| 1. |
- Agerholm, Janne, et al.
(författare)
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Impact of Integrated Care on the Rate of Hospitalization for Ambulatory Care Sensitive Conditions among Older Adults in Stockholm County : An Interrupted Time Series Analysis
- 2021
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 21:2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Reducing avoidable hospital admissions is often viewed as a possible positive consequence of introducing integrated care (IC). The aim of this study was to investigate the impact of implementing IC in Norrtälje on the rate of admissions for ambulatory care sensitive conditions (ACSC).Method: Using interrupted time series analyses we investigated the effect of implementing IC in Norrtälje municipality in the northern part of Stockholm county, Sweden. The time period included 48 time points, from year 2000 to year 2011 with measurements before and after introducing IC in Norrtälje in 2006. In order to control for other extraneous events that could affect the outcome measure, but not related to the introduction of IC, we included a control population from Stockholm municipality.Results: After introducing IC in Norrtälje the rate of admissions for ACSC decreased. This decrease was greater in Norrtälje than in the matched control population, however the difference between the two areas was not statistically significant (p = 0.08).Conclusion: Introducing IC in Norrtälje may have had positive impact on admissions for ACSC for older people living in Norrtälje; however, the interpretation of the impact of IC on admissions for ACSC is complicated by intervening policy changes in health and social care during the study period.
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| 2. |
- Aidemark, Jan, 1967-, et al.
(författare)
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Barriers to adoption of eHealth solutions based on research project result
- 2021
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 21:S1
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Tidskriftsartikel (refereegranskat)abstract
- ICT projects, development and/or research driven, are sources of new innovative eHealth solutions. However, the rate of continued use is low and gaining sustainable benefits in daily operations is difficult (Warth et al.). This research looks at the barriers for the organizational implementation based on research driven projects. Three eHealth projects have been analyzed for aspects on the phenomenon, to gain a deeper understanding of the problem. Results are based on discussions between project participants, (professionals, decision makers, patients), and analysis of the project set ups and purposes. ResultsFactors that could be seen as important for lack of continued use includes: pure research setup of projects, lack of financial resources in the post projects time , lack of organizational competences for adoption of solutions, no organizational champion or CEO support, lack of fit to organizational processes or scheduling, professional resistance to change, among others. DiscussionProject set ups and working methods of the project might hamper the possibilities of effective knowledge transfer and organizational adoption. Experiences from mentioned projects show that a 360-degree co-design approach, which includes major stakeholder (for example, professionals, patients, researchers, patients, decisions makers) should be included. There is a need to prepare for knowledge transfer processes in post project phases, including competence development strategies for professionals and organizational change plans. Conclusions A holistic understanding of conditions and challenges is needed for paving the way for health organization to reap benefits from research projects. Lessons learned Projects need to include processes for engaging the stakeholders through 360 co-design, knowledge transfer plans and competence development strategies. Limitations The research is exploratory and based on analysis of past and ongoing eHealth projects. Suggestions for future researchBetter understanding for how to integrating competence development and organizational change as a part of eHealth project are needed. An investigation on digital competence among patients and healthcare personnel is planned, with the purpose of defining competence development strategies and requirements for IT-enabled cooperation and co-production.
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| 3. |
- Aidemark, Jan, 1967-, et al.
(författare)
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Co-designing self-care solutions with elderly : lessons learnt
- 2020
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 20:S1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Ehealth solutions are in great need in the community of elderly in general, as patients or home carers, however a design approach that delivers this is illusive. In this research we present the experiences from a set of design processes targeting elderly’s needs of support or home care, based on a co-design approach. The purpose is to present guiding principles for how to work with elderly in a co-design process, to be used as basis for future set up of co-design processes.
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| 4. |
- Aidemark, Jan, 1967-, et al.
(författare)
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ICT challenges of Integrated care from a Co Design perspective using a Quadraple Helix
- 2020
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 20:S1
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Tidskriftsartikel (refereegranskat)abstract
- The Internet of Things (IoT) plays a vital role in today’s medicine (Islam et al, 2015). In 2020, 40% of IoT-related technologies will be assigned to the health domain, which makes up around a 117 $ billion in the global market (Bauer, Patel & Veira, 2016). Adding to this the demographic changes will further set a significant challenge in Europe (Steinführer & Haase, 2007). Innovative techniques for supporting health systems and independent life for the aging population is therefore essential, not at least in relation to fall prevention and technology for promoting a good life throughout the lifespan. Further, participation from patients is a goal for healthcare worldwide (Lundgren, Sunesson & Tunved, 2014). For example according to the Health and Medical care act in Sweden (1982:763) it is described that the goal for health care “is good health and care on equal terms for the entire population”. In line with this challenge of integrated care the patient itself will be the most important resource for promotion of health, why Co Design is needed as a method for innovation in healthcare sector. It is important for the users ‘experiences and insights to contribution in improvements but not at least because it has been shown that increased involvement with the user in care reduces the number of hospital visits (Simpsons, 2007).
