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| 2. |
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| 3. |
- Hedman, Karl, 1967-
(författare)
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Managing Medical Emergency Calls
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation is a conversation analytic examination of recurrent practices of interaction in medicalemergency calls. The study expands the analytical focus in past research on emergency calls betweenemergency call operators and callers to pre-hospital emergency care interaction on the phone betweennurses, physicians and callers. The investigation is based on ethnographic fieldwork in a Swedish emergencycontrol centre. The data used for the study consists primarily of audio recordings of medical emergency calls.Fundamental procedures in medical emergency calls examined in the dissertation are: (1) questioning; (2)emotion management; (3) risk management and (4) instruction giving. Emergency call-takers ask questions toelicit descriptions by callers of what is happening and to manage symptoms of patients to help keep them safeuntil ambulance crews arrive. In the questioning practice about acutely ill or injured patients call-takers usemainly yes-no questions and clarify problems by questioning callers making a distinction between defined andundefined problems. The analysis reveals four core types of emotion management practices: (1) call-takerskeep themselves calm when managing callers’ social displays of emotions; (2) promising ambulanceassistance; (3) providing problem solving presentations including emergency response measures to concernsof callers, and (4) emphasising the positive to create hope for callers. Call-takers use seven key procedures tomanage risk in medical emergency calls: (1) risk listening through active listening after actual and possiblerisks; (2) risk questioning; (3) risk identification; (4) risk monitoring; (5) risk assessment; (6) making decisionsabout elicited risk and (7) risk reduction. Instruction giving using directives and recommendations isaccomplished by call-takers in four main ways: (1) acute flow maintaining instruction giving when callers areprocedurally out of line; (2) measure oriented instructions for patient care and emergency responsemanagement; (3) organisational response instructions and (4) summarising instruction giving. Callers routinelyacknowledge risk identifications and follow instructions delivered by call-takers to examine statuses and lifesigns of patients such as breathing, movement and pulse, and perform basic first aid and emergency responsemeasures.The findings generated from this study will be useful in emergency call-taker training in carrying out interactiveprocedures in medical emergency calls and add to the larger research programmes on on-telephoneinteraction between professionals and citizen callers. This is an essential book for pre-hospital emergency careproviders and institutional interaction researchers and students.
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| 4. |
- Leppänen, Vesa
(författare)
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Arbetsvillkor och maktrelationer i avlönat hushållsarbete
- 2013
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Det har funnits hushållsarbetare under mycket lång tid och i de flesta delar av världen. Det är nu ett av de vanligaste kvinnoyrkena internationellt. Under mer än ett århundrade har pågått en debatt om hushållsarbetarnas arbetsvillkor där det sagts bl.a. att arbetet är lågavlönat, fysiskt tungt, innebär långa arbetstider, kan leda till social isolering och olika former av övergrepp. Dessa arbetsvillkor uppkommer vid mötet mellan hushållsarbetare och de som anlitar dem. I denna text analyseras maktrelationen mellan dessa två parter. Analysen är baserad på etnografiska studier om hushållsarbetares vardag i Sverige och den övriga västvärlden under slutet av 1900- och början av 2000-talet. Som analytiskt redskap används Tönnies begreppspar Gemeinschaft och Gesellschaft (1887). I det förmoderna samhället karakteriserades relationen mellan hushållsarbetare och familj av Gemeinschaft, d.v.s. att hushållsarbetaren var en del av hushållet och hade en viss status som innebar underordning under husbonden. Det har länge hävdats – och hoppats – att samhällets modernisering leder till att relationen ersätts med Gesellschaft, d.v.s. baseras på kontrakt där arbetsuppgifter, arbetstider, löner, m.m. är reglerade. Men i denna text hävdas att yrkesrollen som hushållsarbetare alltid innebär en blandning av Gemeinschaft och Gesellschaft. Det betyder att vissa av de problem som förknippas med hushållsarbetet inte helt kan lösas genom ökad grad av Gesellschaft, t.ex. att hantera nedlåtande inställning från vissa kunder eller den sorg som kan uppstå efter att ha fått sluta arbeta i en familj där man fått starka emotionella band till familjens barn. Istället behövs andra metoder, t.ex. utbildning och organiserat socialt stöd.
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| 5. |
- Leppänen, Vesa, 1966-, et al.
