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- De Lima, Wenderson, 1981-
(författare)
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Modern Missionaries : An Ethnography of Social Entrepreneurs and Entrepreneurial Legitimation in the Humanitarian Field
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In nearly six decades of international interventions, the question of how to promote societal progress in African societies is still the subject of lively debates. The persistence of wars, famine, political instability and economic underdevelopment on the continent continues to fuel spirited discussions about how to organize aid most efficiently and whether old forms of international assistance still work. In this scenario, modern missionaries appear bearing promises to solve poverty related problems. Some of these people call themselves: ‘social entrepreneurs’. These entrepreneurs have during the last decade gained increased space in the humanitarian field. Based on the premise that business and self-interest may in fact be the most effective way to assist the ‘extreme poor’ in the Global South, entrepreneurs and social entrepreneurs have increasingly begun to gain recognition as innovative humanitarian players. By applying business principles and practices to the humanitarian field, social entrepreneurs are constructed as challengers of previously institutionalized forms of organizing aid, such as charities and NGOs. The aim of this dissertation is to create a greater understanding of how social entrepreneurs gain legitimacy in the humanitarian field. Drawing on ethnographic methods, I address this aim by exploring the realities of social entrepreneurs creating organizations in Kenya’s largest urban slum Kibera, in Nairobi. I argue that, to gain legitimacy in the humanitarian field, social entrepreneurs depend on the interplay between social, cultural, symbolic and economic capital. Furthermore, I emphasize the symbolic power of places in the processes by which entrepreneurs gain social acceptance and support for their interventions. While seemingly fostering social transformation and entrepreneurship in the Global South, social entrepreneurs may informally create and support an economy which justifies the existence of NGOs in Kibera. Within this economy local actors create several mechanisms for profiting from foreign led organizations. This phenomenon I call ‘unexpected entrepreneurship’: activities that emerge as reactions to processes of development and the delivery of humanitarian services and products as well as the implementation of policies. Although often commercial and informal in nature, this form of entrepreneurship influences how social entrepreneurs gain access to local settings. Unexpected entrepreneurship also changes how social entrepreneurs design and deliver their solutions.
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| 2. |
- Granqvist, Karin, 1974, et al.
(författare)
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Central aspects when implementing an electronic monitoring system for assessing hand hygiene in clinical settings: A grounded theory study
- 2024
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Ingår i: Journal of Infection Prevention. - 1757-1774 .- 1757-1782. ; 25:3, s. 51-58
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Tidskriftsartikel (refereegranskat)abstract
- Background: New technologies, such as electronic monitoring systems, have been developed to promote increased adherence to hand hygiene among healthcare workers. However, challenges when implementing these technologies in clinical settings have been identified. Aim: The aim of this study was to explore healthcare workers’ experiences when implementing an electronic monitoring system to assess hand hygiene in a clinical setting. Method: Interviews with healthcare workers (registered nurses, nurse assistants and leaders) involved in the implementation process of an electronic monitoring system (n = 17) were conducted and data were analyzed according to the grounded theory methodology formulated by Strauss and Corbin. Results: Healthcare workers’ experiences were expressed in terms of leading and facilitating, participating and contributing, and knowing and confirming. These three aspects were merged together to form the core category of collaborating for progress. Leaders were positive and committed to the implementation of the electronic monitoring system, endeavouring to enable facilitation and support for their co-workers (registered nurses and nurse assistants). At the same time, co-workers were positive about the support they received and contributed by raising questions and demands for the product to be used in clinical settings. Moreover, leaders and co-workers were aware of the objective of implementing the electronic monitoring system. Conclusion: We identified dynamic collective work between leaders and co-workers during the implementation of the electronic monitoring system. Leadership, participation and knowledge were central aspects of enhancing a collaborative process. We strongly recommend involving both ward leaders and users of new technologies to promote successful implementation.
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| 3. |
- Granqvist, Karin, 1974, et al.
