Syftet med studien är att undersöka enhetschefers upplevelser av rekryteringsprocessen efter införandet av en skyddad yrkestitel för undersköterskor inom kommunal hemtjänst. Vidare syfte är att undersöka eventuella konsekvenser av införandet av den skyddade yrkestiteln samt enhetschefernas strategier för att hantera eventuella konsekvenser på rekryteringsprocessen. Det kvalitativa materialet består av elva transkriberande intervjuer med enhetschefer för kommunala hemtjänster runt om i Sverige. En innehållsanalys valdes för att analysera resultatet där sex kategorier genererades: 1) Rekryteringsprocessen förlängs efter krav på yrkestitel, 2) Ingen skillnad i rekrytering efter krav på skyddad yrkestitel, 3) Krav på yrkestitel underlättar i rekryteringsprocessen, 4) Kravet på skyddad yrkestitel minskar urvalet, 5) Tidsbegränsade anställningar i avvaktan på yrkestitel 6) Svårigheter i rekryteringsprocess. Resultaten visade att enhetschefernas upplevelser varierade beroende på förutsättningar i form av arbetsbelastning, personalomsättning och antalet sökande kandidater. Majoriteten var dock eniga i att införandet av yrkestitel minskade urvalet av kvalificerade kandidater. Enhetscheferna använde sig av visstidsanställningar för kandidater som inte hade bevis på yrkestitel då dessa inte kunde tillsvidareanställas. Enhetscheferna upplevde vidare etiska dilemman i att anställa undersköterskor med skyddad yrkestitel men saknade personlig lämplighet, på grund av politiska krav. Resultaten analyserades utifrån Abbotts professionsteori. Den tidigare forskningen varierade, liksom vårt resultat, men belyste att rekryteringssvårigheter av undersköterskor är ett faktum efter införandet av skyddad yrkestitel. Detta är något som försvårar möjligheterna till hållbar organisering. Professionsteorin belyste svårigheter med legitimitet för undersköterskeyrket och hur införandet av skyddad yrkestitel påverkar olika delar av rekryteringsprocessen. Slutsatserna är att det hälsofrämjande ledarskapet kan gynnas av ett stort handlingsutrymme och ekonomiska resurser för att kunna möta rekryteringssvårigheterna. / The purpose of the study is to investigate unit managers' experiences of the recruitment process after the introduction of a protected professional title for assistant nurses in municipal home care. A further aim is to investigate possible consequences of the introduction of the protected professional title as well as the unit managers' strategies for dealing with possible consequences on the recruitment process. The qualitative material consists of eleven transcribed interviews with unit managers for municipal home services around Sweden. A content analysis was chosen to analyze the result where six categories were generated: 1) The recruitment process is prolonged after the requirement of a professional title, 2) No difference in recruitment after the requirement of a protected professional title, 3) The requirement of a professional title facilitates the recruitment process, 4) The requirement of a protected professional title reduces the selection , 5) Time-limited employment pending a professional title 6) Difficulties in the recruitment process. The results showed that the unit managers' experiences varied depending on conditions in the form of workload, staff turnover and the number of candidates applying. However, the majority agreed that the introduction of professional titles reduced the selection of qualified candidates. The unit managers used fixed term employment for candidates who did not have proof of a professional title, as these could not be employed indefinitely. The unit managers further experienced ethical dilemmas in employing assistant nurses with a protected professional title but lacking personal suitability, due to political demands. The results were analyzed based on Abbott's profession theory. The previous research varied, as did our results, but highlighted that recruitment difficulties of assistant nurses are a fact after the introduction of protected professional title. This is something that makes the possibilities for sustainable organization more difficult. The profession theory highlighted difficulties with legitimacy for the nursing profession and how the introduction of a protected professional title affects different parts of the recruitment process. The conclusions are that the health-promoting leadership can benefit from a large scope for action and financial resources to be able to meet the recruitment difficulties.

