Syftet med avhandlingen är att ur ett medborgarskaps- och kommunikativt perspektiv undersöka och problematisera funktionshindrade ”brukares” självbestämmande i samtal som förs under s.k. brukarcentrerade teammöten organiserade av en vuxen- respektive en barn- och ungdomshabilitering. I mötena deltar en funktionshindrad brukare och/eller anhöriga och professionella från skilda verksamheter. Studien baseras på diskursanalys av 18 observerade och bandinspelade möten hållna av tio olika team. Analyserna visar att brukarna hade ett mer eller mindre begränsat inflytande över samtalens organisering. Inflytandet varierade med organiseringen av samtalen samt med i vilken utsträckning brukarna deltog aktivt genom att identifiera egna problem och framtida mål. Det synliggjorde en spänning mellan ett ”idealt” självbestämmande och brukarnas förmåga/benägenhet att leva upp till de krav som det ”ideala” självbestämmandet ställde och gav upphov till situationer i vilka dilemman mellan självbestämmande och paternalism uppstod. I analyserna av hanterandet av dessa situationer framkom att deltagarna i möten utan deltagande brukare motiverade sina åsikter och beslut rörande behandlingen av brukaren genom att referera till egna övertygelser om vad som är bäst för brukaren respektive till tolkningar av brukarens egna preferenser utifrån hennes/hans agerande i vardagslivet. I möten med deltagande brukare använde övriga deltagare diskursiva strategier som var mer eller mindre paternalistiska då de innebar att de styrde brukaren på ett sätt som det inte var säkert att brukaren själv ville. I avhandlingen diskuteras vilka möjliga strategier som skulle kunna öka brukarnas självbestämmande. Utfallet relateras också till det ”samtalande” och sociala medborgarskap som brukarna i avhandlingen anses utöva samt till andra möjliga innebörder av ett socialt medborgarskapsutövande. / From a citizenship and communicative perspective the aim of the dissertation is to examine and problematize the self-determination of disabled “users” during conversations taking place at “user-centred” team meetings. The meetings are organised by two habilitation centres, one for children and young people and one for adults. One disabled user and/or his/her relatives and professionals representing different institutions participate in the meetings. The study is based on discourse analysis of 18 observed and audiotaped team meetings held by ten different teams. The analyses show that the users exerted a more or less restricted influence on the organisation of the conversations. This varied with the organisation of the conversations and to the extent that the users participated actively by identifying their own problems and future goals. Hence, a certain conflict between an “ideal” type of self-determination and the users’ ability/willingness to live up to the demands that this kind of self-determination makes on them was revealed. This conflict gave rise to situations in which dilemmas between selfdetermination and paternalism appeared. By analysing how these situations were handled it was found that the participants in meetings without participating users accounted for their opinions and decisions concerning the treatment of the users by referring either to interpretations of the user’s preferences, which were based on the user’s behaviour in everyday life, or to their own beliefs of what would benefit the user. In meetings with participating users, the other participants handled the situations by steering the discussions in directions the user may not have chosen him-/herself. These discursive strategies were more or less paternalistic. In the dissertation it is discussed what other possible strategies exist that could increase the users’ self-determination. The result is also related to the “spoken” and social citizenship that the users are considered to exercise, as well as to other possible meanings of social citizenship.

<p>This essay is about needs assessors within public elder care. The method is a quantitative vignette study. The aim of the study is to find out whether there is an existing consensus among the needs assessors when a relative to a client with reduced cognitive functions wants to make an application even though the client does not want to. We also wanted to find out whether there are any underlying circumstances which have influence on the needs assessors’ reactions to this specific situation. We used a questionnaire which consisted of four vignettes that illustrated a meeting between a needs assessor, a client and a relative to the client. The vignettes was complemented with questions that made it possible to find underlying circumstances that determine whether the needs assessors do accept the application from the clients relative. The result shows that professional experience and education is significant for whether the needs assessors choose to accept the application or not. It is also clear that there are variations depending on which town district the needs assessors work in. In some town district the needs assessors act with great similarity while there are huge differences in other town districts.</p>

<p>The aim of our study was to investigate how much self-determination persons with intellectual disabilities living in group-homes have when it comes to recreational activities. We studied what the recreational activities looked like, if there was any self-determination concerning recreational activities and which factors influenced self-determination for persons with intellectual disabilities. We used qualitative interviews with persons with intellectual disabilities, next of kin and personnel at group-homes. The result has been analyzed from earlier research, central concepts as self-determination and recreational activities and the theory of empowerment. The most important results that emerged in our study were; that recreational activities for persons with intellectual disabilities varied substantially, that there is a large number of to recreational activities available and no one seemed directly displeased with their recreational activities. Organized recreational activities mostly took place in segregated environments. This circumstance led to discussions within the interview-groups. The interviewed persons were of the opinion that there existed self-determination concerning recreational activities, however, there were many factors influencing the degree of self-determination. These factors were; the level of intellectual disability, the personnel at group-homes, organisation and personnel-resources, economy and public communications.</p>

