Genom kvalitativa intervjuer med fem kriminalvårdsanställda och en transidentifierad intagen ville jag bidra med kunskap om hur Kriminalvårdens möten med fängelsedömda transpersoner kan se ut. Syftet med studien var att undersöka normer, värderingar och praktiker som intervjudeltagarna gav uttryck för när det gäller intagna transpersoner. Intervjudeltagarna uttryckte en medvetenhet kring gruppens utsatta position i fängelsemiljön men vittnade samtidigt om avsaknad av såväl riktlinjer som strukturerade arbetssätt i frågorna. Praktiker fokuserade snarare på det avvikande och direkta än det normativa och förebyggande. Intagna själva förväntades begripliggöra sin identitet för omgivningen, samtidigt som insatser riktade mot personalens (o)medvetenhet saknades. Kriminalvården kan sägas bidra till att upprätthålla normativa föreställningar om två binära kön genom att inte tillhandahålla handlingsplaner eller självklara alternativ för personer som sträcker sig mellan, bortom eller är föränderliga mellan de två könskategorierna kvinna och man. Att inte ta ställning illustrerar maktutövning, osynliggörande och kan innebära en kränkning i sig själv. / Through qualitative interviews with five employees in the Swedish correctional system and one trans-identified inmate, I sought to get an understanding of transgender inmates are dealt with in the Swedish correctional system. The aim of this study was to examine norms, values and practices expressed by the interview participants regarding transgender inmates. The interview participants expressed an awareness of the group’s vulnerable position in the prison environment, but also the lack of guidelines as well as structured methods to handle the group. Responses focused on the deviant and direct rather than the normative and preventive. The transgendered inmates themselves were responsible to explain their identity to others. At the same time there were no efforts to make the staff members aware of questions concerning gender identities and/or expressions. The Swedish correctional system can be said to maintain normative conceptions of two binary sexes by failing to provide action plans or natural options for persons with gender identities that extend beyond woman or man, or fluctuate between the two categories. To refuse to take a stand is to exercise power, make transgender inmates invisible, and perhaps even be seen as a violation in itself.

<p><em>Syfte:</em> Utvärdering av hur patienter upplever den förbokade återbesökstiden, väntetiden samt personalens bemötande vid återbesöket. Syftet är även att undersöka hur personal på ortopedens nyinrättade ”snabbmottagningen” vid AS upplever stress, patientflöde samt telefonförfrågningarna, efter införandet enligt Lean-modellen</p><p><strong></strong><em>Metod:</em> Deskriptiv kvantitativ enkätstudie. Slumpmässigt urval utfördes på patienter och av hundra procent (n=55) tillfrågade, deltog fyrtionio procent (n=27). Av hundra procent tillfrågad personal (n=14), deltog sextiofyra procent (n=9). Urvalet utförde avdelningschefen.</p><p><strong></strong><em>Resultat<strong>:</strong></em> Utvärderingen av patienternas upplevelser av planerad återbesökstid, bemötande och väntetid på snabbmottagningen var generellt mycket bra. Personal på ortopedmottagningens snabbmottagning upplevde ingen större förändring efter införandet enligt Lean-modellen.</p><p><strong></strong><em>Slutsats:</em> Resultatet visar att patienterna upplevde den planerade återbesökstiden generellt mycket bra. Personalens upplevde inte att arbetet förändrats. Fler och större studier behövs för att utvärdera organisationsförändringar som initierats av Lean-modellen.</p> / <p><em>Aim:</em> Evaluation of paitents’ experiences of the prebooked time for next appointment, the waiting time and the staff’s treatment at the next appointment. The aim is also to examine how the staff at the newly established orthopedic “quickreception” at the Uppsala University hospital experience stress, patientflow and the telephonerequests, after the introduction according to the Lean-model.</p><p><em>Method</em>: Descriptive quantitative inquirystudy. Patients were selected randomly and out of one hundred percent (n=55) who were asked, fortynine percent (n=27) participated. Out of one hundred percent (n=14) of the staff asked, sixtyfour percent (n=9) participated. The selection was made by the head of the ward.</p><p><em>Results</em>: Evaluation of the patients’ experiences of the planned time for next appointment, treatment and waiting time at the “quickreception” was generally very good. The staff at the orthopedic “quickreception” did not experience a big change after the introduction according to the Lean-model.</p><p><em>Conclusion:</em> The results show that the patients experienced the planned time for next appointment generally very good. The staff did not experience that the work had changed. More and larger studies are needed to evaluate changes of organisations that were initiated by the Lean-model.</p>

