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- Elfström, Magnus, 1971-, et al.
(författare)
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Correlates of desire to work in persons visiting psychiatric outpatient clinics
- 2019
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Persons with mental health problems often express a clear desire to work, although whatfactors that contribute to this healthy aspiration are less clear. The purpose of this study thuswas to explore person, healthcare, and work-related factors in relation to desire to work inpersons visiting psychiatric outpatient clinics. The sample consisted of 272 persons visitingone of four psychiatric outpatient centres from two county councils in the south of Sweden.The possible participants were asked if they wanted to participate in research while waitingfor their scheduled appointments. A comprehensive questionnaire consisting of factors inthe research literature as well as factors advocated by patient organisations was used. Theparticipants’ ratings were analysed using non-parametric group comparisons and logisticregressions. Free-text answers were analysed by content. Higher education, better mentalhealth self-efficacy, and more experiences of demands and conflicts at the workplace wereall significantly related to desire to work in bivariate analyses. However, fighting spirit andsocial support at work had the strongest associations with desire to work in the multivariatelogistic analyses. The Nagelkerke R2 was .34. Free text answers indicated the importanceof managers’ role for the psychosocial work climate, and for receiving help with structuringthe workday to allow recovery after sickness absence. In contrast to the traditional prevocationalrehabilitation approach, and in line with a supportive work environment approach,the results points to the possibility to influence a further improved desire to work throughsupportive leadership and an open and communicative psychosocial climate.
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- Elfström, Magnus, 1971-, et al.
(författare)
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Reablement for older persons by an interprofessional home rehabilitation team : An ongoing RCT
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The aim is to evaluate the effects of intensive home rehabilitation regarding multidimensional health perceptions and other quality of life domains, physical ability and capacity among older people (65+). The design is a randomized controlled study of a reablement intervention with controls receiving traditional home care. The intervention is goal- and user oriented, home-based, time limited (3 months), and organized by an interprofessional team consisting of the professions nurse, enrolled nurses, physiotherapists, social worker, and occupational therapists. The effects of the intervention are measured by self-reported health and quality of life (EQ-5D-5L, HACT) including psychological well-being (GP-CORE), physical capacity (SPPB, hand dynamometer test), activity performance (COPM), and home care hours needed. Data are collected at inclusion (T1; applying for home care), after the three months intervention (T2), and at six months (T3). Primary outcome analyses will be performed according to intention to treat; 2 x 3 mixed design (group x time) ANCOVA with each dependent variable at T1 as covariate. Based on a medium effect size in favour of the intervention in the pilot study, and a dropout of 20%, the power calculation indicated that 240 persons should be included. The project will contribute with evidence of the effects of interprofessional home rehabilitation for reablement, and consequences for older persons’ bio-psycho-social health. The project is ongoing with more than 120 persons included. The intervention may result in reduced costs for care, but especially individual gains in relation to reduced care needs, maintained independence and good health.
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- Fredriksson, Matilda
(författare)
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Fostran till anställningsbarhet : Ungas berättelser inifrån den kommunala arbetsmarknadspolitiken
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The issue of unemployment has become individualised. In recent decades, Swedish social- and labour market policies have changed towards an emphasis on activation, which places greater demands on the job seeker to actively seek work, participate in employment initiatives and improve their employability. This thesis studies how these requirements are expressed in the municipal activation of young people (18-29 years of age). The purpose of the study is to highlight and problematise the activation’s creation of employable individuals and its consequences for young people’s identity work.The study is based on ethnographic field work in an activation programme. The data consists of field notes, interviews and audio recordings from the programme’s daily activities and the young people’s tripartite meetings with public employment officers, which are also attended by staff from the activation programme. Based on Goffman’s perspective on total institutions and an interactionist, discursive and narrative approach, the study illustrates activation from the point of view of the programme participants’ own perspectives and narratives.The analysis shows how the programme screens young people from their environment and at the same time monitors and controls them. A daily schedule has to be followed, which means that all the young people do the same activity at the same time. The analysis identifies the prominent discourses that set the framework for the design of the activation and the everyday activities, as well as how the young people’s situations and needs are understood. The participants are categorised as “problem young people” with faults and failings. Included in the activation is a desire to change them into employable and capable individuals who can fit into the adult world. However, it is the young people who are responsible for working on themselves in accordance with the prevailing ideals. Thus, it is not primarily about reinforcing their competences in aspects like education and experience of working life. Rather, the young people are encouraged to adopt new ways of thinking and characteristics, such as being active, flexible, reflexive, well-behaved and accepting responsibility. They are challenged to show motivation, self-confidence and social and communicative skills. By encouraging the young people to change themselves and adopt certain personal characteristics, the activation conveys the image of unemployment as a personal problem that requires a personal solution, rather than a social problem. In the young people’s narratives, the activation is depicted as meaningless in that the programme does not lead to employment. At the same time, the young people say that the programme has given them new values and ways of seeing themselves. The activation can therefore be understood as a practice of normalisation as well as a semi-total institution that disciplines and changes the participants.
