| 1. |
- Antonsson, Helena, et al.
(författare)
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Caregivers' reflections on their interactions with adult people with learning disabilities
- 2008
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Ingår i: Journal of Microscopy. - : Wiley. - 0022-2720 .- 1365-2818. ; 15:6, s. 484-91
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Tidskriftsartikel (refereegranskat)abstract
- People with learning disabilities and their professional carers often have difficulty interacting. The aim of this study was to illuminate carers' reflections on their interactions with adult people with learning disabilities. In a previous study, interactions between 16 carers and 11 residents with learning disabilities were recorded on video. In this study, stimulated recall interviews about the interactions were carried out with all the carers. The text was analysed using qualitative content analysis. The findings indicate that the carers reflected on both successful and unsuccessful interaction. Examples of successful interaction included understanding cues, satisfying needs, and managing challenging behaviours, and the carers reflected on the influences that successful interaction had on security, confidence, and satisfaction among the residents. Examples of unsuccessful interaction included failing to understand cues, failing to satisfy needs and failing to manage challenging behaviours, and the carers reflected on the consequences of such interaction, which included irritation, aggression and violence among the residents. Our findings have implications for interventions aimed at strengthening the competence of carers and developing strategies for managing challenging behaviour, in order to ensure high-quality care and a good working climate. © 2008 The Authors.
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| 2. |
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| 3. |
- Antonsson, Helena, et al.
(författare)
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Evaluation of a Web-Based Training Program for Professional Carers Working With People With Learning Disabilities and Challenging Behavior : A Pilot Study with SSED-Design
- 2016
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Ingår i: Issues in Mental Health Nursing. - : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 37:10, s. 734-743
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Tidskriftsartikel (refereegranskat)abstract
- The interaction between people with intellectual disabilities and professional carers is often influenced by communicative difficulties contributing challenging behaviours. The aims of this study were to evaluate to a web-based training program aimed at improving carers' abilities to interact with people with learning disabilities who exhibit challenging behaviours and to explore carers' experiences of participating in such a program. A single-subject experimental design and mixed methods were used to integrate qualitative and quantitative data. Triangulation of questionnaires, interviews with carers, and assessments of one woman's behaviour was performed. The participants were professional carers aged 20 to 55 years. The web-based training program increased carers' abilities to handle challenging behaviours and decreased challenging behaviours in daily care. The program improved the opportunities to offer training to carers who work in community-based accommodations with limited time to receive training.
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| 4. |
- Antonsson, Helena, 1962-
(författare)
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Interaktion i särskilt boende för personer med utvecklingsstörning och utmanande beteende
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Många personer med utvecklingsstörning har kommunikativa svårigheter och har därför behov av att utveckla olika sätt att kommunicera för att kunna förstå andra och göra sig förstådda. Svårigheter i kommunikationen påverkar interaktionen mellan personer med utvecklingsstörning och deras vårdare. Detta ställer höga krav på vårdare att kunna tolka och förstå den enskilda individens sätt att uttrycka önskningar och behov. På samma sätt riskerar vårdares budskap att missförstås. Om vårdaren misslyckas att förstå den boendes kommunikation och vice versa, kan det leda till situationer med utmanande beteende exempelvis i form av vägran, verbal eller fysisk aggressivitet.Syfte: Det övergripande syftet med avhandlingen är att studera interaktion mellan vuxna personer med utvecklingsstörning och vårdare i gruppbostäder, samt att studera effekter av en utbildningsintervention för vårdare som arbetar i gruppbostäder.Metod: Avhandlingens samtliga delstudier har genomförts i gruppbostäder för personer med utvecklingsstörning bland boende och vårdare i ett län i norra Sverige. I studie I insamlades data kring 556 personer med utvecklingsstörning. I studie II och III deltog 16 vårdare och 11 personer med utvecklingsstörning. I studie IV deltog 7 vårdare. Studie I bygger på personalens skattningar av funktionsnivåer och förekomst av begränsningsåtgärder. I Studie II och III utgörs data av videoobservationer och narrativa intervjuer. I