| 111. |
- Petersson, Kerstin, et al.
(författare)
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User perspectives on the Swedish Maternal Health Care Register
- 2014
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Established in 1999, the Swedish Maternal Health Care Register (MHCR) collects data on pregnancy, birth, and the postpartum period for most pregnant women in Sweden. Antenatal care (ANC) midwives manually enter data into the Web-application that is designed for MHCR. The aim of this study was to investigate midwives? experiences, opinions and use of the MHCR.Method: A national, cross-sectional, questionnaire survey, addressing all Swedish midwives working in ANC, was conducted January to March 2012. The questionnaire included demographic data, preformed statements with six response options ranging from zero to five (0 = totally disagree and 5 = totally agree), and opportunities to add information or further clarification in the form of free text comments. Parametric and non-parametric methods and logistic regression analyses were applied, and content analysis was used for free text comments.Results: The estimated response rate was 53.1%. Most participants were positive towards the Web-application and the included variables in the MHCR. Midwives exclusively engaged in patient-related work tasks perceived the register as burdensome (70.3%) and 44.2% questioned the benefit of the register. The corresponding figures for midwives also engaged in administrative supervision were 37.8% and 18.5%, respectively. Direct electronic transfer of data from the medical records to the MHCR was emphasised as significant future improvement. In addition, the midwives suggested that new variables of interest should be included in the MHCR ? e.g., infertility, outcomes of previous pregnancy and birth, and complications of the index pregnancy.Conclusions: In general, the MHCR was valued positively, although perceived as burdensome. Direct electronic transfer of data from the medical records to the MHCR is a prioritized issue to facilitate the working situation for midwives. Finally, the data suggest that the MHCR is an underused source for operational planning and quality assessment in local ANC centres.
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| 112. |
- Petersson, Maria, et al.
(författare)
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Oxytocin and Cortisol Levels in Dog Owners and Their Dogs Are Associated with Behavioral Patterns : An Exploratory Study
- 2017
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Ingår i: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- We have previously shown that dog–owner interaction results in increasing oxytocin levels in owners and dogs, decreasing cortisol levels in owners but increasing cortisol levels in dogs. The present study aimed to further investigate whether oxytocin and cortisol levels in the previously tested owners and dogs were associated with their behaviors during the interaction experiment. Ten female volunteer dog–owners and their male Labrador dogs participated in a 60 min interaction experiment with interaction taking place during 0–3 min and blood samples for analysis of oxytocin and cortisol were collected at 0, 1, 3, 5, 15, 30, and 60 min. The entire experiment was videotaped and the following variables were noted; the different types (stroking, scratching, patting and activating touch, i.e., scratching and patting combined) as well as the frequency of touch applied by the owner, the number of times the owner touched her dog, the dog’s positions and time spent in each position. Correlations were analyzed between the behavioral variables and basal oxytocin levels, maximum oxytocin levels, delta oxytocin levels, basal cortisol levels and cortisol levels at 15 min. Owners with low oxytocin levels before and during the interaction touched their dogs more frequently (0 min: Rs = −0.683, p = 0.042; oxytocin maximum: Rs = −0.783, p = 0.013). The lower the dogs’ oxytocin levels during the interaction, the more stroking they received (Rs = −0.717, p = 0.041). The more frequently activating touch was applied by the owner, the higher the dogs’ cortisol levels became (15 min: Rs = 0.661, p = 0.038). The higher the owners’ maximum oxytocin level the fewer position changes the dogs made (Rs = −0.817, p = 0.007) and the shorter time they spent sitting (Rs = −0.786, p = 0.036), whereas the higher the owners’ basal cortisol levels, the longer time the dogs spent standing (0 min: Rs = 0.683, p = 0.041). In conclusion, oxytocin and cortisol levels, both in dogs and in their owners, are associated with the way the owners interact with their dogs and also with behaviors caused by the interaction.
