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- Gyllensten, Hanna, 1979, et al.
(författare)
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A national research centre for the evaluation and implementation of person-centred care: Content from the first interventional studies
- 2020
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Ingår i: Health Expectations. - : Wiley. - 1369-6513 .- 1369-7625. ; 23:5, s. 1362-1375
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Person-centred care (PCC) has been suggested as a potential means to improve the care of patients with chronic and long-term disorders. In this regard, a model for PCC was developed by the University of Gothenburg Centre for Person-Centred Care (GPCC). OBJECTIVE: The present study aimed to explore the theoretical frameworks, designs, contexts and intervention characteristics in the first 27 interventional studies conducted based on the ethics for person-centredness provided by the GPCC. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: A questionnaire to the principal investigators of the 27 intervention studies financed by the GPCC and conducted between 2010 and 2016. MAIN OUTCOME MEASURES: Theoretical frameworks, contexts of studies, person-centred ethic, and outcome measures. RESULTS: Most of the interventions were based on the same ethical assumptions for person-centredness but theories and models in applying the interventions differed. All studies were controlled; 12 randomized and 15 quasi-experimental. Hospital in- and outpatient and primary care settings were represented and the outcome measures were related to the specific theories used. A complexity in designing, introducing and evaluating PCC interventions was evident. CONCLUSION: The frameworks, designs and interventions in the studies were in line with the established ethical basis of PCC, whereas outcome measures varied widely. Consensus discussions among researchers in the field are needed to make comparisons between studies feasible. PATIENT OR PUBLIC CONTRIBUTIONS: Patients or the public made no direct contributions, although most of the studied projects included such initiatives.
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| 4. |
- Jakobsson Ung, Eva, 1960, et al.
(författare)
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The pre- and postoperative illness trajectory in patients with pituitary tumours.
- 2019
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Ingår i: Endocrine connections. - 2049-3614. ; 8:7, s. 878-886
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Tidskriftsartikel (refereegranskat)abstract
- Experiences and need of support during surgery and start of replacement therapy in patients with pituitary tumours are highly unknown. This study therefore aimed at exploring patient experiences during pre- and postoperative care and recovery after pituitary surgery in patients with a pituitary tumour.Within a qualitative study design, 16 consecutive patients who underwent surgery for pituitary tumours were repeatedly interviewed. In total 42 interviews were performed before and after surgery. Analysis was performed using qualitative interpretation.Suffering a pituitary tumour was overwhelming for many patients and struggling with existential issues was common. Patients expressed loneliness and vulnerability before and after surgery. How professionals handled information in connection with diagnosis greatly affected the patients. Other patients with the same diagnosis were experienced as the greatest support. Normalisation of bodily symptoms and relationships with others were reported during postoperative recovery. However, a fear that the tumour would return was present.Patients with pituitary tumours need structured support, including peer support, which acknowledges physical, cognitive as well as emotional and existential concerns. Information related to diagnosis and surgery should be adapted in relation to the loneliness and the existential seriousness of the situation. Care and support for patients with pituitary tumours should preferably be organised based on continuity and an unbroken care pathway from the first pre-operative evaluation through to post-operative care and the start of a life-long endocrine treatment and tumour surveillance.
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| 5. |
- Assarlind, Marcus, 1983, et al.
(författare)
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Adopting new ways of working in small and medium-sized enterprises: findings from interventions in 12 European companies
- 2013
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Ingår i: Total Quality Management and Business Excellence. - : Informa UK Limited. - 1478-3371 .- 1478-3363. ; 24:8, s. 945-958
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Tidskriftsartikel (refereegranskat)abstract
- This paper elaborates on the factors to be considered in order for interventions (activities aimed at introducing new ways of working through a series of focused activities in an organisation) to lead to long-term effects inside small and medium-sized enterprises (SMEs). Its purpose of it is to describe how interventions can be carried out in order for SMEs to adopt new ways of working by understanding the context, process and content of an intervention. The results of this study suggest that in designing interventions for the SMEs, the context aspects of an intervention must be carefully considered. Not only is the process or context of an intervention important, but so is the content. As a consequence, we suggest content that accomplishes the following: (1) supports the formulation of strategies; (2) encourages dialogue and (3) uses company data. The paper is based on a multiple case study of 12 SMEs from 6 European countries undergoing similar interventions within the FutureSME project. These long-term relationships within a large-scale project have provided access and a rare opportunity to conduct research on this often overlooked business sector. The empirical data have been collected through company presentations, structured reports and narratives. The material has been subject to a cross-case analysis.
