Bakgrund: År 2010 infördes det fria vårdvalet i Sverige och därmed har även privata aktörer rätt att etablera sig som vårdgivare samt har också patienten rätt att själv välja mellan olika vårdgivare inom primärvården. Det övergripande målet inom primär- vården är att erbjuda vård på lika villkor för hela befolkningen och på så vis uppnå en god folkhälsa. Ett sätt att säkerställa att man som organisation arbetar i linje med sin strategi och når upp till de övergripande målen är att använda sig av prestations- mätningar och inom primärvården kan det bidra med en förbättring av effektiviteten med syftet att kunna erbjuda vård med en högre kvalitet till ett större antal patienter. Syfte: Syftet med uppsatsen är att skapa förståelse för hur privata vårdcentraler använder sig av prestationsmätningar för att nå upp till de övergripande målen om kvalitativ vård och samtidigt sina egna finansiella målsättningar samt hur de mäter och utvärderar resultaten av dessa mätningar. Metod: Uppsatsen är en intervjustudie där 11 verksamhetschefer från 11 olika privata vårdcentraler inom 6 olika regioner i Sverige inkluderas. Vidare har uppsatsen antagit en kvalitativ forskningsstrategi med semistrukturerade intervjuer. Slutsats: I uppsatsen identifieras ett antal steg som ingår i processen med att mäta och utvärdera prestationer, dessa är strategi, måtturval, mätning och utvärdering. Upplevelserna av huruvida mätningarna bidrar till kvalitativ vård skiljer sig dock åt beroende på i vilken utsträckning mätningar valts ut av respektive enhet. I frågan om finansiella målsättningar anses dock prestationsmätningar vara ett viktigt verktyg. / Background: In 2010, free choice of healthcare provider was introduced in Sweden, which means that private actors also have the right to establish themselves as health- care providers and patients have the right to choose between different healthcare providers within primary care. The overall goal within primary care is to offer healthcare on equal terms for the entire population and thereby achieve good public health. One way to ensure that an organization is working in line with its strategy and achieving its overall goals is to use performance measurements, and within primary care, this can contribute to improving efficiency with the aim of providing higher quality care to a larger number of patients. Purpose: The purpose of this essay is to create an understanding of how private healthcare providers use performance measurements to achieve the overall goals of providing high-quality care while also meeting their own financial objectives, as well as how they measure and evaluate the results of these measurements. Method: The essay is an interview study that includes 11 managers from 11 different private healthcare providers in 6 different regions in Sweden. Furthermore, the essay has adopted a qualitative research strategy using semi-structured interviews. Conclusion: The essay identifies a number of steps involved in the process of measuring and evaluating performance, which include strategy, metric selection, measurement, and evaluation. However, experiences of whether the measurements contribute to high-quality care differ depending on the extent to which metrics are chosen by each unit. In the question of financial objectives, however, performance measurements are considered an important tool.

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The study was conducted with the aim of assessing the Saudi Arabian cultural knowledge among the non-Muslim nurses. These nurses work in the obstetric units at the King Faisal Specialist Hospital and Research Centre, Jeddah and come from different cultural groups and are caring for the Saudi Arabian Muslim women. In order for care to be congruent, comprehensive and of a high quality, the patients' needs should be met at the best attainable level. Nurses in all health care settings are expected to demonstrate knowledge of the culture that they serve in order to eliminate barriers. Data analysis was facilitated with the use of the SPSS 11.5 computer program. The study findings may suggest the development of educational guidelines, which will direct the activities of an educational intervention. / Health Studies / M.A. (Health Studies))

This study investigated access and use of information in the health-care of home-based elderly people (EPs) in Nakuru District, Kenya. The literature review revealed a gap with respect to information behaviour in health-care of EPs in a development context. The researcher used qualitative methods; with exploratory and descriptive research design because the focus of the study was on the littleknown and socially disadvantaged community of EPs in Nakuru District. Respondents were sampled by using the snowball technique. At the end of an interview session, each respondent was encouraged to nominate someone who either shared the same or had different experiences, views, socio-economic levels and gender. The researcher collected data through face-to-face interviews with EPs, informal care providers (ICPs) and formal health-care providers (FHCPs), in order to gain insight of information behaviour in health-care of EPs, by focusing on aspects of information needs; sources; use of information and factors that influence the respective groups of respondents to access and use health-care information health-care of EPs. The findings showed that the respective groups of respondents had similar as well as diversified needs for information for health-care. The groups used both formal and informal sources of information and channels of communication to access information for health-care, with FHCPs using authoritative sources more than the EPs and ICPs. Factors such as being a professional or a lay person, cost, ease of accessibility, availability of sources and channels of communication, time and trustworthiness of a source or channel of communication determined preference for use of information. The major contribution of the study is to the theory about information behaviour: some EPs and ICPs used CAM services without informing FHCPs, thereby revealing a form of concealed information use behaviour (CIUB). / Information Science / D. Litt. et Phil. (Information Science)

