| 1. |
|
|
| 2. |
|
|
| 3. |
- Kvarnström, Susanne, 1958-
(författare)
-
Collaboration in Health and Social Care : Service User Participation and Teamwork in Interprofessional Clinical Microsystems
- 2011
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis addresses the relationship between citizens and the welfare state with a focus on the collaboration between service users and professionals in Swedish health and social care services. The overall aim of the thesis was to explore how professionals and service users experience collaboration in health and social care. Descriptive and interpretative study designs were employed in the four studies that comprise this thesis. A total of 87 persons participated in the four studies, including 22 service users and 65 front-line professionals. The research methods included focused group interviews, individual interviews and interactive participant reflection dialogues. The first study describes the discursive patterns in the front-line professionals’ constructions of ‘we the team’ which positions the service user as both a member and a non-member of the interprofessional team. The second study surfaces the difficulties of interprofessional teamwork as perceived by professionals. The third and the fourth studies explore how service users and professionals construct and perceive the concept of service user participation. The findings show that collaboration in terms of service user participation cannot only be understood as contract relationships between consumers and service providers. Service users and professionals perceive that there are several other ways to act as a citizen and for people to exercise human agency in relation to the welfare state. This thesis shows that the various conceptions of service user participation in interprofessional practice encompass dimensions that include themes of togetherness, understanding and interaction within the clinical microsystem. The findings of the four studies are discussed and used to create models that aim to conceptualise collaboration. These models can contribute to learning and improvement processes which facilitate the development of innovative service user-centered clinical microsystems in health and social care.
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
- Kvarnström, Susanne, 1958-, et al.
(författare)
-
How Service Users Perceive the Concept of Participation, Specifically in interprofessional practice
- 2012
-
Ingår i: British Journal of Social Work. - : Oxford University Press (OUP). - 0045-3102 .- 1468-263X. ; 42:1, s. 129-146
-
Tidskriftsartikel (refereegranskat)abstract
- This paper reports on empirical research exploring and describing the variations in service users' conceptions of service user participation (SUP), specifically in interprofessional practice. The social work practices in which front line workers were using interprofessional teamwork were explored at three Swedish welfare institutions. Service users included individuals with chronic pain disorders, obesity conditions or in need of short-term placement in elder care facilities. The qualitative study design was informed by a phenomenographical approach and conducted as semi-structured individual interviews with twenty-two service users. The main findings suggest five qualitative variations of service user's conceptions of SUP: (i) information transmission; (ii) choices and decisions among resources; (iii) comfortable relationship and communication; (iv) interaction for increased understanding; and (v) conditions for service user participation. The findings highlight the importance for the interprofessional team of social workers and other professionals to recognise the various ways of experiencing SUP by service users. The findings thereby support the possibilities to understand and to take into consideration the individual service user's conceptions of SUP in interprofessional practice.
|
|
| 7. |
- Kvarnström, Susanne, 1958-
(författare)
-
Interprofessionella team i vården : En studie om samarbete mellan hälsoprofessioner
- 2007
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There are great expectations that collaboration among professions and various sectors will further develop health care and thus lead to improved public health. In the World Health Organization’s declaration “Health 21” the designated goal for health professions in the member nations in Europe by the year 2010 is to have developed health promotional competence, including teamwork and cooperation based on mutual respect for the expertise of various professions. The challenges faced by the interprofessional teams are, however, multifaceted, and these challenges place demands upon society, which, in turn, determines the fundamental conditions for collaboration among the health professions within the health care organizations.This licentiate dissertation contains discourse and content analyses of interprofessional teamwork in health care. The major objective of this dissertation is to study and describe how the team members construct and create the content and significance of teams and teamwork among health professions. One specific goal has been to study how the members of a multi-professional health care team refer to their team, especially the discursive patterns that emerge and the function that these patterns has (I). The second specific goal has been to identify and describe the difficulties that the health professionals have experienced within their interprofessional teamwork. One purpose has been to enable discussions of the implications for interprofessional learning (II).Focused group interviews with team members (n=32) from six teams were studied using discursive social psychological research approach. The analysis