| 1. |
- Rosengren, Kristina, 1963-
(författare)
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Hälso- och sjukvårdsorganisation i förändring : Från distanserat till delat ledarskap
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Syfte: Avhandlingen syftar till att följa upp, beskriva samt generera tentativ teori om pågående förändringsprocesser inom hälso- och sjukvården på såväl makronivå genom studier av sjukhusfusioner som mikronivå genom studier av delat ledarskap. Metod: ”Sjukhusfusioner” beskriver två genomförda sjukhussammanslagningar utifrån en kvalitativ ansats, Grounded Theory med intervjuer av vårdpersonal (I, II). ”Delat ledarskap” utgår från en förändrad ledarskapsmodell på en intensivvårdsavdelning med intervjuer (III-IV) samt frågeformulär (V) som datainsamlingsmetod. Vårdpersonalens uppfattningar av ledarskap redovisas genom en fenomenografisk ansats (III). Vidare beskrivs två avdelningschefers upplevelser av att ha arbetat i ett delat ledarskap genom Grounded Theory (IV). I den sista delstudien (V) används en kvantitativ metod i form av ett frågeformulär. En del av dessa frågor ingår i instrumentet QPSNordic som belyser vårdpersonalens åsikter om arbete, ledarskap och delat ledarskap. Resultat: Vårdpersonalen uttryckte behov av delaktighet och balans mellan olika behov och krav i ett förändringsarbete. Ledarskapets betydelse lyftes fram som en framgångsfaktor för att utveckla hälso- och sjukvårdsorganisationer i förändring. Vårdpersonalens idealbild av sjuksköterskans ledarskap utgjordes av en chef som var närvarande och tillgänglig i den dagliga verksamheten. Begreppet stödjande tvåsamhet lyftes fram som kärnan i delat ledarskap. Stödjande tvåsamhet, en tillitsfull relation mellan avdelningscheferna, bidrog till en god arbetsmiljö då ansvar och befogenheter delades av aktuellt ledarpar. Vårdpersonalen hade en positiv syn på sitt arbete och ledarskapet. De ansåg att det delade ledarskapet ökade avdelningschefernas möjligheter att vara engagerade och tillgängliga i det dagliga arbetet. Konklusion: Resultatet har bildat underlag för två empiriskt grundade modeller; engagerat ledarskap och stödjande tvåsamhet. Engagerat ledarskap utgår från begreppen delaktighet och stöd i en vårdande kultur. Stödjande tvåsamhet bygger på en gemensam värdegrund och olikheter i kompetens hos ledarparet som ligger till grund för utveckling av en tillitsfull relation. Vidare har teorin om det caritativa ledarskapet vidareutvecklats genom begreppet stödjande tvåsamhet som belyser relationen chef till chef i en vårdande kultur.
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| 2. |
- Nilsson, Magnus
(författare)
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The Discourse of Ageism within Anti-ageist Policy
- 2008
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Ingår i: Paper presenterat vid The 6th International Symposium on Cultural Gerontology. Extending Time, Emerging Realities, Imagining Response. University of Lleida, Spanien, 16-18 oktober 2008.
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Konferensbidrag (refereegranskat)
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| 3. |
- Almasri, Abdullah, et al.
(författare)
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Clustering Using Wavelet Transformation
- 2008
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Ingår i: Handbook of Research on Cluster Theory. - Cheltenham : Edward Elgar. - 9781845425166
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Bokkapitel (refereegranskat)
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| 4. |
- Henricson, Maria, 1972-
(författare)
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Tactile touch in intensive care : Nurses' preparation, patients' experiences and the effect on stress parameters
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of this thesis was to acquire knowledge about whether tactile touch as a complementary method can (i) promote comfort and (ii) reduce stress reactions during care in an intensive care unit (ICU) Method: In Paper I, five nurses with a touch therapist training were interviewed about their experiences of preparation before giving tactile touch in an ICU. To analyse the meaning of preparation as a phenomenon, Giorgi’s descriptive phenomenological approach was used. In Paper II and III a randomised controlled trial was set up to investigate the effects of a five-day tactile touch intervention on patients’ oxytocin levels in arterial blood (II), on patients’ blood pressure, heart rate and blood glucose level, and on patients’ levels of anxiety, sedation and alertness (III). Forty-four patients were randomised to either an intervention group (n = 21) or a control group (n = 23). Data were analysed with non-parametric statistics. In Paper IV, six patients who had received the tactile touch intervention were interviewed to illuminate the experience of receiving tactile touch during intensive care. To gain a deeper understanding of the phenomenon and to illuminate the meaning, Ricoeur’s phenomenological hermeneutical method, developed by Lindseth and Norberg, was used. Findings: The nurses need four constituents (inner balance, unconditional respect for the patients’ integrity, a relationship with the patient characterized by reciprocal trust and a supportive environment) to be prepared and go through the transition from nurse to touch therapist (I). In the intervention study, no significant differences were shown for oxytocin levels between intervention and control group over time or within each day (II). There were significantly lower levels of anxiety for patients in the intervention group. There were no significant differences between the intervention and control groups for blood pressure, heart rate, the use of drugs, levels of sedation or blood glucose levels (III). The significance of receiving tactile touch during intensive care was described as the creation of an imagined room along with the touch therapist. In this imagined room, the patients enjoyed tactile touch and gained hope for the future (IV). Conclusion: Nurses needed internal and external balance to be prepared for providing tactile touch. Patients did not notice the surroundings as much as the nurses did. Patients enjoyed the tactile touch and experienced comfort. The impact on stress parameters were limited, except for levels of anxiety which declined significantly. The results gave some evidence for the benefit of tactile touch given to patients in intensive care.
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| 5. |
- Henricson, Maria, 1972-, et al.