This study aimed to provide evidence on knowledge of attitudes toward standard precautions (SPs) and its practice of Healthcare Workers (HCWs) in government and private hospitals in Botswana. It utilised descriptive cross-sectional methodology. A range of significant findings were revealed. Good practice of SPs was noted more amongst the HCWs in government than in private hospitals. Knowledge of SPs amongst HCWs in government hospital was significantly and positively correlated to good practice of SPs. Registered Nurses (RNs) had better knowledge of SPs than HealthcareAssistants (HCAs).There was no significant difference between RNs and HCAs practice of SPS and attitudes toward the same. No significant difference in the knowledge, attitudes and practice of SPs was noted between General Practitioners (GPs) and RNs. No significant difference in the knowledge, attitudes and practice of SPs was observed between GPs and HCAs. The study findings have implications for the application of SPs in practice / Health Studies / M.A. (Public Health)

This study used narrative inquiry to answer the question “What are the stories of older adults who choose not to share information with health care professionals?” The study explored the experiences of older adults who did not share information with health care professionals (HCPs), who they defined as doctors. A thematic analysis of five participants’ stories revealed three themes: Illusions of Care, describing the participants’ experiences with doctors before they chose not to share information; The Last Straw, revealing the final incident that caused participants to choose not to share information; and The Mask of the Non-sharing Older Adult, describing how participants interacted with their doctors after they decided not to share information. Relationship development between older adults and their doctors, sensitive topics, issues and perceptions of ageing, and structure of the health care system contribute to the complex issue of older adults not sharing information. The decision not to share information with health care professionals may adversely affect the health and health care of older adults.

This study used narrative inquiry to answer the question “What are the stories of older adults who choose not to share information with health care professionals?” The study explored the experiences of older adults who did not share information with health care professionals (HCPs), who they defined as doctors. A thematic analysis of five participants’ stories revealed three themes: Illusions of Care, describing the participants’ experiences with doctors before they chose not to share information; The Last Straw, revealing the final incident that caused participants to choose not to share information; and The Mask of the Non-sharing Older Adult, describing how participants interacted with their doctors after they decided not to share information. Relationship development between older adults and their doctors, sensitive topics, issues and perceptions of ageing, and structure of the health care system contribute to the complex issue of older adults not sharing information. The decision not to share information with health care professionals may adversely affect the health and health care of older adults.

The study was conducted with the aim of assessing the Saudi Arabian cultural knowledge among the non-Muslim nurses. These nurses work in the obstetric units at the King Faisal Specialist Hospital and Research Centre, Jeddah and come from different cultural groups and are caring for the Saudi Arabian Muslim women. In order for care to be congruent, comprehensive and of a high quality, the patients' needs should be met at the best attainable level. Nurses in all health care settings are expected to demonstrate knowledge of the culture that they serve in order to eliminate barriers. Data analysis was facilitated with the use of the SPSS 11.5 computer program. The study findings may suggest the development of educational guidelines, which will direct the activities of an educational intervention. / Health Studies / M.A. (Health Studies))

This study investigated access and use of information in the health-care of home-based elderly people (EPs) in Nakuru District, Kenya. The literature review revealed a gap with respect to information behaviour in health-care of EPs in a development context. The researcher used qualitative methods; with exploratory and descriptive research design because the focus of the study was on the littleknown and socially disadvantaged community of EPs in Nakuru District. Respondents were sampled by using the snowball technique. At the end of an interview session, each respondent was encouraged to nominate someone who either shared the same or had different experiences, views, socio-economic levels and gender. The researcher collected data through face-to-face interviews with EPs, informal care providers (ICPs) and formal health-care providers (FHCPs), in order to gain insight of information behaviour in health-care of EPs, by focusing on aspects of information needs; sources; use of information and factors that influence the respective groups of respondents to access and use health-care information health-care of EPs. The findings showed that the respective groups of respondents had similar as well as diversified needs for information for health-care. The groups used both formal and informal sources of information and channels of communication to access information for health-care, with FHCPs using authoritative sources more than the EPs and ICPs. Factors such as being a professional or a lay person, cost, ease of accessibility, availability of sources and channels of communication, time and trustworthiness of a source or channel of communication determined preference for use of information. The major contribution of the study is to the theory about information behaviour: some EPs and ICPs used CAM services without informing FHCPs, thereby revealing a form of concealed information use behaviour (CIUB). / Information Science / D. Litt. et Phil. (Information Science)

This study aimed to provide evidence on knowledge of attitudes toward standard precautions (SPs) and its practice of Healthcare Workers (HCWs) in government and private hospitals in Botswana. It utilised descriptive cross-sectional methodology. A range of significant findings were revealed. Good practice of SPs was noted more amongst the HCWs in government than in private hospitals. Knowledge of SPs amongst HCWs in government hospital was significantly and positively correlated to good practice of SPs. Registered Nurses (RNs) had better knowledge of SPs than HealthcareAssistants (HCAs).There was no significant difference between RNs and HCAs practice of SPS and attitudes toward the same. No significant difference in the knowledge, attitudes and practice of SPs was noted between General Practitioners (GPs) and RNs. No significant difference in the knowledge, attitudes and practice of SPs was observed between GPs and HCAs. The study findings have implications for the application of SPs in practice / Health Studies / M.A. (Public Health)