a supporter in cost efficient and high quality health care. The objective is to achieve healthier life years and more efficiency in health and social care. Even if the potential of IoT in HSCWB has been proven in pilot projects and small-scale solutions, the benefits and opportunities for many actors are still unclear. There is a research gap in studying the roles and business opportunities for market-driven technology-based solutions enabled by connected devices. The research approach separates technological and business domains. On the technology side, the focus is on advances in connectivity for IoT. We present the technical details on a limitation to support IoT devices in cellular networks. We quantify the limitations in the Random Access Channel of the LTE air interface to support IoT devices. Moreover, we propose the adaptation of an access mechanism to enable massive number of simultaneous access attempt in cellular networks. On the business side, we identify and present how the conditions of the health and social care structure in Sweden affect the establishment of IoT solutions in HSCWB. We then show how these conditions have generated three distinctive development patterns—to innovate within the public sector, to develop solutions in the private care sector, or to target the wellbeing sector to avoid regulatory setbacks. Based on these patterns, we look closer into study cases to show how business opportunities have been addressed from a business network perspective. When deploying an IoT service, not all critical challenges can be appreciated at a single firm level. Therefore, we rely on a network-level business model framework to analyze emerging IoT services in HSCWB. The findings suggest that IoT components can improve an existing service by automating internal working processes, or they can enable new value propositions and convenience to end users. In general terms, the collaboration can be used (i) to improve the efficiency of existing services in health and social care without an original intention to change the service offering, or (ii) to create novelty and differentiation, without affecting the internal logics of existing HSCWB services. / <p>QC 20180828</p> / IoT Ecosystems (VINNOVA) / COIN-SWEAT / MTC2020 / M2MRISE

1 Abstract Informal care is one of the important sources of the help and support provided at home to the seniors requiring the assistance from other people. This topic is highly relevant since it is linked to the growing need of long-term care of seniors reflecting the ageing of population in developed countries. The care provided by informal carers is important also because of the changes in the social services. The changes are related to the shift from institutional care of depending persons including seniors to the social services provided in the natural social environment. Such approach supports the autonomy of clients. This master degree thesis addresses the support of informal carers in the area of the care of non self-sufficient elderly people. The investigation is focused on the needs of informal family caregivers as for the information support, financial support, the support from the social services and the support expected from the services of long-term residential care. The thesis also deals with the motivation of the carers and their understanding of the social context of provided care. The research which is included in the empirical section of the thesis was implemented through qualitative methods, namely using semi-standardized interviews. The interviews with ten informal carers were carried...

Denna uppsats undersöker från ett brukarperspektiv om det finns några kvalitetsskillnader mellan den privata och kommunala äldreomsorgen inom Borås kommun. Undersökningen använder sig av sekundärdata, där Socialstyrelsen gjorde en enkätundersökning runt om i landets alla kommuner och som vi därefter sammanfattade alla svar utifrån det vi undersökte. I denna studie så samlades sekundärdata in för att sedan analyseras, för att sedan komma fram till hur kvaliteten är men även hur den skiljer sig åt på den kommunala samt privata äldreomsorgen. Kvaliteten som undersöks är bemötandet, tiden, tryggheten samt 4 äldreomsorgens olika områden som helhet. I studien finns även olika teorier kring kvaliteten samt hur man ska effektivisera arbetsplatserna så kvaliteterna höjs, så att man får fler nöjda brukare. Studien undersöker äldreomsorgen från tre olika sidor, vi undersökte hur kvaliteten är på ett äldreboende, särskilt boende samt hemtjänsten på både kommunal och privat äldreomsorg. Efter analysen av datamaterialet som används så fick vi fram ett resultat kring frågeställningen som löd, "Hur skiljer sig kvaliteten åt på kommunala kontra privat äldreomsorg?". Resultatet blev inte exakt som vi tänkte. Vår hypotes var att kommunal äldreomsorg skulle vara bättre på alla punkter med tanke på att privat äldreomsorg har mer med ett vinstdrivet tänk att göra. Slutresultatet var att det var ganska så jämnt, inom vissa områden var kvaliteten på kommunal bättre och i vissa fall så var kvaliteten inom privat bättre. Om man ser resultatet i helhet så var kommunal äldreomsorg bättre inom flera områden men inte med stora skillnader. Det vi