Formål: Å undersøke foreldreerfaringer med tjenester fra Habiliteringstjenesten for barn i Nord-Trøndelag, Norge. Metode: Det ble gjort en deskriptiv tverrsnittsundersøkelse blant foreldre, hvis barn fikk tjenester fra avdelingen i en periode på et år. MPOC-20 NO, et spørreskjema spesielt utviklet for målgruppen og oversatt til norsk, ble brukt. Det inneholder fem faktorer: dyktiggjøring og parterskap, generell informasjon, spesifikk informasjon, helhetlige og koordinerte tjenester og respektfull og støttende omsorg. Det er 3-5 spørsmål innen hver faktor. Resultater: Svarprosenten ble 54,4% og foreldre til barn med større funksjonsvansker var overrepresentert blant svarene. Resultatene bør derfor tolkes med forsiktighet. Resultatene viste at gjennomsnittskår på generell informasjon var lavere enn på de andre faktorene. Gjennomsnittsskår i Nord-Trøndelag var lavere enn resultater fra Canada, men lik resultater fra Uppsala, Sverige. Foreldre til barn under 6 år hadde bedre erfaringer enn foreldre med eldre barn. Foreldre til barn med mindre funksjonsvansker ga bedre tilbakemeldinger. Foreldre under 36 år og mødre hadde bedre erfaringer enn eldre foreldre og fedre. Foreldre som bodde mindre enn 11 dager/mnd sammen med barnet hadde lavere tilfredshet. Å ha en individuell plan og/eller koordinator utgjorde en positiv forskjell på informasjonsområdet, men ikke på de andre faktorene. Konklusjon: Svarene viste at visse områder og kvaliteter ved avdelingens tjenester burde videreutvikles og noen grupper av foreldre burde få et tjenestetilbud bedre tilpasset deres behov. Det bør vurderes andre metoder for rekruttering til spørreundersøkelse og innhenting av svar fra målgruppen for å sikre høyere svarprosent. / Aim: To explore experiences with professional services among parents of disabled children in contact with Childrens Habilitation Department in Nord-Trøndelag, Norway. Method: A descriptive cross-sectional survey among parents, who’s children received services from the Childrens Habilitation Department during one year, was done. MPOC-20 NO, a questionnaire developed for this target group and translated into norwegian, was used. It consists of five factors: enabling/partnership, general information, spesific information, co-ordinated/comprehensive care and respectful/supportive care. Each factor consists of 3 – 5 questions. Results: The respons rate was 54,5%, parents of children with severe disabilities were overrepresented. Thus the results should be interpreted with care. The mean score on general information was lower than on other factors. The mean scores in Nord-Trøndelag was generally lower than in Canada, but about the same as results from Uppsala, Sweden. Parents of children under 6 years had better experiences than parents with older children. Parents with children with minor disabilities were more satisfied than others. Parents under 36 years and mothers had better experiences than older parents and fathers. Parents living together with their child less than 11 days/month were less satisfied than others. Having a key worker and/or an individual service plan made a positive difference on information factors, but not on the other factors. Conclusion: The answers showed that certain areas and qualities of the departments service should be better developed and some groups of parents should get a service delivery more fitted to their needs. Other methods should be considered to recruite parents and collect anwers to ensure a higher response rate. / <p>ISBN 978-91-85721-37-5</p>

Abstract The study describes and analyses the practices of interprofessional family work in the rehabilitation of severely handicapped children in the special needs groups of a day care centre from the viewpoint of parents and medical and educational professionals before and after a development project. At the baseline, the phenomenon under study was also described and analyzed as activity of the responsible unit of rehabilitation. The obstacles in the development of interprofessional family work and the factors that contributed to the development of interprofessional practices are also described. Based on these, a process of developing interprofessional family work is described. The study was part of the education and development project on interprofessional family work arranged co-operatively by the Department of Public Health Science and General Practice, University of Oulu, and Oulu Deaconess Institute in 2000–2002. The theoretical frame of reference consists of the ecocultural theory, according to which the life of a child is considered an inseparable part of the family's life. The family is conceived of a unit that actively influences its own life. Work with families is carried out as interprofessional family work. The study was implemented as action research, which included three interventions: education in interprofessional family work, discussion groups and Growing: Birht to Three, which consisted of education in the use of a rehabilitation and education model for children aged 0–3 years. The interventions made up an integrated whole. The participants in action research consisted of a interprofessional team working on the rehabilitation of severely handicapped children in the special needs group of a day care centre, which included specialists of early special education, physiotherapists and speech therapists. The research data were collected by thematic interviews at the beginning and at the end of the process by interviewing parents and professionals. The data were analysed with methods of content analysis using the QSR Nvivo computer software. At the beginning of the action research project the parents' role included both activities and passive presence and compliance with instructions. Professionals' activities were accordant with the expert- child- and family-oriented operating models. The major obstacles of interprofessional family work were a lack of knowledge, intolerance, which