The aim of this study was to investigate how staff members at residential homes experience encountering sexuality among the youths. The study was conducted by using qualitative interviews with four staff members at four different residential homes. The interviews have been analyzed by using content analysis and have been looked at through a perspective of experience, as described by Richard Stevens, and by applying developmental psychology. The results show that, although sexuality is experienced as being distinctly present and being a topic of major concern, the staff members have given sex-education as a means by which to raise their own competence little or no thought. One way to interpret this is that sexuality and sex-education haven’t been given a sufficient space in the work with the youths. Several staff members do experience the need of skills development in order to be able to function in the role as significant others when it comes to sexuality among the youths, and express that they would like to receive training in doing so. To a certain degree they experience situations in which they are not entirely certain how to act and which they are not sure how to handle. The result is somewhat in line with what previous research has pointed at, but does not include staff members having severe problems talking about sexuality with the youths. All participants express that they have minor or no problems with talking about sexuality and with encountering sexuality-related aspects in relation to the youths.

Varje år placeras över 1000 ungdomar inom Statens Institutions Styrelse (SiS), varav ungefär hälften placeras för behandling. Studiens frågeställningar är: I vilken grad uppfattar behandlingsplacerade ungdomar inom SiS att de får hjälp med sina familjeproblem? Finns det synliga samband mellan ungdomarnas könstillhörighet eller etniska ursprung och deras skattade upplevelse av hjälp med familjeproblem under placeringstiden? För att besvara frågorna har kvantitativ arkivdata analyserats, material som vid in- och utskrivning av ungdomar samlats genom strukturerade ADAD-intervjuer (Adolescent Drug Abuse Diagnosis). Studien visar att ungdomarnas upplevelse av hjälp kan delas in i tre kategorier; ”över förväntan” 27%, ”motsvarar förväntan” 41%, ”mindre än förväntat”, 32%. Inskrivningsintervjuerna visar en signifikant skillnad (p<.05) att pojkarna i större grad ger uttryck för att inte behöva hjälp med familjeproblem, att flickorna i större grad önskar hjälp. Resultaten visar även en signifikant skillnad (p<.05), att utlandsfödda ungdomar i högre grad än svenskfödda uppger det vara viktigt att få hjälp med familjeproblem under placeringstiden. Vid utskrivning framträder ingen tydlig skillnad i nöjdhetsgrad avseende kön eller etnisk bakgrund. En diskrepans framträder mellan personals skattning av ungdomarnas hjälpbehov med familjeproblem vid inskrivning och ungdomarnas skattning av upplevd hjälp vid utskrivning. För 42% av ungdomarna skattade personal hjälpbehovet som ”litet” eller ”inget”, vid utskrivning skattade samma ungdomar att de fått ”ganska mycket” eller ”mycket” hjälp. För 10%, av ungdomarna skattade personal att de hade ”betydande” eller ”avsevärda” familjeproblem där hjälpinsatser var ”nödvändiga”. Vid utskrivning skattade ungdomarna graden av hjälp som ”liten” eller ”inte alls”. / Each year over 1000 adolescents are placed within the National Board of Institutional Care (SiS) of which half stay in the facilities for treatment. The essay is built from information gathered through ADAD interviews (Adolescent Drug Abuse Diagnosis) performed during registration and discharge of adolescents from SiS. The questions that are meant to be answered are; “How do the treatment placed adolescents in SiS apprehend the help they get with their family related problems?” and “Are there visible connections between gender or ethnic origin and the adolescent’s experience of help with the family related problems during the placement period?” During the registration the boys gave an expression of not being in need of help, the girls gave an expression of being in need of help, significance (p<.05). At discharge no clear differences appears in degree of satisfaction. The results also show a significant difference (p<.05). that foreign-born adolescents greater than Swedish-born stated that it is important to get help with family problems during the investment period. At discharge no clear differences appears in degree of satisfaction.

