Nos últimos anos, a problemática das internações psiquiátricas compulsórias, isto é, aquelas determinadas por medida judicial, tem sido amplamente discutida, dando visibilidade a algumas tensões que atravessam esse campo. Entre outros aspectos, debates têm sido desenvolvidos sobre temas como liberdade, autonomia e direito, e, numa esfera mais específica, sobre a própria legitimidade e efetividade dos atendimentos nesses casos. Estas tensões trazem importantes desafios aos profissionais de saúde mental, os quais precisam, em seu cotidiano, encontrar respostas criativas para o adequado cuidado das pessoas que chegam aos serviços psiquiátricos via processos de internação compulsória. Em revisão da literatura nos deparamos com alguns estudos que discutem os tratamentos compulsórios na perspectiva dos usuários, mas percebemos uma lacuna em relação à perspectiva dos profissionais nesse mesmo contexto. Este estudo tem como objetivo compreender como as equipes de saúde mental significam o trabalho no cotidiano das internações psiquiátricas compulsórias, bem como compreender como esse trabalho se desenvolve, explorando tanto os desafios como os recursos usados pelas equipes profissionais para o desenvolvimento do cuidado nesse contexto. O corpus de análise foi constituído a partir de entrevistas semiestruturadas no formato de grupos focais e entrevistas individuais, que foram gravadas em áudio e, posteriormente, transcritas na íntegra. A análise envolveu a construção de eixos temáticos, para os quais se buscou compreender a diversidade de sentidos produzidos e possíveis implicações dos mesmos para a produção de práticas em saúde mental. Foram construídos cinco eixos temáticos: 1) IPC como tratamento; 2) Sentidos sobreo uso da IPC e suas implicações; 3) IPC, relações familiares e tratamento; 4) IPC e RAPS; e 5) Sugestões dos profissionais para contribuições no campo da saúde mental. Concluímos que não existem terapêuticas ou práticas distintas para paciente em IPC, mas que dificuldades para conceder alta aos pacientes, sobretudo em função da necessária relação com o judiciário, cria desafios e impõe limites terapêuticos para os pacientes e profissionais. A partir disso, discutimos a valorização das IPC em detrimento às alternativas de cuidado ambulatorial e comunitário, e de que forma isso se reflete na efetivação da Rede de atenção psicossocial. (Apoio financeiro: Capes). / In recent years, the issue of compulsory psychiatric hospitalizations, for example, those determined by judicial order, has been widely discussed, giving visibility to some tensions that run through this field. Among other things, discussions have been developed on topics such as freedom, autonomy and rights, and on a more specific level, the legitimacy and effectiveness of care in such cases. These tensions bring about some important challenges to mental health professionals, who need in their daily lives, to find creative answers to provide the proper care for the people who come to psychiatric services via compulsory admission processes. In the literature review we came across a few studies that discuss the compulsory treatment from the perspective of users, but we noticed a gap in relation to the perspective of professionals in this same context. This study aims to understand what kind of meaning mental health professionals make in the day to day work during compulsory psychiatric hospitalizations, as well as understand how this work develops, exploring both the challenges and the resources used by professional teams for the development of care in this context. The corpus analysis was made from semi-structured interviews in the form of focus groups and individual interviews, which were audio recorded and later fully transcribed. The analysis involved the construction of themes, for which it sought to understand the diversity of meanings produced and their possible implications in the production of mental health practices. Five themes were built: 1) Compulsory psychiatric hospitalizations as treatment; 2) Senses on the use of compulsory psychiatric hospitalizations and its implications; 3) Compulsory psychiatric hospitalizations, family relationships and treatment; 4) Compulsory psychiatric hospitalizations and Network of Psychosocial Attention; 5) The suggestions of the professionals for contributions in the field of mental health. We conclude that there are no therapeutic or different practices for patients in compulsory psychiatric hospitalization, however the difficulty to grant discharge to patients, mainly due to the necessary relation with the judiciary, creates challenges and imposes therapeutic limits for patients and professionals. Based on this, we discussed the valuation of Compulsory Psychiatric Hospitalization over the ambulatory and community care alternatives, and how this is reflected in the effectiveness of the Network of Psychosocial Attention. (Financial support: Capes).