Syfte: Utvärdering av hur patienter upplever den förbokade återbesökstiden, väntetiden samt personalens bemötande vid återbesöket. Syftet är även att undersöka hur personal på ortopedens nyinrättade ”snabbmottagningen” vid AS upplever stress, patientflöde samt telefonförfrågningarna, efter införandet enligt Lean-modellen Metod: Deskriptiv kvantitativ enkätstudie. Slumpmässigt urval utfördes på patienter och av hundra procent (n=55) tillfrågade, deltog fyrtionio procent (n=27). Av hundra procent tillfrågad personal (n=14), deltog sextiofyra procent (n=9). Urvalet utförde avdelningschefen. Resultat: Utvärderingen av patienternas upplevelser av planerad återbesökstid, bemötande och väntetid på snabbmottagningen var generellt mycket bra. Personal på ortopedmottagningens snabbmottagning upplevde ingen större förändring efter införandet enligt Lean-modellen. Slutsats: Resultatet visar att patienterna upplevde den planerade återbesökstiden generellt mycket bra. Personalens upplevde inte att arbetet förändrats. Fler och större studier behövs för att utvärdera organisationsförändringar som initierats av Lean-modellen. / Aim: Evaluation of paitents’ experiences of the prebooked time for next appointment, the waiting time and the staff’s treatment at the next appointment. The aim is also to examine how the staff at the newly established orthopedic “quickreception” at the Uppsala University hospital experience stress, patientflow and the telephonerequests, after the introduction according to the Lean-model. Method: Descriptive quantitative inquirystudy. Patients were selected randomly and out of one hundred percent (n=55) who were asked, fortynine percent (n=27) participated. Out of one hundred percent (n=14) of the staff asked, sixtyfour percent (n=9) participated. The selection was made by the head of the ward. Results: Evaluation of the patients’ experiences of the planned time for next appointment, treatment and waiting time at the “quickreception” was generally very good. The staff at the orthopedic “quickreception” did not experience a big change after the introduction according to the Lean-model. Conclusion: The results show that the patients experienced the planned time for next appointment generally very good. The staff did not experience that the work had changed. More and larger studies are needed to evaluate changes of organisations that were initiated by the Lean-model.

<p>Årsakene til at mennesker med psykisk utviklingshemming utvikler utfordrende atferd er mange og sammensatte. Biologiske, psykologiske og miljømessige faktorer bidrar hver for seg eller sammen til at atferden oppstår. Uri Bronfenbrenners økologiske modell for sosial utvikling beskriver faktorer som kan påvirker atferd. Det handler om nære relasjoner og om omkringliggende systemers innvirkning på relasjonene. Studiens hensikt har vært å beskrive kommunalt ansatte omsorgsgiveres erfaringer med økologiske faktorers betydning for å kunne mestre og forebygge for utfordrende atferd hos mennesker med psykisk utviklingshemming. Åtte omsorgsgivere fra seks ulike omsorgsmiljøer har blitt intervjuet om sine erfaringer. Studien er gjennomført etter kvalitativ forskningsmetode. Materialet har blitt samlet inn og analysert etter hermeneutisk tilnærming. Omsorgsyternes erfaringer med økologiske faktorers betydning i omsorgsarbeidet er tydeliggjort i fem beskrivningskategorier: Tøff hverdag, Ulik tilnærming - nesten samme praksis, Ulike miljøer, Trygt arbeidsmiljø og Lukkede miljøer. Studien viser at økologiske faktorer påvirker forekomst av utfordrende atferd hos mennesker med psykisk utviklingshemming. Bevisstheten om de enkelte faktorenes betydning kan bidra til å utvikle forebyggende tiltak i omsorgsmiljøene.</p> / <p>The causes behind the development of challenging behaviour in people with learning disability are numerous and complex. This type of behaviour is prompted by a combination of biological, psychological and environmental variables. The ecological model proposed by Uri Bronfenbrenner for social development describes variables that can influence behaviour, mainly the close relations between people and how surrounding systems influence those relations. The purpose of this study is to describe how caretakers, employed by various municipalities, have used ecological factors and drawn experience from them in handling and preventing challenging behaviour in people with learning disability. Eight caretakers from six different environments have been interviewed on their practical experience. The study has been carried out with qualitative research techniques. The material has been collected and analyzed according to a hermeneutical approach. The caretakers` experience of the importance of ecological factors in the caregiving tasks is demonstrated in five description categories: Difficult daily tasks, Different approach- almost same practice, Different environments, Safe working environment and Closed environments. The study demonstrates that ecological factors influence the incidence of challenging behaviour in people with learning disability. Being conscious of the importance of the various factors may promote the development of preventive measures in the caretaking environments.</p>