studie IV användes flera datainsamlingsmetoder i en mixed method design med både vårdarnas skattningar, med hjälp av instrument och semi-strukturerade intervjuer. Analys av materialet i studie II, III och IV har gjorts med kvalitativ innehållsanalys och i studie I och IV har data analyserats statistiskt.Resultat: I studie I framkom att av 556 boende hade 99 (18%) varit föremål för fysiska begränsningsåtgärder under den senaste veckan. Av dessa 99 hade nästan alla varit föremål för mer än en typ av begränsningsåtgärd. Den vanligaste begränsningsåtgärden var bälte i stol (74%). Användningen av begränsningsåtgärder var relaterade både till fysiska funktionsnedsättningar och till beteende.I studie II reflekterade vårdare över videoinspelad interaktion där vårdarna medverkat, både framgångsrik och misslyckad interaktion. Exempel på framgångsrik interaktion var att förstå tecken, kunna möta behov och hantera situationer med utmanande beteenden. Vårdarna reflekterade över att framgångsrik interaktion ledde till säkerhet, trygghet och självförtroende hos de boende. Vårdarna reflekterade även över de konsekvenser misslyckad interaktion fick i form av irritation, aggression och våld från de boende.I studie III studerades videoinspelad interaktion mellan 11 personer med utvecklingsstörning och 16 av deras vårdare. Verbal och icke-verbal interaktion identifierades. Fyra inspelade situationer valdes ut för att belysa framgångsrikt samspel. Resultatet visade att framgångsrikt samspel mellan personer med utvecklingsstörning och deras vårdare bland annat bygger på möjligheten att bekräfta varandra, dela vardagshändelser, ge tid och utrymme och på att använda ett kongruent och tydligt språk.I studie IV utvärderades effekterna av en web-baserad utbildningsintervention, vars syfte var att förbättra interaktionen mellan personer med utvecklingsstörning och vårdare samt att därmed reducera förekomsten av situationer med utmanande beteende. Resultatet visade att vårdarna hade förbättrat sin förmåga att hantera situationer med utmanande beteende och att förekomsten av utmanande beteende minskat. Vårdarna beskrev att den web-baserade utbildningen upplevts givande och möjlig att ta del av parallellt med arbetet.Slutsats: Fysiska begränsningsåtgärder förekommer i gruppbostäder för personer med utvecklingsstörning. Användningen av begränsningsåtgärder kan vara relaterade både till fysiska funktionsnedsättningar och till beteenden i samspelet mellan brukare och vårdare. Vårdare upplever användningen av fysiska begränsningsåtgärder svår och tröttande. Brott i kommunikationen mellan personer med utvecklingsstörning och deras vårdare kan leda till försvårad interaktion med risk för situationer med utmanande beteenden. När vårdare är framgångsrika i interaktionen med personer med utvecklingsstörning ger det tillfredsställelse både för de boende och vårdarna. Vårdarna upplever dock ofta hjälplöshet och osäkerhet i relation till hantering av situationer med utmanande beteende och efterfrågar utbildning. Web-baserad utbildning om interaktion med personer med utvecklingsstörning och utmanande beteende har i vår studie visat sig ge lovande effekter och bör vara möjlig att utveckla för både introduktion av nyanställda vårdare och för kompetensutveckling bland mer erfaren personal.
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| 5. |
- Antonsson, Helena, et al.
(författare)
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Monitoring persons’ rights to equal care : registered nurses’ experiences of caring for people with mental ill-health and somatic comorbidity in psychiatric outpatient care
- 2024
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Ingår i: Issues in Mental Health Nursing. - : Taylor & Francis Group. - 0161-2840 .- 1096-4673. ; 45:6, s. 630-638
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Tidskriftsartikel (refereegranskat)abstract
- Persons with severe mental ill-health die early from preventable physical ill-health. Registered nurses in psychiatric outpatient care play a key role in improving persons’ physical health, and it is important to examine how they view their responsibility, their experiences of care, and the obstacles they meet in providing person-centred care. The purpose of this study was to explore registered nurses’ experiences of caring for persons with mental ill-health and somatic comorbidity in psychiatric outpatient care, using qualitative content analysis to analyze data from semi-structured interviews. The results show that these nurses monitored the person’s right to equal care, embraced the whole of the persons suffering, and dealt with unclear boundaries in care. This highlights the unique role that registered nurses play in psychiatric outpatient care via their ability to interpret symptoms and find ways to adapt care based on persons’ needs. Registered nurses consider physical health in all care and provide a link between psychiatric and somatic care. Together with mental health nurses at primary health care centers, they are key in reducing persons’ suffering. There is a need for structural and functional changes in line with person-centred care including collaboration both within and outside healthcare organizations.
