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- Friberg, Febe, 1950, et al.
(författare)
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Exploration of dynamics in a complex person-centred intervention process based on health professionals' perspectives
- 2018
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The assessment and evaluation of practical and sustainable development of health care has become a major focus of investigation in health services research. A key challenge for researchers as well as decision-makers in health care is to understand mechanisms influencing how complex interventions work and become embedded in practice, which is significant for both evaluation and later implementation. In this study, we explored nurses' and surgeons' perspectives on performing and participating in a complex multi-centre person-centred intervention process that aimed to support patients diagnosed with colorectal cancer to feel prepared for surgery, discharge and recovery. Method: Data consisted of retrospective interviews with 20 professionals after the intervention, supplemented with prospective conversational data and field notes from workshops and follow-up meetings (n = 51). The data were analysed to construct patterns in line with interpretive description. Results: Although the participants highly valued components of the intervention, the results reveal influencing mechanisms underlying the functioning of the intervention, including multiple objectives, unclear mandates and competing professional logics. The results also reveal variations in processing the intervention focused on differences in using and talking about intervention components. Conclusions: The study indicates there are significant areas of ambiguity in understanding how theory-based complex clinical interventions work and in how interventions are socially constructed and co-created by professionals' experiences, assumptions about own professional practice, contextual conditions and the researchers' intentions. This process evaluation reveals insights into reasons for success or failure and contextual aspects associated with variations in outcomes. Thus, there is a need for further interpretive inquiry, and not only descriptive studies, of the multifaceted characters of complex clinical interventions and how the intervention components are actually shaped in constantly shifting contexts.
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| 4. |
- Norbergh, Karl-Gustaf, 1950-, et al.
(författare)
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Omvårdnad på avancerad nivå : kärnkompetenser inom sjuksköterskans specialistområden
- 2013
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Ingår i: Omvårdnad på avancerad nivå. - Lund : Studentlitteratur. - 9789144071459 ; , s. webb artiklar-
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Denna bok och webb är den efterfrågade och fristående fortsättningen på Omvårdnadens grunder. Redan före sin publicering har Omvårdnad på avancerad nivå varit känd för många under det lekfulla arbetsnamnet Omvårdnadens höjder. Innehållet är två sammanflätade delar: en tryckt bokdel och en digital webbdel. Den senare är helt unik i sitt slag. Ett åttiotal forskande och/eller kliniskt verksamma sjuksköterskor har skapat en digital artikelsamling som beskriver tillämpningen av avancerad omvårdnad inom respektive specialistområde. Webbmaterialet innehåller även sammanfattande ljudklipp, frågor samt den tryckta boken i sin helhet så att den kan läsas på exempelvis iPad. Detta är det första bokverket i Sverige som beskriver huvudområdet omvårdnad på avancerad nivå. Utgångspunkten är de sex kärnkompetenser som är gemensamma för alla professioner inom hälso- och sjukvården och som Svensk sjuksköterskeförening rekommenderar bör utgöra en röd tråd med progression genom utbildningarnas nivåer: Personcentrerad vård Samverkan i team Evidensbaserad vård Förbättringskunskap för kvalitetsutveckling Säker vård Informations- och kommunikationsteknologi Tillsammans bildar bok och webb ett gemensamt och mångfaldigt innehåll för specialistsjuksköterskeutbildningarna. Avsikten är att skapa en grund för dessa utbildningar och deras motsvarigheter där omvårdnad på avancerad nivå kan beskrivas och problematiseras. Instruktioner för hur du kommer åt det digitala materialet finns på omslagets insida.
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| 6. |
- Smith, Frida, 1973, et al.
(författare)
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Readability, suitability and comprehensibility in patient education materials for Swedish patients with colorectal cancer undergoing elective surgery: a mixed method design
- 2014
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 94:2, s. 202-209
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To characterize education materials provided to patients undergoing colorectal cancer surgery to gain a better understanding of how to design readable, suitable, comprehensible materials. Method: Mixed method design. Deductive quantitative analysis using a validated suitability and comprehensibility assessment instrument (SAM. +. CAM) was applied to patient education materials from 27 Swedish hospitals, supplemented by language technology analysis and deductive and inductive analysis of data from focus groups involving 15 former patients. Results: Of 125 patient education materials used during the colorectal cancer surgery process, 13.6% were rated 'not suitable', 76.8% 'adequate' and 9.6% 'superior'. Professionally developed stoma care brochures were rated 'superior' and 44% of discharge brochures were 'not suitable'. Language technology analysis showed that up to 29% of materials were difficult to comprehend. Focus group analysis revealed additional areas that needed to be included in patient education materials: general and personal care, personal implications, internet, significant others, accessibility to healthcare, usability, trustworthiness and patient support groups. Conclusion: Most of the patient education materials were rated 'adequate' but did not meet the information needs of patients entirely. Discharge brochures particularly require improvement. Practice implications: Using patients' knowledge and integrating manual and automated methods could result in more appropriate patient education materials.
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| 7. |
- Öhlén, Joakim, 1958, et al.
(författare)
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Preparedness for colorectal cancer surgery and recovery through a person-centred information and communication intervention - A quasi-experimental longitudinal design.
- 2019
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:12
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Tidskriftsartikel (refereegranskat)abstract
- To meet patients' information and communication needs over time in order to improve their recovery is particularly challenging for patients undergoing cancer surgery. The aim of the study was to evaluate whether an intervention with a person-centred approach to information and communication for patients diagnosed with colorectal cancer undergoing surgery can improve the patients' preparedness for surgery, discharge and recovery during six months following diagnosis and initial treatment. The intervention components involving a novel written interactive patient education material and person-centred communication was based on critical analysis of conventional information and communication for these patients. During 2014-2016, 488 consecutive patients undergoing elective surgery for colorectal cancer were enrolled in a quasi-experimental longitudinal study. In three hospitals, first a conventional care group (n = 250) was recruited, then the intervention was introduced, and finally the intervention group was recruited (n = 238). Patients' trajectories of preparedness for surgery and recovery (Preparedness for Colorectal Cancer Surgery Questionnaire-PCSQ) health related quality of life (EORTC QLQ-C30) and distress (NCCS Distress Thermometer) were evaluated based on self-reported data at five time points, from pre-surgery to 6 months. Length of hospital stay and patients' behavior in seeking health care pre- and post-surgery were extracted from patient records. Longitudinal structural equation models were used to test the hypothesized effects over time. Statistically significant positive effects were detected for two of the four PCSQ domains (patients searching for and making use of information, and making sense of the recovery) and for the role functioning domain of the EORTC QLQ-C30. Patients in the intervention group were also more likely to contact their assigned cancer "contact nurse" (a.k.a. nurse navigator) instead of contacting a nurse on duty at the ward or visiting the emergency department. In conclusion, the overall hypothesis was not confirmed. Further research is recommended on written and oral support tools to facilitate person-centred communication.
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