Magistro baigiamajame darbe išanalizuota ir įvertinta „Šv. Juozapo globos namų“ vidaus ir išorės aplinkos veiksnių kompleksinė įtaka, identifikuotos probleminės sritys ir tuo remiantis sudaromos prielaidos organizacijos strategijos formavimui bei strateginio plano rengimui. Pirmoje darbo dalyje teoriniu aspektu apibrėžiamos socialinės globos paslaugos, strateginio planavimo teoriniai aspektai ir socialinių globos paslaugų kokybės vertinimo ypatumai apžvelgiant paslaugų kokybės vertinimo modelius bei užsienio valstybių empirinius tyrimus. Antroje dalyje, remiantis tam tikrais metodais (Porter 5 jėgos, PEST, 7 - S, SSGG), atliekama „Šv. Juozapo globos namų“ strateginė analizė. Trečioje darbo dalyje pateikiama „Šv. Juozapo globos namų“ socialinės globos paslaugų kokybės empirinio tyrimo metodika bei organizavimas ir rezultatų analizė. Tyrimo tikslas - palyginti socialines paslaugas į namus gaunančių asmenų bei jų artimųjų ir globos įstaigoje gyvenančių asmenų bei jų artimųjų požiūrį į jiems teikiamų paslaugų kokybę bei identifikuoti kokybės kriterijus, darančius didžiausią įtaką bendram kokybės įvertinimui. Atsižvelgiant į strateginės analizės rezultatus pateikiami siūlymai organizacijos veiklos tobulinimui. / This Master's thesis analyzes and evaluates St. Joseph's Care Home’s internal and external environmental factors’ complex influence, identifies problematic areas and leads to the preconditions for organization's strategy formulation and preparation of strategic plan. The first part of the thesis defines the theoretical terms of social care services, strategic planning in theory and the peculiarities of social care services quality assessment by reviewing service quality evaluation models and empirical studies from foreign countries. The strategic analysis of St. Joseph's Care Home is performed in the second part of this thesis basing on certain techniques (Porter's five forces, PEST, 7 – S, SWOT). The third part of the thesis provides the methodology of St. Joseph's Care Home empirical research on social care service quality, organization and analysis of the results. The aimof the research is to compare the attitudes on services quality of individuals and their family members, who receive social services athomeand the ones living in carehome; also to identify the quality criteria that havethe greatestimpact on the general qualityassessment. Based on the results of strategic analysis the suggestions on how to improve organization’s performance are provided.

Authors: Carolina Magnusson and Johanna Magnusson Title: The balance between research and practice. A study of family therapist’s knowledge retrieval and the application of evidence-based practice. Supervisor: Jan Petersson Assessor: Peter Hultgren During our research we discovered that a very small amount of research had been conducted about the effect of the social services. It inspired us to fulfill this study. The aim of the study is to describe and analyze what knowledge family therapists in two Swedish municipalities use in family therapy work. We were also interested in which methods they consider having the best effect for social services. Our data collection consisted of qualitative semi-structured interviews conducted with family therapists in two Swedish municipalities. Our primary focus of the study has been the meeting that is taking shape within the family treatment and which components are key elements. Based on the results we have also been able to draw conclusions about how the function of the social services family therapy can be improved and how the work process is characterized by an evidence-based practice. We discovered that family therapist’s knowledge acquisition was extremely haphazard and not on a systematic basis, which the evidence-based model requires. Keywords / Nyckelord Evidence based social work, families/children in social care, knowledge, competence, protective and risk factors and social service. Evidensbaserad praktik, familjebehandling, familjer/barn i socialtjänsten, kunskap,kompetens, tidiga insatser och risk och skyddsfaktorer.

Abstract Authors: Carolina Magnusson and Johanna Magnusson Title:  The balance between research and practice. A study of family therapist’s knowledge retrieval and the application of evidence-based practice. Supervisor: Jan Petersson Assessor: Peter Hultgren During our research we discovered that a very small amount of research had been conducted about the effect of the social services. It inspired us to fulfill this study. The aim of the study is to describe and analyze what knowledge family therapists in two Swedish municipalities use in family therapy work. We were also interested in which methods they consider having the best effect for social services. Our data collection consisted of qualitative semi-structured interviews conducted with family therapists in two Swedish municipalities. Our primary focus of the study has been the meeting that is taking shape within the family treatment and which components are key elements. Based on the results we have also been able to draw conclusions about how the function of the social services family therapy can be improved and how the work process is characterized by an evidence-based practice. We discovered that family therapist’s knowledge acquisition was extremely haphazard and not on a systematic basis, which the evidence-based model requires.

