The presented paper deals with the issue of dual diagnosis from the point of view of community/social psychiatry. The main aim of the paper is to introduce readers to the issues of dual diagnosis and ways how to reach recovery and interpret individual case studies to demonstrate approach of case management in social services of community/social psychiatry, to explore the aetiology and interaction of diseases and to map the internal potential and the external sources of recovery of individual clients. The main point of the theoretical part is the analysis of integrative treatment approach of dual diagnosis. The theoretical basis is to introduce readers to the existing system of mental health care in the Czech Republic, which currently undergoes the transformation of medical institutional treatment into developing community/social psychiatry. One of the applied approaches of community/social psychiatry is case management that focuses on recovery of clients and their psychosocial rehabilitation. The last chapter of the theoretical part analyses an example of a specific social service in the Belgian city of Ghent, for people with dual diagnosis, which tries to connect together all the aforementioned concepts and use them in the direct care of clients. The practical basis consists of qualitative...

Ungdomsarbetslösheten är ett problem i Sverige och det finns flera unga som uppbär försörjningsstöd. Det har visat sig vara svårt för en del ungdomar att etablera sig på arbetsmarknaden och kommunerna har ett ansvar för skapa arbetsmarknadsåtgärder som kan hjälpa personer att komma ut i arbetslivet. En del unga är mer utsatta än andra vilket gör att de kan vara i behov av ett intensivare stöd. Denna studies syfte är att undersöka vilka komponenter eller händelser i Case management-projektet som haft inverkan för de unga vuxnas livssituation. Projektet som är en arbetsmarknadsåtgärd syftar till att hjälpa ungdomar som har svårigheter med att strukturera upp sin vardag. En kvalitativ studie har gjorts för att undersöka vilka erfarenheter både klienter och professionella har av projektet. Detta skedde med hjälp av semistrukturerade intervjuer där fyra klienter och tre professionella deltog. Tidigare forskning visar att en god relation mellan klient och hjälpare är en väsentlig komponent och att ett tätt samarbete mellan myndigheter samt klient är en avgörande faktor för om insatsen ska ha någon effekt. Samtidigt är övrigt stöd från nätverket en hjälpande faktor samt att klienten är motiverad till att förändra sin livssituation. Undersökningens resultat visar att alla respondenter är positivt inställda till projektet och att klienterna anser case managern har varit det stöd som de har saknat. / Youth unemployment is a problem in Sweden and there are several young people who receive income support. It has proven difficult for some young people to establish themselves in the labor market and local governments have a responsibility to create labor market policies which help people to establish themselves on the labor market. Some young people are more vulnerable than others so they may be in need of more intensive support. The aim of this study is to examine which components or events in the case management project that has impacted the young adults' lives. The project is a labor market program aimed at helping young people that find it difficult to structure their daily lives. A study has been done to examine both clients and professionals experience of the project. This was done by semi-structured interviews with four clients and three professionals participated. Previous research shows that a good relationship between client and helper is an essential component and that a close cooperation between agencies and clients is a crucial factor if the effort will have any effect. Additional network is also a helping factor and that the client is motivated to change their lives. The results of the study shows that all respondents are in favor of the project and the clients consider that the case manager has been the support that they have been missing.

Denna studie syftar till att, utifrån ett personal- och brukarperspektiv, undersöka vilka yttre och inre maktaspekter som kommer till uttryck och påverkar CM-teamets arbete samt hur dessa maktaspekter tar sig i uttryck i relations- och motivationsarbetet. CM-teamet är en verksamhet som arbetar för att samordna insatser från kommun och landsting för de individer som har ett vårdbehov för sitt missbruk och sin psykiska problematik och som faller mellan stolarna. Denna studie är baserad på en kvalitativ metod där materialet analyserades med hjälp av meningskoncentrering. Vi har gjort intervjuer med såväl personal som brukare på CM-teamet för att belysa två perspektiv av verksamhetens arbete. Resultatet visar på att de yttre maktaspekterna dels påverkar och begränsar CM-teamets arbete men även påverkar de inre maktaspekterna vilket tar sig uttryck i paternalism från personalens sida. Resultatet diskuteras med hjälp av tidigare forskning inom case management som visar på likheter och skillnader gentemot CM-teamets arbete. / This study aims to, from a professional and consumer perspective, examine the external and internal aspects of power that come to expression and affect the work of the CM-team and how these aspects of power affect the progress on relationships and motivation. The aim of CM-team’s work is to coordinate efforts by the municipality and county for those individuals who have a need for treatment for their substance abuse and their psychiatric problems, who often fall between the chairs. This study is based on qualitative methodology in which the data was analyzed with the help of sentence concentration. We have done interviews with both professionals and consumers of the CM-team. The results point out the external aspects of power that influence and limit the work of CM-team but also the affects the internal aspects of power as reflected in the paternalism of the professionals. The results are discussed with previous research in Case Management that shows both similarities and differences compared to CM-team's work.