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| 113. |
- Petersson, Pia, 1961-
(författare)
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Att göra abstrakta begrepp och komplexa situationer konkreta : en avhandling om deltagarbaserad aktionsforskning i svensk vård och omsorg
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation covers the subject of how abstract concepts and complex situations can be concretized through research together with practitioners. The dissertation is based on four empirical studies. The researcher role, the practitioner participation and the methods for data collection and analysis have varied. In study I the concept ‘Närsjukvård’ was explored to understand how practitioners, managers and politicians in hospitals, primary health care and municipalities interpreted the concept. The researcher acted as consultant who collected data by interviews and questionnaires. Practitioners’ participation was limited. ‘Närsjukvård’ was interpreted as accessibility to hospital beds, accessibility to primary health care, collaboration between care providers and continuity and developed home care. Study II aimed to explore how people experienced leg ulcer care. The researcher acted as a consultant who performed the interviews and analysed the data. Although the informants experienced their encounters with the nurses as satisfying, the study illuminated low participation in the care and low practitioner involvement in issues about daily living with the leg ulcer. The findings were brought back to the informants and the practitioners. The project did not proceed towards development and change. In study III the aim was to explore the Swedish concept ‘trygghet’ by using stories from daily life. Four older women were interviewed and the Story Dialogue method was used together with assistant nurses and registered nurses who participated in data collection and analysis. Two themes emerged: Sense of Security and factors strengthening the Sense of Security. Together with the assistant nurses, areas for improvements were identified. Study IV aimed to explore the discharge planning situation in order to generate ideas for development. Members from a discharge planning network participated in the whole research process. Conditions for a successful coordinated discharge planning situation were a system including: the participation of the patient, the competence of the staff and the support from the organisation. The group arranged a workshop about communication and interdisciplinary collaboration. The findings resulted in a form with self-evaluation questions. In conclusion, this thesis illustrates that it is possible to clarify abstract concepts and complex situations together with practitioners. To do this successfully, sense making activities and to start from practitioners’ experiences and their own context are key factors. The studies illuminate that building trust, relationship and sense of participation are essential in health and social care in general and specifically in the participatory action research process.
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| 114. |
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| 115. |
- Petersson, Pia, 1961-, et al.
(författare)
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Local interpretations of health policy concepts : the example of Närsjukvård in Sweden
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Health care systems in Europe face many challenges requiring greater integration of health and social care. The health policy response in government financed health systems has varied but a consistent feature has been continual change in an attempt to secure greater efficiencies and to meet patient expectations concerning service quality. This paper explores the manifestation of this phenomenon in a subregion of Sweden, where a new concept ‘Närsjukvård’ (literally Nearby Care) was introduced.Method: Data was collected through interviews and questionnaires. A convenience sample of 57 practitioners and managers was interviewed. A questionnaire with four statements based upon the findings from the interviews was answered by 1361 practitioners, managers and politicians working in primary health care, in municipalities and in hospitals.Results: The findings illustrated that the concept was interpreted as; accessibility to hospital beds, accessibility to primary health care, collaboration between care providers and continuity and developed home care. The study revealed different understanding and interpretations partly depending on the respondents’ professional domain and their organisational belonging. Conclusion. A prerequisite for creating a common meaning to the expression ‘Närsjukvård’ is that activities that help the creation of meaning are offered at and between all domain levels and organisations.
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| 116. |
- Petersson, Pia, et al.
(författare)
-
Local interpretations of health policy concepts : the exemple of Närsjukvård in Sweden
- 2010
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Annan publikation (populärvet., debatt m.m.)abstract
- Health care systems in Europe face many challenges requiring greater integration of health and social care. The health policy response in government financed health systems has varied but a consistent feature has been continual change in an attempt to secure greater efficiencies and to meet patient expectations concerning service quality. This paper explores the manifestation of this phenomenon in a subregion of Sweden, where a new concept ‘Närsjukvård’ (literally Nearby Care) was introduced. Method: Data was collected through interviews and questionnaires. A convenience sample of 57 practitioners and managers was interviewed. A questionnaire with four statements based upon the findings from the interviews was answered by 1361 practitioners, managers and politicians working in primary health care, in municipalities and in hospitals. Results: The findings illustrated that the concept was interpreted as; accessibility to hospital beds, accessibility to primary health care, collaboration between care providers and continuity and developed home care. The study revealed different understanding and interpretations partly depending on the respondents’ professional domain and their organisational elonging. Conclusion: A prerequisite for creating a common meaning to the expression ‘Närsjukvård’ is that activities that help the creation of meaning are offered at and between all domain levels and organisations.
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| 117. |
- Petersson, Pia, 1961-, et al.
(författare)
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Sense of security – searching for its meaning by using stories : a Participatory Action Research study in health and social care in Sweden
- 2011
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Ingår i: International Journal of Older People Nursing. - : Wiley. - 1748-3735 .- 1748-3743. ; 6:1, s. 25-32
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, attempts to implement core values to ensure high quality health and social care for older people are given high priority and concepts such as security and dignity are often used. As concepts are abstract they are difficult to transform into practical work. The aim of this study was to make sense of the Swedish concept ‘trygghet’ by using stories from daily life in a participatory action research project. One group of seven assistant nurses and one group of five registered nurses working in municipality participated in Story Dialogue Method and four older women were interviewed. ‘Trygghet’ was found to be an internal sense – an intrinsic state based on faith and trust in oneself and others called Sense of security. External factors that strengthened Sense of security were to be part of a community, to recognise and be familiar with things and situations and to use various kinds of aids. A prerequisite for the professionals being able to support the care receivers adequately is that they have a sense of security themselves, and that they are allowed to operate in a system that facilitates for the care receivers to maintain trustworthy and reliable relations over time.
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| 118. |
- Petersson, Pia, et al.
(författare)
-
Story dialogue as a method to connect theory and practice.
