| 1. |
- Alverbratt, Catrin, et al.
(författare)
-
A New Working Method in Psychiatric Care : the impact of implementation
- 2016
-
Ingår i: International Journal of Public Administration. - : Informa UK Limited. - 0190-0692 .- 1532-4265. ; 40:3, s. 295-304
-
Tidskriftsartikel (refereegranskat)abstract
- An equal mix of organizational cultures is important for a successful implementation process. The aim of this study was to examine the implementation of a new working method in psychiatric hospital wards, representing different cultural characteristics. Descriptive quantitative data were collected at two hospitals (intervention and control). The results revealed one ward characterized by a mix of organizational cultures. This ward, compared with other intervention wards, showed the best results regarding patient assessed empowerment and participation. The result shows tentatively that organizational culture may have an impact on the implementation processes.
|
|
| 2. |
- Alverbratt, Catrin
(författare)
-
Implementation of a New Working Method in Psychiatric Care
- 2015
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The implementation of evidence-based methods in hospital settings is challenging and multifaceted. There are several different factors that may affect implementation processes, of which the organisational culture may be one. It is well known that conservative organisational culture can hinder implementations; accordingly, a mix of different organisational cultures is preferable. Aim: The aim of this thesis was to follow the implementation process of an ICF-based assessment tool regarding cultural differences associated with the implementation in a psychiatric clinic. As part of the project, an assessment tool based on the International classifi cation of functioning disability and health (ICF) was developed and implemented. Method: In Study I, three Swedish expert groups participated and analysis of inter-rater reliability was conducted through simulated patient cases. In Study II, data were collected through focus group interviews pre- and post-implementation of the ICF-based assessment tool; thereafter, data were analysed using directed content analysis guided by Normalization Process Theory (NPT). Data from 109 nursing staff who completed the organisational values questionnaire (OVQ) and resistance to change (RTC) were investigated, and the association between the OVQ and RTC was examined with regression analysis (Study III). Patients n=50 representing the intervention hospital and n=64 representing the control hospital answered the Empowerment scale (ES) and Quality in psychiatric care (QPC-IP) (n=45 from intervention hospital and n=64 from control hospital). Staff n=37 at the control hospital answered the OVQ which was presented as descriptive data (Study IV). Results: Inter-rater reliability of the ICF-based assessment tool (DLDA) displayed acceptable kappa values (Study I). The DLDA tool showed the potential for empowering patients. Furthermore, it was considered useful for dialogues, refl ection and for identifying patients’ strengths. Nonetheless, it was diffi cult to implement it in practice due to contributing factors such as time pressure, heavy workload, stress and lack of routine in using the tool (Study II). The intervention hospital was characterised by an organisational culture of trust, belongingness and fl exibility, i.e. a human relation culture. One ward (I.W.3), however, was not dominated by a human relation culture. This ward had an almost equal mix of different cultures (human relation, open system, internal processes and rational goal) (Study III). The results of Study IV were non-signifi cant; however, it indicated that intervention ward 3 proved to be the most prominent ward regarding patient participation and empowerment among the intervention group. The results suggest hospital wards with equal mix of different cultures is more successful than cultural polarisation. Conclusion: Only one of fi ve wards succeeded in implementing the DLDA successfully (ward 5). Ward number three was the most successful of the inpatient intervention wards. The intent of the DLDA method was considered to be good and its use in a psychiatric nursing context can provide structured support in order to improve the dialogue with the patient, but it was not used in practice in all the studied wards. The organisational culture of the intervention hospital was dominated by human relation properties, however with one exception, ward number three. The results tentatively show that organisational culture may affect outcomes of implementation processes. Consequently, it appears that an equal mix of different cultures are more auspicious than cultural polarisations. The results seems to confi rm previous research, where one ward with a balanced mix of different cultures succeeded best to implement DLDA, of the wards representing psychiatric inpatient care. Ward number three did also show the best results in terms of empowerment and patient participation of the intervention wards. Further research aims to continue developing and conducting psychometric testing of the DLDA tool. The DLDAs impact on patient assessed empowerment and patient participation requires studies on larger populations than the current study
|
|
| 3. |
- Alverbratt, Catrin, et al.
