| 1. |
- Ekman, Inger, 1952, et al.
(författare)
-
Person-centered care -ready for prime time.
- 2011
-
Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 10:4, s. 248-251
-
Tidskriftsartikel (refereegranskat)abstract
- Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that PCC is systematically and consistently practiced, i.e. not just when we feel we have time for it. In this paper, we propose a few simple routines to facilitate and safeguard the transition to PCC. We believe that if conscientiously and systematically applied, they will help to make PCC the focus and mainstay of care in long-term illness.
|
|
| 2. |
- Dahlin-Ivanoff, Synneve, 1950, et al.
(författare)
-
Comprehensive geriatric assessment of frail older people: ideals and reality
- 2018
-
Ingår i: Journal of Interprofessional Care. - : Informa UK Limited. - 1356-1820 .- 1469-9567. ; 32:6, s. 728-734
-
Tidskriftsartikel (refereegranskat)abstract
- We explored different professionals’ views on and experiences of comprehensive geriatric assessment (CGA) of frail older people. Forty-six professionals working in hospitals, primary care, or municipal health and social care participated in 10 focus groups. Professional groups comprised of occupational therapists, physiotherapists, nurses, physicians, and social workers. Participants shared an ideal image of how the CGA of frail elderly people should be conducted. Experience-based competence was more often used as an assessment tool than standardized tests. The ideal image contrasted with reality, listening to the needs expressed, with the person’s problems, needs, and priorities in the foreground, as described by the categories: a need that can be met; different perspectives on needs; needs can be hidden; and needs assessment is affected by the collaboration around the person, by the context, and by the dialogue. The health and social care professionals’ first priority is to make a person-centred tailor-made comprehensive geriatric assessment and not be bound to instruments. Clear guidelines need to be developed, stating which profession assesses what, when and how in order to ensure that person-centred needs are assessed including structures and procedures for how communication and collaboration within the team as well as between the organizations are achieved in order to perform a good person-centred CGA.
|
|
| 3. |
- Lindahl, Berit, 1955, et al.
(författare)
-
A meta-synthesis describing the relationships between patients, informal caregivers and health professionals in home-care settings
- 2011
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 20:3/4, s. 454-463
-
Tidskriftsartikel (refereegranskat)abstract
- The present study describes, through a meta-synthesis, the relationship between patients, informal caregivers and health professionals involved in home care. Today, many people receive help from health care professionals in their homes with the consequence that, for many health care professionals, their working place is the patients' homes. Research that addresses the dynamics in the caring relationship in home care seems to be rare. A meta-synthesis is an integrated interpretation of qualitative research findings, which is more substantive than the results from each individual investigation. We performed a systematic literature search regarding studies published during the period 1992-2005, using the search terms home nursing, professional and home health care. The included studies described relations in a home care context, between health professionals and patients or relations between health professionals, patients and their informal caregivers published in the same study. The fi ; ndings showed that when professionals entered people's home, the private area changed. The study presents an interpretation of the changed meanings of home as the place and space for professional care. We described the meanings of the relationship in two main themes with subthemes. The main themes are 'being there' and 'home care as a co-creation'. The understanding of relationships in home care is seen as the development of a professional friendship. This concept is reflected on through the writings of Aristotle and Alberoni. To address these concerns, it is important that home care providers, recipients and their family members develop friendships. These friendships should be a part of any professional relationship. When health professionals enter patients' homes, they have to be aware of the risk of transgressing borders of privacy. In addition, devaluing patients' or their informal caregivers' knowledge and their opinions about the care is interpreted as an exercise of institutiona ; l power.
|
|
| 4. |
- Lundin Gurné, Frida, et al.
(författare)
-
Striving to be in close proximity to the patient: An interpretive descriptive study of nursing practice from the perspectives of clinically experienced registered nurses
- 2021
-
Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 28:2
-
Tidskriftsartikel (refereegranskat)abstract
- © 2020 The Authors. Nursing Inquiry published by John Wiley & Sons Ltd This paper explores essential characteristics of current nursing practice from the perspectives of clinically experienced registered nurses in various fields of health care in Sweden. Nursing practice has been the subject of much debate in the past and because of its complexity as well as continuous changes in society it is important to continue the debate. A qualitative study, including 16 group interviews with altogether 74 participants, was conducted. Nursing practice was viewed as a multifaceted field. The participants struggled to define nursing but were able to describe it using concrete examples. The analysis, using interpretive description, identified current practice as essentially consisting of: ‘A practice pervaded by comprehensive responsibility’, ‘A practice that recognises a patient's unique needs’, ‘A practice based on multifaceted knowledge’ and ‘A practice that mediates between traditional values and changing demands’. Current nursing practice can be understood as striving to be in close proximity to the patient, but in tension with pervasive requirements and societal changes. Going forward, it is necessary to continue to reflect on and discuss the nature of nursing practice in an interprofessional context. Studies from primary and home care are also needed to broaden the understanding of nursing practice.
|
|
| 5. |
- Alnervik, Karin, 1958-, et al.
