Diss. (sammanfattning) Stockholm : Univ. / Härtill 5 uppsatser.

Objectives: To explore why so few mothers breastfeed when their babies are admitted to neonatal intensive care unit (NICU), and to gain an understanding of the impact of this for the mothers and staff involved. DESIGN: This study adopted an ethnographic approach. The data collection involved 135 hours of participant observation over a 6-month period and 32 semi-structured interviews of 17 mothers, 10 nurses, and 5 physicians. Findings: Data from the participants’ interviews and the participant observation were analysed focusing on the two different perspectives; one relating to the mothers and the other to the staff members and their working conditions. The mothers’ experiences were revealed as a developing process as their feeling changed from fearful and terrifying toward becoming and feeling like a ‘real’ mother. Their experience of mothering and breastfeeding differed from their expectations in that breastfeeding became a complex process for some and impossible for others. Five distinct themes emerged; the first highlighted the crisis, which involved the mother's feelings of emotional instability, their strategies for coping such as not visiting the baby, and recognition of the NICU as a stressful environment. The second theme described issues relating to control and power. This involved the perception of having a lack of control and needing to seek permission, the use of language as a mechanism for control, and mothers being placed in a subordinate role. The third theme related to the separation, which included difficulties of acceptance, feeling like stranger and not being important, and the need for physical closeness. Acceptance and adaptation comprised the fourth theme in which gradual acceptance occurred and a spiritual aspect emerged. The final theme, becoming a mother, included issues such as the special moments, breastfeeding as a turning point, and practical and informational needs. Almost all the mothers in this study spoke about going through all these stages during their infants’ stay in the NICU. Analysis of these findings suggests that mothers who deliver prematurely, may have their rite of passage into motherhood interrupted, resulting in them being placed in a position of suspended liminality. v The data also suggest that while staff members agree with the benefits of breastfeeding for preterm infants, the actual implementation of a breastfeeding policy within the neonatal units is more problematic. Three key themes emerged from the analysis relating to the staff perspectives. The first described the contradiction that exists between the staff beliefs and behaviours in relation to breastfeeding and supporting mothers. Elements that comprised this theme were “breast milk is best”, perceiving breastfeeding promotion as a nicety not a necessity; lacking support for mothers, and abdication of responsibility. The second theme related to their working conditions: this included a lack of institutional support for the health care team, and barriers to support breastfeeding. The final theme of controlling relationships captured the essence of the practitioner: mother association. Together, these elements revealed a situation whereby staff appeared more preoccupied in addressing the task aspect of care for the babies than supporting mothers in feeding and subsequently mothering their preterm child. Conclusions: An understanding of the experiences of mothers of preterm infants who wish to breastfeed, and the connection that breastfeeding has to the process of becoming a mother, allows for the finding of more positive strategies to support mothers and breastfeeding within the NICU. This study reveals a new understanding of how breastfeeding is connected to the process of becoming a mother, within the context of two Jordanian NICUs. It also highlights the difficult working conditions for nurses within these units. It is anticipated that recognition of these findings may assist with service developments and lead to improvements in the NICU environment in Jordan, thus enhancing health care delivery in accordance with the individual needs of infants and their mothers.

Thesis (M.S.)--University of Wisconsin--Madison, 1966. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Abstract The purpose of this study was three-fold: to analyze how the work-relatedness of well-being has been constructed by the presently prevailing work stress approach, to develop better ways of conceptualizing the work-relatedness of well-being on the basis of cultural historical activity theory, and to test these new conceptualizations with empirical data from two nursing homes for the elderly. An analysis of the development of work stress theory and previous studies of nursing homes showed that their foundations lie in the paradigmatic person – environment formulation which inhibits taking into account the activity of the individual, the changing of the work process and the specific context in which stress is experienced. With respect to work-related well-being two activity-theoretical hypotheses were developed: the object-dependedness of work-related emotions (object-dependent well-being) and the increased physical and psychological work load as a result of disturbances in the flow of work (disturbance load). An empirical analysis of the historical development of the two nursing homes showed how the function of the nursing homes had changed several times and continued to do so. The analysis also suggested that changes in the work-related well-being of the employees followed the developmental phases of the work activity. The second empirical analysis showed how the employees' explanatory models of both tiring- and strength- giving events were related to several historical, present and possible future aspects of the object of their work. Signs of individual motive development could be detected in the interviews. The third empirical analysis of videorecorded morning routine episodes showed how the current institutional script carried out by the employees collided with the residents' own script resulting in resident resistance which increased the physical and psychological workload of the employees. Focusing on disturbance load may uncover important sources of emotional distress and physical tiredness among employees. Understanding work-related well-being also as qualitatively developing object-dependent well-being points to the need to create a dialogue between the development of the collective activity and the object and motive development of individual employees.

