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- Jobe, Ingela
(författare)
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“A chain is only as strong as its weakest link” : collaborative care planning as a person-centred practice
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In recent years, person-centred care has become one of the major goals of health and social care policies. A method used, to facilitate collaboration and integrate the person’s perspective in the decision-making process, is the collaborative care planning process. The collaborative care planning process, taking place within primary health care with actors from different welfare services, is a relative new phenomenon. There is a need for more research to understand the process and outcomes.The overall aim of the thesis was to explore and describe the collaborative care planning process as a person-centred practice. This was achieved by conducting four studies describing the collaborative care planning conference (I), exploring how the person-centred practice framework can be applied to professionals participating in collaborative care planning (II), exploring which attributes contribute to making the collaborative care planning process work for all participants (III) and exploring documented collaborative care plans (IV). The design of the studies were a single – instrumental qualitative case study (I), explorative deductive approach (II), qualitative explorative with a grounded theory approach (III) and explorative descriptive approach (IV). Using different methodologies, data were collected through interviews with older adults, their care partners and health and social care professionals, focus group discussion with health and social care managers, observations of collaborative care planning conferences and documented collaborative care plans. Data were analysed with qualitative case study, qualitative content analysis, constructivist grounded theory and content analysis.Older adults wanted to be actively engaged in decision-making processes regarding their care and services. However, the professionals had challenges in carrying out the collaborative care planning process (I). Collaborative care planning and person-centred practice was a complex process that needed to take into account system factors both on macro- and micro level (II). A joint philosophy, an ethic, could facilitate and guide professionals in everyday practice (III). The collaborative care plans had poor quality, insufficient content and lack of personcentredness (IV). Further research is needed to understand the role of the documented collaborative plan and the best way of working to make the collaborative care planning process and collaborative care plan person-centred. To gain a deeper understanding of the studies (I – IV) results an interpreted synthesis were conducted resulting in two common threads, personhood and power asymmetry. The two common threads were discussed using philosophy and Paul Ricoeur’s (1994) “little ethics”. The collaborative care planning process has to be seen in a larger context for it to be person-centred. All levels, the older adult and their care partners, the professionals and the organizations, need to be permeated of ethics and human values, and these have to be visible in every action and practice. Health and social care are relational practices and organizations. During the collaborative care planning the professionals, the older adults, and their care partners become interwoven. By using reciprocity and balancing the different dimensions and perspectives, the plan, their relationships and the organizations can improve. In conclusion, the thesis highlight the importance of ethics, relationships and reciprocity during the collaborative care planning process. The philosophical texts by Ricoeur expand the perspectives and contribute to a greater understanding of the collaborative care planning process as a person-centred practice.
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| 2. |
- Johansson, Gunilla
(författare)
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Nature-based interventions to promote health in people with stress-related illness
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Stress-related illness is increasing and is a common cause of sick leave in Sweden. Spending time in nature reduces stress and promotes health and well-being. Consequently, nature-based interventions (NBI) for people with stress-related illness have been developed, implemented and studied in southern Scandinavia. However, such interventions are uncommon in the Circumpolar North with a different climate which affect conditions for outdoor activities. The overall aim of this doctoral thesis was to explore NBIs to promote health in people with stress-related illness from the perspectives of previous research, people with stress-related illness, healthcare professionals and entrepreneurs offering NBIs with a specific focus on northern natural conditions.The thesis includes four studies. An integrative literature review (I) identified and summarised scientific studies of NBIs for people with stress-related illness. Studies using both qualitative and quantitative designs were included. Study II explored key stakeholders’ perceptions of the value of NBIs in promoting health in people with stress-related illness. Semi-structured interviews were conducted with people with stress-related illness experience, healthcare professionals, and entrepreneurs offering NBI and data were analysed through qualitative content analysis. In study III people with stress-related illness experiences of participating in an NBI program in a northern natural setting were explored. A longitudinal case study design was used, and data were collected through repeated semi-structured interviews, diary entries and self-assessment questionnaires. Qualitative content analysis was used to analyse interviews and reflections from diaries and data from self-assessing questionnaires were presented descriptively. Study IV explored people with stress-related illness experiences of nature prescription. Data were collected through interviews with open-ended questions and analysed with a phenomenological-hermeneutic method.Findings show that natural environments offer unique qualities for individualised, meaningful activities and interactions with others in a non-demanding atmosphere. In NBI people with stress-related illness find a source for recovery, joy, and well-being. Spending time in nature is perceived as calming and facilitates being in the present. NBIs improve health and strengthen self-efficacy and work ability. Time in nature provides new perspectives, supports existential reflections, and empowers people with stress-related illness to find opportunities for change to achieve balance in everyday life. NBIs can be helpful for people with stress-related illness to overcome barriers to going out in nature or to find their way back to nature. In conclusion, NBIs seem to be beneficial in promoting health in people with stress-related illness. Different stakeholders have similar perceptions of the value of NBIs, indicating that it could be a valuable complement to health care. NBIs in a northern natural setting seems to have similar health promoting qualities as those seen in studies of NBIs in other natural settings.
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| 3. |
- Wijk, Helle, 1958, et al.
(författare)
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Verksamhetsförlagd utbildning på avancerad nivå : ny utmaning för specialistutbildningar för sjuksköterskor
- 2009
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Ingår i: Vård i Norden. - København : Sjuksköterskornas samarbete i Norden. - 0107-4083 .- 1890-4238. ; 29:94, s. 41-43
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this article is to discuss challenges in the development of Specialist Nursing Educations as a result of the 2007 Swedish Higher EducationReform: the implementation of the so-called Bologna process. Certain challenges follow this reform, particularly since the specialist nursingprogrammes will be part of the second cycle of the higher education system, and it will be possible to combine the professional degree witha masters degree (one year). Possible strategies in four areas related to the Specialist Nursing Education are discussed: integration of researchbasedknowledge, experienced-based knowledge, improvement knowledge, and strategies for collaboration between university institutions andclinics. Specific didactical issues are raised.
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| 4. |
- Öhlén, Joakim, 1958, et al.
(författare)
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Students’ learning as the focus for shared involvement between universities and clinical practice : a didactic model for postgraduate degree projects
- 2012
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Ingår i: Advances in Health Sciences Education. - Dordrecht : Springer Netherlands. - 1382-4996 .- 1573-1677. ; 17:4, s. 471-487
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Tidskriftsartikel (refereegranskat)abstract
- In an academic programme, completion of a postgraduate degree project could be a significant means of promoting student learning in evidence- and experience-based practice. In specialist nursing education, which through the European Bologna process would be raised to the master’s level, there is no tradition of including a postgraduate degree project. The aim was to develop a didactic model for specialist nursing students’ postgraduate degree projects within the second cycle of higher education (master’s level) and with a specific focus on nurturing shared involvement between universities and healthcare settings. This study embodies a participatory action research and theory-generating design founded on empirically practical try-outs. The 3-year project included five Swedish universities and related healthcare settings. A series of activities was performed and a number of data sources secured. Constant comparative analysis was applied. A didactic model is proposed for postgraduate degree projects in specialist nursing education aimed at nurturing shared involvement between universities and healthcare settings. The focus of the model is student learning in order to prepare the students for participation as specialist nurses in clinical knowledge development. The model is developed for the specialist nursing education, but it is general and could be applicable to various education programmes. © 2011 Springer Science+Business Media B.V.
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