AbstractOur purpose for making this study is to study the implementation, the use of and the effects of Lean within our case objects.  We chose to make this thesis by case studies. The three themes mentioned above is also the main research questions that we aim to find an answer to by this study. We have chosen to do a cross section analysis where we conducted structured interviews to find answers to these questions. The theoretical reference frame consists partly of traditional theoreticians within Lean but also more recent research within the subject as well as theory specifically for Lean within the Health Care sector.The result of this study shows in all our case studies that the Management has been supporting the implementation, but that the implementation process proceeds faster if also the professionals are involved in the process.  To succeed with the implementation there is a great need for good reasons and strives that can benefit the professionals. By the use of Lean our case studies have evaluated its processes, with the main intentions being to reduce waste activities and to create flows with ?pull systems?.

The aim of this study is to become aware of how the children at the after-school care perceive the adults at after-school care. The most interesting parts are to find out what they thought made a good teacher, which qualities were preferable and how the children expressed their opinions. The children often spend long time at the after-school care which means that the children?s work environment matters. The children look at adults from another perspective and see other qualities than adults see in each other.

With good knowledge about the disease and the treatment, the fear and worry of children and parents can be reduced. Children may be helped by painting to express their experiences. In order to have a good care, the care-personnel need to see and understand what the children need. It is important to live an as regular life as possible during the disease and its treatment. The aim of this study was to elucidate how children experience chemotherapy in conection with their cancer disease.

Every day in medical care the nurse and the patient meet, they are not just represented as the care giver and the care taker, but also as two unique individuals. The meeting is a very important part in caring and few studies have been made on this topic from the patient.s perspective. The purpose of this study was to describe the patient.s perspective on the meeting with the nurse. The study is a literature review, where articles have been reviewed, encoded, and then categorized. The result builds on our four main categories, confirmed as a unique indidual, the meaning of the information according to the patient, the humanistic side of the nurse, and the importance of humor in the meeting.

Aim: Compare occurrences of first-time-events reported by mothers and fathers with children at high tech NICU according to kangaroo-mother-care method in two university hospitals. Method: Descriptive, quantitative design. Fourty-five couples of parents, with premature children born and cared for at university hospitals in Uppsala or Örebro, answered questionnaires about first-time-events: interaction-events, measures-of-care-events and sleeping-place-events. Results: All differences regarding the children?s age at first-time-events showed Uppsala-children to be younger than Örebro-children. Interaction-events were reported first in children?s lives, measures-of-care-events and sleeping-place-events later.

Background: During the 1980s, the fear of HIV spread over the world. Health professionals'attitudes to patients with HIV, was negatively impacted because of their fear to be infected.Patients with HIV have therefore,during disease history's first two decades, experienced stigma and discrimination in the response from health professionals. Because of the increasing knowledge of HIV it is of interest to study patients' contemporary experiences of the encounter with health professionals. Aim:To explore how patients with HIV experiencing the meeting with health professionals. Method:Literature study with seven qualitative and three quantitative articles.

The aim of this study was to, using previously collected data from self-declared antisocial behaviour questionnaires, examine if the crime frequency has been different between adolescents that have either been referred to two different forms of open care in social service, child and youth psychiatric inpatient care or have been sent to Homes for Specialised Supervision. The criminality frequency and the most common crimes committed were compared between the study groups and further between genders in each particular study group. Statistical significance testing was used and the results of the survey revealed that juvenile delinquents that had committed severe criminal acts were represented in all four groups. The study group with adolescents in national care was the most different from other groups. These youths seemed to have had a lower crime frequency than the other groups with the exception assault and robbery.

Munnen är ett viktigt organ vad gäller äldres fysiska, psykiska och sociala välbefinnande. Syftet med studien är att sammanställa sjuksköterskans syn på vilka faktorer och förhållande som spelar in på hur den orala vården utförs på äldre. Metoden för studien är en litteraturstudie. Resultatet visade att kunskapsbrist, rutinbrist, tidsbrist, utvärderingsredskap, oral hälsa i syfte att förebygga sjukdomar, etiska dilemma och samarbete med tandvården hade en stor betydelse för hur den orala vården utfördes. Kunskapsbristen ansågs vara kärnan till varför de äldres orala vård försummades av vårdpersonalen.

