| 1. |
- Hansson, Anders, 1953-, et al.
(författare)
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Flawed communications: Health professionals' experience of collaboration in the care of frail elderly patients
- 2018
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 46:7, s. 680-689
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Frail elderly patients who have multiple illnesses do not fare well in modern health care systems, mainly due to a lack of care planning and flawed communication between health professionals in different care organisations. This is especially noticeable when patients are discharged from hospital. The aim of this study was to explore health care professionals' experience of obstacles and opportunities for collaboration. Methods: Health professionals were invited to participate in three focus groups, each consisting of a hospital physician, a primary care physician, a hospital nurse, a primary care nurse, a municipal home care nurse or an assistant officer, a physical or occupational therapist and a patient or a family member representative. These individual people were then asked to discuss the obstacles and opportunities for communication between themselves and with the patients and their relatives when presented with the case report of a fictitious patient. Content analysis was used to identify categories. Results: Several obstacles were identified for effective communication and care planning: insufficient communication with patients and relatives; delayed collaboration between care-givers; the lack of an adequate responsible person for care planning; and resources not being distributed according to the actual needs of patients. The absence of an overarching responsibility for the patient, beyond organisational borders, was a recurring theme. These obstacles could also be seen as opportunities. Conclusions: Obstacles for collaboration were found on three levels: societal, organisational and individual. As health care professionals are well aware of the problems and also see solutions, management for health care should support employees' own initiatives for changes that are of benefit in the care of frail elderly patients with multiple illnesses.
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| 2. |
- Larsson, Agneta, et al.
(författare)
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Effects of work ability and health promoting interventions for women with musculoskeletal symptoms : A 9-month prospective study
- 2008
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 9, s. 105-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Women working in the public human service sector in 'overstrained' situations run the risk of musculoskeletal symptoms and long-term sick leave. In order to maintain the level of health and work ability and strengthen the potential resources for health, it is important that employees gain greater control over decisions and actions affecting their health - a process associated with the concept of self-efficacy. The aim of this study was to describe the effects of a self-efficacy intervention and an ergonomic education intervention for women with musculoskeletal symptoms, employed in the public sector.Methods: The design of the study was a 9-month prospective study describing the effects of two interventions, a comprehensive self-efficacy intervention (n = 21) and an ergonomic education intervention ( n = 21). Data were obtained by a self-report questionnaire on health-and work ability-related factors at baseline, and at ten weeks and nine months follow-up. Within-group differences over time were analysed.Results: Over the time period studied there were small magnitudes of improvements within each group. Within the self-efficacy intervention group positive effects in perceived work ability were shown. The ergonomic education group showed increased positive beliefs about future work ability and a more frequent use of pain coping strategies.Conclusion: Both interventions showed positive effects on women with musculoskeletal symptoms, but in different ways. Future research in this area should tailor interventions to participants' motivation and readiness to change.
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| 3. |
- Larsson, Agneta, et al.
(författare)
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Identifying work ability promoting factors for home care aides and assistant nurses
- 2012
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- In workplace health promotion, all potential resources needs to be taken into consideration, not only factors relating to the absence of injury and the physical health of the workers, but also psychological aspects. A dynamic balance between the resources of the individual employees and the demands of work is an important prerequisite. In the home care services, there is a noticeable trend towards increased psychosocial strain on employees at work. There are a high frequency of work-related musculoskeletal disorders and injuries, and a low prevalence of sustainable work ability. The aim of this research was to identify factors promoting work ability and self-efficacy in care aides and assistant nurses within home care services.This study is based on cross-sectional data collected in a municipality in northern Sweden. Care aides (n = 58) and assistant nurses (n = 79) replied to a self-administered questionnaire (response rate 46%). Hierarchical multiple regression analyses were performed to assess the influence of several independent variables on self-efficacy (model 1) and work ability (model 2) for care aides and assistant nurses separately.Perceptions of personal safety, self-efficacy and musculoskeletal wellbeing contributed to work ability for assistant nurses (R2adj of 0.36, p < 0.001), while for care aides, the safety climate, seniority and age contributed to work ability (R2adj of 0.29, p = 0.001). Self-efficacy was associated with the safety climate and the physical demands of the job in both professions (R2adj of 0.24, p = 0.003 for care aides), and also by sex and age for the assistant nurses (R2adj of 0.31, p < 0.001).The intermediate factors contributed differently to work ability in the two professions. Self-efficacy, personal safety and musculoskeletal wellbeing were important for the assistant nurses, while the work ability of the care aides was associated with the safety climate, but also with the non-changeable factors age and seniority. All these factors are important to acknowledge in practice and in further research. Proactive workplace interventions need to focus on potentially modifiable factors such as self-efficacy, safety climate, physical job demands and musculoskeletal wellbeing.