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- Hjalmarsson, Anna, 1976-
(författare)
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Being provided with a safe haven : Care-dependent older persons' participation in prehospital emergency care
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Participation in care is a key concept in many welfare societies and serves to guide clinical practice and adapt care to personal preferences and needs in order to promote well-being and quality of life. Previous research has shown that practicing participation in care is complex due to the concept not being clearly defined. A significant risk is, therefore, that participation in care is practiced based on the professional caregivers' own definitions, which might be inconsistent with the cared-for persons' perceptions of what participation is.Older persons can continue to live in their own homes with the support of municipal home care services that meet everyday care needs. Care-dependent older persons are known to have increased emergency care needs, which in Sweden require inter-organizational and inter-professional collaboration involving a care transfer between welfare levels. This thesis aimed to deepen the understanding of care-dependent older persons' participation in prehospital emergency care from lifeworld and welfare perspectives. The inductive design was based on a lifeworld approach and included triangulation of the phenomenon of participation in care using descriptive, interpretative, and comparative methods.From the perspective of care-dependent older persons, participation in prehospital emergency care means a forced transfer of life responsibility to professional caregivers when being existentially unsafe and incapacitated due to acute illness. Through authorized representation, the professional caregivers act for the older person, with the power to bring about change and create opportunities for existence. Care-dependent older persons' participation in prehospital emergency care involves a deepened dependence that necessitates coexistence and being provided with a 'safe haven' through the entire emergency care chain. A 'safe haven' can be understood as an unconditional, calm, and sheltered interpersonal space for emotional rest that is provided to the older person during an existentially challenging situation. From the perspective of care-dependent older persons, the emergency care chain transcends organizational boundaries and includes mobile safety alarm services and emergency department attendance.The involved professionals must be supported in practicing participation in care based on a comprehensive understanding of the concept, and emergency care options must be aligned with the care-dependent older persons' need for coordinated and continuous care. Collaborative challenges related to unstructured collaboration and professional hierarchy need to be addressed to support well-functioning collaboration in situations involving acutely ill older persons. The involved organizations need to recognize care-dependent older persons' deepened dependence when acutely ill, as well as their extended view of the prehospital emergency care chain.
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- Hjalmarsson, Anna, 1976-, et al.
(författare)
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When older persons need Emergency Medical Services at home : a critical incident study on Swedish municipal care personnel
- 2021
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Older persons in Sweden can continue to live at home, assisted by the municipal home care services. Older age raises the risk of emergency situations that require involvement of the emergency medical services (EMS). Such situations intersect two different organizations, the municipal social care services and the regional EMS. The transfer of care between the organizations might impact the older persons´ health, and quality of life or death. Research question: How do municipal care personnel describe their experiences of and actions in situations when older persons are in need of EMS? Design: The study has a qualitative inductive design. Sample: Municipal care personnel (n=19) consisting of home care personnel and security alarm responders. Data collection and analysis: Data was collected through group interviews and free text written critical incidents analyzed according to critical incident technique. Results: Experiences related to the two main areas Lifesaving competence, and Collaborative care, which encompass the four categories Emergency knowledge, Companionship in a vulnerability, Limited caring options and Conditions for EMS collaboration. Actions related to the one main area Adjusting actions to actual conditions, which encompasses the three categories Adapting care to emergency needs, Safeguarding the person, and Adapting actions to EMS leadership.
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