<p></p><p>Studies have shown that patients receiving mechanical ventilation in an intensive care unit (ICU), who are entirely dependent on the nursing staff, often experience frustration due to a temporary loss of the voice source. Limited communication is an important factor contributing to patient discomfort. Nursing staff also report communication as frustrating and difficult.</p><p>The aim of the present study is to introduce a neck-type electrolarynx as a communication aid in an ICU, to study the nursing staff experiences of communication with tracheotomized patients receiving mechanical ventilation, and to examine the patient´s experiences regarding communicative abilities. Communication between a ventilator treated, tracheotomized patient and members of the nursing staff was recorded and analyzed according to principles of Conversation Analysis (CA).</p><p>The results show that several members of the nursing staff experience difficulties communicating with tracheotomized patients receiving mechanical ventilation. A majority believe that the conditions for communication could be improved. The results of CA also indicate that an electrolarynx may be an effective and appropriate communication aid for ventilator treated, tracheostomized patients. Further research is needed to broaden the knowledge of<strong> </strong>the electrolarynx as a communication aid for these patients.</p><p>Keywords: communication, mechanical ventilation, electrolarynx, patient experience, nursing staff experience, Conversation Analysis (CA).</p>

 Studies have shown that patients receiving mechanical ventilation in an intensive care unit (ICU), who are entirely dependent on the nursing staff, often experience frustration due to a temporary loss of the voice source. Limited communication is an important factor contributing to patient discomfort. Nursing staff also report communication as frustrating and difficult. The aim of the present study is to introduce a neck-type electrolarynx as a communication aid in an ICU, to study the nursing staff experiences of communication with tracheotomized patients receiving mechanical ventilation, and to examine the patient´s experiences regarding communicative abilities. Communication between a ventilator treated, tracheotomized patient and members of the nursing staff was recorded and analyzed according to principles of Conversation Analysis (CA). The results show that several members of the nursing staff experience difficulties communicating with tracheotomized patients receiving mechanical ventilation. A majority believe that the conditions for communication could be improved. The results of CA also indicate that an electrolarynx may be an effective and appropriate communication aid for ventilator treated, tracheostomized patients. Further research is needed to broaden the knowledge of the electrolarynx as a communication aid for these patients. Keywords: communication, mechanical ventilation, electrolarynx, patient experience, nursing staff experience, Conversation Analysis (CA).

Årsakene til at mennesker med psykisk utviklingshemming utvikler utfordrende atferd er mange og sammensatte. Biologiske, psykologiske og miljømessige faktorer bidrar hver for seg eller sammen til at atferden oppstår. Uri Bronfenbrenners økologiske modell for sosial utvikling beskriver faktorer som kan påvirker atferd. Det handler om nære relasjoner og om omkringliggende systemers innvirkning på relasjonene. Studiens hensikt har vært å beskrive kommunalt ansatte omsorgsgiveres erfaringer med økologiske faktorers betydning for å kunne mestre og forebygge for utfordrende atferd hos mennesker med psykisk utviklingshemming. Åtte omsorgsgivere fra seks ulike omsorgsmiljøer har blitt intervjuet om sine erfaringer. Studien er gjennomført etter kvalitativ forskningsmetode. Materialet har blitt samlet inn og analysert etter hermeneutisk tilnærming. Omsorgsyternes erfaringer med økologiske faktorers betydning i omsorgsarbeidet er tydeliggjort i fem beskrivningskategorier: Tøff hverdag, Ulik tilnærming - nesten samme praksis, Ulike miljøer, Trygt arbeidsmiljø og Lukkede miljøer. Studien viser at økologiske faktorer påvirker forekomst av utfordrende atferd hos mennesker med psykisk utviklingshemming. Bevisstheten om de enkelte faktorenes betydning kan bidra til å utvikle forebyggende tiltak i omsorgsmiljøene. / The causes behind the development of challenging behaviour in people with learning disability are numerous and complex. This type of behaviour is prompted by a combination of biological, psychological and environmental variables. The ecological model proposed by Uri Bronfenbrenner for social development describes variables that can influence behaviour, mainly the close relations between people and how surrounding systems influence those relations. The purpose of this study is to describe how caretakers, employed by various municipalities, have used ecological factors and drawn experience from them in handling and preventing challenging behaviour in people with learning disability. Eight caretakers from six different environments have been interviewed on their practical experience. The study has been carried out with qualitative research techniques. The material has been collected and analyzed according to a hermeneutical approach. The caretakers` experience of the importance of ecological factors in the caregiving tasks is demonstrated in five description categories: Difficult daily tasks, Different approach- almost same practice, Different environments, Safe working environment and Closed environments. The study demonstrates that ecological factors influence the incidence of challenging behaviour in people with learning disability. Being conscious of the importance of the various factors may promote the development of preventive measures in the caretaking environments.