Neste trabalho é apresentado um estudo da evolução da acidentalidade viária em cinco municípios do Estado de São Paulo: Araraquara, Franca, Matão, Ribeirão Preto e São Carlos. O estudo tem como objetivo verificar se os fatores que influenciaram na alteração da tendência dos índices de acidentalidade estão relacionados a ações de Engenharia, Educação e Esforço Legal, e se a acidentalidade é proveniente de adaptações comportamentais dos usuários do sistema viário de cada município. Para que isso fosse possível, foi utilizada uma metodologia composta pelas seguintes etapas: (1) realização de entrevistas de grupo investigativas com as autoridades de cada município analisado, (2) elaboração e aplicação de um questionário junto aos usuários do sistema viário e (3) análise dos resultados obtidos para devidas considerações. Na primeira etapa foram realizadas entrevistas seguindo as técnicas de Grupos Focais com as autoridades competentes responsáveis pela gestão do trânsito nas áreas de engenharia, educação e esforço legal. A partir dos resultados obtidos na primeira etapa, foi elaborado e aplicado um questionário que visava identificar qual a sensibilidade da população frente às ações implementadas em cada um dos municípios analisados composto por questões ligadas à avaliação da qualidade do trânsito dos municípios do ponto de vista dos usuários do sistema e à avaliação da frequência de investimentos em engenharia, educação e esforço legal por parte das autoridades competentes. Por fim, com os dados obtidos através dos questionários, foi possível realizar uma investigação sobre os principais fatores que afetaram os índices de acidentalidade de cada município. Em alguns municípios foi possível observar que as ações implementadas foram percebidas pela população, ficando claro que houve adaptação comportamental dos usuários do sistema, fato que pode explicar a alteração da tendência dos índices de acidentalidade. Em outros, não foi possível chegar a conclusões por não ser possível identificar as causas da mudança da tendência dos índices de acidentalidade devido a dificuldades encontradas e sentidas de adesão e colaboração por parte das autoridades gestoras responsáveis pelo trânsito, ou por parte da população. / This thesis presents a study of the evolution of road accidentality in five municipalities of the State of São Paulo: Araraquara, Franca, Matão, Ribeirão Preto and São Carlos. The study has as objective to verify if the factors that influenced the change in the tendency of accidentality indexes are related to engineering, education and enforcement actions and if the accidentality is coming from road users behavioral adaptations in each municipality. In the first step, group interviews were conducted following the Focus Groups techniques with the competent authorities responsible for the traffic management in the areas of engineering, education and enforcement. To make this possible, the following methodology was used: (1) carrying out investigative group interviews with authorities of each targeted municipality, (2) development and application of a questionnaire to road users and (3) analysis of the results obtained, and its proper considerations. From the results obtained in the first step, a questionnaire was prepared and applied to identify the sensitivity of the population to the actions implemented in each analyzed municipalities. This questionnaire resulted in road users evaluations regarding the quality of urban road transport and the frequency of investments in engineering, education and enforcement by the competent authorities. Finally, with the data obtained from the questionnaires, it was possible to conduct an investigation into the major factors affecting the accidentality rates of each municipality. In some municipalities it was observed that the implemented actions were perceived by the population, making it clear that there were road users behavioral adaptations, which may explain the change in the tendency of accidentality rates. In other municipalities, it was not possible to reach conclusions that could explain the causes of changes in the tendency of accidentality rates due to experienced difficulties in getting the cooperation from the administrative authorities responsible for traffic, or from the population.