(författare)
-
Barn och vårdnadshavares minnen av deltagande i pedagogisk dokumentation
- 2018
-
Ingår i: Nordisk Barnehageforskning. - : OsloMet – storbyuniversitetet. - 1890-9167. ; 17:1
-
Tidskriftsartikel (refereegranskat)abstract
- Syftet med artikeln är att bidra till kunskapandet om pedagogisk dokumentation med specifikt fokus på dokumentationens betydelse ur ett demokratiperspektiv. Trots många studier kring pedagogisk dokumentation finns det få studier som explicit utgår ifrån barn och vårdnadshavares perspektiv. I artikeln analyseras barns och vårdnadshavares samtal utifrån minnesbilder, vilka framträder i fokusgruppssamtal, från förskoletiden i relation till pedagogiskt dokumentationsarbete. Resultatet visar att den pedagogiska dokumentationspraktiken bidrog till skapandet av en praktikgemenskap på förskolan vilket i sin tur möjliggjorde en demokratisk undervisning.
|
|
| 6. |
- Bångsbo, Angela, 1968, et al.
(författare)
-
Barriers for Inter-Organisational Collaboration: What Matters for an Integrated Care Programme?
- 2022
-
Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 22:22
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Inter-organisational collaboration is challenging but essential in managing the complex and comprehensive needs of frail older people. Therefore, there is a need to investigate the influence of different barriers to inter-organisational collaboration when implementing an integrated care programme. The aim of this study was to investigate both inpatient and outpatient staff views on the factors they deemed to be influential to inter-organisational collaboration for an integrated care programme. Methods: The study was a cross-sectional study and included staff from hospitals, primary care and municipal health and social care. Results: There were no significant differences between staff from inpatient and outpatient care in measuring factors that may cause difficulties for inter-organisational collaboration. Staff views diverged significantly on all factors, such as educational level at long physical distances, laws and regulations, knowledge of each others work settings, experience from inter-organisational collaboration, different professions, variations in professional status and power, psychosocial factors such as positive work environment and interpersonal chemistry. Discussion: A multidisciplinary team culture and avenues for inter-organisational collaboration need to be developed for improved care continuity. Conclusion: The staffs’ educational level influenced what was perceived as barriers to inter-organisational collaboration, and may guide future development of integrated care programmes.
|
|
| 7. |
- Bångsbo, Angela, 1968, et al.
(författare)
-
Collaboration in discharge planning in relation to an implicit framework
- 2017
-
Ingår i: Applied Nursing Research. - : Elsevier BV. - 0897-1897 .- 1532-8201. ; 36, s. 57-62
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of our study was to explore healthcare and social care professionals’ experiences of preconditions for interorganizational and interprofessional collaboration to support frail elderly patients in discharge planning conferences. Background: At the time for hospital discharge, healthcare and social care professionals have to balance safe care, need for continuity of care, and elderly patients’ own expectations with economical demands. Therefore, collaboration interorganizationally and interprofessionally is essential, since deficiencies are risks to patient safety. Methods: Four focus groups, which consisted of 30 participants—occupational therapists, social workers, physiotherapists, and nurses from hospital, primary care, municipal health, and social welfare—were held. Results: The tacit framing of normative and contextual aspects that influenced discharge conferences’ outcomes, such as around decision-making about post-discharge activities, was identified as a main category in the results, comprised of the following four categories: (1) Different perceptions of prioritizing the elderly patients’ involvement in practice; (2) Choice of method for information transferal affecting collaboration; (3) The limited timeframe affecting assessments and choice of actions; (4) Underlying professional hierarchies. Conclusions: Overall, we found professional hierarchies and organizational administrative demands on efficiency reduced collaboration interorganizationally and between healthcare and social care professionals. Based on our findings, it is our opinion further development is needed both locally at hospitals and at a systemic level in Sweden.
|
|
| 8. |
- Bångsbo, Angela, 1968, et al.
