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  • 51.
    Cederlöf, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Man, Isabelle
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    "Men shit, hur fan har vi kunnat glömma bort det?": Falu kommuns socialtjänsts arbete gällande prostitution2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study was to examine whether and how the social services in the municipality of Falun is managing social work related to prostitution. It is a qualitative study based on three focus group interviews conducted in parts of the social services organization in the municipality of Falun. The empirical data collected was analyzed from an intersectional perspective.

    Several distinct findings emerged from the study. Social work against prostitution does not exist in the social services organization in the municipality of Falun. The organization possesses no procedures or guidelines for this kind of work, and no preventive work or cooperation with other organizations is carried out.

    It also emerged, that several social work officers had a stereotype image of who a potential sex- seller could be. This fact may influence who would be able to get any support from social services regarding to this social problem.

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  • 52. Cheung Chung, M
    et al.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Austin, C
    Barkby, H
    Brown, H
    Cash, S
    Ellingford, J
    Hanger, L
    Pais, T
    Posttraumatic stress disorder in older people after a fall2009In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 24, no 9, p. 955-964Article in journal (Refereed)
  • 53. Dag, Munir
    et al.
    Kullberg, Christian
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Can they work it out and do they get any satisfaction?: Young Swedish physically disabled men’s and women’s work involvement and job satisfaction2010In: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 12, no 4, p. 287-303Article in journal (Refereed)
  • 54.
    Dahl, Rebecca
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Gillström, Josefine
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Integrering och inkludering genom föreningslivet: En intervjustudie om föreningslivets möjligheter till integration av nyanlända och ensamkommande barn och ungdomar2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Over the past few years, children and youths have been forced to escape their homes. On arrival in Sweden it is important that they become included into the Swedish society. The organization ‘Save the Children’ has developed a project to include these newly arrived children through organized sport activities. The main purpose of this study is to examine whether the leaders involved in this project experience that sport can promote integration for these newly arrived children. This qualitative study is based on 5 semi-structured interviews with the leaders. The main results are as follows: Most of the leaders find that this contributes to a certain level of integration in the society, the project contributes with knowledge despite some obstacles and the leaders have gained a greater cultural understanding and are assisting these children and youths in their everyday life.

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  • 55.
    Dahlberg, Lena
    Dalarna University, School of Education, Health and Social Studies, Social Work. Karolinska Institutet; Stockholm University.
    Ageing in a changing place: a qualitative study of neighbourhood exclusion2019In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779Article in journal (Refereed)
    Abstract [en]

    An inclusive neighbourhood is a key facilitator enabling older adults to age in place. Neighbourhoods have been identified as a dimension of social exclusion important to older adults, and it has been argued that older adults are particularly vulnerable to neighbourhood change. The aim of this study was to explore older adults’ experiences of neighbourhood exclusion within the context of neighbourhood change. Focus groups were undertaken in the urban and rural areas of a metropolitan borough in England involving a total of 41 older adults, with data analysed via thematic analysis. Urban areas in the borough studied have transformed following the closure of the mining industry, with a high level of deprivation in many areas, while some rural areas have undergone gentrification. Within the context of structural neighbourhood change, four themes were identified: community cohesion, political agency, feelings of safety and the physical environment. The themes were interlinked, which calls for collaboration across traditional lines of professional responsibility, and for research that encompasses different aspects of neighbourhood exclusion. This study contributes with knowledge on older adults’ experiences of exclusion, including novel findings on the importance of political agency and collective memory, and identifies actions to combat exclusion. An active involvement of older adults in the development of initiatives to tackle social exclusion is recommended.

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  • 56.
    Dahlberg, Lena
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    De äldre och ensamheten2013In: Äldre i Centrum, ISSN 1653-3585, no 1, p. 46-46Article in journal (Other (popular science, discussion, etc.))
  • 57.
    Dahlberg, Lena
    Dalarna University, School of Health and Social Studies, Social Work.
    Older people’s perspectives on the causes of social exclusion2009Conference paper (Other academic)
  • 58.
    Dahlberg, Lena
    Dalarna University, School of Health and Social Studies, Social Work.
    Risk för ensamhet2013In: Äldre i Centrum, ISSN 1653-3585, no 3, p. 20-21Article in journal (Other (popular science, discussion, etc.))
  • 59.
    Dahlberg, Lena
    Dalarna University, School of Health and Social Studies, Social Work.
    Social exclusion and care receipt in old age2010Conference paper (Other academic)
  • 60.
    Dahlberg, Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. Karolinska Institutet.
    Agahi, Neda
    Karolinska Institutet.
    Lennartsson, Carin
    Karolinska Institutet.
    Lonelier than ever?: Loneliness of older people over two decades2018In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 75, p. 96-103Article in journal (Refereed)
    Abstract [en]

    To live with feelings of loneliness has negative implications for quality of life, health and survival. This study aimed to examine changes in loneliness among older people, both with regard to prevalence rates, and socio-demographic, social and health-related correlates of loneliness. This study had a repeated cross-sectional design and was based on the nationally representative Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD). Analyses of trends in loneliness covered the years 1992, 2002, 2004, 2011 and 2014, and included people aged 77 years or older (n=2 572). Analyses of correlates of loneliness covered 2004 and 2014, and included people aged 70 years or older (n=1 962). Logistic regression analyses were conducted with findings presented as average marginal effects. Contrary to what is often assumed, there has been no increase in loneliness among older people over time (1992-2014). Regression analyses for 2004 and 2014 showed that social and health-related correlates were more strongly associated with loneliness than socio-demographic correlates. Psychological distress was most strongly associated with loneliness, followed by widowhood. Most associations between the correlates and loneliness were stable over time.

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  • 61.
    Dahlberg, Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Agahi, Neda
    Karolinska Institutet & Stockholms universitet.
    Schön, Pär
    Karolinska Institutet & Stockholms universitet.
    Lennartsson, Carin
    Karolinska Institutet & Stockholms universitet.
    Planned and unplanned hospital admissions and their relationship with social factors: Findings from a national, prospective study of people aged 76 years or older2018In: Health Services Research, ISSN 0017-9124, E-ISSN 1475-6773, Vol. 53, no 6, p. 4248-4267Article in journal (Refereed)
    Abstract [en]

    Objective

    To examine the relationship between social factors and planned and unplanned hospital admissions among older people.

    Data Sources/Study Setting

    2011 data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) and data from the Swedish National Patient Register until December 31, 2012.

    Study Design

    The study had a prospective design. Data were analyzed via Cox proportional hazard regressions with variables entered as blocks (social factors, sociodemographic and ability factors, health factors).

    Data Collection

    Data were collected via interviews with people aged 76+ (n = 931).

    Principal Findings

    Living in institutions was negatively associated with planned admissions (hazard ratio (HR): 0.29; confidence interval (CI): 0.09–0.88), while being in receipt of home help was positively associated with unplanned admissions (HR: 1.57; CI: 1.15–2.14). Low levels of social contacts and social activity predicted unplanned admissions in bivariate analyses only. Higher ability to deal with public authorities was positively associated with planned admissions (HR: 1.77; CI: 1.13–2.78) and negatively associated with unplanned admissions, although the latter association was only significant in the bivariate analysis.

    Conclusions

    Hospital admissions are not only due to health problems but are also influenced by the social care situation and by the ability to deal with public authorities.

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  • 62.
    Dahlberg, Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Andersson, Lars
    Linköpings universitet.
    Lennartsson, Carin
    Karolinska Institutet & Stockholms universitet.
    Long-term influences on loneliness: Results of a nationally representative study with follow-up after 20 years2016Conference paper (Refereed)
  • 63.
    Dahlberg, Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Andersson, Lars
    Linköping University.
    Lennartsson, Carin
    Karolinska Institutet & Stockholms universitet.
    Long-term predictors of loneliness in old age: Results of a 20-year national study2018In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 22, no 2, p. 190-196Article in journal (Refereed)
    Abstract [en]

    Objectives: There is a general lack of longitudinal research on loneliness in old age. Drawing on life course theory and the convoy model, this study aimed to examine whether there is an association between loneliness in old age and social engagement 20 years earlier.