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| 6. |
- Antonsson, Helena, et al.
(författare)
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School Nurses' Attitudes toward Family Involvement in School Healthcare
- 2020
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Ingår i: Health Behavior and Policy Review. - : Paris Scholar Publishing. - 2326-4403. ; 7:1, s. 51-58
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We evaluated school nurses' attitudes towards family involvement in school healthcare when children exhibit signs of mental health problems.Methods: In a cross-sectional study, the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) instrument was used to measure school nurses' (N = 133) attitudes towards family involvement. Data were analyzed with the Mann-Whitney U-test.Results: School nurses (95%) encountered students with mental health problems every day or every week. Overall, school nurses were positive towards family involvement in school healthcare. Primary school nurses were more positive compared to secondary school nurses, seeing the family as a resource and a conversation partner. School nurses who felt that they had insufficient tools to work with children with mental health problems saw the family as a burden compared to school nurses who reported they have sufficient tools. Conclusion: School nurses' attitudes toward involving families as a resource are promising. However, when nurses perceive themselves as lacking sufficient tools to respond to children's mental health problems, they are more likely to experience the family as a burden than a resource. Cooperation between school nurses and families may be crucial. Therefore, we suggest a Family Health Conversations model to improve nurse-family collaboration
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| 7. |
- Antonsson, Helena, et al.
(författare)
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Skilled interaction among professional carers in special accommodations for adult people with learning disabilities.
- 2013
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 20:7, s. 576-583
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Tidskriftsartikel (refereegranskat)abstract
- Communicative difficulties affect interactions between people with learning disabilities and their carers. Despite such difficulties, however, some carers seem to interact successfully with people who have limited ability to communicate verbally and exhibit challenging behaviour. This study aims to illuminate skilled interaction among carers working in special accommodations for people with learning disabilities. Interactions between 16 caregivers and 11 residents with learning disabilities were recorded on video. Verbal and non-verbal interaction skills among the carers were identified. Four caring situations with people with learning disabilities were chosen to illuminate skilled interaction. The transcribed text was subjected to qualitative content analysis and core stories were created. The results show that skilled interaction between the carers and the people with learning disabilities is based upon being confirming, sharing daily life experience, giving time and space, and using congruent and distinct language. In this paper we present examples that offer concrete suggestions of how to promote successful interaction and create meaning in the shared day-to-day life in special accommodations for people with learning disabilities.
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| 8. |
- Antonsson, Helena, et al.
(författare)
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Struggling with unnecessary suffering : registered nurses' experiences of delayed decisions on treatment without consent in forensic psychiatric inpatient care
- 2023
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Ingår i: International Journal of Mental Health Nursing. - : John Wiley & Sons. - 1445-8330 .- 1447-0349. ; 32:6, s. 1681-1690
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Tidskriftsartikel (refereegranskat)abstract
- Chemical restraints are used in forensic psychiatric inpatient care, however with caution as it can feel like an assault against patients' integrity. When waiting for decisions on treatment without consent, nursing staff are expected to care for patients with severe mental ill-health without the use of medical treatment, often with a feeling of already having tried all other available means. Knowledge about how registered nurses experience such situations is sparse but could contribute to the development of both teamwork and nursing approaches that could mean reduced suffering for patients. The aim of this study was to describe registered nurses' experiences of delayed decisions on treatment without consent in forensic psychiatric inpatient care. Eleven semi-structured interviews were conducted with registered nurses working in forensic psychiatric units in Sweden. Data were analysed through qualitative content analysis. The result showed that experiences of treatment without consent were about striving to protect patients from harm, striving for collaboration during difficult circumstances and striving to do good. This was interpreted as a struggle with unnecessary suffering. For registered nurses to be able to handle such challenging situations and relieve suffering for patients, experience and master-level education in mental health nursing are highlighted. Another aspect that is highlighted is the importance of having consultants familiar with the circumstances at the unit. A method for joint reflection is suggested, to promote an open-minded work culture with a well-functioning decision-making process and ensure that both consultants and nursing staff have support.