Covid-19-pandemin har haft en stor inverkan på det svenska samhället och den svenska vård- och omsorgen. Det finns flertalet utländska studier som undersöker upplevelsen av att arbeta på särskilt boende för äldre under covid-19-pandemin, men ännu ingen svensk studie inom området. Syftet med denna studie var att utifrån en svensk kontext få en ökad förståelse kring personalens upplevelse av att arbeta på särskilt boende för äldre under covid-19-pandemin. Data samlades in genom semistrukturerade intervjuer med personal på boenden i södra Sverige. Data analyserades därefter genom induktiv tematisk analys. Vilket resulterade i fem teman: Jobbigt med skyddsutrustning, Rädsla för smittan, Att göra sitt bästa i en svår situation, Ökad arbetsbörda blev vardag samt Ris och ros i kommunikationen. Resultatet ger en bild av den upplevelse som personalen erfor. Vilket var att personalen upplevde en känsla av att göra sitt bästa trots nya utmaningar på arbetsplatsen. På så sätt kan beslutsfattare skapa sig en förståelse kring hur arbetsmiljön behöver anpassas efter personalens behov i framtiden. / The Covid-19 pandemic has had a major impact on Swedish society and Swedish healthcare. There are several foreign studies that examine the experience of working in nursing homes during the covid-19 pandemic, but there is no Swedish study in the area yet. The purpose of this study was to, based on a Swedish context, gain an increased understanding of the staff's experience of working in nursing homes for the elderly during the covid-19 pandemic. Data was collected through semi- structured interviews with staff at nursing homes in southern Sweden. Data was then analyzed through inductive thematic analysis. Which resulted in five themes: Difficulty with protective equipment, Fear of infection, Doing one's best in a difficult situation, Increased workload became accustomed and Criticized and praised communication. The result gives a picture of the experience that the staff experienced. Which was that the staff experienced a sense of doing their best despite new challenges in the workspace. In this way, decision makers can create an understanding of how the work environment needs to be adapted to the staff's needs in the future.

