| 1. |
- Hedlund, M., et al.
(författare)
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The disciplining of self-help : Doing self-help the Norwegian way
- 2019
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Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 225, s. 34-41
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Tidskriftsartikel (refereegranskat)abstract
- We explore how Norwegian self-help groups are defined and managed to create a particular form of health system governmentality. Self-help groups are typically framed as therapeutic communities where participants define the agenda creating a space where open and equal interaction can produce individual learning and personal growth. In Norway, however, self-help groups are managed in a way that integrates them in to the health system but insulates them from clinical medicine; an approach that disciplines participants to act in a particular way in relation to the health system. We draw on the analysis of 1456 pages of public documents and websites from the National Nodal Point for Self-Help (NPSH), the organisation that manages self-help groups, and central government including individual testimonies from participants published between 2006 and 2014. We argue, drawing on Foucault, that self-help premised on lay-leadership and self-determination is at odds with the centrally defined regulation apparent in the model adopted in Norway and an example of disciplining that reinforces health system governmentality and serves the interests of the medical profession and the state. Further we propose that this illustrates the contestation between the pastoral power of medics, the National Nodal Point for Self-Help and the Ministry of Health. Our analysis of Norwegian self-help as a mechanism to create a particular form of health system governmentality helps explain the expansion of self-help and self-management within developed health systems and provides an explanation for why self-help within health systems, is typically situated adjacent to, rather than integrated into, clinical medicine.
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| 2. |
- Andersen-Hollekim, Tone E., et al.
(författare)
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Patient participation in the clinical pathway : Nurses' perceptions of adults' involvement in haemodialysis
- 2019
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Ingår i: Nursing Open. - : Wiley. - 2054-1058. ; 6:2, s. 574-582
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To develop knowledge of nurses' perceptions of participation for patients treated with haemodialysis and their next of kin.Design: A qualitative study with a hermeneutic approach.Methods: The data were collected in 2015 through focus groups with 13 nurses in Central Norway.Results: The nurses reported that patient participation ranging from non-involvement to shared decision-making was related to whether dialysis was initiated as acute or scheduled. The restrictions required in chronic haemodialysis limited participation. The next of kin were not involved. The nurses highlighted interventions on both the individual and system levels to strengthen participation.Conclusion: Dialysis units should develop strategies for participation related to individual needs and design treatment in cooperation with patients and their families, ensuring involvement early in the clinical pathway. Further research is needed on issues related to next of kin, including their desired level of involvement.
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| 3. |
- Brulin, Emma, et al.
(författare)
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An impaired learning environment : Resident physicians’ experience of the transition to pandemic care during the first wave of the COVID-19 pandemic in Sweden
- 2023
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Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Extensive studies regarding the COVID-19 pandemic have shown negative effects on physicians-in-training. Besides a high workload, their learning environment has been affected. A quality learning environment is vital for residents’ physician’s clinical development and also their health. Nevertheless, few studies have explored this. The aim of this study was to explore resident physicians’ experiences of transition to pandemic care during the first wave of the COVID-19 pandemic in Sweden. Method: In this qualitative study, 12 Swedish resident physicians were interviewed using a semi-structured interview guide. They were interviewed between June and October of 2020 and asked to reflect on the pandemic and, more specifically, the first wave. The empirical material was analysed using qualitative content analysis. The analysis resulted in one theme and four categories. Results: The theme identified was An impaired learning environment which signifies the disruptions the resident physicians experienced during the first wave of the pandemic. The four categories, Professional role insecurity, High expectations but little influence, Stagnant clinical development, and Professional growth through experience, describe in what way the learning environment was impacted.
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| 4. |
- Brulin, Emma, et al.
(författare)
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Money talks : performance-based reimbursement systems impact on perceived work, health and patient care for physicians in Sweden
- 2023
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Ingår i: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The study aimed to investigate in which way performance-based reimbursement (PBR) systems in Swedish healthcare services (1) subjectively impacted physicians’ work and patient care and (2) were associated with the occurrence of stress-induced exhaustion disorders among physicians.Method: The study applied a mixed-method design. Data were collected from a representative sample of Swedish physicians. In the questionnaire, respondents were asked to answer an open-ended question regarding their reflections on PBR. The answers to the open-ended question were analysed using thematic analysis. Respondents were also asked to rate the impact of PBR on their work. The association between PBR and self-rated stress-induced exhaustion disease was analysed with logistic regressions. Stress-induced exhaustion disorder was measured using the Burnout Assessment Scale.Results: Thematic analysis resulted in four themes: (1) Money talks, (2) Patients are affected, (3) Medical morals are challenged, and (4) PBR increase the quantity of illegitimate tasks. Logistic regressions showed that physicians who experienced PBR had an impact on their work and had a two-fold higher risk of stress-induced exhaustion disorder.Discussion: Our findings suggest that current reimbursement systems in Sweden play an essential role in Swedish healthcare and negatively influence physicians’ work and health. Also, current PBR impact patients negatively. No previous study has explored the potentially harmful impact of PBR on how physicians perceive work, health and patient care. Results indicate that policymakers should be encouraged to deeply review PBR systems and focus on ways that they can limit the negative impact on physicians’ work and health while meeting future challenges.
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| 5. |
- Evensen, Aud, et al.