This dissertation covers the subject of how abstract concepts and complex situations can be concretized through research together with practitioners. The dissertation is based on four empirical studies. The researcher role, the practitioner participation and the methods for data collection and analysis have varied. In study I the concept ‘Närsjukvård’ was explored to understand how practitioners, managers and politicians in hospitals, primary health care and municipalities interpreted the concept. The researcher acted as consultant who collected data by interviews and questionnaires. Practitioners’ participation was limited. ‘Närsjukvård’ was interpreted as accessibility to hospital beds, accessibility to primary health care, collaboration between care providers and continuity and developed home care. Study II aimed to explore how people experienced leg ulcer care. The researcher acted as a consultant who performed the interviews and analysed the data. Although the informants experienced their encounters with the nurses as satisfying, the study illuminated low participation in the care and low practitioner involvement in issues about daily living with the leg ulcer. The findings were brought back to the informants and the practitioners. The project did not proceed towards development and change. In study III the aim was to explore the Swedish concept ‘trygghet’ by using stories from daily life. Four older women were interviewed and the Story Dialogue method was used together with assistant nurses and registered nurses who participated in data collection and analysis. Two themes emerged: Sense of Security and factors strengthening the Sense of Security. Together with the assistant nurses, areas for improvements were identified. Study IV aimed to explore the discharge planning situation in order to generate ideas for development. Members from a discharge planning network participated in the whole research process. Conditions for a successful coordinated discharge planning situation were a system including: the participation of the patient, the competence of the staff and the support from the organisation. The group arranged a workshop about communication and interdisciplinary collaboration. The findings resulted in a form with self-evaluation questions. In conclusion, this thesis illustrates that it is possible to clarify abstract concepts and complex situations together with practitioners. To do this successfully, sense making activities and to start from practitioners’ experiences and their own context are key factors. The studies illuminate that building trust, relationship and sense of participation are essential in health and social care in general and specifically in the participatory action research process.

The overall aim of this thesis was to describe and evaluate interprofessional education on an interprofessional training ward in municipal care for older persons. Interprofessional education has for some years now been proposed as a means to meet the call for effective collaboration, co-ordination and quality in health and social care. On the interprofessional training ward considered in this thesis, stu-dents from nursing, occupational therapy and social work programmes worked together for three weeks to learn with, from and about each other. In the first study (I) students’ perceptions and attitudes concerning the training on the ward were studied. An attitude questionnaire and a retrospective goal-fulfilment questionnaire were distributed to all students. Non-parametric statistics were used for the quantitative analysis, and qualitative content analysis for the qualitative parts. The results showed that the students had positive attitudes to-wards the training ward and in most respects the learning goals set up for the course were considered to have been met. In Studies II and III the focus was on students’ knowledge and understanding of their own and the others’ professions. Sixteen students were interviewed before and after. In the analysis of the interviews a phenomenographic approach was used. The findings showed a variation from simplistic conceptions of the profes-sions in terms of tasks to more complex conceptions in terms of the profession’s knowledge, responsibility and values. Differences in the ways professions were described concerning their professional stance towards the patients were espe-cially accentuated. The comparison between before and after indicated that there were changes in the students’ views. In some areas, however, there remained dis-crepancies between students’ understanding of their own profession and the oth-ers’ understanding of this profession. To promote mutual agreement on each other’s role this needs to be given careful consideration. In the fourth study (IV) the focus was on the students’ participation in the community of practice on the ward, and the findings reveal an ambivalent picture of this participation (and thus of their learning). The students collaborated in the care of the patients. However, they sometimes experienced a gap between expec-tations and reality with regard to both the profession-specific and the interprofes-sional training on the ward: what they had to do was sometimes felt to be be-neath their qualifications and irrelevant to the programme of education they were pursuing. This applied to all three groups, but especially student social workers. Interprofessional training wards can promote interprofessional learning, but it is crucial that setting should be right: it needs to be realistic for all the students involved, offering relevant profession-specific and interprofessional tasks and situations where the students can develop skills in collaborative, patient-centred care.

