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- Choiniere, Jacqueline A., et al.
(author)
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Mapping Nursing Home Inspections and Audits in Six Countries
- 2016
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In: Ageing International. - : Springer Science and Business Media LLC. - 0163-5158 .- 1936-606X. ; 41:1, s. 40-61
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Journal article (peer-reviewed)abstract
- International quality concerns regarding long-term residential care, home to many of the most vulnerable among us, prompted our examination of the audit and inspection processes in six different countries. Drawing on Donabedian’s (Evaluation & Health Professions, 6(3), 363–375, 1983) categorization of quality criteria into structural, process and outcome indicators, this paper compares how quality is understood and regulated in six countries occupying different categories according to Esping Andersen’s (1990) typology: Canada, England, and the United States (liberal welfare regimes); Germany (conservative welfare regime); Norway, and Sweden (social democratic welfare regimes). In general, our review finds that countries with higher rates of privatization (mostly the liberal welfare regimes) have more standardized, complex and deterrence-based regulatory approaches. We identify that even countries with the lowest rates of for profit ownership and more compliance-based regulatory approaches (Norway and Sweden) are witnessing an increased involvement of for-profit agencies in managing care in this sector. Our analysis suggests there is widespread concern about the incursion of market forces and logic into this sector, and about the persistent failure to regulate structural quality indicators, which in turn have important implications for process and outcome quality indicators.
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- Glasdam, Stinne, et al.
(author)
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Nurses’ use of social media during the COVID-19 pandemic—A scoping review
- 2022
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In: PLoS ONE. - San Francisco, CA : Public Library of Science (PLoS). - 1932-6203. ; 17:2
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Journal article (peer-reviewed)abstract
- BackgroundDuring the COVID-19 pandemic, nurses stand in an unknown situation while facing continuous news feeds. Social media is a ubiquitous tool to gain and share reliable knowledge and experiences regarding COVID-19. The article aims to explore how nurses use social media in relation to the COVID-19 pandemic.MethodA scoping review inspired by Arksey and O’Mally was conducted by searches in Medline, CINAHL, Academic Search Complete and Web of Sciences. Empirical research studies investigating nurses’ use of social media in relation to COVID-19 were included. Exclusion criteria were: Literature reviews, articles in languages other than English, articles about E-health, and articles investigating healthcare professionals without specification of nurses included. Articles, published in January-November 2020, were included and analysed through a thematic analysis. The PRISMA-ScR checklist was used.ResultsMost of the eleven included studies were cross-sectional surveys, conducted in developing countries, and had neither social media nor nurses as their main focus of interest. Three themes were identified: ‘Social media as a knowledge node’, ‘Social media functioned as profession-promoting channels’ and ‘Social media as a disciplinary tool’. Nurses used social media as channels to gain and share information about COVID-19, and to support each other by highlighting the need for training and changes in delivery of care and redeployment. Further, social media functioned as profession-promoting channels partly sharing heroic self-representations and acknowledgment of frontline persons in the pandemic, partly by displaying critical working conditions. Finally, nurses used social media to educate people to perform the ‘right ‘COVID-19’ behaviours in society.ConclusionThis review provided snapshots of nurses’ uses of social media from various regions in the world, but revealed a need for studies from further countries and continents. The study calls for further multi-methodological and in depth qualitative research, including theoretically framed studies, with a specific focus on the uses of social media among nurses during the pandemic.
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- Glasdam, Stinne, et al.
(author)
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Scandinavian Nurses’ Use of Social Media during the COVID-19 Pandemic—A Berger and Luckman Inspired Analysis of a Qualitative Interview Study
- 2022
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In: Healthcare. - : MDPI AG. - 2227-9032. ; 10:7
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Journal article (peer-reviewed)abstract
- There is a knowledge gap about nurses’ use of social media in relation to and during the COVID-19 pandemic, which demands the upholding of a physical distance to other people, including patients and their relatives. The study aims to explore how nurses in the Scandinavian countries used social media for professional purposes in relation to the first 15 months of the COVID-19 pandemic. Qualitative, semi-structured interviews with 30 nurses in three Scandinavian countries (Denmark, Norway, and Sweden) were conducted. Thematic analyses were made, methodically inspired by Braun and Clarke, and theoretically inspired by Berger and Luckmann’s theory about the construction of social reality. The Standards for Reporting Qualitative Research (SRQR) checklist was used. The results showed that social media was a socialisation tool for establishing new routines in clinical practice. Virtual meeting places supported collective understandings of a specific COVID-19 ‘reality’ and ‘knowledge’ amongst nurses, with the pandemic bringing to the fore the issue of eprofessionalism among nurses relating to their clinical practice. However, social media and virtual education were not commonly used in patient contacts. Further, nurses attempted a re-socialisation of the public to proper COVID-19 behaviour through social media. Moreover, blurred boundaries between acting as a private individual and a professional nurse were identified, where ethics of the nursing profession extended to nurses’ private lives.