Introduktion: Personer med funktionsnedsättning har nedsatt förmåga att fungera fysiskt, psykiskt eller intellektuellt, vilket kan medföra hinder med att sköta den dagliga munhygienen. I omvårdnaden i bostad med särskild service för vuxna ingår skyldighet att stödja funktionsnedsatta med deras personliga behov. Syfte: Syftet med studien var att undersöka boendeassistenters kunskap om munhälsa. Ytterligare ett syfte var att undersöka boendeassistenters inställning till munvård samt faktorer som påverkar deras inställning till munvård. Material och metod: Studien är en kvantitativ tvärsnittstudie baserad på en enkät med 31 strukturerade frågor samt en öppen fråga.  Enkäten besvarades av 43 boendeassistenter i en kommun i södra Sverige. Resultat: Resultatet visar att majoriteten (n=34) av boendeassistenterna anser att de boende behöver dagligt stöd med munhygienen. Det största hindret är att de boende inte vill ha hjälp med munhygienen. En stor del (n=31) av boendeassistenterna anser att de har tillräcklig kunskap om munvård för att stödja de boende med den dagliga munhygienen. Resultatet visar att 29 av boendeassistenterna har kunskap om fluor och 38 har kunskap om gingivit. Slutsats: Resultatet tyder på att boendeassistenterna i viss mån har kunskap om munhälsa och att de anser att de boende behöver dagligt stöd med munvården. Vidare anser boendeassistenterna att det största hindret till att stödja med munvården är att de boende inte vill ha hjälp vilket påverkar boendeassistenternas inställning till munvård. / Introduction: Persons with disabilities have a reduced capacity to function physically, mentally, or intellectually, which can lead to obstruction in daily oral hygiene. Health care in supervised residential care facilities for adults includes the responsibility to support disabled persons in their personal hygiene. Purpose: The purpose of this study was to examine the knowledge resident assistants have of oral health. A further purpose was to examine the attitude of resident assistants toward oral care and factors that affect their attitude toward oral care. Materials and method: The study is a quantitative cross-sectional study based on a questionnaire with 31 structured questions and one open question. Forty-three resident assistants in one municipality in southern Sweden participated. Results: Results show that the majority (n=34) of resident assistants believe residents need daily assistance with oral hygiene. The greatest obstacle to supporting residents is that residents do not want help with oral hygiene. The majority (n=31) of resident assistants believe they have sufficient knowledge of oral care to support residents in daily oral hygiene. Results show that 29 resident assistants have knowledge of fluoride and 38 have knowledge of gingivitis.  Conclusions: The results indicate that resident assistants have adequate knowledge of oral health to some extent, and that resident assistants believe residents need daily support in oral care. Also, resident assistants report the greatest obstacle in supporting oral care is that residents do not want help, which impacts the attitude of resident assistants towards oral care.

An exploration of the interpersonal experiences of loneliness by older people in a residential care facility It is estimated that there were about 3, 8 million older people in South Africa in 2010 (Statistics South Africa, 2010). Many older people have to be cared for in residential care facilities due to their weakening health, the migration of children and grandchildren, or due to limited financial resources. This has led to the attempt in this research study to explore the interpersonal experiences of loneliness by older people living in a residential care facility. Loneliness is an unpleasant experience associated with inadequate interpersonal contact. It is widely accepted that loneliness is closely associated with ageing as a consequence of multiple losses – loss of abilities, loss of and changes in personal relationships, loss of relationships with familiar environments and changed contact with friends and relatives resulting in reduced relationships. Changes in the relationship with the environment are regarded as a particular loss by older people, especially if they have to rely on institutionalized care and loose contact with familiar social networks and the free association with other people. Lonely people are isolated people. For the purpose of this study, loneliness is regarded as a relational phenomenon, and the theory of complex responsive processes of relating will be used as the theoretical framework for this study. In an attempt to understand the interpersonal experiences associated with loneliness, a qualitative and exploratory research method was used. The research was conducted in a residential care facility in Johannesburg, South Africa. The group of older people, who was purposively selected for the study, consisted of 10 older persons: 7 female and 3 male and with ages ranging between 62 and 82 years of age. The data was collected by means of various qualitative techniques, including the Mmogo-methodTM and visual drawings. The collected data was analysed by using thematic analysis, visual analysis and key-words-in-context, and crystallization was used to increase the trustworthiness of the findings. Ethical approval for the research project was obtained from the North-West University. Two themes emerged from the findings, being: 1) Relationships are experienced in terms of the interactions in relationships as well as in terms of preferred interpersonal styles; and 2) The relationships experienced in the context of the residential care facility are described as being unsafe and lacking in care, while the environment is described as non-stimulating. Some of the findings are confirmed by existing literature. However, the unique contribution of the study is the finding that the environment in which the relationships are embedded is perceived to be dangerous, and that it is perceived to be a risk to become visible to each other in order to establish meaningful interpersonal relationships. Several suggestions regarding future interventions are made and some limitations of the study are mentioned. The contribution of the study is that loneliness are expressed and described in terms of interpersonal relationships embedded in the broader environment. Thus, the potential of older people to form meaningful interpersonal relationships are limited in the broader environment if the environment is experienced as unsafe and lacking in care. / Thesis (MSc (Research Psychology))--North-West University, Potchefstroom Campus, 2012

