Frihet i handläggningsarbetet? : En studie om handläggarnas handlingsutrymme vid beslut i sjukförsäkringsärenden på Försäkringskassan

Syftet med vår uppsats var att få en djupare insikt i och kunskap om hur de människor som arbetar med försäkringsärenden på Försäkringskassan upplever och ser på sitt arbete. Våra frågeställningar söker svaret på hur handläggarna uppfattar sina möjligheter till egna initiativ i handläggningsarbetet. För att få svar på dessa frågor från ett ”inifrånperspektiv” har vi valt att hämta empirin från en fokusgruppintervju med fyra tjänstemän som arbetar med handläggning på en Försäkringskassa i Mellansverige. Vårt teoretiska utgångsläge var Johan Asplunds teori om den sociala responsiviteten och Roine Johanssons teori om organisatoriska begränsningar i kundrelaterat arbete. En annan utgångspunkt för vår studie har varit tidigare forskning inom områden som berör Försäkringskassan. Vi har genom vår studie kommit fram till att den teori som Roine Johansson tar upp om handläggningsutrymme bekräftas utifrån de slutsatser vi dragit från vår analys. Den sociala relationen som utspelas mellan handläggarna i det dagliga arbetet får sin förklaring genom Asplunds teori om den socialt responsiva människan och ger upphov till en intern policy som formar ärendehanteringen för lokalkontoret på ett specifikt sätt. Vi har kommit fram till att det finns ett handlingsutrymme i Försäkringskassan som grundar sig på interna överenskommelser och egna initiativ i arbetet. Detta bekräftas av Roine Johanssons teori om handlingsutrymme inom Försäkringskassans arbetsområde.

Tha contribution of home-based technology to older people's quality of life in extra care housing

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.

Motståndets betydelse : Ett bidrag till aktör-strukturdebatten

The significance of inhibition: a contribution to the agency-structure debate A central problem in social theory today is how to integrate agency and structure. The vital question is how to explain social reality by proceeding from both the notion of people doing things which affect the social relationships in which they are embedded (agency) and the idea of the social context moulding social activity (structure). Sociologists as Pierre Bourdieu, Anthony Giddens and Jürgen Habermas call attention to social practices as the ”missing link” between agency and structure. In accentuating social practices, the aim is to explain how people in their daily encounters actively contribute to the production and reproduction of social structures. This article puts forth the posthumous contribution of George Herbert Mead to the agency-structure debate. I argue that his social pragmatist theory gives us a compound and thorough– but not fully recognized – explanation of the dynamics and the course of events in structurally framed encounters. By especially emphasizing the importance Mead ascribes to the inhibited social act, I examine how his theory deepens the understanding of social practices as a bridge between agency and structure.

Upplevelser av palliativ vård i hemmet under livets slutskede – ur ett anhörigperspektiv : En litteraturöversikt

Bakgrund: Palliativ vård handlar om att ge stöd till patienten och anhöriga under och efter vårdtiden. De ”6 s:n” är en arbetsmodell inom palliativ vård där patienten har rätt till självbestämmande och att upprätthålla sina sociala relationer, även stöd till anhöriga ingår. Anhöriga har en betydelsefull roll i den palliativa vården, deras närvaro skapar möjlighet för den döende att vara hemma i livets slutskede. Syfte: Syftet var att beskriva anhörigas upplevelse av palliativ vård i hemmet under livets slutskede. Metod: Litteraturöversikt baserad på 15 vetenskapliga artiklar från fem olika länder med kvalitativ ansats. Resultat: Fem kategorier identifierades kopplade till anhörigas upplevelser: Palliativa teamets inträde i hemmet, anhörigas vårdansvar, den medicintekniska utrusningens inverkan på vardagslivet, känslor och konsekvenser för anhöriga samt förbättringsmöjligheter och anhörigas uppfattning om palliativ vård. Slutsats: Anledningen till anhörigas vårdansvar var löftet att få dö hemma, uppgiften upplevdes krävande och gav konsekvenser på sömnen och deras fysiska och psykiska mående. Detta var genomgående i hela litteraturöversikten. Vården i hemmet sågs som den rätta platsen att dö på för alla parter, endast en anhörig uttryckte avsky för situationen. Enligt anhöriga var stödet bra dock fanns det ett ökat behov av mer resurser för fullständig trygghet.