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- Harrington, Charlene, et al.
(author)
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Marketization in Long-Term Care : A Cross-Country Comparison of Large For-Profit Nursing Home Chains
- 2017
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In: Health Services Insights. - : SAGE Publications. - 1178-6329. ; 10, s. 1-23
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Journal article (peer-reviewed)abstract
- This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability.
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- Harrington, Charlene, et al.
(author)
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Nursing Home Staffing Standards and Staffing Levels in Six Countries
- 2012
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In: Journal of Nursing Scholarship. - : Wiley. - 1527-6546 .- 1547-5069. ; 44:1, s. 88-98
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Journal article (peer-reviewed)abstract
- Purpose: This study was designed to collect and compare nurse staffing standards and staffing levels in six counties: the United States, Canada, England, Germany, Norway, and Sweden. Design: The study used descriptive information on staffing regulations and policies as well as actual staffing levels for registered nurses, licensed nurses, and nursing assistants across states, provinces, regions, and countries. Methods: Data were collected from Internet searches of staffing regulations and policies along with statistical data on actual staffing from reports and documents. Staffing data were converted to hours per resident day to facilitate comparisons across countries. Findings: We found wide variations in both nurse staffing standards and actual staffing levels within and across countries, although comparisons were difficult to make due to differences in measuring staffing, the vagueness of standards, and limited availability of actual staffing data. Both the standards and levels in most countries ( except Norway and Sweden) were lower than the recommended levels by experts. Conclusions: Our findings demonstrate the need for further attention to nurse staffing standards and levels in order to assure the quality of nursing home care.
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- Jacobsen, Frode F., et al.
(author)
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Job Autonomy of Long-Term Residential Care Assistive Personnel : A Six Country Comparison
- 2018
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In: Ageing International. - : Springer Science and Business Media LLC. - 0163-5158 .- 1936-606X. ; 43:1, s. 4-19
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Journal article (peer-reviewed)abstract
- Assistive personnel are the primary caregivers in long term residential care (LTRC) and their job autonomy is a major social determinant of health. Our goal is to explore experiences of assistive personnel in six industrialized countries (Canada, Germany, Norway, Sweden, England, and the U.S.), and consider innovations in the LTRC setting that might influence their job autonomy. The methodology is based on on-site observations at nursing homes and interviews with assistive personnel and other relevant LTRC staff in selected nursing homes in all six countries. Previously published statistical material from the study on staff characteristics like pay, formal education, unionization, employment-related benefits and extent of part-time work is employed as relevant context for discussing job autonomy. Our results show that assistive personnel are highly supportive of job autonomy though they interpret autonomy differently and report widely varying levels of job autonomy. Those LTRC organizations that have a reputation for encouraging autonomy of assistive personal, report recruiting is far easier even where there is a shortage. In some countries we were told that “resident-centered” (“person-centered”) care and a leveling of the division of labor, understood as more equal and horizontal division of labor, was on the rise and this could affect autonomy. Job autonomy is welcomed by assistive personnel. The wide variation in job autonomy across nursing homes and across countries is surprising. Within nursing homes variation may reflect imperfect or incomplete implementation of autonomy policies, or differential application of policies. The resident-centered philosophy and the leveling of the division of labor could make for greater autonomy for assistive personnel. These workplace innovations are not universal in all countries and they could be more difficult to apply where resources and commitment are lacking. The increasingly frail population of LTRC facilities and the general trend toward growth of specialized medical treatment within LTRC in some of the countries may support an argument for some limitations to job autonomy in assistive personnel. Autonomy is favored by assistive personnel though not all have it. The workplace innovations of resident-centered care and a leveling of the division of labor in LTRC, could make for a greater degree of autonomy for assistive personnel in the future, while increased demand for highly skilled care could work in the other direction.
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| 14. |
- Jacobsen, Frode, et al.
(author)
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Migration and health : exploring healthy ageing of immigrants in European societies
- 2023
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In: Primary Health Care Research and Development. - 1463-4236. ; 24
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Journal article (peer-reviewed)abstract
- Aim: The aim is to identify important factors for immigrants’ health and well-being and for their use (or non-use) of primary health care (PHC) and other non-specialised services, and for possible ways that PHC can support healthy ageing of immigrants.Background: Older persons are an increasing share of the immigrant population in the global north, frequently in contact with various forms of health services, (PHC services most of all. Consequently, PHC services are in a particularly unique position to support healthy ageing of immigrants.Methods: The position paper builds on five international, multi-professional and cross-disciplinary small group discussions as well as an international workshop early summer. During the discussions and the workshop, topics were arrived at as to factors related to the health situation of older immigrants, their needs, and health-seeking behaviour, and to how PHC professionals could support healthy ageing in immigrants. Those main topics in turn guided search for relevant research literature and informed the selection of the main research questionsof this paper. Findings: Several factors, in addition to culture and cultural differences, are important to for PHC professionals and decision-makers to take into consideration in encounters with older immigrants. The socio-economic position of the older immigrant and close relatives, inter-generational relationships within the immigrant communities, country-specific factors in the host country like health care expenditure, and communication skills in health professionalsare all examples of factors playing an important role regarding the health and health-seeking behaviour of older immigrants.
