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Spiseforstyrelser. Sagsbehandling i danske kommuner: en kvalitativ undersøgelse af kommunerne i Region Hovedstaden
Nordic Council of Ministers, Nordic School of Public Health NHV.
2014 (Danish)Independent thesis Advanced level (degree of Master (Two Years))Student thesisAlternative title
Eating disorders: A qualitative study of case management in municipalities in Denmark’s Capital Region (English)
Abstract [da]

Formål:Formålet med undersøgelsen har været at undersøge hvilke oplevelser, erfaringer ogforståelse kommunalt ansatte sagsbehandlere med bevilligendekompetence ansat i Region Hovedstaden har i sager der vedrører voksne med spiseforstyrrelser. Hvorfor henvender de sig, hvilke ydelser bevilliges/ afslås og hvilket formål har indsatsen set i et folkesundhedsperspektiv.

Metode: Semistrukturerede kvalitative interviews blev udførtmed ti sagsbehandlere fra ni kommuner i region hovedstaden. Data blev analyseret ved hermeneutisk filosofi og analyse.

Resultater:Resultaterne gavfem temaer og 20 undertemaer. Defem temaervar; ansvarsforholdetimellem regioner og kommuner; henvendelser fra borgere med spiseforstyrrelser til sagsbehandlere; sagsbehandling; den primære sektor; sagsbehandlernes faglige viden og inddragelse af teori. Resultaterne viser at sektoransvarlighedsprincippet og økonomiske budgetter medvirker til at borgere lander imellem to sektorer i sagsbehandlingen.Sagsbehandlerne ser en til to sager om året og oftest drejer det sig om unge piger som lider af enten AN, BN eller BED. Der sesCo-morbide lidelser og sociale problemer, sagerne er langvarige og der forekommer tvangsindlæggelse. Oftest anvendes § 85, §100, §107, §108 fra loven om Social Serviceog den bedste sagsbehandling sker i samarbejde med eksperter fra den behandlende sektor. Der ses ikke behov for etablering af indsatser rettet imod spiseforstyrrelser i kommunalt regi. Sagsbehandlerne arbejder på et generaliseret niveau og inddrager erfaringer oginstrukser isagsbehandlingen. Fagteori inddrages i begrænset omfang for eksempel recovery, sundhedsfremme, motiverende samtale, balance skema og anerkendende tilgang.

Konklusion: Hvis sagsbehandlerne i kommunerne skal medvirke til at opdage, påbegynde behandling, henvise, tvangsindlægge, efterbehandle og opdage recidiv på baggrund af deres fags empiri må de have klare rammer og retningslinjer for hvor de kan opsøge informationer om samarbejdspartnere, behandlingssteder og henvisnings metoder. Det er vigtigt at eliminere de barrierer der er for at tilbyde ydelser som indeholder terapi hvis intentionen om den primære sektors indsats skal blive praksis

Abstract [en]

Aim:Thisstudy aimedto examine grant-competent social workers’experiences and understanding of adults with eating disordersin Denmark’s Capital Region. In particular, we aimed to identify social needs, benefits grantedor denied and for what purposes, and the public health perspective.

Method: We used semi-structured qualitative interviews with ten social workers from nine municipalities in the Capital Region. All data was analyzed using Hermeneutic philosophy.

Results: Our dataidentifiedfive major themes: (i) responsibilities between regions and municipalities; (ii) contact between individuals with eating disorders and social workers; (iii) case management; (iv) the primary sector; and (iv) social workers’ knowledge and use of theory. We determined that sector responsibility and financial budgets contribute to public landing between the community sector and the regional sector. Each year, social workerssee one or two individuals with eating disorders, often young girls suffering from anorexianervosa, bulimia nervosa,or binge eating disorder. When clients exhibit co-morbidityand social problems, cases are lengthy and sometimes requirein voluntary hospitalization, most often facilitated by §85, §100, §107, and §108 of the Law on Social Services.Cases with the best outcomeare characterized by cooperation with medical experts. Specialist theory is involved to a limited extent (e.g.,examples, recovery, health promotion, motivational interviewing, balance sheet,and the appreciative approach.

Conclusion: Social workers operateon a generalized level,professional experience and instructions to treat clients. They see no need for the establishment of efforts directed towards specialized eating disorders units in the primary sector.If social workers in local authorities are granted to detect disease, initiate treatment, initiate referrals, involuntarily institutionalize clients and record their progress,and detect recurrence on the basis of subjective empiricism,they need clear guidance and direction for locating information about professional partnerships, health care facilities, and referral methods. Importantly, eliminating barriers to services that include therapy will enhance the primary sector's ability to meet legal requirements

Place, publisher, year, edition, pages
2014. , p. 62
Series
Master of Public Health, MPH, ISSN 1104-5701 ; MPH 2014:13
Keywords [en]
Eating Disorders, Social Work, Primary Health Care, Public Health, Case Management
Keywords [da]
spiseforstyrrelser, socialt arbejde, primær sektor, folkesundhed, sagsbehandling
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3449OAI: oai:DiVA.org:norden-3449DiVA, id: diva2:755632
Presentation
Nordic School of Public Health NHV, Göteborg, Sweden
Supervisors
Note

ISBN 978-91-86739-78-2

Available from: 2014-10-15 Created: 2014-10-15 Last updated: 2015-01-23Bibliographically approved

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