Made available in DSpace on 2016-04-25T19:20:53Z (GMT). No. of bitstreams: 1 Angela Maria Lucas Quintiliano.pdf: 1526113 bytes, checksum: 01dee377b4037cee9e0ab5d3e546ff43 (MD5) Previous issue date: 2008-05-08 / This study explores transformations in the perceived meaning of life among in a specific group of adolescents. Relations between the traditional institutions (family and school) and the media as established in the socializing process in contemporary western capitalist societies - is correlated with a modification in the production of these meanings. Two concepts were fundamental to the analysis of this shift: the dynamics of the imaginary understood as both reservoir and motor; and mediations understood as "free zones." The study focuses on cinema as the media form best suited for reflection on processes of projection and identification. The methodology is based on qualitative research with data collected from focus groups. The study group consisted of twelve middle class students, between 14 and 17 years of age, in a non-confessional school in the northern area of the city of São Paulo. The chosen film was Constantine. Group interactions revealed a type of discourse that clarify the role of cinematographic media in the construction of the religious imaginary of this group / Esta pesquisa aborda transformações percebidas em um grupo específico de adolescentes, no que se refere ao significado por eles atribuído à sua existência no mundo. A partir da relação que se estabelece no contexto atual nas sociedades ocidentais capitalistas, no processo de socialização, entre as instâncias tradicionais (família e escola) e a mídia constata-se uma modificação na produção de significados para a existência humana. A dinâmica do imaginário entendida como reservatório/motor, e as mediações como zonas livres , foram os conceitos fundamentais para a compreensão de como se dá essa mudança na produção de sentidos. Dentro das possibilidades oferecidas pela mídia, utilizamos o cinema como mediação capaz de levar à reflexões a partir de um processo de projeção-identificação. A metodologia utilizada para a coleta de dados baseou-se na perspectiva qualitativa a partir da técnica de grupos focais. A pesquisa foi realizada com um grupo de 12 adolescentes, na faixa etária entre 14 e 17 anos, de classe média, que estudam em uma escola não confessional da Zona Norte da cidade de São Paulo. O filme escolhido foi Constantine, e as interações do grupo traduziram um tipo de discurso que nos possibilitou associações significativas para dar conta da hipótese levantada, ou seja, o papel da mídia cinematográfica na construção do imaginário religioso de um determinado grupo de adolescentes

Introdução: A perda dentária e o edentulismo podem afetar de maneira significativa a saúde bucal e a saúde geral, a qualidade de vida, e a nutrição de idosos. A cárie e a perda dentária têm sido descritas como o resultado de processos que envolvem elementos biológicos, nas superfícies dentárias, e de uma combinação de fatores comportamentais e sociais. Além disso, o contexto histórico no qual os indivíduos estão inseridos influencia seus comportamentos e percepções em relação à saúde bucal. Uma compreensão acerca de comportamentos de saúde demanda a utilização de métodos que permitam explorar a realidade subjetiva destes fatores. Objetivo: Os objetivos deste estudo de métodos quantitativo e qualitativo foram avaliar a associação entre fatores demográficos, socioeconômicos, comportamentais e de saúde e a incidência de Cárie Coronária, Cárie Radicular, e Perda Dentária na amostra estudada, e realizar entrevistas de grupo focal com membros desta amostra para explorar suas percepções acerca da perda dentária. Métodos: Um estudo de coorte foi conduzido com uma amostra aleatória simples de indivíduos com 60 anos ou mais em Carlos Barbosa, RS, entre 2004 e 2008. Entrevistas e exames bucais foram conduzidos com 388 indivíduos dentados na linha de base, e com 273 participantes no seguimento. A incidência de perdas dentárias, cáries coronárias e radiculares e suas associações com variáveis da linha de base foram modeladas com o uso de regressão binomial negativa. Em um segundo momento, informações de natureza qualitativa foram produzidas através de uma séria de oito entrevistas de grupo focal envolvendo 41 idosos, selecionados dos participantes do seguimento do estudo. As discussões de grupo foram moderadas pelo autor, foram gravadas, codificadas e analisadas através do uso da Teoria Fundamentada em Dados. Resultados: Foi observado no modelo multivariável que, ser mais velho; do sexo masculino; viver em área rural; ser casado; ter menor escolaridade; ser fumante; e estar insatisfeito com os serviços de saúde acessados, estiveram associados com a incidência perdas dentárias. Entre as variáveis clínicas, o uso de próteses parciais removíveis e o índice de sangramento gengival foram preditores, enquanto maior taxa de fluxo salivar foi um fator protetor para o desfecho. Com relação às cáries coronárias, no modelo multivariável final foi observado que, ser mais