O presente estudo analisou as trajetórias de vida de mulheres acompanhadas por serviços da Proteção Social Básica, no âmbito do Sistema Único de Assistência Social (SUAS). Pretendeu-se compreender, a partir das narrativas dessas mulheres e da observação de sua circulação na rede da Assistência Social, o modo como diferentes marcadores sociais se articulam em suas experiências, desde uma perspectiva interseccional, produzindo sujeitos dessa Política Pública. Tal perspectiva considera, portanto, as articulações entre diferentes marcadores sociais de diferença - como gênero, raça, etnia, classe, idade, etc -, procurando compreender de que modo a experiência de um modifica a experiência de outro, intensificando formas de vida precarizadas, mas também se rearranjando em possibilidades de resistência (BRAH, 2006). A experiência dessas mulheres, ao mesmo tempo em que absolutamente particular, já que os marcadores podem se articular de diferentes formas e em contextos distintos, mesmo na vida de uma mesma mulher, remete ao funcionamento das instituições pelas quais passam, ao local onde vivem e às estratégias que acionam nesses campos. No que se refere aos aspectos metodológicos, tratou-se de uma pesquisa qualitativa em que foi privilegiada a observação participante, com registro em diário de campo, e a entrevista etnográfica. / This study analyzed the life‘s trajectories of women accompanied by social services‘ agencies in Porto Alegre, Brazil. From these women narratives, it intended to understand the ways that different social markers articulate themselves with those experiences in an intersectional perspective, producing subjects from that public police. Such perspective take into account the articulations between different social markers of difference –as gender, race, ethnicity, class, age, etc. – trying to understand how a social marker experience modifies others social marker experiences, intensifying precarious life‘s way, but rearranging itself in resistance possibilities (BRAH, 2006). The narrative of these women, at the same time they‘re particular as the social markers can articulates themselves sin different ways, refers to the institutional operation that they pass through as also to the place where they live. As for the methodological aspects, it consists a qualitative research who privileged the participant observation registered in field journals.

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Lorsqu’elle s’inscrit dans un contexte tel que celui des pays en développement, la notion de handicap se caractérise par des tendances bien singulières. C’est notamment en République de Guinée que nous avons décidé de centrer notre travail, traitant des problématiques liées aux handicaps physiques et plus particulièrement aux déficiences des membres inférieurs. Les objectifs fixés dans cette recherche consistent à expliquer les causes et les conséquences de la prédominance de ce type de déficiences à Conakry. De plus, parmi d’autres problématiques que soulève notre travail, nous nous intéressons aux représentations que reflètent les handicaps et aux influences qu’elles subissent de la part des croyances traditionnelles et religieuses. Notre travail s’inscrit donc à la fois dans la volonté d’établir un état des lieux de la situation actuelle et dans la réalisation d’un important travail de terrain qui a été mené à Conakry entre 2008 à 2011 auprès d’un millier de personnes. D’après nos résultats, la principale cause des déficiences des membres inférieurs est liée aux séquelles de la poliomyélite et à la présence d’autres facteurs de risques tels que l’insécurité routière. De plus, selon nos analyses, près de 80% des personnes atteintes de ce type de déficience résidant à Conakry sont issues de l’exode rural. Une fois installées à Conakry, elles optent pour les trois modes de subsistance à savoir : la pratique de la mendicité (48%), l’occupation d’un emploi (16%) et la prise en charge familiale (18%). Par ailleurs, chaque mode semble déterminer leur participation et leur intégration au sein de la société. Enfin, nos résultats montrent que près de la moitié des Guinéens croit en la sorcellerie et en la nature maléfique des handicaps. Comme nous l’expliquons, ces croyances influencent négativement les représentations des handicaps. Pour conclure, selon nos analyses la majorité des Guinéens s’accorde à définir le handicap comme un phénomène biomédical et le considère comme un problème individuel et non social. / While dealing with the context of the developing countries, the notion of handicap is characterized in a specific way. We carried out our study in the Republic of Guinea, particularly related to the problems of the handicap, more specifically with the disability of inferior members. The main objectives of this research consist in explaining the causes and the consequences of the ascendancy of this type of deficiencies in Conakry. Furthermore, among the other problems analyzed in this work, we are interested in the representations which reflect the handicaps and the influence of traditional and religious beliefs on handicap. Our work is aimed to present the current conditions of the situation and to carry out a significant work on the site. In this framework, we organized two surveys during 2008 and 2009, dealing with approximately 1000 persons. According to our results, the main cause of the deficiencies of lower limbs is associated to the aftereffects of the poliomyelitis and to the presence of the other risk factors, such as the lack of safety on the roads. Furthermore, according to our analyses, about 80 % of the people questioned, belonged to the rural depopulation. Once installed in Conakry, they opt for three modes of subsistence: the practice of begging (48 %), working (16 %) and the family care (18 %). Moreover, each mode seems to determine the participation and the integration of these individuals in the society. Finally, our results show that nearly half of the Guineans believe in the witchcraft and in the malefic nature of the handicaps. Consequently, the faith influences negatively on the interpretation of the handicaps. To conclude, according to our analyses, the majority of the Guineans agrees to define the handicap as a biomedical phenomenon and considers it as an individual and not a social problem.

