<p>During the past twenty years the immigration to Sweden has changed significantly. Earlier immigration mainly focused at filling the vacancies in the Swedish industry, today immigrants primarily come to Sweden as Refugees. This change of immigration combined with the restructuring of the Swedish industrial sector has resulted in great a deterioration of the chances for immigrants to gain entry to the Swedish labor market.</p><p>This study aims at examining how the cooperation between authorities in the municipal of Hörby in Sweden fosters integration. The study primarily examines how the cooperation between authorities in a integration project can contribute to a better integration to the labor market.</p><p>Through a qualitative study, five persons who occupy important roles in the project have been interviewed. The results of these interviews have been complemented by internal documents as well as extern material to validate the results.</p><p>The most important findings that have been revealed are the importance of language in the process of gaining entrance to the Swedish labor market. Subsequently the education of immigrants receives criticism and the importance of a new and more effective as well as more time saving education for immigrants are being stressed.</p>

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Archivists have made considerable efforts in recent decades to address the challenge of making archival records more useful. They have attracted new researchers by using various methods: from launching books and exhibits, handing out brochures, and sending press releases, to hosting lectures and, more recently in the digital age, launching websites and blogs, digitizing records, and posting archival records on websites like Flickr. However, these methods amount to a scattered approach that seeks out a variety of new users -- often in the wider society -- while the majority of potential users, often connected to an archives’ own sponsoring institution, still too rarely take advantage of the archives at their doorstep. These people may have never used an archives and likely think they do not need to do so. This thesis addresses the issue of how, in effect, to create users of archives among this group by a more direct approach to them than the typically scattered and more general one. The study of such efforts by archives is the study of archival public programming. Although current public programming efforts at university archives do bring in new users from the campus community, a more targeted approach might address this concern by attracting far more of them. Particularly on university campuses most students, faculty, support staff, retired professors, and administration do not make use of and may even be unaware of the campus archives. Archives on university campuses are repeatedly challenged to prove their usefulness in order to warrant continued funding from campus administration. I argue that this thesis offers university archivists (and other archivists) a tool with which to work to raise statistics of new users in order to satisfy university administrative metrics for sustainability. This thesis will test this approach through a case study of eleven University of Manitoba Faculty of Arts professors who have not used archives much or at all. Academics are often looking for new sources for their research. By understanding the usefulness of archives to their work, they may discover a vast new source of information in a variety of local, national, and foreign repositories and become more comfortable in navigating archives. The thesis will also discuss any weaknesses discovered in the testing of the approach and suggest improvements. In addition, it will discuss how such an approach might be phased in to archival work at a university archives such as the University of Manitoba's Archives & Special Collections as a feature of day-to-day work, rather than a one-time exercise.

Archivists have made considerable efforts in recent decades to address the challenge of making archival records more useful. They have attracted new researchers by using various methods: from launching books and exhibits, handing out brochures, and sending press releases, to hosting lectures and, more recently in the digital age, launching websites and blogs, digitizing records, and posting archival records on websites like Flickr. However, these methods amount to a scattered approach that seeks out a variety of new users -- often in the wider society -- while the majority of potential users, often connected to an archives’ own sponsoring institution, still too rarely take advantage of the archives at their doorstep. These people may have never used an archives and likely think they do not need to do so. This thesis addresses the issue of how, in effect, to create users of archives among this group by a more direct approach to them than the typically scattered and more general one. The study of such efforts by archives is the study of archival public programming. Although current public programming efforts at university archives do bring in new users from the campus community, a more targeted approach might address this concern by attracting far more of them. Particularly on university campuses most students, faculty, support staff, retired professors, and administration do not make use of and may even be unaware of the campus archives. Archives on university campuses are repeatedly challenged to prove their usefulness in order to warrant continued funding from campus administration. I argue that this thesis offers university archivists (and other archivists) a tool with which to work to raise statistics of new users in order to satisfy university administrative metrics for sustainability. This thesis will test this approach through a case study of eleven University of Manitoba Faculty of Arts professors who have not used archives much or at all. Academics are often looking for new sources for their research. By understanding the usefulness of archives to their work, they may discover a vast new source of information in a variety of local, national, and foreign repositories and become more comfortable in navigating archives. The thesis will also discuss any weaknesses discovered in the testing of the approach and suggest improvements. In addition, it will discuss how such an approach might be phased in to archival work at a university archives such as the University of Manitoba's Archives & Special Collections as a feature of day-to-day work, rather than a one-time exercise.