velho; do sexo masculino; viver em área rural; e ser fumante, estiveram associados à sua incidência. Entre as variáveis clínicas, o uso de próteses parciais removíveis foi um preditor, enquanto maior taxa de fluxo salivar foi um fator de proteção para este desfecho. No modelo multivariável final tendo como desfecho a densidade de incidência de cáries radiculares, ser mais velho; viver em área rural; e escovar os dentes com frequência menor do que diária, foram preditores; ao passo que a única variável clínica associada ao desfecho foi uma maior taxa de fluxo salivar, como fator de proteção. No segmento qualitativo, as respostas dos participantes permitiram concluir que as perdas dentárias estiveram relacionadas com a falta de programas de saúde bucal; normas sociais (incluindo valores relativos ao gênero); nível limitado de informações de saúde; e reduzidas acessibilidade e disponibilidade de serviços odontológicos. Contextos de vulnerabilidade social e programática tiveram um papel fundamental no desenvolvimento de normas e valores sociais e comportamentos individuais que resultaram em extrações dentárias. Conclusão: Estes achados são importantes, porque compreender as relações causais entre práticas individuais como higiene bucal, hábito de fumar, e procura por cuidados odontológicos preventivos, e perdas dentárias, não elucida as razões para as pessoas assumirem tais comportamentos. / Introduction: Tooth loss and edentulism may have a negative impact in the oral and general health, in the quality of life, and nutrition of the elderly. Dental caries and tooth loss have been described as results of processes involving biologic factors, on the surfaces of the teeth, and of a combination of behavioral and social factors. Furthermore, the historical context in which people are placed influences their behaviors and perceptions towards oral health. The understanding of health behaviors requires the use of methods which allow for the exploration of the subjective reality of those factors. Objective: The objectives of this study using quantitative and qualitative methods were to evaluate the association between demographic, socioeconomic, behavioral and health factors and the incidence of tooth loss, coronal and root caries in the studied sample. Also, to carry on focus groups interviews with members from the sample to explore their perceptions about tooth loss. Methods: A cohort study was conducted with a simple random sample of subjects 60 years old or older in Carlos Barbosa city, southern Brazil, between the years of 2004 and 2008. Interviews and oral examinations were conducted with 388 dentate subjects at baseline, and 273 participants at follow-up. The incidence of tooth loss, coronal and root caries and their association with baseline variables were modeled with the use of negative binomial regression. Following the quantitative part of the study, information of qualitative nature was obtained through a series of eight focus groups, involving 41 participants, purposefully selected from those participating in the follow-up. The focus groups discussions’ were moderated by the author, were recorded, coded and analyzed through the use of Grounded Theory. Results: In the multivariate model it was observed that, older age; male gender; living in a rural area; being married; less schooling; being a current smoker; and being dissatisfied with the health services accessed, were associated with the incidence of tooth loss. Among clinical variables, the use of removable partial dentures, and the gingival bleeding index were predictors, whereas higher stimulated saliva flow rate showed a protective effect for the outcome. With regards to the incidence of coronal caries, in the multivariate model it was found that, older age; male gender; living in a rural area; and being a current smoker, were associated with the outcome. Among clinical variables, the use of removable partial dentures was a predictor, whereas a higher stimulated saliva flow was a protective factor for the outcome. In the final model, for the outcome defined as the incidence density of new root caries, it was observed that, older age; living in a rural area; and brushing less than daily were predictors, whereas a higher stimulated saliva flow rate showed a protective effect for the outcome. With regards to the qualitative part of the study, the answers of the participants allowed for the conclusion that tooth extractions had been related, in the past, with the lack of oral health problems; social norms (including social values related to gender); low level of health information; and limited accessibility and availability of dental services. Contexts of social and programmatic vulnerability played a major role in the development of social norms and individual behaviors which resulted in tooth extractions. Conclusion: These findings are important, because understanding the causal relations between individual behaviors such as oral hygiene, smoking, and the pursuing of preventive dental care, do not elucidate why people engage in such behaviors.

