11 resultados para Process of work in health

em Dalarna University College Electronic Archive


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In software development organizations there is sometimes a need for change. In order to meet continuously increasing demands from their customers, Sandvik IT Services- SITS, at Sandvik in Sweden, required improving the way they worked with software development. Due to issues like a lot of work in progress and lot of simultaneous tasks for individuals in the teams that caused stress, it was almost impossible to address the question of working with improvements. In order to enable the improvement process Kanban was introduced in the software development teams. Kanban for software development is a change method created by David J. Anderson. The purpose of this thesis is twofold. One part is to assess what effects Kanban has had on the software development teams. The other part is to make a documentation of the Kanban implementation process at SITS. The documentation has been made on the basis of both company internal resources and observations of the Kanban implementation process. The effects of Kanban have been researched with an interview survey to the teams that have gone through the Kick start of the Kanban process. The result of the thesis is also twofold. One part of the result is an extensive documentation of the implementation process of Kanban at SITS. The other part is an assessment of the effects that Kanban has had at SITS. The major effects have been that the teams are experiencing less stress, more focus on quality and better customer collaboration. It is also evident is that it takes time for some effects to evolve when implementing Kanban

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Background In the Neonatal health – Knowledge into Practice (NeoKIP) trial in Vietnam, local stakeholder groups, supported by trained laywomen acting as facilitators, promoted knowledge translation (KT) resulting in decreased neonatal mortality. In general, as well as in the community-based NeoKIP trial, there is a need to further understand how context influences KT interventions in low- and middle-income countries (LMICs). Thus, the objective of this study was to explore the influence of context on the facilitation process in the NeoKIP intervention. Methods A secondary content analysis was performed on 16 Focus Group Discussions with facilitators and participants of the stakeholder groups, applying an inductive approach to the content on context through naïve understanding and structured analysis. Results The three main-categories of context found to influence the facilitation process in the NeoKIP intervention were: (1) Support and collaboration of local authorities and other communal stakeholders; (2) Incentives to, and motivation of, participants; and (3) Low health care coverage and utilization. In particular, the role of local authorities in a KT intervention was recognized as important. Also, while project participants expected financial incentives, non-financial benefits such as individual learning were considered to balance the lack of reimbursement in the NeoKIP intervention. Further, project participants recognized the need to acknowledge the needs of disadvantaged groups. Conclusions This study provides insight for further understanding of the influence of contextual aspects to improve effects of a KT intervention in Vietnam. We suggest that future KT interventions should apply strategies to improve local authorities’ engagement, to identify and communicate non-financial incentives, and to make disadvantaged groups a priority. Further studies to evaluate the contextual aspects in KT interventions in LMICs are also needed.

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BACKGROUND: Pre- and post-migration trauma due to forced migration may impact negatively on parents' ability to care for their children. Little qualitative work has examined Somali-born refugees' experiences. The aim of this study is to explore Somali-born refugees' experiences and challenges of being parents in Sweden, and the support they need in their parenting. METHODS: A qualitative descriptive study was undertaken. Data were collected from four focus group discussions (FGDs) among 23 Somali-born mothers and fathers living in a county in central Sweden. Qualitative content analysis has been applied. RESULTS: A main category, Parenthood in Transition, emerged as a description of a process of parenthood in transition. Two generic categories were identified: Challenges, and Improved parenting. Challenges emerged from leaving the home country and being new and feeling alienated in the new country. In Improved parenting, an awareness of opportunities in the new country and ways to improve their parenting was described, which includes how to improve their communication and relationship with their children. The parents described a need for information on how to culturally adapt their parenting and obtain support from the authorities. CONCLUSIONS: Parents experienced a process of parenthood in transition. They were looking to the future and for ways to improve their parenting. Schools and social services can overcome barriers that prevent lack of knowledge about the new country's systems related to parenthood. Leaving the home country often means separation from the family and losing the social network. We suggest that staff in schools and social services offer parent training classes for these parents throughout their children's childhood, with benefits for the child and family.

