The public health care sector has come under increasing pressure to cut down costs, maximize productivity and satisfy patients' needs during the 1990s and onwards. As a way of "getting more for less" quality management has been introduced. Originating in the private manufacturing industry, quality management has a strong focus on productivity and efficiency, aspects which are measured in quantitative terms. However, there are strong concerns that quality management is a means of speeding up the marketization of public health care by introducing core values much different from the ethic and medical norms that traditionally underpin health care organizations.This essay focuses on how quality management has been introduced to, and transformed by, public health care. A theoretical framework based on new institutionalism is constructed, and translation theories are used as a way of illustrating how the medical institutional environment, in fact, changes the concept of quality management.

Aim: Through the review of scientific articles, this study aimed to identify which oral health-related quality of life instruments that have been used in studies to measure the oral health-related quality of life in older individuals and the application of such instruments. Method: The study is based on a systematic literature review, where 14 articles have been chosen and evaluated against a checklist. Result: The oral health-related quality of life instruments that have been used on individuals, 65 years and older, are OHIP-49, OHIP-14, OHIP-20 or OHIP-EDENT, GOHAI and OIDP. The instruments are used to examine factors associated with the oral health-related quality of life. Significant associations have been identified, among other things, between the number of teeth in static occlusion, dry mouth and the quality of the dentures, and oral health-related quality of life. Social and cultural associations have also been revealed. Conclusions: Today there exist several well functioning instruments that are used for research purposes.

Aim: Through the review of scientific articles, this study aimed to identify which oral health-related quality of life instruments that have been used in studies to measure the oral health-related quality of life in older individuals and the application of such instruments.Method: The study is based on a systematic literature review, where 14 articles have been chosen and evaluated against a checklist. Result: The oral health-related quality of life instruments that have been used on individuals, 65 years and older, are OHIP-49, OHIP-14, OHIP-20 or OHIP-EDENT, GOHAI and OIDP. The instruments are used to examine factors associated with the oral health-related quality of life. Significant associations have been identified, among other things, between the number of teeth in static occlusion, dry mouth and the quality of the dentures, and oral health-related quality of life. Social and cultural associations have also been revealed.Conclusions: Today there exist several well functioning instruments that are used for research purposes.

Background: The population of the world is getting older and in the year of 2020, 1.2 billion people will be 60 years or older. A common health complaint affecting the quality of life in elderly persons are sleep difficulties. Physical activity is claimed to improve sleep quality and the maintenance of a normal circadian rhythm. Several studies have shown positive effects of physical activity on sleep quality, still the evidence of physical activity as sleep-promoter is insufficient. Aim: The aim of this study was to investigate associations between physical activities and sleep quality in persons ?60 years of age.

The aim of the thesis was to identify whether, and if so how, aspects of sexual health (reproductive health and cohabitation) are compiled in the National Quality Register and identify reasons for this. A quantitative method has been applied to go through the registers annual reports. In the first part of the thesis, the registers annual reports was mapped with the help of a checklist designed through World Health Organizations (WHO) definition of sexual health. In the second part, a questionnaire was sent to those responsible for each register to find reasons to why and how sexual health is included in the National Quality Registers. The result shows that sexual health is not usually included in the register data, although the survey showed that most registers brought up aspects that could affect the current target group's sexual health.

Background Satisfaction of life and wellbeing is shown to be important when the quality of life is to be understood. The nurse has a significant role in the care of the patient and in his/her experience of life. Aim The purpose of this study is to examine the quality of life, from a nurse perspective. Method The text analysis was carried out with qualified attempts, of a book, "Quality of life a challenge for the nurse" (in Swedish) by T. Rustoen, a nurse who also worked as a teacher in Norway. The book describes how quality of life is experienced from the patients and staffs view. Results The text analysis showed that out of the ordinary descriptions of quality of life, the author found four new themes. These themes where; the meaning of solidarity, confidence, activity and meaningfulness in the existence. Conclusion Quality of life is an important word, which means different to different kind of people.

Background: The population of the world is getting older and in the year of 2020, 1.2 billion people will be 60 years or older. A common health complaint affecting the quality of life in elderly persons are sleep difficulties. Physical activity is claimed to improve sleep quality and the maintenance of a normal circadian rhythm. Several studies have shown positive effects of physical activity on sleep quality, still the evidence of physical activity as sleep-promoter is insufficient. Aim: The aim of this study was to investigate associations between physical activities and sleep quality in persons ?60 years of age.

