1.
Wannheden, C., et al.
(författare)
Digital Health Technologies Enabling Partnerships in Chronic Care Management : Scoping Review
2022
Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 24:8
Tidskriftsartikel (refereegranskat) abstract
Background: An increasing number of patients expect and want to play a greater role in their treatment and care decisions. This emphasizes the need to adopt collaborative health care practices, which implies collaboration among interprofessional health care teams and patients, their families, caregivers, and communities. In recent years, digital health technologies that support self-care and collaboration between the community and health care providers (ie, participatory health technologies) have received increasing attention. However, knowledge regarding the features of such technologies that support effective patient-professional partnerships is still limited. Objective: This study aimed to map and assess published studies on participatory health technologies intended to support partnerships among patients, caregivers, and health care professionals in chronic care, focusing specifically on identifying the main features of these technologies. Methods: A scoping review covering scientific publications in English between January 2008 and December 2020 was performed. We searched PubMed and Web of Science databases. Peer-reviewed qualitative, quantitative, and mixed methods studies that evaluated digital health technologies for patient-professional partnerships in chronic care settings were included. The data were charted and analyzed thematically. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist was used. Results: This review included 32 studies, reported in 34 papers. The topic of participatory health technologies experienced a slightly increasing trend across publication years, with most papers originating from the United States and Norway. Diabetes and cardiovascular diseases were the most common conditions addressed. Of the 32 studies, 12 (38%) evaluated the influence of participatory health technologies on partnerships, mostly with positive outcomes, although we also identified how partnership relationships and the nature of collaborative work could be challenged when the roles and expectations between users were unclear. Six common features of participatory health technologies were identified: patient-professional communication, self-monitoring, tailored self-care support, self-care education, care planning, and community forums for peer-to-peer interactions. Conclusions: Our findings emphasize the importance of clarifying mutual expectations and carefully considering the implications that the introduction of participatory health technologies may have on the work of patients and health care professionals, both individually and in collaboration. A knowledge gap remains regarding the use of participatory health technologies to effectively support patient-professional partnerships in chronic care management.
2.
Lornudd, C., et al.
(författare)
A champagne tower of influence : An interview study of how corporate boards enact occupational health and safety
2021
Ingår i: Safety Science. - : Elsevier B.V.. - 0925-7535 .- 1879-1042. ; 143
Tidskriftsartikel (refereegranskat) abstract
The board of directors is responsible for governing organizations, including firms’ occupational health and safety (OHS). However, empirical research addressing how boards of directors enact OHS responsibility is scarce. In this study, we explored how boards of directors describe how their board acts to take responsibility for OHS. A secondary aim was to analyze whether those actions represent governance according to the agency theory and/or the stewardship theory. The empirical material consisted of 34 interviews with board members and chief executive officers in large private companies from four industries: trade, construction, manufacturing, and health/social care. Using Boardman and Lyon's framework for OHS governance, we conducted a hybrid thematic analysis. The findings deepen and broaden the current understanding of the role that the board of directors may play in OHS governance in private companies. The boards’ actions for taking responsibility for OHS both represent governance in line with the agency theory and stewardship theory. However, the boards’ actions also underpin a behavioral view of corporate OHS governance. This suggests an influence on the organization that starts with actions in the boardroom and, like champagne in a glass tower, trickles down from the executive directors to other layers of the organization.
3.
Bjurling-Sjöberg, Petronella, 1968-, et al.