    Method: Data from the nationally representative Swedish Panel Study of Living Conditions of the Oldest Old (2002 and 2011 data collection waves) and the Swedish Level of Living Survey (1981 and 1991 data collection waves) were used, including 823 individuals with an average age of 82.4 years at follow-up.

    Results: Each form of social engagement in old age was associated with the same form of social engagement 20 years earlier. Close forms of social engagement were negatively associated with loneliness in old age; as were more distant forms of social engagement, but only when they were considered solely in old age.

    Conclusion: Patterns of social engagement in old age were established at least 20 years earlier. Close forms of social engagement are long-term predictors of loneliness, although current social engagement tended to be more influential on loneliness. The study underlines the importance of interventions targeted at close relationships that can provide social support in old age.

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  • 64.
    Dahlberg, Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Andersson, Lars
    Linköpings universitet.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Lennartsson, Carin
    Karolinska Institutet ; Stockholms universitet.
    Predictors of loneliness among older women and men in Sweden: A national longitudinal study2014Conference paper (Other academic)
    Abstract [en]

    Objectives: To examine the extent to which older women and men (70+) report feelings of loneliness with a focus on: a) changes in reported loneliness as people age, and b) which factors predict loneliness.

    Methods: Data from the 2004 and 2011 waves of SWEOLD, a longitudinal national survey study, was used. The prediction of loneliness in 2011 by data collected in 2004 was examined in three logistic regression models for the total sample (n=587), for women and for men.

    Results: Older people moved in and out of frequent loneliness over time, but there was a general increase in loneliness as they aged. Recent widowhood and depression increment were associated with loneliness in both women and men. Loneliness, widowhood, depression and mobility problems measured in 2004 predicted loneliness uniquely in women in 2011; whereas low level of education and social contact reduction predicted loneliness uniquely in men.

    Discussion: Loneliness is not always a stable condition, demonstrating the importance of longitudinal research. Gender differences in incidence and predictors make it important to look at women and men separately both when researching loneliness and when targeting interventions to prevent or reduce loneliness in older people.

  • 65.
    Dahlberg, Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. Karolinska institutet.
    Berndt, Hanna
    Karolinska Institutet & Stockholm Universitet.
    Lennartsson, Carin
    Karolinska Institutet & Stockholms universitet.
    Schön, Pär
    Receipt of formal and informal help with specific care tasks among older people living in their own home: National trends over two decades2018In: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515, Vol. 52, no 1, p. 91-110Article in journal (Refereed)
    Abstract [en]

    Sweden is seen as a typical example of a social-democratic welfare regime, with universal and generous welfare policies. However, in the last decades, there have been substantial reductions in the Swedish provision of care for older people. This study aimed to examine trends in sources of care-receipt in older people (77+) living in their own home and with a perceived need of help with two specific tasks: house cleaning or food shopping. Trends in care-receipt were examined in relation to gender, living alone, having children and socioeconomic position. Data from the 1992, 2002 and 2011 data collection waves of the national study SWEOLD was used. Response rates varied between 86 and 95 per cent, and the sample represents the population well. Trends and differences between groups were explored in bivariate and logistic regression analyses. There was a reduction in formal care-receipt regarding house cleaning and food shopping over the study period. It was more common for women than men to receive formal care, and more common for men than women to receive informal care. Reductions in formal care have affected older women more than older men. Still, living alone was the most influential factor in care-receipt, associated with a greater likelihood of formal care-receipt and a lower likelihood of informal care-receipt. It can be concluded that public responsibility for care is becoming more narrowly defined in Sweden, and that more responsibility for care is placed on persons in need of care and their families.

  • 66.
    Dahlberg, Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Berndt, Hanna
    Karolinska Institutet & Stockholms universitet.
    Lennartsson, Carin
    Karolinska Institutet & Stockholms universitet.
    Schön, Pär
    Karolinska Institutet & Stockholms universitet.
    Sweden’s changing welfare mix over two decades: Trends in care for community-based older people with perceived need2015Conference paper (Refereed)
  • 67.
    Dahlberg, Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Frank, Amanda
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Naseer, Mahwish
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Systematic review of longitudinal risk factors for loneliness among older adults2019Conference paper (Refereed)
  • 68.
    Dahlberg, Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Living on the edge: Social exclusion and the receipt of informal care in older people2016In: Journal of Aging Research, ISSN 2090-2204, E-ISSN 2090-2212, p. 1-10, article id 6373101Article in journal (Refereed)
    Abstract [en]

    Older people have been identified as being at risk of social exclusion. However, despite the fact that care is commonly required in later life and the majority of that care provided by informal carers, a connection between social exclusion and informal care-receipt has rarely been considered. The aim of this study was to examine how informal care-receipt is related to social exclusion.

    A face-to-face questionnaire survey on social exclusion and informal care-receipt was carried out among older people (n=1255) living in Barnsley, United Kingdom. Multivariable analyses examined the association between social exclusion and categories of informal care-receipt: care receiver; assurance receiver; non-receiver with no need; non-receiver with need.

    Compared to being a non-receiver with no need participants were more likely to be a care receiver or assurance receiver if they had higher levels of social exclusion. The highest level of social exclusion, however, was found in non-receivers with need. Despite a lack of informal care and support, formal practical support and personal care was also low in this latter group. Findings are discussed in relation to the conceptualisation of care-receipt and how contact with medical services could be an opportunity for identification and appropriate referral of non-receivers with need.

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  • 69.
    Dahlberg, Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Psychological, health and social predictors of emotional and social loneliness in older people2013In: Proceedings of the 20th IAGG World Congress of Gerontology and Geriatrics, Seoul, Korea, 2013Conference paper (Refereed)
    Abstract [en]

    Background: Loneliness in old age has been shown to have negative outcomes such as mortality, physical and mental health problems, and reduced activity levels. To reduce loneliness in older people, factors associated with loneliness and open to intervention must be identified.

    Methods: Older people (aged 65+, N=1255) from the United Kingdom received a questionnaire-based interview (response rate: 66.0%). The questionnaire covered items on demographic, psychological, health and social characteristics. It also contained the de Jong-Gierveld Loneliness Scale (de Jong-Gierveld & Kamphuis, 1985), measuring Emotional and Social Loneliness.

    Findings: Eight percent of the respondents were found to be severely or very severely lonely, while another 38% were moderately lonely. Being female, widowed, low well-being, low self-esteem, high activity restriction, and high concern about personal finances were significant predictors of Emotional Loneliness (F(17, 976)=25.59, R2=.31, p<.001).  Being female, widowed, low well-being, low self-esteem, high concern about personal finances, low contact with family, low contact with friends, low engagement, and low perceived community integration were significant predictors of Social Loneliness (F(17, 982)=19.63, R2=.25, p<.001).

    Discussion:  This study provides empirical evidence for conceptual separation of emotional and social loneliness. Consequently, different targets for intervention are required in order to reduce emotional and social loneliness respectively, although psychological intervention has the potential to reduce both. 

    Background: Loneliness in old age has been shown to have negative outcomes such as mortality, physical and mental health problems, and reduced activity levels. To reduce loneliness in older people, factors associated with loneliness and open to intervention must be identified.

    Methods: Older people (aged 65+, N=1255) from the United Kingdom received a questionnaire-based interview (response rate: 66.0%). The questionnaire covered items on demographic, psychological, health and social characteristics. It also contained the de Jong-Gierveld Loneliness Scale (de Jong-Gierveld & Kamphuis, 1985), measuring Emotional and Social Loneliness.