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| 9. |
- Antonsson, Jenny, et al.
(författare)
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Ulf-projektet : Samordnaruppdraget Nyanländas lärande
- 2023
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Ingår i: Abstracts för Decemberkonferensen. - Trollhättan : Högskolan Väst. ; , s. 1-1
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- I Skolverkets satsning på generella insatser för nyanländas lärande har kommunala samordnare en central roll. I projektet beskriver vi samordnarnas egna berättelser om uppdrag, mandat och positioner i kommunen, hur kommunen tillvaratar deras kunskaper och kompetenser i arbetet. I studien undersöker vi även implementeringsarbetet med den nya kursplanen i svenska som andraspråk samt vilken roll samordnaren har haft i arbetet. Ambitionen är att belysa konsekvenser det kan få i utbildningssammanhang och förutsättningar att möta komplexiteten i undervisningen som kan råda lokalt.Studiens teoretiska ansats vilar på Stephen J. Balls (2012) arbete kring hur skolor förhåller sig till policydokument, regelverk och politiska krav; dvs. en policy- enactmentstudie. Diskursanalysen utgör grunden för att studera kontexten i policyarbetet, att studera samordnaren som policysubjekt och som policyaktör samt hur samordnarna omvandlar de regler och föreskrifter som ges inom ramen för samordnaruppdraget inom nyanländas lärande (a.a.).Det är preliminära resultat som kommer att lyftas och diskuteras. Vi ser att samordnarfunktionen är en förutsättning för kontinuitet och långsiktighet i arbetet med nyanlända elevers lärande i Fyrbodals kommuner. Vi ser också ett värde i att tillvarata kompetensen och erfarenheterna från detta nätverk i arbetet på Högskolan Väst. Det kan bidra till ett kunskapstillskott för högskolan och lärarutbildningarna.
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| 10. |
- Ericson-Lidman, Eva, et al.
(författare)
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Registered nurses' experiences of challenging situations in their psychosocial working environment in home care of patients with functional and/or intellectual disability : a qualitative study
- 2023
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:1
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Tidskriftsartikel (refereegranskat)abstract
- Around 15% of the world’s population lives with some form of functional and/or intellectual disability (FID). Nursing staff often face threats and violence in the care of patients with FID. This study aimed to illuminate registered nurses’ experiences of challenging situations in their psychosocial working environment in home care of patients with functional and/or intellectual disabilities. Nine registered nurses/district nurses working in municipal settings were interviewed using a qualitative approach. COREQ was used for explicit and comprehensive reporting of qualitative studies. Three categories were revealed: To face challenging behaviour, To face emotional burden and To face communication difficulties. Nurses need continuous training and support to cope with work-related stress to meet a person with FID in a calm and relaxed mood and to be prepared for critical situations in their psychosocial environment. Training and support may enable nurses to be in a state of harmony and to be present in order to build caring relationships.
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| 11. |
- Hedelin, Henrik, 1975, et al.
