| 1. |
- Andersson, Peter, 1980-, et al.
(författare)
-
Exploring stakeholder perspectives to facilitate the implementation of shared decision-making in coordinated individual care planning : [Utforskande av stakeholderperspektiv för att stödja implementeringen av delat beslutsfattande i samordnad individuell vårdplanering]
- 2023
-
Ingår i: European Journal of Social Work. - : Routledge. - 1369-1457 .- 1468-2664.
-
Tidskriftsartikel (refereegranskat)abstract
- This article explores conditions for implementing shared decision-making (SDM) in coordinated individual care planning (CIP) with individuals with complex mental health needs. SDM in CIP are described as central, although such user centred collaboration still remains to be realised. Research underlines the need for a changed way of working, where user expertise is valued and a balance of power is promoted. The aim of the present study is to investigate the conditions for implementing SDM in connection with CIP for and with people with mental illness. To better understand the context and conditions that can promote such an implementation, altogether 15 participants were interviewed in three regions in Sweden within the scope of a stakeholder analysis. Both hindering and supporting factors were identified with respect to an implementation process, such as staff turnover, differences in work culture and committed leadership. Further focus should be directed specifically towards professionals working more closely with CIP and towards in-depth analysis of the construct of culture in terms of implementation processes.
|
|
| 2. |
- Andersson, Peter, et al.
(författare)
-
Exploring stakeholder perspectives to facilitate the implementation of shared decision-making in coordinated individual care planning
- 2024
-
Ingår i: European Journal of Social Work. - Abingdon, Oxon : Routledge. - 1369-1457 .- 1468-2664. ; 27:5, s. 1073-1085
-
Tidskriftsartikel (refereegranskat)abstract
- This article explores conditions for implementing shared decision-making (SDM) in coordinated individual care planning (CIP) with individuals with complex mental health needs. SDM in CIP are described as central, although such user centred collaboration still remains to be realised. Research underlines the need for a changed way of working, where user expertise is valued and a balance of power is promoted. The aim of the present study is to investigate the conditions for implementing SDM in connection with CIP for and with people with mental illness. To better understand the context and conditions that can promote such an implementation, altogether 15 participants were interviewed in three regions in Sweden within the scope of a stakeholder analysis. Both hindering and supporting factors were identified with respect to an implementation process, such as staff turnover, differences in work culture and committed leadership. Further focus should be directed specifically towards professionals working more closely with CIP and towards in-depth analysis of the construct of culture in terms of implementation processes. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
|
|
| 3. |
- Bromark, Kristina, 1973-, et al.
(författare)
-
Practitioners exploring intertwined challenges and possible solutions for user participation in social services
- 2024
-
Ingår i: Nordic Social Work Research. - 2156-857X .- 2156-8588. ; , s. 283-295
-
Tidskriftsartikel (refereegranskat)abstract
- Despite a strong emphasis on user participation in social services, scientific knowledge on how to achieve these goals is limited. The aim of this study is to explore what social work practitioners identify as challenging in implementing user participation and what solutions they propose to be necessary to meet these challenges. Future workshops were applied, combining data from brainstorming processes and from the participants’ analytical work, identifying current obstacles and co-creating solutions. The workshops took place at the Personal Social Services section in a suburban area outside a large city in Sweden with 95 participants. The findings are discussed in relation to a model of participation, where creating openings, opportunities, and obligations are essential. The participants highlighted the need to strengthen commitment to user participation, increased access to knowledge and methods that enhance user participation, and support from management, with increased resources to ensure continuous development and maintenance. Practitioners must be able to engage in user participation, and actions need to be taken at all organizational levels. To overcome a complex and intertwined set of challenges, an intertwined set of solutions is required.
|
|
| 4. |
- Bromark, Kristina, et al.
(författare)
-
Samskapande processer : om makt, ansvar och epistemisk rättvisa i deltagande forskning
- 2023
-
Ingår i: Socialvetenskaplig tidskrift. - : Linköping University Electronic Press. - 1104-1420 .- 2003-5624. ; 29:3-4, s. 325-344
-
Tidskriftsartikel (refereegranskat)abstract
- Participatory research designs are often used to improve the opportunities of marginalized groups to participate in knowledge production. This article is based on experiences from a research project, where participatory design was used to develop and implement user participation for children and young people in out-of-home care. The aim is to discuss opportunities and challenges within different stages of this research project to problematize which participation in participation research involves. Special emphasis is placed on the power relations between researchers, professionals and users through the different stages of the research process – from research design and co-creation to the implementation of co-created knowledge – and to explore how the opportunity maintaining epistemic justice varies among participants throughout this process. This article shows that the conditions for maintaining justice and epistemic justice change when the participatory research process goes from knowledge production to implementation of co-created knowledge. The implementation of knowledge takes place in a context of complex and competing interests, where the responsibility and power of researchers are weakened in favor of the responsibility and power of professionals. At this stage, users' opportunities for power and responsibility is also weakened. This shift of responsibility and power has ethical implications, which users at this stage may feel let down about their expectations of change that were raised in the past stages of the process, are not met in practice.
|
|
| 5. |
|
|
| 6. |
- Dahlqvist Jönsson, Patrik, 1974-, et al.
(författare)
-
Service users' experiences of participation in decision making in mental health services
- 2015
-
Ingår i: Journal of Psychiatric and Mental Health Nursing. - Chichester : Wiley-Blackwell. - 1351-0126 .- 1365-2850. ; 22:9, s. 688-697
-
Tidskriftsartikel (refereegranskat)abstract
- Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core category that emerged in the analysis described a 'struggle to be perceived as a competent and equal person' while three related categories including being the underdog, being controlled and being omitted described the difficulties of participating in decisions. The data analysis resulted in a model that describes internal and external conditions that influence the promotion of participation in decision making. The findings offer new insights from a user perspective and these can be utilized to develop and investigate concrete methods in order to promote user's participation in decisions.
|
|
| 7. |
- Erlandsson, Sara, 1979-, et al.
