Världen har blivit mer digital och människor blivit mer beroende av att teknik alltid finns nära tillhands. Verksamheter använder sig av informationssystem för att utföra uppgifter mer effektivt och mindre kostsamt. För att informationssystem ska underlätta för användaren måste dessa vara användbara. För att uppnå användbarhet har designprinciper skapats, dessa principer är riktlinjer eller direktiv för att uppnå en god design. När problematik uppstår för användare måste dessa användare ofta komma i kontakt med kunnig IT-personal. Kontakten mellan användare och IT-personal brukar ske via ärendehanteringssystem.  Syftet med studien var att utifrån användarens perspektiv identifiera vilka designprinciper som är viktigast för ett ärendehanteringssystem för att uppnå användbarhet. Studien var begränsad till att undersöka Nielsens 10 heuristiska designprinciper.  Studien utgick från en deduktiv ansats med en kvalitativ datainsamlingsmetod. Det utfördes intervjuer på ett fallföretag för att samla in åsikter från användare av ett ärendehanteringssystem. Bredd och variation användes som metod för urval då det var av intresse att informanterna hade olika förkunskaper. Syftet med den insamlade empirin var att komma fram till viktiga egenskaper för att uppnå användbarhet för ett ärendehanteringssystem. Med denna information gick det att undersöka hur väl designprinciper uppnår dessa egenskaper. Även användares åsikter kring specifika designprinciper undersöktes, vilket också kom att påverka resultatet.  Studiens resultat visade sig innebära fyra viktiga egenskaper som användarna ansåg bör uppfyllas för att uppnå användbarhet. Hittbarhet, navigerbarhet, informationsstruktur och enkelhet menar användarna bör uppnås. Vidare när designprinciper utvärderades framkom fem principer som användare ansåg vara viktigast, anknytning mellan systemet och verkligheten, flexibilitet och effektivitet av användning, användarkontroll och frihet, överensstämmelse och standard och att känna igen sig snarare än att minnas. Dessa principer var även de som ansågs uppnå egenskaperna för användbarhet på bästa vis. / The world has become more digital and people have become more dependent on that technology always is accessible. Businesses are using technology to perform tasks more efficient and less costly. For information systems to facilitate the user, the systems must be useful. To achieve usability, design principles have been created. These principles are guidelines or directives to achieve a good design. When problems arise for a user, these users often must get in touch with knowledgeable IT-staff. The contact between user and IT-staff usually occurs via case management systems. The purpose of the study was to identify design principles that from the user's perspective are the most important for a case management system to achieve usability. The study was limited to examining Nielsen's ten heuristic design principles. The study was based on a deductive approach with a qualitative data collection method. Interviews were conducted on a case business to collect the views of users of a case management system. Width and variation was the method used for the selection of informants as it was of interest that the informants had different previous knowledge. The purpose of the empirical data was to identify important characteristics to achieve usability for a case management system. With this information, it was then possible to examine how well the design principles achieve these characteristics. The study also examined the users’ opinions about specific design principles, which also contributed to the results. The result of the study included four characteristics which the users felt should be met to achieve usability. Findability, navigability, information structure and simplicity are the characteristics users thought should be met to achieve usability. Furthermore, when design principles were evaluated, four principles emerged that users considered to be the most important, link between system and reality, flexibility and efficiency of usage, user control and freedom, compliance and standard, and to recognize themselves rather than remembering. These principles were those who were considered to answer the usability characteristics best.

