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- Batljan, Ilija, 1967-
(author)
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Demographics and Future Needs for Public Long Term Care and Services among the Elderly in Sweden : The Need for Planning
- 2007
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Doctoral thesis (other academic/artistic)abstract
- Long term care and social services (LTCaS) for older people are an important part of the Scandinavian welfare state. The fast growing number of elderly people in Sweden has caused many concerns about increases in future needs (and particularly costs) of age-related social programs such as LTCaS. The general aim of this dissertation is to examine how projected demographic changes may affect future needs for long-term care and services in Sweden assuming different trends in morbidity and mortality. The following data sources are used: national population registers, register data on inpatient/outpatient health care from region Skåne, the Swedish National Survey on Living Conditions (SNSLC) for the period 1975-1999. Three alternative methods to inform simple demographic extrapolations of needs for health and social care for the elderly are presented. Furthermore, a new method for demographic projections has been developed. According to our studies, the health of older people (measured as the prevalence of severe ill-health) has improved during the study period. Taking into account health status, when projecting future needs for LTCaS, will result in a fairly substantial reduction of the rate of the demographically influenced increase in projected LTCaS needs. The changes in population composition regarding education and mortality differentials per educational level may have a significant impact on the number of the elderly in the future. On the other hand, the projected increase in the number of older people suffering from severe ill-health, as a consequence of population ageing, may be counterbalanced to a large extent by changes in the educational composition towards a higher proportion of the population having a high educational level and lower prevalence of severe ill-health. We need to improve our planning tools in order to support policy-makers to plan for uncertainty concerning future needs and demand for LTCaS.
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| 2. |
- Jegermalm, Magnus
(author)
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Carers in the Welfare State : On Informal Care and Support for Carers in Sweden
- 2005
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Doctoral thesis (other academic/artistic)abstract
- The general aim of this dissertation is to describe and analyse patterns of informal care and support for carers in Sweden. One specific aim is to study patterns of informal care from a broad population perspective in terms of types of care and types of carer. A typology of four different care categories based on what carers do revealed that women were much more likely than men to be involved at the ‘heavy end’ of caring, i.e. providing personal care in combination with a variety of other caring tasks. Men were more likely than women to provide some kind of practical help (Study I).Another aim is to investigate which support services are received by which types of informal caregiver. Relatively few informal caregivers in any care category were found to be receiving any kind of support from municipalities or voluntary organizations, for example training or financial assistance (Study II).The same study also examines which kinds of help care recipients receive in addition to that provided by informal carers. It appears that people in receipt of personal care from an informal caregiver quite often also receive help from the public care system, in this case mostly municipal services. However, the majority of those receiving personal, informal care did not receive any help from the public care system or from voluntary organizations or for-profit agencies (Study II).The empirical material in studies I and II comprises survey data from telephone interviews with a random sample of residents in the County of Stockholm aged between 18 and 84.In a number of countries there is a growing interest among social scientists and social policymakers in examining the types of support services that might be needed by people who provide informal care for older people and others. A further aim of the present dissertation is therefore to describe and analyse the carer support that is provided by municipalities and voluntary organizations in Sweden. The dissertation examines whether this support is aimed directly or indirectly at caregivers and discusses whether the Swedish government’s special financial investment in help for carers actually led to any changes in the support provided by municipalities and voluntary organisations. The main types of carer support offered by the municipalities were payment for care-giving, relief services and day care. The chief forms of carer support provided by the voluntary organizations were support groups, training groups, and a number of services aimed primarily at the elderly care recipients (Study III).Patterns of change in municipal carer support could be discerned fairly soon. The Swedish government’s special allocation to municipalities and voluntary organisations appears to have led to an increase in the number of municipalities providing direct support for carers, such as training, information material and professional caregiver consultants. On the other hand, only minor changes could be discerned in the pattern of carer support services provided by the voluntary organizations. This demonstrates stability and the relatively low impact that policy initiatives seem to have on voluntary organizations as providers (Study IV).In studies III and IV the empirical material consists of survey data from mail questionnaires sent to municipalities and voluntary organizations in the County of Stockholm.In the fields of social planning and social work there appears to be a need to clarify the aims of support services for informal carers. Should the support be direct or indirect? Should it be used to supplement or substitute caregivers? In this process of reappraisal it will be important to take the needs of both caregivers and care recipients into account when developing existing and new forms of support. How informal caregivers and care recipients interact with the care system as a whole is undeniably a fertile field for further research.
