Global ETD Search

1	Vård i rörelse : En kvalitativ intervjustudie om den mobila vården Teske, Christofer, Andreasson, Sara January 2019 (has links) Bakgrund: Vård i hemmet tycks bli allt mer nödvändigt när befolkningen blir allt äldre och det förordas i nationella utredningar om framtidens vårdorganisation. Det finns dock stora utmaningar med att förflytta vård av akut sjuka patienter från akutmottagningar till patienters hem. Syfte: Studiens syfte är att beskriva erfarenheter av den mobila vården. Metod: Semistrukturerade intervjuer genomförs med 12 personer med erfarenhet av mobil vård i Sverige, så som sjuksköterskor, läkare, tjänstemän och politiker. Kvalitativ latent innehållsanalys användes som analysmetod. Resultat: Studiens resultat redovisas utifrån ett tema “En holistisk vård given genom samverkan i patientens hemmiljö”, med tre huvudkategorier “gränslöst samarbete”, “resurser i närmiljö” och “helhetssyn av patienten”. Studiens resultat visade att samverkan är av stor vikt för fungerande mobil vård. Det behövs både organisatoriskt samarbete mellan olika vårdorganisationer och ett nära samarbete mellan de olika läkare och sjuksköterskor som har hand om samma patient för att de ska kunna ta ett gemensamt ansvar för patienten. Eftersom mobil vård främst används för äldre multisjuka behövs en helhetssyn på patienten, där mobil vård ger patienter och anhöriga en upplevelse av trygghet. Slutsats: Studien antyder att den mobila vården ses som en rörlig vård som kommer till den vårdsökande och inte tvärtom. Resurserna fördelas där de gör mest nytta, det vill säga närmast individen. Den mobila vården ses som ett komplement till den traditionella sjukhusvården. Det innebär ett annorlunda arbetssätt som kräver ett tätt samarbete mellan olika personalkategorier och organisationer, där det inte pratas om gränser utan om patientens behov och situation. / Introduction: Provision of mobile care at the home of patients appears to become necessary as the population becomes increasingly older. But there are challenges in moving acute care from hospitals to the home of patients. Aim: The aim of the study is to describe the experiences of the mobile care. Method: Semi structured interviews are conducted with 12 persons with experience of mobile care in Sweden, such as nurses, doctors, civil servants and politicians. Qualitative latent content analysis was used as an analysis method. Result: The study's result is presented on the basis of a theme "A holistic care given through collaboration in the patient's home environment", with three main categories "borderless cooperation" "resources in the immediate environment" and "holistic view of the patient". The results show that cooperation is of utmost importance to achieve functioning mobile care. Cooperation both on an interorganizational level and on a close teamwork level is required for all of the involved parties in mobile care to take on a joint responsibility for the patient. As mobile care is foremost provided to elderly multimorbid patients, a comprehensive view on patient care is required in which the patient and its relatives experience security. Conclusion: This study suggests that mobile care is seen as a moving care that comes to the seeking person and not the other way around. The resources are distributed where they make the most use, that is, closest to the individual. Mobile care is seen as a complement to the traditional hospital care. This means a different way of working that requires close collaboration between different categories of personnel and organizations, where it does not talk about boundaries but about the patient's needs and situation. Mobile care close care mobile team emergency care security patient safety organization collaboration patients Den mobila vården nära vård mobila team akutsjukvård trygghet patientsäkerhet organisation samverkan patienten Nursing Omvårdnad
2	Framgångsfaktorer för några centrala stödteam i arbetet med problematisk skolfrånvaro / Factors of success for some central support team in their work with problematic school absenteeism Pihl, Torbjörn January 2021 (has links) De centrala stödteamen som studerats i denna studie är ett komplement till den lagstadgade verksamheten i sina respektive kommuner i arbetet med elever som utmanar i skolan och /eller är i problematisk skolfrånvaro. De studerade teamen arbetar på uppdrag av socialförvaltningen, Barn och ungdomsförvaltningen eller en kombination av de båda. Studien är gjord med den grundade teorin som metod och med ett socialkonstruktionistiskt perspektiv då både metod och teori lyfter informanternas upplevelse av sin verklighet. Syftet med denna studie är att analysera de framgångsfaktorer men även hinder som några studerade centrala stödteam upplever i arbetet med elever i problematisk skolfrånvaro. Det som framkommer i studien är att de studerade stödteamens konstruktion och centrala styrning där genom att verka på alla skolor i en kommun gör det möjligt att använda sig av både de bemötanden och förutsättningar som presenteras i studiens resultat.De framgångsfaktorer som framkommit i studien som också är studiens main concern är uppdelade i två huvudgrupper. Den ena är Framgångsrika Bemötanden där några nyckelkategorier blivit centrala. Dessa nyckelkategorier är; Icke-dömande, Respekterande, Inlyssnande, Förstående, Icke kravsättande, Avlastande, Samarbetande, Samordnande samt Relationsskapande. De studerade teamen menar att det inte går att prioritera dessa kategorier, men att Icke-dömandet är en förutsättning för de övriga. Den andra huvudgruppen är Gynnsamma Förutsättningar. Denna huvudgrupp delas in i: Tid, Kompetens och erfarenhet, Likvärdighet, Upparbetade relationer, Intensivvarande samt organisation. I studien har också framkommit hinder i de studerade teamens verksamhet. Dessa framkommer i