A dramatic and historic evolution has occurred as mental health care has shifted from institutional-based care to community-based care. Framed by the social exchange theory, the purpose of this study was to identify the correlation of the leadership style of supervisors in residential care facilities with the organizational citizenship behavior of the residential care workers. The research questions focused on the correlation between the leadership styles and organizational citizenship behavior (OCB) with a secondary focus specifically on transformational leadership. Residential care workers in 3 states working in 65 facilities within a single organization completed 2 surveys: the Multifactor Leadership Questionnaire and the Organizational Citizenship Behavior Checklist. Forty-nine completed surveys were returned. The transactional leadership style was correlated to OCB in 2 defining subfactors: contingency reward r(42)=.424, p < .001 and management by exception/active r(42)=.417, p <.001. The transformational leadership style was correlated to OCB in 4 defining subfactors: idealized behaviors r(42)=.388, p <.001, instrumental motivation r(42)=.417, p <.001, idealized influence r(42)=.395, p <.001, and individual consideration r(42)=.371, p <.005. These findings have not been previously reported in mental health residential care settings. The generalizability of this study is limited by sample size and scope, because the employees come from facilities within a single corporate organization. Residential care is part of the overall positive social change in care of the mentally ill, by offering the mentally ill the opportunity of an enhanced, community-based life. This study begins the process of ensuring that sufficient evidence-based knowledge and scholarly practitioners are available to lead work that benefits this vulnerable population; additional study is recommended.

Uppsatsen handlar om tre verksamhetschefers och en behandlingsassistents uppfattningar om hur ungdomar som vistas på Hem för vård och boende (HVB)- eller Statens Institutionsstyrelse –hem (SiS, som kan använda låsbara avdelningar), påverkas av de omplaceringar som sker när ungdomen flyttar från SiS till HVB. I den här studien fokuserar vi på en specifik del i behandlingen, som kan påverka ungdomar som är vårdplacerade – omplaceringar mellan vårdboenden. Vi undersöker bland annat hur dessa omplaceringar går till/skulle kunna gå till, samt vilka anledningar som kan tänkas vara bakgrunden till att en ungdom omplaceras. Som underlag för vår studie har vi utöver litteratur och forskning inom området, genomfört fyra intervjuer med personal från HVB och SiS boenden. Vi använder anknytningsteorin och Sense of coherence modellen som teoretisk referensram. Resultatet visar att det finns brister gällande omplaceringar. Samtliga informanter önskade mer tid till förberedelserna i arbetet med ungdomen som ska flytta in. Ett önskemål vore att det från beslut till inflyttning skulle ta 3-6 månader, då det ger möjlighet för personalen på det nya boendet att besöka ungdomen och börja knyta band redan innan flytten ska genomföras. Slutsatsen blir att omplaceringen spelar roll för ungdomens behandling och vistelse på boendet. Samtidigt är det oroväckande att det saknas tydliga riktlinjer för hur dessa omplaceringar ska ske. Om mer resurser och tydligare riktlinjer kring omplaceringar gavs, kan det minska det antal omplaceringar där ungdomen tvingas flytta tillbaka till SiS. Idag får ungefär var fjärde ungdom flytta tillbaka igen. / This paper investigates the perspective of managers' and processing staffs concerning young people living on a Home for care or living(HVB)- or Institutional board of the states- home (SiS - they can use lockable departments), and how they think youths are affected by the transfer between SiS and HVB. This study focus on factors that can affect young people's health - replacing youths between different nursing homes. The paper investigates how these replacements are performed/could be performed, as well as the underlying factors that might explain why a youth is being relocated. As a basis for our study, in addition to the literature and research in the field, we have conducted four interviews with personnel from HVB- and SiS- accommodations. We use the attachment theory and the Sense of coherence theory as a theoretical frame. The results show that there are shortcomings in the process of redeployment. All informants wanted more time to prepare the work of a youth who is about to move. A proposal from the informants, was that the process from decision to the actual moving should take between 3-6 months. This would give the staff in the new accommodation a chance to visit the youth and begin to build ties, before the move is implemented. The conclusion is that the transfer has an important role in the treatment and the stay of the youth. At the same time, it is of great concern that there are no clear guidelines for how these replacements should be performed. If there would be more resources and clearer guidelines for how redeployments should be handled, it might perhaps reduce the number of shifts where young people are moving back to SiS. Today approximately one of four youth needs to move back.