(författare)
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Arbetsvillkor och trivsel bland anställda inom hushållsnära tjänster
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The number of domestic workers decreased continuously in Sweden over the course of the twentieth century. As a share of the total workforce, the proportion of waged domestic workers had fallen to 2.9% in 1950 and 0.05% by 1990, largely because of the mechanization of domestic work, the growth of public child-care and eldercare, a shortage of labour, and increased taxes on labour. Yet at the end of the twentieth century the demand for domestic services increased, and there were signs that the informal sector was growing. In 2007 the Swedish Parliament decided to make domestic services—domestic cleaning, cooking, clothes care, snow removal, gardening, child-care, and help with personal hygiene—tax deductible for private persons. For many this reduced the cost of home help by 50%. The reform started a political debate (the ‘maid debate’), with opponents of the reform arguing it would create a new, low-pay sector of female and immigrant workers, characterized by asymmetric power relations between families and domestic workers, exploitation, and bad working conditions in general. Following the reform, the number of domestic service businesses and employees increased rapidly. In the second half of 2007, 46,000 people applied for the tax deduction, and by 2011 their number was almost 416,000. From 2009 to 2011, the number of hours of waged domestic work doubled to the equivalent of 61,400 full-time jobs a year.A previous report, which was based on the same data used here, describes various characteristics of the workers (for example, gender, age, birth, educational background, previous career, reasons for taking the job, and experience of informal work in the domestic sector) (http://hkr.diva- portal.org/smash/record.jsf ?pid=diva2:556163). The present study describes working conditions and job satisfaction among domestic workers employed by Swedish firms. The empirical data were collected by means of a questionnaire sent to employees of companies with five or more employees in the four southernmost counties of Sweden (Skåne, Blekinge, Halland, and Kronoberg), which together have a population of 1.9 million out of national total of 9.45 million. A total of 249 questionnaires were returned by domestic workers from 86 companies.Almost 70% of respondents were in permanent employment. About 80% were female (of the total workforce in Sweden, 88% of men and 83% of women were in permanent employment, and among cleaners in general 64%). About 28% said they had managerial functions. One possible explanation for this high percentage was that their workplaces were rather small and geographically scattered (about 30% reported their workplaces had 5–9 employees, and 36.5% reported that their workplaces had 10–19 employees.)About 54% work full time (35 hours or more per week). According to a national survey in Sweden, 76.6% of the workforce work full time. Male domestic workers are more likely to work full time (76%) than female workers (about 49%), and those with managerial functions work are more likely to work full time (74%) than those without managerial functions (47%). Of those who work fewer than 30 hours per week, only 43% reported that their employer could not offer them more hours.Most of the respondents did routine, weekly domestic cleaning (89%). A majority also did one- off cleaning (62%) and end-of-tenancy cleaning (58%), and about half of them also did window cleaning (46%). Other common tasks were clothes care and shopping. Only a small proportion reported providing care for the elderly (7.7%), the disabled (1.2%), or children (2%). One explanation for the low percentage of care work is that the public sector provides most of these services in Sweden, while such gaps as exist are largely covered by private care companies (funded by the public purse).Tasks are divided by gender. For example, 34% of male workers did odd jobs, compared to 3.5% of the female workers, and while almost 48% of the male workers shovelled snow, only 8% of the female workers did. The female workers performed tasks that are traditionally considered to be female, namely routine domestic cleaning, one-off cleaning, clothes care, and child-care and eldercare.Most of the domestic workers’ wages included time spent travelling between jobs (73%) and most of them had their travel costs paid for by their employers (84.5%). Most of them took their breaks in other places than their company’s break room (74%).When asked about their relationships with managers, 90.5% agreed with the statement that they received help and support from their managers (compared with a national survey of general cleaners in Sweden, of whom 28% said they rarely or never received support from supervisors); 74% agreed with the statement that they planned their work with their supervisors (again, 22% of general cleaners in the national survey said they had difficulty getting information from their supervisors about what should be given priority); and when asked about their relationships with co-workers, 86% agreed with the statement that they got help and support from their co-workers. About 50% agreed with the statement that they did not meet their co-workers often enough, although not all domestic workers longed for co-workers: 20% said they took the job because it entailed little interaction with co-workers. Meanwhile, 19% took the job because it entailed few interactions with customers.In the ‘maid debate’ prompted by