(författare)
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The outcome of tactile touch on oxytocin in intensive care patients : a randomized controlled trial
- 2008
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 17:19, s. 2624-2633
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To explore the effects of five-day tactile touch intervention on oxytocin in intensive care patients. The hypotheses were that tactile touch increases the levels of oxytocin after intervention and over a six-day period. Background. Research on both humans and animals shows a correlation between touch and increased levels of oxytocin which inspired us to measure the levels of oxytocin in arterial blood to obtain information about the physiological effect of tactile touch. Design. Randomised controlled trial. Method. Forty-four patients from two general intensive care units, were randomly assigned to either tactile touch ( n = 21) or standard treatment – an hour of rest ( n = 23). Arterial blood was drawn for measurement of oxytocin, before and after both treatments. Results. No significant mean changes in oxytocin levels were found from day 1 to day 6 in the intervention group (mean −3·0 pM, SD 16·8). In the control group, there was a significant ( p = 0·01) decrease in oxytocin levels from day 1 to day 6, mean 26·4 pM (SD 74·1). There were no significant differences in changes between day 1 and day 6 when comparing the intervention group and control group, mean 23·4 pM (95% CI −20·2–67·0). Conclusion. Our hypothesis that tactile touch increases the levels of oxytocin in patients at intensive care units was not confirmed. An interesting observation was the decrease levels of oxytocin over the six-day period in the control group, which was not observed in the intervention group. Relevance to clinical practice. Tactile touch seemed to reduce the activity of the sympathetic nervous system. Further and larger studies are needed in intensive care units to confirm/evaluate tactile touch as a complementary caring act for critically ill patients.
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| 6. |
- Hussain, Shakir, et al.
(författare)
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Performance Evaluation Based on the Robust Mahalanobis Distance and Multilevel Modelling Using Two New Strategies
- 2008
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Ingår i: Communications in statistics. Simulation and computation. - : Informa UK Limited. - 0361-0918 .- 1532-4141. ; 37:10, s. 1966-1980
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Tidskriftsartikel (refereegranskat)abstract
- In this article, we propose a general framework for performance evaluation of organizations and individuals over time using routinely collected performance variables or indicators. Such variables or indicators are often correlated over time, with missing observations, and often come from heavy-tailed distributions shaped by outliers. Two new double robust and model-free strategies are used for evaluation (ranking) of sampling units. Strategy 1 can handle missing data using residual maximum likelihood (RML) at stage two, while strategy two handles missing data at stage one. Strategy 2 has the advantage that overcomes the problem of multicollinearity. Strategy one requires independent indicators for the construction of the distances, where strategy two does not. Two different domain examples are used to illustrate the application of the two strategies. Example one considers performance monitoring of gynecologists and example two considers the performance of industrial firms.
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| 7. |
- Chen, Yaoming, et al.
(författare)
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Wireless E-Care Sensor Network Management
- 2008
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Ingår i: Proceedings of The 1st Workshop on Wireless Broadband Access for Communities and Rural Developing Regions (WIRELESS4D'08, co-located with M4D 2008). - Karlstad : Karlstad University. ; , s. 164-167
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Konferensbidrag (refereegranskat)
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| 8. |
- Henricson, Maria, 1972-, et al.
(författare)
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The outcome of tactile touch on stress parameters in intensive care : a randomized controlled trial
- 2008
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Ingår i: Complementary Therapies in Clinical Practice. - : Elsevier BV. - 1744-3881 .- 1873-6947. ; 14:4, s. 244-254
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Tidskriftsartikel (refereegranskat)abstract
- The study aimed to investigate the effects of a five-day tactile touch intervention in order to find new and unconventional measures to moderate the detrimental influence of patients’ stressors during intensive care. The hypothesis was that tactile touch would decrease stress indicators such as anxiety, glucose metabolism, blood pressure, heart rate and requirements of sedative drugs and noradrenalin. A randomized controlled trial was undertaken with 44 patients, which were assigned either to tactile touch or standard treatment (a rest hour). Observations of the stress indicators were made before, during and after the intervention or standard treatment. The study showed that tactile touch led to significantly lower levels of anxiety. The circulatory parameters suggested increased circulatory stability indicated by a reduction in noradrenalin requirement. The results need to be further validated through studies with larger sample sizes.
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| 9. |
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| 10. |
- Lindmark, Ulrika, 1965-, et al.
(författare)
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Sense of coherence (SOC), a determinant to oral health status among adults? : a cross sectional population study
- 2008
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Ingår i: International Research Seminar on Salutogenesis and at the 1st Research Meeting of the IUHPE Thematic Working Group on Salutogenesis.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim To investigate sense of coherence in relation to oral health status. Method A stratified random sample of 910 individuals from Jönköping, Sweden, aged 20,30,40,50,60,70 and 80 years old, was used. The investigation contained the Swedish 13-items version of the SOC questionnaire and a self-reported questionnaire about demographic information. In addition an oral clinical and radiographical examination was performed. Results A total of 525 individuals participated in the study, 261 men and 264 women. Socioeconomic factors such as age, marital status, income and education had a statistical significant association to SOC. Bivariate analyse showed that higher mean SOC scores had a statistically significant relationships with more decayed filled surfaces (DFS) and filled surfaces (FS), less caries severity, less teeth with calculus and a better periodontal health. Logistic regression analysis showed that Individuals with high SOC score were predictive of high DFS and FS but low gingivitis scores. After controlling for age, high SOC scores showed a protective effect for gingivitis and dental plaque. Conclusions Socioeconomic factors had an association with SOC. Statistical associations were found between SOC scores and oral health status with regard to several important oral clinical variables and high SOC scores may indicate a protective determinant for gingivitis and plaque.
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