1.
2.
Grünloh, Christiane, 1980-, et al.
(författare)
"why do they need to check me?" patient participation through ehealth and the doctor-patient relationship : Qualitative study
2018
Ingår i: Journal of Medical Internet Research. - : J M I R Publications, Inc.. - 1438-8871. ; 20:1
Tidskriftsartikel (refereegranskat) abstract
Background: Roles in the doctor-patient relationship are changing and patient participation in health care is increasingly emphasized. Electronic health (eHealth) services such as patient accessible electronic health records (PAEHRs) have been implemented to support patient participation. Little is known about practical use of PAEHR and its effect on roles of doctors and patients. Objective: This qualitative study aimed to investigate how physicians view the idea of patient participation, in particular in relation to the PAEHR system. Hereby, the paper aims to contribute to a deeper understanding of physicians' constructions of PAEHR, roles in the doctor-patient relationship, and levels and limits of involvement. Methods: A total of 12 semistructured interviews were conducted with physicians in different fields. Interviews were transcribed, translated, and a theoretically informed thematic analysis was performed. Results: Two important aspects were identified that are related to the doctor-patient relationship: roles and involvement. The physicians viewed their role as being the ones to take on the responsibility, determining treatment options, and to be someone who should be trusted. In relation to the patient's role, lack of skills (technical or regarding medical jargon), motives to read, and patients' characteristics were aspects identified in the interviews. Patients were often referred to as static entities disregarding their potential to develop skills and knowledge over time. Involvement captures aspects that support or hinder patients to take an active role in their care. Conclusions: Literature of at least two decades suggests an overall agreement that the paternalistic approach in health care is inappropriate, and a collaborative process with patients should be adopted. Although the physicians in this study stated that they, in principle, were in favor of patient participation, the analysis found little support in their descriptions of their daily practice that participation is actualized. As seen from the results, paternalistic practices are still present, even if professionals might not be aware of this. This can create a conflict between patients who strive to become more informed and their questions being interpreted as signs of critique and mistrust toward the physician. We thus believe that the full potential of PAEHRs is not reached yet and argue that the concept of patient empowerment is problematic as it triggers an interpretation of "power" in health care as a zero-sum, which is not helpful for the maintenance of the relationship between the actors. Patient involvement is often discussed merely in relation to decision making; however, this study emphasizes the need to include also sensemaking and learning activities. This would provide an alternative understanding of patients asking questions, not in terms of "monitoring the doctor" but to make sense of the situation.
3.
Moller, H., et al.
(författare)
Technology-Enhanced Learning of Human Trauma Biomechanics in an Interprofessional Student Context
2022
Ingår i: Teaching and Learning in Medicine. - : Informa UK Limited. - 1040-1334 .- 1532-8015. ; 34:2, s. 135-144
Tidskriftsartikel (refereegranskat) abstract
Phenomenon This study aimed to investigate how students can develop their understanding of trauma biomechanics by means of technology-enhanced learning-an interactive visualization tool developed to enhance understanding of the biomechanics underlying an injury via dynamic imaging sequences. Approach: Students were invited to explore the content as a learning resource during an interprofessional clinical placement on an orthopedic ward. Thirty volunteer medical, nursing, and physiotherapy/occupational therapy students participated in 10 interprofessional groups of three participants. They were video recorded while interacting with learning software that was divided into five sections: Work Up, General Information, Biomechanical Case Study, Biomechanical Risk Assessment, and Treatment. Investigators probed students' learning experiences via four focus group discussions. A sociomaterial perspective was adopted, directing the analytical focus to how students' made use of talk, gestures, bodies, and material objects to understand the visualized phenomena. Findings: When connecting the visualization to a patient case, certain features of the technology stood out as important for promoting engagement and understanding trauma mechanisms. Decreased tempo, showing the directions and dynamics of trauma biomechanics in slow-motion, and color coding of the strain on the affected structures were especially important for evoking the emotional responses. The visualization tool also supported students' explorations of causal relationships between external forces and their biomedical effects. These features emphasize the sociomaterial relation between the design of the technology and the student activities. Insights: Dynamic visualization of biomechanical events has the potential to improve the understanding of injury mechanisms and specifically to identify anatomical structures at high risk of injury. Dynamic visualizations for educational purposes seem to promote possibilities for learners to contextualize visual representations relative to one's own body. Educational methods and practice need explicit attention and development in order to use the full potential of the visualization technology for learning for the health care professions.
4.
Andreasson, Jörgen, et al.
(författare)
Professional Bureaucracy and Health Care Managers' Planned Change Strategies: Governance in Swedish Health Care
2018
Ingår i: Nordic Journal of Working Life Studies. - : Det Kgl. Bibliotek/Royal Danish Library. - 2245-0157. ; 8:1, s. 23-41
Tidskriftsartikel (refereegranskat) abstract
To increase efficiency and quality, process development has been implemented in many Swedish hospitals. These hospitals are usually organized as professional bureaucracies in which health care managers have limited decision control. The new governance principles has been implemented without removing bureaucratic elements. This study analyzes how managers implement planned change in these professional bureaucracies, considering if managers coaching style, organizational preconditions, implementation strategy, appraisal of change and clinic autonomy, is associated with health care process quality (HPQ). The study is based on interviews with health care managers and longitudinal assessments of HPQ. The results revealed significant differences between coaching style, organizational preconditions, and HPQ over time. The conclusion is that leadership and preconditions is of importance for the health care manager's ability to work with planned change, as that the health care managers understand how management methods, governance principles, and professional bureaucracies work in practice.
5.