This essay investigates the attitudes of social work students’ from Stockholm University, Sweden, towards people with autism and ADHD. The students participated in focus groups, where they discussed their thoughts and potential actions in the meeting with people with autism and ADHD. Through a thematic analysis, we identified the four following themes: perceptions; ignorance and its consequences; adaptation and actions tendencies; and needs of change. The results were then analyzed with a classic attitude theory. The results show that social work students mostly have positive attitudes towards people with autism and ADHD and that it is important to consider them like anybody else and to have knowledge about the disabilities, which leads to a helping and supporting preparedness towards them. Social work student has a strong will to help people with autism and ADHD but sometimes feel that society and organizations prevent them from doing so. In conclusion, social work students have a caring attitude, wants more knowledge about diagnoses and wants to help and do more for people with autism and ADHD.

Nos últimos anos, a problemática das internações psiquiátricas compulsórias, isto é, aquelas determinadas por medida judicial, tem sido amplamente discutida, dando visibilidade a algumas tensões que atravessam esse campo. Entre outros aspectos, debates têm sido desenvolvidos sobre temas como liberdade, autonomia e direito, e, numa esfera mais específica, sobre a própria legitimidade e efetividade dos atendimentos nesses casos. Estas tensões trazem importantes desafios aos profissionais de saúde mental, os quais precisam, em seu cotidiano, encontrar respostas criativas para o adequado cuidado das pessoas que chegam aos serviços psiquiátricos via processos de internação compulsória. Em revisão da literatura nos deparamos com alguns estudos que discutem os tratamentos compulsórios na perspectiva dos usuários, mas percebemos uma lacuna em relação à perspectiva dos profissionais nesse mesmo contexto. Este estudo tem como objetivo compreender como as equipes de saúde mental significam o trabalho no cotidiano das internações psiquiátricas compulsórias, bem como compreender como esse trabalho se desenvolve, explorando tanto os desafios como os recursos usados pelas equipes profissionais para o desenvolvimento do cuidado nesse contexto. O corpus de análise foi constituído a partir de entrevistas semiestruturadas no formato de grupos focais e entrevistas individuais, que foram gravadas em áudio e, posteriormente, transcritas na íntegra. A análise envolveu a construção de eixos temáticos, para os quais se buscou compreender a diversidade de sentidos produzidos e possíveis implicações dos mesmos para a produção de práticas em saúde mental. Foram construídos cinco eixos temáticos: 1) IPC como tratamento; 2) Sentidos sobreo uso da IPC e suas implicações; 3) IPC, relações familiares e tratamento; 4) IPC e RAPS; e 5) Sugestões dos profissionais para contribuições no campo da saúde mental. Concluímos que não existem terapêuticas ou práticas distintas para paciente em IPC, mas que dificuldades para conceder alta aos pacientes, sobretudo em função da necessária relação com o judiciário, cria desafios e impõe limites terapêuticos para os pacientes e profissionais. A partir disso, discutimos a valorização das IPC em detrimento às alternativas de cuidado ambulatorial e comunitário, e de que forma isso se reflete na efetivação da Rede de atenção psicossocial. (Apoio financeiro: Capes). / In recent years, the issue of compulsory psychiatric hospitalizations, for example, those determined by judicial order, has been widely discussed, giving visibility to some tensions that run through this field. Among other things, discussions have been developed on topics such as freedom, autonomy and rights, and on a more specific level, the legitimacy and effectiveness of care in such cases. These tensions bring about some important challenges to mental health professionals, who need in their daily lives, to find creative answers to provide the proper care for the people who come to psychiatric services via compulsory admission processes. In the literature review we came across a few studies that discuss the compulsory treatment from the perspective of users, but we noticed a gap in relation to the perspective of professionals in this same context. This study aims to understand what kind of meaning mental health professionals make in the day to day work during compulsory psychiatric hospitalizations, as well as understand how this work develops, exploring both the challenges and the resources used by professional teams for the development of care in this context. The corpus analysis was made from semi-structured interviews in the form of focus groups and individual interviews, which were audio recorded and later fully transcribed. The analysis involved the construction of themes, for which it sought to understand the diversity of meanings produced and their possible implications in the production of mental health practices. Five themes were built: 1) Compulsory psychiatric hospitalizations as treatment; 2) Senses on the use of compulsory psychiatric hospitalizations and its implications; 3) Compulsory psychiatric hospitalizations, family relationships and treatment; 4) Compulsory psychiatric hospitalizations and Network of Psychosocial Attention; 5) The suggestions of the professionals for contributions in the field of mental health. We conclude that there are no therapeutic or different practices for patients in compulsory psychiatric hospitalization, however the difficulty to grant discharge to patients, mainly due to the necessary relation with the judiciary, creates challenges and imposes therapeutic limits for patients and professionals. Based on this, we discussed the valuation of Compulsory Psychiatric Hospitalization over the ambulatory and community care alternatives, and how this is reflected in the effectiveness of the Network of Psychosocial Attention. (Financial support: Capes).

