| 1. |
- Gustafsson, Markus, et al.
(författare)
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Case managers’ experiences of their everyday practice
- 2013
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Ingår i: European Geriatric Medicine. - Venice : Elsevier Masson SAS. - 1878-7649.
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Konferensbidrag (refereegranskat)abstract
- Introduction.– Today, there is an interest in how Case Management (CM) should be designed to best suit the complex needs of the older people with multi-morbidity. Current research on CM has mainly focused on health care costs and consumption, but the results have been inconsistent and ranging from positive outcomes to no effect. To improve CM, there is need to investigate what mechanisms are important for a successful intervention. To advance this knowledge, there is a necessity for studies investigating the experiences of those practicing CM i.e. Case Managers. There might be unknown factors or interpersonal factors that can contribute to a CM intervention's success or failure. Therefore, the aim of this study was to explore the Case Managers’ experiences of their everyday practice. Methods.– The study design was qualitative and descriptive utilizing an ethnographic approach, consisting of participant observations, a focus group interview and individual interviews with nine Case Managers conducted during 2012/2013. The interviews were recorded and transcribed verbatim and then subjected to content analysis. Results.– Three main themes described Case Managers’ experience of their everyday practice: navigating the older person, working to improve the health care system and being the older persons advocate. Conclusions.– Findings from this study sheds light on the complexity of CM for older people with multi-morbidity, from the experiences of Case Managers. These findings could help in the development of CM models designed for older people with complex health needs.
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| 2. |
- Gustafsson, Markus, et al.
(författare)
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Case managers for older persons with multi-morbidity and their everyday work -- a focused ethnography
- 2013
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Ingår i: BMC Health Services Research. - : Biomed Central. - 1472-6963. ; 13:496
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Tidskriftsartikel (refereegranskat)abstract
- Background Modern-day health systems are complex, making it difficult to assure continuity of care for older persons with multi-morbidity. One way of intervening in a health system that is leading to fragmented care is by utilising Case Management (CM). CM aims to improve co-ordination of healthcare and social services. To better understand and advance the development of CM, there is a need for additional research that provides rich descriptions of CM in practice. This knowledge is important as there could be unknown mechanisms, contextual or interpersonal, that contribute to the success or failure of a CM intervention. Furthermore, the CM intervention in this study is conducted in the context of the Swedish health system, which prior to this intervention was unfamiliar with this kind of coordinative service. The aim of this study was to explore the everyday work undertaken by case managers within a CM intervention, with a focus on their experiences. Methods The study design was qualitative and inductive, utilising a focused ethnographic approach. Data collection consisted of participant observations with field notes as well as a group interview and individual interviews with nine case managers, conducted in 2012/2013. The interviews were recorded, transcribed verbatim and subjected to thematic analysis. Results An overarching theme emerged from the data: Challenging current professional identity, with three sub-themes. The sub-themes were 1) Adjusting to familiar work in an unfamiliar role; 2) Striving to improve the health system through a new role; 3) Trust is vital to advocacy. Conclusions Findings from this study shed some light on the complexity of CM for older persons with multi-morbidity, as seen from the perspective of case managers. The findings illustrate how their everyday work as case managers represents a challenge to their current professional identity. These findings could help to understand and promote the development of CM models aimed at a population of older persons with complex health needs.
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| 3. |
- Hjelm, Markus, et al.
(författare)
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Family members of older persons with multi-morbidity and their experiences of case managers in Sweden : an interpretive phenomenological approach
- 2015
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Ingår i: International Journal of Integrated Care. - : Igitur Publishing. - 1568-4156. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Family members of older persons (75+) with multi-morbidity are likely to benefit from utilising case management services performed by case managers. However, research has not yet explored their experiences of case managers. The aim of the study was to deepen the understandning of the importance of case managers to family members of older persons (75+) with multi-morbidity. The study design was based on an interpretive phenomenological approach. Data were collected through individual interviews with 16 family members in Sweden. The interviews were analysed by means of an interpretive phenomenological approach. The findings revealed one overarching theme: "Helps to fulfil my unmet needs", based on three sub-themes: (1) "Helps me feel secure - Experiencing a trusting relationship", (2) "Confirms and strengthens me - Challenging my sense of being alone" and (3) "Being my personal guide- Increasing my competence". The findings indicate that case managers were able to fulfil unmet needs of family members. The latter recognised the importance of case managers providing them with professional services tailored to their individual needs. The findings can contribute to the improvement of case management models not only for older persons but also for their family members.
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| 4. |
- Hjelm, Markus, et al.
(författare)
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The work of case managers as experienced by older persons (+75) with multi-morbidity : a focused ethnography
- 2015
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background Complex health systems make it difficult for older persons (75+) with multi-morbidity to achieve continuity of care. Case management could be one way to address this difficulty. Currently, there is a need to extend the knowledge regarding case management as experienced by those utilising the services, namely older persons (75+) with multi-morbidity. The study aimed to explore older persons’ (75+) with multi-morbidity experiences of case managers. Methods The study design was qualitative and used a focused ethnographic approach. Data was collected through individual interviews with 13 older persons and by participant observations with accompanying field notes, all conducted in 2012–2013. Results The data revealed four themes illustrating the older persons’ experiences of case managers: 1) Someone providing me with a trusting relationship; 2) Someone assisting me; 3) Someone who is on my side; and 4) Someone I do not need at present. Conclusions This study illustrates the importance of establishing trusting relationships between older persons and their case managers in order to truly provide assistance. The older persons valued the case managers acting as informed but unbiased facilitators. The findings could be of help in the development of case management interventions better designed for older persons with multi-morbidity.
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| 5. |
- Holst, Göran, et al.
(författare)
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Quality of care : prevention of pressure ulcers - nursing students as facilitators of evidence based practice
- 2010
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Ingår i: Vård i Norden. - : Sage Publications. - 0107-4083 .- 1890-4238. ; 30:1, s. 40-42
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Tidskriftsartikel (refereegranskat)abstract
- This development project was aimed at engaging nursing students in a project targeting the prevention and reduction of pressure ulcers on an education based hospital ward. An intervention was implemented based on systematic assessment, skin observation, together with training and educational sessions, i.e. on how to make risk assessments and how to prevent and treat a pressure ulcer, were carried out. The project demonstrated the importance of offering nursing students an environment for clinical practice which supports them in participating and developing patient care starting from Evidence-Based Practice. During the project no patients developed pressure ulcers while on the ward. The opportunityto act as facilitators of evidence-based methods was found to enhance student ability to draw conclusions and make connections between quality of care and end result.
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| 6. |
- Lindvall, Agneta, et al.
(författare)
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Informal Care Provided by Family Caregivers : Experiences of Older Adults With Multimorbidity
- 2016
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Ingår i: Journal of Gerontological Nursing. - : Slack. - 0098-9134 .- 1938-243X. ; 8:42, s. 24-31
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Tidskriftsartikel (refereegranskat)abstract
- Informal care given by family caregivers is an important part of the total care provided to older adults with multimorbidity. The current study aimed to describe how older adults with multimorbidity experienced care from family caregivers. Interviews were conducted with 24 participants (mean age = 86 years). Older adults with multimorbidity felt gratitude toward family caregivers for their willingness to help with everyday life and for representing their interests in contacts with health care providers. Family caregivers also had a significant impact on older adults’ psychological well-being. However, the results also showed that older adults often felt they were a burden to their family caregivers and that their independence might be reduced. Older adults with multimorbidity should have the opportunity to be more involved in and have more influence over their health care so that they do not have to depend on representation by family caregivers.
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| 7. |
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