This essay is about needs assessors within public elder care. The method is a quantitative vignette study. The aim of the study is to find out whether there is an existing consensus among the needs assessors when a relative to a client with reduced cognitive functions wants to make an application even though the client does not want to. We also wanted to find out whether there are any underlying circumstances which have influence on the needs assessors’ reactions to this specific situation. We used a questionnaire which consisted of four vignettes that illustrated a meeting between a needs assessor, a client and a relative to the client. The vignettes was complemented with questions that made it possible to find underlying circumstances that determine whether the needs assessors do accept the application from the clients relative. The result shows that professional experience and education is significant for whether the needs assessors choose to accept the application or not. It is also clear that there are variations depending on which town district the needs assessors work in. In some town district the needs assessors act with great similarity while there are huge differences in other town districts.

The aim of our study was to investigate how much self-determination persons with intellectual disabilities living in group-homes have when it comes to recreational activities. We studied what the recreational activities looked like, if there was any self-determination concerning recreational activities and which factors influenced self-determination for persons with intellectual disabilities. We used qualitative interviews with persons with intellectual disabilities, next of kin and personnel at group-homes. The result has been analyzed from earlier research, central concepts as self-determination and recreational activities and the theory of empowerment. The most important results that emerged in our study were; that recreational activities for persons with intellectual disabilities varied substantially, that there is a large number of to recreational activities available and no one seemed directly displeased with their recreational activities. Organized recreational activities mostly took place in segregated environments. This circumstance led to discussions within the interview-groups. The interviewed persons were of the opinion that there existed self-determination concerning recreational activities, however, there were many factors influencing the degree of self-determination. These factors were; the level of intellectual disability, the personnel at group-homes, organisation and personnel-resources, economy and public communications.

The aim of this thesis was to study elderly people’s experiences of and approach to their usage of home care services with tax deduction. The aim was also to describe how elderly people reason about their underlying motives of using home care service with tax deduction. The study is based on six qualitative interviews with people between the ages of 65 and 80, living in Nacka, Sweden. This thesis is a collaboration with Stiftelsen Stockholms läns Äldrecentrum/ Stockholm Gerontology Center and part of their follow up study concerning simplified administration for elderly people applying for home care services in Nacka. The theory of rational choice was used in the analysis of the results. The primary results showed that elderly people’s usage of home care services with tax deduction was limited though regular and consist mainly of basic domestic work. The overall experiences of using home care services with tax deduction were positive and described in terms of satisfaction and as a possibility of independence and influence regarding their needs of services and how they were executed. The results indicate that the usage of home care services with tax deduction is partly based on elderly people’s lack of confidence in publicly-financed elderly care. Due to the distrust in elderly care and the self-determing factors home care services with tax deduction generated, their choice of using home care services with tax deduction seemed more appealing than publicly-financed home care services.

The dissertation is about people with serious functional impairments who receive support pursuant to the Swedish LSS – the Act Concerning Support and Service for Persons with Certain Functional Impairments. LSS gives compensatory support, so that a person can enjoy the right to live a life like anyone else. The user’s right to influence and self-determination is emphasized in the Act. The overall aim of the dissertation is to describe and analyse conditions, possibilities, and limitations to influence and self-determination for people receiving LSS support. The investigation includes two interview studies. One is a study of influence and self-determination in everyday life with personal assistance. The other study focuses on people receiving some form of LSS service in combination with having a limited guardian. The thesis shows that LSS can be understood on a general level as a judicial recognition of the group’s right to support for citizenship on individual terms. In many cases LSS service give the user influence and self-determination in everyday life. The interaction between the user and the supporting persons are crucial. If it involves mutual recognition of equality and recognition of difference – the right to be compensated for restricted abilities – then the user can act autonomously. The study deals with power and recognition as essential aspects. The analysis shows that recognition and power together contribute to an understanding of the complex situation that users of LSS measures have in their day-to-day lives. The intention behind the care is to ensure the user’s best interest. Relations and encounters around the user are affected by pastoral power with a caring purpose where support and control are interwoven. Mis-directed recognition is perceived as an infringement of integrity. The dilemma is that care that aims for something good without recognition reduces the user to an object and disrespect. The studies reveal a tension between the ideal of influence and self-determination as ”subject of rights” and the user’s everyday life. Personal assistance can be designed to contribute to achieving the intentions. Among many people receiving LSS support and having a legal guardian, the personal influence and self-determination are not distinct and guardianship is unclear. Relations are characterized by dilemmas concerning the preferential right of interpretation. The individuals are seen as “objects of care” by others. Influence and self-determination depend on a fundamental recognition of the user as subject with a need for individually adapted care. This means the right to be and act as a “subject of care”. Recognition, relations and power are keys to influence and self-determination in LSS.