(författare)
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Stability in Pelvic Triple Osteotomies in Children Using Resorbable PLGA Screws for Fixation
- 2021
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Ingår i: Journal of Pediatric Orthopaedics. - : Ovid Technologies (Wolters Kluwer Health). - 0271-6798. ; 41:9
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Tidskriftsartikel (refereegranskat)abstract
- Background: The triple pelvic osteotomy (TPO) is a major redirectional osteotomy used to improve the acetabular coverage of the femoral head in selected pediatric patients with hip disorders. Traditionally the iliac osteotomy is stabilized by metal screws that require a second surgery for removal. Despite favorable results for both adults and children in related pelvic osteotomies, resorbable implants have not previously been used for TPOs. This study aims to suggest a novel modified TPO surgical method in children using resorbable poly lactic-co-glycolic acid (PLGA) screws for fixation and to radiographically evaluate the postoperative stability achieved by these implants in a case series. Methods: All patients (n=11) with dysplasia of the hip (2), Perthe disease (5), or Down syndrome (4), who underwent primary TPO surgery during 2013 to 2019, using resorbable PLGA screws for fixation were included. The stability of the osteotomy was evaluated in the postoperative radiograph series using the acetabular index, migration percentage, Sharp's angle and the center-edge angle. The osteotomy angle was introduced as a parameter to confirm the postoperative integrity of the achieved correction. All cases were evaluated until radiographic healing of the iliac osteotomy. Hospital notes were analyzed for complications or local reactions in relation to the implants. Results: In all studied hips, the overall achieved correction was well maintained. The mean (SD) correction achieved, from the preoperative images to the last measurable postoperative image, was a 16.7 degrees decrease for Sharp angle, a 20.9 degrees decrease in acetabular index and a 24.7 degrees increase for the center-edge angle, respectively. There were no complications related to the bioabsorption of the implants. Conclusion: The present findings suggest that the modified TPO method, using resorbable PLGA screws, provides sufficient stability and appears to be a promising alternative to traditional TPO. Avoiding implant removal is a major benefit in a pediatric population. Resorbable screws enable the surgeon to place implants with more degrees of freedom since later implant removal is not a limiting factor.
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| 12. |
- Lundström, Mats, et al.
(författare)
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Use of physical restraints with people with intellectual disabilities living in Sweden's group homes
- 2011
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Ingår i: Journal of Policy and Practice in Intellectual Disabilities. - : Wiley. - 1741-1122 .- 1741-1130. ; 8:1, s. 36-41
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Tidskriftsartikel (refereegranskat)abstract
- People with intellectual disabilities (ID) often exhibit physical and communicative difficulties as well as challenging behaviors. Physical restraints are one method used to manage challenging behaviors and promote physical safety for people with ID, their fellow residents, and professional carers. However, there is a lack of data regarding the practice of employing physical restraints in Swedish group homes for people with ID. The aim was to investigate the prevalence of physical restraint use in group homes for people with ID, and to identify the characteristics of individuals subjected to these restraints. The study had a cross-sectional design and included 556 people with ID, aged 16–90 years, living in 118 group homes. Physical restraint use and residents' characteristics were surveyed with a questionnaire. Of the 556 residents studied, 99 (17.8%) had been subjected to physical restraint over the previous week. Of these, 99.2% were subjected to more than one type of restraint. The most commonly used type of physical restraint was a belt (73.7%). Using logistic regression analysis, the independent risk factors strongly associated with being physically restrained were inability to walk independently, impaired speech, screaming and shouting continuously, epileptic seizures, and spasticity. Despite the absence of legal authority for physical restraint use in group homes for people with ID, physical restraints are frequently used in Sweden. Both physical impairments and behavioral symptoms are significantly associated with physical restraint use.
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| 13. |
- Molin, Jenny, 1974-, et al.
(författare)
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From traditional counselling to health‐promoting conversations? Registered nurses' experiences of providing health counselling to people living with severe mental ill‐health in supported housing
- 2023
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Ingår i: International Journal of Mental Health Nursing. - : John Wiley & Sons. - 1445-8330 .- 1447-0349. ; 32:3, s. 875-883
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Tidskriftsartikel (refereegranskat)abstract
- People with severe mental ill-health have lower life expectancies than the rest ofthe population, partly due to unhealthy lifestyles. Counselling to help these people improve their health can also be complex, and registered nurses are key to its success.The aim of this study was to elucidate registered nurses' experiences of providing health counselling to people living with severe mental ill-health in supported housing. We conducted eight individual semi-structured interviews with registered nurses working in this context and subjected the responses to qualitative content analysis. The results show that registered nurses who counsel people with severe mental ill-health feel dispirited, but they defend their often fruitless endeavours and strive, through health counselling, to help these people meet healthier lifestyle goals. Shifting the focus from traditional health counselling to person-centred care using health-promoting conversations could strengthen registered nurses in their efforts towards improving lifestyles among people living with severe mental ill-healthin supported housing. Therefore, to facilitate healthier lifestyles among this population, we recommend that community healthcare support registered nurses working in supported housing by educating them in the use of health-promoting conversations, including teach-back techniques.