”Ska jag jobba med en ny, gud vad jobbigt. Dom kan ju ingenting” : En undersökning om socialisationsprocesser för nyanställda

Denna studie grundar sig i att rekryteringsbehoven inom vård och omsorg i Sverige ökar enligt SKL (2015). Personalbristen leder till en konkurrens om arbetskraft bland organisationer. En lösning på detta problem är kunskap och förståelse för människors socialisation, med fokus i arbetslivet. För att på detta sätt kunna underlätta organisationens hantering för att behålla personal. Utgångspunkten för studien är att det tycks krävas mer forskning kring vilken betydelse chefers stöd och kollegors relationer har på nyanställdas socialisationsprocess. Syftet med denna studie är således att undersöka hur ett företag inom vård och omsorgssektorn arbetar med socialisationsprocessen av nyanställda med fokus på relationer och chefers stöd. Forskning som berör nyanställdas socialisationsprocesser belyser kollegor som ett verktyg för att få tillgång till viktiga resurser exempelvis tyst kunskap. Chefer behöver vara närvarande och ge feedback. Organisationskulturen påverkar som en del av organisationens personlighet. Studien bygger på en abduktiv ansats och kvalitativa intervjuer, då intresset låg på individens tolkning och upplevelse av deras socialisation till företaget. Elva intervjuer har genomförts, fyra ansvariga chefer och sju nyanställda har deltagit i studien. Resultatet från intervjuerna har analyserat utifrån den teoretiska referensramen. I denna studie har vi kommit fram till att chefernas medvetenhet om vad individen går igenom i sin socialisationsprocess påverkar processen och chefernas stöd till de nyanställda. Kollegor är inte bara ett verktyg för nyanställda till viktiga resurser, utan behöver även ta på sig ett stort ansvar för individens introducerade till den sociala miljön på arbetsplatsen. Dock behöver individen vara öppen och aktiv för att få stöd från kollegorna. För att personalen ska dela organisationskulturen behöver de få vara involverade i förändringar och gemensamma mål. Dessa genomsyrar hela verksamheten, vilket underlättar nyanställdas socialisationsprocess. Vid nyanställdas socialisation har HR funktionen en stor del om processen blir lyckad eller inte.

Åldersblandning i skolan : elevers erfarenheter

Mixing ages in school classes became more and more common during the last dec-ades of the 20th century. From being a way to organise classes out of necessity they have now come to be something which is implemented on the basis of pedagogical arguments. The aim of this research has been to improve our knowledge of classes where pupils are not of the same age. A study of the pupils’ perspectives has been my main interest. (Age) homogeneous class can been looked upon as a result of the authorities’ deci-sion to have a fixed age for children to start school and their decision that certain courses should be completed within a defined period of time. Terms and the data concerning heterogeneous age groupings are ambiguous and cannot be fully understood without knowledge of national and sometimes even local contexts. Practices within age heterogeneous classes may differ greatly. A great deal of individual work takes place in age heterogeneous classes. Whether the class is non-mixed or mixed-aged does not seem to have a major im-pact on cognitive or non-cognitive abilities among the pupils, but there are suggestions that age heterogeneous classes might be disadvantageous to pupils in problematic situations. I am able to show that more than 30% of pupils in grades 1-3, close to 25% in grades 4-5, about 15% in grade 6 and a couple of percent of Swedish pupils in the later school years are taught in mixed-age groups. My own empirical research focuses on pupils’ experiences. My investigation has a ‘life-world’ oriented approach inspired by phenomenology. Pupils in grades 5 and 6 from three schools in three different socio-economic settings were interviewed. These pupils had experienced both mixed-age and single-age classes. The life-world of pupils seems to be something different from that encompassed by the philosophy about the advantages of mixing the ages in classes. Pupils find it diffi-cult to maintain or create relationships when only a few pupils of the same sex, who have started school at the same time, can be together in a class for a long time. Be-cause of the importance of social relationships almost every pupil in this investigation wished to be in a single-age class during the following year. It is the importance of common experiences rather than age that is central. Pupils stated that having things in common to study in their everyday schoolwork makes it easier to communicate and contributes to stable friendships. In my conclusion I focus on what it means to have relationships and how these are important for human identity. I also try to show how relationships are important in learning situations at school and for pupils’ opportunities to expand their knowledge.

