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Sökning: WFRF:(Wijk Lena)

  • Resultat 1-10 av 39
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  • Kirvalidze, Mariam, et al. (författare)
  • Effectiveness of integrated person-centered interventions for older people's care: Review of Swedish experiences and experts’ perspective
  • 2024
  • Ingår i: Journal of Internal Medicine. - : John Wiley & Sons. - 1365-2796 .- 0954-6820. ; 295:6, s. 804-824
  • Tidskriftsartikel (refereegranskat)abstract
    • Older adults have multiple medical and social care needs, requiring a shift toward an integrated person-centered model of care. Our objective was to describe and summarize Swedish experiences of integrated person-centered care by reviewing studies published between 2000 and 2023, and to identify the main challenges and scientific gaps through expert discussions. Seventy-three publications were identified by searching MEDLINE and contacting experts. Interventions were categorized using two World Health Organization frameworks: (1) Integrated Care for Older People (ICOPE), and (2) Integrated People-Centered Health Services (IPCHS). The included 73 publications were derived from 31 unique and heterogeneous interventions pertaining mainly to the micro- and meso-levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability outcomes in 48%, and service utilization outcomes in 58%. Workshop discussions in Stockholm (Sweden), March 2023, were recorded, transcribed, and summarized. Experts emphasized: (1) lack of rigorous evaluation methods, (2) need for participatory designs, (3) scarcity of macro-level interventions, and (4) importance of transitioning from person- to people-centered integrated care. These challenges could explain the unexpected weak beneficial effects of the interventions on health outcomes, whereas service utilization outcomes were more positively impacted. Finally, we derived a list of recommendations, including the need to engage care organizations in interventions from their inception and to leverage researchers’ scientific expertise. Although this review provides a comprehensive snapshot of interventions in the context of Sweden, the findings offer transferable perspectives on the real-world challenges encountered in this field.
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  • Berg, Linda, et al. (författare)
  • Students’ learning as the focus for shared involvement : an action research project
  • 2012
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • The aim of this participatory action research project was to develop a didactic model for specialist nursing students' postgraduate degree projects within the second cycle of higher education. The specific focus was on nurturing shared involvement between universities and practice. A series of activities at five Swedish universities and their regional practice settings was performed and a number of data sources secured before proposing a model. Tensions and conflicting views during the process of change were identified. Meaningful academic learning was found as a major concern for students. The proposed didactic model is general and can be applied in various profession-oriented programmes.
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  • Elf, Lena Marie, 1962, et al. (författare)
  • Space Planners' Perception of an Assessment Instrument for Briefs in the Pre-Design Phase of New Healthcare Environments
  • 2014
  • Ingår i: HERD. - : SAGE Publications. - 2167-5112 .- 1937-5867. ; 8:1, s. 67-80
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The main purpose of the study was to investigate the usability of a newly developed instrument designed to assess the content and quality briefs (CQB-I) in programs for new healthcare environments. We studied the perception of using the instrument on a group of space planners.BACKGROUND: The study is part of a larger project designed to ensure the quality of the planning of new healthcare environments with a focus on documents (programs or briefs) created in the early phases of the planning process. In this study, we used an instrument that measures the clarity of the mission statement for the project based on user needs and care activities that will take place in the new healthcare environment. The instrument further evaluates whether there are clear patient-related outcome measures specified and whether the information in the documents is person-oriented and evidence-based.METHODS: The study used a mixed-method design where the relevance and usability of the instrument was estimated and a focus group interview was conducted.RESULTS: The study showed that a CQB-I is perceived to be a relevant instrument primarily as a guide for programming, but also for monitoring the produced programs.CONCLUSIONS: Instruments like CQB-I can help to bring research results into planning and contribute to dialogue and collaboration in the early phases of a planning process by orienting planning participants to user needs and facilitating the discussion and articulation of clear performance indicators.
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  • Falconer, Henrik, et al. (författare)
  • Robot-assisted approach to cervical cancer (RACC) : an international multi-center, open-label randomized controlled trial
  • 2019
  • Ingår i: International Journal of Gynecological Cancer. - : BMJ Publishing Group Ltd. - 1048-891X .- 1525-1438. ; 29:6, s. 1072-1076
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Radical hysterectomy with pelvic lymphadenectomy represents the standard treatment for early-stage cervical cancer. Results from a recent randomized controlled trial demonstrate that minimally invasive surgery is inferior to laparotomy with regards to disease-free and overall survival.Primary Objective: To investigate the oncologic safety of robot-assisted surgery for early-stage cervical cancer as compared with standard laparotomy.Study Hypothesis: Robot-assisted laparoscopic radical hysterectomy is non-inferior to laparotomy in regards to recurrence-free survival with the advantage of fewer post-operative complications and superior patient-reported outcomes.Trial Design: Prospective, multi-institutional, international, open-label randomized clinical trial. Consecutive women with early-stage cervical cancer will be assessed for eligibility and subsequently randomized 1:1 to either robot-assisted laparoscopic surgery or laparotomy. Institutional review board approval will be required from all participating institutions. The trial is coordinated from Karolinska University Hospital, Sweden.Major Inclusion/Exclusion Criteria: Women over 18 with cervical cancer FIGO (2018) stages IB1, IB2, and IIA1 squamous, adenocarcinoma, or adenosquamous will be included. Women are not eligible if they have evidence of metastatic disease, serious co-morbidity, or a secondary invasive neoplasm in the past 5 years.Primary Endpoint: Recurrence-free survival at 5 years between women who underwent robot-assisted laparoscopic surgery versus laparotomy for early-stage cervical cancer.Sample Size: The clinical non-inferiority margin in this study is defined as a 5-year recurrence-free survival not worsened by >7.5%. With an expected recurrence-free survival of 85%, the study needs to observe 127 events with a one-sided level of significance (alpha) of 5% and a power (1-beta) of 80%. With 5 years of recruitment and 3 years of follow-up, the necessary number of events will be reached if the study can recruit a total of 768 patients.Estimated Dates for Completing Accrual and Presenting Results: Trial launch is estimated to be May 2019 and the trial is estimated to close in May 2027 with presentation of data shortly thereafter.
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