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| 7. |
- Bångsbo, Angela, 1968, et al.
(författare)
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Barriers for Inter-Organisational Collaboration: What Matters for an Integrated Care Programme?
- 2022
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 22:22
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Inter-organisational collaboration is challenging but essential in managing the complex and comprehensive needs of frail older people. Therefore, there is a need to investigate the influence of different barriers to inter-organisational collaboration when implementing an integrated care programme. The aim of this study was to investigate both inpatient and outpatient staff views on the factors they deemed to be influential to inter-organisational collaboration for an integrated care programme. Methods: The study was a cross-sectional study and included staff from hospitals, primary care and municipal health and social care. Results: There were no significant differences between staff from inpatient and outpatient care in measuring factors that may cause difficulties for inter-organisational collaboration. Staff views diverged significantly on all factors, such as educational level at long physical distances, laws and regulations, knowledge of each others work settings, experience from inter-organisational collaboration, different professions, variations in professional status and power, psychosocial factors such as positive work environment and interpersonal chemistry. Discussion: A multidisciplinary team culture and avenues for inter-organisational collaboration need to be developed for improved care continuity. Conclusion: The staffs’ educational level influenced what was perceived as barriers to inter-organisational collaboration, and may guide future development of integrated care programmes.
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| 8. |
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| 9. |
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| 10. |
- Hallberg, Anna, 1989-, et al.
(författare)
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Balancing Pragmatism and Sustainability : A Case Study of an Interorganisational Network to Improve Integrated Care for the Elderly
- 2021
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 21:3
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Networks constitute a promising strategy for interorganisational collaboration, but may fail due to network tensions. By investigating the activities and internal dynamics of a voluntary meso-level network operating in the intersection of health and social care, this study aims to enhance the understanding of the relationship between pragmatism and sustainability and the role network governance plays in this respect.Methods: In this descriptive case study, 2–3 researchers observed 3 three-hour long network meetings during the course of a year, and four complementary interviews were performed. Data were analysed based on the literature on network functioning and effectiveness.Results: Pragmatism (a focus on ‘getting things done’) was more emphasised than sustainability although the network meetings also contained elements of relationship- and trust-building. The network leadership (a Network Administrative Organisation, NAO) created structure and concretized the participants’ ideas while remaining flexible and perceptive, and also carried out tasks which would otherwise not have been performed.Discussion: The emphasis on pragmatism did not seem to influence sustainability negatively which has been pointed out as a potential risk in previous literature. Rather, the focus on pragmatism reinforced sustainability in a way that is similar to what has been described in prior research as a “trust-building loop” and discussed further in terms of a “perception of progress” mechanism. However, it was unclear what future the voluntary network would have without the NAO.Conclusion: Network governance is instrumental to success, and should be carefully considered when initiating interorganisational network initiatives for integrated care.
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| 11. |
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| 12. |
- Johansson, Erika, et al.
(författare)
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Let’s Try Social Prescribing in Sweden (SPiS) : an Interventional Project Targeting Loneliness among Older Adults Using a Model for Integrated Care: A Research Protocol
- 2021
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 21:2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Loneliness and social isolation among older adults (≥65) are an emerging issue of public concern, associated with increased morbidity and mortality. Today there is no systematic intervention developed, implemented or evaluated in Sweden addressing loneliness. The overall aim for this project is to develop, test and refine a person-centred Swedish model for social prescribing (SPiS), and to assess whether and how it reduces loneliness, promotes health and improves well-being among older adults.Description: The focus will be to develop, culturally adapt, evaluate and refine the SPiS model. Following the sequential structure of realist evaluation in three consecutive phases qualitative and quantitative data along with subsequent analysis methods will be collected and utilized. The project will provide knowledge of what works with the social prescribing model, for whom, in what conditions and why, in relation to loneliness, health and well-being among older adults.Discussion: SPiS has the unique position of providing initial knowledge regarding how to reduce loneliness in the Swedish context. However, evaluation is complex as this research goes beyond the unidimensional question “Is it working?”.Conclusion: Developing, implementing and evaluating such a complex program needs systematic and close evaluation.