    Findings: Eight percent of the respondents were found to be severely or very severely lonely, while another 38% were moderately lonely. Being female, widowed, low well-being, low self-esteem, high activity restriction, and high concern about personal finances were significant predictors of Emotional Loneliness (F(17, 976)=25.59, R2=.31, p<.001).  Being female, widowed, low well-being, low self-esteem, high concern about personal finances, low contact with family, low contact with friends, low engagement, and low perceived community integration were significant predictors of Social Loneliness (F(17, 982)=19.63, R2=.25, p<.001).

    Discussion:  This study provides empirical evidence for conceptual separation of emotional and social loneliness. Consequently, different targets for intervention are required in order to reduce emotional and social loneliness respectively, although psychological intervention has the potential to reduce both. 

  • 70.
    Dahlberg, Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Social exclusion and well-being among older adults in rural and urban areas2018In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 79, p. 176-184Article in journal (Refereed)
    Abstract [en]

    Background: Social exclusion (SE) is a process that limits participation in society across life domains, and is associated with poor quality of life. Neighbourhood exclusion has been identified as particularly important for older adults. This paper examines the association between SE and well-being in older adults from urban and rural areas, focusing on neighbourhood exclusion.

    Methods: Using a cross-sectional survey design with a stratified sampling frame, participants (aged 65+) from rural (n=628) and urban (n=627) areas of Barnsley, United Kingdom, completed a questionnaire containing indicators of five SE domains: civic activity, material resources, social relationships, services and neighbourhood. Sequential linear regression models were developed for 1) total sample; 2) rural areas; and 3) urban areas, with well-being regressed on SE indicators after controlling for self-reported health.

    Results: SE indicators explained 13.4% of the variance in well-being in the total sample (of which neighbourhood exclusion explained 1.2%); corresponding figures for the rural model were 13.8% (3.8%) and for the urban model 18.0% (1.7%); the addition of neighbourhood exclusion significantly improved all three models.  Five SE indicators were significant in the rural model, compared with seven in the urban model, with four common to both.

    Discussion: Neighbourhood exclusion explained more variance in well-being in rural than urban areas, whereas exclusion from services explained more variance in urban than rural areas. Area characteristics and the role of neighbourhood should be considered in policy initiatives to reduce SE and promote well-being.

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  • 71.
    Dahlberg, Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Fritzell, Johan
    Lennartsson, Carin
    Trends in social exclusion among older women and men in Sweden2018Conference paper (Refereed)
    Abstract [en]

    Background: Social exclusion is a framework for understanding the complexity of disadvantage across various domains of life such as material resources, social relations, civic activities and services. Reviews have identified a lack of gender perspective in social exclusion research. This paper will introduce the framework of social exclusion, and examine trends over time in the levels of social exclusion across different life domains for older women and men in Sweden.

    Methods: Data on indicators of social exclusion were analysed from respondents aged 76+ years who participated in the 1992, 2002 and 2011 waves of the nationally representative Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD).

    Results: There was evidence of a gender different in exclusion from material resources and civic activities, from which women were more often excluded than men. Regardless of gender there were improvements in access to material resources, such as owning a house/apartment.  Social contacts (visiting or being visited by friends) decreased over time, while engagement in cultural activities and going to restaurants increased.

    Conclusions: Trends in social exclusion in older adults over the last 20 years are dependent on the domain considered. Over a range of indicators, older women were more vulnerable to exclusion than men, which needs to be taken into account in policy to combat exclusion.

  • 72.
    Dahlberg, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Kardell, Elin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Beviljad hemtjänst: En jämförelse mellan två kommuner2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to explore what home care services were granted to older residents of two municipalities in Dalarna in 2016, and whether there were differences between the municipalities in the level of services. A random sample of 64 cases from each municipality’s database was drawn, allowing for descriptive analysis of services granted and bivariate analysis of associations with municipality and age, gender, and living arrangements of cases. The results showed that the municipalities offered similar home care services, but that the level of services granted differed significantly between municipalities. Municipality moderated the relationships between age, gender, and living arrangements of cases, and between the level of "serviceinsatser" and both age and living arrangements. Social activity service was granted more to older people in one municipality but to younger people in the other municipality. The results are discussed in relation to institutional theory and interpreted as due to conforming forces and local organization.

  • 73.
    Delibasic, Amina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Foroughi, Michelle
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Sköldberg, Mikaela
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Boendestöd - en insats som leder till större självständighet: Politikers synpunkter gällande boendestöd och avgifter2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The overall aim of the study was to investigate housing support from a politician’s perspective and why some municipalities chose to introduce a fee for the housing support. Qualitative data collection methods were used in the form of semi-structured telephone interviews with politicians in different municipalities in Sweden. The data collected were analyzed with thematic analysis and divided into four main themes: independence, home help assistance, fees for assistance and support free of charge. The theoretical frame was empowerment theory. The results showed that all municipalities agree that housing support is important in the individual's life and contributes to increased independence. The result showed further that that the municipalities' reasoning differs very much concerning the fees. Some municipalities consider that the municipality's economy is of significant importance when introducing the fees while some considers that the economy has no significance.

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  • 74.
    Djuse, Åsa
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Nordqvist, Lovisa
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Att möta dubbel problematik: En kvantitativ studie om våldsutsatta kvinnor med missbruksellerberoendeproblematik utifrån missbrukshandläggaresperspektiv2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Most women with substance-abuse problems are also subjected to violence, constituting a

    serious societal challenge. The social support they receive has been found insufficient and a

    need to strengthen knowledge/skills within social services has been highlighted. Using Christies

    (1986) ’ideal victim’ theory as a framework, the purpose of this study was to describe social

    workers self-perceived competence in relation to female clients subjected to violence, and to

    explore their attitudes regarding women with substance-abuse problems. Social workers

    managing female substance-abuse cases were recruited from all municipalities of Dalecarlia,

    Sweden. The study was conducted based on a quantitative approach and questionnaires were

    used for data collection. Participants’ responses indicated that the majority perceived their

    competence to be good. Furthermore, participants tended to endorse non-ideal victim

    descriptors of women with substance-abuse problems, and while the largest proportion (47,4%)

    agreed with the statement that violence should be considered secondary to substance-abuse, a

    similar proportion (42,1%) disagreed. These findings suggested that inadequate competence

    within social services does not serve as an explanation for the insufficient social support.

    Instead the study highlights attitudes and organizational conditions within social services in

    relation to the women.

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  • 75.
    Efendic, Elvira
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Fahlin, Lovisa
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Biståndshandläggaren och samvetsstressen: En kvalitativ intervjustudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of our study was to examine the experience of work-related stress of conscience within social workers. We aimed to identify what stress of conscience is for the professional group social workers, whose work include exercise of public authority, and what specifically causes stress of conscience in their work. We conducted six qualitative interviews with social workers whose profession includes exercise of public authority. The result shows that all the respondents experience stress of conscience as they describe themselves having difficulties to cope with their bad conscience, thus leading to negative stress symptoms, both mentally and physically. The interviewees described, however, the experience of stress of conscience in various degrees which were categorized: constant presence of stress of conscience, presence of stress of conscience in specific situations, and conscious suppression of stress of conscious. The result further shows that stress of conscious can be created by the demands and expectations that the organisation, clients and their relatives, as well as the social workers have, if they are experienced as overwhelming and conflicting. Our study indicates that there is a need for further research regarding stress of conscience within social workers.

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  • 76.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet; Chalmers University of Technology.
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.
    Wijk, Helle
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    A systematic review of the psychometric properties of instruments for assessing the quality of the physical environment in healthcare2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2796-2816Article in journal (Refereed)
    Abstract [en]

    AIM: To identify instruments measuring the quality of the physical healthcare environment, describe their psychometric properties.