This study aims to explore Scottish and Korean carers‘ attitudes towards the diagnosis of dementia in their relative, family care, community care and to residential care in Scotland and Korea respectively, also under examination was the origin of different carers‘ attitudes between Scotland and Korea. The dominant argument between previous Western and Eastern comparative studies on attitudes, has been that culture made the difference. In other words, the cultural factor was recognised as a main determinant of attitudes towards a diagnosis of dementia, towards social services at home and residential care in Asian societies, including Korea. This thesis starts with the question: Does culture really explain the phenomenon of Asian people‘s attitudes towards dementia? Indeed the tradition of filial piety has been changing and now seems to be rather weak in modern Asian society. In particular, contemporary Korea is modernised and westernised, as a result, many older people live apart from their adult children and their nuclear families. This study asserts that Confucianism is a much less significant factor than differences in social policy. In other words, this thesis focuses not on Confucianism, but on the impact of institutions on carers‘ attitudes towards dementia. Finally, this thesis explores this argument through the following research question: What are the origins of different carers‘ attitudes between Scotland and Korea? In order to develop this argument, this thesis has carried out interviews with 14 Scottish carers and 28 Korean carers; and adopted a qualitative approach that would yield a rich exploration and deeper understanding of the different attitudes between carers in Scotland and Korea. Based on this data, this thesis examines carers‘ attitudes towards the diagnosis of dementia (chapter 3), family care (chapter 4), community care (chapter 5), and residential care (chapter 6). Each chapter analyses similarities and differences in attitudes in Scotland and Korea from the point of view of culture or the social welfare system. To conclude, these findings explain that the origin of carers‘ attitudes in this study is based on social policy rather than culture. In other words, the Korean carers‘ attitudes and behaviours towards diagnosis and long-term care services are rooted in the residual welfare system rather than Confucianism. Likewise, this study found that Confucianism has a less significant influence than social policy on carers‘ attitudes towards the utilisation of health care, community care and residential care. Unlike previous studies on East Asia, that argue for a cultural explanation, this study of Korean carers demonstrates that the residual welfare system is more persuasive than the cultural approach derived from Confucianism . This study contributes to the comparative study of Scotland and Korea as well as being a qualitative study in Korea. In addition, it will provide a new perspective on attitudes towards studies on East Asia. Moreover, the study will suggest political implications through the exploration of the carers‘ attitudes towards dementia diagnosis, social services at home and residential care. It also can provide lessons on dementia and dementia care from different experiences in Scotland and Korea.