(författare)
Struggling for a feasible tool - the process of implementing a clinical pathway in intensive care: a grounded theory study
2018
Ingår i: BMC Health Serv Res. - : Springer Science and Business Media LLC. - 1472-6963. ; 18
Tidskriftsartikel (refereegranskat) abstract
BackgroundClinical pathways can enhance care quality, promote patient safety and optimize resource utilization. However, they are infrequently utilized in intensive care. This study aimed to explain the implementation process of a clinical pathway based on a bottom-up approach in an intensive care context.MethodsThe setting was an 11-bed general intensive care unit in Sweden. An action research project was conducted to implement a clinical pathway for patients on mechanical ventilation. The project was managed by a local interprofessional core group and was externally facilitated by two researchers. Grounded theory was used by the researchers to explain the implementation process. The sampling in the study was purposeful and theoretical and included registered nurses (n31), assistant nurses (n26), anesthesiologists (n11), a physiotherapist (n1), first- and second-line managers (n2), and health records from patients on mechanical ventilation (n136). Data were collected from 2011 to 2016 through questionnaires, repeated focus groups, individual interviews, logbooks/field notes and health records. Constant comparative analysis was conducted, including both qualitative data and descriptive statistics from the quantitative data.ResultsA conceptual model of the clinical pathway implementation process emerged, and a central phenomenon, which was conceptualized as Struggling for a feasible tool,' was the core category that linked all categories. The phenomenon evolved from the Triggers' (Perceiving suboptimal practice' and Receiving external inspiration and support'), pervaded the Implementation process' (Contextual circumstances,' Processual circumstances' and Negotiating to achieve progress'), and led to the process Output' (Varying utilization' and Improvements in understanding and practice'). The categories included both facilitating and impeding factors that made the implementation process tentative and prolonged but also educational.ConclusionsThe findings provide a novel understanding of a bottom-up implementation of a clinical pathway in an intensive care context. Despite resonating well with existing implementation frameworks/theories, the conceptual model further illuminates the complex interaction between different circumstances and negotiations and how this interplay has consequences for the implementation process and output. The findings advocate a bottom-up approach but also emphasize the need for strategic priority, interprofessional participation, skilled facilitators and further collaboration.
4.
Marmstål Hammar, Lena, 1979-, et al.
(författare)
Being Treated With Respect and Dignity? : Perceptions of Home Care Service Among Persons With Dementia
2021
Ingår i: Journal of the American Medical Directors Association. - New York : Elsevier. - 1525-8610 .- 1538-9375. ; 22:3, s. 656-662
Tidskriftsartikel (refereegranskat) abstract
Objective: Studies on the quality of home care services (HCS) offered to persons with dementia (PwDs) reveal the prevalence of unmet needs and dissatisfaction related to encounters and a lack of relationships with staff. The objective of this study was to enhance knowledge of the perceptions of PwDs regarding their treatment with dignity and respect in HCS over time.Design: A mixed longitudinal cohort study was designed to study trends in the period between 2016 and 2018 and compare the results between PwDs (cases) and persons without dementia (controls) living at home with HCS.Setting and Participants: Persons aged 65 years and older with HCS in Sweden.Methods: Data from an existing yearly HCS survey by the Swedish National Board of Health and Welfare (NBHW) was used. The focus was on questions concerning dignity and respect. NBHW data sets on diagnoses, medications, HCS hours, and demographic information were also used. We applied GEE logistic and cumulative logit regression models to estimate effects and trends of interest after controlling for the effects of age, gender, self-rated health, and number of HCS hours.Results: Over the study period, 271,915 (PwDs¼8.1%) respondents completed the survey. The results showed that PwDs were significantly less likely (3%-10% lower odds and cumulative odds) than controls to indicate that they were satisfied in response to questions related to dignity and respect. Both groups experienced a decrease in satisfaction from 2016 to 2018. Females, individuals with poor self-rated health, and individuals granted more HCS hours were found to be more dissatisfied.Conclusions and Implications: The HCS organization needs to shift from a task-oriented system to a person-centered approach, where dignity and respect are of the utmost importance. The HCS organizations need to be developed to focus on competence in person-centered care, and leadership to support staff.
5.