    BACKGROUND: The physical healthcare environment is regarded as a quality factor for healthcare. To facilitate evidence-based design there is a need for valid and usable instruments that can evaluate the design of the healthcare environment.

    DESIGN: Systematic psychometric review.

    DATA SOURCES: A systematic literature search in Medline, CINAHL, Psychinfo, Avery index and reference lists of eligible papers (1990-2016).

    REVIEW METHOD: COSMIN guidelines were used to evaluate psychometric data reported.

    RESULTS: Twenty-three instruments were included. Most of the instruments are intended for for healthcare environments related to the care of older people. Many of the instruments were old, lacked strong, contemporary theoretical foundations, varied in the extent to which they had been used in empirical studies and in the degree to which their validity and reliability had been evaluated.

    CONCLUSIONS: Although we found many instruments for measuring the quality of the physical healthcare environment, none met all of our criteria for robustness. Of the instruments, The Multiphasic environmental assessment procedure, The Professional environment assessment protocol and The therapeutic environment screening have been used and tested most frequently. The Perceived hospital quality indicators is user centred and combine aspects of the physical and social environment. The Sheffield care environment assessment matrix has potential as it is comprehensive developed using a theoretical framework that has the needs of older people at the centre. However, further psychometric and user-evaluation of the instrument is required. 

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  • 77.
    Elvhage, Gudrun
    et al.
    Stockholms Universitet.
    Forsner, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Identifying children at risk in Swedish schools2016Conference paper (Refereed)
  • 78.
    Elvhage, Gudrun
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Liedgren, Pernilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    They call me "Mum"2013In: Becoming a social worker: Narratives from Around the World / [ed] Cree, Vivianne, Edinburgh: Routledge, 2013, p. 70-77Chapter in book (Other academic)
    Abstract [en]

    This is a book about social workers and social work. It tells the story of the journey into and through social work of people from around the world living and working in social work today. We hear what has brought them into social work and what has kept them in it since. Their lively accounts demonstrate that commitment and passion remain at the heart of social work today. This new edition of Becoming a Social Worker is made up of entirely new stories. It describes what it is like to be a social worker in a range of different practice settings in different countries. While many of the narratives are from practitioners and educators who either grew up in, or came as adults to, the UK, half of the narratives explores the experiences of social workers and educators working in different parts of the world in countries as diverse as Australia and New Zealand, India and Bangladesh, Ireland, Sweden and Eastern Europe, Nigeria, the USA and Canada. The book ends with a commentary, which argues that social work is truly a global profession.Some of the contributors will be recognised as those who have played a key part in shaping social work over the years and they provide valuable insights into how the profession has developed over time. Other contributors, less well known but no less interesting, give a vivid account of the challenges that social work education and practice face, and the shared values that underpin social work wherever it is located. Social work is a demanding and difficult job that goes largely unseen within society. We only ever hear about social work and social workers when something goes wrong and a vulnerable adult or child is hurt. Becoming a Social Worker sets out to change that - to make social work visible, so that those considering a career in the caring professions across the world can make an informed choice about whether social work is the career for them.

  • 79.
    Engh, Johan
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Att få ett jobb har betytt mycket: En kvalitativ brukarutvärdering av Krami2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In this qualitative user evaluation, users from the Krami-programme in Borlänge have been interviewed on what they consider to have been positive changes in their social situation after participating in the programme. The respondents also point out factors in the programme that have supported these changes. The method consisted of interviews with five men who have undergone the Krami programme.

    The results show that Krami primarily helps the users to get an employment which results in the repeal of criminogenic factors. This plays an important part in the positive change of the users self-esteem, which tends to lead towards ”unlabeling” of the individual as “criminal”.

    The study also indicates other factors in the program that the users found helpful in their process of change highlighting the interaction between authorities, the approach of the Krami- staff and also the common rules that the participants has to agree upon. The users also poins out the importance of ones own motivation for changes to take place. 

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  • 80.
    Englund, Emla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Sandström, Frida
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Röster från ett bostadsområde i Sverige: En kvalitativ studie om boendes egna upplevelser av att bo i ett såkallat utsatt område2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study is to investigate residents own experience of living in Tjärna ängar and examine the notions they have about how outsiders think of Tjärna ängar to see if these notions affect the residents. The study is a qualitative study in which semi-structured interviews were used. The material has been analyzed from three different theoretical perspectives, territorial stigmatization, established and outsiders and the media. The result showed that the image of the area Tjärna ängar differ between the residents and the community. The residents experience the neighborhood as safe while the community sees it as disordered. The residents think that a major factor in the creation of the image that exists in the community is what media reports about the neighborhood. Furthermore the result showed that the neighborhood Tjärna ängar are subject to a territorial stigmatization.

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  • 81.
    Engström, Harald
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Karlsson, Malin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Skolkuratorns stora uppdrag: Handlingsutrymme och förväntningar på yrkesrollen2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    There is a limited amount of research on the school counselors’ perspective and

    perception of their work situation and professional role within the school. The aim

    of the study was to explore how school counselors’ perceive expectations of their

    professional role by teachers and principals, how they handle these expectations and

    how they perceive their discretion within the school. The method was qualitative

    and semi-structured interviews were conducted with six school counselors. The

    theoretical framework of the study were Role theory and the theory of Negotiated

    order. The study showed that the role of the school counselor is extensive and

    influenced by the school counselor itself, surrounding values and norms and also the

    expectations of teachers and principals. Further, the study showed that expectations

    are best managed through dialogues which leads to improved cooperation between

    the different professions. The conclusion is that the school counselors’ perception

    of discretion is large, but that organizational conditions inhibit their ability to utilize

    it.

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  • 82.
    Eriksson, Gina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Tømmervold, Maria
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Kvinnors kamp mot hedersrelaterat våld och förtryck: En kvalitativ studie om fyra kvinnors upplevelser av motmakt, frigörelse och upprättelse.2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    This study aimed to investigate how four women, through countermeasures, left honor-related violence and oppression, what their liberation looked like and whether they experienced a sense of redemption. It was a qualitative study based on four autobiographies and a targeted content analysis as method and used theories as power, counter-power and shame. The results of the study included how the women in different ways demonstrated their counter-power towards the perpetrators and communities with degrading women´s views. Furthermore, all women liberated themselves, which was a process that was going on for a long time and could to a large extent be related to increased knowledge and their right of self-determination. The results of the establishment were linked to confirmation in some form, which could come from the community, other individuals or that they confirmed themselves. The study contributed to a deeper understanding of women´s experiences of honor-related violence and oppression.

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  • 83.
    Eriksson, Hanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Emretsson, Veronica
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Öppenvårdsbehandling och återhämtningskapital: En utvärdering av ett kommunalt öppenvårdskoncept för beroendebehandling2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att utvärdera ett kommunalt öppenvårdskoncept för behandling vid beroendeproblematik i en svensk mellanstor kommun. Detta genom att undersöka klienters måluppfyllelse och positiv förändring gällande hälsa, välmående och livssituation samt sociodemografiska faktorers samband med behandlingsresultat. En kvantitativ innehållsanalys genomfördes av klienters akter (n = 37) med hjälp av ett kodningsprotokoll. En beskrivande samt bivariat analys genomfördes i SPSS. Resultatet visade att måluppfyllelsen var hög bland de klienter som fullföljde behandlingen. Resultatet visade även ett starkt signifikant samband mellan positiv förändring och fullföljande av behandling. Bland sociodemografiska faktorer visade andra insatser sig vara betydelsefullt både gällande fullföljande av behandling och positiv förändring.