(författare)
-
The process of implementing a new working method - a project towards change in a Swedish psychiatric clinic
- 2014
-
Ingår i: Journal of Hospital Administration. - : Sciedu Press. - 1927-6990 .- 1927-7008. ; 3:6, s. 174-189
-
Tidskriftsartikel (refereegranskat)abstract
- The implementation of evidence-based methods in hospital settings is difficult and complex. The aim of the present study was to highlight the implementation process concerning a new working method, i.e. a new assessment tool, based on the International Classification of Functioning Disability and Health (ICF), among psychiatric nursing staff on five participating wards at a Swedish county hospital. Descriptive, qualitative data were collected through focus group interviews pre- and post-implementation. Data were analysed using directed content analysis, guided by Normalization Process Theory (NPT). The results revealed that just one of the five participating wards met the criteria for a successful implementation process. The results confirm previous studies showing the difficulty of implementation. Although participants agreed with the intention of the model, they were reluctant to apply it in practice. The implementation process seemed to be influenced by factors such as: time pressure; heavy workload; stress; lack of routines in using the tool; lack of nursing staff; as well as cultural characteristics and resistance to change.
|
|
| 4. |
- Truong, Anh, et al.
(författare)
-
Caring for Persons With Intellectual Disabilities and Challenging Behavior : Staff Experiences With a Web-Based Training Program
- 2021
-
Ingår i: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 12
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Clear and effective communication is a prerequisite to provide help and support in healthcare situations, especially in health, and social care services for persons with intellectual disabilities, as these clients commonly experience communication difficulties. Knowledge about how to communicate effectively is integral to ensuring the quality of care. Currently, however, there is a lack of such knowledge among staff working in the disabilities sector, which is exacerbated by challenges in the competence provision in municipal health and social care services. Therefore, the aim of the study was to explore staffs' experience of web-based training in relation to their professional caring for persons with intellectual disabilities and challenging behavior. The intention is to move toward well-evaluated and proven web-based training in order to contribute to competence provision in this specific context.Methods: Fourteen semi-structured interviews were carried out with individual staff members to gather data regarding their experiences with web-based training in relation to their profession. The collected data were analyzed using qualitative content analysis with a focus on both manifest and latent content.Results: The staff's experiences with the web-based training program were presented as a single main theme: "Web-based training for staff initiates a workplace learning process by promoting reflections on and awareness of how to better care for persons with intellectual disabilities and challenging behavior." This theme contained three categories which are based on eight sub-categories.Conclusion and clinical implications: The benefits of web-based training for workplace learning could clearly be observed in the strengthening of professional care for persons with intellectual disabilities and challenging behavior. Staff members claimed to have gained novel insights about how to better care for clients as well as about the importance of interactions in their encounters with clients. Professional teamwork is crucial to providing effective care for persons with intellectual disabilities and challenging behavior. Hence, future research aimed at investigating the views of other healthcare professionals, such as registered nurses, is recommended to improve the competence provision within municipal health and social care services and thereby enhance the quality of care.
|
|
| 5. |
- Truong, Anh, et al.