This doctoral thesis deals with the type of architecture that materializes when age-related problems become a long-term condition (LTC) and gradually restrain the individual’s ability to perform activities in daily life (ADL). Their life situation necessitates a support from relatives or municipal eldercare staff in order for them to continue to participate in everyday living. In addition, the architectural space requires a close adjustment to the personal panorama of cognitive or functional impairments. The habitat can be a flat appropriated many years previously or in a residential care home for dependent and frail seniors. Architecture for ageing with dependency demonstrates how space can be used either to affirm or oppress the older person’s attempts to maintain an independent life style. By use of design theory, case study methodology and a heterogeneous research strategy, this study uses a threefold approach—a retrospective, a contemporaneous, and a future-oriented approach—to explore frail older people’s interaction with the architectural space of residential care homes. This has resulted in seven papers that focus on aspects of these human interactions with the built environment. Based on twelve exemplary models, the research paper I concludes that national guidelines result in a homelike, a hotel-like or a hospital-like environment. Research paper II is a retrospective study that examines the use of architecture competitions as a socio-political instrument to define architectural guidelines. Research paper III focuses on dependent seniors’ spatial appropriation of the communally shared space of a ward in a residential care home. Research paper IV employs two environmental assessment methods from the architecture profession and gerontological research (TESS-NH) in order to evaluate the use of interior colouring when refurbishing two residential care homes while the residents remained in place. Research paper V displays a municipal organizer’s considerations to opt for an architecture competition as a means of renewing architecture for the ageing population. Research paper VI examines competition documentation of three municipal architecture competitions organized during the period of 2006 to 2009. Research paper VII, the final study, explores notions concerning the appropriate space for ageing found among a group of municipal representatives, and people from organizations defending older people’s right. It supplies a model for understanding the appropriate space for ageing. This study illustrates the absence of older people with frailties in the public discussion about appropriate architecture for ageing. During the 20th century, the multi-dimensional idea of an architectural space with a homelike appearance has been used to contrast the negatively charged opposite—the complete and austere institution. The overarching conclusion of this study is that architecture for dependent and frail seniors constitutes a particular type of built space that requires an extended dialogue involving dependent seniors, architects, building contractors and care planners in order to conceive appropriate architecture for the ageing society. / QC 20110921

This study explores the childhood experiences and transitions to adulthood of 39 Romanian care leavers and adoptees, born around 1989 - 1990. In the past, Romania's children in care became known to the world as 'the Romanian orphans' and some of them have been subjects to neurodevelopmental research studies focusing on the setbacks posed by institutionalisation in early life. This research project takes a different angle by: • Using life history approach and therefore capturing the participants' in-depth accounts of how they recall their childhoods and the challenges they encountered in their transition to independent life; • Exploring four different types of placements and how they affect transition to independent life, from a user's perspective. The fact that Romania undertook reform of the child protection system within the timespan of this generation of children provided a research opportunity to collect the users' views on different types of placement that belonged to the unreformed system of the 1990s (large residential care and intercountry adoption) and the new types of placement (small group homes and foster care). For comparison purposes, I also included domestic adoption, a type of placement that was less controversial than the others at the time reforms were being introduced. Thus, the types of placement that are analysed through the research participants' accounts are: • Residential care (institutions and small group homes); • Foster Care; • Domestic Adoption; • Intercountry adoption. The study addressed two research questions: 1. How do Romanian born young people who grew up in care understand and narrate their experiences in different types of placement? 2. What narratives of agency are constructed by Romanian-born adults who grew up in different types of placement when they describe their transition to adulthood? By taking an interpretive stance, this study brings in the academic arena the voices of care leavers and adoptees. By using narrative analysis and focussing on the concept of dignity by employing identity theories, the UN Convention on the Rights of the Child and the Capabilities Approach, the study makes an important contribution to knowledge, with implications for further research, policy and practice. While interventions in child protection are influenced in each country by cultural, political and socio-legal factors, understanding the basic needs of children who are not raised by their birth families is important across different child protection systems. Therefore, the relevance of the research findings is not limited to Romania.