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  • 84.
    Eriksson, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Matsson, Monika
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    ”Vi stänger dörren och går ut…”: En kvalitativ studie om hemtjänstpersonalens erfarenheter, rutiner och kunskaper om våld i nära relationer hos äldre2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna studie är att undersöka hemtjänstpersonalens kunskaper om, rutiner och erfarenheter av att arbeta med äldre personer som är eller misstänks vara utsatta för våld i nära relationer. Fem stycken kvalitativa intervjuer genomfördes med hemtjänstpersonal som jobbar i ordinärt boende. Resultatet visar genomgående i hela studien att samtliga intervjupersoner uppvisar en kunskapsbrist gällande våld i nära relationer hos äldre, vilket skapar en frustration hos personal då de blir oförmögna att hjälpa den äldre på bästa sätt. Resultatet visar även på att intervjupersonerna känner ett bra stöd hos kollegor och chefer vilket underlättar deras arbetssituation. Studien påvisar ett behov av fortbildning för personalen inom området våld i nära relationer.

  • 85.
    Eriksson, Sara
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    "Man känner sig ju lite grann som en spelpjäs" : Ett klientperspektiv på samverkansmöten inom Socialtjänsten2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    This is a qualitative study aimed to gain a deeper understanding of a client´s participation in collaboration meetings. Four clients that get interventions from the Social services have been interviewed with a semi-structured interview. After the intake of empirical data it has been made a content analysis.

    The research shows that a collaboration meeting is built out of social processes that can either create participation of the client or obstruct it. The study also shows that there are power differences in collaboration meetings and that these must be made visible continuously in order to create a more equal discussion. It has also emerged that there are factors at an individual, group and structural level which hinders or promotes client participation.

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  • 86.
    Fagerberg, Johan
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Lydnadsmodus på socialtjänsten: En operationalisering av funktionell dumhet2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The study's aim was to apply Paulsen’s (2017) model of functional stupidity as a form of organizational compliance to a social work context. A questionnaire was developed with 20 Likert items that operationalised Paulsen's ten “stupidity rationales”, together with a measure of work satisfaction, and distributed to social workers in six municipalities (N=73). Results show that most stupidity rationale items were endorsed by a majority of participants, with the “despair” mode of compliance most strongly endorsed. Bivariate and internal consistency reliability analysis indicated that Paulsen's model was a good fit to the data, while multiple regression analysis demonstrated that the model of functional stupidity explained 30 percent variance in work satisfaction, with “authoritarian” and "cynicism" modes as significant predictors in the model. The study suggests that Paulsen's model of functional stupidity has potential value for increasing our understand of how social workers' cope with the demands of their work.

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  • 87.
    Fahlvik, Ida
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Simonsson Lindberg, Siri
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Det gäller att hålla huvudet kallt och hjärtat varmt: En studie om socialarbetares upplevelser av rollkonflikt och makt i socialt arbete2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    As a social worker, you need to think with a cool head while having a warm heart. Driven by

    a will to help, but faced with laws and regulations that can lead to conflicts between the

    professional and governing body. This study has been put in place to examine this

    relationship from the social workers point of view. This qualitative study aims to examine

    social workers experiences of power in “the authority role” and how that power affect “the

    helper role” within social work. We also want to investigate how these roles affect in meeting

    with the client. In order to understand the social workers experiences semi-structured

    interviews were made with workers within this department. The main focus was to exam how

    the specified roles affect the meeting with clients. Factors examined are: The relationship,

    conflicts, management and power between the roles. In the analysis of the result, the concepts

    of pastoral power and caring power have been used, and thus lift the social workers view of

    power and help. The study shows that all informants experienced contradictions between the

    roles and that the balance between power and help is complex. However, the study also shows

    that the subject is relatively unreflected by the social workers.

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  • 88.
    Fatoohi, Sally
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Koch, Nadine
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Varför kvinnor stannar i våldsutsatta relationer.: Professionellas uppfattningar och arbete.2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In this study, the topic of domestic violence and men’s violence against women have been highlighted. Reasons as to why women chose to stay in abusive relationships have been investigated, and further on how professionals work and respond to these women. Six semistructured interviews with professionals were conducted during the collection of data, and thematic analysis were used when analyzing the data. The study revealed that the main reasons as to why women chose to stay were fear, love and internalization. Regarding working methods when it comes to dealing with battered women; professionals believed that there are five stages to go about: be where the woman is, listening and believing, clarifying, strengthening self-esteem and motivating to make their own decisions.

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  • 89.
    Finnman, Ella
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Kaur, Harpreet
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Man är ju ändå en människa: En kvalitativ intervjustudie av socialsekreterarnas egna emotioner i handläggningsarbetet2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The Social Welfare Board work to ensure that children grow up in safe circumstances and they are responsible for investigating and child safety (Socialstyrelsen, 2019).Social workers work closely in the private sphere of children and caregivers, take part of difficult life situations and take action for their wellbeing. Social workers are expected to respond and manage their clients and own emotions/feelings, the work is therefore considered emotionally demanding. The study aims to examine how social workers within the Childcare handle their emotions at work, what strategies they use and whether it would be valuable to be taught about emotional management. Data collection has been conducted through semi-structured interviews with six social workers. The results show that the work requires strong emotional commitment by social workers and they must show restraint regarding their own feelings at work. Furthermore, the results show that social workers use different strategies to manage their own emotions that arise at work.

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  • 90.
    Fjellfeldt, Maria
    Umeå universitet, Institutionen för socialt arbete.
    Choice as governance in community mental health services2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In 2009, the Act on Freedom of Choice Systems (SFS 2008:962) wasestablished in Sweden, and this enabled municipalities to organise services aschoice models. This thesis describes and analyses the implementation of afreedom of choice system within community mental health services. Daycentre services were in focus, and a case study was conducted of a majormunicipality that sought to be a “world-class city” in regard to citizens’ choice.The experiences of policy makers, managers, professionals, and participantswere explored in interviews, and documents on a national, municipal, and citydistrict level, as well as homepages of providers of community mental healthservices, were all part of the study and were analysed using content-analysismethods.

    The results showed that the freedom of choice system aimed for two objectives– improvements at the individual level and financial efficiency. In practice,financial efficiency was experienced as the main objective. Increased varietyof services was aimed for by the competitive model, but such variety was notobserved. Instead, services tended to be more similar than specialised.Concerning new providers, they were characterised as committedprofessionals running companies with strained economies. Participantsaffected by the reform expressed anxiety and worries due to theunpredictability and uncertainty embedded in the competitive choice model.Choice within the system concerned where to go, whereas participantsemphasised a wish to be able to influence the choice aspects of who carriedout the service and how much time to attend the services.

    The conclusion was that the freedom of choice system was implemented as atechnology of governance to increase financial efficiency of services.Individual choice was not experienced as increased in any aspect except forthe choice of where to go. Instead, freedom of choice actually appeared todecrease due to standardisation and hierarchical structures. Aspects that werefound to be relevant when designing freedom of choice systems aiming toincrease individual freedom of choice were to address predictability andcontinuity, to address sustainable financial premises, to analyse the predictedimpact of administrative systems that are to be used, and to avoid the use of“hidden goals” in the policy-making process.

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  • 91.
    Fjellfeldt, Maria
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Implementing a new mental health policy in Sweden2019Conference paper (Refereed)
    Abstract [en]

    Background: Sweden faces increasing problems related to mental ill-health. To address this problem, the government recently launched a new mental health policy to cover mental health issues in general.

    Purpose of study: This study aimed to explore the implementation process of the new mental health policy.

    Methods/Theory: A case study was conducted in which national governance and regional response constituted the main elements of the case. A period of 4 years was chosen. In all, 68 national and regional key documents were selected for the analysis. Theories of implementation processes and governance strategies were used to enhance the understanding of the data.

    Findings: The implementation process showed the following the distinctive features: 1) a broad range of target groups were addressed from persons at risk of mental ill-health to persons suffering from severe mental illness; 2) the whole spectra from preventive interventions to treatment interventions were included; 3) the mental health of children and youth was prioritized; and 4) the character of the governance gradually shifted over time from an open to a more targeted approach. A major difficulty associated with the implementation process was the lack of options to systematically follow-up government policy efforts.