D.Cur. (Nursing Management) / A health maintenance organisation (HMO) that implements managed care is the health care service provider for a mine group. Case management is an integral part of managed care. Case management in a managed care setting within this mine group should be to the holistic benefit of both the client/patient and the service provider. Within the case management environment, nurse case managers (CMs) and their counterparts (professional nurses) should provide and facilitate quality patient care. However, they face many challenges, such as working in isolation from one another. The purpose of the study was to develop a training programme for CMs and professional nurses (PNs) to facilitate quality patient care in a managed care environment for the health care service provider for a mine group. In this study a qualitative, exploratory, descriptive, and contextual design was followed. Purposive sampling was conducted from the populations of six CMs (N=6) and thirty PNs (N=30). Focus group discussions with twenty-eight (28) PNs and individual unstructured interviews with four (4) CMs were conducted to describe their experiences in the case management environment. Open coding followed, based on Tesch’s (1990) method of qualitative analysis (De Vos, 1998:343), and a conceptual framework emerged from the data analysis. A programme to facilitate quality patient care in a case management environment of the HMO was described for stakeholders (nurse case-managers and PNs). Recommendations for implementing the programme were described. Adapted phases of the programme development process of Meyer and van Niekerk (2008) were used in developing the programme. The survey list of the Practice Oriented Theory of Dickhoff, James and Wiedenbach (1968:434) formed the basis for developing a conceptual framework for the programme. Principles of case- and problem-based approaches (Scheider, 2010) served as a point of departure to develop the context-specific training programme. Trustworthiness was maintained by using Guba’s (De Vos, 2006:346; Babbie & Mouton, 2001: 276) model criteria, which are credibility, transferability, conformability and dependability. Ethical standards were adhered to throughout the study.

No description available.

Since the deinstitutionalisation of chronic mentally ill patients, there has been an increase in the number of relapsed chronic mentally ill patients who become acutely mentally ill and need to be re-admitted for acute care in psychiatric institutions. Professional nurses working at rural primary healthcare clinics find it difficult to care for these individuals because they lack the necessary knowledge and skills. Chronic mentally ill patients who have been admitted to acute care facilities are stabilised by rendering care, treatment and rehabilitation and then released into the care of the professional nurses working at rural primary healthcare clinics. These patients live in the community and have to make use of the primary healthcare clinics nearest to their homes to provide them with their prescribed medication and care. Furthermore the patients’ mental conditions do not always remain stable, possibly because of a knowledge deficit, at times about their mental status. Patients may become non-compliant, resulting in the recurrence of symptoms, and thus need to be re-admitted to the acute care facility. However, the problem leading to re-admission is not clear for all admissions. It may be that patients do not make use of the primary healthcare clinics. It also seems that the professional nurses in the primary healthcare clinics are unfamiliar in dealing with chronic mentally ill patients living in rural communities. The aim of this study was therefore, to explore and describe the experiences of these professional nurses in caring for chronic mentally ill patients living in a rural community. The researcher used qualitative, explorative, descriptive, and contextual research design. The research population consisted of professional nurses working at primary healthcare clinics. Non-probability purposive sampling was used to identify participants for inclusion in the study. Data collection was conducted using one-on-one, semi structured interviews, observations and field notes and interviews were tape-recorded and transcribed. Data analysis was conducted using Tesh’s method of content analysis to identify themes and sub-themes. A literature control was done to compare the findings to the current published research. Trustworthiness was ensured by using Gubas’s model (1985) of trustworthiness. A pilot study, conducted by interviewing a small sample prior to the start of the main study, determined whether the sampling and interviewing techniques of the researcher as well as the research questions were adequate for data collection. The researcher ensured that the study was of a high ethical standard by taking into consideration values that guide the principles of autonomy, beneficence, non-maleficence and justice. The findings of the study was categorised into three main themes and 13 sub-themes. The main themes were as follow: Professional nurses experience problems when they have to take care of psychiatric patients attending rural primary healthcare clinics. This theme had six sub-themes which were discussed in details in chapter three. The second theme was that professional nurses experience that psychiatric patients in rural communities experience problems which affected their well-being. This second theme has got five sub-themes which were discussed further in chapter three. The last theme was that professional nurses have positive experiences when caring for psychiatric patients in rural communities. This theme has got two sub-themes as well discussed further in chapter three.

