| 1. |
- Carlsson, Eva, 1959-, et al.
(författare)
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Information transfer and continuity of care for stroke patients with eating difficulties from the perspectives of nursing staff in Swedish elderly care
- 2012
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Ingår i: Nursing informatics ... : proceedings of the ... International Congress on Nursing Informatics. - Montreal, Kanada. ; 2012, s. 61-
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Konferensbidrag (refereegranskat)abstract
- Continuity of care is a key issue in the care for elderly people, for example, those having experienced stroke, particularly with regards to informational and managerial continuity based on patient record data. The study aim was to explore municipal nursing staff's (n=30) perceptions of discharge information provided to them for stroke patients with eating difficulties. Structured interviews were used and data were analysed by content analysis and descriptive statistics. Results showed that nursing staff perceived informational continuity and accuracy of information on patients' eating difficulties as poor and that little information on eating difficulties reached licensed practical nurses, who instead relied on their own assessments of patients' eating ability. Co-ordinated care planning and management continuity were largely lacking, increasing the risk for undernutrition and related complications for the patients.
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| 2. |
- Egholm, Cecilie Lindström, et al.
(författare)
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Facilitators for using data from a quality registry in local quality improvement work : a cross-sectional survey of the Danish Cardiac Rehabilitation Database
- 2019
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 9:6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To investigate use of data from a clinical quality registry for cardiac rehabilitation in Denmark, considering the extent to which data are used for local quality improvement and what facilitates the use of these data, with a particular focus on whether there are differences between frontline staff and managers. Design Cross-sectional nationwide survey study. Setting, methods and participants A previously validated, Swedish questionnaire regarding use of data from clinical quality registries was translated and emailed to frontline staff, mid-level managers and heads of departments (n=175) in all 30 hospital departments participating in the Danish Cardiac Rehabilitation Database. Data were analysed descriptively and through multiple linear regression. Results Survey response rate was 58% (101/175). Reports of registry use at department level (measured through an index comprising seven items; score min 0, max 7, where a low score indicates less use of data) varied significantly between groups of respondents: frontline staff mean score 1.3 (SD=2.0), mid-level management mean 2.4 (SD=2.3) and heads of departments mean 3.0 (SD=2.5), p=0.006. Overall, department level use of data was positively associated with higher perceived data quality and usefulness (regression coefficient=0.22, p=0.019), management request for data (regression coefficient=0.40, p=0.008) and personal motivation of the respondent (regression coefficient=1.63, p<0.001). Among managers, use of registry data was associated with data quality and usefulness (regression coefficient=0.43, p=0.027), and among frontline staff, reported data use was associated with management involvement in quality improvement work (regression coefficient=0.90, p=0.017) and personal motivation (regression coefficient=1.66, p<0.001). Conclusions The findings suggest relatively sparse use of data in local quality improvement work. A complex interplay of factors seem to be associated with data use with varying aspects being of importance for frontline staff and managers.
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| 3. |
- Enlund, Karolina Brunius, et al.
(författare)
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Dog Owners' Ideas and Strategies Regarding Dental Health in Their Dogs-Thematic Analysis of Free Text Survey Responses
- 2022
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Ingår i: Frontiers in Veterinary Science. - : Frontiers Media S.A.. - 2297-1769. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Periodontal disease is the most common disease in dogs over 3 years of age. In dogs, as in humans, daily tooth brushing, as a means of active dental home care, is considered the gold standard for prophylaxis and prevention of periodontal disease progression. However, the performance of adequate tooth brushing is insufficient in dogs. There is no full account as to why dog owners fail to comply with this routine, but in order to facilitate better practice, a further understanding of dog owner's perspectives is needed. The aim of this study was to investigate dog owners' ideas and strategies regarding their dogs' dental health. In a large-scale Swedish survey regarding dental health in dogs, dog owners' free text comments (n = 8,742) from a concluding open-ended query were analyzed using qualitative methods. Many different notions concerning dental health in dogs were identified, of which perceived importance of different diets and chewing being the most prominent. Five common themes represented dog owners' ideas and strategies regarding dental health in their dogs: what is considered to cause dental problems; what is deemed not to promote dental health; how to prevent dental problems; what impedes proper dental care, and; needs for increased knowledge and support. Contrary to existing research and knowledge in the field, the respondents commonly trusted that diet procure good dental health in the dog, as does chewing on bones. Seemingly, a range of misconceptions flourish among dog owners, indicating a need to share information and experiences, as well as support to bridge barriers to tooth brushing and other aspects that can enhance dog owners' knowledge and practice. In addition, this study highlights the need for randomized controlled trials on effects of diets and supplements on different aspects of dental health; calculus, periodontal disease, and dental fractures, including dogs of different breeds, sizes and ages. Further research is also needed with respect to which strategies that best aid dog owners, by whom the support is best provided, when, and at what time point.
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| 4. |
- Strandberg, Elisabeth, et al.
(författare)
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The concept of research utilization as understood by Swedish nurses : demarcations of instrumental, conceptual, and persuasive research utilization.
- 2014
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Ingår i: Worldviews on Evidence-Based Nursing. - : John Wiley & Sons. - 1545-102X .- 1741-6787. ; 11:1, s. 55-64
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: The literature implies research utilization (RU) to be a multifaceted and complex phenomenon, difficult to trace in clinical practice. A deeper understanding of the concept of RU in a nursing context is needed, in particular, for the development of instruments for measuring nurses' RU, which could facilitate the evaluation of interventions to support the implementation of evidence-based practice. In this paper, we explored nurses' demarcation of instrumental RU (IRU), conceptual RU (CRU), and persuasive RU (PRU) using an item pool proposed to measure IRU, CRU, and PRU.METHODS: The item pool (12 items) was presented to two samples: one of practicing registered nurses (n = 890) in Sweden 4 years after graduating and one of recognized content experts (n = 7). Correlation analyses and content validity index (CVI) calculations were used together with qualitative content analysis, in a mixed methods design.FINDINGS: According to the item and factor analyses, CRU and PRU could not be distinguished, whereas IRU could. Analyses also revealed problems in linking the CRU items to the external criteria. The CVIs, however, showed excellent or good results for the IRU, CRU, and PRU items as well as at the scale level. The qualitative data indicated that IRU was the least problematic for the experts to categorize, whereas CRU and PRU were harder to demarcate.CONCLUSIONS: Our findings illustrate a difficulty in explicitly demarcating between CRU and PRU in clinical nursing. We suggest this overlap is related to conceptual incoherence, indicating a need for further studies. The findings constitute new knowledge about the RU concepts in a clinical nursing context, and highlight differences in how the concepts can be understood by RNs in clinical practice and experts within the field. We suggest that the findings are useful for defining RU in nursing and further development of measures of RU.