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| 3. |
- Karlsson, Patrik, 1977-
(author)
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Margins of Prevention : - On Older Adolescents' Positive and Negative Beliefs about Illicit Drug Use
- 2006
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Doctoral thesis (other academic/artistic)abstract
- This study explores older adolescents’ positive and negative beliefs about illicit drug use from a preventive perspective. By positive beliefs is meant positive expectancies and benefit perceptions. By negative beliefs is meant negative expectancies and risk perceptions. The choice of studying beliefs originates from the assumption that there is much to gain for prevention in considering the target audience’s starting point. An appraisal of the extent to which positive and negative beliefs are held suggests the margins for change.The data used for the study derive from a survey conducted among a sample of third-year students in upper secondary school in the greater Stockholm area (n=2104). Overall, findings demonstrate that high negative beliefs are held and that positive beliefs to some extent are held. While this being the general trend, marked differences emerge between individuals who have used illicit drugs and individuals who have not. By and large, experienced individuals rate the negative sides as lower and the positive sides as higher than the other group. Substantial differences are found among lifetime users of illicit drugs as well. Those who have used illicit drugs more frequently during the last 12 months differ in particular from those who have refrained during this period. The differences are dramatic in some cases. In addition, consistent differences are documented between the sexes. Males are found to hold lower negative beliefs and higher positive beliefs across most measures employed. Few systematic relationships are found between other variables and outcomes.Plausible explanations for the findings are discussed theoretically and potential implications for drug prevention are highlighted. A saturation hypothesis is introduced in order to accentuate that the overall room for change in negative beliefs probably is limited. Conversely, the fact that positive beliefs are held to a certain degree suggests a belief domain with change potential.
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| 4. |
- Kejerfors, Johan
(author)
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Parenting in urban slum areas : families with children in a shantytown of Rio de Janeiro
- 2007
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Book (other academic/artistic)abstract
- This is a study of parenting and child development in a slum area in a developing part of the world. The aims of the study were threefold. The first aim was to explore the physical and social contexts for parenting in a shantytown in Rio de Janeiro using an ecological perspective. The second aim was to examine parenting and subsequent child outcomes among a sample of families living in the shantytown. The third aim was to explore what factors contribute to differences among parents in how they nurture and protect their children. The theoretical framework of the study was an updated version of Bronfenbrenner’s bioecological model of human development. Using self-report questionnaires developed by Rohner, data on perceived parental acceptance–rejection were collected from 72 families with adolescents 12–14 years old, representing approx. 75% of all households with children in this age group in the shantytown. Besides self-report questionnaires, each adolescent’s main caregiver replied to several standardized questionnaires developed by Garbarino et al., eliciting demographic and social-situational data about the family, neighborhood, and wider community. The results of the study paint a complex portrait of the social living conditions of the parents and children. Despite many difficulties, most parents seemed to raise their children with loving care. The results from the self-report questionnaires indicate that the majority of the adolescents perceived substantial parental acceptance. The adolescents’ experience of greater or lesser parental acceptance–rejection seems to influence their emotional and behavioral functioning; it also seems to be related to their school attendance. Much of the variation in degree of perceived acceptance–rejection seems to be related both to characteristics of the individual adolescents and their main caregiver(s) and to influences from the social and environmental context in which they and their caregivers interact and live their lives.