Background: Healthcare associated infection (HCAI) is a global issue and one of the most frequent adverse events in healthcare. HCAI is a major burden for patients’ and leads to added pain and higher cost for the society. The most important measure to prevent the transmission of HCAI is hand hygiene. In developing countries can insufficient equipment and supplies, lack of financial support and understaffed hospital units have a negative effect for the patients safety and makes it difficult to reduce HCAI. Aim: The aim of the study was to get knowledge about Kenyan nurses’ experiences of healthcare-associated infections. Method: The author used a qualitative method. Individual semi-structured interviews were made with four nurses at a government financial hospital in Eldoret, Kenya. The interviews were analyzed with a manifest analysis. Result: The analysis of the transcribed text made five categories, Education for healthcare workers, students and patients, Lack of equipment and supplies, The issues with crosscontamination, Prevention of HCAI and Understaffed hospital. The results were discussed with Dorothea Orem’s Self-care Theory with a focus on the Theory of Nursing system and other studies relating to the results. Conclusion: Knowledge about HCAI is one of the first steps to be able to reduce infections. Cross-contamination is the main risk factor for HCAI and multiple interventions are an effective strategy to successfully increase hand hygiene.

Bakgrund Världshälsoorganisationen (WHO) klassar våld i nära relationer som ett folkhälsoproblem. Även om både män och kvinnor är utsatta så är det främst kvinnor som utsätts för den här typen av våld och enligt Nationellt centrum för kvinnofrid (NCK) är kvinnor nästan tre gånger mer utsatta än män. Hälso- och sjukvården behöver utveckla sitt arbete för att upptäcka våldsutsatta patienter men det finns begränsad forskning om hur fysioterapeuter arbetar med detta ämne. Syfte Att utforska fysioterapeuters upplevelser och erfarenheter av att möta kvinnor som blivit utsatta för våld i nära relation. Metod I studien användes en kvalitativ design med en semistrukturerad intervjuguide. Sex fysioterapeuter, som samtliga arbetade på antingen privat eller offentlig vårdcentral inom primärvården i Region Uppsala, intervjuades. Resultat Deltagarnas erfarenheter varierade i stor grad. Ingen av deltagarna ställde frågan om våldsutsatthet som en standardiserad fråga vid nybesök. Tvärtom uttryckte flera att de upplevde sig behöva skapa en relation med patienten innan de kunde ställa frågan. Deltagarna tog till olika åtgärder vid våldsutsatthet, framförallt hänvisade de vidare till kurator och/eller gav vidare information om kvinnofridslinjen. Samtliga upplevde ett behov av djupare kunskap och förståelse om ämnet. Konklusion Mer praktisk och teoretisk kunskap samt medvetenhet hos fysioterapeuter behövs för att de ska kunna arbeta mer effektivt med kvinnor som utsätts för våld i nära relation. / Background The World Health Organization (WHO) classifies intimate partner violence as a global health problem. Even if both men and women are affected, data from National Centre for Knowledge on Men’s Violence against Women (NCK) shows that almost three times more women than men have been affected. The Swedish health care needs to improve on how they work on finding these patients but there is little research of how physiotherapists work regarding this matter. Objective To explore how physiotherapists investigate and examine female patients who are or have been a victim of intimate partner violence. Methods This survey used a qualitative method with a semi structured interview guide. Six interviews were carried through with physiotherapists who worked in Uppsala’s primary care, either in public or private health centers. Results The survey showed various experiences within the partakers. None of the physiotherapists asked about intimate partner violence as a standardized question at all new visits. On the contrary, several informants expressed that they felt a need to create a relationship with the patients before asking such questions. The physiotherapist took different actions when detecting intimate partner violence; mainly referring the patients to a curator and/or giving information of the women’s peace line. All partakers felt the need of a deeper knowledge and understanding of this issue. Conclusion Physiotherapists need more awareness as well as practical and theoretical knowledge to be able to work more efficiently with women that are affected by intimate partner violence.