The aim of this study was to comprehend and explain the idea and function of Case Management and its diffusion in Swedish municipalities. More specifically its aim was to investigate factors for the diffusion of Case Management and its differences to similar professional roles. The study was based on interviews with four managers at various levels and two case managers representing two municipalities in Sweden. Five themes were identified that were especially interesting when discussing the function of Case Management, its differences to similar professional roles and its diffusion in Swedish municipalities. The themes were: shortcomings in the welfare system, the functions of Case Management, differences to similar professional roles, descriptions of Case Management and factors for the diffusion. The analysis was based on organizational institutionalism and translation, as well as previous research on Case Management and the diffusion of ideas. As a conclusion Case Management was described as a revolutionizing method that would import evidence based social work in the organization. That, and the obvious effort to adapt and integrate Case Management in the institutionalized metods and values of Swedish welfare organizations were factors for the diffusion. Case Management also turned out to be a similar method to the already established profession personligt ombud, wherefor Case Management can be seen as a relaunch of personligt ombud.

Abstract Diploma thesis deals with the issue of community care in psychiatry and its objective is to describe the importance of a nurse in providing this care. Community psychiatric care is a very wide area of an intermediary patient assistance designed to help the patients in any areas of their lives. Although in the Czech Republic community care has not achieved the appropriate development yet, its benefits for patients are important now and its importance has been growing. In the theoretical part, after a brief introduction to community care issues, history, principles, but also community care connection with nursing care, are mentioned. Subsequently, attention is paid to particular areas of community care that are important for the mentally ill and the role of a nurse in these areas is described. The approach to the mentally ill, the issue of stigmatization and psychiatric care organizations are mentioned. In the theoretical are part, psychiatric illnesses that may occur in community care are also analyzed and it is explained how community care may be beneficial for psychiatric patients. In the practical part, the objective was to find out the level of psychiatric nurses´ awareness of community care and to determine if they see the sense of community care in psychiatry. Making a survey of community care in which nurses can be involved was another objective of the work. The nurses´ responses to the stated hypotheses were statistically analyzed within quantitative research. The purpose of hypotheses stated was to determine whether nurses with the work experience longer than ten years are more likely to believe that psychiatric care is more beneficial for patients than hospitalization., And also, if nurses with an education higher than secondary have better awareness of community services provision. Other hypotheses were focused on finding out whether nurses consider the most common community care services issue in the Czech Republic to be housing promotion and if nurses aged over thirty years are more aware of the nurses´ role importance in community care. None of those hypotheses were confirmed. The hypothesis assuming that nurses obtain more information on community care from the Internet and literature than at workshops was confirmed. Psychiatric nurses working in mental homes in the South Moravian region and the Vysočina region took part in this research. A component of the practical part is also an analysis of community services in these regions. In both the regions 13 civic associations and community centers were mapped.

<p>The main purpose of this qualitative study was to describe clients’ descriptions of the professional role case manager and how it relates to the job description provided from a project in which both case managers and clients were participating. Both what case managers do and are expected to do were explored. The project involved case management in the purpose to strengthen and enhance the care and quality of life for clients who are dually diagnosed. Interviews were conducted with five clients and the result was analyzed with theoretical concepts from role theory. The clients’ descriptions of the case manager corresponded fairly well to the job description and former studies that have captured client descriptions. The role of the case manager was described as being available, flexible, outreach oriented, motivating, supportive, committed, giving immediate assistance and doing a lot of tasks. Furthermore as someone who activates the clients, goes by car, represents, clarifies, co-ordinates and should work professionally and individual-based.</p>

The main purpose of this qualitative study was to describe clients’ descriptions of the professional role case manager and how it relates to the job description provided from a project in which both case managers and clients were participating. Both what case managers do and are expected to do were explored. The project involved case management in the purpose to strengthen and enhance the care and quality of life for clients who are dually diagnosed. Interviews were conducted with five clients and the result was analyzed with theoretical concepts from role theory. The clients’ descriptions of the case manager corresponded fairly well to the job description and former studies that have captured client descriptions. The role of the case manager was described as being available, flexible, outreach oriented, motivating, supportive, committed, giving immediate assistance and doing a lot of tasks. Furthermore as someone who activates the clients, goes by car, represents, clarifies, co-ordinates and should work professionally and individual-based.