(författare)
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Learning to interact with new technology: Health care workers’ experiences of using a monitoring system for assessing hand hygiene – a grounded theory study
- 2022
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Ingår i: American Journal of Infection Control. - : Elsevier BV. - 0196-6553 .- 1527-3296. ; 50:6, s. 651-656
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recently, innovative technologies for hand hygiene (HH) monitoring have been developed to improve HH adherence in health care. This study explored health care workers’ experiences of using an electronic monitoring system to assess HH adherence. Methods: An electronic monitoring system with digital feedback was installed on a surgical ward and interviews with health care workers using the system (n = 17) were conducted. The data were analyzed according to grounded theory by Strauss and Corbin. Results: Health care workers’ experiences were expressed in terms of having trust in the monitoring system, requesting system functionality and ease of use and becoming aware of one's own performance. This resulted in the core category of learning to interact with new technology, summarized as the main strategy when using an electronic monitoring system in clinical settings. The system with digital feedback improved the awareness of HH and individual feedback was preferable to group feedback. Conclusions: Being involved in using and managing a technical innovation for assessing HH adherence in health care is a process of formulating a strategy for learning to interact with new technology. The importance of inviting health care workers to participate in the co-design of technical innovations is crucial, as it creates both trust in the innovation per se and trust in the process of learning how to use it.
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| 5. |
- Hjalmarsson, Anna, 1976-
(författare)
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Being provided with a safe haven : Care-dependent older persons' participation in prehospital emergency care
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Participation in care is a key concept in many welfare societies and serves to guide clinical practice and adapt care to personal preferences and needs in order to promote well-being and quality of life. Previous research has shown that practicing participation in care is complex due to the concept not being clearly defined. A significant risk is, therefore, that participation in care is practiced based on the professional caregivers' own definitions, which might be inconsistent with the cared-for persons' perceptions of what participation is.Older persons can continue to live in their own homes with the support of municipal home care services that meet everyday care needs. Care-dependent older persons are known to have increased emergency care needs, which in Sweden require inter-organizational and inter-professional collaboration involving a care transfer between welfare levels. This thesis aimed to deepen the understanding of care-dependent older persons' participation in prehospital emergency care from lifeworld and welfare perspectives. The inductive design was based on a lifeworld approach and included triangulation of the phenomenon of participation in care using descriptive, interpretative, and comparative methods.From the perspective of care-dependent older persons, participation in prehospital emergency care means a forced transfer of life responsibility to professional caregivers when being existentially unsafe and incapacitated due to acute illness. Through authorized representation, the professional caregivers act for the older person, with the power to bring about change and create opportunities for existence. Care-dependent older persons' participation in prehospital emergency care involves a deepened dependence that necessitates coexistence and being provided with a 'safe haven' through the entire emergency care chain. A 'safe haven' can be understood as an unconditional, calm, and sheltered interpersonal space for emotional rest that is provided to the older person during an existentially challenging situation. From the perspective of care-dependent older persons, the emergency care chain transcends organizational boundaries and includes mobile safety alarm services and emergency department attendance.The involved professionals must be supported in practicing participation in care based on a comprehensive understanding of the concept, and emergency care options must be aligned with the care-dependent older persons' need for coordinated and continuous care. Collaborative challenges related to unstructured collaboration and professional hierarchy need to be addressed to support well-functioning collaboration in situations involving acutely ill older persons. The involved organizations need to recognize care-dependent older persons' deepened dependence when acutely ill, as well as their extended view of the prehospital emergency care chain.
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| 6. |
- Ilgunas, Aurelija, et al.