Background: Diabetes mellitus is increasing rapidly and will be one of the future leading causesof death globally. Diabetes mellitus type 2 (DMT2) is the most common type of diabetes and is a chronic and lifelong illness that can affect people of all ages. The disease causes suffering and affects the patient's quality of life. Ability to self-care is very important to avoid complications associated with the illness. Aim: The aim of this study was to illuminate patient´s experience of living with DMT2 Method: A literature-based study consisting of twelve articles based on qualitative research was conducted and analyzed with the help of the five-stage model of Friberg. Results: The result show that people`s experiences of living with type 2 diabetes are initially about being a disease where emotional emotions dominated and where health care and the support of relatives was important. The experiences were also about managing one´s self-care with the impact of diet, creating activity in everyday life and dealing with one´s treatment. They tried to find a new identity through acceptance, living with limitations in everyday life and a concern for the future.  Conclusion: The results show that the experiences of living with diabetes type 2 varies from person to person and every person have to live with challenges like lifestyle change. A diabetic needs help, motivation, understanding, instruction and support from health professionals as well as family and friends to manage the illness, improve their well-being, overcome and deal with the challenges. / Diabetes är en sjukdom som ökar i omfattning och drabbar många människor. Den är en av den främsta dödsorsaken i världen. Diabetes typ 2 är den vanligaste typen och räknas som en livslång och kronisk sjukdom. Hos drabbade kontrolleras sjukdomen för att öka möjligheten till välbefinnande, hälsa samt att undvika komplikationer. Studien syfte var att belysa personensupplevelse av att leva med diabetes typ 2. Den är litteraturbaserad och inkluderar tolv vetenskapliga artiklar som analyserades. Resultatet visade tre huvudteman och nio subteman. Studien belyser hur personer med diabetes typ 2 upplever att leva med sjukdomen och dess behandling. Det visade sig skillnad mellan upplevelse hos diabetiker inom olika kulturer och härkomst. Personer som kommer från länder med stark kulturell integritet upplevde svårigheter att hantera diabeteskosten. Deras traditioner var stark kopplad till matvanor som gjorde att kostförändringar visade sig svåra att genomföra. Det innebär en upplevelse av utanförskap när det gäller umgänge, firande med släkt och vänner. Dessutom framkom det att dessa personer upplevde fysisk aktivitet så som oviktig att genomföra, medan medicinsk behandling ansågs som mer betydelsefull. Personer med diabetes typ 2 från västvärlden upplevde fysisk aktivitet som positivt och värdefullt. Flertalet kvinnliga diabetiker oavsett härkomst upplevde livsförändringarna som krävande. Dels att ständigt behöva anpassa matlagning och att vara begränsade när det gäller kosten i övrigt. Kvinnliga diabetiker upplevde dessutom att familjelivet blev försämrat efter diagnosen och att de saknade stöd och uppmuntran från sina närmaste. Desto längre tid som diabetiker levde med sjukdomen desto mer ökade förståelsen kring sjukdomen. Det innebar ökad förmåga att hanterade sin hälsa på ett adekvat sätt och en lägre stress kring sjukdomen och behandling.  Resultat visade att upplevelse av att leva med diabetes typ 2 varierar hos individer. För att diabetiker ska kunna bibehålla sin hälsa måste de genomföra livsstilsförändringar. Dessa förändringar medför stora utmaningar. Det behövs kunskap, acceptans och vårdens vägledning för att individer med diabetes typ 2 ska kunna uppnå sina mål. En diabetiker behöver också uppmuntran och förståelse från sin familj och vänner för att kunna hantera sin sjukdom, förbättra välbefinnande men också att övervinna och hantera utmaningarna.