This exploratory research study examines changes in food and foodways (food habits) among Arab migrant families in a small community in Tampa, Florida. It also explores how those families’ children may play a role in the process of change. Within this community, I conducted my research study at a private school, where I recruited families with children between the ages of eight and seventeen. In applying the ecological model of food and nutrition and the developmental niche theoretical framework, this research draws on qualitative methods, including structured interviews with parents; focus group discussion with parents; a food survey; and children’s focus groups that included engaging activities such as vignettes (role playing), free-listing and sorting, and one-day food menus. I used MAXQDA 18 software for qualitative data analysis, and the results show that the main factors aiding in post-migration food and foodways changes are time constraints (lifestyle), ingredients, and availability and accessibility of permissible food (halal). Parent did not mention their children as a main factor; however, they perceive influence of their children. Feeding practices such as rewarding, restriction, forcing, and family meals were emerging themes, and children express their agency around those practices. Children developed their own agency regarding food because of their social and physical environments. Older children perceived their influence on their families’ food and foodways by introducing food items to their own families.

Abstract This thesis set out to achieve the following objectives: (1) To identify the priorities and expectations that the Geelong community has of its public health care system. (2) To determine if there is a common view on the attributes of a just health system. (3) To consider a method of utilising the data in the determination of health care priority setting in Barwon Health. (4) To determine a model of community participation which enables ongoing input into the decision making processes of Barwon Health. The methodology involved a combination of qualitative and quantitative research. The qualitative work involved the use of focus groups that were conducted with 64 members of the Geelong community. The issues raised informed the development of the interview schedule that was the basis of the quantitative study, which surveyed a representative sample of 400 members of the Geelong community. Prior to reporting on this work, the areas of distributive justice, scarcity and community participation in health care were considered. The research found that timely access to public hospitals, emergency care and aged care services were the major priorities; for many people, the cost was less relevant than a quality service. Shorter waiting times and increased staffing levels were strongly supported. Increased taxes were nominated as the best means of financing the health system they sought. Community based services were less relevant than hospital services but health education was supported. An egalitarian approach to resource distribution was favoured although the community was prepared to discriminate in favour of younger people and against older people. There was strong support for the community to be involved in decision making in the public health care system through surveys or focus groups but very little support was given to priorities being determined by politicians, administrators and to a lesser extent, medical professionals.

