Esta tese investigou fatores de risco e proteção ao desenvolvimento de adolescentes em medida de proteção de acolhimento institucional, através de três estudos. No primeiro estudo, verificouse a exposição a fatores de risco entre 113 adolescentes, por meio de um questionário. Além do excessivo tempo de institucionalização, foram identificados fatores de risco ao desenvolvimento como repetência escolar e exposição à violência intra e extrafamiliar. No segundo estudo, foram investigados, de forma transversal, indicadores de ajustamento psicossocial entre os adolescentes. Através de escores das variáveis autoestima, expectativa de futuro, repetência, comportamento infrator, uso de drogas e tentativas de suicídio, compôs-se um Índice de Ajustamento Psicossocial. Foi observado que o número de eventos estressores, a faixa etária e a exposição à violência extrafamiliar estavam independentemente associadas ao ajustamento psicossocial, tendo explicado 48% da variância do índice. No terceiro estudo, longitudinal, analisou-se o ajustamento psicossocial de 69 adolescentes acolhidos institucionalmente, comparando-se a estabilidade das variáveis em dois tempos, T1 e T2. Além disso, buscou-se identificar preditores do ajustamento psicossocial em T2. O modelo com maior poder explicativo (46,3%) para o ajustamento psicossocial em T2 envolveu o ajustamento em T1 e o apoio familiar. A convivência entre irmãos na mesma instituição revelou-se estatisticamente significativa para um melhor ajustamento psicossocial em T2, o que reforça a necessidade de preservar os laços familiares. Os resultados dos três estudos demonstram a necessidade de ações mesossistêmicas de políticas públicas, a fim de que a convivência familiar e comunitária seja incentivada, o que pode trazer impacto no ajustamento psicossocial dos adolescentes, além de auxiliar na tomada de decisão de cuidadores e operadores do direito. / This work investigated risk and protection factors regarding adolescent development in the context of residential care through three studies. In the first study, the exposure to risk factors among 113 adolescents was verified using a questionnaire. Besides the excessive institutionalization period, other risk factors to development found were school failure and exposure to intra- and extra-familial violence. In the second study, indicators of psychosocial adjustment among adolescents were investigated, in a cross-sectional design. A Psychosocial Adjustment Index was proposed through scores of the variables self-esteem, future expectation, school failure, antisocial behavior, drug use and suicide attempt. The number of stressor events, age range and exposure to extra-familial violence were independently associated to psychosocial adjustment, explaining 48% of the variance of such index. In the third study, characterized as longitudinal, psychosocial adjustment of 69 adolescents in residential care was analyzed, comparing variables stability at time 1 (T1) and time 2 (T2). Moreover, predictors of psychosocial adjustment were identified at T2. The model with greater explanation power (46.3%)concerning psychosocial adjustment at T2 involved adjustment at T1 and family support. Living with siblings in the same institution revealed to be statistically significant regarding improved psychosocial adjustment at T2, highlighting the need to preserve family bonds. Results of the three studies demonstrate the need of mesosystemic actions as concerns public policies, so that family and community living may be encouraged, possibly causing an impact in the psychosocial adjustment of adolescents, and supporting the caregivers' and law professionals' decision-making process.

Bakgrund: Den psykiatriska vården har förändrats genom historien. En stor förändring skedde i samband med psykiatrireformen på 1990-talet. I samband med detta upplevde de närstående att de fick inta en mer vårdande roll och ett större ansvar för familjemedlemmen med psykisk ohälsa.   I tidigare studier framkommer att de närstående upplever börda i förhållande till sin familjemedlem och att det i sin tur har inverkan på den närståendes eget välbefinnande. Vidare påverkar detta den närståendes relation till familjemedlemmen med psykisk ohälsa.   Syfte: Syftet med denna studie var att beskriva närståendes upplevelser av hur relationen till en familjemedlem med psykisk ohälsa påverkas när familjemedlemmen flyttat till ett HVB-hem.   Metod: Studien genomfördes som en intervjustudie med kvalitativ induktiv ansats. I studien deltog tio respondenter och insamlat material bearbetades av författarna genom en kvalitativ latent innehållsanalys.   Resultat: I föreliggande studie framkommer att de närstående upplever att de befinner sig i en komplicerad situation. Rollen som närstående till en person med psykisk ohälsa kan upplevas som påfrestande och relationen blir på grund av olika anledningar ofta ansträngd. Det resultat som framträdde var att Relationen präglas av ömsesidig påverkan och att HVB-hemmet kan ge trygghet och underlätta relationen.    Slutsats: Att öka delaktigheten och att underlätta för de närstående gör att de kan minska sitt lidande och öka sitt eget välbefinnande. Vilket, ur ett helhetsperspektiv, kan skapa förutsättningar för en bättre relation och ökad livskvalité för samtliga individer i systemet. / Background: Psychiatric care has changed through history. A major change occurred in connection to the psychiatric reform in the 1990s. In relation to this, the relatives also felt that they were taking a more caring role and a greater responsibility for the family member with a mental illness.Previous studies have shown that close relatives to family members with a mental illness, experience a burden related to their family member. This burden is so significant that it affects the relatives own well-being and further influenced their relationship with the family member with mental illness. Purpose: The aim of this study was to describe relatives’ experiences of how the relationship to a family member with mental illness is affected when the family member moves to a residential care home. Method: The study was conducted as an interview study with a qualitative inductive approach. In the study ten respondents were interviewed and collected material were processed by the authors through a qualitative latent content analysis.Results: The present study revealed that the close relatives find that they are in a complicated situation. The role of being related to a person with mental illness can be experienced as stressful and the relationship, due to various reasons, becomes strained. The result that emerged was that the relationship is characterized by mutual influence and the residential care home can provide security and ease the relation.   Conclusion: To increase participation and ease the burden for the close relatives, can reduce their suffer and increase their own well-being. Which, from a holistic perspective, can create conditions for a better relationship and increase the quality of life for all individuals in the system.