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| 6. |
- Assarlind, Marcus, 1983, et al.
(författare)
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Designing interventions in SMEs: Experiences from a pan-European multiple case study
- 2012
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Ingår i: Proceedings of the 15th QMOD-ICQSS conference. - 9788389333469 ; , s. 123-135
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Konferensbidrag (refereegranskat)abstract
- PurposeThe purpose of this paper is to describe how interventions can be carried out in order for small and medium sized companies (SMEs) to adopt new ways of working, by understanding the context, process and content of the intervention. Interventions are defined as activities aimed at introducing new ways of working through a series of focused activities in the organization.Design/methodology/approachThe work was part of an EU-funded project called FutureSME aiming at aiding SMEs in becoming more competitive. This paper is based on a multiple case study of twelve SMEs from six European countries undergoing similar interventions. The empirical data has been collected through presentations by company representatives, A3 reports including structured information about the intervention and its outcome, and case essays containing subjective descriptions of respective company’s experiences from the interventions. The material has been subject to a cross-case analysis.FindingsThis paper elaborates on previous research on important factors to consider in order for interventions to lead to long-term effects in SMEs. The results from this study suggest that in the design of the interventions at SMEs, one needs to carefully consider the context aspects regarding the intervention, which is seen as a deficiency in the project. It is also pointed out that not only the process or context of the intervention is of importance, but also the content. We suggest content that 1) supports the formulation of strategies, 2) encourages dialogue, and 3) uses company data. Hence, when designing an intervention in SMEs it is beneficial if the content have such characteristics, and by inclusion both short-term success and long-term sustainability are more likely as a result of the intervention.Research limitations/implicationsThis paper does not deal with how to motivate SMEs to initiate an intervention process.Originality/valueIntervention studies have mostly focused on larger companies. The special set-up with dedicated external support and a long term relationship within a large-scale project has provided access to a study of twelve SMEs across Europe and has provided a rare opportunity for research.
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- Björkman, Ida, et al.
(författare)
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An Intervention for Person-Centered Support in Irritable Bowel Syndrome Development and Pilot Study
- 2019
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Ingår i: Gastroenterology Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 1042-895X. ; 42:4, s. 332-341
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Tidskriftsartikel (refereegranskat)abstract
- Irritable bowel syndrome is a common and often chronic functional bowel disorder that can cause severe disruption of daily functioning in those affected, with subsequent high healthcare utilization and work absenteeism. Nurses represent an underutilized group in the current management of irritable bowel syndrome. The aim of this study was to systematically develop a person-centered support intervention in irritable bowel syndrome and evaluate this in a pilot study. The development followed the revised framework for complex interventions from the Medical Research Council and involved literature reviews and multiprofessional expert groups. The intervention was then tested in a pilot study including 17 patients and evaluated through validated questionnaires measuring irritable bowel syndrome symptom severity, gastrointestinal-specific anxiety, and self-efficacy as well as through interviews. There was a significant improvement in irritable bowel syndrome symptom severity between baseline and follow-up, but not for self-efficacy or gastrointestinal-specific anxiety. The patients' perceptions of participating in the intervention were positive and induced a learning process; they were able to form a supportive relationship with the nurse and their ability to self-manage improved. The promising results from this small pilot study in terms of feasibility, potential efficacy, and the patients' positive feedback make this intervention a suitable candidate for a larger controlled trial.