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| 15. |
- Lloyd, Liz, et al.
(author)
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It’s a scandal! Comparing the causes and consequences of nursing home media scandals in five countries
- 2014
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In: International journal of sociology and social policy. - 0144-333X .- 1758-6720. ; 34:1/2, s. 2-18
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Journal article (peer-reviewed)abstract
- Purpose – This study aims to explore the causes and consequences of media scandals involving nursing homes for older persons in Canada, Norway, Sweden, the UK and the USA.Design/methodology/approach – This study uses a descriptive case-study methodology which provides an in-depth, focused, qualitative analysis of one selected nursing home scandal in each jurisdiction. Scandals were selected on the basis of being substantive enough to potentially affect policy. An international comparative perspective was adopted to consider whether and how different social, political and economic contexts might shape scandals and their consequences.Findings – This study found that for-profit residential care provision as well as international trends in the ownership and financing of nursing homes were factors in the emergence of all media scandals, as was investigative reporting and a lack of consensus around the role of the state in the delivery of residential care. All scandals resulted in government action but such action generally avoided addressing underlying structural conditions.Research limitations/implications – This study examines only the short-term effects of five media scandals.Originality/value – While there has been longstanding recognition of the importance of scandals to the development of residential care policy, there have been few studies that have systematically examined the causes and consequences of such scandals. This paper contributes to a research agenda that more fully considers the media's role in the development of residential care policy, attending to both its promises and shortcomings.
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| 16. |
- Rostgaard, Tine, et al.
(author)
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Revisiting the Nordic long-term care model for older people-still equal?
- 2022
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In: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 19:2, s. 201-210
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Journal article (peer-reviewed)abstract
- With the extensive long-term care services for older people, the Nordic countries have been labelled 'caring states' as reported (Leira, Welfare state and working mothers: the Scandinavian experience, Cambridge University Press, Cambridge, 1992). The emphasis on services and not cash benefits ensures the Nordics a central place in the public service model (Anttonen and Sipila, J Eur Soc Policy 6:87-100, 1996). The main feature of this ideal model is public social care services, such as home care and residential care services, which can cover the need for personal and medical care, as well as assistance with household chores. These services are provided within a formally and professionally based long-term care system, where the main responsibility for the organization, provision and financing of care traditionally lays with the public sector. According to the principle of universalism (in: Antonnen et al. (eds), Welfare state, universalism and diversity, Elgar, Cheltenham, 2013), access to benefits such as home care and residential care is based on citizenship and need, not contributions nor merit. Also, care services should be made available for all and generally be used by all, with no stigma associated. Vabo and Szebehely (in: Anttonen (ed), Welfare State, universalism and diversity, Edward Elgar Publishing, London, 2012)) further argue that the Nordic service universalism is more than merely issues of eligibility and accessibility, in that it also encompasses whether services are attractive, affordable and flexible in order to meet a diversity of needs and preferences. However, recent decades have seen a continuous tendency towards prioritization of care for the most frail, contributing to unmet need, informalization of care and privatization in the use of topping up with market-based services. These changes have raised questions about increasing inequalities within Nordic long-term care systems. We investigate in the article what effect changes have for equality across social class and gender, for users and informal carers. The article is based on analysis of comparable national and international statistics and a review of national research literature and policy documents.
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- Stjernswärd, Sigrid, et al.
(author)
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Scandinavian nurses’ use of social media to position themselves as nurses and the nursing profession during the COVID-19 pandemic – a Berger and Luckmann inspired qualitative study
- 2023
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In: Canadian Journal of Nursing Informatics. ; 18:2
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Journal article (peer-reviewed)abstract
- Based on a study of nurses’ social media uses during the pandemic, this article aims to illuminate how nurses used social media to position themselves as nurses and safeguard the nursing profession. Thirty semi-structured interviews were conducted with nurses in the three Scandinavian countries. Data were thematically analysed, with theoretical inspiration from Berger and Luckmann (1966). The findings revealed that nurses used social media as a showcase to illuminate their working conditions and to support their unions’ struggle. However, nurses were also cautious regarding social media uses. Conclusively, nurses used social media as a mouthpiece to reach an audience, which could include colleagues, the general public, and possibly a wider audience, while balancing their professional role and associated ethics, so as not to cross the line of internalised values pertaining to the nursing profession. This motivates further studies on nurses’ professional uses of social media.
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