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| 5. |
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| 6. |
- Bergström, Anna, 1983-, et al.
(författare)
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The use of the PARIHS framework in implementation research and practice-a citation analysis of the literature
- 2020
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Ingår i: Implementation science : IS. - : Springer Science and Business Media LLC. - 1748-5908. ; 15:1
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: The Promoting Action on Research Implementation in Health Services (PARIHS) framework was developed two decades ago and conceptualizes successful implementation (SI) as a function (f) of the evidence (E) nature and type, context (C) quality, and the facilitation (F), [SI = f (E,C,F)]. Despite a growing number of citations of theoretical frameworks including PARIHS, details of how theoretical frameworks are used remains largely unknown. This review aimed to enhance the understanding of the breadth and depth of the use of the PARIHS framework. METHODS: This citation analysis commenced from four core articles representing the key stages of the framework's development. The citation search was performed in Web of Science and Scopus. After exclusion, we undertook an initial assessment aimed to identify articles using PARIHS and not only referencing any of the core articles. To assess this, all articles were read in full. Further data extraction included capturing information about where (country/countries and setting/s) PARIHS had been used, as well as categorizing how the framework was applied. Also, strengths and weaknesses, as well as efforts to validate the framework, were explored in detail. RESULTS: The citation search yielded 1613 articles. After applying exclusion criteria, 1475 articles were read in full, and the initial assessment yielded a total of 367 articles reported to have used the PARIHS framework. These articles were included for data extraction. The framework had been used in a variety of settings and in both high-, middle-, and low-income countries. With regard to types of use, 32% used PARIHS in planning and delivering an intervention, 50% in data analysis, 55% in the evaluation of study findings, and/or 37% in any other way. Further analysis showed that its actual application was frequently partial and generally not well elaborated. CONCLUSIONS: In line with previous citation analysis of the use of theoretical frameworks in implementation science, we also found a rather superficial description of the use of PARIHS. Thus, we propose the development and adoption of reporting guidelines on how framework(s) are used in implementation studies, with the expectation that this will enhance the maturity of implementation science.
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| 7. |
- Carlsson, Eva, 1952-, et al.
(författare)
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Accuracy and continuity in discharge information for patients with eating difficulties after stroke
- 2012
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 21:1-2, s. 21-31
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To describe the accuracy and continuity of discharge information for patients with eating difficulties after stroke.Design: Prospective, descriptive.Methods: The study investigated a sample of 15 triads, each including one patient with stroke along with his patient record and discharge summary and two nursing staff in the municipal care to whom the patient was discharged. Data were collected by observations of patients' eating, record audits and interviews with nurses. Data were analysed using content analysis and descriptive statistics.Results: Accuracy of recorded information on patients' eating difficulties and informational continuity were poor, as was accuracy in the transferred information according to nursing staff's perceptions. All patients were at risk of undernutrition and in too poor a state to receive rehabilitation. Nevertheless, patients' eating difficulties were described in a vague and unspecific language in the patient records. Co-ordinated care planning and management continuity related to eating difficulties were largely lacking in the documentation. Despite their important role in caring for patients with eating difficulties, little information on eating difficulties seemed to reach licensed practical nurses in the municipalities.Conclusions: Comprehensiveness in the documentation of eating difficulties and accuracy of transferred information were poor based on record audits and as perceived by the municipal nursing staff. Although all patients were at risk of undernutrition, had multiple eating difficulties and were in too poor a state for rehabilitation, explicit care plans for nutritional problems were lacking.Relevance to clinical practice: Lack of accuracy and continuity in discharge information on eating difficulties may increase risk of undernutrition and related complications for patients in continuous stroke care. Therefore, the discharge process must be based on comprehensive and accurate documentation.
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| 8. |
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Delaktighet och patientmedverkan
- 2018
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Boken behandlar det för vård och omsorg centrala begreppet patientdelaktighet. Vidden av begreppet delaktighet gör att det behövs vägledning för vardagens möten och samtal, mellan den som är patient och den som är personal. Boken utgör en resurs och bör ses som en diskussionspartner, med utgångspunkt i aktuell kunskap men även andra förutsättningar, som lagtexter och normer.Delaktighet och patientmedverkan omfattar två övergripande kapitel som introducerar och problematiserar patientdelaktighet och fyra kapitel som belyser begreppet ur olika, specifika perspektiv. De generella kapitlen kan läsas för sig, eller i kombination med ett eller flera fallbaserade kapitel, utifrån läsarens aktuella kunskapsbehov eller intresse.Boken vänder sig till blivande och yrkesverksamma inom hälso- och sjukvård eller omsorg men är också avsedd att vara till nytta för andra nyckelpersoner, som beslutsfattare och patienter.
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| 9. |
- Drott, Jenny, et al.
(författare)
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Patient preferences and experiences of participation in surgical cancer care
- 2022
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Ingår i: Worldviews on Evidence-Based Nursing. - : John Wiley & Sons. - 1545-102X .- 1741-6787. ; 19:5, s. 405-414
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Tidskriftsartikel (refereegranskat)abstract
- Background Quality cancer care necessitates opportunities for patient participation, supposedly recognizing the individual's preferences and experiences for being involved in their health and healthcare issues. Previous research shows that surgical cancer patients wish to be more involved, requiring professionals to be sensitive of patients' needs. Aims To explore preference-based patient participation in surgical cancer care. Methods A cross-sectional study was conducted. The Patient Preferences for Patient Participation tool (4Ps) was used, which includes 12 attributes of preferences for and experiences of patient participation. Data were analyzed with descriptive and comparative statistical methods. Results The results are based on a total of 101 questionnaires. Having reciprocal communication and being listened to by healthcare staff were commonly deemed crucial for patient participation. While 60% of the patients suggested that taking part in planning was crucial for their participation, they had experienced this only to some extent. Learning to manage symptoms and phrasing personal goals were items most often representing insufficient conditions for preference-based patient participation. Linking Evidence to Action To support person-centered surgical care, further efforts to suffice preference-based participation are needed, including opportunities for patients to share their experiences and engage in the planning of healthcare activities.