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| 8. |
- Björkman, Ida, et al.
(författare)
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More similarities than differences between men and women with irritable bowel syndrome
- 2015
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Ingår i: Neurogastroenterology and Motility. - : Wiley. - 1350-1925 .- 1365-2982. ; 27:6, s. 796-804
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Tidskriftsartikel (refereegranskat)abstract
- Background: Differences regarding symptoms, coping abilities, and quality of life (QOL) between men and women with irritable bowel syndrome (IBS) have been reported but data are sparse and sometimes conflicting. The aim of present study was to investigate gender differences in gastrointestinal, extra-intestinal, and psychological symptoms, and sense of coherence (SOC) and QOL in a large group of patients diagnosed with IBS. Methods: We analyzed questionnaire data from 557 patients (152 men) diagnosed with IBS consecutively included in studies at an outpatient clinic for functional bowel disorders between 2002 and 2010. Following questionnaires were included: IBS severity scoring system (IBS-SSS), Hospital Anxiety and Depression Scale (HAD), IBSQOL Scale, Visceral Sensitivity Index (VSI), SOC Scale, Bristol Stool Form Scale (BSFS), and Patient Health Questionnaire (PHQ-15). Key Results: Women had harder stools (FDR-adjusted p-value: q = 0.033), more severe bloating (q = 0.020), higher symptom severity (q = 0.042), higher total somatic symptom burden (q = 0.035), lower SOC (q = 0.042), and lower QOL. Women rated more general anxiety (q = 0.017) and gastrointestinal-specific anxiety (q = 0.042), but there were no group differences in depression, pain, stool frequency, impact on daily life, dissatisfaction with bowel habit, or extra-colonic symptoms. The differences found were small (effect sizes: r < 0.3). Conclusions & Inferences: In this study, we demonstrated more similarities than differences between men and women with IBS. The largest difference were seen for QOL which might reflect certain structural stressors to which women in general are more exposed than men. © 2015 John Wiley & Sons Ltd.
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| 10. |
- Björkman, Ida, et al.
(författare)
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Patients’ experiences of healthcare encounters in severe irritable bowel syndrome: an analysis based on narrative and feminist theory
- 2016
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 25:19-20, s. 2967-2978
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: This study aimed to explore patients’ experiences of healthcare encounters in severe irritable bowel syndrome. Background: Irritable bowel syndrome is a common functional disorder with symptoms such as abdominal pain and disturbed bowel habits, the cause of which is not completely known. Treatments options are limited, and healthcare encounters in irritable bowel syndrome have been described as unsatisfying and frustrating for both patients and professional healthcare providers. Furthermore, the influence of power on healthcare encounters has long been recognised, especially regarding the disadvantaged position of those suffering from functional illness which cannot be identified by commonly used tests or investigations. Methods: We interviewed 10 patients during 2014, all attending an outpatient clinic and suffering from severe irritable bowel syndrome. Relying on narrative and feminist theory, we explored how they actively negotiate professional discourse communicated to them in the clinical encounter. Results: The patients’ experiences of healthcare encounters in irritable bowel syndrome were mostly described as negative, and often induced feelings of confusion and self-doubt. Positive encounters were described as being listened to, believed and taken seriously. Narrators found it especially problematic when healthcare professionals described irritable bowel syndrome as a minor disorder with primarily stress or psychological aetiology and put the responsibility for recovery onto the patient. Patients’ actively negotiated such professional discourse by presenting a counternarrative describing their own suffering and strengths, experienced healthcare shortcomings and possible organic aetiology of irritable bowel syndrome. Conclusions: Patients suffering from severe irritable bowel syndrome described how they often felt a need to protect their positive identities in the face of trivialisation and disbelief by healthcare professionals. Relevance to clinical practice: A deepened understanding of patients’ experiences of healthcare encounters in irritable bowel syndrome could enable more helpful and supporting interventions by healthcare professionals. © 2016 John Wiley & Sons Ltd
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