| 1. |
- Lidén, Eva, et al.
(author)
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Mobilitet på lika villkor : fordonsanpassningar, infrastruktur, elbilar, laddstationer
- 2024
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In: Sammanställning av referat från Transportforum 2024. - Linköping : Statens väg- och transportforskningsinstitut. ; , s. 306-307
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Conference paper (other academic/artistic)abstract
- Projektet fokuserar på att kartlägga behoven och svårigheterna för att säkerställa individens rätt till självständig och säker mobilitet, mot bakgrund av omställningen till en samhällsomfattande användning av elbilar. Målet är att identifiera och utveckla inkluderande lösningar för att anpassa infrastrukturen och fordonen för personer med reducerad rörlighet. Otillgänglig laddinfrastruktur är en av flera faktorer som omöjliggör obehindrad mobilitet. Det kan vara svårt att finansiera och använda elbilar, som fortfarande är dyrare än fossildrivna fordon. Många modeller tillåter inte anpassningar (t.ex. golvsänkningar), eller är för små för att rymma hjälpmedel. Projektet involverar användare av laddstationer i sin forskning för delaktighet och tillgänglighet. Faserna inkluderar en brukarstudie om laddstationsanvändning och identifiering av hinder. Research och intervjuer genomförs för att analysera och kartlägga strukturella och allmänna utmaningarna. Problem och nödvändiga anpassningar kring dagens elbilar dokumenteras för nuvarande och framtida behov. BraunAbility Europe bidrar med ett bredare perspektiv på hållbarhet, mobilitet och tillgänglighet. Projektet förväntas visa vad funktionsvarierade användare av laddinfrastruktur och elbilsanpassning upplever i sin vardag. Insikterna ska hjälpa utveckla tillgängliga lösningar. Resultaten syftar till att öka medvetenheten om situationen för människor med varierande behov och stödja en övergång till en inkluderande eldriven mobilitet. Projektet vill bidra till att uppnå målen för hållbarhet och jämlikhet inom trafiksäkerhet, både enligt FN:s Agenda 2030 och nationella riktlinjer för funktionshinderspolitiken. Genom att belysa svårigheterna inom fordonsanpassningar och elbilsinfrastruktur kan vi påverka förändringar som säkerställer innovativ och inkluderande mobilitet. Med vår expertis från fordonsindustrin vill vi bygga en framtid där alla människor kan delta i samhället på ett tryggt och hållbart sätt, oavsett ålder och rörlighet. Att göra elbilar och laddinfrastruktur tillgängliga är ett avgörande steg i denna utveckling. Tillgänglighet handlar om mer än fysiska hinder och tekniska lösningar, utan om att främja ett samhälle där mångfald och lika rättigheter prioriteras.
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| 2. |
- Lundin Gurné, Frida, et al.
(author)
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District nurses' perspectives on health-promotive and disease-preventive work at primary health care centres: A qualitative study.
- 2023
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In: Scandinavian journal of caring sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 37:1, s. 153-162
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Journal article (peer-reviewed)abstract
- Health promotion and disease prevention are of utmost importance for sustainable health care and primary health care. District nurses play a key role in primary health care centres, where they meet people suffering from, and/or having risk factors for, non-communicable diseases.The study aim was to describe district nurses' perspectives on their health-promotive/disease-preventive work at primary health care centres.Interviews were conducted with 16 district nurses at primary health care centres in Sweden. An interpretive descriptive approach was employed for the analysis.The district nurses integrated a focus on health-promotive and disease-preventive work into every patient encounter, which manifested through four intertwined themes: finding opportunities and striving for visibility; building relationships; considering patients' life situations; and inviting patients to share responsibility. Our findings show how, through a flexible approach, the district nurses strived for equal health and care for all, and how the care was built on a shared responsibility between the district nurse and patient, where district nurses aimed to empower patients to take action for their own health.The district nurses described health-promotive endeavours, in line with person-centred care in prioritising building relationships with patients, starting from their lived experience. They spoke of barriers, at both micro and macro levels, to health-promotive/disease-preventive work. These included language barriers, the impact of the media, and the overall organisation of primary health care. The work at primary health care centres should be restructured to clarify the district nurse's role, and to strengthen community outreach, and thereby improve individuals' access to support in lifestyle changes.