(författare)
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Individuell læring i gruppebasert psykoedukativ kognitiv rehabilitering
- 2010
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Ingår i: Nordisk tidsskrift for helseforskning. - : UiT The Arctic University of Norway. - 1504-3614 .- 1891-2982. ; 6:2, s. 70-83
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Tidskriftsartikel (refereegranskat)abstract
- Artikkelen omhandler en kvalitativ studie om individuell læring i gruppebasert psykoedukativ kognitiv rehabilitering. Studiens formål var å få frem kunnskap om betydning av å benytte kombinasjon av individrettet og grupperettet metode i rehabiliteringsopplegg.Metode: Kvalitativ beskrivende og fortolkende studie med bruk av fokusgruppeintervjuer to år etter deltakelse i rehabiliteringsopplegget.Resultater: Gruppebasert rehabilitering var opplevd som gjensidig støtte. Rehabilitering med kognitiv tilnærming førte til oppdaging om egen lært hjelpeløshet og lavt selvbilde før rehabilitering og læring om andre måter å møte belastninger på. To år etter deltakelse på gruppebasert rehabilitering var opplegget erfart å ha betydning for selvfølelse, meningsfulle liv, mer aktivitet og mestring i hverdagen. Det er behov for mer forskning hvor opplevelse av mening og sammenheng måles og effekter av ulike rehabiliteringsmetoder sammenlignes.Konklusjon: Kombinasjonen gruppebasert rehabilitering med individuell kognitiv tilnærming hadde betydning for motivasjon, mestring og aktivt liv to år etter rehabiliteringen.
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| 6. |
- Giske, S., et al.
(författare)
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Mapping interaction quality for nursing and medical students in primary care placement in municipal emergency care units : a systematic observational study
- 2024
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Ingår i: Frontiers in Medicine. - : Frontiers Media SA. - 2296-858X. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Primary care placement for nursing and medical students is vital for developing the competence to accommodate the increasing number of patients with multimorbid and complex conditions. Prior studies have suggested that interaction quality in primary care placement empowers learning. However, research mapping interaction quality in primary care placements in municipal emergency care units is lacking. This study aimed to systematically map interaction quality for nursing and medical students in primary care placement in two municipal emergency care units. Materials and methods: This study adopted a systematic descriptive observational design. Systematic observations (n = 201 cycles) of eight nursing students (n = 103 cycles) and six medical students (n = 98 cycles) were used to map interaction quality across six learning situations between March and May 2019. Observations were coded using the Classroom Assessment Scoring System-Secondary (CLASS-S). Data were analyzed using descriptive statistics and Spearman correlations. Results: Interaction quality is described in three domains: (I) emotional support, (II) framework for learning, and (III) instructional support, and the overall measure, student engagement. The results indicated middle-quality interactions in the emotional and instructional support domains and high quality in the framework for learning domain and student engagement. Correlations exhibited similar patterns and ranged from non-significant to strong correlations. Conclusion: The interaction qualities indicated a generally positive and supportive learning environment contributing to nursing and medical students’ learning and active participation in work tasks related to their professional roles. Thus, this new form for primary care placement for nursing and medical students in the municipal emergency care units was found to be a positive learning arena. These results may enhance nursing and medical education programs in countries with similar health services and education. Health education, supervisors, peers, and others contributing to students’ learning should recognize which interaction qualities may affect learning and how to improve quality, thus affecting supervisors’ approach to training students. While the CLASS-S showed potential for mapping interaction qualities for nursing and medical students in primary care placement in municipal emergency care units, further studies are needed to validate the CLASS-S for use in clinical placement settings.
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| 7. |
- Giske, Solveig, et al.
(författare)
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Medical students' learning experience and participation in communities of practice at municipal emergency care units in the primary health care system : a qualitative study
- 2022
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Ingår i: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Medical education has been criticised for not adapting to changes in society, health care and technology. Internationally, it is necessary to strengthen primary health care services to accommodate the growing number of patients. In Norway, emergency care patients are increasingly treated in municipal emergency care units in the primary health care system. This study explores medical students' learning experience and how they participated in communities of practice at two municipal emergency care units in the primary health care system. Methods In this qualitative study, we collected data from March to May 2019 using semi-structured individual interviews and systematic observations of six ninth-semester medical students undergoing two-week clerkships at municipal emergency care units. The interview transcripts were thematically analysed with a social constructivist approach. A total of 102 systematic observations were used to triangulate the findings from the thematic analysis. Results Three themes illuminated what the medical students learned and how they participated in communities of practice: (i) They took responsibility for emergency care patients while participating in the physicians' community of practice and thus received intensive training in the role of a physician. (ii) They learned the physician's role in interprofessional collaboration. Collaborating with nursing students and nurses led to training in clinical procedures and insight into the nurses' role, work tasks, and community of practice. (iii) They gained in-depth knowledge through shared reflections when time was allocated for that purpose. Ethical and medical topics were elucidated from an interprofessional perspective when nursing students, nurses, and physicians participated. Conclusions Our findings suggest that this was a form of clerkship in which medical students learned the physician's role by taking responsibility for emergency care patients and participating in multiple work tasks and clinical procedures associated with physicians' and nurses' communities of practice. Participating in an interprofessional community of practice for professional reflections contributed to in-depth knowledge of ethical and medical topics from the medical and nursing perspectives.
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| 8. |
- Hagqvist, Emma, 1980-, et al.
(författare)
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Falling outside the system : Occupational safety and health inspectors’ experiences of micro-enterprises in Sweden
- 2020
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Ingår i: Safety Science. - : Elsevier B.V.. - 0925-7535 .- 1879-1042. ; 125
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Tidskriftsartikel (refereegranskat)abstract
- In this study, 11 Swedish occupational safety and health (OSH) inspectors were interviewed about their views of and experiences interacting with micro-enterprises (1-9 employees). The qualitative content analysis found one theme, “Falling outside the system”, and three subthemes, “The inspector—shaped by specific standards”, “The bureaucrat and the micro-entrepreneur—two separate worlds”, and “System faults and system changes”. According to the inspectors, the Swedish OSH regulatory system, with inspectors on the front line, neglects the specific needs, circumstances and characteristics of micro-enterprises. Therefore, we suggest revising the OSH regulatory system and following inspection methods and enforcement styles to better address the needs of micro-enterprises.
