| 1. |
- Bergman, Caroline, et al.
(author)
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Exploring communication processes in workplace meetings: A mixed methods study in a Swedish healthcare organization
- 2016
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In: Work : A journal of Prevention, Assesment and rehabilitation. - : IOS Press. - 1051-9815 .- 1875-9270. ; 54:3, s. 533-541
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Journal article (peer-reviewed)abstract
- BACKGROUND: An efficient team and a good organizational climate not only improve employee health but also the health and safety of the patients. Building up trust, a good organizational climate and a healthy workplace requires effective communication processes. In Sweden, workplace meetings as settings for communication processes are regulated by a collective labor agreement. However, little is known about how these meetings are organized in which communication processes can be strengthened. OBJECTIVE: The aim of this study was to explore communication processes during workplace meetings in a Swedish healthcare organization. METHODS: A qualitatively driven, mixed methods design was used with data collected by observations, interviews, focus group interviews and mirroring feedback seminars. Data were analyzed using descriptive statistics and conventional content analysis. RESULTS: The communication flow and the organization of the observed meetings varied in terms of physical setting, frequency, time allocated and duration. The topics for the workplace meetings were mainly functional with a focus on clinical processes. Overall, the meetings were viewed not only as an opportunity to communicate information top down but also a means by which employees could influence decision-making and development at the workplace. CONCLUSIONS: Workplace meetings have very distinct health-promoting value. It emerged that information and the opportunity to influence decisions related to workplace development are important to the workers. These aspects also affect the outcome of the care provided. © 2016 - IOS Press and the authors. All rights reserved.
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| 2. |
- Bergman, Peter, et al.
(author)
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Safety and efficacy of the mRNA BNT162b2 vaccine against SARS-CoV-2 in five groups of immunocompromised patients and healthy controls in a prospective open-label clinical trial
- 2021
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In: EBioMedicine. - : Elsevier BV. - 2352-3964. ; 74
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Journal article (peer-reviewed)abstract
- Background: Patients with immunocompromised disorders have mainly been excluded from clinical trials of vaccination against COVID-19. Thus, the aim of this prospective clinical trial was to investigate safety and efficacy of BNT162b2 mRNA vaccination in five selected groups of immunocompromised patients and healthy controls.Methods: 539 study subjects (449 patients and 90 controls) were included. The patients had either primary (n=90), or secondary immunodeficiency disorders due to human immunodeficiency virus infection (n=90), allogeneic hematopoietic stem cell transplantation/CAR T cell therapy (n=90), solid organ transplantation (SOT) (n=89), or chronic lymphocytic leukemia (CLL) (n=90). The primary endpoint was seroconversion rate two weeks after the second dose. The secondary endpoints were safety and documented SARS-CoV-2 infection.Findings: Adverse events were generally mild, but one case of fatal suspected unexpected serious adverse reaction occurred. 72.2% of the immunocompromised patients seroconverted compared to 100% of the controls (p=0.004). Lowest seroconversion rates were found in the SOT (43.4%) and CLL (63.3%) patient groups with observed negative impact of treatment with mycophenolate mofetil and ibrutinib, respectively.Interpretation: The results showed that the mRNA BNT162b2 vaccine was safe in immunocompromised patients. Rate of seroconversion was substantially lower than in healthy controls, with a wide range of rates and antibody titres among predefined patient groups and subgroups. This clinical trial highlights the need for additional vaccine doses in certain immunocompromised patient groups to improve immunity.
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| 3. |
- Healy, Katie, et al.
(author)
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Salivary IgG to SARS-CoV-2 indicates seroconversion and correlates to serum neutralization in mRNA-vaccinated immunocompromised individuals
- 2022
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In: Med. - : Cell Press. - 2666-6359 .- 2666-6340. ; 3:2, s. 137-153.e3
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Journal article (peer-reviewed)abstract
- Background: Immunocompromised individuals are highly susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Whether vaccine-induced immunity in these individuals involves oral cavity, a primary site of infection, is presently unknown.Methods: Immunocompromised patients (n = 404) and healthy controls (n = 82) participated in a prospective clinical trial (NCT04780659) encompassing two doses of the mRNA BNT162b2 vaccine. Primary immunodeficiency (PID), secondary immunodeficiencies caused by human immunodeficiency virus (HIV) infection, allogeneic hematopoietic stem cell transplantation (HSCT)/chimeric antigen receptor T cell therapy (CAR-T), solid organ transplantation (SOT), and chronic lymphocytic leukemia (CLL) patients were included. Salivary and serum immunoglobulin G (IgG) reactivities to SARS-CoV-2 spike were measured by multiplex bead-based assays and Elecsys anti-SARS-CoV-2 S assay.Findings: IgG responses to SARS-CoV-2 spike antigens in saliva in HIV and HSCT/CAR-T groups were comparable to those of healthy controls after vaccination. The PID, SOT, and CLL patients had weaker responses, influenced mainly by disease parameters or immunosuppressants. Salivary responses correlated remarkably well with specific IgG titers and the neutralizing capacity in serum. Receiver operating characteristic curve analysis for the predictive power of salivary IgG yielded area under the curve (AUC) = 0.95 and positive predictive value (PPV) = 90.7% for the entire cohort after vaccination.Conclusions: Saliva conveys vaccine responses induced by mRNA BNT162b2. The predictive power of salivary spike IgG makes it highly suitable for screening vulnerable groups for revaccination.