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| 14. |
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| 15. |
- Pusa, Susanna, et al.
(författare)
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Nurses' perceptions about a web-based learning intervention concerning supportive family conversations in home health care
- 2019
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 28:7-8, s. 1314-1326
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives To describe the perceptions that municipal primary healthcare nurses and municipal registered nurses had about a web-based learning intervention concerning supportive family health conversations in municipal home health care. Background Even though family health conversations are well grounded in theory with several reported benefits for patients and families, most working nurses have little or no training in practising family systems nursing including family health conversations. Continued learning is necessary for nurses, where web-based learning may be one answer of updating the professional skills and knowledge of nurses regarding supporting families. Design The study used a descriptive design and followed the "Consolidated criteria for reporting qualitative research" (COREQ) checklist. Methods Twenty-one nurses participated in an educational intervention that consisted of web-based learning and two face-to-face seminars about family systems nursing including family health conversations. The nurses were interviewed after completion, and the audio-recorded interviews were transcribed verbatim and analysed using qualitative content analysis. Results The findings consist of nurses' perceptions regarding the disposition of instruction, the prerequisites for learning and a changed approach when working with families. The findings are further reflected on through Illeris' theory concerning learning triangle. Conclusions The findings are encouraging for educating nurses in family health conversations at their workplace, with the purpose of supporting patients and families. However, it is important to be aware of the different dimensions of learning, in addition to the appraisal of social aspects and organisational circumstances when educating nurses as they influence the utilisation of the knowledge. Relevance to clinical practice This web-based learning intervention seems to be suitable for educating nurses in family health conversations and could be an appropriate step towards implementing these conversations in home health care with the purpose of supporting families.
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| 16. |
- Truong, Anh, et al.
(författare)
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Caring for Persons With Intellectual Disabilities and Challenging Behavior : Staff Experiences With a Web-Based Training Program
- 2021
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 12
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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.
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| 17. |
- Truong, Anh, et al.
(författare)
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Caring for Persons With Intellectual Disabilities and Challenging Behavior : Staff Experiences With a Web-Based Training Program
- 2022
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Ingår i: International Conference on Work Integrated Learning. - Trollhättan : University West. - 9789189325302 ; , s. 39-41
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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.
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| 18. |
- Truong, Anh
(författare)
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Developing an educational intervention to support work-integrated learning among professionals in health and social care for individuals with intellectual disabilities
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Continuing education in the workplace has become a crucial part of contemporary working life, in alignment with modern labor market policies advocating lifelong learning. Work-integrated learning (WIL) is aimed at supporting professional development as part of lifelong learning, emphasizing both theoretical and practical knowledge alongside interactive engagement. Despite its significance, WIL within the context of educational interventions geared toward supporting learning and development among professionals remains an under-researched domain compared to its application in higher education focused on student learning. Previous research has shown that the learning process among professionals may follow a different logic compared to that of students in higher education. This dissertation highlights the development of an educational intervention from both an effectiveness and theory-based perspective, with WIL based on socio-constructivism serving as the point of departure. The intervention was aimed at professionals in municipal health and care for individuals with intellectual disabilities. The intention behind studying these professionals’ learning and development was to extend our knowledge of the ways in which the educational intervention influenced the professionals’ learning process and to reveal key aspects that must be considered in further developments of the intervention. Such knowledge contributions can potentially improve and expand future educational efforts aimed at professionals.The development of the educational intervention followed a pragmatic process consisting of three stages described in four individual papers. Data were collected through surveys and individual semi-structured interviews, which were then analyzed using statistical calculations and qualitative content analysis.The findings illustrated that learning and development among professionals did not follow a straightforward trajectory from the completed educational intervention to the learning outcome. The intervention, consisting of web-based lectures and structured group reflections, was found to support the professionals’ learning, with group reflections acting as a catalyst for collective learning and for the integration of theoretical knowledge into daily practice. However, creating the conditions needed for all participants to engage in group reflections was a key issue and should not be taken for granted in future educational initiatives in which group reflections are intended to be used. Likewise, organizational support and encouragement were found to constitute an important driving force in the professionals’ learning. Overall, learning and development among professionals are complex and influenced by multiple factors and mechanisms. Addressing these complexities requires a simultaneous focus on three fundamental elements: the actors involved in the learning process, the educational intervention itself, and the surrounding context. This can be best accomplished through a structured and systematic approach to the developmental process of the intervention. Such an approach could strengthen professionals’ commitment to lifelong learning and contribute to sustainable educational efforts, both economically and socially.