I syfte att undersöka vad som påverkar medarbetarattityder till en intervention, genomfördes en enkätstudie med 23 frågor inom två kommunala verksamhetsprocesser. Bland 137 besvarade enkäter och en svarsfrekvens på 77 procent var deltagarna mellan 22 och 64 år med olika utbildningsnivåer och omfattning på chefskontakt. Frågeställningen var: Hur påverkas medarbetarnas attityder av 1) chefens engagemang, 2) yrkes- och arbetsplatsfaktorer och 3) arbetsbelastning. Genom varians-, korrelations- och regressionsanalyser undersöktes de oberoende variablernas förhållande till medarbetarnas attityder till interventionen. Resultatet visade att medarbetarattityderna till interventionen var mer positiva när chefens engagemang uppfattades som högt. En negativ inställning till interventionen bland kollegorna på arbetsplatsen visade samband med en mer negativ medarbetarattityd. Studien gav inte stöd för något samband mellan arbetsbelastning och medarbetarattityd. Ett klusterurval hade eventuellt ökat validiteten och förbättrat könsfördelningen. Förslag till vidare forskning är att undersöka påverkan av upplevd nytta på sambandet mellan arbetsbelastning och attityd till förändring.

Background: occupational injuries are common in health care and social welfare professions. Therefore, the municipality of offers all permanent nursing stuff a 20-hour course in staff - assisted transfers. Objective: to investigate the effects of this course in assisted client transfers with respect to self-reported health care professionals approach in moving situations, sick leave, perceived work load and work-related musculoskeletal disorders in the municipal activities, compared with health workers that have not received education during the same time. Method: A Quasi-experimental study with intervention and comparison group of 30 participants in each group. The course was based on the PRECEDE-PROCEED model with focus on 1) predisposing factors, 2) reinforcing and 3) enabling factors as these are considered important for the success when implementing a new work approach. The course was divided into 5 half-days and 20 hours in total. The participants responded to a study specific partly Web-based survey before, immediately after and six months after the education. Repeated measures ANOVA were used for data analyses. Results: The nursing stuff reported no change in working methods; to stimulate the patient's own activity and ability to influence their working load. Health care employees perceived work load in general and linked to transfer situations decreased compared to the comparison group. Number of people with self-reported work-related musculoskeletal disorders decreased and sick-leave increased less in the intervention group after the course. Conclusion: Perceived/self-reported work load related to mobility situations and generally decreased after the movement training. / Bakgrund: Arbetsskador är vanligt förekommande inom vård- och omsorgsyrken. En kommun i Mellansverige utbildar därför all tillsvidareanställd vårdpersonal i en 20 timmars förflyttningsutbildning. Syfte: att undersöka effekterna av en verksamhetsanpassad och kompetensinriktad förflyttningsutbildning inom kommunal verksamhet med avseende på vårdpersonalens självrapporterade arbetssätt i förflyttningssituationer, sjukfrånvaro, upplevd arbetstyngd och arbetsrelaterade besvär, jämfört med vårdpersonal som inte genomgått utbildning under motsvarande tid. Metod: En kvasiexperimentell utvärderingsstudie med intervention- och jämförelsegrupp om 30 deltagare i varje grupp. Utbildningen hade sin grund i modellen PRECEDE-PROCEED med fokus på 1) mottagliggörande faktorer, 2) förstärkande faktorer och 3) möjliggörande faktorer då dessa anses viktiga för att lyckas med implementering av ett nytt arbetssätt. Utbildningen var uppdelad på 5 halvdagar om 20h totalt. Deltagarna fick svara på en studiespecifik delvis webbaserad enkät före, direkt efter och 6 månader efter avslutad utbildning. Repeated measures ANOVA användes för statistisk analys. Resultat: Vårdpersonalen rapporterade ingen förändring i arbetssätt; att stimulera brukarens egen aktivitet och förmåga att påverka sin arbetstyngd. Vårdpersonalens upplevda arbetstyngd generellt och kopplat till förflyttningssituationer minskade jämfört med jämförelsegruppen. Färre personer rapporterade arbetsrelaterade besvär och sjukfrånvaron ökade i mindre omfattning i interventionsgruppen efter utbildning. Slutsats: Arbetsrelaterade besvär och upplevd/självrapporterad arbetstyngd generellt och kopplat till förflyttningssituationer minskade efter genomförd förflyttningsutbildning.