O presente estudo analisou as trajetórias de vida de mulheres acompanhadas por serviços da Proteção Social Básica, no âmbito do Sistema Único de Assistência Social (SUAS). Pretendeu-se compreender, a partir das narrativas dessas mulheres e da observação de sua circulação na rede da Assistência Social, o modo como diferentes marcadores sociais se articulam em suas experiências, desde uma perspectiva interseccional, produzindo sujeitos dessa Política Pública. Tal perspectiva considera, portanto, as articulações entre diferentes marcadores sociais de diferença - como gênero, raça, etnia, classe, idade, etc -, procurando compreender de que modo a experiência de um modifica a experiência de outro, intensificando formas de vida precarizadas, mas também se rearranjando em possibilidades de resistência (BRAH, 2006). A experiência dessas mulheres, ao mesmo tempo em que absolutamente particular, já que os marcadores podem se articular de diferentes formas e em contextos distintos, mesmo na vida de uma mesma mulher, remete ao funcionamento das instituições pelas quais passam, ao local onde vivem e às estratégias que acionam nesses campos. No que se refere aos aspectos metodológicos, tratou-se de uma pesquisa qualitativa em que foi privilegiada a observação participante, com registro em diário de campo, e a entrevista etnográfica. / This study analyzed the life‘s trajectories of women accompanied by social services‘ agencies in Porto Alegre, Brazil. From these women narratives, it intended to understand the ways that different social markers articulate themselves with those experiences in an intersectional perspective, producing subjects from that public police. Such perspective take into account the articulations between different social markers of difference –as gender, race, ethnicity, class, age, etc. – trying to understand how a social marker experience modifies others social marker experiences, intensifying precarious life‘s way, but rearranging itself in resistance possibilities (BRAH, 2006). The narrative of these women, at the same time they‘re particular as the social markers can articulates themselves sin different ways, refers to the institutional operation that they pass through as also to the place where they live. As for the methodological aspects, it consists a qualitative research who privileged the participant observation registered in field journals.

This thesis considers whether the concept of resilience is applicable to people ageing with dementia; and, if so, what the implications are for social work practice. It begins with an exploration of the literature on dementia, resilience and social work. Using a symbolic interactionist approach it then details how the interactions of people with dementia and their social workers can potentially influence the realisation of resilience in practice. I collected data over a two year period. During this period six dyads comprising a person with dementia and social worker provided rich verbal accounts of their respective experiences. Using narrative analysis the stories of each person with dementia were explored to reveal threats to identity and possible resilience strategies. A resilience lens was applied to the verbal accounts of social workers in order to reveal opportunities and challenges to using resilience in practice. The findings indicate that identity continues to be of importance to people who are ageing with dementia. The preservation of identity could therefore be re-framed as the outcome of a resilience process. Each person could potentially acquire resources over their life which could help to mitigate threats to identity. This is referred to as the resilience reserve. This thesis details the potential domains of such a reserve. Further, it contains details of possible resilience strategies that a person with dementia might employ within stories of self. These strategies are placed within the context of protective and vulnerability factors in order that a resilience framework can emerge. This thesis argues for a re-framing of theories of what social work is. This, combined with a definition of resilience, and the development of a resilience practice framework could promote and realise the resilience of the person ageing with dementia.