The main topic of the thesis is case management - a modern concept of dynamic business processes that emphasizes data and user involvement in decision-making process. The main goal is to create a functional prototype of information system for e-procurement based on case management approach that solves problematic aspects of current electronic procurement environment in Czech Republic. In the theoretical section, there is a description of the basic concept of case management and the possible use of case management across various sectors. Subsequently the reference model and general architecture of case management system are introduced and an optimal methodology for modelling and analysis of case management solution that combines existing standards in context is proposed. The practical section contains an analysis of the functional requirements and description of the electronic public procurement system, both in terms of the minimum legal requirements for solutions and problematic area derived from the perspective of Czech eGovernement. Detailed implementation-ready model is created using the proposed modelling methodology that forms a foundation for implementation of the selected scope of the electronic procurement system based on the IBM platform. Created prototype facilitates a procurement specification via an easy-to-use interface that incorporates methodological support when entering the data, automatic recommendation of suitable suppliers and proactive inspection of a compliance with regulatory requirements. Contribution of the work lies in the demonstration of possibilities for optimal e-procurement solution implementation. Within the results of the work are identified obvious practical benefits of case management for this area, particularly the speed of deployment and implementation changes, variable and dynamic user experience and efficient distribution of necessary information to the end-user. I have evaluated usage of a case management system for similar projects as appropriate and useful.

Bakgrund: Antalet personer med demenssjukdom i Sverige är omkring 130 000– 150 000 och 20 000 - 25 000 personer uppskattas insjukna varje år. Den basala demensutredningen utförs av hälso- och sjukvården, oftast inom primärvården och av en sjuksköterska på uppdrag från läkaren. Livslängden i Sverige ökar, demenssjukdom blir allt vanligare och personer med denna sjukdom bor kvar i eget boende med behov att vårdas av närstående eller hemtjänst. Det ställs allt högre krav på primärvård att arbeta personcentrerat och att möjlighet finns till tidig demensdiagnos. Syfte: Utforska sjuksköterskors upplevelser och av att arbeta med utredning och uppföljning av personer med demenssjukdom inom primärvård.  Metod: Kvalitativa individuella intervjuer genomfördes för att utforska upplevelsen hos åtta sjuksköterskor i primärvården. Insamlade data bearbetades med hjälp av en kvalitativ innehållsanalys med induktiv ansats. Resultat: Analysen resulterade i tio underkategorier som sedan utmynnade i följande fyra kategorier: ”Att se helheten av personen”, ”Vikten av diagnos för ett gott omhändertagande”, ”Att sträva efter partnerskap” och ”Att ha organisatoriska förutsättningar”. Slutsats: Det finns behov av att lyfta patienten och närståendes upplevelse i samband med demensutredningen samt sjuksköterskans behov av stöd vid svåra situationer i primärvården. / Background: The number of people with dementia in Sweden is about 130,000150,000 and 20,000-25,000 people are estimated to be diagnosed each year. The basic dementia examination is performed by the health and medical service, usually in primary care and by a nurse on behalf of a physician. Life expectancy in Sweden is increasing, dementia becomes increasingly common, and people with this disease live in their own homes with the need to be cared for by a related or home help. There is an increasing demand for primary care to work personcentered and that there is an opportunity for early dementia diagnosis. Aim: Explore nurses´ experiences of working with investigation and follow-up of persons with dementia in primary care. Method: Qualitative individual interviews were conducted to explore the experience of eight primary care nurses. Collected data was processed using a qualitative content analysis with inductive approach. Result: The analysis resulted in ten subcategories, these led to four categories: "See the entirety of a person", "The importance of diagnosis for a good care", "To strive for partnership" and "Having organizational conditions".  Conclusion: There is a need to lift the patient's and relatives' experience in connection with the dementia investigation and the nurse's need for support in difficult situations in primary care.