Allteftersom livslängden ökar i Sveriges demografiska struktur höjs andelen äldre i befolkningen vilket skapar en ökad efterfrågan av äldreomsorg. För att möta denna efterfrågan krävs ny kunskap, förändringar och förbättringar om hur vi i framtiden kan garantera våra äldre god vårdkvalitet. Genom att använda en mixed-methods design bestående utav datainsamling från kvalitativa och kvantitativa observationer är denna studies syfte att undersöka och beskriva interaktionen mellan vårdgivare och vårdtagare utifrån ett teoretiskt ramverk baserat på social resursteori och en modell för interpersonellt resursutbyte. Studiens primära forskningsfråga är att undersöka vilka interpersonella resurser som utbyts mellan vårdgivare och vårdtagare. Studiens resultat rapporterar att ett brett spektrum av resurser utbyts mellan aktörerna och analysen presenterar två komplimenterande teoretiska dimensioner i vilka olika typer av resursutbyten sker, en socialt orienterad dimension och en uppgiftsorienterad dimension. Denna begreppsbildning möjliggör för en bättre förståelse av de befintliga resursutbyten som utgör interaktionen mellan vårdgivare och vårdtagare då olika resursutbyten kräver olika förutsättningar eller förkunskaper. De kvantitativa resultaten gav stöd till denna teoretiska utveckling som visar att utbyte av socialt orienterade och uppgiftsorienterade resurser inte skedde samtidigt. Slutaktligen kan analysen i denna studie ge vårdgivare, institutioner och organisationer en bättre förståelse för villkoren de olika resursutbytena kräver. Att säkerställa kontinuiteten mellan vårdtagare och vårdgivare möjliggör för långsiktiga och kultiverade relationer, vilket gör socio-dimensionella utbyten mer sannolikare. Social resursteori är potentiellt användbar för att förstå interaktionen mellan vårdgivare och vårtagare i vårdsammanhang. / As life-expectancy rises in the demographic structure of Sweden, the population of elderly citizens steadily increases. To meet the increasing demand of elderly care, new knowledge about how we will grant our elderly good quality care is needed as changes and improvements in public health care becomes increasingly of importance. This study have primary focus on residental care homes in Sweden. Using mixed-methods consisting of data collection using qualitative and quantitative observations, the purpose of this study is to examine and describe the interactions between caregivers and caretakers using a theoretical framework based on social resource theory and a model of interpersonal resource exchange. The primary research question of this study is to examine which interpersonal resources is exchanged between caregivers and caretakers. The results reported a wide range of resource exchange between caregivers and caretakers in the residental care home context. The analysis demonstrated two complimentary theoretical dimensions in which different types of resource exchanges takes place, a social oriented dimension and a task oriented dimension. This conceptualization allows for a better understanding of the existing resource exchanges that constitutes the caregiver-caretaker interaction as certain exchanges requires different prerequisities. Quantitative findings from observations supported this theoretical development, showing that exchanges of social oriented and task oriented resources did not occur concurrently. Conclusively, the analysis presented in this study can provide health care providers, institutions and organizations a better understanding for these different conditions of exchange. Ensuring continuity between caretakers and caregivers enables long-term and cultivated relationships, thus making socio-dimensional exchanges more likely. Social resource theory is potentially useful for understanding interactions between caregivers and caretakers in the residental care home context.

Background: Increasing numbers of older people are requiring residential care and there are high levels of depression in such settings. Existing literature suggests that social support can help maintain psychological wellbeing. This study aimed to examine perceived changes in social support following a move into residential care. The key theories drawn upon were socioemotional selectivity theory (Carstensen et al., 1999) and the convoy model (Kahn & Antonucci, 1980). Method: Forty care home residents were interviewed using a structured interview. A hierarchical network mapping technique was used to measure perceptions of total network, inner network and peripheral network size. Functional support from a key significant other was measured using the Significant Others Scale. Contact with network members, depression and demographic information were also examined. Retrospective ratings were obtained by asking participants to think back to before they moved into care. Current and retrospective ratings on all measures were compared using Wilcoxon signed rank tests. Results: Total network size was perceived to have decreased following a move into residential care. There was no significant difference between current and retrospective ratings of inner network size. Peripheral network size decreased but this difference was not statistically significant. There was no perceived change in emotional and practical social support received from a key significant other following the move. Discussion: The results suggest that an individual‟s social network is compacted following a move into care but that membership of the inner network remains stable. These findings are discussed in terms of socioemotional selectivity theory (Carstensen et al., 1999) and the convoy model (Kahn & Antonucci, 1980). Strengths and weaknesses of the study are discussed and clinical implications of the findings explored.

The purpose of this study is to understand the collaboration between the head of unit, coordinators and accommodation supervisors in a residential care homes for children. It also aims to critically analyze how the staff experience the effects of an increased workload which caused the organization to the reorganize. This requires good interaction between the different functions in the organization which is the primary focus of this study. The study analyzes how the reorganization affects collaboration between the professions and examines what effect the organizations’ different functions have on collaboration. The coordinator has a new function in the organization and that involves a new condition that needs to be emphasized. The study is based on seven semi-structured interviews. Theories that have been the basis for the analysis is Lipskys theories of street-level bureaucracy and discretion as well as interaction based on i.a. Danemarks theories. The result of the essay shows that the professions are effected by the increased work overload. They therefor request clearness in their function and role in the organization. Simply the time is not enough and major difficulties occur for the personal to handle the lodge and at the same time have time for the children living there. The reorganization is also an effect of the collaboration between the professions.