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| 9. |
- Hagqvist, Emma, 1980-, et al.
(författare)
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The Swedish HealthPhys Study: Study Description and Prevalence of Clinical Burnout and Major Depression among Physicians
- 2022
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Ingår i: Chronic Stress. - : SAGE Publications. - 2470-5470. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The study purpose was to describe the Swedish HealthPhys cohort. Using data from the HealthPhys study, we aimed to describe the prevalence of clinical burnout and major depression in a representative sample of Swedish physicians across gender, age, worksite, hierarchical position, and speciality in spring of 2021, during the third wave of the Covid-19 pandemic. Method: The HealthPhys questionnaire was sent to a representative sample of practising physicians (n = 6699) in Sweden in February to May of 2021 with a 41.3% response rate. The questionnaire included validated instruments measuring psychosocial work environment and health including measurements for major depression and clinical burnout. Results: Data from the HealthPhys study showed that among practising physicians in Sweden the prevalence of major depression was 4.8% and clinical burnout was 4.7%. However, the variations across sub-groups of physicians regarding major depression ranged from 0% to 10.1%. For clinical burnout estimates ranged from 1.3% to 14.5%. Emergency physicians had the highest levels of clinical burnout while they had 0% prevalence of major depression. Prevalence of exhaustion was high across all groups of physicians with physicians working in emergency departments, at the highest (28.6%) and anaesthesiologist at the lowest (5.6%). Junior physicians had high levels across all measurements. Conclusions: In conclusion, the first data collection from the HealthPhys study showed that the prevalence of major depression and clinical burnout varies across genders, age, hierarchical position, worksite, and specialty. Moreover, many practising physicians in Sweden experienced exhaustion and were at high risk of burnout.
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| 10. |
- Hansson, Josefine, et al.
(författare)
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A Comparative Study of Financial Support and Resilience of Self-Employed people in Sweden and Canada
- 2023
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Ingår i: <em>European Journal of Public Health</em>, Volume 33, Issue Supplement_2, October 2023. - : Oxford University Press (OUP).
-
Konferensbidrag (refereegranskat)abstract
- BackgroundGlobally the COVID-19 pandemic presented major difficulties for self-employed people such as financial decline, restrictions and business closures. A plethora of financial support measures was rolled out worldwide to support them, but there is a lack of research looking at the effectiveness of the policy measures on small businesses. The aim of the study was to compare policies addressing government financial support in Sweden and Canada to get an understanding of how different governmental financial support measures enhanched self-employed people's resilience and improved their chances to manage the pandemic. In addition, individual interviews with Swedish and Canadian self-employed people were conducted to get an understanding of how they experienced the support measures and how these measures factored into their resilience during and after the restrictions had ended.MethodsWe conducted a mixed-method study encompassing document analysis and semi-structured interviews with self-employed people in Sweden and Canada. The constant comparative method guided the data analysis and documentary and interview data were analysed together. Three categories were formed: Welfare protection and effects, Self-employed well-being and Agility during COVID-19, based on their ability to represent the overall sense of the phenomena.ResultsKey results were that self-employed people in both countries unable to telework, were less resilient during the pandemic due to financial problems, restrictions and lockdowns, and that this negatively affected their well-being.ConclusionsPotential future policy responses in Sweden and Canada to support self-employed people during crises or adversity should consider the diversity among small businesses and tailor programmes towards viable businesses in greatest need of support, such as those in businesses unable to telework.Key messages • Self-employed people in Sweden and Canada unable to telework, were less resilient during the pandemic due to financial problems, restrictions and lockdowns. • Future policy responses to support self-employed people during adversity should tailor programmes towards viable businesses in greatest need of support.
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| 11. |
- Hedlund, Marianne, 1958-, et al.
(författare)
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Challenges in Disability Management of Long-Term Sick Workers
- 2008
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Ingår i: The international journal of disability management research. - : Cambridge University Press (CUP). - 1833-8550 .- 1834-4887. ; 2:2, s. 47-56
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Tidskriftsartikel (refereegranskat)abstract
- In Norway various welfare state authorities assist in disability management (DM) of long-term sick workers. This study provides empirical-based knowledge about the Norwegian DM process. The data are based on focus-group interviews with health care providers and case-workers in welfare state authorities. A key issue outlined in this article is that long-term sick workers can easily become ‘stuck’ in the rehabilitation system. The focus is on topics that can explain difficulties of re-employing long-term sick workers. Furthermore, we look at what challenges are typical for DM of these workers in Norway, with respect to re-employment issues.
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| 12. |
- Hedlund, Marianne, 1958-, et al.
(författare)
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Equal treatment in working life for people with disabilities : A Sweden and Norway Perspective
- 2009. - 1
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Ingår i: Disabilities: Insights from Across Fields and Around the World Vol 3. - Westport : Praeger. - 9780313346040 - 9780313346101 ; , s. 155-165
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- In November 2000, the European Union issued a directive establishing a general framework for promoting equal treatment in employment and outlawing discrimination based on religion, beliefs, disability, age, and sexual orientation (the “framework for the equal treatment directive,” FETD). Equal treatment and non-discrimination are among the most well-developed components of social policy in the EU. In Scandinavia, antidiscrimination policy is a relatively new type of regulatory policy that approaches disability from the following perspective: “The EU . . . sees disability as a social construct. The EU social model of disability stresses the environmental barriers in society which prevent the full participation of people with disabilities in society. These barriers must be removed”. The main aim of this chapter is to examine and discuss how this new approach relates to existing policies in Norway and Sweden. In this chapter, we more closely examine how Norwegian and Swedish social policies define disability in relation to the EU’s FETD directive. We examine the relationship between the traditional methods of supporting people with disabilities in Swedish and Norwegian social policy and the principles put forth in the EU’s FETD directive.