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| 13. |
- Kjellberg, Inger, 1959
(författare)
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Collaborative Experience Success Stories in Integrated Care of Older People: A Narrative Analysis
- 2020
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 20:3
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Inter-organisational collaboration is crucial in the care of older people, as is the development of integrated care. Storytelling in organisations is one way of understanding how to achieve successful collaboration. This article provides insights into the ways in which storytelling in collaborative experiences contributes to a collective identity instrumental in the successful collaborations involved in integrated care for older people. Theory: Managing cultural diversity is one specific theme in the theory of collaborative advantage; this is used in combination with theories of storytelling in organisations. Method: Interviews with staff from three different municipalities applying three various strategies for integrated care were carried out. Stories of the collaborative experiences were analysed using a narrative approach. Results: The most significant finding was that a similar type of success story was evident across all three municipalities. The story was identified as an epic-comedy story where success was accomplished through the heroic characterisations of the managers, in addition to their improvisation abilities and discretionary work towards common goals. Conclusion: It is suggested that storytelling in collaborative experiences is one way of overcoming cultural frictions between different collaborating actors and may contribute to a coherent sense of a collective identity, thus facilitating further collaboration.
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| 14. |
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| 15. |
- Lim, Esther Li Ping, et al.
(författare)
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An Evaluation of the Relationship between Training of Health Practitioners in a Person-Centred Care Model and their Person-Centred Attitudes
- 2023
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 23:4
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The Esther Network (EN) person-centred care (PCC) advocacy training aims to promote person-centred attitudes among health practitioners in Singapore. This study aimed to assess the relationship between the training and practitioners’ PCC attributes over a 3-month period, and to explore power sharing by examining the PCC dimensions of “caring about the service user as a whole person” and the “sharing of power, control and information”. Methods: A repeated-measure study design utilising the Patient-Practitioner Orientation Scale (PPOS), was administered to 437 training participants at three time points – before training (T1), immediately after (T2) and three months after training (T3). A five-statement questionnaire captured knowledge of person-centred care at T1 and T2. An Overall score, Caring and Sharing sub-scores were derived from the PPOS. Scores were ranked and divided into three groups (high, medium and low). Ordinal Generalised Estimating Equation (GEE) model analysed changes in PPOS scores over time. Results: A single, short-term training appeared to result in measurable improvements in person-centredness of health practitioners, with slight attenuation at T3. There was greater tendency to “care” than to “share power” with service users across all three time points, but the degree of improvement was larger for sharing after training. The change in overall person-centred scores varied by sex and profession (females score higher than males, allied health showed a smaller attenuation at T3). Conclusion: Training as a specific intervention, appeared to have potential to increase health practitioners’ person-centredness but the aspect of equalising power was harder to achieve within a hierarchical structure and clinician-centric culture. An ongoing network to build relationships, and a supportive system to facilitate individual and organisational reflexivity can reinforce learning.
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| 16. |
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| 18. |
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| 19. |
- Lindblom, Sebastian, et al.
(författare)
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Perceptive Dialogue for Linking Stakeholders and Units During Care Transitions - A Qualitative Study of People with Stroke, Significant Others and Healthcare Professionals in Sweden
- 2020
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156 .- 1568-4156. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Care transitions are a complex set of actions that risk poor quality outcomes for patients and their significant others. This study explored the transition process between hospital and continued rehabilitation in the home. The process is explored from the perspectives of people with stroke, significant others and healthcare professionals in Stockholm, Sweden. Method: Focus group interviews (n = 10), semi-structured individual interviews (n = 23) and interviews in dyad (n = 4) were conducted with healthcare professionals, people with stroke and significant others, altogether 71 participants. Data was collected and analyzed using Grounded Theory. Results: One core category "Perceptive dialogue for a coordinated transition", and two categories "Synthesis of parallel processes for common understanding" and "The forced transformation from passive attendant to uninformed agent" emerged from the analysis. The transition consisted of several parallel processes which made it difficult for the stakeholders to get a common understanding of the transition as a whole. Enabling a perceptive dialogue was as a prerequisite for the creation of a common understanding of the care transition. Conclusion: This study elucidates that a perceptive dialogue with patients/significant others as well as within and across organizations is part of a coordinated and person-centred transition. There is an extensive need for increased involvement of patients and significant others regarding dialogue about health conditions, procedures at the hospital and preparation for self-management after discharge.
