The aim of this study was to investigate unit managers views on staff continuity within municipal home care services to get a wider understanding regarding the organization’s work with staff continuity, which action dilemmas the unit managers encounter and how they handle these. The study was conducted by qualitative research through semi-structured interviews with six unit managers in one middle-sized municipality in Sweden. The results showed a diverseness in working methods regarding staff continuity between the home care services in the municipality. It was also concluded that the home care services are guided by goals and guidelines regarding staff continuity which the unit managers finds unclear and undeveloped. The conclusion highlights that the unit managers finds themselves in a position where the care users needs and requests of a staff continuity does not always match the conditions and regulations within the organization. Lastly the results showed that this position causes the unit managers to make priorities in the work for staff continuity. It can be concluded that the unit managers either finds themselves adjusting to the organizations conditions or regulations or they find solutions to meet the request and needs from the care users regarding staff continuity.

Denna kvantitativa studie har som syfte att kartlägga kompetensen/utbildningsbakgrund och belysa möjligheterna till kompetensutveckling inom kommunal äldreomsorg. Studien bygger på svar från 108 elektroniska enkäter från undersköterskor och vårdbiträden inom kommunal äldreomsorg. Studiens resultat visar att det finns så mycket som 23,2% yrkesverksamma inom kommunal äldreomsorg som anser sig inte vara kvalificerade för sitt arbete. Studien visar också att kommunerna runt om i landet generellt erbjuder sina undersköterskor och vårdbiträden en bra mängd kompetensutveckling, dock visar det sig att man i mindre kommuner har sämre tillgång på kompetensutveckling än i mellanstora kommuner. / This quantitative study has the purpose of mapping educational background and illustrate the possibilty of competence development in municipal elderly care. The study is based on answers from 108 electronic questionnaires from assistance nurses and nurse´s aides in municipal elderly care in Sweden. The result of the study shows that as much as 23,2% that are working in municipal elderly care is unqualified for their jobs. The study also shows that the municipalities around Sweden give their employees a good amount of competence development, but in the smaller municipalities there is less access to competence development than in the middle sized municipalities.

There is a need to create efficiency through digital technology within the elder care, as the elderly population of society is increasing. Existing IT-systems are considered incompatible with healthcare work, despite of Swedish investments in digital development in healthcare. Practices and the use of digital artefacts within an elder care home was therefore studied. Through an ethnographic qualitative method (consisting of field studies, video ethnography and interviews), the empirically driven study identified the healthcare workers existing interactions with- and use of digital technology, as well as the consequences that the use entailed. The study showed that the healthcare workers used the workplace’s existing digital technology as well as personal digital artefacts to solve daily tasks. Furthermore, the results showed that the healthcare workers interactions with personal digital artefacts mediated new work situations, and the healthcare workers desire for new digital work tools. / Inom äldreomsorgen finns ett behov av digital teknik som kan effektivisera omsorgsarbetet, eftersom den äldre befolkningen i samhället ökar. Trots Sveriges satsningar på digital utveckling inom vård- och omsorg, har det visat sig att personal inte anser att befintliga IT-system är kompatibla med vård- och omsorgsarbetet. Därför studerades praktiker och användning av digitala artefakter på ett vård- och omsorgsboende. Genom etnografisk kvalitativ metod (i form av fältstudier, videoetnografi och intervjuer) identifierade den empiriskt drivna studien personalens befintliga interaktioner med- och användning av digital teknik, samt de konsekvenser användningen medförde. Resultatet visade även att personalen använde arbetsplatsens befintliga digitala teknik, samt personliga digitala artefakter för att lösa dagliga arbetsuppgifter. Vidare visade studien att personalens interaktioner med personliga digitala hjälpmedel medierade nya situationer i arbetet och att personalen önskade nya digitala arbetsverktyg.