Background: Eating disorders as term includes several diagnoses that often result in serious conditions related to eating-habits, weight and body image. Early detection, confirmed diagnosis and initiated treatment significantly increases the chance of recovery. There is a lack of knowledge regarding how physiotherapists identify and treat eating disorders in primary care.  Objective: To examine the physiotherapists’ experiences of identifying and treating eating disorders as well as problems related to them, within primary care.  Methods: A qualitative method with semi structured interviews with five participants, based on convenience sampling was used. Qualitative content analysis was used for data analysis.  Results: This study showed experienced difficulty in both identifying and treating eating disorders among physiotherapists. They pointed out that it was important to have an awareness about the diagnoses, and that plenty of different factors can complicate the process of identifying them. They also experienced an uncertainness regarding the role of the physiotherapist. Treatment was described to be individualized and applied with a biopsychosocial approach.  Conclusion: Eating disorders and problems related to them were experienced as complicated and hard to treat. This study shows an uncertainness regarding the role of the physiotherapist when it comes to these patients. Previous research indicates that physiotherapeutic methods could have a positive effect as a part of the treatment. However, further research and knowledge are needed to establish the utility of physiotherapy when it comes to eating disorders in primary care. / Bakgrund: Begreppet ätstörningar inkluderar ett flertal diagnoser och tillstånd som ofta leder till allvarliga tillstånd kopplade till ätbeteende, vikt och kroppsuppfattning. Tidig upptäckt, ställd diagnos och påbörjad behandling ökar chansen för tillfrisknande hos drabbade individer. Det finns en tydlig kunskapslucka i hur fysioterapeuter upptäcker och behandlar ätstörningar inom primärvården.  Syfte: Att undersöka fysioterapeuters upplevelser och erfarenheter av att upptäcka och behandla ätstörningar samt problem relaterade till dessa inom primärvården.  Metod: I studien användes kvalitativ design i form av semistrukturerade intervjuer med fem deltagare utifrån ett bekvämlighetsurval. Databearbetning utfördes genom kvalitativ innehållsanalys.  Resultat: Studien visade att fysioterapeuter upplevde att det var svårt att upptäcka och behandla ätstörningar. De påpekade att det var viktigt att ha en medvetenhet om sjukdomarnas existens och att många olika faktorer kan försvåra identifieringen. De upplevde också en oklarhet i om fysioterapeuten bör ha en aktiv roll i efterföljande behandling. Gällande behandlingen fanns uppfattningen att den bör individanpassas och tillämpas med ett bio- psyko-socialt synsätt.  Slutsats: Ätstörningar och problem relaterade till dessa upplevs i många fall komplicerade och svårbehandlade. Studien visar på en osäkerhet i vilken roll fysioterapeuten bör ta vid mötet av dessa patienter. Tidigare forskning tyder på att fysioterapeutiska åtgärder kan ha en positiv inverkan på behandlingen. Ytterligare forskning och kunskap behövs dock för att tydliggöra fysioterapeutens roll och kompetens gällande ätstörningar inom primärvården.

Telefonrådgivning till föräldrar med sjuka barn är en stor del av arbetet inom primärvård och sjukvårdsrådgivning. Telefonsjuksköterskor ställs inför många utmaningar i samtalen med föräldrar. Syftet med den här studien var att belysa telefonsjuksköterskors erfarenheter av telefonrådgivning till föräldrar med sjuka barn. Datainsamlingen gjordes genom kvalitativa forskningsintervjuer och analyserades med innehållsanalys. I resultatet framkom tre kategorier; att skapa ett samtal, att bedöma och prioritera barn samt att möta vårdsökande föräldrar. Telefonsjuksköterskor hade erfarenhet av olika svårigheter med att göra en bedömning av barnets hälsotillstånd via telefonen. En stor del av samtalen ägnades åt att bemöta oro och skapa trygghet. Till hjälp i bedömningen fanns ett datoriserat bedömningsstöd men också ett kollegialt stöd. Telefonsjuksköterskans uppgift handlade till stor del om att förmedla kunskap till föräldrarna och det upplevdes viktigt att i samtalen uppnå samförstånd. Telefonsjuksköterskor hade erfarenhet av att möta föräldrar i olika sammanhang såsom föräldrar med annan kulturell bakgrund och särboende för-äldrar. Föräldrar sökte gärna information på internet. Telefonsjuksköterskor ställdes inför många ut-maningar men upplevde ändå sitt arbete som tillfredsställande. Det behövs handledning och fördjupad utbildning med inriktning på telefonrådgivning då det är nödvändigt med en bred och god kompetens för att på ett bra sätt utföra uppdraget som telefonsjuksköterska. / Telephone consulting for parents with sick children is a large part of health consulting. Telephone nurses faces many challenges in the calls with parents. The purpose of this study was to illustrate the experiences of telephone consulting to parents with sick children. Qualitative research interviews were made and analyzed through content analysis. The result is presented in three categories; to create a conversation, to assess and prioritize children and to meet care-seeking parents. Telephone nurses experienced many difficulties in the assessment of a sick child’s state of health. A large part of the conversations were spent addressing concerns and provide security. A digital appraisal system was available as well as collegial support. A major part of the conversation was to conveying knowledge and achieving consensus was perceived as vital. Telephone nurses met parents in various situations such as parents with a different cultural and ethnic background as well as parents who were living apart. Parents today are seeking information on the internet. Telephone nurses are facing many difficult challenges but are still perceiving their work as satisfying. There is a need for further education focusing on telephone consulting as wide and deep competence is essential in order to be able to perform telephone consulting.