The aim of this study was to gain knowledge about how professionals experience user influence within family-treating residential care. To collect empiricism for this study semi structed interviewes was conducted with eight employees within family-treating residential care. These interviews were later processed through a content analysis, it becomes clear that the participants acknowledged the importance of user influence within its own treatment. Further on, the result has been analysed by the theory called empowerment and previous research within the current subject, ”user influence within family-threating residential care”. However, the result of this study is that the user influence should always exist though in certain circumstances it should be limited.

The Masters thesis deals with the psychosocial needs of seniors in residential care. The theoretical part characterizes the old age phenomenon as a natural part of human life. It describes the attitude of society to senior citizens and the status of the senior in the family system. The thesis focuses on the saturation of psychosocial needs of seniors within institutional care. Impact is placed on the role of a social worker in providing social help to these people. The research part detects through semi-structured interviews how the users of social services perceive the quality of their life in the retirement home. The results of the research are compared with the opinions of experts dealing with senior issues.

O trabalho pretende apresentar uma cartografia das atividades desenvolvidas pelos profissionais de saúde mental que prestam assistência aos moradores dos serviços residenciais terapêuticos do município de Carmo, no Estado do Rio de Janeiro. Estas moradias constituem uma etapa do processo de desinstitucionalização de um hospital psiquiátrico estadual do tipo colônia agrícola, fundado na década de 40 do século passado, onde estavam internados cerca de 280 pacientes. A partir de 2003, com a extinção do hospital coordenada pelo gestor estadual e a municipalização dos recursos, uma pequena parcela dos internos retornou ao seio familiar, mas a maioria (cerca de 160) foi alocada em moradias assistidas, espalhadas pelas áreas urbana e rural do município. Tomando a tarefa de reinserção social como o viés político da Reforma Psiquiátrica Brasileira, o trabalho cotidiano da equipe multiprofissional é focalizado. Neste plano relacional o texto busca a conceitualização de Política e de um trabalho político, através das idéias de Arendt, Gramsci, Deleuze e Guattari, entre outros; já a ergologia possibilita uma metodologia para a abordagem do trabalho humano. Com base na pesquisa de campo, a cartografia revela como a tarefa política é realizada, nas atividades dos técnicos, quer dizer, na micropolítica dos encontros dos profissionais uns com os outros, com a sociedade civil e com os moradores, onde os valores da Reforma Psiquiátrica são negociados. No fim, trata-se de uma etapa em um processo, ainda a meio caminho entre a gestão estadual e a gestão municipal, onde a proposta mantém-se sustentada pela vontade política do gestor e, na via da hegemonia, deve ser trabalhada entre os profissionais e na sociedade civil. O panorama é heterogêneo, e a dinâmica revela a diversidade de entendimentos e interesses. No cenário do trabalho cotidiano, conceitos como autonomia e cidadania se atualizam em atividades que caracterizam a vida nas cidades e se desdobram em torno de certos temas, como o uso do dinheiro, ou a apropriação do espaço. A experiência dos técnicos envolvidos mais diretamente com os moradores, como os cuidadores, produz uma técnica de escuta e mobilização, que não admite cartilhas nem regras pré-estabelecidas ou imutáveis. Este trabalho conjunto, formador de redes e sustentado na interação, é indicador de integralidade na execução da proposta da Reforma Psiquiátrica. / The work intends to present a map of the activities performed by mental health professionals that assist the dwellers of the residential care homes in the municipal district of Carmo, State of Rio de Janeiro. These residences are part of a stage in the process of desinstitutionalisation of a state Psychiatry Hospital, an agricultural colony type, founded during the forties in the 20th century, and where about 280 inpatients lived. From 2003 on, when the hospital was closed under coordination of the state manager, and the resources were municipalised, a small part of the inpatients returned to their families, but the majority (about 160) were placed in care homes, scattered over country or urban district areas. Taking the task of social inclusiveness as the political bias of Brazilian Psichiatric Reform, day-to-day work of the multiprofessional team is focused. In this relational level, the text looks forward to conceptualise Politics and political work, through Arendt, Gramsci, Deleuze and Guattaris ideas, among others. And ergonomics enables a view to knowledge production, with its approach to human work. Based on a camp research, the map production reveals how politic task is performed, in the professionals activities, that means, in the micropolitics of professionals meetings with one another, with civil society and with the residents, where values of Psichiatric Reform are negotiated. In the end, its a phase in a process, still half way between state and municipal administration, where the proposal is sustained by the administrators politic will, and, on its way to become hegemonic, must be discussed among professionals and civil society. The landscape is not homogeneous, and the dinamics reveal the diversity of understandings and interests. In the scenery of everyday work, concepts such as autonomy or citizenship are present on activities which are characteristic of city life, and they unfold over some themes, as the use of money, or the making and occupying of ones personal space. The experience of the professionals that work closer to the residentes, as the caretakers do, produces a technique of hearing and stimulation, which by no means admits unchangeable or preestablished rules. This group work, maker of nets and relying on interaction, is an indicator to integrality when Psychiatric Reform proposal is performed.