    Conclusion: The broad definition of mental health care and support meant there were regional variations in the prioritizing of groups, as well as regional variations on the working methods used.

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  • 92.
    Fjellfeldt, Maria
    et al.
    Umeå universitet, Institutionen för socialt arbete.
    Eklund, Mona
    Sandlund, Mikael
    Umeå universitet, Psykiatri.
    Markström, Urban
    Umeå universitet, Institutionen för socialt arbete.
    Implementation of choice from participants' perspectives: a study of community mental healthcare reform in Sweden2016In: Journal of Social Work in Disability & Rehabilitation, ISSN 1536-710X, E-ISSN 1536-7118, Vol. 15, no 2, p. 116-133Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore participants' experiences and opinions about a free-choice system in relation to policy objectives articulated by the national government and local authorities. A case study was conducted. Thirty-five informants participated. Qualitative interviews were undertaken. Results are discussed on how to address different dimensions of choice, not only where, but also what, by whom, how much, and when. They also concern how to design systems that in some ways ensure predictability and continuity to avoid unwanted harm caused by the unpredictability embedded in competitive choice systems. Finally, different aspects of quality need to be addressed.

  • 93.
    Fjellfeldt, Maria
    et al.
    Umeå universitet, Institutionen för socialt arbete.
    Markström, Urban
    Umeå universitet, Institutionen för socialt arbete.
    Länsgemensamma insatser för psykisk hälsa – en balansakt: Sammanställning och analys av handlingsstrategier i 21 handlingsplaner formulerade inom ramen för statens satsning Överenskommelse 20172018Report (Other academic)
    Abstract [sv]

    För att få behålla de statliga stimulansmedel som delats ut till kommuner och landsting inom området psykisk hälsa 2017 förväntades aktörerna lämna in länsgemensamma handlingsplaner avseende riktade insatser. Forskare vid Umeå universitet fick i uppdrag att sammanställa och analysera dessa planer. Både kvantitativa och kvalitativa sammanställningar och innehållsanalyser genomfördes. Under en forskarpanel bidrog experter inom olika områden med sina kunskaper till att fördjupa och nyansera analyser av preliminära resultat.

    Inför länens arbete med handlingsplanerna uppmanades kommuner och landsting att länsvis, liksom 2016, presentera en aktuell gemensam analys och handlingsplan med tillhörande budget för att arbeta med befolkningens psykiska hälsa utifrån ett gemensamt ansvarstagande. År 2017 förväntades länen även presentera en fördjupad analys och handlingsplan med fokus på barn och unga 0–24 år, samt en uppföljning av arbetet 2017.

    Liksom 2016 fanns det även 2017 en stor variation i länsplanerna, både beträffande struktur och innehåll. Det framstår dock som att varje län funnit en form för det egna arbetet under detta andra år med gemensamt handlingsplansarbete. Handlingsplanerna 2017 påminner mycket om handlingsplanerna 2016, med tillägget att de 2017 inkluderar uppföljning av insatser samt särskilt fokuserar barn, unga och unga vuxna. Några handlingsplaner visar att den statliga satsningen inneburit att länen under 2017 kunnat utvecklat nya strategier för att arbeta länsgemensamt med insatser inom området psykisk hälsa. Andra handlingsplaner visar att länsnivån inte heller 2017 varit en naturlig plattform för kommunerna och landstingens arbete på området. I anslutning till länsplanerna 2017 har länen skickat in ett flertal dokument som de anser är relaterade till handlingsplanen, exempelvis regionernas egna handlingsplaner för utveckling av insatser inom området psykisk hälsa.

    Alla län följer upp insatser genomförda 2017. Uppföljningarna tenderar att vara instrumentella i meningen att man mäter om insatser är genomförda eller inte, snarare än att man följer upp resultaten av insatserna. Några län problematiserar uppföljningen av specifika indikatorer, samt länsnivåns möjligheter och svårigheter i relation till uppföljning och utvärderingsarbete.

    I de delar av handlingsplanerna som presenterar insatser riktade till den vuxna och äldre delen av befolkningen kunde följande iakttagelser göras:

    • Det fanns en balans mellan generella insatser för psykisk hälsa riktade till en bred målgrupp i termer av hela befolkningen och specifika insatser riktade till en mer specifik målgrupp i termer av personer med långvarig psykisk ohälsa.
    • Insatser riktade till både en bred och en snävare målgrupp befann sig i ett spektrum från främjande insatser, till tidiga insatser och slutligen behandlande och långsiktigt stödjande insatser.
    • Den breddade policyn tycks ha påverkat med vilka perspektiv man betraktar även den traditionella målgruppen, lämpligast uttryckt som ett helhetstänkande som inte bara omfattar stöd och behandling utan även prevention och hälsofrämjande arbete.
    • Handlingsplanerna presenterar även ett antal utvecklingsområden som är av övergripande karaktär. De två teman som förekommer i flest planer är: brukare och närståendes delaktighet samt samverkan och samordning. Detta resultat kan tolkas som områden där hierarkier och maktrelationer, olika gruppers handlingsutrymme och olika syn på uppdrag och professionalitet aktualiseras.

    Sammantaget så är det en mycket jämn fördelning mellan de olika målgrupperna; den breda målgruppen medborgare, och den snävare målgruppen personer med etablerad psykisk ohälsa.

    I de delar av handlingsplanerna som presenterar insatser riktade till barn, unga och unga vuxna kunde följande iakttagelser göras:

    • Sammanställningen av planerna visar att det har varit ett trevande arbete i flera län, samtidigt som det i vissa län varit en fortsättning på ett sedan flera år redan påbörjat arbete.
    • Länen har gjort analyser utifrån elevhälsodata, folkhälsodata, riktade enkäter, intervjuer och fokusgrupper. I samband med analysarbetet har SKL gett länen 58 nyckelindikatorer att genomföra sina analyser utifrån. Dessa indikatorer har påverkat länens sökljus, och i förlängningen innehållet i länens handlingsplaner.
    • Handlingsplanerna för barn, unga och unga vuxna präglas av att riskgrupper för psykisk ohälsa identifieras. Tio olika riskgrupper nämns. Asylsökande, nyanlända och ensamkommande, ”hemmasittare” som varken studerar eller arbetar, personer med annan funktionsnedsättning, barn som anhöriga till personer med psykisk funktionsnedsättning och barn i samhällsvård är de riskgrupper som flest län nämner. Dessa fem riskgrupper finns med bland nyckelindikatorerna.
    • Bland övriga utvecklingsområden, förebyggande, tidiga, behandlande insatser samt övergripande teman, syns tydliga spår av de 58 nyckelindikatorerna. Det finns dock även en lokal variation beträffande riskgrupper, insatser, målgrupper och övergripande teman.
    • Samverkan och delaktighet utgör de viktigaste övergripande utvecklingsområdena även när det gäller övergripande områden med fokus på insatser för barn och unga.

    Länen formulerar sig med några få undantag, ofta svepande kring frågan om kunskapsbaserade arbetssätt. Det finns generellt en lyhördhet för nationella initiativ, där man i planerna kan referera till Socialstyrelsen, Folkhälsomyndigheten, SBU eller SKL med innebörden att sådana statliga satsningar utgår från bästa tillgängliga kunskaper.

    Trots en breddad policy i den nationella satsningen, är många av de specifika arbetssätt och interventioner som nämns i planerna riktade till personer med allvarliga tillstånd eller funktionsnedsättningar. Oaktat den uppmärksamhet som ägnas åt psykosociala interventioner vid allvarlig psykisk sjukdom, är suicidprevention det enskilda insatsområde som dominerar handlingsplanerna.