Child and youth care workers in residential care provide support and intervention to young people who are experiencing difficulties in their lives. Caring for these young people can be complex and demanding and many child and youth care practitioners struggle to meet the challenges associated with their roles. Practice problems include volatile and punitive environments, inability of practitioners to safely manage young people’s threatening and aggressive behaviours, and staff turnover and burnout. These problems are often attributed to job stress, personal characteristics of practitioners, and lack of education, training, and professional development. To reconceptualise the aforementioned practice problems, Robert Kegan’s (1982) constructive-developmental theory was used as a theoretical framework to explore the experiences of child and youth care workers in residential care. The research was guided by 2 main questions: 1. How do different meaning-making systems influence how practitioners cope with and experience the demands of the job? 2. What role does the organizational environment play, if any, in mediating or exacerbating the demands of the job for practitioners with different meaning-making systems? An exploratory study was conducted using a mixed methods design. The study was conducted in two stages. First, 99 participants completed the Professional Quality of Life Scale (ProQOL), Work Environment Scale (WES), and Leadership Development Profile (LDP). Linear regression was conducted to explore the relationships between the ProQOL, LDP, and WES and most results were not significant. From the initial pool, 18 participants were selected for in-depth, qualitative interviews to assess their constructive-developmental orders – the ways in which they make meaning - and explore their experiences in residential care in the areas of job satisfaction and success, challenge, and coping with the demands of the job. The ways in which participants at different constructive-developmental orders experience and cope with the challenges of their jobs are described and themes are identified. There was internal coherence among participants of the same epistemological order and across organizations. This dissertation examines implications of the findings for child and youth care practice, education, training, supervision, research, and organizational management in residential care. / Graduate

The study is aimed at understanding the life experiences of children living in childcare institutions and to gain insight into what impact these experiences have in their lives and everyday functioning. I also anticipate that findings of the study will make a contribution in the Department of Health and Social Development, social workers, childcare institutions and other stakeholders who work with children in order to plan and implement programs that will enhance the children’s lives. The research project will be qualitative in nature with the use of the interpretivist approach and the stigmatisation theory as its theoretical background. The study revealed that children in childcare institutions view their environment as normal besides the absence of their parents, there were mixed feelings however about whether they find it as pleasant or unpleasant. One thing that stood out and was positive for them being in a childcare institution was that they have access to privileges which they would not have access to if they were living with their families. / Dissertation (MEd)--University of Pretoria, 2012. / Educational Psychology / unrestricted

In the last couple of years there has been an immense increase in the number of unaccompa­nied refuge minors seeking asylum in Sweden. These minors share one thing in common; they have all abandoned things they hold dear in pursuit of a better life. The majority of them are placed into residential care homes, accommodations where they are aided and cared for by personnel. Unfortunately, there is a lack of research regarding how these personnel experience their work. With help of the method grounded theory and interviews, I investigate their working situation and their role in these homes. All participants agree that their primary role and task are to establish a feeling of safety amongst the minors, however, organizational aspects can hinder this process. Organizational aspects are also key factors that have to be adequate in order for the personnel to increase their professional knowledge. By including the framework resilience therapy and comparing this to my result, I put my study in a bigger context, suggesting that if the minors are capable of feeling safe, they will also develop skills that increase their wellbeing throughout their lives.