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BACKGROUND: People living at home who lack ability to manage their medicine are entitled to assistance to improve adherence provided by a home care assistant employed by social care. AIM: The aim was to describe how older people with chronic diseases, living at home, experience the use and assistance of administration of medicines in the context of social care. DESIGN: A qualitative descriptive study. METHODS: Ten participants (age 65+) living at home were interviewed in the participants' own homes. Latent content analysis was used. FINDINGS: The assistance eases daily life with regard to practical matters and increases adherence to a medicine regimen. There were mixed feelings about being dependent on assistance; it interferes with self-sufficiency at a time of health transition. Participants were balancing empowerment and a dubious perception of the home care assistants' knowledge of medicine and safety. Physicians' and district nurses' professional knowledge was a safety guarantee for the medicine process. CONCLUSIONS: Assistance eases daily life and medicine regimen adherence. Dependence on assistance may affect self-sufficiency. Perceived safety varied relating to home care assistants' knowledge of medicine. RELEVANCE TO CLINICAL PRACTICE: A well-functioning medicine assistance is crucial to enable older people to remain at home. A person-centred approach to health- and social care delivery is efficient and improve outcome for the recipient of care.

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The internet has revolutionized the way we socialize, and as a consequence the way to love. The new communication technologies have facilitated intercultural relationships. Nowadays family relations are one of the major factors in immigration to European countries. Family relations means persons who arrive as family dependents and in accordance with laws regulating family reunification. This thesis aims to apply the classical assimilation theory stated by Milton Gordon (1964), which formulates a series of assimilation stages through which an individual must pass in order to be completely assimilated. In accordance with this theory, marriage is the final phase for a newcomer to fully incorporate into the host society. Thus, based on this presumption and other contemporary theories, the present study has analysed how women who get involved in intercultural marriages based on internet meeting experience these assimilation stages and evaluated the resources used by respondents to incorporate themselves into Swedish society.The main goal of the study was to determine if jumping to the last stage of assimilation does assure the incorporation in the social or/and labour spheres and the findings demonstrate that even though husbands are a valuable resource for assimilation, several cultural issues in Swedish society make it difficult to assure success for the newcomers.On the other hand, Sweden is a country with a strong national sentiment and the assimilation of immigrants still is an important issue to deal with. The Swedish Integration Board has disappeared and major projects for integration have been left in the hands of the municipalities or the Migration Board, institutions that still do not know how to deal with this dilemma.

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The capacitor test process at ABB Capacitors in Ludvika must be improved to meet future demands for high voltage products. To find a solution to how to improve the test process, an investigation was performed to establish which parts of the process are used and how they operate. Several parts which can improves the process were identified. One of them was selected to be improved in correlation with the subject, mechanical engineering. Four concepts were generated and decision matrixes were used to systematically select the best concept. By improving the process several benefits has been added to the process. More units are able to be tested and lead time is reduced. As the lead time is reduced the cost for each unit is reduced, workers will work less hours for the same amount of tested units, future work to further improve the process is also identified. The selected concept was concept 1, the sway stop concept. This concept is used to reduce the sway of the capacitors as they have entered the test facility, the box. By improving this part of the test process a time saving of 20 seconds per unit can be achieved, equivalent to 7% time reduction. This can be compared to an additional 1400 units each year.

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Background. Surveillance is a central activity among mental health nursing, but it is also questioned for its therapeutic value and considered to be custodial. Aim. The aim of this study was to describe how mental health nurses use different approaches to observe patients in relation to the practice of surveillance in psychiatric nursing care. Methods. In this study, Spradley's twelve-step ethnographic method was used. Results. Mental health nurses use their cultural knowing to observe patients in psychiatric care in various ways. Two dichotomous approaches were identified: the latent and the manifest approach. Discussion. Different strategies and techniques for observing patients are structured along two dichotomies. The underlying relationships between these two different dichotomous positions transform the act of observing into surveillance. This is further developed in a theoretical model called the powerful scheme of observation and surveillance (PSOS).