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| 20. |
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| 21. |
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| 22. |
- Robert, Glenn, et al.
(författare)
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Applying Elinor Ostrom’s Design Principles to Guide Co-Design in Health(care) Improvement : A Case Study with Citizens Returning to the Community from Jail in Los Angeles County
- 2021
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 21:1, s. 1-15
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Increased interest in collaborative and inclusive approaches to healthcare improvement makes revisiting Elinor Ostrom’s ‘design principles’ for enabling collective management of common pool resources (CPR) in polycentric systems a timely endeavour.Theory and method: Ostrom proposed a generalisable set of eight core design principles for the efficacy of groups. To consider the utility of Ostrom’s principles for the planning, delivery, and evaluation of future health(care) improvement we retrospectively apply them to a recent co-design project.Results: Three distinct aspects of co-design were identified through consideration of the principles. These related to: (1) understanding and mapping the system (2) upholding democratic values and (3) regulating participation. Within these aspects four of Ostrom’s eight principles were inherently observed. Consideration of the remaining four principles could have enhanced the systemic impact of the co-design process.Discussion: Reconceptualising co-design through the lens of CPR offers new insights into the successful system-wide application of such approaches for the purpose of health(care) improvement.Conclusion: The eight design principles – and the relationships between them – form a heuristic that can support the planning, delivery, and evaluation of future healthcare improvement projects adopting co-design. They may help to address questions of how to scale up and embed such approaches as self-sustaining in wider systems.
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| 23. |
- Sarkadi, Anna, Professor, 1974-, et al.
(författare)
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An Integrated Care Strategy for Pre-schoolers with Suspected Developmental Disorders : The Optimus Co-design Project that has Made it to Regular Care
- 2021
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 21:2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Multiple neurodevelopmental problems affect 7-8% of children and require evaluation by more than one profession, posing a challenge to care systems.Description: The local problem comprised distressed parents, diagnostic processes averaging 36 months and 28 visits with 42% of children >4 years at referral to adequate services, and no routines for patient involvement. The co-design project was developed through a series of workshops using standard quality improvement methodology, where representatives of all services, as well as parents participated. The resulting integrated care model comprises a team of professionals who evaluate the child during an average of 5.4 appointments (N = 95), taking 4.8 weeks. Parents were satisfied with the holistic service model and 70% of children were under 4 at referral (p < 0.05). While 75% of children were referred, 25% required further follow-up by the team.Discussion: The Optimus model has elements of vertical, clinical and service integration. Reasons for success included leadership support, buy-in from the different organisations, careful process management, a team co-ordinator, and insistent user involvement.Conclusion: Evaluating multiple neurodevelopmental problems in children requires an integrated care approach. The Optimus care model is a relevant showcase for how people-initiated integrated care reforms can make it into usual care.
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| 24. |
- Spangler, Douglas, et al.
(författare)
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The Impact of the Swedish Care Coordination Act on Hospital Readmission and Length-of-Stay among Multi-Morbid Elderly Patients : A Controlled Interrupted Time Series Analysis
- 2023
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 23:2
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Tidskriftsartikel (refereegranskat)abstract
- Coordinating follow-up care after discharge from hospital is critical to ensuring good outcomes for patients, but is difficult when multiple care providers are involved. In 2018, Sweden adopted the Care Coordination Act, which modified economic incentives to reduce discharge delays and mandated a discharge planning process for patients requiring post-discharge social-or primary care services. This study evaluates the impact of this reform on hospital length-of-stay and unplanned readmissions among multi-morbid elderly patients. Interrupted time series analysis of all in-patient care episodes involving multi-morbid elderly patients in Sweden from 2015 - 2019 (n = 2 386 039) was performed. Secondary analyses using case-mix adjustment and controlled interrupted time series analysis were employed to assess for bias. Average length of stay decreased during the post-reform period, corresponding to 248 521 saved care days. Unplanned readmissions meanwhile increased, corresponding to 7 572 excess unplanned readmissions. While reductions in length-of-stay were concentrated among patients targeted by the reform, increases in readmission rates were similar in patients not targeted by the reform, indicating potential confounding. The reform thus appears to have achieved its goal of decreasing in-patient length of stay, but a robust effect on readmissions, outpatient visits, or mortality was not found. This may be due to lackluster implementation or an ineffective mandated intervention.