(författare)
-
Caring for Persons With Intellectual Disabilities and Challenging Behavior : Staff Experiences With a Web-Based Training Program
- 2022
-
Ingår i: International Conference on Work Integrated Learning. - Trollhättan : University West. - 9789189325302 ; , s. 39-41
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The quality of care for persons with intellectual disabilities (ID) is affected by many factors, including the knowledge of the professionals. Educational training in, for example, general communication was identified as a priority issue among healthcare professionals working with persons with IDs, as it is the basis for a better understanding of the clients and their behavior, which can otherwise be perceived as problematic and challenging. Challenging behaviors (CB) have been reported by professionals as problems they frequently witness or experience and/or struggle to manage in the daily work. Yet they do not always have access to such training nor to the resources needed to practice skillful communication when supporting persons with IDs. In addition, challenges concerning the competence provision in the sector are likely to contribute to further deterioration of the situation.Earlier research has shown that web-based training for staff within healthcare settings can generate good results. In addition to being able to participate during work hours, staff can also overcome access issues in the delivery of training. With this study, we hope to advance an existing web-based training program with the intention to move toward well-evaluated and proven training in order to contribute to competence provision in the context of health and social care.Aim: To explore staff experiences with a web-based training program in relation to their professional care for persons with ID and CB. Methods: Staff working in residences for people with ID within municipal health and social care were offered the web-based training. In total 20 residences in a medium-size city in Sweden were included in this study. After completed training, fourteen semi-structured interviews were carried out with individual staff members to gather data regarding their experiences with web-based training in relation to their profession. The informants constituted of 11 women and 3 men, aged 27–55. Of the nine informants who had received upper secondary school education, five had specialized in the care of persons with IDs. More precisely, one informant had received higher vocational education, whereas the remaining four had received university education in the social sciences. The work experience with persons with IDs ranged from 8 to 30 years. The interviews were based on two open -ended questions: “What is your experience of attending the web-based training?” and “What do you think about the web-based training in relation to your daily work with persons with IDs and CB?” Follow-up questions were directed in such a way as to encourage the staff to freely share their experiences. This study has an inductive approach. The collected data were analyzed using qualitative content analysis as described by Graneheim and Lundman (2014). Results: The staff’s experiences with the web-based training program in relation to their professional care for persons with IDs and CB were presented as a single main theme: “Web-based training for staff initiates a workplace learning process by promoting reflections on and awareness of how to better care for persons with IDs and CB”. This theme contained three categories: “Web-based training provides freedom but also requires responsibility, both of which affect the learning outcome”, “The learning process contributes to generating insights about caring” and “The mutual impact of training and the opinions of staff about learning for the care of persons with IDs and CB”. These categories were based on eight sub-categories.Overall, the staff claimed that they had gained novel insights into the profession and into the caring process for the clients. Opinions about clients and CB changed somewhat, and the staff was inspired to adopt new ways of working which ultimately benefited interactions with the client. At the same time, requests were made for additional group discussions, and the desire for better planning to enhance learning among the staff was expressed.Discussion: In this study, web-based training seemed to have had a stimulating effect on workplace learning. Sharing self-reflections with group members in addition to individual study is essential for stimulating and consequently extracting knowledge from training. In the preparation of the training, close attention was paid to how to enable both individuals and social processes in learning but, judging from the results, further developments should focus on optimizing the effect of social interaction.Additionally, organizational support appears to be relevant for improving learning outcomes. However, prior research has shown significant differences in perceived workplace learning support from different occupational groups. Higher-status occupations offer a workplace environment that is more conducive to learning than that of lower-status occupations.These aspects must be addressed and overcome to fully develop the competence provision and counteract potential negative consequences in terms of job satisfaction and well-being among professionals working with persons with IDs.Conclusions and clinical implications: Our findings illustrate the complexity of providing staff training in the workplace through a web-based training program. Beyond the benefits of web-based training for workplace learning, some challenges also emerged. We conclude that web-based training, workplace organization, and individuals’ opinions each have an important impact on the learning outcome. To reach the best possible outcome, however, resources need to be invested in all three parts concurrently. This knowledge can contribute to the development of competence provision in municipal health and social care services more generally, where similar circumstances in terms of a notable downward trend in competence provision prevail, a pattern that could have negative impact on the welfare of the professionals.In addition to knowledge, cooperation in both healthcare and social services was also highlighted to improve care for persons with IDs and CB. In order to better meet their needs, professional teamwork is critically important. Hence, future research should investigate the views of other professionals e.g. nurses regarding education and competence development. This approach would enrich our knowledge and understanding of how the competence provision could be enhanced in this context to contribute to social sustainability in the sector.
|
|