O trabalho pretende apresentar uma cartografia das atividades desenvolvidas pelos profissionais de saúde mental que prestam assistência aos moradores dos serviços residenciais terapêuticos do município de Carmo, no Estado do Rio de Janeiro. Estas moradias constituem uma etapa do processo de desinstitucionalização de um hospital psiquiátrico estadual do tipo colônia agrícola, fundado na década de 40 do século passado, onde estavam internados cerca de 280 pacientes. A partir de 2003, com a extinção do hospital coordenada pelo gestor estadual e a municipalização dos recursos, uma pequena parcela dos internos retornou ao seio familiar, mas a maioria (cerca de 160) foi alocada em moradias assistidas, espalhadas pelas áreas urbana e rural do município. Tomando a tarefa de reinserção social como o viés político da Reforma Psiquiátrica Brasileira, o trabalho cotidiano da equipe multiprofissional é focalizado. Neste plano relacional o texto busca a conceitualização de Política e de um trabalho político, através das idéias de Arendt, Gramsci, Deleuze e Guattari, entre outros; já a ergologia possibilita uma metodologia para a abordagem do trabalho humano. Com base na pesquisa de campo, a cartografia revela como a tarefa política é realizada, nas atividades dos técnicos, quer dizer, na micropolítica dos encontros dos profissionais uns com os outros, com a sociedade civil e com os moradores, onde os valores da Reforma Psiquiátrica são negociados. No fim, trata-se de uma etapa em um processo, ainda a meio caminho entre a gestão estadual e a gestão municipal, onde a proposta mantém-se sustentada pela vontade política do gestor e, na via da hegemonia, deve ser trabalhada entre os profissionais e na sociedade civil. O panorama é heterogêneo, e a dinâmica revela a diversidade de entendimentos e interesses. No cenário do trabalho cotidiano, conceitos como autonomia e cidadania se atualizam em atividades que caracterizam a vida nas cidades e se desdobram em torno de certos temas, como o uso do dinheiro, ou a apropriação do espaço. A experiência dos técnicos envolvidos mais diretamente com os moradores, como os cuidadores, produz uma técnica de escuta e mobilização, que não admite cartilhas nem regras pré-estabelecidas ou imutáveis. Este trabalho conjunto, formador de redes e sustentado na interação, é indicador de integralidade na execução da proposta da Reforma Psiquiátrica. / The work intends to present a map of the activities performed by mental health professionals that assist the dwellers of the residential care homes in the municipal district of Carmo, State of Rio de Janeiro. These residences are part of a stage in the process of desinstitutionalisation of a state Psychiatry Hospital, an agricultural colony type, founded during the forties in the 20th century, and where about 280 inpatients lived. From 2003 on, when the hospital was closed under coordination of the state manager, and the resources were municipalised, a small part of the inpatients returned to their families, but the majority (about 160) were placed in care homes, scattered over country or urban district areas. Taking the task of social inclusiveness as the political bias of Brazilian Psichiatric Reform, day-to-day work of the multiprofessional team is focused. In this relational level, the text looks forward to conceptualise Politics and political work, through Arendt, Gramsci, Deleuze and Guattaris ideas, among others. And ergonomics enables a view to knowledge production, with its approach to human work. Based on a camp research, the map production reveals how politic task is performed, in the professionals activities, that means, in the micropolitics of professionals meetings with one another, with civil society and with the residents, where values of Psichiatric Reform are negotiated. In the end, its a phase in a process, still half way between state and municipal administration, where the proposal is sustained by the administrators politic will, and, on its way to become hegemonic, must be discussed among professionals and civil society. The landscape is not homogeneous, and the dinamics reveal the diversity of understandings and interests. In the scenery of everyday work, concepts such as autonomy or citizenship are present on activities which are characteristic of city life, and they unfold over some themes, as the use of money, or the making and occupying of ones personal space. The experience of the professionals that work closer to the residentes, as the caretakers do, produces a technique of hearing and stimulation, which by no means admits unchangeable or preestablished rules. This group work, maker of nets and relying on interaction, is an indicator to integrality when Psychiatric Reform proposal is performed.