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| 13. |
- Hjorth-Hansen, A. K., et al.
(författare)
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Real-time automatic quantification of left ventricular function by hand-held ultrasound devices in patients with suspected heart failure : a feasibility study of a diagnostic test with data from general practitioners, nurses and cardiologists
- 2022
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 12:10
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate the feasibility and reliability of hand-held ultrasound (HUD) examinations with real-time automatic decision-making software for ejection fraction (autoEF) and mitral annular plane systolic excursion (autoMAPSE) by novices (general practitioners), intermediate users (registered cardiac nurses) and expert users (cardiologists), respectively, compared to reference echocardiography by cardiologists in an outpatient cohort with suspected heart failure (HF). DESIGN: Feasibility study of a diagnostic test. SETTING AND PARTICIPANTS: 166 patients with suspected HF underwent HUD examinations with autoEF and autoMAPSE measurements by five novices, three intermediate-skilled users and five experts. HUD results were compared with a reference echocardiography by experts. A blinded cardiologist scored all HUD recordings with automatic measurements as (1) discard, (2) accept, but adjust the measurement or (3) accept the measurement as it is. PRIMARY OUTCOME MEASURE: The feasibility of automatic decision-making software for quantification of left ventricular function. RESULTS: The users were able to run autoEF and autoMAPSE in most patients. The feasibility for obtaining accepted images (score of ≥2) with automatic measurements ranged from 50% to 91%. The feasibility was lowest for novices and highest for experts for both autoEF and autoMAPSE (p≤0.001). Large coefficients of variation and wide coefficients of repeatability indicate moderate agreement. The corresponding intraclass correlations (ICC) were moderate to good (ICC 0.51-0.85) for intra-rater and poor (ICC 0.35-0.51) for inter-rater analyses. The findings of modest to poor agreement and reliability were not explained by the experience of the users alone. CONCLUSION: Novices, intermediate and expert users were able to record four-chamber views for automatic assessment of autoEF and autoMAPSE using HUD devices. The modest feasibility, agreement and reliability suggest this should not be implemented into clinical practice without further refinement and clinical evaluation. TRIAL REGISTRATION NUMBER: NCT03547076.
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| 14. |
- Kvalslund Bårdsgjerde, Elise, et al.
(författare)
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Nurses' perceptions of patient participation in the myocardial infarction pathway
- 2020
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Ingår i: Nursing Open. - : Wiley. - 2054-1058. ; 7:5, s. 1606-1615
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To explore nurses' perceptions of patient participation in different phases of the myocardial infarction pathway. Design: Qualitative design with a hermeneutical approach. Methods: Five focus groups were conducted at two hospitals, one with and one without percutaneous coronary intervention facilities, between February–November 2018. Participants were recruited through purposive sampling. Twenty-two nurses experienced in cardiac care participated. The analysis had a hermeneutical approach. Results: The findings revealed nurses' perceptions of patient participation in different phases of the myocardial infarction pathway. Four themes were identified: (a) variation between paternalism and autonomy in the acute phase; (b) individualization of dialogue and patient participation during treatment; (c) lack of coherence in the pathway hinders patient participation at discharge; and (d) cardiac rehabilitation promotes patients' autonomous decisions in lifestyle changes.
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| 15. |
- Landstad, Bodil Johanne, 1965-, et al.
(författare)
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Change in pattern of absenteeism as a result of workplace intervention for personnel support
- 2001
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Ingår i: Ergonomics. - : Informa UK Limited. - 0014-0139 .- 1366-5847. ; 44:1, s. 63-81
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate whether a preventive intervention carried out in a predominantly female workplace, that of hospital cleaners (consisting of a group of 97 women), had any effect on patterns of absenteeism. As a background, a model for analysing complex patterns of absenteeism, including sickness absences, was also developed. A further aim was to study the interactions between different forms of absenteeism. Comparison was made with a reference group consisting of employees in the same job category who only received the customary personnel support. For individuals in the intervention group who were <42 years of age, total absence due to sickness decreased. In a multiple regression analysis, the contribution from the intervention to the decrease was significant at the 5% level. This change was particularly obvious in those who had a previous history of high absence due to sickness. No clear relationship was shown between short-term absenteeism and the interventions applied. For those who were > 42 years, short-term absence decreased for those who had been in the same jobs for a long time. The combination of increased age and experience showed a tendency to enhance this decline in short-term absenteeism due to sickness. For those > 42 years, and who at the same time have a previous history of high absenteeism, long-term absenteeism due to sickness seemed to be increasing. Increased experience tended to reduce this increase in long-term sickness absence. This combination of different effects possibly indicated the presence of a process of selection which determined who remained in the job as opposed to those who did not. An important conclusion is that different forms of absenteeism need to be looked at in parallel, and at the same time multivariate statistical analysis needs to be carried out to determine the different interactions between the factors.
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| 16. |
- Landstad, Bodil J., 1965-, et al.
