Health and quality of care from older peoples' and formal caregivers' perspective

Aim: The overall aim of this thesis was to gain a deeper understanding of older people's view of health and care while dependent on community care. Furthermore to describe and compare formal caregivers' perceptions of quality of care, working conditions, competence, general health, and factors associated with quality of care from the caregivers' perspective. Method: Qualitative interviews were conducted with 19 older people in community care who were asked to describe what health and ill health((I), good and bad care meant for them (II). Data were analyzed using content analysis (I) and a phenomenological analysis (II). The formal caregivers; 70 nursing assistants (NAs) 163 enrolled nurses (ENs) and 198 registered nurses (RNs), answered a questionnaire consisting of five instruments: quality of care from the patient's perspective modified to formal caregivers, creative climate questionnaire, stress of conscience, health index, sense of coherence and items on education and competence (III). Statistical analyses were performed containing descriptive statistics, and comparisons between the occupational groups were made using Kruskal-Wallis ANOVA, Mann-Whitney U-test and Pearson's Chi-square test (III). Pearson's  product moment correlation analysis and multiple regression analysis were performed studying the associations between organizational climate, stress of conscience, competence, general health and sense of coherence with quality of care (IV). Results: The older people's health and well-being were related to their own ability to adapt to and compensate for their disabilities and was described as negative and positive poles of autonomy vs. dependence, togetherness vs. being an onlooker, security vs. insecurity and tranquility vs. disturbance (I).  The meaning of good care (II) was that the formal caregivers respected the older people as unique individuals, having the opportunity to live their lives as usual and receiving a safe and secure care. Good care could be experienced when the formal caregivers had adequate knowledge and competence in caring for older people, adequate time and continuity in the care organization (II). Formal caregivers reported higher perceived quality of care in the dimensions medical-technical competence and physical-technical conditions than in identity-oriented approach and socio-cultural atmosphere (III). In the organizational climate three of the dimensions were close to the value of a creative climate and in seven near a stagnant climate. The formal caregivers reported low rate of stress of conscience. The RNs reported to a higher degree than the NAs/ENs a need to gain more knowledge, but the NAs and the ENs more often received training during working hours. The RNs reported lower emotional well-being than the NAs/ENs (III). The formal caregivers' occupation, organizational climate and stress of conscience were associated with perceived quality of care (IV). Implications: The formal caregivers should have an awareness of the importance of kindness and respect, supporting the older people to retain control over their lives. The nursing managers should employ highly competent and adequate numbers of skilled formal caregivers, organize formal caregivers having round the clock continuity. Improvements of organizational climate and stress of conscience are of importance for good quality of care.

Electrical Evaluation of a Low Concentrating PVT Collector Based on Performance Ratio

Photovoltaic Thermal/Hybrid collectors are an emerging technology that combines PV and solar thermal collectors by producing heat and electricity simultaneously. In this paper, the electrical performance evaluation of a low concentrating PVT collector was done through two testing parts: power comparison and performance ratio testing. For the performance ratio testing, it is required to identify and measure the factors affecting the performance ratio on a low concentrating PVT collector. Factors such as PV cell configuration, collector acceptance angle, flow rate, tracking the sun, temperature dependence and diffuse to irradiance ratio. Solarus low concentrating PVT collector V12 was tested at Dalarna University in Sweden using the electrical equipment at the solar laboratory. The PV testing has showed differences between the two receivers. Back2 was producing 1.8 energy output more than Back1 throughout the day. Front1 and Front2 were almost the same output performance. Performance tests showed that the cell configuration for Receiver2 with cells grouping (6- 32-32-6) has proved to have a better performance ratio when to it comes to minimizing the shading effect leading to more output power throughout the day because of lowering the mismatch losses. Different factors were measured and presented in this thesis in chapter 5. With the current design, it has been obtained a peak power at STC of 107W per receiver. The solar cells have an electrical efficiency of approximately 19% while the maximum measured electrical efficiency for the collector was approximately 18 % per active cell area, in addition to a temperature coefficient of -0.53%/ ˚C. Finally a recommendation was done to help Solarus AB to know how much the electrical performance is affected during variable ambient condition and be able to use the results for analyzing and introducing new modification if needed.