Background The Swedish population is ageing quickly and the system for elderly home care is under increasing pressure. Staff turnover is high, nursing assistants are reporting stress, and employers have to recruit staff lacking sufficient experience. These factors are barriers to empathic care, considered essential to patient health outcomes. Elderly care should rely on cognitive empathy, be other-oriented and improve the client’s situation based on contextual understanding. There is a need for education and support for nursing assistants, so that they can provide empathic care. Purpose The thesis explores empathy as a skill in elderly home care to identify opportunities of promoting empathy in the client-nursing assistant interaction, by means of behaviour change interventions delivered through an mHealth application that nursing assistants already use at work. Method A group interview was conducted with six nursing assistants from four elderly home care organisations in a Swedish municipality, to learn about their experience of empathy at work, and factors affecting their ability to give empathic care. The respondents were using the same mHealth application to get and provide information about client visits. The Behaviour Change Wheel framework was used to analyze behavioural drivers of empathic care in elderly home care. Results Influences on empathic behaviour was identified in all 14 domains in the Theoretical Domains Framework. 13 target behaviours, 7 Intervention Functions and 45 Behaviour Change Techniques were suggested as suitable candidates to investigate for intervention development. Conclusion Empathy seems possible to promote through resource-efficient digital behaviour change interventions. Future studies may use this work as a starting point for development of interventions to promote empathic behaviour in elderly care.

Background: The National Board of Health and Welfare (2020) states that when coordination fails this leads to difficulties in the cooperation between the roles of the various professions and this lack results in the staff's holistic approach to care are failing.  The National Board of Health and Welfare (2020) also shows that the elderly drink more and more alcohol and statistics show that alcohol consumption among 65-84-year-olds has risen by 21% since 2014. Purpose: The purpose of our study was to get a deeper understanding of how the work on the elderly with alcohol abuse is carried out within the home care service from the perspective of leaders and assistant nurses. Method: Collection of data material was carried out through a qualitative method which was carried out in total through eight semi-structured interviews with unit managers and assistant nurses in the home care service. Result: To then analyze the results we used collaboration from Bert Danermark, room for maneuver from Michael Lipsky and Ingrid Karlsson's thesis there she reflects on room for maneuver and freedom of action.  was used. The results of the study showed a lack of knowledge among the staff when it comes to the elderly and alcohol abuse as well as the managers' room for maneuver and the staff's freedom of action is limited towards the elderly with alcohol abuse in the home care service through laws and guidelines. They require further collaboration between the home care service and other organizations such as substance abuse care to prevent the elderly from ending up in alcohol abuse. Conclusion: Our conclusion is that there is a great need for collaboration and cooperation between the various actors in society and that one should review the already existing laws or come up with proposals for a new law. / Bakgrund: Socialstyrelsen (2020) konstaterar är att när samordning brister leder detta till svårigheter i samarbetet mellan de olika yrkesprofessionernas roller och denna brist resulterar i att personalens helhetsgrepp kring vården fallerar. Socialstyrelsen (2020) visar även att äldre dricker alltmer alkohol och statistik visar att alkoholkonsumtionen bland 65–84-åringar har stigit med 21 % sedan 2014. Syfte: Syftet med vår studie var att få en ökad förståelse om hur arbetet kring äldre med alkoholmissbruk bedrivs inom hemtjänsten utifrån enhetschefer och undersköterskors perspektiv. Metod: Insamling av datamaterial har genomförts genom en kvalitativ metod som sammanlagt genomfördes genom åtta semistrukturerade intervjuer med enhetschefer och undersköterskor inom hemtjänsten. Resultat: För att sedan analysera resultatet användes teorierna om samverkan från Bert Danermark, handlingsutrymme från Michael Lipsky och Ingrid Karlssons avhandling där hon reflekterar över handlingsutrymme och handlingsfrihet. Studiens resultat visade kunskapsbrist hos personalen när det kommer till äldre och alkoholmissbruk samt chefernas handlingsutrymme och personalens handlingsfrihet begränsar deras arbete gentemot de äldre med alkoholmissbruk inom hemtjänsten. De krävs ytterligare samverkan mellan hemtjänsten och andra organisationer så som missbruksvården för att förebygga att äldre hamnar i ett alkoholmissbruk. Slutsats: Vår slutsats är att det finns ett stort behov av samverkan och samarbete mellan de olika aktörerna i samhället samt att man bör se över de redan befintliga lagarna eller komma med förslag till en ny lag.