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| 3. |
- Lundin Gurné, Frida, et al.
(author)
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Seeking lifestyle counselling at primary health care centres: a cross-sectional study in the Swedish population
- 2023
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In: BMC Primary Care. - : Springer Science and Business Media LLC. - 2731-4553. ; 24:1
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Journal article (peer-reviewed)abstract
- Background: Millions of people follow an unhealthy lifestyle in terms of tobacco consumption, hazardous use of alcohol, poor eating habits, and insufficient physical activity. Healthy lifestyles can to a large extent prevent and/or delay progression of non-communicable diseases. Factors influencing persons health-seeking behaviour regarding unhealthy lifestyles are of importance for sustainable health-promotive and disease-preventive work in primary health care. Generally, lifestyle interventions within primary health care are seen as feasible, but rarely reach all members of the general population. Few studies have been conducted about the likelihood among the general population to voluntarily contact a primary health care centre for support regarding lifestyle changes. The present study therefore aimed to investigate the general population’s likelihood of contacting a primary health care centre regarding their lifestyles, and factors associated with a lower such likelihood. Methods: A probability sample of adults living in Sweden (n = 3 750) were invited to participate in a cross-sectional survey regarding how societal developments affect attitudes and behaviours of the adult Swedish population. Data were collected between September and December 2020. Participants completed a questionnaire about lifestyle changes, and the data were analysed using descriptive statistics, Chi-square test and logistic regression analysis. Results: The response rate was 52.0% (n = 1 896). Few persons responded that they would be likely to contact a primary health care centre for support regarding their lifestyles. Factors predicting a lower likelihood of contacting primary health care included few yearly visits to a primary health care centre, male sex, and living in a rural area. Conclusions: Primary health care centres are not the first choice for lifestyle counselling for the majority of adults living in Sweden. We have identified factors predicting low likelihood of using the support available at these centres. In order to work with sustainable and visible health-promotive and disease-preventive strategies at primary health care centres, these settings need to find valid methods to involve and collaborate with the members of the general community, to meet the needs of a population struggling with unhealthy lifestyles.
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| 4. |
- Silverglow, Anastasia, et al.
(author)
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Patient safety culture in home care settings in Sweden: a cross-sectional survey among home care professionals
- 2023
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In: BMC Health Services Research. - 1472-6963. ; 23:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: The connection between a weak patient safety culture and adverse patient events is well known, but although most long-term care is provided outside of hospitals, the focus of patient safety culture is most commonly on inpatient care. In Sweden, more than a third of people who receive care at home have been affected by adverse events, with the majority judged to be preventable. The aim of this study was to investigate the patient safety culture among care professionals working in care at home with older people. METHODS: This cross-sectional study used a purposive sample of 66 municipal care workers, health care professionals, and rehabilitation staff from five municipal care units in two districts in western Sweden who provided care at home for older people and had been employed for at least six months. The participants completed the Hospital Survey on Patient Safety Culture (HSOPSC) self-report questionnaire, which assessed aspects of patient safety culture-norms, beliefs, and attitudes. Logistic regression analysis was used to test how the global ratings of Patient safety grade in the care units and Reporting of patient safety events were related to the dimensions of safety culture according to the staff's professions and years of work experience. RESULTS: The most positively rated safety culture dimension was Teamwork within care units (82%), which indicates good cooperation with the closest co-workers. The least positively rated dimensions were Handoffs and transitions among care units (37%) and Management support (37%), which indicate weaknesses in the exchange of patient information across care units and limited support from top-level managers. The global rating of Patient safety grade was associated with Communication openness and Management support (p < 0.01 and p = 0.03, respectively). Staff with less work experience evaluated the Patient safety grade higher than those with more work experience. CONCLUSIONS: This study suggests that improvements are needed in care transitions and in support from top-level managers and that awareness of patient safety should be improved in staff with less work experience. The results also highlight that an open communication climate within the care unit is important for patient safety.