kom fram till vara att kvaliteten på kommunal äldreomsorg är i sin helhet bättre än den privata äldreomsorgen. Vård och omsorg är ett brett ämne och vi rekommenderar att man forskar vidare kring det för att få en större samt djupare inblick i det hela. / This study has been made from a user perspective to discuss and find out if there are any differences in quality between the municipal and private performers in elderly care in Borås municipality. The study was made through secondary data/information where the national board of health and welfare (Socialstyrelsen) made a survey in Sweden where the municipalities in Sweden participated, where we summarized the answers based upon our study. The valuable secondary data was collected and analyzed to learn how the quality is and how it differs from each other in private and municipal performers. The quality that is studied is the treatments, the time, and the feeling of safety but also the different parts that are included in the elderly care. The study also includes different theories that discuss the quality and how to make the workplaces more effective so that the quality could be improved so you have more satisfaction among the users. The study researches the elderly care from three different perspectives and how the quality is in a retirement home, special homes and home care in private and municipal performers. After analyzing the information and the data we got an answer on the question "How is the difference in municipal performance compared to private performers?" where our hypothesis was that the municipal performers would be better because the private ones are often profit-driven. The result was that they are pretty equal, in some areas the municipal was better than the private ones, but in some the private ones was better than the municipal. If we zoom out and look at the bigger picture, the municipal performers were better in more areas, but there wasn't that big of a difference, so if you compare the difference in performance between the municipal and private performers, in the whole big picture the municipal performers have better quality. Health and social care is a big subject and we recommend further study for better knowledge and differences that may come up.

Introduction : Peu d'études se sont intéressées aux aides à domicile dans l'accompagnement de la vieillesse et moins encore, dans celui concernant les conduites d'alcoolisation à cet âge. Dans cette thèse s'inscrit dans une approche intégrative incluant une méthodologie quantitative et qualitative. Ainsi, nous étudions les aspects psychologiques de ces aides à domicile tout en les comparant à celles accompagnant la maladie d'Alzheimer.Méthode : 99 aides à domicile recrutées en milieu écologique ont répondu à un questionnaire de données professionnelles de 62 items, une échelle d'estime de soi (EES), un questionnaire de satisfaction de vie professionnelle (ESVP), un inventaire d'épuisement professionnel (MBI) et une échelle évaluant la symptomatologie anxio-dépressive (HADS). Les participantes ont été réparties en deux groupes : celles soulignant des difficultés dans l'accompagnement de la maladie d'Alzheimer (n=63) et celles évoquant des difficultés dans l'accompagnement de conduites d'alcoolisation (n=36). Parmi elles, 18 ont accepté de participer à un entretien de recherche enregistré et analysé à l'aide du logiciel QDA Miner 4.Résultats : Les résultats des dimensions psychologiques sont statistiquement significatifs lorsqu'ils sont associés aux caractéristiques professionnelles. Dans l'accompagnement des conduites d'alcoolisation, lorsqu'elles connaissent le diagnostic de la pathologie, l'épuisement émotionnel est plus élevé et celui-ci est corrélé positivement avec l'humeur dépressive et négativement avec la satisfaction de vie professionnelle. L'accomplissement personnel est corrélé négativement avec la symptomatologie dépressive. La satisfaction de vie professionnelle est corrélée positivement avec la relation de satisfaction avec l'entourage. Dans l'accompagnement de la maladie d'Alzheimer, quand elles ne connaissent pas le diagnostic de la pathologie de la personne âgée, leur épuisement émotionnel est plus élevé et celui-ci est corrélé négativement avec la satisfaction de vie professionnelle et positivement avec la symptomatologie anxio-dépressive.Pour les conduites d'alcoolisation, le discours relatant des difficultés avec la personne âgée a un lien de similarité avec les représentations de la maladie, la progression de la maladie, les relations avec les familles et le sentiment d'impuissance de l'aidante face à la pathologie de l'aidé. Le discours sur les satisfactions a un lien de similarité avec ceux évoquant l'expérience pour accompagner, les représentations et les compétences pour parler de la maladie avec les âgés. Concernant la maladie d'Alzheimer, le discours relatant des difficultés avec la personne âgée a un lien de similarité avec ceux évoquant les représentations et la progression de la maladie, ainsi que les identifications de l'aidante face au vieillissement de l'âgé. Le discours sur les satisfactions a un lien de similarité avec l'expérience pour accompagner et les raisons pour lesquelles elles exercent ce métier. Cette étude permet de mieux appréhender les spécificités psychologiques des aides à domicile française et ouvre ainsi, des perspectives de recherche. Des implications cliniques pourraient voir le jour dans la prévention des aspects psychologiques auprès de cette population. / In France, few studies were interested by care social workers in the accompaniment of old age and less still, in that concerning the alcohol misuse at this age. In this thesis, we study the psychological aspects of these professional all while comparing them with those to support the Alzheimer's disease. 