Around 30,000 people in Sweden suffer stroke every year, out of which about 12,000 end up with language difficulties, aphasia. Behind every person with aphasia there are significant others whose lives are also affected. Studies of how aphasia affects the health of these people are few. The overall aim of the present study was to examine how significant others of people with aphasia perceive their life situation, and how their quality of life is affected by the illness of their partner. Spouses of people with aphasia were contacted through aphasia groups and the Swedish Aphasia Association.

Introduction: Sex and education level has demonstrated effects on health status.Osteoarthritis is a widespread disease that causes reduced health-related quality of life and isthe most common reason for total hip replacement. Osteoarthritis was ranked as the 11thhighest contributor to global disability as reported in the Global Burden of Disease 2010.Aim: The aim of this study was to explore how sex and education level together affectedhealth-related quality of life after total hip replacement. The aim was also to examine whatdimensions of EQ-5D that changed.Methods: The study is a prospective observational study with a quantitative approach. Dataconsisted of education level, obtained from Statistics Sweden (SCB) and health-relatedquality of life before and one year after total hip replacement from the Swedish HipArthroplasty Register (SHAR). Health-related quality of life was measured with astandardised instrument, the EQ-5D, and the study population consisted of 39,141 patients.Results: Womens? EQ-5D-value, before and one year after surgery, were lower in alleducational categories compared with men.

The care for the elderly in the municipalities has recently seen the need for a formalized system for quality assurance. Under increasing demands for monetary efficiency while bound by law to retain acceptable standards in health care, there is need for efficient and at the same time quality-assured management. The municipalities often solve this puzzle by introducing systems and standards influenced by theory-clusters such as NPM (New Public Management), TQM (Total Quality Management) or other quality management theories.This essay focuses on how the public administration in the municipalities defines quality and designs and implements system for formalized quality assurance. Our basic view of organizations is institutionalist and our theoretical framework includes theories about quality, NPM and TQM..

Introduction: The health for individuals with intellectual disabilities is asubject that is prioritized by the Swedish Institute for Public Health. Socialsupport has been proven to be important for health and quality of life. Despitethis fact there is no research available regarding the influence social support hason health and quality of life for people with intellectual disabilities in Sweden.Aim: To describe social support and the consequence of social support forhealth and quality of life for individuals with intellectual disabilities. Method:A litterature review of research in a defined area with a descriptive design.Systematic searches for articles were done in several databases and ultimately16 articles were chosen. Themes and categories were created with respect to theaim of this study during the analysis of the articles.

Introduction: The health for individuals with intellectual disabilities is asubject that is prioritized by the Swedish Institute for Public Health. Socialsupport has been proven to be important for health and quality of life. Despitethis fact there is no research available regarding the influence social support hason health and quality of life for people with intellectual disabilities in Sweden.Aim: To describe social support and the consequence of social support forhealth and quality of life for individuals with intellectual disabilities. Method:A litterature review of research in a defined area with a descriptive design.Systematic searches for articles were done in several databases and ultimately16 articles were chosen. Themes and categories were created with respect to theaim of this study during the analysis of the articles.

An individual´s health is an important quality and asset to the individual, as well as to organizations and communities. The health of a human being is affected by the whole life situation, where the work place forms a significant part. The work place is an arena that can contribute to creating ill-health. In the light of increasing work- related ill-health in our society, it is important today to work with health-promoting initiatives in order to improve the well-being of people. It is advisable that an appointed key person at the work place works with health-promoting efforts.

Introduction: The health for individuals with intellectual disabilities is asubject that is prioritized by the Swedish Institute for Public Health. Socialsupport has been proven to be important for health and quality of life. Despitethis fact there is no research available regarding the influence social support hason health and quality of life for people with intellectual disabilities in Sweden.Aim: To describe social support and the consequence of social support forhealth and quality of life for individuals with intellectual disabilities. Method:A litterature review of research in a defined area with a descriptive design.Systematic searches for articles were done in several databases and ultimately16 articles were chosen. Themes and categories were created with respect to theaim of this study during the analysis of the articles.

Introduction: The health for individuals with intellectual disabilities is asubject that is prioritized by the Swedish Institute for Public Health. Socialsupport has been proven to be important for health and quality of life. Despitethis fact there is no research available regarding the influence social support hason health and quality of life for people with intellectual disabilities in Sweden.Aim: To describe social support and the consequence of social support forhealth and quality of life for individuals with intellectual disabilities. Method:A litterature review of research in a defined area with a descriptive design.Systematic searches for articles were done in several databases and ultimately16 articles were chosen. Themes and categories were created with respect to theaim of this study during the analysis of the articles.