Les réformes du marché ont notamment été mises en œuvre comme une solution pour améliorer la qualité des services publics et l'efficacité depuis les années 1990. Face à l'augmentation des besoins de soins et afin de maintenir les coûts de soins à un niveau raisonnable, la Suède a également introduit la marchéisation dans le domaine des soins aux personnes âgées depuis 1992. Pourtant, l'introduction d'un mécanisme de marché dans l'État-providence fait l’objet des débats politiques et publics de plus en plus nombreux. Beaucoup sont sceptiques quant aux avantages supposés d'un marché, en termes par exemple d'amélioration de la qualité et de réduction des coûts, tels que proposées par « New Public Management ». Il y a eu également des critiques croissantes sur la rentabilité dans les services de soins ces dernières années.Après deux décennies de marchéisation, il nous paraît nécessaire de recenser les attitudes des politiciens locaux, à savoir comment ils perçoivent le rôle d'un marché ou d'un quasi-marché dans un État providence où le mécanisme du marché pourrait remettre en cause des principes traditionnels tels que l'universalisme, la solidarité et l’égalité. En dehors des études des attitudes sur le bien-être public déjà existantes, cette recherche se base aussi sur un ensemble de données d'enquête uniques construit depuis 2014 et permettra ainsi une compréhension plus profonde et actuelle sur les perspectives de marchéisation chez les politiciens.Précisément, cette étude analyse trois aspects différents de la marchéisation : la production, la réglementation et le financement. Les résultats montrent que les différences d'attitudes sont évidentes entre les politiciens de gauche et de droite à l’égard des prestataires privés à but lucratif. Les orientations politiques des individus, la majorité politique dans les municipalités et le niveau de privatisation déjà atteint localement sont repérés comme des facteurs importants qui expliquent la volonté des politiciens locaux de privatiser davantage ou non. Les différences de préférences continuent à exister entre les deux blocs, et l'idéologie politique joue un rôle majeur dans l'explication de ces différences, plus que des facteurs individuels tels que l'âge, le sexe ou la position de travail. Les réponses autodéclarées révèlent que l'idéologie politique influence la formation des attitudes.Dans une large mesure, les politiciens de gauche et de droite s'accordent sur les principes de bien-être public tels que l'universalisme et tous les deux reconnaissent les impacts potentiels que le marché pourrait avoir sur la société, dont la question de l'inégalité. Il semble plausible que le pluralisme de l'État-providence soit la direction de l'avenir.Cette étude de cas constitue un exemple solide pour examiner le développement du marché du bien-être public dans les États-providence avancés et contribue également à la discussion du rôle potentiel de l'idéologie politique dans les réformes post-austérité sur le bien-être public. / Market reforms have quite notably been used as a solution to increase the quality of public services and efficiency since the 1990s. Sweden has also introduced marketisation in the field of elderly care since 1992 to cope with increasing care needs while maintaining costs at a reasonable level. Yet, the introduction of a market mechanism in the welfare state is subject to increasing political and public debates. Many are sceptical about the purported benefits of a market, such as increased quality and reduced costs, as proposed by New Public Management. There have also been increasing critiques of the profit-making in care services in recent years.After two decades of marketisation, it is worthwhile to map out local politicians’ attitude patterns, namely, how they perceive the use of a market or quasi-market in a welfare state, where the market mechanism might challenge traditional principles such as universalism, solidarity, and equality. Complementary to studies on attitudes of public welfare, this research uses a unique survey dataset from 2014 to expand current understandings of politicians’ perspectives of marketisation.To be more specific, this study analyses three different aspects of marketisation: production, regulation, and financing. The results show that attitudinal differences between left- and right-wing politicians on private for-profit providers remain distinct. Political orientations of individuals, political majority in municipalities, and the privatisation level already achieved locally are identified as important factors in explaining local politicians’ willingness to privatise further. The preference differences continue to exist between the two blocs, and political ideology plays a major role in explaining these differences, more so than individual factors such as age, gender, or working position. Self-reported answers reveal that political ideology influences attitude formation. To a large extent, left- and right-wing politicians agree on welfare principles such as universalism, and they both recognise potential impacts that the market could have on society, such as inequality. It seems plausible that welfare state pluralism is the direction of the future.This case study serves as a solid example for examining the market development of public welfare in advanced welfare states and also contributes to the discussion of the potential role of political ideology in post-austerity welfare reforms.