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| 10. |
- Duong, Duc M., et al.
(författare)
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Exploring the influence of context in a community-based facilitation intervention focusing on neonatal health and survival in Vietnam : a qualitative study
- 2015
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; :15
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn the Neonatal health – Knowledge into Practice (NeoKIP) trial in Vietnam, local stakeholder groups, supported by trained laywomen acting as facilitators, promoted knowledge translation (KT) resulting in decreased neonatal mortality. In general, as well as in the community-based NeoKIP trial, there is a need to further understand how context influences KT interventions in low- and middle-income countries (LMICs). Thus, the objective of this study was to explore the influence of context on the facilitation process in the NeoKIP intervention.MethodsA secondary content analysis was performed on 16 Focus Group Discussions with facilitators and participants of the stakeholder groups, applying an inductive approach to the content on context through naïve understanding and structured analysis.ResultsThe three main-categories of context found to influence the facilitation process in the NeoKIP intervention were: (1) Support and collaboration of local authorities and other communal stakeholders; (2) Incentives to, and motivation of, participants; and (3) Low health care coverage and utilization. In particular, the role of local authorities in a KT intervention was recognized as important. Also, while project participants expected financial incentives, non-financial benefits such as individual learning were considered to balance the lack of reimbursement in the NeoKIP intervention. Further, project participants recognized the need to acknowledge the needs of disadvantaged groups.ConclusionsThis study provides insight for further understanding of the influence of contextual aspects to improve effects of a KT intervention in Vietnam. We suggest that future KT interventions should apply strategies to improve local authorities’ engagement, to identify and communicate non-financial incentives, and to make disadvantaged groups a priority. Further studies to evaluate the contextual aspects in KT interventions in LMICs are also needed.
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| 11. |
- Ehrenberg, Anna, et al.
(författare)
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Evidensbaserad praktik i omvårdnad.
- 2021. - 2
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Ingår i: Omvårdnad på avancerad nivå – kärnkompetenser inom sjuksköterskans specialistområden. - Lund : Studentlitteratur AB. - 9789144136240 ; , s. 261-284
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 12. |
- Ehrenberg, Anna, 1956-, et al.
(författare)
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Evidensbaserad vård
- 2021. - 2
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Ingår i: Omvårdnad på avancerad nivå – kärnkompetenser inom sjuksköterskans specialistområden. - Lund : Studentlitteratur AB. - 9789144136240 ; , s. 225-260
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 13. |
- Eldh, Ann Catrine, 1965-, et al.
(författare)
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A comparison of the concept of patient participation and patients' descriptions as related to healthcare definitions
- 2010
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Ingår i: International Journal of Nursing Terminologies and Classifications. - Malden, USA : Wiley-Blackwell. - 2047-3087 .- 2047-3095 .- 1744-618X. ; 21:1, s. 21-32
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To depict what patients describe as patient participation and whether descriptions of patient participation are affected by gender, age, healthcare contact, and duration of disease.Data sources: Current patients (n= 362) responded to a questionnaire on participation.Data synthesis: Patients' descriptions focused on having knowledge, rather than being informed, and on interacting with health professionals, rather than merely partaking in decision making.Conclusions: Patients' descriptions of participation correspond with the International Classification of Functioning, Disability and Health's definition, which includes "being involved in a life situation." Healthcare legislation and professionals employ a narrower concept of patient participation as defined by, e.g., Medical Subject Headings.Practice implications: Findings suggest that health professionals need to embrace what patients describe as participation.
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| 14. |
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| 15. |
- Eldh, Ann Catrine, et al.
(författare)
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Assessing and reporting patient participation by means of patient preferences and experiences
- 2020
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Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although patient participation is strongly associated with high quality of healthcare, valid means to measure and report a comprehensive notion of patient participation are scarce. The Patient Preferences for Patient Participation (4Ps) is a new healthcare practice and research tool, comprising patients' preferences as well as experiences. The 4Ps employs 12 items for the patient to conceptualise patient participation. The aim of this paper is to describe how the two perspectives of patient participation, namely preferences and experiences, can be combined to visualise and report preference-based patient participation.METHODS: With four response alternatives in each section, the 4Ps offers sixteen possible combinations of degree of match per item. Theoretical and clinical principles fostered a tentative order of six ranks and three levels of preference-based patient participation. To test the standard, statistical analyses for ordinal data were performed, using data from a randomised controlled trial evaluating an intervention aiming to improve patient participation. Further, structures for visualising the preference-based patient participation of individuals and groups were suggested.RESULTS: Data from the 4Ps demonstrated the individuals' preference-based patient participation, indicating either a match or a mismatch for each item. Mismatches represented either the experience of participation surpassing the patient's preferences, or the patient's preferences for patient participation not being established. At group level, the suggested approach for visualising and reporting the 4Ps demonstrated that the intervention group had a significantly higher proportion of sufficient preference-based patient participation for certain items than the control group. These results had not been identified earlier, when using the preferences and experiences of patient participation as separate measures.CONCLUSIONS: Ways to easily acquaint stakeholders with patients' preferences for patient participation are needed, in order for healthcare staff to better use resources to match the basic requirements of individuals and groups. While the 4Ps can guide professionals to patient participation as framed in legislations, concept analyses and by patients, a visualisation of the results is needed to capture preference-based patient participation. The proposed route to representing degree of match in preferences and experiences may also be relevant to other dimensions of quality of healthcare.
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| 16. |
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| 17. |
- Eldh, Ann Catrine, et al.
(författare)
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Clinical interventions, implementation interventions, and the potential greyness in between -a discussion paper
- 2017
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 17:16
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is increasing awareness that regardless of the proven value of clinical interventions, the use of effective strategies to implement such interventions into clinical practice is necessary to ensure that patients receive the benefits. However, there is often confusion between what is the clinical intervention and what is the implementation intervention. This may be caused by a lack of conceptual clarity between 'intervention' and 'implementation', yet at other times by ambiguity in application. We suggest that both the scientific and the clinical communities would benefit from greater clarity; therefore, in this paper, we address the concepts of intervention and implementation, primarily as in clinical interventions and implementation interventions, and explore the grey area in between. Discussion: To begin, we consider the similarities, differences and potential greyness between clinical interventions and implementation interventions through an overview of concepts. This is illustrated with reference to two examples of clinical interventions and implementation intervention studies, including the potential ambiguity in between. We then discuss strategies to explore the hybridity of clinical-implementation intervention studies, including the role of theories, frameworks, models, and reporting guidelines that can be applied to help clarify the clinical and implementation intervention, respectively. Conclusion: Semantics provide opportunities for improved precision in depicting what is 'intervention' and what is 'implementation' in health care research. Further, attention to study design, the use of theory, and adoption of reporting guidelines can assist in distinguishing between the clinical intervention and the implementation intervention. However, certain aspects may remain unclear in analyses of hybrid studies of clinical and implementation interventions. Recognizing this potential greyness can inform further discourse.