(författare)
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Conceptualizing the driving forces for successful rehabilitation back to work
- 2018
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 40:15, s. 1781-1790
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Tidskriftsartikel (refereegranskat)abstract
- Background: An earlier study states that the terms of desire, longing, and vanity carry with them ideas, emotions, and values that influence how individuals perceive themselves and their rehabilitation process. Our aim was (1) to use concept analysis to explore the meaning of the terms desire, longing, and vanity and (2) to investigate the potential role of these concepts in successful rehabilitation back to work. Methods: To achieve these two objectives, we used a model of concept analysis. The final step in the model is to define empirical references, for example, articles within the scientific literature, to determine the existence of a concept in a given situation. Results: The concept analysis resulted in 15 new searchable terms. All of these were accepted in the thesaurus system for the databases we used. We identified 59 scientific articles that were deemed relevant to the purposes of the study. Of these, only 20 was about emotions as driving forces in a rehabilitation process back to work. Conclusion: The conclusion of the study is that the concepts of desire, longing, and vanity encompassed ideas, emotions, and values that influence how individuals perceived themselves and their situations. How individuals talk about and understand rehabilitation will undoubtedly play a role in how they respond to interventions, and thus, the success of the rehabilitation process back to work.Implications for rehabilitationEmotional energy often drives behavior and can provide significant motivation that potentially can mobilize vocational rehabilitation.The concepts of desire, longing and vanity encompass ideas, emotions, and values that influence individuals’ self-perception and their view of their situation. To engage people in discussions on what they long for and desire could be a new way to connect with a person in a rehabilitation situation.It can be less provoking to talk about what a person desires or longs for than to ask them what they want or are motivated for.Feelings of meaningfulness are a basic driving force and a contributing factor in how health is experienced. By affirming the desire to do activities that are liked, this in turn generates motivation to be engaged in other activities. Individual confidence is generated through the experience of mastering a skill and this in turn can underpin a desire to return to work after long-term sick leave. Earlier experience of success can be an inspiration and create expectations for a forthcoming working-role.Emotions relating to work such as pride can generate motivation in a rehabilitation process. Vanity and the possibility of being “ashamed” in a certain situation can be an emotional driving force to re-establish one’s self.
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| 17. |
- Landstad, Bodil J, 1965-, et al.
(författare)
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Long-term sick workers experience of professional support for re-integration back to work.
- 2009
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Ingår i: Work. - 1051-9815 .- 1875-9270. ; 32:1, s. 39-48
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Tidskriftsartikel (refereegranskat)abstract
- In recent years researchers have tried to identify important factors that can explain re-integration to work for workers on long-term sick leave. The results indicate that multiple factors can explain whether or not people return to work. The aim of the study was to investigate long-term sick workers' experience of professional support for re-integration to work. Participants were drawn from the database of The National Social Insurance Board in Norway. A random sample was selected of persons with mental illness or musculoskeletal disorders (either p- or 1-diagnosis/symptoms related to International Classification in Primary Care), who were in receipt of Rehabilitation allowance. The questionnaire was sent to 1 493 persons of whom 740 responded. The most significant finding is that work training/mastering actions were identified by the majority of the rehabilitation benefit recipients as being of slight or moderate use. This highlights the importance of work training/mastering actions being relevant in proportion to the specific situation the individual is presently within. Delays in waiting for treatment attributed to approximately half of the rehabilitation benefit recipient's problems returning to work. This study also highlights that rehabilitation benefit recipients experience loss of co-ordinated measures from those who are supposed to contribute to simplifying their return to work.
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| 18. |
- Landstad, Bodil J., 1965-, et al.
(författare)
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Making things work–In spite of a pandemic small scale enterprise managers’ approach to business changes and health issues
- 2023
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:7
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCovid-19 is one of the worst crises in modern working life with a direct negative impact on many enterprises and organizations. The aim of this study is to explore what managers in Small Scale Enterprises (SSEs) changed in their business during the Covid-19 pandemic, particularly addressing health issues.MethodsA longitudinal qualitative research methodology was used, interviewing 16 managers of SSEs in the Norwegian and Swedish manufacturing and service sector both before (round 1) and during the pandemic (round 2). In this approach, time is designed into the research process, making change a key focus for analysis.ResultsThe analysis resulted in two main themes, resilience and demanding occupational health and safety conditions, and five sub-themes. Results show how managers in SSEs changed their business during the Covid-19 pandemic and the impact of these changes. Although, the enterprises were heavily affected in the beginning of the pandemic, several managers found new solutions for their businesses to maintain and reach new customers. They applied a socially responsible management which addressed different health issues.ConclusionCrises like the Covid-19 pandemic will have future impact on SSEs making it important to understand how managers in such enterprises address business and health issues. This knowledge may have practical implications for supporting managers in SSEs in how to perform a socially responsible management and maintain occupational health and safety measures. The managerial implications from this research are that they need to be flexible, reorientable and, at the same time, be loyal to the core business. This study shows the importance of doing longitudinal studies about business and health issues among mangers in SSEs.
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| 19. |
- Landstad, Bodil J., 1965-, et al.
(författare)
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Management by values : A qualitative study of how small business owners in the cleaning sector view and implement their employer responsibilities with respect to occupational safety and health management
- 2022
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Ingår i: Safety Science. - : Elsevier BV. - 0925-7535 .- 1879-1042. ; 148
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Tidskriftsartikel (refereegranskat)abstract
- Nine Swedish small business owners in the cleaning sector were interviewed regarding their personal views and experiences concerning employer responsibilities in relation to occupational safety and health management for this study. The analysis is guided by a qualitative content analysis exploring strategies applied to responsible leadership. We found that there was one specific behavioural pattern that stood out above all others. Small business owners regularly implemented a form of responsible leadership we call management by values. Management by values was applied using three strategies building employee relationships, rational management and transferring responsibility. This managing style can be both a strength and a weakness for the employees working conditions. The strengths are that the owners are supporting, guiding, and communicating in their leadership with their employees while the weaknesses can be that they, the owners, base their occupational safety and health management on values rather than knowledge. As a result, there is a transference in responsibilities from the small business owners to their employees for measures related to the working environment. The conclusions of the study are that by applying management by values, the small business owners seem to promote good psychosocial working conditions in their enterprises while showing a lack of knowledge about occupational safety and health management. This might mean a risk that systematic approaches will not be applied to physical working environment conditions regarding safety issues.
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| 20. |
- Landstad, Bodil J, 1965-, et al.
(författare)
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Municipal Acute Bed Units as a Health Service Innovation—A Qualitative Study
- 2024
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Ingår i: Journal of Health Management. - : SAGE Publications. - 0972-0634 .- 0973-0729.