Bakgrund: Alzheimer och vaskulär demens är de vanligaste demensdiagnoserna som drabbar den äldre patienten. Diagnoserna påverkar patienten olika beroende på var i hjärnan skadan sitter. Agitation, oro och svårigheter att förstå sin omgivning är dock vanliga symptom. Husdjursrobot definieras som ett gemensamt begrepp då det finns olika benämningar för tekniken. Denna teknik har blivit vanligare att använda inom vården särskilt t inom äldreomsorgen som terapi för patienter med demensdiagnos och syftet är att förbättra deras välbefinnande och livskvalité. Syfte: Att beskriva vårdpersonalens erfarenhet av husdjursrobotar i omvårdnaden av patienter med en demensdiagnos. Metod: En allmän litteraturöversikt där resultatet baserades på tolv artiklar varav sex med mixad metod, fem kvalitativa och en kvantitativ. Resultat: Analysen av resultaten resulterade i tre kategorier: omvårdnad, vårdmiljö och designens betydelse. Vårdpersonal som beskriver att arbetsmiljön i demensvården ofta är psykiskt påfrestande erfor att arbetsmiljön blir mindre psykiskt påfrestande vid användning av husdjursrobot. Slutsats: Husdjursrobot är ett viktigt och positivt verktyg som både gynnar vårdpersonalen och patienten med demensdiagnos. När patienterna med demensdiagnos integrerade med husdjursrobot, såg vårdpersonalen att tekniken husdjursrobot frambringade känslor som kärlek och trygghet. / Background: Alzheimer’s and vascular dementia are the most common dementia diagnoses affecting elderly patients. Dementia affects patients differently depending on the location of the damage in the brain. Agitation, anxiety and difficulty understanding one's surroundings are, however, common symptoms. Pet robots is defined as a common term, as although this technology has various names. This technology has become more common to use in healthcare particularly in elderly care as therapy for patients with dementia and the aim is to improve their well being and life quality. Purpose: Is to describe the nursing staff's experience with pet robots in the care of patients diagnosed with dementia. Methods: A general literature review was conducted on twelve articles, six of which were mixed methods, five qualitative, and one quantitative. Results: The analysis of the results was separated into three categories: nursing; the care environment; and the design’s importance for the interaction. The care staff, who often describe the work environment in dementia care as psychologically stressful, found that their work became less psychologically stressful when using a pet robot. Conclusion: Pet robots are an important and positive tool that benefits both patients with a diagnosis of dementia and the staff responsible for their care. When patients with a diagnosis of dementia integrated with the pet robot, the care staff could see that the pet robot brought out emotions such as love and security.

Våld i nära relationer (VNR) är ett utbrett samhällsproblem som kan få förödande konsekvenser, både för den utsatta individen och för samhället i stort. Många som utsätts för VNR är tveksamma till att söka hjälp och upprätta en polisanmälan. Hälso- och sjukvården besöks vid olika typer av problem och vårdcentraler kan vara en av de få instanser individer utsatta för VNR söker sig till. Syftet med studien är att undersöka personal på vårdcentralers möjligheter och förutsättningar att identifiera och hantera VNR genom sin yrkesroll utifrån kunskap om Region Skånes vårdprogram mot VNR med förhoppningen att styrka vårdcentralers brottspreventiva arbete mot VNR. Intervjuer har genomförts med personal på vårdcentral och resultatet visade att kännedom och användning av Region Skånes vårdprogram mot VNR varierade mellan studiens informanter. Många informanter kände till att ett vårdprogram mot VNR existerar men hade endast lite kunskap om innehållet. Gemensamt för alla informanter var dock att vårdprogrammet ofta inte användes som ett stöd i arbetet. Det fanns möjligheter till identifiering och hantering av VNR på vårdcentraler då frågan om utsatthet ofta ansågs lätt att ställa, men det var svårt för informanter att avgöra vem som skulle tillfrågas. Informanter kände sig även osäkra gällande hanteringen av identifierad VNR. Det uppgavs dock finnas goda möjligheter för detta arbete men hinder sågs i form av tidsbrist, otillräcklig kunskap om VNR, otillräckliga riktlinjer för hanteringen av VNR och osäkerhet kring dokumentation av VNR. Informanter menade att de ser arbetet med VNR som en del av deras ansvar men inte uttalat tänkt på vårdcentraler som en del av samhällets brottsprevention. / Violence in close relationships (VCR) is a widespread societal problem that may have devastating consequences for the victim and the society. Many victims of VCR are hesitant to seek help. The Swedish healthcare system is widely visited by the public and primary health centers (PHC) can be one of the few places victims of VCR visit. The aim of the study was to examine the possibilities and barriers medical professionals working in PHC have to be able to identify and manage VCR with the basis in the knowledge of Region Skåne’s care program against VCR. The results showed that many informants know that the care program exists but have little knowledge of the contents and rarely use the program. There were possibilities to identify and manage VCR in PHC as the question regarding patient’s victimization is seen as easy to ask but it was difficult to determine who should be asked. Informants felt insecure regarding the management of VCR and barriers were identified in the form of lack of time, inadequate knowledge about VCR, inadequate guidelines for the management of VCR and uncertainty regarding the documentation of VCR. The informants saw identification and management of VCR as part of their responsibility, however they did not outspokenly think about PHC as part of society’s crime prevention.