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| 18. |
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| 19. |
- Eldh, Ann Catrine, et al.
(författare)
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Conditions for patient participation and non-participation in health care
- 2006
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Ingår i: Nursing Ethics. - Malden, USA : SAGE Publications. - 0969-7330 .- 1477-0989. ; 13:5, s. 503-514
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Tidskriftsartikel (refereegranskat)abstract
- This study explored patients' experiences of participation and non-participation in their health care. A questionnaire-based survey method was used. Content analysis showed that conditions for patient participation occurred when information was provided not by using standard procedures but based on individual needs and accompanied by explanations, when the patient was regarded as an individual, when the patient's knowledge was recognized by staff, and when the patient made decisions based on knowledge and needs, or performed self-care. Thus, to provide conditions for true patient participation, professionals need to recognize each patient's unique knowledge and respect the individual's description of his or her situation rather than just inviting the person to participate in decision making.
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| 20. |
- Eldh, Ann Catrine, et al.
(författare)
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Considering patient non-participation in health care
- 2008
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Ingår i: Health Expectations. - : Wiley. - 1369-7625 .- 1369-6513. ; 11:3, s. 263-71
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to depict patient non-participation as described by a diverse group with recent experiences of being patients. BACKGROUND: Patient participation is regarded as a primary condition for optimal quality of care, suggesting that non-participation should be avoided. A common understanding of the concept of patient non-participation is needed. A discrepancy in definitions of patient non-participation has been found in health-care interactions, health-care classifications and health-care research, and little is known of what patient non-participation represents to patients. STUDY DESIGN: A survey consisting of closed-ended and open-ended questions was administered to persons that had recently been patients to gather respondents' descriptions of what they considered as patient non-participation. Qualitative content analysis was used to analyse free-text descriptions, and descriptive statistics were used for the close-ended alternatives. FINDINGS: Lacking information (e.g. not being provided with appropriate information) and lacking recognition (e.g. not being listened to and/or lacking recognition as an individual with individual needs and concerns) were significant aspects of patient non-participation. Furthermore, non-participation encompassed facing organization-centred, as opposed to patient-centred, health care as well as feeling insecure in health care interactions. CONCLUSION: The findings provide input for a better understanding of what patients experience as non-participation. Organising for the caregivers to be able to thoroughly listen to the patients' illness narratives would easily reduce the risk of patient's experiencing what is described as non-participation and would provide a sound base for patient learning needs.
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| 21. |
- Eldh, Ann Catrine
(författare)
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Delaktighet och gemenskap
- 2014. - 2
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Ingår i: Omvårdnadens grunder. - Lund : Studentlitteratur AB. - 9789144083551
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Bokkapitel (refereegranskat)
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| 22. |
- Eldh, Ann Catrine, 1965-, et al.
(författare)
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Depicting the interplay between organisational tiers in the use of a national quality registry to develop quality of care in Sweden
- 2015
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: With a pending need to identify potential means to improved quality of care, national quality registries (NQRs) are identified as a promising route. Yet, there is limited evidence with regards to what hinders and facilitates the NQR innovation, what signifies the contexts in which NQRs are applied and drive quality improvement. Supposedly, barriers and facilitators to NQR-driven quality improvement may be found in the healthcare context, in the politico-administrative context, as well as with an NQR itself. In this study, we investigated the potential variation with regards to if and how an NQR was applied by decision-makers and users in regions and clinical settings. The aim was to depict the interplay between the clinical and the politico-administrative tiers in the use of NQRs to develop quality of care, examining an established registry on stroke care as a case study.METHODS: We interviewed 44 individuals representing the clinical and the politico-administrative settings of 4 out of 21 regions strategically chosen for including stroke units representing a variety of outcomes in the NQR on stroke (Riksstroke) and a variety of settings. The transcribed interviews were analysed by applying The Consolidated Framework for Implementation Research (CFIR).RESULTS: In two regions, decision-makers and/or administrators had initiated healthcare process projects for stroke, engaging the health professionals in the local stroke units who contributed with, for example, local data from Riksstroke. The Riksstroke data was used for identifying improvement issues, for setting goals, and asserting that the stroke units achieved an equivalent standard of care and a certain level of quality of stroke care. Meanwhile, one region had more recently initiated such a project and the fourth region had no similar collaboration across tiers. Apart from these projects, there was limited joint communication across tiers and none that included all individuals and functions engaged in quality improvement with regards to stroke care.CONCLUSIONS: If NQRs are to provide for quality improvement and learning opportunities, advances must be made in the links between the structures and processes across all organisational tiers, including decision-makers, administrators and health professionals engaged in a particular healthcare process.
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| 23. |
- Eldh, Ann Catrine, Professor, 1965-, et al.
(författare)
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Facilitating facilitators to facilitate : Some general comments on a strategy for knowledge implementation in health services
- 2023
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Ingår i: Frontiers Health Services. - : Frontiers Media S.A.. - 2813-0146. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Numerous endeavours to ensure that day-to-day healthcare is both evidence-based and person-centred have generated extensive, although partial, comprehension of what guarantees quality improvement. To address quality issues, researchers and clinicians have developed several strategies as well as implementation theories, models, and frameworks. However, more progress is needed regarding how to facilitate guideline and policy implementation that guarantees effective changes take place in a timely and safe manner. This paper considers experiences of engaging and supporting local facilitators in knowledge implementation. Drawing on several interventions, considering both training and support, this general commentary discusses whom to engage and the length, content, quantity, and type of support along with expected outcomes of facilitators' activities. In addition, this paper suggests that patient facilitators could help produce evidence-based and person-centred care. We conclude that research about the roles and functions of facilitators needs to include more structured follow-ups and also improvement projects. This can increase the speed of learning with respect to what works, for whom, in what context, why (or why not), and with what outcomes when it comes to facilitator support and tasks.
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| 24. |
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| 25. |
- Eldh, Ann Catrine, et al.