HIV/AIDS is now widely recognized as a medically manageable condition. However, more than 2,000 new HIV infections are reported across Canada each year. A pressing issue in the public health response to HIV is how to better engage people at risk and living with the virus in testing, treatment, and support services. For this study, a critical ethnography was undertaken with 22 public health nurses involved in HIV case management in 14 public health units across Ontario. The objectives were to describe the experiences of case management nurses involved in the follow-up of people who test positive for HIV in public health units across Ontario and identify how public health policies shape the boundaries of nursing care and client outcomes in the response to HIV. A poststructuralist, feminist and critical geographical lens was employed to understand how different discourses determine the social and spatial organization of case management and structure the possibilities in nurses’ follow-up at the point-of-care. The main finding is evidence of two different sets of goals and measures in the public health response to HIV in Ontario: (1) a medical-epidemiological discourse tied to a biosecurity approach and goal of disease containment; and (2) a nursing discourse linked to a relational approach aimed at promoting meaningful engagement and ensuring people with HIV “feel supported.” The thesis of this study is that the hegemony of a biosecurity approach and singular biomedical indicator of success (an undetectable viral load) are contributing to the relegation of relational work and nurses’ efforts to support people who are unable or unwilling to engage in risk reduction measures to the margins of care. Strengthening the capacity of case management nurses to develop a relational approach and account for the diversity of emotional and social issues impacting the ability of people to live with HIV may be an important starting point for improving the outcomes of the public health response. The findings have implications for future research, policy, and practice in the areas of governmentality, public health nursing and efforts to end the “War on HIV.”

No description available.

Mångbesökare är en heterogen grupp med stora komplexa vårdbehov som kräver personcentrerad vård med skräddarsydda lösningar av personal med tvärvetenskaplig kunskap för att ge rätt interventioner. Sjukdomsproblematik som inte anses vara av somatiskt slag kräver stor kunskap om psykosociala symtom och orsaker som troligtvis kräver en omfattande utredning och samverkan för att tillgodose patientens psykosociala behov. En del av dessa behov kan anses vara förebyggande insatser genom att skapa ett tryggt säkerhetsnät där individer med samsjuklighet inte hamnar mellan stolarna samt tryggare boendeformer. Detta kräver ett stort fokus på de sociala aspekterna av mångbesökares liv och villkor där kuratorer anses ha en nyckelroll för att bistå med rätt hjälp och vägledning. Bristande vård- och kommunikationskompetens samt erfarenhet tycks påverka möjligheterna till att diagnostisera rätt. Ett behov av underkategorier för denna heterogena grupp har uppmärksammats. Även behovet av ett stort handlingsutrymme för vårdsamordnaren betonas, någon som anses ha en nyckelroll i det omfattande interventionsarbetet som ofta inkluderar att ansvara för samordning med fokus på social omsorg. På det stora hela krävs vidare forskning angående många aspekter av mångbesökare och deras psykosociala miljö men det är tydligt att vård- och omsorgsvillkor påverkar denna grupp och att långsiktiga lösningar troligen kräver ett omfattande förändringsarbete inom social omsorg. Framför allt tryggt boende för äldre med samsjuklighet men även stöd för att skapa stabila ekonomiska och psykiska förhållanden.

Intresset för ämnet uppstod efter en lång yrkesverksamhet i människobehandlande organisationer och den brist på samverkan och förståelse för andra yrkesområdens perspektiv som framkommit i den dagliga verksamheten. En önskan att se hur samverkansarbetet praktiseras, hos dem i vars uppgifter samarbete över institutionsgränserna ingår som en central del. Syftet med uppsatsen var att undersöka hur case managers organiserar sitt arbete utifrån frågetällningarna: vilka uppgifter har en case manager? Hur beskriver de sin respektive arbetsmodell och vilka för- och nackdelar ser de med sitt arbete?För att svara på frågorna genomfördes kvalitativa intervjuer med sju case managers i tre skilda arbetsmodeller: klinisk case management, personligt ombud och Assertive Community Treatment (ACT). Teoridelen består av en sammankoppling av de tre begreppen: biopsykosocialt perspektiv, samverkan och människobehandlande organisationer. Resultatet visade att en case managers grundläggande uppgift var att se till att de stöd- och behandlingsinsatser klienten har behov av utifrån ett biopsykosocialt perspektiv kommer klienten tillgodo. För att kunna göra detta krävdes bland annat att skapa en förtroendefull relation till klienten och att kunna se klientens behov utifrån ett biopsykosocialt perspektiv. Vidare krävdes en samhällsbaserad, uppsökande arbetsmetodik och tillgodoseende av klientens delaktighet i planeringen av stöd och behandling samt att arbetet kunde organiseras med en hög grad av självständighet utifrån klientens behov. / Case management: work models and tasks