the Swedish Parliament’s deliberations about the tax reform, opponents argued it would create a new and exploitative low-pay sector for female and immigrant workers, with poor working conditions. The debate thus contributed to the public image of working conditions in domestic service as generally bad. We therefore asked the respondents if they felt that others looked down upon their work, and 25.5% agreed with the statement, while almost 9% said that they were ashamed of their work and chose not tell others what they did for a living.This public image and the shame felt by some of the domestic workers are in sharp contrast to how they felt about the work per se. Almost 94% agreed with the statement ‘I enjoy my work’, and 78% with the statement that the work was more fun than they thought it would be. When asked what they thought was best about their work, the most common answer referred to customers in some way (57%)—for example, meeting them, helping them, and pleasing them. The second source of satisfaction was flexibility and self-determination (43%)—for example, being able to influence how many hours they had to work, when to work, and how to do the work. In answering another question, 85% agreed with the statement that they preferred cleaning because the hours were flexible. A large number said that the work was varied, that they liked the contact they had with their supervisors, and that it was a form of physical exercise.When asked about the worst aspects of their work, many said it was stressful (24%), physically demanding (21%), and low paid (11%), and that some customer interactions could be difficult.Given the well-documented health risks of cleaning work, we asked if they thought their work affected their health: 31% agreed with the statement that the work had an adverse effect on their health, and about 50% agreed with the statement, ‘I believe my work will have an adverse effect on my health in the long term’.
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| 6. |
- Leppänen, Vesa, et al.
(författare)
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Arbetsvillkor och trivsel bland anställda inom hushållsnära tjänster
- 2012
-
Bok (övrigt vetenskapligt/konstnärligt)abstract
- The number of domestic workers decreased continuously in Sweden over the course of the twentieth century. As a share of the total workforce, the proportion of waged domestic workers had fallen to 2.9% in 1950 and 0.05% by 1990, largely because of the mechanization of domestic work, the growth of public child-care and eldercare, a shortage of labour, and increased taxes on labour. Yet at the end of the twentieth century the demand for domestic services increased, and there were signs that the informal sector was growing. In 2007 the Swedish Parliament decided to make domestic services—domestic cleaning, cooking, clothes care, snow removal, gardening, child-care, and help with personal hygiene—tax deductible for private persons. For many this reduced the cost of home help by 50%. The reform started a political debate (the ‘maid debate’), with opponents of the reform arguing it would create a new, low-pay sector of female and immigrant workers, characterized by asymmetric power relations between families anddomestic workers, exploitation, and bad working conditions in general. Following the reform, the number of domestic service businesses and employees increased rapidly. In the second half of 2007, 46,000 people applied for the tax deduction, and by 2011 their number was almost 416,000. From 2009 to 2011, the number of hours of waged domestic work doubled to the equivalent of 61,400 full-time jobs a year. A previous report, which was based on the same data used here, describes various characteristics of the workers (for example, gender, age, birth, educational background, previous career, reasons for taking the job, and experience of informal work in the domestic sector) (http://hkr.diva- portal.org/smash/record.jsf ?pid=diva2:556163). The present study describes working conditions and job satisfaction among domestic workers employed by Swedish firms. The empirical data were collected by means of a questionnaire sent to employees of companies with five or more employees in the four southernmost counties of Sweden (Skåne, Blekinge, Halland, and Kronoberg), which together have a population of 1.9 million out of national total of 9.45 million. A total of 249 questionnaires were returned by domestic workers from 86 companies. Almost 70% of respondents were in permanent employment. About 80% were female (of the total workforce in Sweden, 88% of men and 83% of women were in permanent employment, and among cleaners in general 64%). About 28% said they had managerial functions. One possible explanation for this high percentage was that their workplaces were rather small and geographically scattered (about 30% reported their workplaces had 5–9 employees, and 36.5% reported that their workplaces had 10–19 employees.) About 54% work full time (35 hours or more per week). According to a national survey in Sweden, 76.6% of the workforce work full time. Male domestic workers are more likely to work full time (76%) than female workers (about 49%), and those with managerial functions work are more likely to work full time (74%) than those without managerial functions (47%). Of those who work fewer than 30 hours per week, only 43% reported that their employer could not offer them more hours. Most of the respondents did routine, weekly domestic cleaning (89%). A majority also did one- off cleaning (62%) and end-of-tenancy cleaning (58%), and about half of them also