(författare)
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Facilitators and barriers to applying a national quality registry for quality improvement in stroke care
- 2014
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 14, s. 354-
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Tidskriftsartikel (refereegranskat)abstract
- Background: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. Methods: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQR's criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis. Results: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from national guidelines which can be used for comparisons over time within the organisation or with other hospitals. Major effort is required to ensure that data entries are accurate and valid, and thus the trustworthiness of local data output competes with resources needed for everyday clinical stroke care and quality improvement initiatives. Local stakeholders with knowledge of and interest in both the medical area (in this case stroke) and quality improvement can apply the NQR data to effectively initiate, carry out, and evaluate quality improvement, if supported by managers and co-workers, a common stroke care process and an operational management system that embraces and engages with the NQR data. Conclusion: While quality registries are assumed to support adherence to evidence-based guidelines around the world, this study proposes that a NQR can facilitate improvement of care but neither the registry itself nor the reporting of data initiates quality improvement. Rather, the local and general evidence provided by the NQR must be considered relevant and must be applied in the local context. Further, the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so.
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| 26. |
- Eldh, Ann Catrine, 1965-, et al.
(författare)
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Factors facilitating a national quality registry to aid clinical quality improvement : findings of a national survey
- 2016
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 6:11
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: While national quality registries (NQRs) are suggested to provide opportunities for systematic follow-up and learning opportunities, and thus clinical improvements, features in registries and contexts triggering such processes are not fully known. This study focuses on one of the world's largest stroke registries, the Swedish NQR Riksstroke, investigating what aspects of the registry and healthcare organisations facilitate or hinder the use of registry data in clinical quality improvement.Methods: Following particular qualitative studies, we performed a quantitative survey in an exploratory sequential design. The survey, including 50 items on context, processes and the registry, was sent to managers, physicians and nurses engaged in Riksstroke in all 72 Swedish stroke units. Altogether, 242 individuals were presented with the survey; 163 responded, representing all but two units. Data were analysed descriptively and through multiple linear regression.Results: A majority (88%) considered Riksstroke data to facilitate detection of stroke care improvement needs and acknowledged that their data motivated quality improvements (78%). The use of Riksstroke for quality improvement initiatives was associated (R2=0.76) with ‘Colleagues’ call for local results’ (p=<0.001), ‘Management Request of Registry data’ (p=<0.001), and it was said to be ‘Simple to explain the results to colleagues’ (p=0.02). Using stepwise regression, ‘Colleagues’ call for local results’ was identified as the most influential factor. Yet, while 73% reported that managers request registry data, only 39% reported that their colleagues call for the unit's Riksstroke results.Conclusions: While an NQR like Riksstroke demonstrates improvement needs and motivates stakeholders to make progress, local stroke care staff and managers need to engage to keep the momentum going in terms of applying registry data when planning, performing and evaluating quality initiatives.
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| 27. |
- Eldh, Ann Catrine, Docent, 1965-, et al.
(författare)
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Health Care Professionals' Experience of a Digital Tool for Patient Exchange, Anamnesis, and Triage in Primary Care : Qualitative Study.
- 2020
-
Ingår i: JMIR Human Factors. - Toronto, Canada : JMIR Publications. - 2292-9495. ; 7:4
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite a growing body of knowledge about eHealth innovations, there is still limited understanding of the implementation of such tools in everyday primary care.OBJECTIVE: The objective of our study was to describe health care staff's experience with a digital communication system intended for patient-staff encounters via a digital route in primary care.METHODS: In this qualitative study we conducted 21 individual interviews with staff at 5 primary care centers in Sweden that had used a digital communication system for 6 months. The interviews were guided by narrative queries, transcribed verbatim, and subjected to content analysis.RESULTS: While the digital communication system was easy to grasp, it was nevertheless complex to use, affecting both staffing and routines for communicating with patients, and documenting contacts. Templates strengthened equivalent procedures for patients but dictated a certain level of health and digital literacy for accuracy. Although patients expected a chat to be synchronous, asynchronous communication was extended over time. The system for digital communication benefited assessments and enabled more efficient use of resources, such as staff. On the other hand, telephone contact was faster and better for certain purposes, especially when the patient's voice itself provided data. However, many primary care patients, particularly younger ones, expected digital routes for contact. To match preferences for communicating to a place and time that suited patients was significant; staff were willing to accept some nuisance from a suboptimal service-at least for a while-if it procured patient satisfaction. A team effort, including engaged managers, scaffolded the implementation process, whereas being subjected to a trial without likely success erected barriers.CONCLUSIONS: A digital communication system introduced in regular primary care involved complexity beyond merely learning how to manage the tool. Rather, it affected routines and required that both the team and the context were addressed. Further knowledge is needed about what factors facilitate implementation, and how. This study suggested including ethical perspectives on eHealth tools, providing an important but novel aspect of implementation.
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| 28. |
- Eldh, Ann Catrine, 1965-, et al.
(författare)
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How single is ‘single’ : some pragmatic reflections on single versus multifaceted interventions to facilitate implementation
- 2015
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Ingår i: International Journal of Health Policy and Management. - : Maad Rayan Publishing Company. - 2322-5939. ; 4:10, s. 699-701
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Tidskriftsartikel (refereegranskat)abstract
- An earlier overview of systematic reviews and a subsequent editorial on single-component versus multifaceted interventions to promote knowledge translation (KT) highlight complex issues in implementation science. In this supplemented commentary, further aspects are in focus; we propose examples from (KT) studies probing the issue of single interventions. A main point is that defining what is a single and what is a multifaceted intervention can be ambiguous, depending on how the intervention is conceived. Further, we suggest additional perspectives in terms of strategies to facilitate implementation. More specifically, we argue for a need to depict not only what activities are done in implementation interventions, but to unpack functions in particular contexts, in order to support the progress of implementation science.
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| 29. |
- Eldh, Ann Catrine, et al.