99 social care workers answered a questionnaire of 62 professional data, a scale of self esteem (EES), a questionnaire of job satisfaction (ESVP), an inventory of burnout (MBI) and a scale of anxio-depressive symptomatology (HADS). The professionals were divided into two groups: those with the difficulties in the support of the disease of Alzheimer (n=63) and those with the difficulties with alcohol misuse (n=36). Moreover, 18 of whom were interviewed. In the support of alcohol misuse, significant results show that when they know the diagnosis of pathology, emotional exhaustion is higher and this one is correlated positively with depressive mood and negatively with the job satisfaction. The personal achievement is correlated negatively with depressive mood. The job satisfaction is correlated positively with relatives' relations. In the support of Alzheimer's disease, when they don't know the diagnosis of the pathology, emotional exhaustion is higher and this one is correlated negatively with the job satisfaction and positively with anxio-depressive symptomatology. For the alcohol misuse, the interview of difficulties with the elder is related to similarity with those showing the representations and progression of the disease, the family's relations and the feeling of ineffectiveness for supporting the pathology. The discussion of satisfactions is related to similarity with those evoking the professional experience, the representations and skills to speak with the person about the disease. For Alzheimer's disease, the discussion of difficulties with the elder is related to similarity with those evoking the representations and the progression of the disease ¿ and that ¿ with the identifications of the senior. The discussion of satisfactions is related to similarity with those talking the professional experience and the evocation of the personal reasons to work. This study allows considering the specificities of French social care workers. It opens some research perspectives and could have a clinical implication in prevention of this population.

Det övergripande syftet med denna studie var att beskriva, tolka och förstå vårdlärares upplevelse av att arbeta med distansundervisning på vård- och omsorgsprogrammets vuxenutbildning. Studien genomfördes som en kvalitativ intervjuundersökning med hermeneutiskt perspektiv. I resultatet framkom nio metaforer som konkretiserar vårdlärarnas upplevelse av arbetet. Metaforerna gestaltar distansformens betydelse för vårdlärarna och visade att vårdlärarna upplevde den egna erfarenheten som ett oumbärligt didaktiskt verktyg. Vårdlärarnas personliga egenskaper var av större betydelse än de tekniska hjälpmedlen. Vikten av att etablera en personlig relation med den studerande och att stötta och stärka den studerandes självkänsla förstods som centralt i vårdlärarnas arbete. Både det webbaserade samtalet och det fysiska mötet samt snabb återkoppling bidrog till att etablera en personlig relation, vilket främjar lärandet. Svagheter med distansformen var när språket inte räckte till, när den studerande hade begränsad studievana, brist på erfarenhet av vård- och omsorgsarbete samt tidsbrist. De flesta av vårdlärarna hade genomfört sina egna vårdlärarstudier på distans. Vårdlärarnas förförståelse, kompetens i flera ämnen med lång och bred yrkeserfarenhet, ett tydligt mål i form av en hög vård- och omsorgskvalitet, samt ett starkt intresse för att den studerande skulle lyckas, gjorde arbetet som distanslärare meningsfullt och betydelsefullt för de studerandes kunskapsutveckling. / The overall aim of this study was to describe, interpret and understand nursing assistant teachers’ experience of working with distance learning for adult students within health and social care education. The study was conducted as qualitative interviews with hermeneutic theoretical perspective. The result indicated nine metaphors that concretize nursing assistant teachers’ perception of their work. The metaphors show the meaning of the distance learning for the teachers and that they regarded their own experience as an indispensable didactic tool. Nursing assistant teachers’ personal characteristics were more important than the technical aids. The importance of establishing a personal relationship with the student, to support and enhance the student's self-esteem were understood as central to the teachers work. Both the web-based conversation and the physical meeting along with rapid feedback helped establish a personal relationship, which promotes learning. Weaknesses in the distance form was when the language was insufficient, when students had limited study habits, lack of experience of care work and lack of time. Most of the nursing assistant teachers had themselves experience of distance learning from their own studies. Nursing assistant teachers’ pre-understanding, expertise in several subjects with extensive professional experience, a distinct aim to higher health-care quality, as well as a strong interest to see the students succeed, made the distance teacher role meaningful and important for the development of the students’ knowledge.