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| 4. |
- Larsson, Agneta, et al.
(författare)
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Perceptions of health and risk management among home care workers in Sweden
- 2013
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Ingår i: Physical Therapy Reviews. - 1083-3196 .- 1743-288X. ; 18:5, s. 336-343
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Tidskriftsartikel (refereegranskat)abstract
- Background: Municipal home care workers provide high-quality services to an increasing proportion of elderly people living in private homes. The work environments and working conditions of these workers vary to a great extent, implying rapid prioritymaking among both employers and employees to ensure that the work can be performed in a safe way. Objectives: This study aims to examine home care workers perceptions of health, risks, working conditions and risk management within their organisation. Method: The study was based on cross-sectional data collected from home care service staff' in a municipality in the north of Sweden. Nursing assistants and care aides(n=133) replied to a self-administered questionnaire. Descriptive statistics and between-group differences were analysed. Results: Home care work was perceived to require high levels of professional skill and ingenuity, a good psychosocial work situation, but required a high physical workload. The general health, the capacity and self-efficacy of the staff in relation to work were good. Difficulties in performing risk assessments and to follow safety regulations due to lack of time, equipment and information were identified.Conclusion: There is a need to increase participation in risk assessments among the staff, improve management support, structures and cooperation with other divisions of the social services and the medical care organisations.
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| 5. |
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| 6. |
- Larsson, Agneta, et al.
(författare)
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Promoting a safety climate and safety activities for health and work ability in home care services workers
- 2011
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Konferensbidrag (refereegranskat)abstract
- Purpose: The present study aims to describe home care service workers' perceptions of safety climate and safety activities at work as well as working conditions, self-efficacy, and health and work ability. Relevance: High frequencies of work-related musculoskeletal disorders and injuries and low prevalence of sustainable work ability in home care services workers are of great concern. They are to provide high quality services to an increasingly proportion of elderly people living in private homes. In order to promote health and safety for the home care workers, increased focus should be on organisational, psychosocial and physical factors contributing to a healthy working environment. Participants: 158 nursing assistants and nursing aides divided in 18 work units participated in this study. They all met the criterion of having worked in the same home care services unit in the last 6 months. Their mean age was 46 years, the majority were women, and the distribution of nursing aides and nursing assistants was about 40/60%. Methods: This study is based on cross-sectional data gathered in February 2009 in home care services in a municipality in the North of Sweden. All the home-care work units shared the experiences of using a model for participatory risk management in home care services. Data were obtained through a comprehensive self-administered questionnaire, covering working conditions, safety climate, safety activities, self-efficacy, health and work ability. Analysis: Descriptive statistics as well as data on between-group differences are analysed. Results: In general, the results showed fairly good levels of safety climate but only moderate levels of safety activities and of perceived safety grade at work. These variables differed significantly between work units. Environmental barriers, such as lack of time and equipment, were given as reasons for not complying with safety rules or participating in proactive risk assessment. Besides a high frequency of musculoskeletal symptoms and high physical exposure at work, the home care workers in general reported being in good health and with good work ability. They also expressed high decision making latitude, skill discretion, social support and self-efficacy. Conclusions: To promote health and safety for the home care workers, interventions could build on the high levels of safety climate and proactive activities in single work units, proposing good solutions and safe behaviour. Focus need to be placed on improved safety climate, communication and coordination with all professionals forming the home care services setting. Also, on individuals' and work units' awareness of safe behaviour and on alternatives of actions in critical risk situations at work. This may act preventive on musculoskeletal well-being and a good working environment. Implications: There need to be an increase in means given to physical therapists in occupational health services, to work with these issues. The ergonomic skills and the safety climate of the front-line home care services workers need to be addressed, as well as the organisational prerequisites for workplace safety and health.