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| 19. |
- Truong, Anh, et al.
(författare)
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Staff’s self-reported frequency and management difficulty of challenging behavior among persons with intellectual disabilities in connection with web-based training
- 2022
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Ingår i: International Conference on Work Integrated Learning. - Trollhättan : University West. ; , s. 42-45
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Healthcare professionals, nationally and internationally, experience that exposure to persons withintellectual disabilities (ID) during education is often insufficient. Professionals within the sector urge enhancedtraining that will better prepare them for working with their clients. Providing care and support to persons with IDis complex and places high demands on the professionals such as knowledge about ID and cha llenging behaviors(CB) as well as communication and interaction. Earlier studies have shown that knowledge deficiencies in theseareas may prevent healthcare professionals from understanding their clients and their behaviors, particularly thosebehaviors considered to be challenging.However, staff working with persons with ID reported CB as a problem they could not always address in thedesired manner while performing their work duties. This predicament was shown to often generate stress, angerand powerlessness among staff, increasing the likelihood of burnout. Helping staff to better understand and bebetter prepared prior to meeting, communicating and interacting with persons with ID, especially concerningaddressing CB, could therefore help to establish and maintain a healthy work environment and sustainable workinglife.In this study, we investigated the impact of web-based training on the staff´s perception of the frequency andmanagement difficulties of CB among persons with ID in residential settings in Sweden. The training addressedthe topics ID and CB as well as communication and interaction and was offered to the staff working in theresidences. Since the basic assumption was that CB is a consequence of interrupted communication and interactionbetween staff and persons with ID, we hypothesized that by introducing web-based training focusing on ID andCB as well as communication and interaction, the frequency of CB and degree of management difficulty of CB indaily care would be reduced.Aim: To explore staff’s perceptions about CB among clients with ID in residential settings before and after a web -based training program, specifically addressing ID and CB as well as communication and interaction.Research questions1. Do staff report a lower frequency of CB among clients with ID in residential settings after the web -basedtraining?2. Do staff report a lower degree of management difficulty of CB among clients with ID in residential settings afterthe web-based training?Methods: A within-subjects study design was applied in which the participants were exposed to the treatment –in this case, web-based training – and measurements were made using the survey instrument “Checklist ofChallenging Behavior” (CCB) before and after exposure to examine any potential changes that occurred.Cluster sampling was conducted whereby 20 residential facilities were included. All staff in those residences wereoffered web-based training and invited to participate in this study.A total of 212 participants accepted the invitation to the survey by filling in CCB and accordingly systematicallyrate the frequency of CB among the clients and the own difficulty in managing these behaviors as perceived byparticipating staff. The CCB includes 41 items related to topographies of aggressive and other CB divided alongthe dimensions of physical violence/aggressive behavior, property destruction, miscellaneous behavior and mentalillness. The CCB was developed by Harris and Humphreys, who assessed the instrument’s content validity andinter-rater reliability. The researchers concluded that the instrument was a reliable indicator of the presence orabsence of CB. All measurements were based on five-point scale.43First, descriptive analysis was performed to summarize the characteristics of the sample. Central measurementswere presented as the mean and dispersion by standard deviation. As the data were represented on an ordinal scale,the Wilcoxon signed-rank test was used to determine whether a lterations existed between the responses before andafter training concerning the frequency of CB and management difficulty of these behaviors.Considering the number of calculations performed, a significance value of p < 0.05 was established. In addition,p-values < 0.1 were interpreted as tendencies. In order to contribute to indications of practical significance, acorrelation coefficient r was calculated by converting the z-values, as described by Pautz and Olivier, of those subitems with significant values. According to the rule of thumb for interpretation of Cohen’s r: 0.1 = small effectsize, 0.3 = medium effect size and 0.5 = large effect size.Results: The demographic description revealed that, of those who provided information about their job ty pe andlevel of education, approximately 87% worked as support assistants in the facilities, and most had completedsecondary education. The analysis showed that, after training, staff