(författare)
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How Single Is "Single" - Some Pragmatic Reflections on Single Versus Multifaceted Interventions to Facilitate Implementation : Comment on "Translating Evidence Into Healthcare Policy and Practice
- 2015
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Ingår i: International Journal of Health Policy and Management. - : Maad Rayan Publishing Company. - 2322-5939. ; 4:10, s. 699-701
-
Tidskriftsartikel (refereegranskat)abstract
- An earlier overview of systematic reviews and a subsequent editorial on single-component versus multifaceted interventions to promote knowledge translation (KT) highlight complex issues in implementation science. In this supplemented commentary, further aspects are in focus; we propose examples from (KT) studies probing the issue of single interventions. A main point is that defining what is a single and what is a multifaceted intervention can be ambiguous, depending on how the intervention is conceived. Further, we suggest additional perspectives in terms of strategies to facilitate implementation. More specifically, we argue for a need to depict not only what activities are done in implementation interventions, but to unpack functions in particular contexts, in order to support the progress of implementation science.
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| 30. |
- Eldh, Ann Catrine, et al.
(författare)
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'I have the world's best job' - staff experience of the advantages of caring for older people.
- 2016
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 30:2, s. 365-73
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Tidskriftsartikel (refereegranskat)abstract
- RATIONALE: Besides a growing demand for safe high-quality care for older people, long-term care (LTC) often struggles to recruit appropriately qualified nursing staff. Understanding what LTC staff value in their work may contribute to a more comprehensive understanding of what can attract staff and support person-centred care.AIM: To explore staff experience of the advantages of working in LTC settings for older people.METHODS: Narrative descriptions of 85 LTC staff in Ireland, the Netherlands and Sweden on what they value in their work were analysed with qualitative content analysis.ETHICS: Ethical approval was obtained according to the requirements of each country, and participants provided informed consent prior to the individual interviews.FINDINGS: Working in LTC signifies bonding with the older people residing there, their next of kin and the team members. It means autonomy in one's daily tasks amalgamated with being a part of an affirmative team. Participants reported a sense of accomplishment and fulfilment; caring meant consideration and recognition of the older people and the relationships formed, which provided for professional and personal growth. The sharing of compassion between staff and residents indicated reciprocity of the relationship with residents.STUDY LIMITATIONS: The findings may be transferable to LTC in general although they address only the positive aspects of caring for older people and only the experiences of those staff who had consented to take part in the study.CONCLUSIONS: The findings add to what underpins the quality of care in nursing homes: compassion in the nurse-resident relationship and person-centred care in LTC. They indicate reciprocity in the relations formed that may contribute to the empowerment of older people, but further studies are needed to explore this in more detail.
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| 31. |
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| 32. |
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| 33. |
- Eldh, Ann Catrine, 1965-, et al.
(författare)
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Kunskapsbaserad omvårdnad och implementering
- 2023. - 2
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Ingår i: Kvalitetsutveckling inom omvårdnad. - Lund : Studentlitteratur AB. - 9789144162164 ; , s. 129-162
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Forskningsresultat fyller en viktig funktion för att utveckla och bibehålla säker, effektiv och personcentrerad vård och omsorg. Trots kontinuerlig forskning är ett känt faktum att det kan ta lång tid från att ny kunskap framställs tills att nödvändiga forskningsresultat nyttiggörs i hälso- och sjukvård och omsorg. Studier visar att det kan ta upp till 17 år innan forskningsresultat får genomslag och blir till rutin i vårdens vardag. Implementeringsforskning är ett tvärprofessionellt forskningsområde där flera forskande sjuksköterskor har gjort betydelsefulla bidrag. Varför tar det så lång tid att implementera en omvårdnadsåtgärd eller omvårdnadsmetod och hur går det till att implementera ny eller annan relevant kunskap kommer att belysas i detta kapitel. Andra frågor som tas upp här är om det går att underlätta implementering och i så fall hur det kan möjliggöras.
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| 34. |
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| 35. |
- Eldh, Ann Catrine, 1965-, et al.
(författare)
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Onset PrevenTIon of urinary retention in Orthopaedic Nursing and rehabilitation, OPTION-a study protocol for a randomised trial by a multi-professional facilitator team and their first-line managers' implementation strategy
- 2021
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Ingår i: Implementation Science. - : BioMed Central. - 1748-5908. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Onset PrevenTIon of urinary retention in Orthopaedic Nursing and rehabilitation, OPTION, project aims to progress knowledge translation vis-à-vis evidence-based bladder monitoring in orthopaedic care, to decrease the risk of urinary retention, and voiding complications. Urinary retention is common whilst in hospital for hip surgery. If not properly identified and managed, there is a high risk of complications, some lifelong and life threatening. Although evidence-based guidelines are available, the implementation is lagging.METHODS: Twenty orthopaedic sites are cluster randomised into intervention and control sites, respectively. The intervention sites assemble local facilitator teams among nursing and rehabilitation staff, including first-line managers. The teams receive a 12-month support programme, including face-to-face events and on-demand components to map and bridge barriers to guideline implementation, addressing leadership behaviours and de-implementation of unproductive routines. All sites have access to the guidelines via a public healthcare resource, but the control sites have no implementation support.Baseline data collection includes structured assessments of urinary retention procedures via patient records, comprising incidence and severity of voiding issues and complications, plus interviews with managers and staff, and surveys to all hip surgery patients with interviews across all sites. Further assessments of context include the Alberta Context Tool used with staff, the 4Ps tool for preference-based patient participation used with patients, and data on economic aspects of urinary bladder care.During the implementation intervention, all events are recorded, and the facilitators keep diaries. Post intervention, the equivalent data collections will be repeated twice, and further data will include experiences of the intervention and guideline implementation.Data will be analysed with statistical analyses, including comparisons before and after, and between intervention and control sites. The qualitative data are subjected to content analysis, and mixed methods are applied to inform both clinical outcomes and the process evaluation, corresponding to a hybrid design addressing effectiveness, experiences, and outcomes.DISCUSSION: The OPTION trial has a potential to account for barriers and enablers for guideline implementation in the orthopaedic context in general and hip surgery care in particular. Further, it may progress the understanding of implementation leadership by dyads of facilitators and first-line managers.TRIAL REGISTRATION: The study was registered as NCT04700969 with the U.S. National Institutes of Health Clinical Trials Registry on 8 January 2021, that is, prior to the baseline data collection.