(författare)
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Conceptualizing the clinical decision-making process in managing temporomandibular disorders : a qualitative study
- 2021
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Ingår i: European Journal of Oral Sciences. - : John Wiley & Sons. - 0909-8836 .- 1600-0722. ; 129:5
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Tidskriftsartikel (refereegranskat)abstract
- Management of patients with temporomandibular disorders (TMD) appears to be more challenging than for other dental conditions. This study aimed to explore the decision-making process in TMD management, and thereby to conceptualize the decision-making process in dentistry. Individual semi-structured interviews were conducted during 2018 and 2019 with a purposive sample of 22 general dental practitioners from the Public Dental Healthcare Services and private practices in the Region of Västerbotten, Northern Sweden. The interviews were analysed using the Grounded Theory approach of Charmaz. Data analysis resulted in the core category 'Combining own competence and others' expectations in the desire to do the right thing'. The dentists showed interest in and a desire to apply professional knowledge, but also reflected on challenges and complexity in the decision-making process forTMD. The challenges were primarily related to organisational factors and lack of self-confidence. This identifies a need for re-organisation of daily clinical management in dentistry, and a need for more postgraduate training to improve self-confidence. The complexity of the decision-making process for TMD makes the study findings applicable in other dental situations.
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- Jakobsson Larsson, Birgitta, 1965-, et al.
(författare)
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Registered nurses' experiences on job satisfaction in nursing home settings
- 2024
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 11:6
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Tidskriftsartikel (refereegranskat)abstract
- AimTo describe what registered nurses' experience to be important to job satisfaction in nursing home settings.DesignThis is a qualitative study based on data from individual interviews.MethodsSixteen registered nurses working in nursing homes were interviewed, and their responses were analysed with systematic text condensation.ResultsA total of six categories were developed to describe various aspects of job satisfaction among registered nurses at nursing homes: meaningfulness is essential, to possess control and manageability is central, a possibility to balance daily challenges with professional development, supportive leadership is imperative, the nursing team's competence and companionship, and being confident in one's own profession.ConclusionIn the present study, meaningfulness was essential to job satisfaction, and work was experienced to be meaningful and engaging when the demands were manageable, the workload controllable, and when the registered nurses felt supported by management and co-workers. Conversely, if the demands were too high, the workload was beyond their control and the nurses felt unsupported, then the work felt meaningless and thus unsatisfactory.
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| 8. |
- Karlsson, Jenny, et al.
(författare)
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Capturing the Unsaid : Nurses’ Experiences of Identifying Mental Ill-Health in Older Men in Primary Care—A Qualitative Study of Narratives
- 2021
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Ingår i: Nursing Reports. - Västerås : MDPI AG. - 2039-439X .- 2039-4403. ; 11:1, s. 152-163
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Tidskriftsartikel (refereegranskat)abstract
- This study describes nurses’ experiences in identifying mental ill-health in older men in primary care. The aging population is growing in Sweden and life expectancy is increasing. Age is a risk factor for mental ill-health. Older men are over-represented in deaths from suicide. When older men seek primary care, it is often because of somatic symptoms and rarely for mental health issues. A questionnaire with five open questions was answered by 39 nurses from 10 primary care centres and subjected to inductive qualitative content analysis. The results revealed a main theme—capturing the unsaid—and two categories: (1) feeling secure in the role, with three subcategories (building trust, daring to ask and interpreting signs); and (2) the need for resources, with two subcategories (time and continuity, and finding support in collaboration). The results confirm that nurses in primary care play a key role in identifying mental ill-health in older men. There is a need for resources in the form of time, competence and collaboration with other professionals and patients’ relatives. This strategy will establish best practice and provide evidence-based care to facilitate improvements in older men’s mental health and prevent suicide.