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| 7. |
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| 8. |
- Larsson, Agneta, Dr, et al.
(författare)
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Teamwork and Safety Climate in home care : a mixed method study
- 2018
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Ingår i: International Journal of Environmental Research and Public Health. - Basel, Switzerland : MDPI. - 1661-7827 .- 1660-4601. ; 15:11
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Tidskriftsartikel (refereegranskat)abstract
- A rapidly changing homecare service sector implies difficulties to control safety and health risks for staff and to guarantee standardised deliveries of services to recipients. This study aimed to describe staff perceptions of safety climate and practices in homecare service teams, and suggestions for improvements. A second aim was to identify if and how the appraisals of safety climate were related to individual perceptions of safety, mental strain and adverse events/injury. A convergent parallel mixed methods design was used. Nursing assistants and care aides (133 in total, representing 11 work teams) in the north of Sweden replied to a survey and participated in focus group interviews. Results were analysed with ANOVA (inter-team differences) and by qualitative content analysis. Significant diversity was identified between the teams in five of seven dimensions of safety climate. Important areas for improvement were: a need to define and agree on criteria for a safe working environment; leadership prioritising safety at work; and management able to provide trust, support and time. A prerequisite for these agreements was improved authority and communication between all parties involved. The safety climate dimensions were related to personal perceptions of safety and mental strain and, partly, to adverse events/injuries.
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| 9. |
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| 10. |
- Larsson, Lena Gunvor, et al.
(författare)
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A national study on collaboration in care planning for patients with complex needs
- 2019
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Ingår i: International Journal of Health Planning and Management. - : Wiley. - 0749-6753 .- 1099-1751. ; 34:1, s. E646-E660
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The purpose of this study was to investigate inter-organisational collaboration on care planning for patients with complex care needs. Internationally, and in Sweden where the data for this study was collected, difficulties in care planning and transition of patients between the main health care providers, hospitals, municipal care, and primary care are well known.METHOD: A survey of a total population of care managers in hospitals, municipalities, and primary care in Sweden was conducted. The study assessed accessibility, willingness, trustworthiness, and collaboration between health care providers. Data were analysed with descriptive statistics, bivariate, and multivariate regressions.RESULTS: The results indicate that Swedish health care providers show strong self-awareness, but they describe each other's ability to collaborate as weak. Primary care stands out, displaying the highest discrepancy between self-awareness and displayed accessibility, willingness, trustworthiness, and collaboration.CONCLUSION: Inability to collaborate in patient care planning may be due to shortcomings in terms of trust between caregivers in the health care organisation at a national level. Organisations that experience difficulties in collaboration tend to defend themselves with arguments about their own excellence and insufficiency of others.
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| 11. |
- Larsson, Lena Gunvor, et al.
(författare)
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Primary care managers’ perceptions of their capability in providing care planning to patients with complex needs
- 2017
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510 .- 1872-6054. ; 121:1, s. 58-65
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate primary care managers’ perceptions of their capability in providing care planning to patients with complex needs. Care planning is defined as a process where the patient, family and health professionals engage in dialogue about the patient's care needs and plan care interventions together. Methods Semi-structured interviews with 18 primary care managers in western Sweden were conducted using Westrin's theoretical cooperation model. Data were analysed using a qualitative deductive method. Main findings Results reveal that the managers’ approach to care planning was dominated by non-cooperation and separation. The managers were permeated by uncertainty about the meaning of the task of care planning as such. They did not seem to be familiar with the national legislation stipulating that every healthcare provider must meet patients’ need for care interventions and participate in the care planning. Implications for practice To accomplish care planning, the process needs to cross – and overcome – both professional and organisational boundaries. There is also a need for incentives to develop working methods that promote local cooperation in order to facilitate optimal care for patients with complex needs.