Lagrosen, Yvonne
(författare)
Waldorf pedagogy as an innovative approach for school health and learning
2019
Ingår i: Proceedings of the European Conference on Innovation and Entrepreneurship, ECIE. - : Academic Conferences and Publishing International Limited. - 9781912764341 ; , s. 572-580
Konferensbidrag (refereegranskat) abstract
A research project regarding health promotion for school health, in the context of a Waldorf School received grants from the Swedish National Agency for Education. Waldorf pedagogy contains methods different from contemporary pedagogy such as integrating aesthetics and movement together in the learning process. The purpose of the study is twofold. First, to explore and evaluate the methods used in Waldorf pedagogy regarding their effects on health and learning. Second, to evaluate the suitability of the approach and methodologies per see for this kind of study. A case-study has been carried out involving pupils, staff and parents. A verified measurement instrument has been used. It is aimed at measuring health, quality and learning and it was further refined to better fit the present context. Quality dimensions previously identified for pupils and staff were used. Questionnaires were sent with a response rate ranging from 66% to 100%. Based on the questionnaires, pertinent questions were defined and explored in five quality cafés based on the world-café methodology. Feed-back from five focus-group interviews including all of the above-mentioned categories were also collected. In addition, a follow-up questionnaire was sent to co-workers and pupils. The results indicate that the school's activities with their basis in Waldorf pedagogy might have a health-promoting effect, since the school's activities are of high quality and the health of the pupils is generally good. The pupils greatly appreciated the quality cafes which gave them a forum to discuss things thoroughly as well as experiences of being listened to. The focus group interviews revealed that the pupils generally think that the school is good now, even better than before this project. Other perceived effects of the study concern increased team-building, happiness, increased awareness of importance of teachers' health, advantages of serving healthy food for learning and acceptance of each pupil's uniqueness. The study provides a holistic methodology to evaluate health promotion activities in a school project and provides insight into benefits of the Waldorf pedagogy.
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.
Gustavsson, Catharina, et al.
(författare)
What is required to facilitate implementation of Swedish physical activity on prescription? - interview study with primary healthcare staff and management
2018
Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 18:1
Tidskriftsartikel (refereegranskat) abstract
BACKGROUND: The method, Swedish Physical Activity on Prescription (SPAP), has been launched in Swedish healthcare to promote physical activity for prevention and treatment of lifestyle related health disorders. Despite scientific support for the method, and education campaigns, it is used to a limited extent by health professionals. The aim of the study was to describe the views of health professionals on perceived facilitators, barriers and requirements for successful implementation of SPAP in primary healthcare.METHODS: Eighteen semi-structured interviews with stakeholders in SPAP, i.e. ten people working in local or central management and eight primary healthcare professionals in two regional healthcare organisations, were analysed using qualitative content analysis.RESULTS: We identified an overarching theme regarding requirements for successful implementation of SPAP: Need for knowledge and organisational support, comprising four main categories: Need for increased knowledge and affirmative attitude among health professionals; Need for clear and supportive management; Need for central supporting structures; Need for local supporting structures. Knowledge of the SPAP method content and core components was limited. Confidence in the method varied among health professionals. There was a discrepancy between the central organisation policy documents declaring that disease preventive methods were prioritised and a mandatory assignment, while the health professionals asked for increased interest, support and resources from management, primarily time and supporting structures. There were somewhat conflicting views between primary healthcare professionals and managers concerning perceived barriers and requirements. In contrast to some of the management's beliefs, all primary healthcare professionals undisputedly acknowledged the importance of promoting physical activity, but they lacked time, written routines and in some cases competence for SPAP counselling.CONCLUSION: The study provides knowledge regarding requirements to facilitate the implementation of SPAP in healthcare. There was limited knowledge among health professionals regarding core components of SPAP and how to practise the method, which speaks for in-depth training in the SPAP method. The findings highlight the importance of forming policies and guidelines and establishing organisational supporting structures, and ensuring that these are well known and approved in all parts of the healthcare organisation.
8.
Ahlstedt, Carina, 1969-, et al.