(författare)
-
Perceptions of participation: how nursing home staff and managers perceive and strive for participation of older residents : [Brukardelaktighet på äldreboenden – vad vill personal och chefer uppnå?]
- 2023
-
Ingår i: European Journal of Social Work. - : Informa UK Limited. - 1369-1457 .- 1468-2664. ; 26:5, s. 815-827
-
Tidskriftsartikel (refereegranskat)abstract
- User participation is increasingly emphasised in policies guiding social services. However, translating policy into practice is fraught with difficulties. The staff’s approaches to user participation are crucial for the users’ opportunities to participate in decision-making, particularly for users with extensive care needs and reduced autonomy. The aim of this article is to explore how nursing home staff and managers perceive the participation of older residents and what the implications are for residents’ involvement in decision-making in everyday life. Interviews and future workshops were carried out with staff and managers in two Swedish nursing homes. The analysis identified differing and partly conflicting perceptions of user participation that have different implications for the residents’ opportunities to be involved in decisions. The staff’s and managers’ approaches to participation ranged from encouraging independent decision-making to excluding the residents from decisions, depending on the situation and the assessment of residents’ abilities. In addition, the analyses showed that perceptions of participation are intertwined with perceptions of good care and with the staff’s and managers’ understandings of their mission and responsibilities. The findings indicate that increasing user participation in nursing homes requires organisational policies that clarify what user participation is and strategies for implementation in daily practice.
|
|
| 8. |
- Grim, Katarina, et al.
(författare)
-
Development- and usability testing of a web-based decision support for users and health professionals in psychiatric services
- 2017
-
Ingår i: Psychiatric rehabilitation journal. - Washington, DC : American Psychological Association (APA). - 1095-158X .- 1559-3126. ; 40:3, s. 293-302
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported. Method: The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers. Results: Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool. Conclusions and Implications for Practice: This web-based decision aid has the potential to strengthen service users’ experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives.
|
|
| 9. |
- Grim, Katarina, 1971-, et al.
(författare)
-
Legitimizing user knowledge in mental health services : Epistemic (in)justice and barriers to knowledge integration
- 2022
-
Ingår i: Frontiers in Psychiatry. - Lausanne : Frontiers Media S.A.. - 1664-0640. ; 13
-
Tidskriftsartikel (refereegranskat)abstract
- Including the voices and knowledge of service users is essential for developing recovery-oriented and evidence-based mental health services. Recent studies have however, suggested that challenges remain to the legitimization of user knowledge in practice. To further explore such challenges, a co-production study was conducted by a team of researchers and representatives from user organizations in Sweden. The aim of the study was to explore the barriers and facilitators to the legitimacy of user knowledge, as a central factor in sustainably implementing user influence in mental health practice. A series of workshops, with representatives of mental health services and user organizations were conducted by the research team to explore these issues. The analysis built on the theoretical framework of epistemic injustice, and the underlying aspects, testimonial, hermeneutic and participation-based injustice, were utilized as a framework for a deductive analysis. Results suggest that this is a useful model for exploring the complex dynamics related to the legitimacy of user knowledge in mental health systems. The analysis suggests that the legitimacy of user knowledge is related to the representativeness of the knowledge base, the systematic formulation of this knowledge inapplicable methods, access to resources and positions within the mental health system and participation in the process of integrating this knowledge-base in mental health contexts. Legitimizing user knowledge in practice additionally challenges mental health systems to support readiness for change in working environments and to address the power and role issues that these changes involve. Copyright © 2022 Grim, Näslund, Allaskog, Andersson, Argentzell, Broström, Jenneteg, Jansson, Schön, Svedberg, Svensson, Wåhlstedt and Rosenberg.
|
|
| 10. |
- Grim, Katarina, et al.
(författare)
-
Shared decision-making in mental health care : a user perspective on decisional needs in community-based services
- 2016
-
Ingår i: International Journal of Qualitative Studies on Health and Well-being. - Järfälla : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 11
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Shared decision-making (SDM) is an emergent research topic in the field of mental health care and is considered to be a central component of a recovery-oriented system. Despite the evidence suggesting the benefits of this change in the power relationship between users and practitioners, the method has not been widely implemented in clinical practice.Objective: The objective of this study was to investigate decisional and information needs among users with mental illness as a prerequisite for the development of a decision support tool aimed at supporting SDM in community-based mental health services in Sweden.Methods: Three semi-structured focus group interviews were conducted with 22 adult users with mental illness. The transcribed interviews were analyzed using a directed content analysis. This method was used to develop an in-depth understanding of the decisional process as well as to validate and conceptually extend Elwyn et al.’s model of SDM.Results: The model Elwyn et al. have created for SDM in somatic care fits well for mental health services, both in terms of process and content. However, the results also suggest an extension of the model because decisions related to mental illness are often complex and involve a number of life domains. Issues related to social context and individual recovery point to the need for a preparation phase focused on establishing cooperation and mutual understanding as well as a clear follow-up phase that allows for feedback and adjustments to the decision-making process.Conclusions and Implications for Practice: The current study contributes to a deeper understanding of decisional and information needs among users of community-based mental health services that may reduce barriers to participation in decision-making. The results also shed light on attitudinal, relationship-based, and cognitive factors that are important to consider in adapting SDM in the mental health system.
|
|