Inledning: Under Covid-19 pandemin har ett intresse väckts hos författarna angående hur en upplevd ensamhet påverkar en äldre negativt.Bakgrund: Bland annat kulturen, upplevelsen av ens egen hälsa och förtrogna kontakter påverkar upplevelsen av ensamhet. Äldre som bor på särskilda boenden upplever en större ensamhet än äldre som bor i eget hushåll. Ensamhet är en subjektiv upplevelse och kan delas in i existentiell, emotionell och social ensamhet. Besvär med ensamhet kan leda till en försämrad hälsa och ett ökat vårdbehov. Syfte: Belysa vilka omvårdnadsåtgärder som minskar de äldres besvär av ensamhet på särskilda boenden.Metod: En litteraturstudie baserad på 13 vetenskapliga artiklar med kvalitativa (n=3) och kvantitativ (n=10) metod.Resultat: Resultatet delas in i två huvudteman och åtta underteman. Den äldres syn på hur ensamhet kan minskas med fyra underteman: att få stöd och uppmärksamt, att ha kontroll över sin vardag och vara nöjd med livet, att vara i kontakt med det existentiell och spirituella samt att få distrahera sig. Andra temat handlar om Omvårdnadsåtgärder i form av aktiviteter med fyra underteman: Reminiscens- och kognitivstimulerandeterapi, videosamtal, djur- och robotterapi samt hobbyaktiviteter.Slutsats: Olika omvårdnadsåtgärder lämpar sig till olika former av ensamhet, beroende på om den äldre upplever existentiell, emotionell eller social ensamhet. Vidare är den äldres individuella intresse och förutsättningar av relevans vid val av omvårdnadsåtgärd. / Introduction: A spark of interest has grown during the Covid-19 pandemic about how experienced loneliness can affect elderly in a negative way.Background: For instance, culture, the experience of once own health and close relationships influences experienced loneliness. Elderly in residential care facilities experience loneliness in a higher regard than elderly who lives at home. Loneliness is a subjective experience and can be divided into existential, emotional, and social loneliness. Encumbrance of loneliness can lead to decline in health and increased care needs. Aim: Portray nursing interventions that decrease the elderly’s encumbrance of loneliness at residential care facilities.Method: A literature review based on 13 scientific studies with qualitative (n=3) and quantitative (n=10) methods.Result: The result has been divided into two main themes and eight sub-themes. The elderly’s view of how loneliness can be decreased, with four sub-themes: to get support and attention, to have control over once daily-life and to be satisfied with life, to be in contact with the existential and spiritual dimensions, and to distract one-self. The second main theme is nursing interventions in the form of activities, with four sub-themes: reminiscence- and cognitive stimulation therapy, videocalls, pet- and robot therapy and leisure activities.Conclusion: Different nursing interventions is suitable to different kind of loneliness, depending if the elderly is experiencing existential, emotional, or social loneliness. Furthermore, the elderly’s individual interest and condition is of relevance when applying nursing intervention.

In the last few years, approximately 40 000 of unaccompanied children, mainly boys, have arrived in Sweden. Initially, these minors were placed into residential care units (HVB). Media has suggested that these adolescents, have difficulties associated to poor mental health. Earlier research concerning the mental state of these minors, indicates a high prevalence of PTSD. This motivated the aim of this study: to explore the professionals’ understanding of support and the form of housing that accommodates these minors, related to poor mental health. An interpretive approach was chosen with attachment theory and Goffmans’ theory regarding institutional life, as theoretical bedrocks and six qualitative semi- structured interviews formed the basis for the result. Four central themes were discovered through content data analysis. The themes indicated that the boys are under pressure and experiencing stress which is a recurrent experience for some authorities and health care units, responsible for supporting these adolescents. However, the personal support from individuals, demonstrates a commitment that likely has a positive impact on these boys life. While the form of housing may have a harmful effect, it could also be cultural differences combined with PTSD affecting the emotional state of unaccompanied children living in Sweden.