This project focused on developing a more complete picture of the event that most often occurs when an older adult’s health care needs can no longer be met in the community setting; the transition from home into a new long-term care (LTC) environment (i.e., assisted living [AL] or residential care [RC]). Informed by a life course perspective (Elder, 1998; Marshall, 2009) and by the health service utilization framework (Andersen, 1995; Andersen & Newman, 1973), this thesis explores the relationship between service users and their social and service contexts in the Fraser Health (FH) region of British Columbia. Employing a multi-method research design, two studies, one quantitative and one qualitative, were conducted. The goal of the quantitative study was to draw attention to individual, social, and structural factors (e.g., age, gender, marital status, presence of/relationship to primary caregiver, and health variables) that influence the transition from home and community care (HC) services to either AL or RC among older LTC clients (age 65+; N=3233) in three geographic areas (urban, suburban, and rural). Findings revealed that marital status, income, functional disability, and cognitive performance influenced type of transition for both rural and urban clients. However, gender, medical frailty (i.e., CHESS score), number of chronic conditions, and total hospitalizations emerged as significant among clients in suburban areas. The goal of the qualitative study was to draw attention to the role of family caregivers in the care transition context. Employing thematic analysis, this study drew on a sample of 15 semi-structured interviews with family caregivers who had helped a family member transition from home into a new care environment in FH. Out of this work, a conceptual framework was developed inductively to illustrate three key phases that seemed important in their care journey: ‘Precursors leading to transition’, ‘Preparing to transition into new care environment’, and ‘Post-transition: Finding a new balance Three overarching themes, labelled with direct quotes (in vivo), were also developed to capture how family caregivers made sense of their roles and responsibilities: “I’m just her daughter” / “I’m just his wife”, “Just go with the flow”, and “There wasn’t a door I didn’t try to open”. Overall, the findings from both studies draw attention to the importance of generating a better understanding of the local service and social contexts. Implications for social policy are addressed and highlight the need to continue to invest in efforts aimed at supporting older adults to remain in the community as long as possible, including ensuring appropriate forms of care are available and adequate resources for family caregivers are offered. / Graduate

V ANGLICKÉM JAZYCE The diploma thesis deals with psychosocial problems of seniors' alimentation. The theoretical part focuses on the area of health, healthy lifestyle of elderly people, and also on the diseases and physical problems typical for old age. The geriatric syndromes, which occur in old age, as well as psychosocial aspects of the nutrition of seniors, are described there. The fourth chapter presents up-to-date documents that are closely related to alimentation. The nutrition of seniors is a crucial chapter of the whole thesis, because it describes how the alimentation of seniors is carried out in the home environment and how in residential care. The aim of the last chapter in the theoretical part is to present to the reader the "Domov ANNA", where the research survey (which is a part of the thesis) was realized at the beginning of the year 2019. The survey was carried out using a questionnaire method among clients of the above-mentioned "Domov ANNA" and also seniors living at home in Český Brod. The aim of the research was to find out if the elderly in residential care have better (more varied and balanced) diet in comparison with the elderly who live and eat at home and how psychosocial and economic factors influence the quality of their nutrition.