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| 36. |
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| 37. |
- Eldh, Ann Catrine, 1965-
(författare)
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Patient participation : what it is and what it is not
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In general, patient participation is regarded as being informed and partaking in decision making regarding one’s care and treatment. This interpretation is common in legislation throughout the Western world and corresponding documents guiding health care professionals, as well as in scientific studies. Even though this understanding of the word participation can be traced to a growing emphasis on individuals’ autonomy in society and to certain dictionary defi nitions, there are other ways of understanding participation from a semantic point of view, and no trace of patients’ descriptions of what it is to participate can be found in these definitions. Hence, the aim of this dissertation was to understand patients’ experience of the phenomenon of patient participation. An additional aim was to understand patients’ experience of non-participation and to describe the conditions for patient participation and non-participation, in order to understand the prerequisites for patient participation. The dissertation comprises four papers. The philosophical ideas of Ricoeur provided a basis for the studies: how communication can present ways to understand and explain experiences of phenomena through phenomenological hermeneutics. The first and second studies involved a group of patients living with chronic heart failure. For the fi rst study, 10 patients were interviewed, with a narrative approach, about their experience of participation and non-participation, as defi ned by the participants. For the second study, 11 visits by three patients at a nurse-led outpatient clinic were observed, and consecutive interviews were performed with the patients and the nurses, investigating what they experience as patient participation and non-participation. A triangulation of data was performed to analyse the occurrence of the phenomena in the observed visits. For paper 3 and 4, a questionnaire was developed and distributed among a diverse group of people who had recent experience of being patients. The questionnaire comprised respondent’s description of what patient participation is, using items based on findings in Study 1, along with open-ended questions for additional aspects and general issues regarding situations in which the respondent had experienced patient participation and/or non-participation. The findings show additional aspects to patient participation: patient participation is being provided with information and knowledge in order for one to comprehend one’s body, disease, and treatment and to be able to take self-care actions based on the context and one’s values. Participation was also found to include providing the information and knowledge one has about the experience of illness and symptoms and of one’s situation. Participation occurs when being listened to and being recognised as an individual and a partner in the health care team. Non-participation, on the other hand, occurs when one is regarded as a symptom, a problem to be solved. To avoid non-participation, the information provided needs to be based on the individual’s need and with recognition of the patient’s knowledge and context. In conclusion, patient participation needs to be reconsidered in health care regulations and in clinical settings: patients’ defi nitions of participation, found to be close to the dictionaries’ description of sharing, should be recognised and opportunities provided for sharing knowledge and experience in two-way-communication.
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| 38. |
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| 39. |
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| 40. |
- Eldh, Ann Catrine, et al.
(författare)
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Quotations in Qualitative Studies : Reflections on Constituents, Custom, and Purpose
- 2020
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Ingår i: International Journal of Qualitative Methods. - : Sage Publications. - 1609-4069. ; 19, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Qualitative studies are often found to be accompanied by quotations from interviews or similar data sources. As with any methodological tradition, it is essential to critically explore the general principle of including quotations in scientific papers: what is the purpose and justification for including quotations? Are there standards and, in that case, what are they and what are their scientific positioning? This paper presents an overview of the somewhat diverse guidance found in the literature in reference to the representation of quotations. Yet, both students and scholars use a variety of approaches to quote from their data, ranging from presenting numerous, extensive, and/or comprehensive quotations throughout the results section to the reporting of a few particular quotations to illustrate certain aspects of the findings only. While their function may be described, scientific reasoning for using quotations is scarce. Along with an overview of the scientific background and options for including quotations in qualitative studies, we discuss the consequences of the different epistemological and methodological aspects found in the literature. In conclusion, we argue that there are incentives for promoting a more deliberate employment of references from data; deriving from the human sciences tradition, a corresponding epistemological stance would suggest that quotations preferably apply for illustrating the analysis process and/or findings, while the idea that quotations can be employed to validate findings has limited support. Further critical examination of the application of and justification for including quotations in the reporting of qualitative studies is needed among researchers, journal editors and reviewers.
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| 41. |
- Eldh, Ann Catrine, 1965-, et al.
(författare)
-
Realist evaluation
- 2020
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Ingår i: Handbook on implementation science. - Cheltenham : Edward Elgar Publishing. - 9781788975988 ; , s. 505-511
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 42. |
- Eldh, Ann Catrine, et al.
(författare)
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Seeking a balance between employment and the care of an ageing parent
- 2011
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 25:2, s. 285-293
-
Tidskriftsartikel (refereegranskat)abstract
- Rationale: A growing number of middle-aged people are engaged in informal care of their parents while employed. To provide support as employers, co-workers or staff, health care professionals need insight into the experiences of people managing these responsibilities. Aim: To elucidate the experience of providing informal care to an ageing parent while managing the responsibilities of a working life. Methods: Narrative interviews were performed with 11 persons with experience of the phenomenon. Transcribed interviews were analysed with phenomenological hermeneutics. Ethics: Informed consent was given prior to the interviews. The study was approved by a research ethics committee. Findings: Providing informal care to an ageing parent while also pursuing a working life implies seeking balance: a balance between providing support to the parent's needs and one's responsibilities at work. Being employed supports this balance as it provides both fulfilment and refuge. Being capable of managing both roles grants a sense of satisfaction, supporting one's sense of balance in life. The balance can be supported by sharing the responsibility of caring for the ageing parent with others. Study limitations: Despite perceived saturation and an effort to provide for the possibility to consider internal consistency, the findings should be considered as a contribution to the understanding of the phenomenon, as experienced by individuals in their life world. Conclusions: It is essential to recognise the impact that providing care for an ageing parent may have on the lives of a growing number of people, particularly if they have employment responsibilities. Acknowledgement by others supports one's ability to attain balance; as co-workers and managers, we can acknowledge the efforts of an informal caregiver and as health care staff recognise the valuable contribution made by people in mid-life who provide informal care for their ageing parents.
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| 43. |
- Eldh, Ann Catrine
(författare)
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Six Honest Serving Matters, Teaching Us All We Need to Know About Context in Knowledge Implementation? Comment on "Stakeholder Perspectives of Attributes and Features of Context Relevant to Knowledge Translation in Health Settings : A Multi-country Analysis"
- 2022
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Ingår i: International Journal of Health Policy and Management. - Iran : Kerman University of Medical Sciences. - 2322-5939. ; 11:8, s. 1574-1576
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- While context is a vital factor in any attempt to study knowledge translation or implement evidence in healthcare, there is a need to better understand the attributes and relations that constitute context. A recent study by J. Squires et al investigates such attributes and definitions, based on 39 stakeholder interviews across Australia, Canada, the United Kingdom, and the United States. Sixteen attributes, comprising 30 elements suggested as new findings, are proposed as the basis for a framework. This commentary argues for the need to incorporate more perspectives but also suggests an initial taxonomy rather than a framework, comprising a wider range of stakeholders and an enhanced understanding of how context elements are related at different levels and how this affects implementation processes. Aligning with person-centred care, this must include not only professionals but also patients and their next of kin, as partners in shaping more evidence-based healthcare.