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| 5. |
- Meinow, Bettina, 1972-
(author)
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Capturing health in the elderly population : Complex health problems, mortality, and allocation of home-help services
- 2008
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Doctoral thesis (other academic/artistic)abstract
- This thesis investigates health trends among very old people and the allocation of public home-help services. A further aim is to examine methodological issues in mortality analysis. Three data sources are used: (1) The Tierp study of community-dwelling persons (n=421, ages 75+), (2) the SWEOLD nationally representative samples (n=537 in 1992 and n=561 in 2002, ages 77+), and 3) SNAC-K comprised of home-help recipients in a district of Stockholm (n=1108, ages 65+).Study I suggests that the length of the follow-up period may explain some of the differences found in predictor strength when comparing mortality studies. Predictors that can change rapidly (e.g., health) were found to be strongest for the short term, with a lower average mortality risk for longer follow-ups. Stable variables (e.g., gender) were less affected by length of follow-up.Studies II and III present a measure of complex health problems based on serious problems in at least two of three health domains. These were diseases/symptoms, mobility, and cognition/communication. Prevalence of complex health problems increased significantly between 1992 and 2002. Older age, female gender, and lower education increased the odds of having complex problems. Complex problems strongly predicted 4-year mortality. Controlled for age, gender, health, and education, mortality decreased by 20% between 1992 and 2002. Men with complex problems accounted for this decrease. Thus, in 2002 the gender difference in mortality risk was almost eliminated among the most vulnerable adults.Study IV revealed that physical and cognitive limitations, higher age, and living alone were significantly related to home-help allocation, with physical and cognitive limitations dominating. Psychiatric symptoms did not affect the assessment.The increased prevalence of complex health problems and increased survival among people with complex needs have important implications concerning the need for collaboration among service providers.
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| 6. |
- Minas, Renate, 1962-
(author)
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Administrating poverty : Studies of intake organization and social assistance in Sweden
- 2005
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Doctoral thesis (other academic/artistic)abstract
- The general purpose of this dissertation is to study the causes and the consequences of the formal structure of intake of potential social assistance clients at Swedish social welfare offices. The focus lies on the social welfare offices, their organizational framework and routines concerning intake. A focus on the formal structure of the intake may provide information about the importance of organization for people seeking help but also for the municipalities themselves. The data used in the analyses comes from two surveys of welfare offices augmented with register data.Study 1 examines the very first contact between social assistance inquirers and the social welfare offices. Telephone intake and first personal visits are documented and a considerable variation in the share of inquirers who received an appointment for further assessment was found. Considerable variation was also found in the share who were granted social assistance after the assessment during the personal visit. An examination of the offices’ intake routines and organization provided some indications that the unequal priority given to intake is an important explanation behind the variation.Study 2 analyzes the link between intake organization and the degree of selection taken place at telephone intakes by focusing on those inquirers not becoming clients. The relationship between intake organization and the social workers’ reasons for selection is examined and several selection strategies could be found. The results confirm the fact that Swedish municipalities have great autonomy in designing the social services and in addition show that offices within the same municipality may choose different organizational solutions.The aim of study 3 is to investigate how intake of social assistance inquirers is organized in Swedish municipalities and what factors determine intake organization. The results show that there are three different intake types. One of them, called special intake units, is distinct from the other two in that the intake staff has relatively high qualifications. Examining factors likely to affect the creation of special intake units, the results show that mainly professional and organizational factors related to the organization of work within the whole social assistance unit are important.The purpose of study 4 is to examine the connection between organizational factors and local social assistance expenditures in Swedish municipalities. The organization of the social assistance unit, in particular to the intake of social assistance inquirers, and its potential implication for local social assistance costs are emphasized. The results show a cost reducing effect of special intake units first when analyzed together with additional specialization and taking account for staff resources. Thus, specialized intake organization by itself does not play a cost reducing role, but in combination with certain other factors describing internal organization.In an introductory part the studies are located in a broader framework starting with a historical description of different strategies and classification systems traditionally used when distributing poor aid. The expansion of the welfare state changed the importance of a last safety net. Specific characteristics of public organizations administering social assistance are described and the legal framework is outlined focusing on the right to apply for social assistance is outlined. Different aspects of intake are then discussed: stages of the intake process, the organization of intake in Sweden and elsewhere, intake organization as a fashion, and possible functions of the intake. Finally, implications of the four studies with regard to access to benefit and the issue of specialization as well as further research are discussed.
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