- 2007
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- There is an ongoing debate about how to bridge the gap between theory and practise and use existing theory in everyday practice. To enhance knowledge, understanding and to promote change in clinical practice, Participatory Action Research (PAR) is recommended. PAR is a process of systematic inquiry as its methodology emphasise equality and participation. To promote change in the clinical practice the research is done with those who are concerned by the issue rather than on them. By involving and engaging, PAR brings collective ownership and responsibility of making use of the findings. Methods which emphasise reflection and dialogue help professionals to elucidate concerns about issues in their clinical practise, to challenge the status quo and to change. Story-telling is a tool in knowledge development as narratives are powerful to convey experiences. By using Story dialogue method narratives can be investigated in a systematic way. Dialogue and reflection enhance different ways of viewing a problemand a day to day problem can be examined in a systematic way. This paper is about how to use Story dialogue method with the aim to support professionals to elucidate, investigate and take action towards significant problems in care planning situations. The on-going research is performed in a multi-professional care planning network. The purpose of the network is to develop knowledge about care planning in clinical settings and to reach understanding about how to make care planning holistic. We decided in collaboration to examine what holism is in a care planning situation and used members’ narratives about care planning situations characterised by holism. The members and the researches have met four times. Narratives were investigated by using a structured dialogue, writing insight cards and building categories based on insights from the dialogue. Based on the categories we constructed an observation manual which later on will be tested in practise. This paper presents an on-going research projectwhere researchers and practitioners work together to bridge the gap between theory and practice. By using PAR and Story Dialogue Method the members in the care planning network enhance their collective knowledge and understanding about holism with the purpose to improve care planning in practice.
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| 119. |
- Petersson, Pia, 1961-, et al.
(författare)
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Telling stories from everyday practice, an opportunity to see a bigger picture : a participatory action research project about developing discharge planning
- 2009
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Ingår i: Health and Social Care in Community. - Oxford : Blackwell Science. - 1365-2524 .- 0966-0410. ; 17:6, s. 548-556
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Tidskriftsartikel (refereegranskat)abstract
- In spite of laws, rules and routines, findings from Swedish as well as international research show that discharge planning is not a simple matter. There is considerable knowledge about discharge planning but the quality of the actual process in practice remains poor. With this in mind, a research and developmental (R & D) health and social care network decided to use Participation Action Research (PAR) to explore the discharge planning situation in order to generate new ideas for development. This paper reports on the research process and the findings about our enhanced understanding about the discharge planning situation. Story Dialogue Method was used as a method. The method is based on stories from everyday practice. The stories are used as ‘triggers’ to ask probing questions in a dialogical and structured form. Local theory is developed to help the participants to find solutions for action in the practice. Our findings were that the discharge planning situation could be seen as a system including three interconnected areas: patient participation, practitioners’ competence and organisational support. To reach good quality in discharge planning all this three issues need to be developed, but not only as routines and forms. Rather, when developing a discharge planning situation a system where relational aspects such as confidence and continuity are essential and thus needs to be considered. To achieve a change the core problem needs to be clarified. When the issue is complex the solution needs to consider the bigger picture and not just the parts. Telling stories from everyday practice and to systematically reflect and analyse those in inter-professional groups can create opportunities for enhanced understanding as well as be a vehicle for future change of practice.
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| 120. |
- Petersson, Pia, 1961-, et al.
(författare)
-
The triumph of hope over experience : using patients' experiences to inform leg ulcer care through participatory action research
- 2009
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - Oxford : Blackwell Publishing. - 1752-9816 .- 1752-9824. ; 1:1, s. 96-104
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: The aim of this Participatory Action Research (PAR) project was to find out how the patients experienced their care in order to allow the practitioners to reflect about the patients’ view as a vehicle for a changed leg ulcer care practice. This paper reports on findings from the project and from the PAR process.Background: Great numbers of people suffer from chronic leg ulcers and many have to live with their illness for a long time. Even when the illness is controlled by medical treatment, the person with the chronic condition has to deal with physical, emotional, cognitive and social problems and usually has frequent and long-term encounters with practitioners. In one municipality in a southern part of Sweden researchers were engaged as consultants in a PAR project aiming to improve the care for persons with chronic leg ulcers.Method: Nine older persons with chronic leg ulcers, mainly treated in primary care, were asked about their experiences of the care. The analysis proceeded in several steps including a number of content analysis and reflective dialogues with practitioners and persons with chronic leg ulcers.Result: Although the persons with chronic leg ulcers experienced their encounters with practitioners as satisfying, findings illuminated low participation in their own care and low practitioner involvement in issues about their daily living with chronic illness. In addition, the PAR project did not succeed to proceed from problem identification towards development and change.Conclusion and relevance to clinical practice: Participation is about negotiation and transferring power and authority from practitioners towards patients and from researchers towards practitioners and patients. This is however difficult to achieve in practice. This project illuminated that success in performing a PAR project that brings sustainable change requires substantial work to involve practitioners in initiating and planning the research.
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