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Tidskriftsartikel (refereegranskat)abstract
- The growing number of older individuals with complex needs and chronic illnesses is a major challenge to the health sector. This has led to a transfer of responsibilities from specialist to the primary healthcare sector. The aim of the study was to explore how healthcare professionals experience setting up and operating a municipal acute bed unit (MAU) in primary healthcare. Three focus groups of health professionals were recruited through purposeful sampling in 2019, and the 10 participants came from different professions. The study has a qualitative design with a hermeneutic approach. The findings identified three themes: (a) Strategic planning and coordinated services, (b) collaborative practice and learning and (c) flexible and family-centred care. The healthcare personnel experienced strengthened quality in the health services, improved work processes and increased safety for patients with relevant diagnoses. The interplay between internal and external factors seems to have been a successful innovation in planning and implementing an MAU in a medical facility in Mid-Norway. We assessed that being prepared for challenges is an important part of innovation in health services. The presence of an ‘inherent capital’ to meet unforeseen challenges in the future should be a prerequisite for innovation.
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| 21. |
- Landstad, Bodil J., 1965-, et al.
(författare)
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Nursing qualifications needed in municipal emergency inpatient units. A qualitative study
- 2021
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Ingår i: BMC Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Providing care to older individuals with complex needs and patients with chronic illness is a concern worldwide. In Norway, this situation led to the transfer of responsibility for care and treatment to the municipalities. Providing emergency care at the municipal level - thereby reducing the need for emergency hospital admissions - is part of the Coordination Reform in Norway. This reform from 2012 warrants a reconsideration of which nursing qualifications are needed in the municipalities. The aim of the study is to explore which professional qualifications nurses need to provide emergency care in municipal emergency inpatient units. Method A qualitative design with a hermeneutic approach was employed. Interviewing physicians about nursing qualifications may be considered inappropriate. We believe that this is important for developing knowledge that can strengthen interprofessional cooperation in emergency situations. Three focus groups were conducted. Physicians with experience in municipal emergency inpatient units were interviewed. Results We synthesised three themes from the data: (1) broad medical knowledge; (2) advanced clinical skills; and (3) ethical qualifications and a holistic approach. The first theme is about knowledge, the second is about skills, and the third conveys the need for overall competence. Conclusions Nurses working in municipal emergency inpatient units need advanced ethical qualifications, which integrate broad medical knowledge, advanced clinical skills and the ability to take a holistic approach. They have a considerable responsibility to work independently and safely in a setting where both the patient and the patient's family play important roles. Establishing arenas for collaborative practice between physicians and nurses on clinical issues may be a way of strengthening patient safety and nurses' clinical judgement.
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| 22. |
- Landstad, Bodil J, 1965-, et al.
(författare)
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Personal Perspectives on Vocational Rehabilitation in Singapore and Sweden
- 2010
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Ingår i: The Asia Pacific Disability & Rehabilitation Journal. - Bangalore. ; 21:1, s. 3-25
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study is to describe and analyse personal reflections on vocational rehabilitation in Singapore and Sweden as described by employees who have been on sick leave. Further, the study investigates what similarities and differences can be discerned from the accounts provided by the participants in the different countries. Interviews were conducted with five Singaporeans and five Swedes undergoing rehabilitation due to musculoskeletal problems. The most significant result is that more differences than similarities were identified; e.g. the Singaporeans had fewer days of sickness absence, they were diagnosed more swiftly, treatment and the rehabilitation process began earlier and there were no queues for treatment. The conclusion is that the Singaporean system seems to be more effective with respect to returning people to work. However, the Swedish system creates more security for all groups of people.
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| 23. |
- Landstad, Bodil J., 1965-, et al.
(författare)
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Physicians' narratives of communication with patients and their relatives in different phases of the palliative pathway
- 2023
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To explore physicians' experiences of the communication with patients and their relatives in the different phases of the palliative pathway. Methods Purposeful sampling was employed to recruit a total of 13 oncologists and general practitioners who engaged in palliative care. A qualitative study with a narrative approach was conducted. Interviews with physicians working in primary and specialist healthcare were conducted via Skype Business in the spring of 2020. The interview guide had open-ended questions with each interview lasting between 35 and 60 min. Results Communication between the physicians, their patients and their relatives was contextual and changed depending on the phase in the palliative pathway. In the first phase, physicians told us that patients and their relatives experienced an emotional shock. Transitioning from the curative to palliative phase was difficult, which emphasised the need for trust through communication. In the middle phase, they revealed that communication about the death process became the priority: what was probably going to happen, the family's role in what was going to happen and perhaps, depending on the illness, any medical decisions that needed to be made. It was important for the physicians to communicate information about the palliative pathway while providing the relatives with knowledge that facilitated any decision making. In the terminal phase, physicians employed a compassionate approach, as bereaved family members needed to process their feelings of guilt and grief. Conclusions The study gives new insight into communication with patients and their relatives during different phases of the palliative pathway, from the physician's perspective. The findings may help physicians improve the quality of communication with patients and their relatives over these vulnerable pathways. The findings also have practical implications in training contexts. The study reveals ethical dilemmas in physicians' communication with patients and their relatives during a palliative pathway.
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| 24. |
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| 25. |
- Lehto, Arja, 1952-, et al.
(författare)
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Jakten på en jämställd myndighet : Process- och måluppfyllelseanalys som utvärderingsmodell
- 2009. - 1:1
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Ingår i: Lärande utvärdering genom följeforskning. - Lund : Studentlitteratur. - 9789144056173 ; , s. 223-243
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- I kapitlet tas utgångspunkt i ett jämställdhetsprojekt som bedrevs inom en myndighet i Sverige. Projektet var ett förändringsarbete som pågick parallellt med en omfattande omorganisation av myndigheten. Jämställdhet skulle integreras i myndighetens organisation och verksamhet. Syftet med kapitlet är att beskriva hur köns- och organisationsforskning kan kombineras med en process- och måluppfyllelseanalysmodell i utvärdering av projekt.