was manifested as a lack of equality and discussion, an expert orientation and fragmentation of activities. After the development project, according to the parents, interprofessional family work provided emotional and cognitive support. According to the professionals, interprofessionality was manifested as partnerships and promotion of empowerment. The development of operation was influenced by a positive attitude, which fostered a favourable atmosphere and acceptance of change, and a conversational culture, which was manifested as communication skills and awareness of matters. The findings of the study can be utilised in the development interprofessional co-operation and family work in professional basic education and further and in-service education. / Tiivistelmä Tutkimuksessa kuvataan ja analysoidaan moniammatillisen perhetyön ilmenemistä vaikeavammaisten lasten kuntoutuksessa päiväkodin erityisryhmässä. Näkökulman antavat vanhemmat ja lääkinnällisen sekä kasvatuksellisen kuntoutuksen ammattihenkilöt ennen kehittämistoimintaa ja sen jälkeen. Alkuvaiheessa tutkittavaa ilmiötä kuvataan ja analysoidaan myös kuntoutuksen vastuuyksikössä ilmenevänä toimintana. Lisäksi kuvataan ja analysoidaan moniammatillisen perhetyön kehittämisen esteitä sekä toiminnan kehittymiseen vaikuttavia tekijöitä. Näiden kautta kuvataan moniammatillisen perhetyön kehittämisprosessi. Tutkimus on osa Oulun yliopiston kansanterveystieteen ja yleislääketieteen laitoksen ja Oulun Diakonissalaitoksen yhteistyönä järjestämää moniammatillisen perhetyön koulutus- ja kehittämisprojektia, joka toteutettiin vuosina 2000–2002. Teoreettisena viitekehyksenä on ekokulttuurinen teoria, jonka mukaan lapsen elämää tarkastellaan kiinteänä osana perheen elämää. Perhe nähdään aktiivisena omaan elämäänsä vaikuttavana yksikkönä. Toiminta perheiden kanssa toteutuu moniammatillisena perhetyönä. Tutkimus toteutettiin toimintatutkimuksena, johon kuului kolme interventiota: moniammatillinen perhetyö -koulutus ja keskustelupiirit sekä Pikku-Portaat - Kasvamaan: syntymästä kolmivuotiaaksi kuntoutus- ja kasvatusmallin käytön koulutus. Interventiot muodostivat yhdessä kokonaisuuden. Toimintatutkimukseen osallistui vaikeavammaisten lasten kuntoutuksessa päiväkodin erityisryhmässä mukana oleva moniammatillinen tiimi, johon kuului varhaiserityiskasvatuksen asiantuntijoita sekä fysio- ja puheterapeutteja. Tutkimusaineistot kerättiin vanhempien ja ammattihenkilöiden teemahaastatteluilla prosessin alussa ja lopussa. Aineistot analysoitiin sisällön analyysilla käyttäen QSR Nvivo -tietokoneohjelmaa. Toimintatutkimuksen alussa vanhempien rooliin kuului sekä aktiivista toimintaa että passiivista ohjeiden noudattamista ja mukana kulkemista. Ammattihenkilöt toimivat asiantuntija-, lapsi- ja perhekeskeisen toimintamallin mukaisesti. Moniammatillisen perhetyön esteenä olivat tiedon puute, suvaitsemattomuus, joka ilmeni tasa-arvon ja keskustelun puutteena, asiantuntijakeskeisyys sekä toiminnan pirstaleisuus. Kehittämistyön jälkeen moniammatillinen perhetyö näkyi vanhempien mukaan emotionaalisena ja tiedollisena tukena. Ammattihenkilöiden mukaan toiminta ilmeni kumppanuutena ja voimaantumisen tukemisena. Toiminnan kehittymiseen vaikuttivat positiivinen asennoituminen, joka ilmeni myönteisenä ilmapiirinä ja muutosmyönteisyytenä, ja keskusteleva kulttuuri, joka ilmeni keskustelutaitona ja tietoisuutena asioista. Tutkimuksessa on tuotettu tietoa, jota voidaan hyödyntää kehitettäessä moniammatillista yhteistyötä ja perhetyötä ammatillisessa peruskoulutuksessa sekä jatko- ja täydennyskoulutuksessa.

En la mayoría de los centros de salud existe una falta de servicios, estructuras y personal capacitado para brindar servicios relacionados con la rehabilitación y cuidado médico de pacientes que sufren trastornos de la comunicación y/o discapacidad. El presente proyecto está enfocado en la mejora de los procesos de admisión y rehabilitación infantil del Centro de Desarrollo Integral DIDACTIKID’S. El resultado es establecer una propuesta de mejora de los procesos actuales e identificar los requerimientos principales que sirvan de base para una futura solución tecnológica que satisfaga las necesidades de la organización. Para ello, es necesario conocer la situación actual de la organización y establecer el Marco Teórico a desarrollar en el presente proyecto para conocer las actividades e identificar los problemas que retrasan su desempeño. El resultado de la propuesta permitirá optimizar, automatizar y medir las operaciones actuales de la organización para lograr una mejora continua. La optimización los procesos de admisión y rehabilitación infantil permite mejorar la eficiencia, facilitar la toma de decisiones, incrementar la rentabilidad y lograr cumplir los objetivos estratégicos de la organización. / In The majority of health centers there is a lack of services, structures and trained personnel to provide services related to the rehabilitation and medical care of patients who have communication and / or disability problems. This project is focused on improving the processes of admission and children rehabilitation at the Centro de Desarrollo Integral DIDACTIKID’S. The result is to establish a proposal to improve current processes and identify the main requirements that serve as the basis for a future technological solution that meets the needs of the organization. For this, it is necessary to know the current situation of the organization and establish the Theoretical Framework to be developed in this project to know the activities and identify the problems that delay their performance. The result of the proposal will allow to optimize, automate and measure the current operations of the organization to achieve continuous improvement. The optimization of the child admission and rehabilitation processes allows improving efficiency, facilitating decision-making, increasing profitability and achieving the strategic objectives of the organization. / Tesis