<p>The aim of this study was to describe and analyse the constructions and</p><p>interplay of gender, ethnicity and sexuality between female and male careworkers</p><p>and residents in a nursing home. To explore this from a qualitative</p><p>everyday life’s approach, material was collected through participating observations,</p><p>interviews, and informal conversation with careworkers and residents.</p><p>The result points out that historical patterns of gender and caring related</p><p>to this context still matter and affect both careworkers and residents. For</p><p>example, female careworkers talked about the concept of caring as a genuine</p><p>female experience, while male careworkers, who were in a minority, instead</p><p>talked about caring in more gender-neutral words. The result also indicates</p><p>that a larger number of male careworkers not necessarily leads to a higher</p><p>grade of gender equality. Instead, the presence of male careworkers made the</p><p>traditional gender-power order more visible.</p><p>When analyzing outcomes of the interplay of gender, ethnicity and sexuality,</p><p>it was obvious that this was a complicated process. On one hand this</p><p>interplay of different categories seemed to affect female and male careworkers</p><p>in a similar way. On the other hand the interplay of gender, ethnicity and</p><p>sexuality can confront female and male careworkers with different types of</p><p>dilemmas. Therefore, an attempt to understand the position and experience</p><p>of being a careworker with non-Swedish background or being a nonheterosexual</p><p>careworker must include a gender-perspective.</p><p>A main result from the study was that the careworkers supported the residents</p><p>to perform their social gender-identity through the daily interactions.</p><p>These interactions were foremost influenced by the careworkers’ own expectations</p><p>about older women’s and older men’s needs and behaviour. The four</p><p>gender-constellations that occurred in the care-interactions also differed</p><p>from each other with regard to what careworkers and residents talked about,</p><p>and how they talked and acted. Even if the outcome from different types of</p><p>gendered meetings differed, there were also some similarities. It was obvious</p><p>that both female and male careworkers seemed to think and talk about the</p><p>female residents as more dependent and vulnerable than male residents. To</p><p>conclude, traditional norms and a gender-power order that influences society</p><p>also affects careworkers and residents in the nursing home.</p><p> </p>

<p>The purpose of this thesis is to study what motivational factors motivates the staff in the public elderly care and to investigate how the staff ranks the different motivational factors and if the rankings differ depending on gender, age, education, type of employment, time of employment, employer, income and ethnic background. The thesis is based on a questionnaire study with a total of 97 participants. The questionnaire was constructed with the help of prior similar studies conducted in the USA and Malaysia over a sixty-year time period. These studies are then used to analyze the results. The participants in our thesis were given ten motivational factors to rank according to what they believed motivated them the most.  The results showed that the participants rank <em>“good wages” </em>as the highest motivational factor for work motivation and <em>“possibility to advance to a higher position”</em> as the least motivating factor. The theoretical base is the <em>Two-factor theory</em> of motivation by Herzberg. We concluded from the results of our research that the participants were dissatisfied with their work situation as their hygiene factors were not contented according to the two-factor theory.          </p>

<p>This paper studies, from a client perspective, how three Swedish municipalities work with information about a voucher system in homecare. The paper is a qualitative study using structured informant interviews and analysis of documents. The interviewees are responsible of information about the voucher system in the municipalities. The studied documents describe and clarify the voucher system of the municipality. Neo-institutional organization theory is used to analyse the result. Existing research has showed how pensioners find information on the voucher systems lacking. The research also shows how care managers have difficulties relating to their new roles as information coordinators on the voucher system. With this background, the study focuses on examining how the municipalities work with and organises the information on the voucher system as well as how the responsibiliy of the information is handled. The result shows that the studied municipalities mainly deal with the issue from a market point of view, where the care providers are to be presented in a neutral way. However, one of the municipalities has reconsidered the principle of neutrality and works to clarify the information to the elders. All three municipalities place the responsibility of information on the care managers in their interaction with the elder. There is no further communication between the municipality and the elderly people in the form of client studies or fora of discussion and review of the information on the voucher system.</p>