olika grad samt på olika sätt för de studerade teamen, men har sammanfattats i några faktorer; Sekretess, Bedömda/dömda pedagoger-ledning, Dömande personal, Komma in i “slutna hem” samt Ekonomi. Dessa hinder menar de studerade teamen kan bromsa upp effektiviteten i både tid och insats i ett ärende de verkar i. Den organisatoriska lösningen där både socialtjänst och skola samverkar är den konstellation som enligt de studerade stödteamen är den bästa och då i kombination med att det i teamet finns både lärare som kan tala skolans språk och även tala med skolan utan att upplevas okunnig eller oförstående. Detsamma gäller anledningen till att socialtjänsten är representerad med en socionom som kan möta socialtjänsten på samma sätt. / The central support team in this study are a complement to the ordinary work with students that is challenging the school or/ and are in problematic school absenteeism. The study uses the grounded theory as method and a social constructive perspective when both method and theory explain the informers experience of their own reality. Studien är gjord med den grundade teorin som metod och med ett socialkonstruktionistiskt perspektiv då både metod och teori lyfter informanternas upplevelse av sin verklighet. The teams that been studied are initiated by the social department, the school department and some by a mix of them both. The mix are de model that all teams meant was the most successful and best suited constellation with a teacher and a social worker, working together. The reason with this opinion is that the team in the study explains it with the credibility that teacher are better suited to talk with the school and the social worker are better suited to run the communication with the social services. The purpose with this study is to reveal the factors of success in some central support teams work with students in problematic school absenteeism, and also unveil the obstacles that the studied support team could meet in their work with these students. What the study shaws is that how the studied team were constructed with their professions and the fact that they are under a central control and not are tied to one separate school or area were the main factor that allows both the factors of success and the favourable prerequisite that is the two main concerns with this study to work.The factors of success that appeared in the study are represented by two main concerns, the first one is the Personal treatment meeting with people. Some key categories that construct this factor of success are None-judging, Respecting, In-listening, Understanding, Not demanding, to unburden, Cooperating, Coworking and Relation construction. The teams in the study point out that there is impossible to prioritize these categories, but the None-judging behaviour is the prerequisite for the others.The second main concern is the favourable prerequisite for the teams to work. This main consern is divided in; Time, competence and experience, comparability, already done relations, intensity being and organization. The team in the study have an agreement in that it is these categories that divide them from the ordinary work whit students in problematic school absenteeism in their municipalities and that is their strikingness that is the key to make the factors of success to work.In this study there also appeared some obstacles in the work for the teams. These obstacles appear in different grade and different ways for the team in the study, but are concluded in the key categories, Confidentiality, judged/ condemned school personnel, Judgemental personnel, to enter closed homes and economy. These categories the team in the study are factors that can inhibit their work and make it less efficient over time and in effort and also are results presented in the study. Central support team support team mobile team factors of success the student in focus the need of the student coworking Centrala stödteam stödteam mobila team framgångsfaktorer eleven i centrum elevens behov samverkan Pedagogical Work Pedagogiskt arbete
3	Health for community dwelling older people : trends, inequalities, needs and care in rural Vietnam Van Hoi, Le January 2011 (has links) Background InVietnam, the proportion of people aged 60 and above has increased rapidly in recent decades. The majority live in rural areas where socioeconomic status is more disadvantaged than in urban areas.Vietnam’s economic status is improving but disparities in income and living conditions are widening between groups and regions. A consistent and emerging danger of communicable diseases and an increase of non-communicable diseases exist concurrently. The emigration of young people and the impact of other socioeconomic changes leave more elderly on their own and with less family support. Introduction of user fees and development of a private sector improve the coverage and quality of health care but increase household health expenditures and inequalities in health care. Life expectancy at birth has increased, but not much is known about changes during old age. There is a lack of evidence, particularly in rural settings, about health-related quality of life (HRQoL) among older people within the context of socioeconomic changes and health-sector reform. Knowledge of long-term elderly care needs in the community and the relevant models are still limited. To provide evidence for developing new policies and models of care, this thesis aimed to assess general health status, health care needs, and perspectives on future health care options for community-dwelling older people. Methods An abridged life table was used to estimate cohort life expectancies at old age from longitudinal data collected by FilaBavi DSS during 1999-2006. This covered 7,668 people aged 60 and above with 43,272 person-years. A 2007 