(författare)
What makes registered nurses remain in work? : An ethnographic study
2019
Ingår i: International Journal of Nursing Studies. - : Elsevier Ltd. - 0020-7489 .- 1873-491X. ; 89, s. 32-38
Tidskriftsartikel (refereegranskat) abstract
Background: Registered nurses’ work-related stress, dissatisfaction and burnout are some of the problems in the healthcare and that negatively affect healthcare quality and patient care. A prerequisite for sustained high quality at work is that the registered nurses are motivated. High motivation has been proved to lead to better working results. The theory of inner work life describes the dynamic interplay between a person's perceptions, emotions and motivation and the three key factors for a good working life: nourishment, progress and catalysts. Objectives: The aim of the study was to explore registered nurses’ workday events in relation to inner work life theory, to better understand what influences registered nurses to remain in work. Design: A qualitative explorative study with an ethnographic approach. Methods: Participant observation over four months; in total 56 h with 479 events and 58 informal interviews during observation; all registered nurses employed at the unit (n = 10) were included. In addition, individual interviews were conducted after the observation period (n = 9). The dataset was analysed using thematic analysis and in the final step of the analysis the categories were reflected in relation to the three key factors in theory of inner work life. Results: Nourishment in a registered nurse context describes the work motivation created by the interpersonal support between colleagues. It was important to registered nurses that physicians and colleagues respected and trusted their knowledge in the daily work, and that they felt comfortable asking questions and supporting each other. Progress in the context of registered nurses’ work motivation was the feeling of moving forward with a mix of small wins and the perception of solving more complex challenges in daily work. It was also fundamental to the registered nurses’ development through new knowledge and learning during daily work. Catalysts, actions that directly facilitate the work, were highlighted as the possibility to work independently along with the opportunity to work together with other registered nurses. Conclusion: This study has a number of implications for future work and research on creating an attractive workplace for registered nurses. Working independently, with colleagues from the same profession, integrated with learning, visible progress, and receiving feedback from the work itself, contribute to work motivation.
9.
Lindfors, Petra, 1973-, et al.
(författare)
Health-related effects of an intervention involving reduced working hours among women employed in the municipal eldercare
2024
Ingår i: Nordic Psychology. - : Taylor & Francis Group. - 1901-2276 .- 1904-0016. ; 76:1, s. 3-18
Tidskriftsartikel (refereegranskat) abstract
Working conditions of eldercare are often characterized by a high workload and different organizational approaches have been suggested to reduce the potentially negative health-related effects of such conditions. One of the suggested approaches involves reducing the exposure to such working conditions by reducing the number of working hours. However, the knowledge of the concurrent health-related effects of working fewer hours remains limited. This longitudinal study set out to examine the health-related effects of an intervention involving daily working hours being reduced from ≥7 to 6 h. Data came from an organizational intervention that included 68 women employed in the municipal eldercare. All employees retained full-time salaries and additional personnel were employed by the organization in order to provide full services throughout the intervention period. A broad range of biomarkers and self-ratings in questionnaires were obtained before the intervention, 6 months after the change, and 12 months after the initial change. Measurements among referents (n = 19), matched with respect to type of work, were performed at corresponding time points. Results from repeated measures ANOVAs showed significant interaction effects for diastolic blood pressure and HbA1c with these effects being primarily related to changes among referents. No other significant group differences were found. Time-related effects emerged in both groups but cannot be attributed to the intervention as such. To conclude, this study showed none of the hypothesized health promoting or other consistent effects of reduced working hours.
10.
Pekkarinen, Satu, et al.
(författare)
Embedding care robots into society and practice : Socio-technical considerations
2020
Ingår i: Futures. - : Elsevier. - 0016-3287 .- 1873-6378. ; 122
Tidskriftsartikel (refereegranskat) abstract
Robots are not yet typical in daily use in elder care services, but recent studies suggest that they will soon be mainstream. In this study, we focus on the future of elder care, affected by the emergence of care robotics. We tackle the socio-technical transition—a multi-level change with a re-configuration of social and technological elements of the system—of elder care. The transition in the elder care system and the conditions of the embedding the robots in welfare services and society in three European countries, Germany, Sweden and Finland, are examined. Our qualitative study focuses on current situation in the use of robots in elder care as well as advancing and hindering elements in embedding robots into society and elder care practices. According to the results, there is a shift towards using robots in care, but remarkable inertia exists in both technological development and socio-institutional adaptation. Advancing and hindering elements in transition are both technical and social – and increasingly interrelated, which needs to be considered in management and policy measures to promote successful future transition pathways. The change of attitudes and embedding robots into society is promoted, for instance, by raising relevant knowledge on robots at different levels.