Amyotrofisk lateralskleros, ALS, är en obotlig sjukdom som klassas som en neurologisk sjukdom där de motoriska nervcellerna i hjärnan, hjärnstammen och ryggmärgen förtvinar. Sjukdomen kan ha ett hastigt förlopp vilket gör att patienterna är i behov av många hjälpinsatser. Syftet med studien är att öka kunskapen hos sjuksköterskor genom att belysa patienters upplevelser av att leva med ALS. För att beskriva dessa har en kvalitativ innehållsanalys använts. Med hjälp av denna modell fördjupas förståelsen av patienternas upplevelser, erfarenheter och förväntningar av sjukdomen.

Bakgrund: Anorexia nervosa innebär för en människa svår viktnedgång, som är en konsekvens av dennes rädsla att gå upp i vikt. Omvårdnaden består till stor del av kontrollerad behandling av de fysiska symtomen, vilket kan resultera i en maktkamp då människor med anorexia nervosa inte inser att de behöver hjälp och inte vill bli friska. Detta utmanar skapandet av en vårdrelation. En fungerande vårdrelation är avgörande för patienters tillfrisknande.Syfte: Att beskriva patienters och sjuksköterskors upplevelser av vårdrelationen i omvårdnaden av anorexia nervosa.Metod: Studien är baserad på en kvalitativ litteraturstudie. Informationssökning gjordes via databasen Cumulative Index to Nursing and Allied Health Literature, CINAHL.

Aim: The aim of the current study was to investigate nurses? experiences of caring for palliative patients in palliative home care, and to examine the coping strategies they use.Method: The study was empirical descriptive with qualitative approach. The data was collected by nine semi-structured interviews and analyzed by using manifest content analysis.Result: By analysing data three categories: Positive experiences of palliative home care, Stressful experiences of palliative home care and Problem-focused coping strategies, and 15 subcategories, were distinguished.Conclusion: Experiences of palliative home care were both of positive and challenging characters. Stressful situations were managed by problem-focused coping strategies. Nurses are in need of the work situation at home to become more ergonomic and designed to protect the nurse?s physical wellbeing.

Middle managers in social care find themselves in a middle position. The middle management position involves demands from several interested parties. The demands affect and generate feelings both within themselves and within others and the middle managers have to deal with them all.The aim of this study was to investigate the social care middle manager?s personal experiences of emotions in work.We have completed interviews with four middle managers who are assigned to carry out social care. When doing the interviews we used an interview guide divided into different interview areas.

Konfusion är mycket vanligt förekommande hos äldre och skapar stort lidande, ger höga samhällskostnader och orsakar hög mortalitet. Syftet med studien var att belysa sjuksköterskans icke farmakologiska omvårdnadsåtgärder vid konfusion hos äldre patienter. Metoden var en litteraturstudie, vilken innefattade tio artiklar där relevanta omvårdnadsåtgärder framkom, dessa presenterades i resultatet under VIPS - modellens åtgärdssökord. Resultatet av studien visade att patienter med konfusion mindes och uppmärksammade vad som skedde med och runt omkring dem. Viktigt var att få information om sitt konfusionstillstånd för att förstå vad som hände och varför.

The number of elderly in Sweden is increasing due to improved living conditions and better medical care. It is important that society adapts to the increase and begins to work preventively to reduce the costs of the increase. An important aspect is the elderly accommodation, the cost of health care in specific accommodation is almost twice as high as those for ordinary housing. Therefore, it is important that we availability adapt dwelling to allow older people to live in ordinary housing for as long as they wish, instead of moving to assisted living before they need it. If we can fulfil the elder?s needs with home care instead, society can save a lot of money.In this report, three different forms of housing has undergone accessibility increases and been inventoried and analysed.

This thesis puts together general guidelines for the design of outdoor environment at nursing homes for people with dementia. The goal is to give the residents a greater quality of life with the garden.The garden must be safe and secure while offering places for fellowship or retirement and experiences of joy and competence. The plant material and other elements in the garden are inserted to stimulate the senses and to inspire to different activities. The paper describes the health promoting effects of nature and gardens by referring to scientific studies. These studies encompass the impact of nature on all human beings as well as how the outdoor environment affects our target group, elderly people with dementia. An essential part of the work focus on the conditions in a garden for people with dementia, on the contact between residence and garden and the access to surrounding life. Eventually, the general guidelines are applied to a real building project ? the Vega project in Lomma,a new nursing home for persons with dementia.