self-reported a significantly lower degree offrequency on the dimension of property destruction, on the sub-item “damaging others’ clothes, furniture, or otherobjects”. Similarly, a significant difference was revealed in the dimension of mental illness. In addition, regardingthe management difficulty of CB, the analysis revealed that, after training, staff self-reported a significantly lowerdegree of management difficulty on all sub-items on the dimension of property destruction. However, the effectsizes were considered small. Apart from that, the calculations also showed tendencies towards significance on anumbers of sub-items e.g biting, throwing things at people, breaking windows and absconding.Discussions: The observed reduction in the frequency of CB after the web-based training may have been due toenhanced knowledge and understanding by staff of CB among their clients, which could have consequently ledthem to no longer consider these behaviors as challenging. In earlier research, it was found that the amount ofknowledge possessed by staff could act as a significa nt predictor of their behavioral responses to CB. Accordingly,it is reasonable to suspect that the reduced management difficulty of CB as perceived by staff may have been dueto their enhanced knowledge of such behaviors, which impacted their views and behavioral responses to CB.Considering the formal education the majority of the staff have and the complexity of the job within this sector, itwould be unreasonable to expect all of the staff to have the capability to perform all job duties without sufficientopportunities to expand their knowledge and improve their skills with the support of the relevant healthcareorganization. This aspect has been equally emphasized to promote a healthy and sustainable workplace from theview of Work-Integrated Learning.Conclusion: Considering the complexity of meeting the needs of persons with ID, in addition to job -specificknowledge, collaboration with multi-professional teams is also recommended. As such, routinely training tosupport Work-Integrated Learning should be offered to all professionals involved in caring for individuals withintellectual disabilities to reinforce social sustainability in the sector.
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| 20. |
- Truong, Anh, et al.
(författare)
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Staff’s self-reported frequency and management difficulty of challenging behaviour among persons with intellectual disabilities in connection with web-based training
- 2022
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Ingår i: Nordic journal of nursing research. - : SAGE Open. - 2057-1585 .- 2057-1593. ; 43:1, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Providing care and support to persons with intellectual disabilities (ID) requires in-depth knowledge about ID and challenging behaviour (CB) as well as communication and interaction. Knowledge deficiencies in these areas may prevent staff from understanding their clients and their behaviours, particularly those behaviours considered to be challenging. The aim of this study was to explore staff’s perceptions about CB among clients with ID in residential settings before and after a web-based training programme using the survey instrument ‘Checklist of Challenging Behaviour’ (CCB). The CRe-DEPTH guideline has served as a guide in this study. Upon completion of the training, staff perceived a reduced frequency of CB as well as reduced management difficulty of CB among clients. As such, training should routinely be offered to all staff in residential settings, but also healthcare professionals in general responsible for caring for clients exhibiting CB to ensure, improve and reinforce the quality of care and support provided to them.
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| 21. |
- Wedin, Helena, et al.
(författare)
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Influence Of Xylan Content On The Oxygen Delignification Performance Of Eucalypt Kraft Pulps As Studied Using Prehydrolysis And Xylanase Treatments
- 2012
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Ingår i: BioResources. - : BioResources. - 1930-2126. ; 7:4, s. 5527-5541
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Tidskriftsartikel (refereegranskat)abstract
- Common metrics for evaluating the efficiency of oxygen delignification include the kappa number and Klason lignin content. As a change in xylan content often leads to a change in HexA content, the kappa number must be corrected for the HexA contribution before evaluating the degree of oxygen delignification when trying to understand the process in detail. Questions could also be raised about the accuracy of the Klason lignin method for oxygen-delignified hardwood kraft pulps, since the amount of residual lignin is small in such pulp. This study investigates the influence of xylan content on oxygen delignification efficiency in Eucalyptus urograndis kraft pulps. Xylan content was varied using two methods: treatment with xylanase and with acid prehydrolysis for various times before kraft cooking. The degree of oxygen delignification, expressed as the HexA-corrected kappa number, indicated no significant trend with xylan removal, and no significant trend was evident when expressed as Klason lignin content.
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