Gund, Anna, 1980, et al.
(författare)
Design Evaluation of a Home-Based Telecare System for Chronic Heart Failure Patients
2008
Ingår i: Engineering in Medicine and Biology Society, 2008. EMBS 2008. 30th Annual International Conference of the IEEE. - : IEEE. - 1557-170X. - 9781424418145 ; , s. 5851-5854, s. 5851-5854
Konferensbidrag (refereegranskat) abstract
In order to improve the care of Chronic Heart Failure (CHF) patients, a system has been developed for monitoring symptoms and document subjective judgments on health conditions in a home environment. Since system usability is an important issue, a two step evaluation of the solution was conducted. First a ten-patient survey was conducted, which was aimed at spotting possible problem areas. The second step involved a small trial in a home setting with CHF patients. The results are promising, indicating that the system is user friendly and easy to use, and that it is suitable as a prototype for the intended use.
6.
Belin, Matts-Åke, 1966-, et al.
(författare)
Vision Zero : a road safety policy innovation
2012
Ingår i: International Journal of Injury Control and Safety Promotion. - : Informa UK Limited. - 1745-7319 .- 1745-7300. ; 19:2, s. 171-179
Tidskriftsartikel (refereegranskat)
7.
Cakici, Baki, 1984-
(författare)
Disease surveillance systems
2011
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Recent advances in information and communication technologies have made the development and operation of complex disease surveillance systems technically feasible, and many systems have been proposed to interpret diverse data sources for health-related signals. Implementing these systems for daily use and efficiently interpreting their output, however, remains a technical challenge. This thesis presents a method for understanding disease surveillance systems structurally, examines four existing systems, and discusses the implications of developing such systems. The discussion is followed by two papers. The first paper describes the design of a national outbreak detection system for daily disease surveillance. It is currently in use at the Swedish Institute for Communicable Disease Control. The source code has been licenced under GNU v3 and is freely available. The second paper discusses methodological issues in computational epidemiology, and presents the lessons learned from a software development project in which a spatially explicit micro-meso-macro model for the entire Swedish population was built based on registry data.
8.
Strömgren, Marcus, et al.
(författare)
Social capital among healthcare professionals : A prospective study of its importance for job satisfaction, work engagement and engagement in clinical improvements
2016
Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 53, s. 116-125
Tidskriftsartikel (refereegranskat) abstract
Background: Social capital can be an important resource to facilitate the needed improvements in quality of care and efficiency in hospitals. Objectives: To assess the importance of social capital (recognition, vertical trust, horizontal trust and reciprocity) for job satisfaction, work engagement and engagement in clinical improvements. Design: A prospective cohort design was used. Settings: Intensive care units and emergency, surgical and medical units at five Swedish hospitals with ongoing development of their processes of care. Participants: Healthcare professionals (physicians, registered nurses, assistant nurses) at five Swedish midsize hospitals. Methods: The participants answered a questionnaire at two occasions, NN = 1602 at baseline and NN = 1548 at one-year follow-up. Mean hospital response rate was 53% at baseline and 59% at follow-up. Univariate, multivariate and logistic regression analyses were performed, and the prospective analysis was based on 477 respondents. Results: Social capital was associated with healthcare professionals' general work engagement and job satisfaction. Analysis showed positive associations between all measured aspects of social capital and engagement in clinical improvements of patient safety and quality of care. The prospective analysis showed that increased social capital predicted increased job satisfaction, work engagement and engagement in clinical improvements of patient safety. Conclusion: Social capital is strongly related to job satisfaction and active engagement with clinical improvements. The findings contribute to a deeper knowledge of social capital as a predictive factor that influences patient safety and health among healthcare staff.
9.
Lindgren, Åsa, 1979, et al.
(författare)
Why risk professional fulfilment: a grounded theory of physician engagement in healthcare development
2013
Ingår i: International Journal of Health Planning and Management. - : Wiley. - 0749-6753 .- 1099-1751. ; 28:2
Tidskriftsartikel (refereegranskat) abstract
The need for trans-professional collaboration when developing healthcare has been stressed by practitioners and researchers. Because physicians have considerable impact on this process, their willingness to become involved is central to this issue.
10.
Eriksson, Andrea, 1977-, et al.
(författare)
Management and Leadership Approaches to Health Promotion and Sustainable Workplaces : A Scoping Review
2017
Ingår i: Societies. - : MDPI AG. - 2075-4698. ; 7:2
Forskningsöversikt (refereegranskat) abstract
Whole-system approaches linking workplace health promotion to the development of a sustainable working life have been advocated. The aim of this scoping review was to map out if and how whole-system approaches to workplace health promotion with a focus on management, leadership, and economic efficiency have been used in Nordic health promotion research. In addition, we wanted to investigate, in depth, if and how management and/or leadership approaches related to sustainable workplaces are addressed. Eighty-three articles were included in an analysis of the studies' aims and content, research design, and country. For a further in-depth qualitative content analysis we excluded 63 articles in which management and/or leadership were only one of several factors studied. In the in-depth analysis of the 20 remaining studies, four main categories connected to sustainable workplaces emerged: studies including a whole system understanding; studies examining success factors for the implementation of workplace health promotion; studies using sustainability for framing the study; and studies highlighting health risks with an explicit economic focus. Aspects of sustainability were, in most articles, only included for framing the importance of the studies, and only few studies addressed aspects of sustainable workplaces from the perspective of a whole-system approach. Implications from this scoping review are that future Nordic workplace health promotion research needs to integrate health promotion and economic efficiency to a greater extent, in order to contribute to societal effectiveness and sustainability.