Bakgrund    Enligt Sveriges Kommuner och Landsting så ska vårdpersonal inom regioner, kommuner och landsting arbeta för införandet av personcentrerad vård (PCV) som arbetssätt. PCV har tre grundpelare: partnerskap, patientberättelse samt dokumentation. Vårda i samråd med personen som behöver vård är grunden i hela den personcentrerade vården. Syfte                                   Syftet med studien var att beskriva sjuksköterskans tillämpning av personcentrerad vård inom den kommunala hemsjukvården i vården av personer 65 år och äldre. Metod                                 Studien har en beskrivande design med kvalitativ ansats. Huvudresultat                   Ingen av de inkluderade kommunerna tillämpade PCV fullt ut idag. De förutsättningar för en god PCV som sjuksköterskorna beskrev var att de arbetade för att ha personen i fokus. De försökte också skapa en relation till personen och dess anhöriga genom kontinuitet, partnerskap och patientens levnadsberättelse. Hinder för att kunna tillämpa PCV var brist på organisatorisk ledning gällande PCV, bristande kontinuitet, tidsbrist och orealistiska önskemål från personen samt kunskapsbrist om PCV.   Slutsats                              Sjuksköterskorna saknar kunskap om vad PCV innebär inom kommunal hemsjukvård och hur PCV skall tillämpas i det dagliga vårdarbetet. Studien visade på att det är ledningen som präglar vilken vård som ges till dem som vårdades. En ledning som guidar, stöttar och ger förutsättningar till sina sjuksköterskor för att de skall kunna tillämpa PCV är den största förutsättningen för att PCV skall kunna implementeras inom den kommunala hemsjukvården. Det borde vara en rättighet för alla som vårdas att få PCV. / Background                  According to the Swedish Association of Local Authorities and Regions should all healthcare professionals within the regions, municipalities and county council work for an introduction of person-centered care (PCC). PCC has three fundamental pillars: partnership, the patient´s story and documentation. Healthcare should be in agreement with the person needing care, it´s the foundation of PCC. Objective                      The objective of the study was to describe the nurse's application of person-centered care in the municipal home healthcare in the care of people aged 65 years and older. Method                              The study has a descriptive design with a qualitative approach. Main results                      The results showed that none of the participating municipalities applied PCC to full extend currently in daily work. The nurses described good conditions for PCC like having focus on the person. The nurses also tried to create a relationship with the patient and their relatives, through continuity, partnership and patient´s life story. The study identified obstacles in the application of PCC like lack of organizational management, continuity and time, unrealistic requests of care from the person and knowledge deficit regarding PCC. Conclusion                         The nurses within municipal home healthcare lacked knowledge regarding PCC and how to apply PCC in daily work. The study showed that it is the management who characterizes the care given. In the application of PCC a necessity is a management who guides, supports and offers relevant conditions for PCC to the nurses. It should be a right for all people receiving care to obtain PCC.