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| 9. |
- Karlsson, Margareta
(författare)
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Att styra mot uthållig organisatorisk samverkan i hälso- och sjukvårdsprocesser : Främjande och motverkande faktorer
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Svensk hälso- och sjukvård står inför utmaningar att möta ändrade behov, nya behandlingsmetoder och ny teknik. Genom samordning och samverkan antas kvaliteten för patienten kunna förbättras samtidigt som kostnader reduceras. Organisatorisk samverkan innebär att aktörer, över organisatoriska gränser, tillsammans försöker uppnå syftet med samverkan, t.ex. att underlätta vården av en patient eller patientgrupp i en vårdkedja. Reformer av styrningen har dock påverkat förutsättningarna för organisatorisk samverkan.Avhandlingen beskriver hur ökad förmåga att styra mot uthållig organisatorisk samverkan kan främja effektivare hälso- och sjukvårdsprocesser. I fyra studier utforskas hur några styrprinciper påverkat organisatorisk samverkan, vilka arbetssätt som kan motverka negativa konsekvenser av dessa styrprinciper och hur systematiskt förbättringsarbete ur ett systemperspektiv kan främja initiering, genomförande och utveckling av organisatorisk samverkan. Studierna utforskar olika former av samverkan; (I) intra-organisatorisk samverkan mellan en servicefunktion och vårdverksamheter, (II) inter-organisatorisk samverkan i en försörjningsprocess, (III) kunskapsutbyte i ett förbättringsarbete och (IV) hur ett marknadsbaserat begrepp som intern kund kan inverka på samverkan i en vårdprocess. Kvalitativa metoder har använts för insamling och analys av data, förutom olika typer av intervjuer även granskning av officiella dokument samt en strukturerad litteraturgenomgång och en konceptuell diskussion.Avhandlingen utforskar några styrprinciper som studierna indikerat kunna påverka organisatorisk samverkan. Strävan mot en sömlös vårdkedja kan motverkas av betoningen av gränser inom och mellan organisationer. Strävan efter ökad kvalitet baserat på bevis kan motverka ambitioner av ökad takt i förbättringsarbetet. Strävan efter ett gemensamt ansvarstagande i värdeskapande för patienten kan motverkas av interna marknader och en marknadsbaserad diskurs. Krav på kostnadskontroll kan motverka strävan mot systemövergripande kostnadseffektivitet och måleffektivitet. Arbetssätt som främjar uthållig organisatorisk samverkan baserad på tillit och ömsesidighet kan dock motverka de negativa konsekvenserna. Strukturerad kommunikation, incitament genom gemensamma mål och indikatorer, uppföljning av dem och utvärdering av samverkan kan främja pågående, nya och förnyade samverkansaktiviteter. Nedtoning av en marknadsbaserad diskurs och betoning av det ömsesidiga ansvaret kan synliggöra servicefunktionernas roll i värdeskapande för patienten. Avhandlingen visar också att organisatorisk samverkan kan främja förbättringsarbete och lärande i processer genom delande av kunskap inom och mellan funktioner och organisationer. Arbetssätt baserade på teorier om organisering, kvalitetsledning, systemtänkande och processledning kan stödja organisationerna vid initiering, genomförande och utveckling av samverkan inom och mellan organisationer.
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| 10. |
- Karlsson, Margareta, et al.
(författare)
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Organizing for sustainable inter-organizational collaboration in health care processes
- 2020
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Ingår i: Journal of Interprofessional Care. - : Taylor & Francis. - 1356-1820 .- 1469-9567. ; 34:2, s. 241-250
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Tidskriftsartikel (refereegranskat)abstract
- Integrating health care services has proven to be important from both the patient and organizational perspectives. This study explores what defines a perceived well-functioning collaboration in the inter-organizational process of providing assistive devices in Sweden. Two focus groups comprising participants with profound knowledge of collaboration were performed, and data were analyzed in five steps, resulting in a data structure. Results yield the identification of three interacting processes: coordinating efforts to patient needs, ensuring evidence-based practice, and planning for efficient use of resources. These processes affected one another, and, therefore, would likely not have been effectively managed separately. The study contributes to theories of process management and organization by specifically focusing on how to analyze and improve sustainable collaboration in health care processes at both the management and professional levels. Theoretical frameworks that show different ways of organizing collaboration, as well as the concepts of action nets and boundary objects, can support both analysis and planning of collaboration. The intention would be to develop integration in inter-organizational health care processes, resulting in more person-centered care.
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