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- Dellenborg, Liselott (Lisen), 1966, et al.
(författare)
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Factors that may promote the learning of person-centred care: an ethnographic study of an implementation programme for healthcare professionals in a medical emergency ward in Sweden
- 2019
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Ingår i: Advances in Health Sciences Education. - : Springer Science and Business Media LLC. - 1382-4996 .- 1573-1677. ; 24:2, s. 353-381
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Tidskriftsartikel (refereegranskat)abstract
- While person-centred care has gained increasing prominence in recent decades as a goal for healthcare systems, mainstream implementation remains tentative and there is a lack of knowledge about how to develop person-centred care in practice. This study therefore aimed to explore what may be required in order for person-centred care programmes to be successful. The study used an ethnographic method of data collection. This consisted of closely following an implementation programme on a medical emergency ward in a Swedish hospital. Data consisted of participant observation and informal interviews with healthcare providers and their management leaders while they were in the process of training to use person-centred care. These interlocutors were using action learning methods under the guidance of facilitators. Our findings revealed that although the programme resulted in some of the processes that are central for person-centred care being developed, organisational factors and a lack of attention to ethics in the programme counteracted these positive effects. The study highlights the importance of facilitating mechanisms to produce desired results. These include management leaders’ learning about the dynamic and collective nature of learning processes and change. They also include allowing for inter-professional dialogue to enable managers and professionals to reflect deeply on professional boundaries, disciplinary knowledge and power relations in their teams. Teamwork is essential for the development of person-centred care and documentation, in accordance with this specific implementation programme, is also indispensable. The space for inter-professional dialogue should also accommodate their various perspectives on the aims of care and organizational reality.
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- Erichsen Andersson, Annette, 1966, et al.
(författare)
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Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room : experiences from the safe hands study
- 2018
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hand hygiene and aseptic techniques are essential preventives in combating hospital-acquired infections. However, implementation of these strategies in the operating room remains suboptimal. There is a paucity of intervention studies providing detailed information on effective methods for change. This study aimed to evaluate the process of implementing a theory-driven knowledge translation program for improved use of hand hygiene and aseptic techniques in the operating room.METHODS: The study was set in an operating department of a university hospital. The intervention was underpinned by theories on organizational learning, culture and person centeredness. Qualitative process data were collected via participant observations and analyzed using a thematic approach.RESULTS: Doubts that hand-hygiene practices are effective in preventing hospital acquired infections, strong boundaries and distrust between professional groups and a lack of psychological safety were identified as barriers towards change. Facilitated interprofessional dialogue and learning in "safe spaces" worked as mechanisms for motivation and engagement. Allowing for the free expression of different opinions, doubts and viewing resistance as a natural part of any change was effective in engaging all professional categories in co-creation of clinical relevant solutions to improve hand hygiene.CONCLUSION: Enabling nurses and physicians to think and talk differently about hospital acquired infections and hand hygiene requires a shift from the concept of one-way directed compliance towards change and learning as the result of a participatory and meaning-making process. The present study is a part of the Safe Hands project, and is registered with ClinicalTrials.gov (ID: NCT02983136 ). Date of registration 2016/11/28, retrospectively registered.
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- Wikström, Ewa, 1967, et al.
(författare)
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The Safe Hands Study: Implementing aseptic techniques in the operating room : Facilitating mechanisms for contextual negotiation and collective action
- 2019
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Ingår i: American Journal of Infection Control. - : Elsevier BV. - 0196-6553 .- 1527-3296. ; 47:3, s. 251-257
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Even though hand hygiene and aseptic techniques are essential to provide safe care in the operating room, several studies have found a lack of successful implementation. The aim of this study was to describe facilitative mechanisms supporting the implementation of hand hygiene and aseptic techniques.METHODS: This study was set in a large operating room suite in a Swedish university hospital. The theory-driven implementation process was informed by the literature on organizational change and dialogue. Data were collected using interviews and participant observations and analyzed using a thematic approach. The normalization process theory served as a frame of interpretation during the analysis.RESULTS: Three facilitating mechanisms were identified: (1) commitment through a sense of urgency, requiring extensive communication between the managers, operating room professionals, and facilitators in building commitment to change and putting the issues on the agenda; (2) dialogue for co-creation, increasing and sustaining commitment and resource mobilization; and (3) tailored management support, including helping managers to develop their leadership role, progressively involving staff, and retaining focus during the implementation process.CONCLUSIONS: The facilitating mechanisms can be used in organizing implementation processes. Putting the emphasis on help and support to managers seems to be a crucial condition in complex implementation processes, from preparation of the change process to stabilization of the new practice.
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- Arola, Lea Annikki, 1961, et al.
(författare)
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Occupational perspective of health among persons ageing in the context of migration
- 2018
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Ingår i: Journal of Occupational Science. - : Informa UK Limited. - 1442-7591 .- 2158-1576. ; 25:1, s. 65-75
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Tidskriftsartikel (refereegranskat)abstract
- In the context of migration, ageing is described as a negative stressor for subjective perceptions of health in everyday life. Most research has adopted a biomedical perspective. An occupational perspective of health was the starting point for this study. The aim was to explore how older persons from Finland who are ageing in Sweden experienced health from an occupational perspective. Qualitative interviews were conducted with 16 persons who had migrated from Finland to Sweden as labour immigrants several decades ago. The interviews were analysed and interpreted using a hermeneutic approach. Participants experienced health when they managed their daily life occupations. Health was also reinforced through affiliation with others who shared similar life situations. A key health resource was maintaining a sense of dual belonging to the country of birth and to the host country. The present study revealed that the experience of health could be seen as a continuum in time and place, which creates a sense of belonging and continuity in life. Connections between health and doing, being and becoming are fundamental aspects to consider when enabling health in everyday life among older persons ageing in the context of migration.
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- Dellenborg, Liselott (Lisen), 1966
(författare)
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A Living Intervention – Anthropology and the Search for Person-centred Teamwork in a Hospital Ward in Sweden
- 2020
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Ingår i: Kritisk etnografi - SWEDISH JOURNAL OF ANTHROPOLOGY. - 2003-1173. ; 3:2, s. 105-124
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Tidskriftsartikel (refereegranskat)abstract
- This article draws on a long-term, team-driven project in a Swedish hospital ward to provide an ethnographic description how anthropology can be used in practice to support healthcare providers in their everyday work. I argue that ethnographic research, by affording participants in the ward an outsider’s view of their workplace and routines, can facilitate healthcare providers’ own process of reflection, communication, and the development of solutions to problems. The project aimed at facilitating change in relation to three challenging circumstances identified by the hospital ward management and staff: better-functioning communication on the ward, closer and more collaborative inter-professional teamwork, and deeper and more respectful integration of the patients in what was termed person-centred care. As an anthropologist I moderated a series of workshops in which I presented fieldwork insights, organised small-group work, and facilitated dialogue. The workshops enabled co-learning and collective reflection across professional boundaries, empowering the healthcare professionals to identify steps for better teamwork and patient care.
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