During the last decades, Swedish policy makers have implemented various marketization reforms into the public welfare sector in order to make it more cost-efficient and to improve its quality. The aim of this dissertation is to investigate what implications this marketization trend has had for the organization of Swedish eldercare. In particular, the research question addressed is how marketization reforms such as privatized provision, increased competition, and user choice have transformed the relationship between the service users, the professionals, and the state. To answer the research question, four articles are presented in the dissertation, each corresponding to a separate empirical investigation. Together, the articles demonstrate that the increased reliance on marketization in Swedish eldercare has made it more difficult for the local authorities to directly control the quality of the services, since it reduces their ability to allocate public resources and expects them to govern the provision of eldercare through the entering of contracts. This development has also implied that service users themselves become increasingly responsible for ensuring that the quality of their care is high. Moreover, the articles show that the increased reliance on audit by the national government and its agencies has tended to undermine the professionalization of eldercare staff, thereby limiting their autonomy and ability to ensure service quality. As a whole, the dissertation contributes with a more comprehensive understanding of how marketization has altered the organization of Swedish eldercare and under what conditions it might undermine the goals of social equality and ensuring that all citizens have equal access to good quality care.

This thesis reports on research focuses on how to deal with the fact that the organization and processesof today’s health and social care are becoming ever more complex as a consequence of societal trends, including an aging population and an increased reliance on care at home. The overall research goal is to suggest ways in which IT-based solutions can enable and leverage collaboration and coordination insituations where a co-morbid patient is subject to care delivered simultaneously by several different professionals and organizations. Patient-centered care is defined as quality health and social care achieved through a partnership between informed and respected patients, their families, and coordinated health and social care teams who conduct care activities according to jointly determined care plans. Against a background of several years of research on patient-centered collaborative care using adesign science approach, using techniques such as focus groups, interviews, and document studies, the author of the thesis has further pursued the work in a project named CoCare. Results show that the care required in aging societies is both a social and a technical challenge. Meeting this challenge will require a redesign of today's health and social care processes in order to focus more clearly on patient needs and values, and poses demands on information services allowing to share knowledge of the patient’s health and social situation among involved care providers. An important aspect of the increased complexity is that a single patient may need care from several autonomous care providers in parallel, particularly patients with co-morbidities. This clearly requires effective coordination of care activities, which poses further demands on information services to support this task. A set of issues involving patient-centered collaborative care is identified and analyzed. The thesis introduces the notions of the Patient-Centered Care Process (PCCP) and a conglomeration of suchprocesses. A conglomeration comprises a set of PCCPs that concern the same patient, that are overlapping in time, and that share the overall goal of improving and maintaining the health and socialwell-being of the patient. The PCCP is inspired by the well-known PDCA cycle and comprises the four phases of assessing the patient situation (ASSESS), planning care activities (PLAN), performingcare activities (DO) and following up care (CHECK) for the patient. Based on a number of key standards, such as HL7, HISA and CONTsys, the thesis introduces a Patient-Centered Information Model (PCIM). A set of information services, together constituting a Coordination Hub, is proposed. The information services aim to help formal as well as informal carers (including the patient) inconducting care according to the PCCP The thesis contributes to a deeper understanding of care processes and suggests ways to achieve patient-centered collaborative care that better contributes to creating value for the patient as an individual.