    Några ”tystnader” som identifierats i materialet är följande: 1, avsaknaden av insyn i det reguljära arbetet, som en följd av att handlingsplanerna fokuserar länens utvecklingsarbete 2, unga vuxna, och specifikt unga flickor och kvinnor utgör inte en prioriterad riskgrupp i länsplanerna, trots att aktuell statistik pekar ut denna grupp som utsatt 3, avsaknaden av familjeinterventioner i länens praktik, trots hög evidensgrad och prioriteringsnivå i nationella riktlinjer 4, avsaknaden av att systematiskt arbeta med brukarerfarenheter på länsnivå.

    I rapportens avslutande del lyfts ett antal reflektioner upp till diskussion. Några saker som diskuteras är:

    • Länsnivåns legitimitet när det inte finns någon politisk nivå att förankra planerna i, eller instans att utkräva ansvar från.
    • Tillitsstyrningens dilemma på länsnivå – staten ingår en överenskommelse med vem?
    • Materialet visar att den breddade folkhälsopolicyn kompletteras med ett perspektiv på ohälsa och sjukdom som värnar om personer med långvarig psykisk ohälsa eller funktionsnedsättningar.
    • Det breda uppdraget landar i en struktur som tidigare skapats för att arbeta med en specifik målgrupp: personer med psykiska funktionsnedsättningar. Denna tradition påverkar vilka aktörer som är delaktiga även när det gäller den breddade policyn. Det tycks vara svårt att förankra delaktighet hos en breddad aktörskara i länen, t.ex. skolan, så länge det inte finns ekonomiska incitament för att delta.
    • Innebär den breddade policyn ett ”förfrämligande” hos specialistpsykiatrin i arbetet med handlingsplanerna?
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  • 94.
    Fjellfeldt, Maria
    et al.
    Umeå universitet.
    Markström, Urban
    Umeå universitet.
    National policy and local response: an implementation strategy to aim at a broader mental health perspective in Sweden2019Conference paper (Refereed)
  • 95.
    Fjellfeldt, Maria
    et al.
    Umeå universitet.
    Markström, Urban
    Umeå universitet.
    Nationell styrning och lokal respons: en implementeringsstudie av länsgemensamt arbete för psykisk hälsa2019Report (Other (popular science, discussion, etc.))
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  • 96.
    Fjellfeldt, Maria
    et al.
    Umeå universitet, Institutionen för socialt arbete.
    Markström, Urban
    Umeå universitet, Institutionen för socialt arbete.
    Rosenberg, David
    Umeå universitet, Institutionen för socialt arbete.
    Psykisk hälsa - ett mångfacetterat uppdrag: analys av behovsbilder och handlingsstrategier i 21 länsplaner sammanställda inom ramen för statens satsning inom området psykisk hälsa2017Report (Other academic)
    Abstract [sv]

    För att få del av de statliga stimulansmedlen inom ramen för överenskommelsen mellan Regeringen och Sveriges Kommuner och Landsting (SKL) 2016 var kommuner och landsting skyldiga att länsvis sammanställa en handlingsplan med avseende på området psykisk hälsa. Forskare vid Umeå universitet fick i uppdrag att analysera dessa planer. Både kvantitativa och kvalitativa sammanställningar och innehållsanalyser genomfördes. Under en forskarpanel bidrog experter inom olika områden med sina kunskaper till att fördjupa och nyansera analyser av preliminära resultat. Preliminära resultat presenterades under en seminariedag i Stockholm där representanter för länen samt företrädare för SKL, Socialstyrelsen och Folkhälsomyndigheten samlats. I samband med denna presentation inkom kompletterande uppgifter som innebar att vissa revideringen av rapporten genomfördes. Inför länens arbete med handlingsplanerna föreslog regeringen i överenskommelsen med SKL att kommuner och landsting skulle beakta fem fokusområden: 1, förebyggande och främjande insatser 2, tillgängliga tidiga insatser 3, enskildas delaktighet och rättigheter 4, utsatta grupper och 5, styrning, ledning och organisation. Dessa fem områden är aktuella för barn och unga, vuxna och äldre. I samtliga handlingsplaner förhåller sig länen till dessa fokusområden. I 18 av 21 län har man strukturerat sina handlingsplaner i relation till fokusområdena. Tre län förhåller sig friare till de angivna fokusområdena. Sveriges län skiljer sig åt på många sätt, vilket återspeglas i handlingsplanerna som varierar till form och innehåll. Vissa län har gjort behovsanalyser utifrån ett folkhälsoperspektiv på psykisk hälsa, medan andra behovsanalyser undersöker faktorer som är mer relaterade till ett perspektiv på manifest ohälsa och sjukdom. I vissa län finns detaljerade målsättningar som specificeras i långsiktiga mål och kortsiktiga delmål. I andra län har målformulerandet just påbörjats. I en del handlingsplaner finns detaljerade åtgärdsförslag medan det i andra län presenteras mer övergripande och generella åtgärder. Variationsrikedomen i handlingsplanerna är mycket stor. När det gäller beskrivningen av arbetsprocessen i samband med att handlingsplanerna utarbetats varierar graden av insyn i hur arbetet gått till. I vissa handlingsplaner beskrivs processen i detalj, och personer som deltagit är namngivna. I andra handlingsplaner går det inte att utläsa vare sig hur arbetsprocessen har gått till eller vilka som varit delaktiga. I ett län har ett ägarskap skrivits in i handlingsplanen som innebär att instanser utsetts som ansvariga för att handlingsplanen i sin helhet omsätts i praktik. I några län utses ansvariga inom respektive insatsområde, medan vissa län inte berör ansvarsfrågan alls. I såväl den nationella policyn som i handlingsplanerna finns en komplexitet när det gäller den tredelade målgruppsbeskrivningen om ”allas” psykiska hälsa, utsatta gruppers psykiska hälsa och personer med omfattande psykiatrisk problematik.

    Hur kommuner och landsting hanterat frågan om brukarmedverkan i arbetet med planerna varierar; alltifrån att inte ha någon brukarmedverkan dokumenterad alls, till att en brukarorganisation är en av tre jämbördiga parter. I ett län anläggs ett folkhälsoperspektiv på brukarmedverkan genom att representanter från ett brett spektrum av brukar- anhörig- och patientföreningar finns representerade, liksom representanter för skola. Att använda sig av länsnivån som avsändare för planerna innebär utmaningar. Vilken grad av struktur som finns varierar mellan länen – se Länsinventering Psykisk Hälsa (SKL 2015). Det finns ingen självklar politisk struktur vilket innebär att det är svårt att förankra handlingsplanerna i en politisk kontext. I 9 län beskrivs politisk förankring av varierande grad. I återstående 12 län framgår det inte om handlingsplanerna är politiskt förankrade eller inte. Graden av politisk förankring påverkar möjligheten att omsätta handlingsplanen i praktiken. En annan utmaning rör tillgången till tjänstemän på länsnivå som kan arbeta med länsgemensamma uppdrag. Även detta skiljer sig åt mellan länen och påverkar arbetet med länsgemensamma planer och målsättningar. När det gäller målsättningar presenteras det i drygt hälften (12 av 21) av handlingsplanerna långsiktiga mål som är nedbrutna i kortsiktiga delmål. I fyra län är långsiktiga och kortsiktiga målsättningar fristående ifrån varandra. Målsättningar strukturerats antingen utifrån de fem fokusområdena eller tematiskt utifrån prioriterade områden i länen. I fem av länen har man hanterat målsättningar på andra sätt. De slutsatser som dragits utifrån analysen av de 21 länens handlingsplaner är följande:

    • Strukturer för att arbeta på länsnivå ser mycket olika ut i länen. Därför skiljer sig handlingsplanerna åt, både till form och innehåll. I vissa län tycks arbetet med länsplanen innebära ett mervärde för de inblandade aktörerna, i andra inte. Om principen från regeringen och SKL att använda sig av länsnivån i kommunikationen ska bestå, bör strategier för stöd till länen övervägas.