The case study has been conducted at a public housing company in Sweden GotlandsHem. The purpose of the study is to survey the case management process of the organisation and to obtain a process development plan as well as offer a proposition for implementation. To understand the current case management process the theoretical origin of the study has been made through process theory and total quality management. Earlier research has illustrated the challanges of finding a generic process of case management. The data of the study have been collected through interviews and documented records. Juran´s Problem-Solving Process and the Plan-Do-Study-Act model have been used for the implementation part of the study. The result illustrates the absence of a common working method, with the case management process. The result also present how other public housing companies are working with case management. The analysis presents the current process compared to the theories and which criteria need to be met for a well-functioning process. The current state of the process indicate an absence of a common working method and the perseption of what a case is differs. The process can be developet by seeing case management as an overall process with the definition "A case is when a customer experiences a need for service and contacts GotlandsHem." For the process, a common companywide working method needs to be established. / Inledning. Fallstudien har utförts hos allmännyttiga bostadsbolaget GotlandsHem som är den största aktören för uthyrning av lägenheter på Gotland. Studiens syfte är att studera organisationens ärendehanteringsprocess samt arbeta fram ett förslag på utveckling av processen samt implementeringsförslag.  Teori. För att skapa förståelse för ärendehanteringens nuläge har teoretisk utgångspunkt för studien varit processer samt offensiv kvalitetsutveckling. Avsnittet behandlar tidigare forskning som har visat att det finns utmaningar i att hitta en generisk process för ärendehantering.  Metod. Datainsamling har utförts genom intervjuer och dokumentär forskning. Studien följer en kvalitativ forskningsdesign där benchmarking har använts. Jurans problemlösningsmodell och förbättringscykeln PDSA är modeller som använts som utgångspunkt för vidare implementering. Resultat. Resultatet visar att det finns en avsaknad av gemensamma arbetssätt genom ärendehanteringsprocessen. I resultatet presenteras hur andra allmännyttiga bostadsbolag arbetar med ärendehantering där ledarskap, gemensamma arbetssätt och registrering av ärenden är tre nyckelkomponenter till en väl fungerande ärendehantering.  Analys. Analysen visar på processens nuläge utifrån teorier inom processarbete. Även intern service analyseras utifrån tidigare forskning där bristande kvalitet på återkoppling till kund genom teorier kan härledas till bristande intern servicekvalitét. Slutsatser. Processens nuläge visar en avsaknad av gemensamma arbetssätt och att uppfattningen om vad som är ett ärende går isär. Processen kan utvecklas genom att se ärendehanteringen som en övergripande process med definitionen ”Ett ärende är när en kund upplever ett behov av service och kontaktar GotlandsHem.”. För processen behöver ett gemensamt företagsövergripande arbetssätt fastställas och processens prestanda behöver mätas. Implementering av förbättringsförslag kan göras med hjälp av Jurans problemlösningsmodell kombinerat med PDSA.

A computerized data base system for managing clinical activity of faculty and residents has been developed and tested in The Department of Anesthesiology, University Medical Center, Tucson, AZ. Using d-Base III+ and an IBM PC AT the system provides the department residents with tabulated data on a monthly and year-to-date basis, which can be easily transposed onto annual clinical activity reports required by The American Board of Anesthesiology. The system maintains a clinical activity history for the faculty, which allows for equitable work scheduling. The system also tabulates anesthesia equipment usage and problems. The system has been in operation since October, 1987 with residents and faculty receiving clinical activity reports on a monthly basis. System operation requires 10 to 12 hours of secretarial time weekly.

Idag sker organisatoriskt administrationsarbete till stor del med hjälp av datoriserad teknik. Det finns dock en ineffektivitet i hur detta administrationsarbete går till i olika datasystem vilket lett till högre kostnad för mindre genererad nytta åt kunderna. Inom den offentliga sektorn är dessa kunder invånarna. Denna studie undersöker hur Huddinge kommun arbetar med ärendehantering i olika medieformer, vad som påverkar ärendehanteringen i och mellan medieformerna, samt vilka problem som uppstår i ärendeprocessen till följd av dessa. Studien tar upp hur socioteknik och människa-dator interaktion samverkar inom ramen för informationssystem och datahantering i förhållande till användarna och ärendehantering. Observationer och intervjuer har genomförts vid tre förvaltningar, samt Servicecenter på Huddinge kommun. Resultatet visar att ärendehanteringen inom kommunen är beroende av flera olika medieformer där informationssystemens användbarhet och funktionalitet påverkar hur säkert, konsekvent och tillförlitligt ärendehanteringen sker. Återkommande problem gällande dubbelarbete, oavslutade ärenden och inkonsekvent datainsamling och registrering av data kopplat till ärenden kan identifieras. Resultaten kan användas av Huddinge kommun vid kravställning och inköp av informationssystem ämnade för ärendehantering. Avgränsningar har gjorts gällande antalet representerade förvaltningsenheter inom kommunen. Övriga förvaltningsenheter kan använda sig av andra medieformer och ha andra erfarenheter gällande användning av dessa vid ärendehantering. / Today organizational management work is largely done with the help of computer technology. However, there are inefficiencies in how these management efforts are performed in various computer systems which has led to higher costs for less-generated benefits for customers. In the public sector, these customers are the residents. This study examines how the municipality of Huddinge works with case management in various forms of media, what influences the case management in and between these media forms and the problems that arise in the case process as a result of these. The study addresses how sociotechnology and human-computer interaction cooperate within the field of information systems and data management in relation to users and case management. Observations and interviews were conducted at three municipal administration units and the Service center in Huddinge. The results show that case management within the municipality is dependent on various forms of media, where the information systems usability and functionality affects how safe, consistent and reliable case handling takes place. Recurring problems regarding duplication of work, unfinished cases and inconsistent data collection and registration of data linked to case work can be identified. The results can be used by the municipality of Huddinge when defining requirements and purchasing information systems intended for case management. Limitations have been made regarding the number of represented administration units within the municipality. Other units within the municipality can use other forms of media, and therefore have other experiences regarding the use of these when working with case management.