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Distriktssköterskors arbete med äldre patienter i vårdvalssystemet: En studie av Stockholms läns landstings vårdvalssystem i Stockholms innerstad
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2011 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Syfte: Att undersöka hur distriktssköterskor uppfattar vårdvalets inverkan på arbetet med den äldre patientgruppen i Stockholms läns landsting. I analysen var fokus på distriktssköterskornas uppfattningar om vårdvalets inverkan på den goda vården. Metod: Studien utfördes som en deskriptiv studie. Kvalitativa analyser av intervjuer med distriktssköterskor genomfördes med ett deduktivt tillvägagångssätt. Resultat: Ett ekonomiskt tänkande och korta patientbesök prioriterades. Distriktssköterskor utförde andra yrkeskategoriers arbetsuppgifter. Prioriteringar bidrog till att hälsofrämjande arbete bortprioriterades, bland annat sjuttiofemåringarnas hälsosamtal. Vården utformades inte i samråd med äldre men distriktssköterskorna arbetade ändå för att kontinuitet och goda relationer skulle främjas. Äldre hade ett formellt självbestämmande i vårdvalssystemet men praktiskt var många passiva. Det berodde delvis på bristande kunskaper om vårdvalssystemet. En annan effekt av vårdvalet var ett förlorat områdesansvar.Slutsats: Distriktssköterskorna uppfattade att arbetet i vårdvalssystemet inverkade på den goda vården. Äldre påverkades då besök prioriterades efter ekonomisk vinning. Ersättningssystemet medförde att distriktssköterskor utförde andra yrkeskategoriers arbetsuppgifter. Det påverkade säker och effektiv vård samt väckte tankar hos distriktssköterskorna angående deras kompetens. Sjuttiofemåringarnas hälsosamtal bortprioriterades, vilket kan påverka goda vårdrelationer till äldre på sikt. Kontinuitet och goda vårdrelationer påverkade den patientfokuserade vården positivt men korta besök medförde negativa effekter i vårdrelationer till äldre. Om äldre var passiva i vårdvalssystemet på grund av okunskap borde individanpassad information erbjudas. Ett förlorat områdesansvar medförde bristande kunskaper om lokala resurser. Det påverkade äldre hemsjukvårdspatienter och den jämlika vården. Det kan ta tid innan ett nytt system har etablerats.

Abstract [en]

Purpose: To explore how district nurses perceive how the choice of care impact on the workwith the elderly population in Stockholms läns landsting. The analysis was focused on the district nurses perceptions of how the choice of care system affects the good treatment. Method: The study was conducted as a descriptive study. Qualitative analysis of interviews with district nurses was conducted with a deductive approach. Results: An economic thinking and short patient visits was a priority. District nurses performed other job tags tasks. Priorities contributed to health promotion away priority, including the seventy-five year people healthy conversation. The care was not devised in consultation with the older but still working district nurses for continuity and good relations would be promoted. Older had a formal self-determination in the choice of care system but in practice, many passive. It was partly due to lack of knowledge of the choice of care system.Another effect of the choice of care was a missed field of responsibility.Conclusion: The district nurses perceived that the work in choice of care system is affecting the good care. Older affected when visit a priority for financial gain. The compensation meant that district nurses performed other job tags tasks. It affected the safe and effective care and brought thoughts of district nurses regarding their competence. The seventy-five year people healthy conversation was away priority, which can affect good health care relationships in the elderly in the long run. Continuity and good care relationships affected the patient-focused care a positive but short visits resulted in negative effects in health care relationships to elderly patients. If the elderly were passive in the choice of care system because of ignorance should be individualized information provided. A lost area of responsibility entailed a lack of knowledge about local resources. It affected the elderly home care patients and the equal treatment. It may take time before a new system has been established.

Place, publisher, year, edition, pages
2011. , 38 p.
Keyword [en]
choice of care, patient´s choice, elderly patients, district nurse
Keyword [sv]
vårdval, patientens val, äldre patienter, distriktssköterska
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-161399OAI: oai:DiVA.org:uu-161399DiVA: diva2:456083
Subject / course
Caring Sciences
Educational program
Specialistsjuksköterskeprogrammet med inriktning mot distriktssköterska
Uppsok
Medicine
Supervisors
Examiners
Available from: 2011-11-29 Created: 2011-11-11 Last updated: 2011-11-29Bibliographically approved

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