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| 26. |
- Lehto, Arja, 1952-, et al.
(författare)
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The hunt for an equal authority : Process- and goal achivement analysis as evaluation model
- 2009. - 1:1
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Ingår i: Learning through onging evaluation. - Lund : Studentlitteratur. - 9789144057491 ; , s. 231-252
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This chapter is based on a gender equality project carried out within a police authority somwhere in Sweden. The project was a change management venture carried out in tandem with a radical re-organisation of the authority. Gender equality was to be integrated into the authority's organisation and activities. The aim is to describe how gender and organisational research have been combined with a process- and goal achivement model in the evaluation.
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| 27. |
- Okkenhaug, Arne, et al.
(författare)
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Developing a research tool to detect iatrogenic adverse events in psychiatric health care by involving service users and health professionals
- 2024
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 31:3, s. 405-416
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Tidskriftsartikel (refereegranskat)abstract
- What is known on the subject: Most health professionals working in psychiatric care will experience adverse events (AE) such as service user suicide or violence, during their career Norway lacks measures to capture potential iatrogenic injuries, such as risk assessment measures, to evaluate patient records for AEs in both inpatient and outpatient psychiatric clinics in hospitals. What the paper adds to existing knowledge: We have described an approach to the validation of a research tool between different national contexts; a process that went beyond language translation We have incorporated the understanding of health professionals and service users; to bring together the lifeworld of the patient with the professional definition of AEs, triggers and risk areas of AEs in a psychiatric context. The service users' experiences resulted in modifications to the tool. What are the implications for nurses: Applying the ‘Global Trigger Tool—Psychiatry’ in Norway and Sweden can help mental health nurses to prevent iatrogenic harm and reduce the occurrence of AEs through the identification of potential triggers. Implementing ‘Global Trigger Tool—Psychiatry’ might help mental health nurses to improve patient safety in Norway and Sweden. Abstract: Introduction: There is little consensus on cross-cultural and cross-national adaptation of research instruments. Aim/Question: To translate and validate a Swedish research tool (GTT-P) to detect iatrogenic adverse events in psychiatric health care by involving service users and health professionals in the process. Method: The GTT-P, designed to identify events in patient records that were triggers for adverse events, was translated to Norwegian using a cross-cultural adaptation approach. This involved two focus groups with clinical staff, one of which involved service users, and a joint discussion at a Dialogue Conference to generate consensus on the definition of the triggers of potential adverse events identifiable in patient records. Results: We highlight both the differences and commonalities in defining the nature of risks, the adverse events and the triggers of such events. The Dialogue Conference resulted in three modifications of the tool, based on service users' experiences. Service user involvement and co-production was essential for both the translation and adaptation of the research instrument. Discussion: We have described an approach to the validation of a research tool between different national contexts; a process that went beyond language translation. This approach enables a more nuanced understanding of potential risks within a psychiatric context as it engages differences in the care delivery. Applying the GTT-P in hospital-based psychiatric care might help to identify processes that need to be changed in order to promote patient safety and a safer work environment for mental health nurses. Implications for practice: When translating and validating the GTT-P from Swedish to Norwegian, we have considered the knowledge and experiences of both service users and health professionals. The application of the GTT-P can promote greater patient safety in hospital settings.
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| 28. |
- Okkenhaug, Arne, et al.
(författare)
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Mitigating risk in Norwegian psychiatric care : Identifying indicators of adverse events through Global Trigger Tool for psychiatric care
- 2019
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Ingår i: International Journal of Risk and Safety in Medicine. - : IOS Press. - 0924-6479 .- 1878-6847. ; 30:4, s. 203-216
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Patients treated in psychiatric care are exposed to the risk of adverse events, similar to patients treated in somatic health care. OBJECTIVES:In this article we report the findings of triggers associated with adverse events (AEs) identified by a version of the Global Trigger Tool – Psychiatry (GTT-P) adapted for Norwegian hospital-based psychiatric treatment. METHODS:The design was a retrospective analysis of a random sample of 240 patient records from a psychiatric clinic in one Norwegian hospital. Patient records were sampled from both inpatient and outpatient psychiatric clinics in hospitals serving the northern part of the county of Trøndelag, Norway. RESULTS:Our analysis was based on the identification of 32 potential triggers of adverse events. Eighteen of the triggers were significantly related to adverse events. No adverse events were identified in patient records that did not also contain triggers included in the Global Trigger Tool. CONCLUSIONS:There is a clear relationship between the presence of triggers in a patient record and the likelihood of adverse events. Particularly relevant for psychiatric patients is ‘suffering’ as a trigger and this may also be relevant to somatic care and has implications for inclusion in the GTT-P.
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| 29. |
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| 30. |
- Skorpen Tarberg, Anett, et al.