Framför dig har du nu en studie som berör ämnet självbestämmande ur ett personalperspektiv. Studien bygger på en kvalitativ ansats där empirin har samlats in med hjälp av semistrukturerande intervjuer. De frågeställningar som ställs i denna studie är: Hur kan personal som arbetar med personer med funktionsnedsättning i sitt professionella förhållnings- och arbetssätt ta hänsyn till den enskildes rätt till självbestämmande? När personal och den enskilde har olika åsikter om vad som ska bestämmas för den enskilde, hur utvecklas då rätten till självbestämmande för den enskilde? Vilka normer och värderingar kan bli dominerande från personalens sida när oenighet uppstår mellan personal och den enskilde om vad som ska bestämmas för henom? Det viktigaste resultatet från denna studie är att personalen upplever en svårighet i att den enskilde ska bestämma själv och samtidigt få stöd och hjälp. / In front of you is now a study concerning the subject of self-determination from a perspective of professionals. The study is based on a qualitative approach where empirical data was collected using semi- structuring interviews. The questions posed in this study were: How can staff working with persons with disabilities, in their professional approaches and practices while considering the individuals self-determination? When staff and the individual have different opinions on what to decide in matters concerning the individual, how then develops the autonomy of the individual? What norms and values can become dominating in the professional approach when disagreements arise between staff and the individual about what should be determined for him/her? The key finding from this study is that the staff is experiencing a difficulty in that the individual should decide for yourself while getting support and help.

Indigenous rights are among the most rapidly progressing domains in international law. The UN Declaration on the Rights of Indigenous Peoples was adopted more than a decade ago, and now the task consists of implementing the rights within the state structure. While the concept of self- determination constitutes the very core of indigenous rights, it also represents the most difficult challenge to establish within the existing system of sovereign states. This thesis seeks to contribute to the discussion regarding the implementation of indigenous peoples’ right to self-determination within states. By examining the public discourse surrounding the concept of self-determination in relation to the Sami people in the Swedish political system, it’s possible to obtain a deeper understanding of the dynamics in play. The thesis focuses on analyzing the core elements of self- determination and the formulation of the perceived problems surrounding the political measures of the concept. The discourse analysis, examining the period 2006-2017, concludes that the understanding of the concept of self-determination is linked to the political status of the indigenous people, the political debate within the national assembly, the perception of possible solutions and the function of indigenous institutions.

Alla människor är egna individer och dessa individuella skillnader påverkar hur vi upplever sociotekniska system. Det finns en problematik bland system inom organisationer nämligen att systemen inte lever upp till organisationers förväntningar. Sett ur ett perspektiv av välmående anställda innebär det att systemen inte uppfyller de psykologiska grundbehoven tillhörighet, kompetens och autonomi. Det finns ett flertal färdiga sociotekniska system på marknaden vars syften är att bidra till ökat välmående bland anställda inom organisationer. Problematiken med färdiga sociotekniska system är att de inte innehar samma grad av flexibilitet till organisationers specifika behov som ett nytt sociotekniskt system. Samtidigt finns en problematik i designprocesser av nya sociotekniska system där den sociala och tekniska kontexten inte anammas som en helhet på grund av att metoder inom sociotekniska system inte har tillräcklig sammanhållning. System som inte designas med hänsyn till anställdas välmående kan orsaka arbetsrelaterad stress. För att motverka den här problematiken har det här examensarbetet gjort en litteratursökning med perspektiv ur informatik, psykologi och Human Resources. Utifrån litteratursökningen har kriterier för sociotekniska system formulerats och applicerats på färdiga sociotekniska system. Jämförelsen resulterar i en djupare diskussion av två sociotekniska system som uppfyller flertalet kriterier men samtidigt visar på en problematik som främst berör att tillräcklig hänsyn inte har tagits till personliga möten och individuella skillnader. Resultatet av diskussionen mynnar ut i ett antal designprinciper som lägger grund för vidare forskning och belyser utvecklingsmöjligheter inom sociotekniska system i relation till välmående anställda inom organisationer. / All people are own individuals and our individual differences affect how we experience a sociotechnical system. There is a problematic situation among systems where they cannot live up to the expectations of organizations. From a wellbeing perspective it implies that the systems do not fulfill our fundamental psychological needs which are competence, autonomy and relatedness. There are some finished sociotechnical systems whose purpose are to contribute to increased wellbeing among employees in organizations. The issue regarding finished sociotechnical systems is that it cannot adopt to organizations needs the same way a new sociotechnical system could. Also, there is another problematic situation with processes of design among new sociotechnical systems where not enough consideration is taken to the social and technical context as a unit because there is a disconnection between methods regarding socio technical systems. When systems are not designed with enough consideration to wellbeing among employees it can cause stress related to work. This examination has taken the perspectives of informatics, psychology and Human Resources to counteract this problem. Criterias have been formulated from the results of the literature search to be applied to finished sociotechnical systems. Two of the finished sociotechnical systems fulfilled most of the criterias but a problem was still highlighted since not enough consideration have been taken to personal meetings and individual differences. The result of the discussion ends up in design principles which build a ground for further research and opportunities of development among sociotechnical systems in relationship to wellbeing among employees in organizations.