Visual functioning and health-related quality of life in diabetic patients about to undergo anti-vascular endothelial growth factor treatment for sight-threatening macular edema

Purpose To examine patient-reported outcome (PRO) in a selected group of Swedish patients about to receive anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME). Material and methods In this cross-sectional study, 59 patients with diabetes mellitus, who regularly visited the outpatient eye-clinics, were included. Sociodemographic and clinical data were collected and the patients completed PRO measures before starting anti-VEGF treatment. PRO measures assessed eye-specific outcomes (NEI-VFQ-25) and generic health-related quality of life (SF-36). Results The participants consisted of 30 men and 29 women (mean age, 68.5 years); 54 (92 %) patients had type 2 diabetes; Five (9%) patients had moderate or severe visual impairment; 28 (47 %) were classified as having mild visual impairment. Some of the patients reported overall problems in their daily lives, such as with social relationships, as well as problems with impaired sight as a result of reduced distance vision. Conclusions Further studies are needed to investigate PRO factors related to low perceived general health in this patient population. It is important to increase our understanding of such underlying mechanisms to promote improvements in the quality of patient care.

Young adults’ perceptions of and affective bonds to a rural tourism community

Many rural areas, in Sweden and worldwide, experience population decline where the young leave for education and work in urban areas. Employment has declined in several rural industries, such as agriculture, forestry, and fishing, while growing in other industries are often located in urban areas. Politicians and organizations have put much hope in tourism as a tool of rural development, but can tourism help reverse the rural out-migration trend among young adults? This paper explores how tourism affects young inhabitants’ perceptions of and affective bonds to a rural area in Sweden, the ski resort of Sälen. Students from the 1993–1995 elementary school graduating classes were interviewed about their migration history, childhood, and view of and ties to Sälen. The respondents experience that tourism contributes to a more vital community incorporating influences from elsewhere, but without eliminating the positive aspects of rural life. The regular flow of people – tourists, seasonal workers, and entrepreneurs – passing through Sälen presents opportunities to extend one’s social network that are widely appreciated by respondents. The high in and out mobility constitutes a key part of Sälen’s character. Contributions from tourism – such as employment, entertainment, leisure, and opportunities to forge new social relationships – are available during the adult transition, the life phase when rural areas are often perceived as least attractive. Even though out-migration occurs in Sälen, and some respondents still find Sälen too small, tourism has clearly increased the available opportunities and contributed significantly to making Sälen more attractive to young adults.

Tourism and Arctic Observation Systems : exploring the relationships

The Arctic is affected by global environmental change and also by diverse interests from many economic sectors and industries. Over the last decade, various actors have attempted to explore the options for setting up integrated and comprehensive trans-boundary systems for monitoring and observing these impacts. These Arctic Observation Systems (AOS) contribute to the planning, implementation, monitoring and evaluation of environmental change and responsible social and economic development in the Arctic. The aim of this article is to identify the two-way relationship between AOS and tourism. On the one hand, tourism activities account for diverse changes across a broad spectrum of impact fields. On the other hand, due to its multiple and diverse agents and far-reaching activities, tourism is also well-positioned to collect observational data and participate as an actor in monitoring activities. To accomplish our goals, we provide an inventory of tourism-embedded issues and concerns of interest to AOS from a range of destinations in the circumpolar Arctic region, including Alaska, Arctic Canada, Iceland, Svalbard, the mainland European Arctic and Russia. The article also draws comparisons with the situation in Antarctica. On the basis of a collective analysis provided by members of the International Polar Tourism Research Network from across the polar regions, we conclude that the potential role for tourism in the development and implementation of AOS is significant and has been overlooked.