(författare)
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Nurses’ experiences of compassionate care in the palliative pathway
- 2020
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 29:23-24, s. 4818-4826
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: The aim was to explore how nurses experience compassionate care for patients with cancer and family caregivers in different phases of the palliative pathway. Background: Compassion is fundamental to palliative care and viewed as a cornerstone of high-quality care provision. Healthcare authorities emphasize that patients should have the opportunity to stay at home for as long as possible. There are, however, care deficiencies in the palliative pathway. Design: This study employed a qualitative design using focus groups and a hermeneutic approach. Methods: Four focus groups with three to seven female nurses in each group were conducted in Mid-Norway in 2018. Nurses’ ages ranged from 28–60 years (mean age = 45 years), and they were recruited through purposive sampling (N = 21). Compassionate care was chosen as the theoretical framework. Reporting followed the COREQ guidelines. Results: Three themes expressing compassionate care related to different phases of the pathway were identified: (a) information and dialogue, (b) creating a space for dying and (c) family caregivers’ acceptance of death. Conclusions: This study showed that it was crucial to create a space for dying, characterized by trust, collaboration, good relationships, empathy, attention, silence, caution, slowness, symptom relief and the absence of noise and conflict. Relevance to clinical practice: The quality of compassion possessed by individual practitioners, as well as the overall design of the healthcare system, must be considered when creating compassionate care for patients and their family caregivers. Nursing educators and health authorities should pay attention to the development of compassion in education and practice. Further research should highlight patients’ and family caregivers’ experiences of compassionate care and determine how healthcare systems can support compassionate care.
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| 31. |
- Sveino Strand, Aasta Marie, et al.
(författare)
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Hvilke legekvalifikasjoner er det behov for ved øyeblikkelig hjelp døgnopphold?
- 2019
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Ingår i: Michael. - 1893-9651. ; 3:16, s. 293-305
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Tidskriftsartikel (refereegranskat)abstract
- What Doctor Qualifications are necessary in Emergency Hospitalization in the Norwegian Primary Health Care Service?Emergency hospitalization in the municipality is a new kind of treatment for patients needing urgent medical care in the Norwegian primary health care service. The purpose of this study was to obtain an insight into what qualifications doctors with experience from emergency hospitalization in the municipality deem important. Ten Norwegian doctors with experience from emergency hospitalization in the municipality were interviewed in three focus groups spring 2016. Systematic text condensation was used in the analysis. The doctors saw the need for general and comprehensive competence. In their experience, central qualifications were thorough knowledge of primary health care, good clinical and communicative skills, and competence in advanced teamwork. Emergency hospitalization in the municipality leads to a new responsibility for doctors in the Norwegian primary health care service. Findings suggest that the work demands experienced doctors who work independently, but who also take the lead in interprofessional collaboration.
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| 32. |
- Tarberg, A. S., et al.
(författare)
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Physicians' perceptions of patient participation and the involvement of family caregivers in the palliative care pathway
- 2022
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Ingår i: Health Expectations. - : Wiley. - 1369-6513 .- 1369-7625. ; 25:4, s. 1945-1953
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Patient participation is essential for quality palliative care, and physicians play a crucial role in promoting participation. This study explores physicians' perceptions of patients and family caregivers' involvement in the different phases of the palliative pathway and employs a qualitative design with thematic analysis and a hermeneutic approach. Methods: A purposive sampling included physicians who worked in different phases of the palliative pathway. In-depth, semi-structured interviews were conducted with 13 physicians in Norway between May and June 2020. Results: Three main themes illustrate physicians' perceptions of patients' and family caregivers' involvement: (1) beneficence for the patient and the family caregivers in the early phase, (2) autonomy and shared decision-making in the middle phase, and (3) family involvement in the terminal phase. Conclusion: The physicians perceived bereavement conversations as essential, particularly if the pathway had been challenging. They also perceived patient participation and family caregivers' involvement as contextual. The results reveal that participation differs across the different phases of the palliative pathway. This type of knowledge should be included in the education of health-care professionals. Future research should explore elements vital to successful patient participation and family involvement in the different phases of care. Patient or Public Contributions: Family caregivers were involved in a previous study through individual interviews. The same interview guide used for the family caregivers was used when interviewing the physicians. The family caregivers' contribution led to nuanced questions in the interviews with the physicians, questions leaning on their stories told.
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| 33. |
- Tjulin, Åsa, 1976-, et al.
(författare)
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The disappointment of financial support measures during the COVID-19 pandemic among small business managers’ in Sweden
- 2022
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Ingår i: SN Business & Economics. - : Springer Science and Business Media LLC. - 2662-9399. ; :2
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Tidskriftsartikel (refereegranskat)abstract
- The COVID-19 pandemic is viewed as an emergent social phenomenon with several negative effects, e.g., financial decline of small businesses, as well as worsened sense of well-being. The aim of this article is to explore small business managers’ perceptions of governmental financial support measures and relate them to how they experienced their own health and consequences on their work environment. This mixed-method study was performed during the COVID-19 pandemic in Sweden. A survey was conducted during the period from October 2020 to February 2021 and answered by 729 small business managers, followed by ten interviews in March 2021. The key result shows that the managers were dissatisfied with the governmental financial support measures implemented. The results show that the attitudes of the small business managers towards the financial support measures may have had a negative impact on their subjective health. The study indicates a mismatch between the needs of small businesses during the COVID-19 pandemic and how society provides resources through support systems. This in turn may have meant a limitation on the government’s ability to assist small business owners with financial support during the pandemic.
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| 34. |
- Tritter, Jonathan, et al.
(författare)
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Focus Groups
- 2020. - 4
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Ingår i: Qualitative Research in Health Care. - Oxford : John Wiley & Sons. - 9781119410836 - 9781119410867 ; , s. 57-66
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Bokkapitel (refereegranskat)abstract
- Focus groups continue to be an insightful way of exploring people's views and how these are shaped by social interaction. In health care settings that increasingly stress the need for a patient‐centred approach to research, they are a fruitful way to gather the views and experiences of groups of patients and service users that offers them more control of the interaction. This chapter defines focus groups and discusses how to use them in research. It then identifies particular challenges and opportunities in the analysis of the qualitative data they generate. Focus groups begin with the collection of the pre‐circulated demographic questionnaire; then the facilitator presents the main topic for discussion as well as a set of 'ground rules' and covers any relevant ethical issues such as how data will be recorded, stored, and used. The ground rules are intended to ensure that only one participant speaks at a time and that different views are respected.
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| 35. |
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