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| 4. |
- Strömgren, Marcus, et al.
(author)
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Leadership quality: a factor important for social capital in healthcare organizations
- 2017
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In: Journal of Health, Organisation and Management. - : Emerald Group Publishing Limited. - 1477-7266 .- 1758-7247. ; 31:2, s. 175-191
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Journal article (peer-reviewed)abstract
- © 2017, © Emerald Publishing Limited. Purpose: The purpose of this paper is to investigate the relation between leadership and social capital and what qualities of leadership are important for social capital among employees in hospital settings over time. Design/methodology/approach: A cohort of employees in hospitals answered a questionnaire at three occasions. Five small (approx. 100-bed) or mid-sized (approx. 500-bed) hospitals were included. The response rate was 54 percent at baseline (n=865), 59 percent at one-year follow-up (n=908) and 67 percent at two-year follow-up (n=632). Findings: Repeated measures over time showed differences between groups in levels of social capital with respect to levels of leadership quality. Relation-oriented leadership had the strongest association with social capital. There was evidence that leadership was associated with social capital over time and that different kinds of leadership qualities we re associated with social capital. Research limitations/implications: This study conducted and analyzed quantitative data, and therefore, there is no knowledge of managers’ or employees’ own perceptions in this study. However, it would be interesting to compare managers’ decreased and increased leadership quality and how such differences affect social capital over time. Practical implications: The findings feature the possibility for healthcare leaders to build high quality leadership as an important resource for social capital, by using different leadership orientations under different circumstances. Originality/value: The paper showed that leadership was an important factor for building social capital and that different leadership qualities have different importance with respect to certain circumstances.
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| 5. |
- Strömgren, Marcus, et al.
(author)
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Social capital among healthcare professionals : A prospective study of its importance for job satisfaction, work engagement and engagement in clinical improvements
- 2016
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In: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 53, s. 116-125
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Journal article (peer-reviewed)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.
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| 6. |
- Strömgren, Marcus
(author)
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Social capital in healthcare : A resource for sustainable engagement in organizational improvement work
- 2017
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Doctoral thesis (other academic/artistic)abstract
- Social capital, work engagement, working conditions, and leadership are concepts that have been studied previously, but there is lack of knowledge about what processes promote sustainable organizational improvement work in hospitals, and specifically, what leads healthcare professionals to engage in clinical developments.The overall aim of this thesis is to increase knowledge of how social capital and engagement contribute to sustainable organizational improvement work in hospitals and how social capital and engagement are created during organizational improvement work. Data were collected by a questionnaire at three times over a period of two years at five hospitals and all studies are quantitative.The results show that improved working conditions and employees’ attitudes to engagement in improvement work are associated with and have importance for healthcare professionals’ work engagement and clinical engagement in improving care processes (Study I). Job demands, social capital, and other job resources are associated with healthcare professionals’ intention to leave their jobs, whereas high levels of social capital are associated with low levels of intention to leave (Study II). Increased social capital predicted healthcare professionals’ job satisfaction, work engagement, and engagement in patient safety (Study III). Leadership is shown to be important for healthcare professionals’ social capital, and levels of leadership quality correlate with levels of social capital over time (Study IV).In conclusion, social capital, increased job resources, and decreased job demands are important conditions for healthcare professionals’ engagement in organizational improvement work. To develop social capital, leadership quality is an important precondition. Social capital can be regarded as a resource for sustainable organizational improvement work in healthcare, because of its importance for healthcare professionals’ engagement, job satisfaction, and intention to leave.
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| 7. |
- Strömgren, Marcus, et al.
(author)
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The importance of Leadership for social capital among healthcare professionals
- 2015
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Conference paper (peer-reviewed)abstract
- IntroductionSocial capital, operationalized as perceived trust, reciprocity and recognition has in earlier research shown to be important for employees´ job satisfaction and to health care staffs´ engagement in clinical improvements of patient safety and quality of care as well as job satisfaction, health and wellbeing. Since social capital has an impact, it is of interest to investigate which factors that influence workplace social capital. Research findings shows that leadership has great importance to staffs´ health and wellbeing, and affects a number of factors in the work environment factors as job satisfaction and work engagement. If and how leadership is associated with social capital is rarely described in previous research. However the few studies performed indicate that there are associated correlations between leadership and social capital, and leadership quality and social capital. Leadership within healthcare sector has been in focus when working with redesign of care processes and it would be of interest to investigate the role of leadership and the quality of leadership with respect to social capital. The aim was to assess the importance of leadership for workplace social capital in hospital settings. Materials and methodsThis study was a longitudinal cohort study. Questionnaires to physicians, nurses, assistant nurses at five Swedish midsize hospitals was used to collect data (T0, n=865, T1, n=908). Bivariate, multivariate analyses was used and a mixed model repeated measurement for the longitudinal analyses (n=477) were performed. ResultsRelationship between staffs perceived quality of leadership and staffs´ social capital was found (R = 0.58, p-value <0.0001). Results of the analysis showed significant differences in levels of social capital between the groups of low, medium and high levels in quality of leadership. The differences between the groups sustained over time where the group with high levels in quality of leadership remained higher in levels of social capital than the other groups. Same pattern were seen in the other groups. ConclusionLeadership quality were related to-, had importance for- and influenced workplace social capital among health care staff.
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