In this essay, we want to highlight the problems that middle managers face in the company. Middle manager is one of the most significant operators in a company, but also one of those most challenged position. Therefore, we want to increase the understanding of the problems through making a qualitative study using semistructured interviews and making use of the understanding the by using hermeneutic as analytical tools. To explain the empirical study we have used two theories - requirement, control and support model and the concept of KASAM. As a result, it emerged that the meaningfulness of work is an important aspect for the middle manager and are reflected in how the middle manager perceives the work load. / I uppsatsen vill vi belysa den problematik som mellanchefer inom privata företag står inför. Mellanchefer är en av de viktigaste aktörerna på företagen men också en av de som är högst belastade på arbetet. Därför vill vi öka förståelsen för den problematiken genom att utföra en kvalitativ studie med semistrukturerade intervjuer och använda oss av förståelsen genom hermeneutiken som analysverktyg. För att förklara det empiriska materialet har vi använt oss av två teorier, krav-, kontroll- och stödmodellen samt begreppet KASAM. I resultatet har det framkommit att meningsfullhet i arbetet är en viktig aspekt för huruvida mellanchefer uppfattar arbetet som alltför påfrestande.

Background: Healthcare professionals are often the subject to occupational stress, the professional radiographer is no exception. Occupational stress has been seen as a predictor to burn outs amongst radiographer and may jeopardise the patients’ safety during radiologic examinations.  Purpose: The purpose of this study is to find out more about how radiographers in Uppsala County perceive stress in their workplace, the study aims to find out which factors affect occupational stress and how it expresses itself physically and mentally to the radiographer.  Method: The study was done through a qualitative method in the form of interviews with staff at x-ray departments at different hospitals.  Results: All of the informants felt some kind of occupational stress from time to time, some very rarely and others more frequent. The most common factors for stress that emerged from this study were staff shortage, and a high workflow, as well as high patient flow for radiological examinations. There were varied symptoms that appeared; mild symptoms such as sweating and more serious symptoms such as fatigue, anxiety and trouble sleeping.  Conclusion: The occupational stress of radiographers affects the radiographer both physically and mentally, and also patient safety and the quality of the examinations. One can clearly see that the amount of patients in relation to the sparse staff density creates an excessively high workload that leads to stress. This means that the radiographer finds it difficult to maintain the care they would like, in terms of time and quality. / Bakgrund: Hälso- och sjukvårdspersonal är ofta föremål för arbetsrelaterad stress, röntgensjuksköterskor är inget undantag. Arbetsrelaterad stress har uppfattats som en bidragande faktor för utbrändhet bland röntgensjuksköterskor och kan påverka patientsäkerheten under radiologiska undersökningar. Syfte: Att få veta mer om hur röntgensjuksköterskor i Uppsala län uppfattar stress på sin arbetsplats. Studien vill ta reda på vilka faktorer som påverkar arbetsrelaterad stress och hur det uttrycker sig fysiskt och psykiskt. Metod: Studien gjordes genom en kvalitativ metod i form av intervjuer med 11 röntgensjuksköterskor på röntgenavdelningar på olika sjukhus inom Uppsala län. Resultat: Alla informanter kände någon typ av arbetsrelaterad stress i olika grad, vissa mycket sällan och andra oftare. De vanligaste faktorerna för stress som uppkom vid denna studie var brist på personal och ett högt arbetsflöde och för många patienter som kom till en radiologisk undersökning samtidigt. Det framkom en del olika symtom, från milda symtom, som till exempel svettning men även allvarligare symptom som trötthet, ångest och sömnbesvär. Slutsats: Den arbetsrelaterade stressen hos röntgensjuksköterskor påverkar röntgensjuksköterskan både fysiskt och psykiskt och även patientsäkerheten och kvaliteten på undersökningarna. Man kan tydligt se att patientmängden i förhållande till den för glesa personaltätheten skapar en för hög arbetsbelastning som leder till stress. Detta gör att röntgensjuksköterskan upplever det som svårt att upprätthålla den vård de skulle vilja, tidsmässigt och kvalitetsmässigt.