(författare)
-
Kommunikativa processer och upplevelser av delaktighet i vård- och omsorgsplaneringsmöten
- 2010
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Äldre personer med flera ohälsoproblem och komplexa vård- och omsorgsbehov är en ökande grupp i samhället. För att åstadkomma en vård och omsorg som svarar mot den enskilda personens behov är samverkan mellan olika vårdgivare och professioner en viktig utgångspunkt vid vård- och omsorgsplanering. I denna studie har vi undersökt hur delaktighet för patienter skapas vid vård- och omsorgsplaneringsmöten (VOP-möten) samt hur deltagarna upplever detta. Datamaterialet består av bandinspelade VOP-möten samt efterföljande intervjuer med mötesdeltagarna. I datamaterialet ingick dels möten som genomfördes av vård- och omsorgspersonal vars huvudsakliga arbetsuppgift är att genomföra vård- och omsorgsplaneringar (här kallade specialiserade vårdplaneringsteam), dels möten som genomfördes av personal som inte specifikt arbetade enbart med VOP-möten. De inspelade VOP-mötena analyserades utifrån dimensionerna aktiv-passiv, subjekt-objekt. I analysen belystes hur såväl patienternas, närståendes samt vård- och omsorgspersonalens förhållningssätt bidrog till den bild av patienten som framställdes under mötet. Resultatet presenteras utifrån följande kategorier: Att vara ett ”aktivt subjekt”, d v s att man är delaktig i sin vård- och omsorgsplanering och förväntas ta ansvar vid formulering av målsättningar; Att vara ett ”passivt subjekt” det vill säga patienten framstår som en hel person som lever i ett livssammanhang men som på grund av hälsoskäl eller påverkan i omgivningen inte är så delaktig vid VOP-mötet; Att vara ett ”aktivt objekt” vilket innebär att endast begränsade aspekter av personen framträder exempelvis genom att patienten bidrar till en beskrivning av sig själv som ett objekt; samt slutligen; Att vara ett ”passivt objekt” där patienten fråntas möjligheten att delta i bedömning eller planering av vård och omsorg. I resultatet beskrivs dessutom omständigheterna kring mötet, ”Samtalsramen”, samt deltagarnas upplevelser före, under och efter mötet. I resultatet framkom att patienterna i huvudsak var aktiva vid VOP-mötena och bemöttes som subjekt. Patienternas delaktighet underlättades i den här studien av att de var väl förberedda inför mötet, de visste vad mötet skulle handla om, flera hade tidigare erfarenheter av VOP-möten och de gavs möjlighet att berätta vem man var och hade varit. Patienterna beskrev i de efterföljande intervjuerna att de, inför VOP-mötet, kände en oro att självbilden skulle komma att förändras från självständighet till beroende. Patienterna beskrev i de flesta fall att de kände sig bekväma under mötet. Vidare framkom att patienterna efter mötet upplevde både att deras önskemål infriats, men också en medvetenhet om att livsavgörande beslut hade aktualiserats, vilket kunde föranleda såväl besvikelse som anpassning till en ny livssituation. Resultatet kan inte sägas representera hur VOP-möten generellt sett genomförs och upplevs. Begränsningar i datamaterialet består av att inspelningarna av VOP-möten och intervjuer ägde rum i ett område där det fanns god tillgång på korttidsplatser. Majoriteten av datamaterialet utgjordes också av möten med vårdpersonal som var särskilt erfarna och intresserade av arbetsuppgiften. Denna rapport kan därför sägas beskriva i huvudsak ”goda exempel” på vård- och omsorgsplaneringsmöten, d v s när det fungerar väl. Trots detta anser vi att den modell som beskriver hur patienterna positionerar sig och positioneras som aktiv/passiv, subjekt/objekt är giltig och möjlig att använda i alla typer av VOP-möten och kan tjäna som stöd för att förstå vad som händer och hur det händer i kommunikationsprocessen.
|
|
| 9. |
- Bångsbo, Angela, 1968, et al.
(författare)
-
Patient participation in discharge planning conference.
- 2014
-
Ingår i: International journal of integrated care. - 1568-4156. ; 14
-
Tidskriftsartikel (refereegranskat)abstract
- There is a need for individualized discharge planning to support frail older persons at hospital discharge. In this context, active participation on their behalf cannot be taken for granted. The aim of this study was to elucidate patient participation in discharge planning conferences, with a focus on frail older persons, supported by the theory of positioning described by Harré & van Langenhove.
|
|
| 10. |
- Bångsbo, Angela, PhD, 1968-, et al.
(författare)
-
Preconditions to implementation of an integrated care process programme
- 2021
-
Ingår i: Journal of Integrated Care. - : Emerald Group Publishing Limited. - 1476-9018.
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeThe purpose of this study was to investigate the preconditions of a full-scale implementation of an integrated care process programme for frail older people from the staff's understanding, commitment and ability to change their work procedures with comparisons over time and between organisations.Design/methodology/approachA repeated cross-sectional study was conducted in a hospital, municipal health and social care setting.FindingsStaff commitment decreased to the importance of a permanent municipal contact from baseline compared to the 12-months follow-up (p = 0.02) and the six- and 12-months follow-up (p = 0.05), to the information transfer from emergency department from the six- to the 12-months follow-up (p = 0.04), to discharge planning at the hospital at six- and 12-months follow-up (p = 0.04) and towards discharge planning at home from baseline to the six-month follow-up (p = 0.04). Significant differences occurred between the organisations about information transfer from the emergency department (p = 0.01) and discharge planning at home (p = 0.03). The hospital staff were the most committed.Practical implicationsThe results can guide the implementation of complex interventions in organisations with high-employee turnover and heavy workload.Originality/valueThe study design, allowing the comparison of implementation results over time and between organisations in a later phase, gives this study a unique perspective.
|
|