cross-sectional survey was conducted among people aged 60 and over living in 2,240 households that were randomly selected from the FilaBavi DSS. Interviews used a structured questionnaire to assess HRQoL, daily care needs, and willingness to use and to pay for models of care. Participant and household socioeconomic characteristics were extracted from the 2007 DSS re-census. Differences in life expectancy are examined by socioeconomic factors. The EQ-5D index is calculated based on the time trade-off tariff. Distributions of study subjects by study variables are described with 95% confidence intervals. Multivariate analyses are performed to identify socioeconomic determinants of HRQoL, need of support, ADL index, and willingness to use and pay for models of care. In addition, four focus group discussions with the elderly, their household members, and community association representatives were conducted to explore perspectives on the use of services by applying content analysis. Results Life expectancy at age 60 increased by approximately one year from 1999-2002 to 2003-2006, but tended to decrease in the most vulnerable groups. There is a wide gap in life expectancy by poverty status and living arrangement. The sex gap in life expectancy is consistent across all socioeconomic groups and is wider among the more disadvantaged populations. The EQ-5D index at old age is 0.876. Younger age groups, position as household head, working, literacy, and belonging to better wealth quintiles are determinants of higher HRQoL. Ageing has a primary influence on HRQoL that is mainly due to reduction in physical (rather than mental) functions. Being a household head and working at old age are advantageous for attaining better HRQoL in physical rather than psychological terms. Economic conditions affect HRQoL through sensory rather than physical functions. Long-term living conditions are more likely to affect HRQoL than short-term economic conditions. Dependence in instrumental or intellectual activities of daily living (ADLs) is more common than in basic ADLs. People who need complete help are fewer than those who need some help in almost all ADLs. Over two-fifths of people who needed help received enough support in all ADL dimensions. Children and grand-children are confirmed to be the main caregivers. Presence of chronic illness, age groups, sex, educational level, marital status, household membership, working status, household size, living arrangement, residential area, household wealth, and poverty status are determinants of the need for care. Use of mobile teams is the most requested service; the fewest respondents intend to use a nursing centre. Households expect to use services for their elderly to a greater extent than did the elderly themselves. Willingness to use services decreases when potential fees increase. The proportion of respondents who require free services is 2 to 3 times higher than those willing to pay full cost. Households are willing to pay more for day care and nursing centres than are the elderly. The elderly are more willing to pay for mobile teams than are their households. ADL index, age group, sex, literacy, marital status, living arrangement, head of household status, living area, working status, poverty and household wealth are factors related to willingness to use services. Conclusions There is a trend of increasing life expectancy at older ages in ruralVietnam. Inequalities in life expectancy exist between socioeconomic groups. HRQoL at old age is at a high level, but varies substantially according to socioeconomic factors. An unmet need of daily care for older people remains. Family is the main source of support for care. Need for care is in more demand among disadvantaged groups. Development of a social network for community-based long-term elderly care is needed. The network should focus on instrumental and intellectual ADLs rather than basic ADLs. Home-based care is more essential than institutionalized care. Community-based elderly care will be used and partly paid for if it is provided by the government or associations. The determinants of elderly health and care needs should be addressed by appropriate social and health policies with greater targeting of the poorest and most disadvantaged groups. Building capacity for health professionals and informal caregivers, as well as support for the most vulnerable elderly groups, is essential for providing and assessing the services. / Aging and Living Conditions Program / Vietnam-Sweden Collaborative Program in Health, SIDA/Sarec older people elderly health health status life expectancy health-related quality of life EQ-5D mobility self-care usual activities pain discomfort anxiety depression activity of daily living basic ADL instrumental ADL intellectual ADL non-communicable diseases need of care health service model of care mobile team day care centre nursing centre inequalities cost of care socioeconomic education marital status living arrangement household head working status living area wealth quintile poverty line community cohort study household survey focus group discussion qualitative research rural Vietnam developing country Asia người cao tuổi y tế thực trạng sức khỏe hy vọng sống chất lượng cuộc sống EQ-5D đi lại tự chăm sóc hoạt động thường xuyên đau khó chịu lo lắng trầm cảm hoạt động hàng ngày bệnh không lây nhiễm nhu cầu chăm sóc dịch vụ y tế mô hình chăm sóc đội lưu động trung tâm chăm sóc ban ngày trung tâm dưỡng lão bất bình đẳng chi phí chăm sóc kinh tế xã hội giáo dục hôn nhân sắp xếp cuộc sống chủ hộ tình trạng làm việc khu vực sống ngũ phân thịnh vượng chuẩn nghèo cộng đồng nghiên cứu theo dõi dọc điều tra hộ gia đình thảo luận nhóm tập trung nghiên cứu định tính nông thôn Việt Nam nước đang phát triển châu Á

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