Concerns about population ageing have been central to reforms of pensions policy and social care policy in the UK over recent decades. However, policy responses to these social problems are in tension, as individuals have been expected to take greater responsibility for both pension saving and provision of care, even when care involves a reduction in earnings and savings. While the pension system protects carers’ state pensions, little attention has been paid to their non-state pensions. This thesis therefore explores the attitudes and beliefs carers hold regarding pensions, and the effect of caring on pensions planning, particularly planning a non-state pension. It focuses on the assumptions made about agency and decision-making contained within social policy. Semi-structured interviews were held with those aged 35-64 who were providing 20 hours of care or more a week in the Thames Valley and Greater London. Almost all of the carers reported disruption to their private pension savings as their employment was impacted by caring. Few felt able to make a choice regarding either caring or employment. Caring also affected the importance many attached to saving, although there was no uniform effect on decision-making. Some carers became more reflexive, attempting to take more control in response to the uncertainty in their lives; others felt powerless due to this uncertainty and limited financial resources. The study provided support for the theory of an ethic of care, which suggests individuals make decisions based on relationships rather than calculations of expected outcomes. The findings challenge the assumptions made in pensions policy. Carers were classed in four categories of approach to pensions savings: reflexive planners, non-reflexive planners, reflexive non-planners and non-reflexive non-planners. A range of financial and social resources corresponding to Bourdieu’s habitus and economic and cultural capital was required for carers to act as reflexive planners.

Care transition, the process of moving from community care to residential care, is one of the biggest changes that older people can experience in their later life. Evidence from the literature suggests that older people's experiences of care transition tend to be negative and traumatic, with most of them being little involved in the process of care transition. How older people exercise choice during the period of care transition is important for understanding their experiences of care transition for the following two reasons: first, choice has been referred to in the literature as the key to less stressful care transition experiences, which can subsequently lead to a better quality of life in residential homes; second, the introduction of choice in public services has been the key plank of British social policy in recent decades and there has been a movement towards extending choice in residential care. This research aims to study older people's care transition experiences and their exercise of choice during the process of care transition, to explore the meaning and the perceived effects of choice and to identify the role of choice in promoting a positive care transition. This thesis presents findings from 48 in-depth interviews with older people who became new residents in one of the ten participating residential homes in London and had their care paid for by the local authority. This research identified four groups of older people who showed marked differences in terms of their needs, their exercise of choice during the care transition process and their adaptation to residential care: Active Planners, Conformists, the Unsettled and Shelter-Seekers. The findings from this research suggest that the older people's care transition experiences varied and that they stretch beyond the prevailing evidence emphasising the stressfulness of the care transition. The cases of Active Planners and Shelter-Seekers show the potential for positive roles for care homes in the case of users with genuine needs for residential care. An overwhelming majority of the older people who were interviewed were great proponents of choice and many of them actively exercised choice in the course of their care transition. This challenges the claim of the passivity of older people which has been argued in the literature. However, the cases of some Conformists who did not want to exercise choice also highlight that having no choice can be a choice for some older people. On the whole, older people’s exercise of choice played an important role in facilitating a positive transition, despite it not being a precondition for such a transition. However, there were administrative issues limiting the level and the extent of choice that were available to the older people and the Unsettled experienced an undesired move into a care home, having their choices denied or rejected. This thesis also questions the working of choice and competition in residential care, as the older people did not seem to enjoy the expected benefits of choice relating to service improvements which have been argued for in the literature.