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| 5. |
- Bångsbo, Angela, 1968, et al.
(author)
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Barriers for Inter-Organisational Collaboration: What Matters for an Integrated Care Programme?
- 2022
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In: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 22:22
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Journal article (peer-reviewed)abstract
- Introduction: Inter-organisational collaboration is challenging but essential in managing the complex and comprehensive needs of frail older people. Therefore, there is a need to investigate the influence of different barriers to inter-organisational collaboration when implementing an integrated care programme. The aim of this study was to investigate both inpatient and outpatient staff views on the factors they deemed to be influential to inter-organisational collaboration for an integrated care programme. Methods: The study was a cross-sectional study and included staff from hospitals, primary care and municipal health and social care. Results: There were no significant differences between staff from inpatient and outpatient care in measuring factors that may cause difficulties for inter-organisational collaboration. Staff views diverged significantly on all factors, such as educational level at long physical distances, laws and regulations, knowledge of each others work settings, experience from inter-organisational collaboration, different professions, variations in professional status and power, psychosocial factors such as positive work environment and interpersonal chemistry. Discussion: A multidisciplinary team culture and avenues for inter-organisational collaboration need to be developed for improved care continuity. Conclusion: The staffs’ educational level influenced what was perceived as barriers to inter-organisational collaboration, and may guide future development of integrated care programmes.
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| 6. |
- Silverglow, Anastasia, et al.
(author)
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Perceptions of providing safe care for frail older people at home: A qualitative study based on focus group interviews with home care staff
- 2022
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 36:3, s. 852-862
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Journal article (peer-reviewed)abstract
- Background Providing safe care is a core competence in healthcare. The concept usually refers to hospitals but, consistent with the increasing importance of integrated care, the provision of safe care needs to be extended to the context of home care, and more research is needed concerning home healthcare providers' perspectives in this context. Aim The aim of this study was to describe care providers' perceptions of providing safe care for frail older persons living at home. Method A qualitative methodology was chosen. In total, 30 care providers agreed to participate. Data were collected through five focus group interviews and analysed using a phenomenographic approach. Results Three themes regarding care providers' perceptions of providing safe care emerged from the data: 'safe care is created in the encounter and interaction with the older person', 'safe care requires responsibility from the caregiver' and 'safe care is threatened by insufficient organisational resources'. The findings show that providing safe care is an endeavour that requires a holistic view among the care providers as well as effective collaboration within the team, but insufficient competence or a lack of time can make it difficult to safeguard the psychological and existential needs of older persons. Conclusion Providing safe care in home environments encompasses more than just risk reduction. The findings highlight the importance of establishing and integrating team-based and person-centred care into home care settings. Traditional communication structures for inpatient care also need to be adapted to the cross-disciplinary work in municipalities. Care providers should be given the opportunity to develop and maintain their competences and to prioritise relationship-oriented care.
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| 7. |
- Bångsbo, Angela, PhD, 1968-, et al.
(author)
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Preconditions to implementation of an integrated care process programme
- 2021
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In: Journal of Integrated Care. - : Emerald Group Publishing Limited. - 1476-9018.
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Journal article (peer-reviewed)abstract
- PurposeThe purpose of this study was to investigate the preconditions of a full-scale implementation of an integrated care process programme for frail older people from the staff's understanding, commitment and ability to change their work procedures with comparisons over time and between organisations.Design/methodology/approachA repeated cross-sectional study was conducted in a hospital, municipal health and social care setting.FindingsStaff commitment decreased to the importance of a permanent municipal contact from baseline compared to the 12-months follow-up (p = 0.02) and the six- and 12-months follow-up (p = 0.05), to the information transfer from emergency department from the six- to the 12-months follow-up (p = 0.04), to discharge planning at the hospital at six- and 12-months follow-up (p = 0.04) and towards discharge planning at home from baseline to the six-month follow-up (p = 0.04). Significant differences occurred between the organisations about information transfer from the emergency department (p = 0.01) and discharge planning at home (p = 0.03). The hospital staff were the most committed.Practical implicationsThe results can guide the implementation of complex interventions in organisations with high-employee turnover and heavy workload.Originality/valueThe study design, allowing the comparison of implementation results over time and between organisations in a later phase, gives this study a unique perspective.