did window cleaning (46%). Other common tasks were clothes care and shopping. Only a small proportion reported providing care for the elderly (7.7%), the disabled (1.2%), or children (2%). One explanation for the low percentage of care work is that the public sector provides most of these services in Sweden, while such gaps as exist are largely covered by private care companies (funded by the public purse). Tasks are divided by gender. For example, 34% of male workers did odd jobs, compared to 3.5% of the female workers, and while almost 48% of the male workers shovelled snow, only 8% of the female workers did. The female workers performed tasks that are traditionally considered to be female, namely routine domestic cleaning, one-off cleaning, clothes care, and child-care and eldercare. Most of the domestic workers’ wages included time spent travelling between jobs (73%) and most of them had their travel costs paid for by their employers (84.5%). Most of them took their breaks in other places than their company’s break room (74%). When asked about their relationships with managers, 90.5% agreed with the statement that they received help and support from their managers (compared with a national survey of general cleaners in Sweden, of whom 28% said they rarely or never received support from supervisors); 74% agreed with the statement that they planned their work with their supervisors (again, 22% of general cleaners in the national survey said they had difficulty getting information from their supervisors about what should be given priority); and when asked about their relationships with co-workers, 86% agreed with the statement that they got help and support from their co-workers. About 50% agreed with the statement that they did not meet their co-workers often enough, although not all domestic workers longed for co-workers: 20% said they took the job because it entailed little interaction with co-workers. Meanwhile, 19% took the job because it entailed few interactions with customers. In the ‘maid debate’ prompted by the Swedish Parliament’s deliberations about the tax reform, opponents argued it would create a new and exploitative low-pay sector for female and immigrant workers, with poor working conditions. The debate thus contributed to the public image of working conditions in domestic service as generally bad. We therefore asked the respondents if they felt that others looked down upon their work, and 25.5% agreed with the statement, while almost 9% said that they were ashamed of their work and chose not tell others what they did for a living. This public image and the shame felt by some of the domestic workers are in sharp contrast to how they felt about the work per se. Almost 94% agreed with the statement ‘I enjoy my work’, and 78% with the statement that the work was more fun than they thought it would be. When asked what they thought was best about their work, the most common answer referred to customers in some way (57%)—for example, meeting them, helping them, and pleasing them. The second source of satisfaction was flexibility and self-determination (43%)—for example, being able to influence how many hours they had to work, when to work, and how to do the work. In answering another question, 85% agreed with the statement that they preferred cleaning because the hours were flexible. A large number said that the work was varied, that they liked the contact they had with their supervisors, and that it was a form of physical exercise. When asked about the worst aspects of their work, many said it was stressful (24%), physically demanding (21%), and low paid (11%), and that some customer interactions could be difficult. Given the well-documented health risks ofcleaning work, we asked if they thought their work affected their health: 31% agreed with the statement that the work had an adverse effect on their health, and about 50% agreed with the statement, ‘I believe my work will have an adverse effect on my health in the long term’.
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| 7. |
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| 8. |
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| 9. |
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| 10. |
- Leppänen, Vesa, 1966-
(författare)
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Coping with troublesome clients in home care
- 2008
-
Ingår i: Qualitative Health Research. - 1049-7323 .- 1552-7557. ; 18:9, s. 1195-1205
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Tidskriftsartikel (refereegranskat)abstract
- I describe methods used by home carers to cope with troublesome clients and analyze how the organizational context affects their use. Empirical data consist of participant observation and field interviews with 14 home carers in three municipalities in southern Sweden. Home carers might try to avoid working with troublesome clients, prepare themselves mentally before visiting them, try to withhold them psychologically, try to understand them and explain their behavior, try to change their behavior, and vent experiences with colleagues. Although some of these methods are practiced frontstage, in interactions with clients, others take place backstage, only involving staff. Their use is influenced both by properties of frontstage work, for instance, the intimate nature of many tasks and the experienced need to keep up a "good" relationship with clients, and by the organization of backstage work, for instance, the organization of staff meetings and supervisors' understanding of coping processes.
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