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| 12. |
- Larsson, Lena Gunvor
(författare)
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Samverkan vid vårdplanering för patienter med komplexa behov – ett mellanorganisatoriskt triangeldrama
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims: The overall aim of this thesis was to deepen the knowledge of collaboration in care planning across healthcare provider boundaries for patients with complex care needs. Specific aims were: to highlight specialist nurses´ experiences of coordinated care planning in primary care (I); to investigate care center manager ´s understanding of the ability of primary care to provide coordinated care planning for patients with complex needs (II); to focus on health professionals from different organizations and describe their experiences of obstacles and opportunities for collaboration with patients and their relatives and between caregivers for frail elderly patients with multiple diseases (III); to investigate inter-organisational collaboration on care efforts for patients with complex care needs (IV). Methods: In study I and III, focus groups were used as a data collection method and analyzed with inductive qualitative content analysis. In study II, individual interviews were conducted and analyzed with deductive qualitative content analysis. In study IV, a survey was used for a total population of health managers in hospitals, health centers and medically responsible nurses (MAS) in Sweden. Data were analyzed with descriptive statistics, bivariate and multivariate regressions. Results: The result highlights the importance of creating consensus in relation to patients and responsible healthcare providers (I). Collaboration in care planning between primary care and other healthcare providers is dominated by non-cooperation (II). Communication with patients and related parties is insufficient and delayed between care providers. There is a lack of adequate care planning and the resources are not distributed according to patients´ needs (III). Each health care organization values its own ability to interact more than they value each other. Primary care and municipality attribute to each other a smoother collaboration than they attribute to hospitals, but primary care is judged to have the least accessibility, lowest degree of willingness to care and trustworthiness of the three organisations in care planning for patients with complex care needs (IV). Conclusions: The communication skills of specialist nurses are of utmost importance for involving and supporting patients and related parties in the care process and for achieving consensus among healthcare providers in the decisions made during care planning. The healthcare manager´s knowledge of primary care´s participation, role and responsibility in care planning was permeated by uncertainty about the tasks. The healthcare staff emphasizes obstacles to collaboration in healthcare planning at social, organisational and individual level. With improved systems for communication, joint care plan and regulated overall responsibility for patients throughout the care process, the possibilities for collaboration increase. Health managers and MAS judge that there is an inability to inter-organisational collaboration, which to some extent can be explained by a discrepancy between one´s own and others´ perception of accessibility, service willingness, trustworthiness and collaboration between hospital, municipality and primary care.
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| 13. |
- Svensson, Ann, 1962-, et al.
(författare)
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IT Systems for Collaboration in Healthcare for Frail Elderly People
- 2016
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Ingår i: 17th European Conference on Knowledge Management (ECKM). Galbraith B.,Moffett S.,Galbraith B. (eds.). - Reading, UK : Academic Conferences Limited. - 9781911218036 ; , s. 859-866
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Konferensbidrag (refereegranskat)abstract
- The ageing population of the western world poses a medical challenge for society of today and of the future. Frail elderly people are described as multi-diseased and vulnerable patients who are in need of medication and hospital care. These patients require healthcare from several different caregivers within the health services, including hospital-based acute care services, primary care services and community care services. This situation will challenge the capacity of the health services to manage inter-professional collaboration for patient-centered care. The aim of this paper is to identify challenges that caregivers within the health services face in relation to the IT systems that are used in their daily work practice, in their collaborative work and for sharing of information and knowledge. The paper is based on a qualitative study which includes three focus group interviews that were conducted within a healthcare organization in the western part of Sweden. The focus groups consisted of all types of professionals who can be found within each of the included healthcare organizations, as well as representatives of relatives of frail elderly people. Each one of the three focus group interviews conducted lasted for two hours. Afterwards, the interviews were analyzed with thematic analysis. The study identifies challenges within the following themes related to the use of IT systems: insufficient information, incoherent communication, differing uses of IT systems and deficient coordination.
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