concentrated on the use of the pronouns “I”, “we” and “them”. The results were then analyzed in relation to theories on discursive membership and discursive communities (I). Individual semi-structured interviews with team members (n=18) from four of the six teams were carried out using critical incident techniques. The interviews were analysed via latent qualitative content analysis and the results were interpreted in the light of theories on sociology of professions and learning at work (II).The findings showed that two discursive patterns emerged in the team members’ constructions of “we the team”. These patterns were designated knowledge synergy and trustful support (I). The following three themes that touched upon the difficulties of interprofessional teamwork were identified in the personal interviews: (A) difficulties concerning the teams’ dynamics that arose when the team members acted as representatives for their respective professions; (B) difficulties when the various contributions of knowledge interacted in the team; and (C) difficulties that were related to the surrounding organisation’s influence on the team (II).The conclusion was reached that the discursive pattern provided rhetorical resources for the team members, both in order to reaffirm membership in the team and to promote their views with other care providers, but also to deal with difficulties regarding, for example, lack of unity in outlook. The conclusion was also drawn that, in addition to the individual consequences, one outcome of the perceived difficulties was that they caused limitations of the use of collaborative resources to arrive at a holistic view of the patient’s problems. Thus the patients could not be met in the desired manner.The practical implications of the research project concern the development of teams in which various forms of interprofessional learning can influence the continued development of the team and the management of health care in regard to the importance of implementation processes and organisational learning.
|
|
| 8. |
- Kvarnström, Susanne, 1958-, et al.
(författare)
-
Introducing the nurse practitioner into the surgical ward : an ethnographic study of interprofessional teamwork practice
- 2018
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 32:2, s. 765-771
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The first nurse practitioners in surgical care were introduced into Swedish surgical wards in 2014. Internationally, organisations that have adopted nurse practitioners into care teams are reported to have maintained or improved the quality of care. However, close qualitative descriptions of teamwork practice may add to existing knowledge of interprofessional collaboration when introducing nurse practitioners into new clinical areas. The aim was to report on an empirical study describing how interprofessional teamwork practice was enacted by nurse practitioners when introduced into surgical ward teams.Methods and results: The study had a qualitative, ethnographic research design, drawing on a sociomaterial conceptual framework. The study was based on 170 hours of ward‐based participant observations of interprofessional teamwork practice that included nurse practitioners. Data were gathered from 2014 to 2015 across four surgical sites in Sweden, including 60 interprofessional rounds. The data were analysed with an iterative reflexive procedure involving inductive and theory‐led approaches. The study was approved by a Swedish regional ethics committee (Ref. No.: 2014/229‐31). The interprofessional teamwork practice enacted by the nurse practitioners that emerged from the analysis comprised a combination of the following characteristic role components: clinical leader, bridging team colleague and ever‐present tutor. These role components were enacted at all the sites and were prominent during interprofessional teamwork practice.Conclusion: The participant nurse practitioners utilised the interprofessional teamwork practice arrangements to enact a role that may be described in terms of a quality guarantee, thereby contributing to the overall quality and care flow offered by the entire surgical ward team.
|
|
| 9. |
- Kvarnström, Susanne, 1958-, et al.
(författare)
-
Multiparty team talk : Constructions of user participation in an interprofessional team context
- 2009
-
Ingår i: Communication, Medicine & Ethics.
-
Konferensbidrag (refereegranskat)abstract
- Background. Today health and social care delivery are largely team based but the question remains whether the voice of the user is perceived as a team member or merely as the recipient of the care. There have however been few efforts to understand or change the smallest interprofessional frontline units who generate the actual service, i.e. the microsystems.Purpose. This paper presents preliminary findings regarding descriptions of constructions of user participation in a multiparty negotiation context.Materials and methods. The material consisted of ethnographic field notes and audiotapes from observations (n=8) of interprofessional team meetings in one clinical healthcare microsystem. The teams included the user and health professionals, e.g. medical social worker, physician and psychologist. The users who participated in the observed team meetings had all long-term mainly physical conditions.Findings and discussion. Preliminary inductive analyses of observations of interprofessional team situations involving users indicates identity constructions in multiparty talk where the user is beheld primarily as a loyal and active member of the team. Discussions will relate to how user participation is learned and constructed by users and health professionals in collaborative care at the microsystem level.
|
|
| 10. |
|
|