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Background: British government policy for older people focuses on a vision of active ageing and independent living. In the face of diminishing personal capacities, the use of appropriate home-based technology (HBT) devices could potentially meet a wide range of needs and consequently improve many aspects of older people's quality of life such as physical health, psychosocial well-being, social relationships, and their physical or living environment. This study aimed to examine the use of HBT devices and the correlation between use of such devices and quality of life among older people living in extra-care housing (ECH).  Methods: A structured questionnaire was administered for this study. Using purposive sampling 160 older people living in extra-care housing schemes were selected from 23 schemes in England. A face-to-face interview was conducted in each participant's living unit. In order to measure quality of life, the SEIQoL-Adapted and CASP-19 were used.  Results: Although most basic appliances and emergency call systems were used in the living units, communally provided facilities such as personal computers, washing machines, and assisted bathing equipment in the schemes were not well utilised. Multiple regression analysis adjusted for confounders including age, sex, marital status, living arrangement and mobility use indicated a coefficient of 1.17 with 95% CI (0.05, 2.29) and p = 0.04 [SEIQoL-Adapted] and 2.83 with 95% CI (1.17, 4.50) and p = 0.001 [CASP-19].  Conclusions: The findings of the present study will be value to those who are developing new form of specialised housing for older people with functional limitations and, in particular, guiding investments in technological aids. The results of the present study also indicate that the home is an essential site for developing residential technologies.

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The research investigates in what extent and how communication for meeting feelings is provided in Truth Commission work. It examines if and in what way feelings are addressed in the communication officially published by the Truth Commissions in East Timor, Ghana and Sri Lanka, occurring between 2002-2011. The research is also looking at the healing processes in a time perspective to find out if there is a communication for Societal healing to be continued in a longer term. My conclusion is that two cases of three in my research, the TRCs in Ghana and East Timor, have communication clearly directed to meet feelings caused by the war. One of the three cases (East Timor) has a communication with a clear ambition to heal over a longer period, to continue after the existence of the Truth Commission. The research suggests that communication with a clear ambition to reach out widely in the society, a communication directed to meet and process feelings over a longer period, can make Societal healing more effective. It also concludes that, in the future, Societal healing, as a field in conflict resolution, will be more based on representational media than today, provided through web communication.

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BACKGROUND: With a pending need to identify potential means to improved quality of care, national quality registries (NQRs) are identified as a promising route. Yet, there is limited evidence with regards to what hinders and facilitates the NQR innovation, what signifies the contexts in which NQRs are applied and drive quality improvement. Supposedly, barriers and facilitators to NQR-driven quality improvement may be found in the healthcare context, in the politico-administrative context, as well as with an NQR itself. In this study, we investigated the potential variation with regards to if and how an NQR was applied by decision-makers and users in regions and clinical settings. The aim was to depict the interplay between the clinical and the politico-administrative tiers in the use of NQRs to develop quality of care, examining an established registry on stroke care as a case study. METHODS: We interviewed 44 individuals representing the clinical and the politico-administrative settings of 4 out of 21 regions strategically chosen for including stroke units representing a variety of outcomes in the NQR on stroke (Riksstroke) and a variety of settings. The transcribed interviews were analysed by applying The Consolidated Framework for Implementation Research (CFIR). RESULTS: In two regions, decision-makers and/or administrators had initiated healthcare process projects for stroke, engaging the health professionals in the local stroke units who contributed with, for example, local data from Riksstroke. The Riksstroke data was used for identifying improvement issues, for setting goals, and asserting that the stroke units achieved an equivalent standard of care and a certain level of quality of stroke care. Meanwhile, one region had more recently initiated such a project and the fourth region had no similar collaboration across tiers. Apart from these projects, there was limited joint communication across tiers and none that included all individuals and functions engaged in quality improvement with regards to stroke care. CONCLUSIONS: If NQRs are to provide for quality improvement and learning opportunities, advances must be made in the links between the structures and processes across all organisational tiers, including decision-makers, administrators and health professionals engaged in a particular healthcare process.