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| 8. |
- Caesar, Ulla, et al.
(author)
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A sense of being rejected : Patients’ lived experiences of cancelled knee or hip replacement surgery
- 2021
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In: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712.
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Journal article (peer-reviewed)abstract
- BackgroundGrowing care queues, reduced access to care and cancelled surgery are realities for some patients being treated with total hip or knee replacement surgery in Sweden.Most of the patients on the waiting lists have experienced pain and limited motion for a varying period of time, with a negative effect on their everyday lives. Overbooked surgical schedules are already contributing to the lengthy waiting times, but, with the addition of cancellations, longer waiting times will increase still further and may affect patients’ well‐being.MethodsIn the present study, we aimed to illuminate the experience of having planned surgery cancelled, based on narratives from 10 participants. The interview transcriptions were analysed using a phenomenological hermeneutic approach.ResultsThe comprehensive analyses revealed that the participants described the agony of being deselected and the additional impression of being excluded. Metaphors of being damaged and feeling physical pain were used and the interpretations referred to the cancellations as unpleasant. Additionally, the important relationship and the trust between the health workers and the patient were negatively affected by the cancellation.ConclusionAfter the cancellation, the participants expressed being vulnerable and from their perspective the cancelled surgery affected them deeply; in fact, much more than the healthcare workers appeared to understand. Therefore, information around the cancellation must be given respectfully and with dignity, in a dialogue between the patient and the healthcare workers. Taken together, to enable an opportunity to be involved in the continued care. The cancellations should be seen as an interruption, in which the patients’ chance of living a pain‐free, active life is postponed.
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| 9. |
- Lundin Gurné, Frida, et al.
(author)
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Striving to be in close proximity to the patient: An interpretive descriptive study of nursing practice from the perspectives of clinically experienced registered nurses
- 2021
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In: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 28:2
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Journal article (peer-reviewed)abstract
- © 2020 The Authors. Nursing Inquiry published by John Wiley & Sons Ltd This paper explores essential characteristics of current nursing practice from the perspectives of clinically experienced registered nurses in various fields of health care in Sweden. Nursing practice has been the subject of much debate in the past and because of its complexity as well as continuous changes in society it is important to continue the debate. A qualitative study, including 16 group interviews with altogether 74 participants, was conducted. Nursing practice was viewed as a multifaceted field. The participants struggled to define nursing but were able to describe it using concrete examples. The analysis, using interpretive description, identified current practice as essentially consisting of: ‘A practice pervaded by comprehensive responsibility’, ‘A practice that recognises a patient's unique needs’, ‘A practice based on multifaceted knowledge’ and ‘A practice that mediates between traditional values and changing demands’. Current nursing practice can be understood as striving to be in close proximity to the patient, but in tension with pervasive requirements and societal changes. Going forward, it is necessary to continue to reflect on and discuss the nature of nursing practice in an interprofessional context. Studies from primary and home care are also needed to broaden the understanding of nursing practice.
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| 10. |
- Silverglow, Anastasia, et al.
(author)
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What constitutes feeling safe at home? A qualitative interview study with frail older people receiving home care
- 2021
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In: Nursing Open. - : Wiley. - 2054-1058. ; 8:1, s. 191-199
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Journal article (peer-reviewed)abstract
- Aim: To highlight experiences of what constitutes feeling safe at home among frail older people receiving home care. Design: Qualitative descriptive study. Methods: The sample consists of 12 individual recorded interviews with frail older people in their homes. Interviews were transcribed verbatim and analysed using qualitative content analysis. The data collection was performed in spring 2018. Results: The analysis resulted in three categories: "Having a feeling of'at-homeness'" describes the older people's surrounding environment and their efforts to maintain independence; "being able to influence" describes the importance for older people to shape their care by being in control and having an opportunity for self-determination in the context of home care; and "being able to trust staff" relates to expecting staff's knowledge and skills and to appreciating the staff's ability to create positive relations.
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