Este trabalho teve por objetivo investigar e discutir as imagens sociais atribuídas às instituições de acolhimento e aos jovens institucionalizados, a partir de dois estudos empíricos exploratórios. O estudo I investigou as imagens sociais atribuídas às instituições de acolhimento. Participaram da pesquisa 202 adultos selecionados por conveniência, com idades entre 16 e 69 anos (M=32,76, DP=11,67), sendo a maioria do sexo feminino (79,2%), solteiro (51%), com ensino médio (48%) ou curso superior (37,6%). Os participantes responderam a um questionário aberto utilizando até cinco palavras para descrever uma instituição de acolhimento. O estudo II investigou as imagens sociais atribuídas aos jovens em acolhimento institucional. Participaram 224 adultos selecionados por conveniência, com idades entre 18 e 71 anos (M=33,97, DP=11,42), sendo que 68,4% já tiveram contato com adolescentes em situação de vulnerabilidade e risco. Foi utilizado um questionário fechado, com 37 palavras para descrever os jovens típicos e em acolhimento, com itens em escala Likert. Os resultados do primeiro estudo indicam que as imagens sociais sobre as instituições de acolhimento, em geral, são positivas e que predominam as percepções relacionadas ao acolhimento/proteção e à organização. Os resultados do segundo estudo apontam que as palavras consideradas negativas foram significativamente mais associadas aos jovens em acolhimento institucional, indicando haver uma imagem social negativa desta população. Embora as mudanças legais e políticas referentes à proteção infantojuvenil venham contribuindo para a qualificação dos serviços de acolhimento, permanecem os estigmas que classificam os jovens inseridos nesse contexto. É importante que se faça uma reflexão social coletiva sobre essa realidade a fim de que se encontrem estratégias de modificação do imaginário social que ainda rotula e discrimina essa população. / This study aimed to investigate and discuss the social images associated to the residential care institutions and the young people in care through two exploratory empirical studies. The first study investigated the social images assigned to the residential care institutions. The participants were 202 adults selected by convenience, aged 16 to 69 years old (M=32.76, SD=11.67), mostly female (79.2%), single (51%), with high school (48%) or higher education (37.6%). The participants answered an open questionnaire using up to five words to describe a residential care institution. The second study investigated the social images assigned to young people in care. The participants were 224 adults selected by convenience, aged 18 to 71 years old (M=33.97, SD=11.42), 68.4% of them have already had contact with teenagers in vulnerability and risk situations. The instrument was a Likert scale questionnaire with 37 words used to describe young people in general and in care. The results of the first study indicated that social images are generally positive, prevailing perceptions related to care/protection and organization. The results of the second study indicated that the negative words were significantly more associated with young people in care, indicating that there is a negative social image related to this population. Although legal and political changes concerning children and youth protection have been contributing to the qualification of residential care institutions, the stigmas that classify young people inserted in this context remain. It is important to make a collective social reflection about this reality in order to find strategies to modify the social imaginary that still labels and discriminates this population.

It is essential that research be conducted regarding both the needs of and the outcomes for children placed outside of their biological homes. According to AFCARS (Adoption and Foster Care Analysis and Reporting System Report), approximately 408,425 children in the United States were in foster care in 2010 (U.S. Department of Health and Human Services [DHHS], 2011a). In addition to the large number of children and adolescents in foster care, there are a disproportionate number of U.S. racial/ethnic minority children in foster care and other out-of-home placements (Committee for Hispanic Children and Families, 2004; Schwartz, 2007; Smith & Devore, 2004). Specifically, African American children are overrepresented in the foster care system compared to either other racial/ethnic groups (U.S. DHHS, 2011b). Approximately 45% of foster parents report caring for children of a different racial ethnic background than their own (Coakley & Orme, 2006). The majority of actual outcome studies regarding transracial placements for children focus on psychological adjustment, and the results are mixed (Brown, George, Sintzel, & Arnault, 2009; Burrow & Finley, 2004; Keller et al., 2001; Moffatt & Thoburn, 2001).However, there is very limited research on the relationship between race/ ethnicity of caregivers in residential settings and the outcomes for children of different racial/ethnic groups. The purpose of the current study was to extend the Jewell et al. (2010) investigation by measuring the youth's behavioral functioning in a family teaching home throughout their stay in a residential setting. The major aims of this study were to (a) investigate the relations between type of family home placement (inracial vs. transracial) and behavioral outcomes for the youth and (b) identify the key variables to consider for placement of racial/ethnic minority youth in a family-style residential treatment center. Results of the study indicate that overall youth placed in inracial family teaching homes had better behavioral outcomes than youth placed in transracial family teaching homes. The current study suggests that both racial/ethnic groups (African American and European American) benefitted from being placed in inracial versus transracial family home settings. Age, gender and race/ethnicity did not appear to be contributing to the behaviors of the youth as much as type of placement (inracial versus transracial).