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| 44. |
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| 45. |
- Eldh, Ann Catrine
(författare)
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Strategier för behandling av urininkontinens inom äldreomsorgen
- 2014. - 1
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Ingår i: Implementering av evidensbaserad praktik. - Malmö : Gleerups Utbildning AB. - 9789140684479 ; , s. 201-216
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Bokkapitel (refereegranskat)abstract
- Ökade krav och förväntningar på att offentlig verksamhet ska nyttiggöra forskning har lett till ett stort intresse för implementeringsfrågor. Detta är en av de första böckerna på svenska om implementering av evidensbaserad praktik. Bokens första del ger en bakgrund till dagens implementeringsforskning och presenterar relevanta teorier, modeller och ramverk. Den andra delen visar hur dessa teorier, modeller och ramverk kan användas för att vägleda och analysera implementering av evidensbaserad praktik i bland annat intensivvård, mödrahälsovård, fysioterapi, äldreomsorg samt lokalsamhället.
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| 46. |
- Eldh, Ann Catrine, et al.
(författare)
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Supporting first-line managers in implementing oral care guidelines in nursing homes
- 2018
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Ingår i: Nordic Journal of Nursing Research. - : SAGE Publications. - 2057-1585 .- 2057-1593. ; 38:2, s. 87-95
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated first-line managers’ experience of and responses to a concise leadership intervention to facilitate the implementation of oral care clinical practice guidelines (CPGs) in nursing homes. Leadership is known to be an important element in knowledge implementation but little is known as to what supports managers to facilitate the process. By means of a process evaluation with mixed methods, the context and a three-month leadership program was explored, including activities during and in relation to the program, and the effects in terms of oral care CPG implementation plans. While the managers appreciated the intervention and considered improved oral care to be a priority, their implementation plans mainly focused the dissemination of an oral care checklist. The findings suggest that extended implementation interventions engaging both managers and clinical staff are needed, and that a concise intervention does not facilitate first-line managers to adopt behaviors known to facilitate knowledge implementation.
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| 47. |
- Eldh, Ann Catrine, 1965-, et al.
(författare)
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The development and initial validation of a clinical tool for patients' preferences on patient participation : The 4Ps
- 2015
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Ingår i: Health Expectations. - : Wiley-Blackwell. - 1369-6513 .- 1369-7625. ; 18:6, s. 2522-2535
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To report on the development and initial testing of a clinical tool, The Patient Preferences for Patient Participation tool (The 4Ps), which will allow patients to depict, prioritize, and evaluate their participation in health care.Background: While patient participation is vital for high quality health care, a common definition incorporating all stakeholders' experience is pending. In order to support participation in health care, a tool for determining patients' preferences on participation is proposed, including opportunities to evaluate participation while considering patient preferences.Methods: Exploratory mixed methods studies informed the development of the tool, and descriptive design guided its initial testing. The 4Ps tool was tested with 21 Swedish researcher experts (REs) and patient experts (PEs) with experience of patient participation. Individual Think Aloud interviews were employed to capture experiences of content, response process, and acceptability.Results: 'The 4Ps' included three sections for the patient to depict, prioritize, and evaluate participation using 12 items corresponding to 'Having Dialogue', 'Sharing Knowledge', 'Planning', and 'Managing Self-care'. The REs and PEs considered 'The 4Ps' comprehensible, and that all items corresponded to the concept of patient participation. The tool was perceived to facilitate patient participation whilst requiring amendments to content and layout.Conclusions: A tool like The 4Ps provides opportunities for patients to depict participation, and thus supports communication and collaboration. Further patient evaluation is needed to understand the conditions for patient participation. While The 4Ps is promising, revision and testing in clinical practice is required.
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| 48. |
- Eldh, Ann Catrine, et al.
(författare)
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The meaning of patient participation for patients and nurses at a nurse-led clinic for chronic heart failure
- 2006
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 5:1, s. 45-53
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe legislation of many Western countries emphasizes active patient participation. Patients with chronic heart failure (CHF), however, have experienced participation differently from the general interpretation of legal definitions. Education improves uptake of self-management strategies yet knowledge is lacking about support of patients' own resources in CHF. AimTo explore the phenomena of patient participation and non-participation as shown in patient visits to a nurse-led clinic for CHF and as experienced by the patients and nurses. MethodsData triangulation of field notes from participatory observations and texts from narrative interviews with the patients and assigned nurse specialists. Data were analyzed according to the phenomenological hermeneutic tradition. FindingsPatients' experience of participation and non-participation was interpreted as “Being responsible and accepting responsibility” and “Lacking an equal relationship while being controlled”, respectively. Nurses experienced patient participation as “Getting information and security to act” and patient non-participation as “Not accepting”. ConclusionConflicting values of patients and nurses, which were interpreted with respect to participation and non-participation, presumably might influence patient information and education negatively. The issue of participation should be raised as a means of attaining concordance and to facilitate patient participation with education specifically tailored to the individual patient's needs.
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| 49. |
- Eldh, Ann Catrine, et al.
(författare)
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The phenomena of participation and non-participation in health care : experiences of patients attending a nurse-led clinic for chronic heart failure
- 2004
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 3:3, s. 239-246
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patient participation is stressed in the health care acts of many western countries yet a common definition of the concept is lacking. The understanding of experiences of patients with chronic heart failure (CHF) who attend nurse-led specialist clinics, a form of care suggested as beneficiary to this group, may promote a better understanding of participation. Aim: To investigate the meanings of participation and non-participation as experienced by patients living with CHF. Methods: Narrative interviews analysed in the phenomenological hermeneutic tradition inspired by Ricoeur where the interpretation is made in the hermeneutic circle, explaining and understanding the experienced phenomena. Findings: Participation was experienced as to “be confident”, “comprehend” and “seek and maintain a sense of control”. Non-participation was experienced as to “not understand”, “not be in control”, “lack a relationship” and “not be accountable”. The findings indicate that the experiences of participation and non-participation can change over time and phases of the disease and treatment. Conclusion: The study suggests an extended view on the concept of participation. Patients' experiences of participation in health care can vary and should therefore be an issue for dialogue between nurses and patients with CHF in nurse-led specialist clinics.
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| 50. |
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