Bakgrund: Demenssjukdom är en progressiv försämring av hjärnans nervceller som leder till att kognitiva funktioner blir nedsatta. Antal människor som drabbas av en demenssjukdom ökar konstant och kommer att ha fördubblats till år 2050. Sjuksköterskan har en viktig roll och det är att leda och ansvara för omvårdnadsarbete. Sjukdomen förvärras över tid och leder till att personer med demens får svårt att klara sig hemma, därför finns särskilda boenden. Tidigare forskning pekar på att sjuksköterskor inte har den kunskap eller utbildning som krävs för att vårda personer med en demenssjukdom. Syfte: Syftet med litteraturöversikten är att beskriva sjuksköterskors upplevelser av att vårda personer med demenssjukdom på särskilt boende. Metod: Föreliggande studie är en litteraturöversikt där femton kvalitativa artiklar analyserats från databasen CINAHL. Alla artiklar är granskade och godkända av en etisk kommitté. Artiklarna är kvalitetsgranskade och är av hög kvalitet. De inkluderade artiklarnas resultat analyserades och sammanställdes för att besvara studiens syfte.  Resultat: I resultatet framkom fem kategorier som var relevanta utifrån studiens syfte. Dessa var upplevelser av skapa en god relation, upplevelse av kommunikation, upplevelse av etiska dilemman, upplevelse av tidsbrist och social arbetsmiljö samt upplevelse av kunskapsbrist.  Slutsats: Det visade sig vara komplicerat att vårda personer med demens. Sjuksköterskan upplevde brister om kunskap att kunna kommunicera med personer med demens. Sjuksköterskorna upplevde även en tidsbrist vilket resulterade i etiska dilemman. Att skapa en god relation med hjälp av patientens livshistoria och anhöriga kan främja patientens resurser. / Background: Dementia is a progressive deterioration of the brain's nerve cells, leading to impaired cognitive functions. The number of people suffering from dementia are constantly increasing and will have doubled by 2050. The nurse has an important role and that’s to lead and be responsible for nursing work. The disease getting worse over time and makes it difficult for people with dementia to manage at home, therefore there are special residential care. Previous research shows that nurses do not have the knowledge or education required to care for people with dementia. Aim: The aim of the study is to describe nurses' experiences of caring for people with dementia in residential care. Method: The present study is a literature review where fifteen qualitative articles were analyzed from the CINAHL database. The articles are reviewed and approved by an ethics committee. The articles are quality checked and are of high quality. The results of the included articles were analyzed and compiled to answer the purpose of the study. Main results: Five categories emerged that were relevant based on the purpose of the study. These were experiences of creating a good relationship, experience of communication, experience of ethical dilemmas, experience of lack of time and social work environment and experience of lack of knowledge. Conclusion:  It turned out to be complicated to care for people with dementia. Especially when it was about shortcomings and knowledge of communication. The nurses felt that if there was a lack of knowledge and a shortness of time for the patients, this could result in ethical dilemmas. Creating a good relationship using the patient's life history and relatives can promote the patient's resources.

The topic of this thesis is the Methods of social work with elderly people used in our territory in 1948-1989. The goal of this thesis is to description of the methods used in social work with seniors in the defined period. The method used in this thesis is a synthesis of scientific knowledge from literature mapping social work in the period from 1948 to 1989 and analysis of the historical period. This thesis is divided into five main chapters. The first chapter is dedicated to the theoretical framework, which describes the social area with an emphasis on old people. The second chapter is devoted to the introductory article on social work from the perspective of the target group of seniors. Attention is paid especially to the introduction to the political context and the social security system and the functioning of social services. A necessary part of this work is also a brief historical excursion, which is described in the third chapter. The historical excursion briefly maps the period from the 17th century to the first half of the 20th century, in the context of perception of old age, death and family cohabitation. The fourth chapter describes the development of social work since 1948, which is focused on social work with old people. The final chapter of this thesis is the fifth chapter,...

Hem för vård eller boende har varit omskrivna i svensk media för missförhållanden det senaste året. Tidigare forskning har visat att placerade ungdomar är en utsatt grupp. Frågor som denna studie försöker besvara är vilka behandlingsmetoder som används inom HVB idag och hur förenligt dessa är med evidensbaserad praktik. Teoretisk utgångspunkt som denna studie tar är social konstruktivism och kategorisering. Studien är av explorativ karaktär där syftet är att kartlägga hem för vård och boende (HVB) som är inriktade mot behandling av ungdomar 13-18 år. Genom kvantitativ innehållsanalys kodades och analyserades innehållet av n=295 HVB hemsidor inriktade mot behandling för ungdomar, 13-18 år. Resultat visar att fältet HVB är i en förändringsprocess där KBT som metod är mest framträdande. Metoder som har vetenskapligt stöd när det gäller missbruk och kriminalitet angavs i låg utsträckning. Många HVB uppgav inget om personal som är betydande när det gäller behandling på HVB. / Residential care agencies in Sweden have been described in the Swedish media for malpractice in recent years. Previous research has shown that youth in residential care are a vulnerable group. This study tries to answer what methods are used by residential care agencies in Sweden today and how compatible these methods are with evidence-based practice. The theoretical framework for this study is social constructivism and categorization. The study is of an exploratory nature and the aim is to map residential care agencies in Sweden (HVB) that are focused on the treatment of adolescents by the age of 13-18 years. Through quantitative content analysis, the content of n = 295 HVB websites were coded and analyzed. Results show that the HVB field in Sweden is in a process of change where CBT as a method is most prominent. Methods that have scientific support for addiction and criminal behavior were mentioned to a small extent. Many HVBs did not provide information on staff which is significant when it comes to treatment and care at HVB.