A necessidade de compreender o trabalho e os processos de saúde-doença a ele relacionados, reverbera em toda instituição empregadora, seja ela pública ou privada. O trabalho constitui-se em um dos principais elementos na determinação social do processo saúde-doença, porém, o mundo do trabalho é dinâmico e suas configurações se modificam conforme os interesses do capital. Na atualidade, as inovações tecnológicas interferindo nos processos de trabalho e o novo modelo econômico, no qual predomina a pressão por tempo e o aumento da rentabilidade econômica, exigem trabalhadores cada vez mais polivalentes e multifuncionais, sintonizados com essa modalidade de trabalho intensificado. Esse contexto submete os trabalhadores do setor público e privado a diversos tipos de cargas de trabalho, especialmente cargas psíquicas que desencadeiam processos de desgaste mental no trabalho. A identificação das situações e fatores que afetam os trabalhadores psiquicamente é de difícil mensuração, o que não deve ser motivo para ignorar este importante aspecto do trabalho. Esta pesquisa está ancorada teoricamente no referencial da medicina social latino-americana e do campo da saúde do trabalhador. Foi desenvolvida no âmbito de um serviço de saúde ocupacional, com o objetivo geral de identificar as cargas o e o desgaste mental associado ao trabalho de servidores administrativos de uma universidade pública estadual, na percepção dos trabalhadores. Trata-se de um estudo de caso qualitativo, no qual utilizou-se a entrevista individual como instrumento de coleta de dados para conhecer o trabalho dos servidores administrativos e ao mesmo tempo testar instrumento para identificação de cargas de trabalho e desgaste mental no trabalho. A análise de dados revelou o trabalho na percepção dos trabalhadores a partir de quatro núcleos temáticos: a) o trabalho real na área administrativa, apresentando elementos da organização do trabalho; b) alegrias e tristezas do trabalho administrativo, no qual aparecem as ambiguidades do trabalho que ora desperta satisfação e bem estar e ora gera insatisfação; c) indicativos de cargas de trabalho, na qual são sintetizados os tipos de cargas mais frequentes na atividade administrativa da universidade; d) indicativos de proteção e de desgaste no trabalho. O estudo apresenta uma proposta de ação factível para ser utilizada no serviço de saúde ocupacional da instituição como forma de complementar e ou auxiliar as avaliações de saúde dos servidores públicos de modo a orientar ações preventivas e de promoção à saúde no trabalho. O instrumento traz como diferencial o enfoque qualitativo, o que possibilita ao trabalhador a manifestação livre da sua visão sobre o trabalho / The need to understand the work and the health-disease processes related to it, reverberates in any employer institution, no matter if it is public or private. The work is one of the main elements in the social determination of the health-disease process, but the world of work is dynamic and its configurations change according to the interests of capital. Nowadays, technological innovations interfere in the work processes and the new economic model, where pressure predominates and economic profitability increases, requiring increasingly multipurpose and multifunctional workers, attuned to this intensified work modality. This context remits public and private sector workers to various types of workloads, especially psychic loads that trigger processes of mental attrition at work. The identification of situations and factors that affect workers psychically is difficult to measure, which should not be a reason to ignore this important aspect of the work. This research is anchored theoretically in the reference of Latin American social medicine and the field of worker health. It was developed within the scope of an occupational health service, with the general objective of identifying the loads and the mental wear and tear associated with the work of administrative employees of a state public university, in the workers\' perception. This is a qualitative case study, in which the individual interview was used as a data collection tool to know the work of the administrative servers and at the same time to test the instrument to identify workloads and mental attrition at work. The data analysis revealed the work in the perception of the workers from four thematic core: a) real work in the administrative area, presenting elements of work organization; b) joys and sorrows of administrative work, in which appear the ambiguities of the work that now awakens satisfaction and well-being and now generates dissatisfaction; c) indicative of workloads, in which are synthesized the types of loads most frequent in the administrative activity of the university; d) indicative of protection and wear at work. The study presents a feasible action proposal to be used in the institution\'s occupational health service as a way of complementing or assisting health evaluations of public servants to guide preventive actions and promote health at work. The instrument brings as a differential the qualitative approach, which allows the worker the free manifestation of his vision about the work

<p>The application of the LSS law and how the public organization (Municipality of Hudiksvall) later had to reform their organization to fit the new demands is the foundation to this master's thesis. An internal evaluation was performed due to this reorganisation process within the social care department (LSS unit). The aim was to investigate and evaluate if the reorganization resulted in a better working environment and if the work load (distribution of work) became more evenly divided between the different unit managing directors. The primary empirical information to this master's thesis is collected from that evaluation report. The main aim of this master’s thesis is to answer if the organisational choice between specialised or de-specialised working tasks has an effect (experienced and measured) on the level of stress among the unit managing directors. We have found that it is a question about moral stress rather than a question about stressed managing directors in general. In this thesis the definition of “moral stress” is the discrepancy between one persons ethical properties and the actions that person have to take due to appointed level of power and the responsibility that follows with this power. Our main recommendation is to find an organisational structure based on the premises of the LSS-law while at the same time attending to the problems of the more and more difficult working situation amongst the employees. This can be achieved by gaining approval for a new prioritizing order form the politicians, the clients, and the employees. Such a reformation process (Sw “omnormeringsprocess”) would imply less moral stress. If the managing directors have a basic employment as a generalist the working tasks will be more evenly divided amongst the employees. Teams of 5-7 employees that encompasses specially qualified generalist and that meets on a regular basis is essential to relieve pressure from colleagues. This is essential to be able to make the most out of the special knowledge of the directors. In the extension of this change the assistants should be included in the existing substitutes-pool and each assistant’s special competence should be clarified.</p>