The purpose of this thesis is to study what motivational factors motivates the staff in the public elderly care and to investigate how the staff ranks the different motivational factors and if the rankings differ depending on gender, age, education, type of employment, time of employment, employer, income and ethnic background. The thesis is based on a questionnaire study with a total of 97 participants. The questionnaire was constructed with the help of prior similar studies conducted in the USA and Malaysia over a sixty-year time period. These studies are then used to analyze the results. The participants in our thesis were given ten motivational factors to rank according to what they believed motivated them the most.  The results showed that the participants rank “good wages” as the highest motivational factor for work motivation and “possibility to advance to a higher position” as the least motivating factor. The theoretical base is the Two-factor theory of motivation by Herzberg. We concluded from the results of our research that the participants were dissatisfied with their work situation as their hygiene factors were not contented according to the two-factor theory.

This paper studies, from a client perspective, how three Swedish municipalities work with information about a voucher system in homecare. The paper is a qualitative study using structured informant interviews and analysis of documents. The interviewees are responsible of information about the voucher system in the municipalities. The studied documents describe and clarify the voucher system of the municipality. Neo-institutional organization theory is used to analyse the result. Existing research has showed how pensioners find information on the voucher systems lacking. The research also shows how care managers have difficulties relating to their new roles as information coordinators on the voucher system. With this background, the study focuses on examining how the municipalities work with and organises the information on the voucher system as well as how the responsibiliy of the information is handled. The result shows that the studied municipalities mainly deal with the issue from a market point of view, where the care providers are to be presented in a neutral way. However, one of the municipalities has reconsidered the principle of neutrality and works to clarify the information to the elders. All three municipalities place the responsibility of information on the care managers in their interaction with the elder. There is no further communication between the municipality and the elderly people in the form of client studies or fora of discussion and review of the information on the voucher system.

Background: At the central administrative level in Sweden, care work is presented as a complex task for which personnel require special qualifications. In elderly care, questions of training and qualifications form the highly topical theme noticed by central actors. According to The National Board of Health and Welfare, the supply of manpower and the educational levels of the workers are the most important factors in ensuring high quality care for the elderly. The question of educational levels is, however, with the exception of personal assistants, not given as much attention in care for people with disabilities. Aim: The aim of this dissertation is firstly to compare elderly care and care for persons with disabilities with the focus to describe and analyse education and work environment in these sectors. Secondly, the aim is to analyse if, and if so how, questions of education interacts with personnel’s view of the social work environment. Methods: The thesis is comprised of four studies and paper 1, 2 and 3 are based on the results of a qualitative interview study, which was comprised of 48 persons who worked in elderly care and the care for persons with disabilities. Of the 48 persons who took part in the study, 11 of them worked as middle managers and 37 worked as care workers in the every day care. Paper 4 consists of a research summary on how education for care workers is being studied in a Swedish and an international context. The personnel who participated in the interview study work in different care settings; in elderly care the personnel work in both sheltered housing and public home care services. In the care for disabled persons, the personnel work in residential housing with special services, in public daily activities for people with intellectual disabilities and as personal assistants. Result: Both managers and personnel find it important for care workers to have a degree of educational background as a basis for the learning process at the work place. The results also show that educational levels and the work environment are themes that are discussed differently by different actors. In previous research on education for care workers in both elderly care and the care for People with disabilities, academic education or education at a ground level has been seen as problematic due to the distance it is said to create between the worker and the care recipient. My results show that the discussion about education for care workers has become rather biased, and that highly educated personnel tend to be more aware of the power they possesses and that the relation to the care receiver is important. In elderly care the issue of education seems to be more a question of a general educational level. In the care for people with disabilities, the question of education for personnel is on a more individual basis, where the care workers learn together with the care recipient. Educational levels, the work environment and relations with colleagues and care recipients are connected and support from the managers is important for understanding the work and the relational perspective.