    • Generellt sett rör länsplanerna utvecklingsarbete och endast i liten utsträckning organisationernas kärnverksamhet.

    • Länsplanerna handlar främst om kommunerna och landstingens gemensamma arbete och om samverkan mellan organisationerna. Detta innebär att de enskilda huvudmännens verksamheter endast uppmärksammas i mycket liten utsträckning. Följaktligen saknas en stor del av den reguljära kärnverksamhet som bedrivs av kommuner och landsting var för sig, som till exempel den specialiserade psykiatrins behandlingsarbete eller primärvårdens insatser. Inriktningen är särskilt tydligt under fokusområdet ”ledarskap och organisering” där handlingsplanerna företrädesvis rör samordning och samverkan.

    • Det finns en hög ambition i länen att främja psykisk hälsa hos barn och unga, och att samarbeta mellan huvudmännen kring barn och unga som har utvecklat någon form av psykisk ohälsa.

    • I länen finns en hög ambition att samarbeta huvudmän emellan och tillsammans med det civila samhället för att bli bättre på hälsofrämjande insatser riktade till asylsökande och nyanlända, samt att bli bättre på insatser som riktas till asylsökande och nyanlända som utvecklat någon form av psykisk ohälsa.

    • Två insatsområden som återkommer frekvent i länen är arbetet med suicidprevention och arbetet med att erbjuda dem som får stöd från de båda huvudmännen en samordnad individuell plan (SIP) samt att utveckla formerna för SIP.

    • I handlingsplanerna finns en ansats att främja den psykiska folkhälsan i länen. Detta sker parallellt med att insatser riktas till riskgrupper och grupper där psykisk ohälsa redan utvecklats. Detta innebär att kommuner och landsting tagit emot de nationella styrsignalerna, och fortsatt vidga sitt fokus från PRIO-satsningen till att omfatta folkhälsoperspektivet inom området psykisk hälsa. Dock sker detta endast i mindre utsträckning för grupperna vuxna och äldre personer.

    Avslutningsvis ges exempel på några aspekter utifrån vilka ”en lyckad plan” kan förstås. En lyckad plan kännetecknas av ett tydligt ägarskap, systematisk analys, realistiska mål och ett val av tydliga aktiviteter som kan implementeras och följas upp. Vi ger även tre rekommendationer till länen i det fortsatta arbetet med att formulera länsgemensamma handlingsplaner: 1, att skriva planerna för sin egen skull 2, att öka genomförbarheten i planerna genom aktiva prioriteringar mellan de breda och olikartade målsättningar som staten lanserat 3, att ta frågan om ansvar för planerna på allvar genom att klargöra vem eller vilka som ansvarar för handlingsplanen och dess implementering.

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  • 97.
    Frost, Mattias
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Johansson, Andreas
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Socialsekreterares arbete med dataspelsberoende ungdomar2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study is to examine how social workers work with adolescents with gaming addiction, and how the social workers talks about the adolescents. We have applied a qualitative approach with semi-structured interviews as a method. Six interviews were held. The material has been analyzed using a body oriented model of explanation regarding drug use and addiction, an action oriented model of explanation regarding drug use and addiction, a theoretic framework based on conflict between social roles and social institutions, and former research. The result of our study is that social workers tend to equate gaming addiction with other types of addiction. The cause of internet gaming disorder is described as complicated, with a combination of social, psychological and biological factors. Treatment is mostly aimed towards parents, in order to support parental ability and boundaries. Social workers describe a lack of knowledge regarding gaming addiction.

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  • 98. Fäldt, Johannes
    et al.
    Kullberg, Christian
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Implications of male and female same-gender dyads2012In: Journal of social service research, ISSN 0148-8376, E-ISSN 1540-7314, Vol. 38, no 5, p. 712-726Article in journal (Refereed)
    Abstract [en]

    In this article a study of male and female social workers’ assessments of a fictitious same-gender client’s problems and needs is presented. A vignette and questionnaire were mailed to a random sample of Swedish social welfare officers. A total of 222 cases of same-gender assessments were statistically analyzed. The findings suggest that the outcome of the assessments, at least to some extent, seems to depend on the gender of the client, the gender of the assessor, and how the problem area or situation of the client is ‘gendered’. Concerning some situations and problem areas, the same-gender dyads tend to strengthen stereotypical expectations on men and women as clients. Above all, the male same-gender dyad seems to have contributively consequences, in particular concerning proposed help-giving practices for the client. One way to carry out further research on this matter could be to incorporate a number of more refined ‘gendered’ problem areas and situations in a study with a comprehensive factorial design.

  • 99.
    Ghasemlou, Hero
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Kifle, Kidane
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Empatitrötthet bland socialarbetare: En kvalitativ intervjustudie2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna studie var att undersöka empatitrötthet bland socialarbetare som arbetar med flyktingar. Studien innehåller fem kvalitativa intervjuer med socialarbetare som arbetar med flyktingar och som arbetade klientnära med flyktingar under flyktingkrisen år 2015. Studiens resultat visar att ingen av respondenterna upplevde empatitrötthet. De hade inte heller tagit del av traumatiska berättelser från flyktingarna gällande deras flykt från hemlandet. Respondenterna uttryckte dock en annan typ av trötthet. Resultatet visar att den typ av trötthet som respondenterna beskrev grundade sig i bristen på förberedelser och riktlinjer. Enligt studiens resultat var trötthet på grund av bristen på förberedelser och riktlinjer störst under flyktingkrisen år 2015. Studien visar behov av vidare forskning om empatitrötthet bland socialarbetare.

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    fulltext
  • 100.
    Gilhooly, M. L.
    et al.
    Brunel Institute for Ageing Studies, Brunel University, Uxbridge, United Kingdom.
    van den Heuvel, E.
    Brunel Institute for Ageing Studies, Brunel University, Uxbridge, United Kingdom.
    Jowitt, F.
    Brunel Institute for Ageing Studies, Brunel University, Uxbridge, United Kingdom.
    Sutherland, I.
    Brunel Institute for Ageing Studies, Brunel University, Uxbridge, United Kingdom.
    Bichard, J.
    Royal College of Art, London, United Kingdom.
    Long, A.
    Bristol Urological Institute, Bristol, United Kingdom.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Dahlberg, Lena
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Vibrating underpants, smell sensors and hospital continence services: tools and technologies for improving the lives of people with incontinence2012In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 52, no s1, p. 185-185Article in journal (Refereed)
    Abstract [en]

    Social isolation, loss of self esteem and depression are often a consequence of incontinence. The overall aim of this interdisciplinary project was to reduce the impact of continence difficulties and, thus, assist older people in maintaining a positive identity and good quality of life. The TACT3 project was comprised of three research work packages:

    Assistive technology development:

    Vibrating underpants: A washable fabric underwear wetness sensor and alert mechanism has been developed to alert continence pad users of leakage. In addition, a colour change odour indicating formula has been developed to indicate the presence of the odour of urine at a just imperceptible level.

    Challenging environmental barriers to continence: Two sets of stakeholders were involved, older people with continence difficulties and toilet providers. Focus groups, workshops, interviews and photographic diaries were conducted to identify key issues. A web based map locating toilets in London was developed which is called the Great British Toilet Map.

    Improving continence interventions and services: 140 patients and their carers were interviewed twice within a 12 month interval from a specialist continence clinic for older people and generic continence clinic. Twenty health and social care managers and 200 practitioners were also be interviewed. Care outcomes are being analysed from each clinic and a cost benefit analysis will be carried out.

    Key findings from this three year interdisciplinary project are highlighted. Prototypes of the vibrating underpants and the odour sensor will be on display. This research was funded by the UK New Dynamics of Ageing Programme.

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