<p>This thesis is about special needs educational competence of educators working in collaborating teams within child and youth habilitation centres. The pedagogy of the moment stands for the decisions made by educators, based on their observations made when meeting the child in its different environments. These decisions build on educational theoretical and practical knowledge and experience developed through collaboration within interprofessional teams. The study was carried out through the use of focus groups consisting of professionals within different child and youth habilitation centres. The data consists of taped and transcribed focus groups discussions. Participants provided additional information concerning, estimations of the focus group session, their education and use of special needs educational assignments through additional questionnaires. The analysis focuses on how the educators conceptualise their competence and the dialogue in the group conversation. To facilitate the interactional analysis, a constructional key for the conversation was developed.</p><p>The educators within child and youth habilitation centers have not developed specific professional strategies, but instead, appear to have adapted a mission through structural means. Their competence appears contextually adapted and devel-oped within three spheres of activities. Their basic education is in the area of pre-school with theoretical focus on children’s normal development, pedagogical experience of working with groups of children, play and learning. On the basis of this background, together with experiences with toy library activities for children with disabilities, they have become one of the corner stone of child and youth habilitation centres of the 1980’s. In these centers, by tradition a mainly medical sphere of activity, they work in teams with family orientated habilitation, and have developed compe-tence for special needs educational intervention for children with disabilities. Special needs education is a supplementary field, which includes educators who are being trained for municipal operation. The educators use professional speech genres with colloquial language terminology, which is adjusted to its communicative context. The educators and their colleagues in the teams emphasize the importance of the educator bridging the medical, treatment and pedagogical contexts, together with a focus on child, parents and staff, at home and in preschool/school. A communicational genre has developed within the occupational group, where the educators reinforce rather than question each other when taking turns during interprofessional conversations. The competence of the educator is based on knowledge and experience when it comes to children, their development, play and learning. The thesis demonstrates that the main focus of the supplementary education increasingly lies on the pedagogical meeting with adults, mostly parents, around specific child. The practical pedagogical work for the child, playing as intervention as well as the specific special needs educational intervention is less conceptualised by the educators. They are requesting relevant research and theories to support their field of knowledge.</p>

<p><strong>Bakgrund: </strong>Den största delen av den vuxna befolkningen befinner sig i arbetslivet och därför är arbetsplatsen en viktig arena i arbetet med att förbättra folkets hälsa. I verksamheters systematiska arbetsmiljöarbete finns verktyget medarbetarsamtal som syftar till att öka förståelsen för organisationens uppgift samt att ge medarbetaren ett större handlingsutrymme. <strong>Syfte: </strong>Att studera chefers och medarbetares upplevelser av hur arbetsmiljö och livsstilsfrågor diskuteras och behandlas i medarbetarsamtalet. <strong>Metod: </strong>Fyra fokusgrupper genomfördes med chefer och medarbetare från proAros olika verksamheter. <strong>Resultat: </strong>Mål, strategier, utveckling samt en enad riktning av verksamheten diskuterades som viktiga delar i medarbetarsamtalet. Tydligt ledarskap, stöd och uppmuntran, delaktighet, det egna ansvaret samt hur mål och krav är anpassade för den rådande situationen var faktorer som upplevdes påverka medarbetarsamtalet. Gällande arbetsmiljö diskuterades främst hur trivseln i arbetslaget var och hur samarbetet fungerade. Gällande livsstilsfrågor diskuterades friskvård, det egna ansvaret för sin hälsa samt balansen mellan arbetsliv och privatliv. <strong>Slutsats: </strong>Den fysiska arbetsmiljön är fortfarande av betydelse för de anställdas hälsa då proAros verksamheter till större delen består av människobehandlande yrken med påfrestande arbetsbelastningar. Frågan om att hitta balans är viktig för den arbetsrelaterade hälsan och bör därför göras mer medveten. Det promotiva hälsoarbetet bör därför integreras även i medarbetarsamtal.</p> / <p><strong>Background: </strong>The majority of the adult population is present in working life and the workplace is therefore an important setting in the efforts to improve public health. In the organizations’ day-to-day work to improve the work environment it is possible to use performance appraisal that aims to increase the understanding for the organization’s commissions and to increase the employees’ participation. <strong>Aim: </strong>To study directors and coworkers experiences about how work environment and lifestyle are discussed and managed during performance appraisal. <strong>Method: </strong>Four focus groups where performed with directors and co-workers from different units at proAros. <strong>Result: </strong>Objectives, strategies, development, and a united direction in the organization were discussed as important for performance appraisals. Leadership, support and encouragement, participation, the own responsibility and how objectives, demands are adjusted to the existing situation were factors that were experienced to influence performance appraisal. Concerning the work environment was the comfort in the team and how the cooperation worked the foremost subjects that were discussed. Concerning lifestyle were the organisation’s health work, the responsibility for your own health and the balance between working life and leisure time discussed. <strong>Conclusion: </strong>The physical work environment is still important for the employees’ health as the units of proAros to a great extent consist of human services with a high workload. The question of how to find a balance is important for the work related health and therefore should the awareness of it be enlarged. The health promoting work should therefore also be integrated in performance appraisals.</p>