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Sökning: WFRF:(Wilde Larsson Bodil)

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  • Alvinius, Aida, et al. (författare)
  • Managing Boundaries in Integrated Care : A Qualitative Study of Collaboration between Municipalities and County Councils in Sweden
  • 2016
  • Ingår i: International Journal of Organization Theory and Behavior. - Highland Beach, Florida, USA : PrAcademics Press. - 1093-4537 .- 1532-4273. ; 19:2, s. 139-165
  • Tidskriftsartikel (refereegranskat)abstract
    • Swedish healthcare has undergone continuous development over several decades. Today, legal responsibility is shared on the local and regional levels, i.e. between municipalities and county councils. The purpose of the present study is to gain a deeper understanding of boundary spanning roles and strategies involved in municipal and county council collaboration. A grounded theory approach was used. Fifteen informants from several Swedish health care authorities were interviewed. A tension exists between preserving boundary strategies that stifle collaboration and boundary spanning strategies that facilitate it. The way boundary spanners manage their role is assumed to influence the centre of gravity for this tension and thus the combination of favourable boundary spanning strategies and favourable boundary spanning roles is one way of getting the current form of collaboration to work.
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  • Kennedy, Catriona, et al. (författare)
  • Diagnosing dying : an integrative literature review
  • 2014
  • Ingår i: BMJ Supportive & Palliative Care. - London : BMJ Publishing Group Ltd. - 2045-435X .- 2045-4368. ; 4:3, s. 263-270
  • Tidskriftsartikel (refereegranskat)abstract
    • Background To ensure patients and families receive appropriate end-of-life care pathways and guidelines aim to inform clinical decision making. Ensuring appropriate outcomes through the use of these decision aids is dependent on timely use. Diagnosing dying is a complex clinical decision, and most of the available practice checklists relate to cancer. There is a need to review evidence to establish diagnostic indicators that death is imminent on the basis of need rather than a cancer diagnosis.Aim To examine the evidence as to how patients are judged by clinicians as being in the final hours or days of life.Design Integrative literature review.Data sources Five electronic databases (2001–2011): Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library, MEDLINE, EMBASE, PsycINFO and CINAHL. The search yielded a total of 576 hits, 331 titles and abstracts were screened, 42 papers were retrieved and reviewed and 23 articles were included.Results Analysis reveals an overarching theme of uncertainty in diagnosing dying and two subthemes: (1) ‘characteristics of dying’ involve dying trajectories that incorporate physical, social, spiritual and psychological decline towards death; (2) ‘treatment orientation’ where decision making related to diagnosing dying may remain focused towards biomedical interventions rather than systematic planning for end-of-life care.Conclusions The findings of this review support the explicit recognition of ‘uncertainty in diagnosing dying’ and the need to work with and within this concept. Clinical decision making needs to allow for recovery where that potential exists, but equally there is the need to avoid futile interventions.
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  • Larsson, Gerry, et al. (författare)
  • Changes over time in the importance patients ascribe to different aspects of care : On the need to improve person-centeredness
  • 2012
  • Ingår i: The International Journal of Person Centered Medicine. - United Kingdom : The University of Buckingham Press. - 2043-7730 .- 2043-7749. ; 2:3, s. 482-490
  • Tidskriftsartikel (refereegranskat)abstract
    • Rational and aim: Knowledge of which aspects of care are more important to patients is crucial for health providers. The aim of the work presented here was to explore changes over time in patients’ preferences in hospital and in out-patient settings.Method: Cross-sectional data were collected among patients at a number of Swedish hospital wards and out-patient clinics in 2003, 2004, 2005 and 2008 (N = 46,525). Data for men and women were analysed separately. The main outcome measure consisted of replies to the questionnaire “Quality from the Patient’s Perspective” (QPP) (numerous references).Results: (1) Subjective importance (preference) ratings increased throughout the time period studied, (2) in-patients gave higher ratings than out-patients and (3) women gave higher ratings than men, particularly in out-patient settings.Conclusion: The increase over time in ratings of the importance ascribed to different aspects of care may reflect a general trend towards strengthened consciousness among citizens as consumers of care and is an important index for improving the person-centeredness of clinical services.
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