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| 25. |
- Strandberg, Susanna, et al.
(författare)
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Patients' and healthcare professionals' experiences regarding patient safety when using telemonitoring of chronic diseases at home
- 2022
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 22:S3, s. 359-359
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Chronic diseases and multi-morbidity are increasing worldwide and the complexity of disease management is putting new demands on safe and secure healthcare. eHealth technology such as telemonitoring (TM) for people with chronic diseases living at home can provide opportunities to improve self-care management through the support of healthcare professionals (HCPs). However, when using TM, patients and HCPs need to feel safe in handling the technology. Since the implementation of TM increases rapidly into healthcare settings, we need to better understand whether and how TM usage affects the experience of safety among patients and HCPs.Aim and Method: To provide a deeper understanding of patients' and HCPs' experiences regarding patient safety when using telemonitoring of chronic diseases at home. The study had a descriptive design with a qualitative approach. Between March and May 2020, semi-structured interviews were conducted with 20 patients and 9 HCPs (nurses and physicians) working in a region in southern Sweden. Inductive content analysis guided by Graneheim and Lundman was used to analyse the interview text in Nvivo.Highlights: Our findings show that TM increased the feeling of shared responsibility and engaged both patients and HCPs. TM can increase the safety awareness of both patients and HCPs and enable them to create care together when monitoring the patients' disease from home. The regular measurements and close contact with HCPs increased the sense of availability to healthcare and enhanced for patients to understand their own health values, provided with insights into their own health and increased engagement in self-care. However, if the telehealth devices were used incorrectly, patient safety risks could emerge. Low health and/or digital literacy may jeopardize the benefits of TM. If the patients do not understand their own health values, they may not understand when to act if their values are deteriorating.Conclusions: This study suggests that TM has potential to enhance patient safety at home through patient's activation in own health and interaction with engaged HCP. It is important to focus on the patients' individual needs, preconditions, and health status to avoid risks and to use the full potential of the service.Implications for applicability/transferability, sustainability, and limitations: The key strength is that both HCPs and patients were involved, enabling several divergent perspectives to be included. One limitation is that the HCPs chose which patients to include, which might have biased the recruitment and limited transferability to groups with lower digital literacy than the included patients.
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| 28. |
- Trane, Kristin, et al.
(författare)
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Integration of Care in Complex and Fragmented Service Systems : Experiences of Staff in Flexible Assertive Community Treatment Teams
- 2022
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 22
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Tidskriftsartikel (refereegranskat)abstract
- To provide more integrated care, several countries have implemented the Flexible Assertive Community Treatment (FACT) model. However, this model does not guarantee full integration, especially in complex and fragmented service systems like in Norway. Hence, we investigated which barriers that might reduce the potential for integrated care in the Norwegian system, as described by staff in FACT teams, and how they adjust their way of working to increase the opportunities for integration. Methods: Online focus group interviews involving 35 staff members of five Norwegian FACT teams were conducted using a semi-structured interview guide. The material was analysed using thematic text analysis. Results: Six themes described the barriers to integrated care in the service system: fragmentation, different legislation and digital systems, challenges in collaboration, bureaucracy and limited opening hours. Three themes described adjustments in the teams’ way of working to enhance integration: working as the responsible co-ordinator, being a collaborator, and the only entry channel into the service system. Conclusion: The FACT team staff described several barriers to integration within the system. However, they made some adjustments in their way of working that might provide opportunities for integrated care within complex and fragmented service systems.
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| 29. |
- Williamsson, Ia, et al.
(författare)
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Experiences in a successful implementation of an IS-development model for co-design in a quadruple helix project
- 2021
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 20:3
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Tidskriftsartikel (refereegranskat)abstract
- Experiences in a successful implementation of an IS-development model for co-design in a quadruple helix project.1. IntroductionInformation systems (IS) research of the last twenty years has shown a phenomenon of unused research results, for instance IS-development models that do not reach practice. In some cases it may be relied upon that it takes considerable long time to transfer the new innovation from academy to practice. The reason for that could be that there is a lack of relevance for practice. In a quadruple helix project where academy and practice are cooperating to develop IS relevant for practice, a new model for IS-development has been formed. It is a co-design model to bridge the gap between all stakeholders. It motivates end-user involvement at an early stage to catch needs of the IS. The co-design model must therefore be transferred to all the stakeholders of the quadruple helix project and the purpose in this research is to obtain deeper understanding of the model transfer process.2. MethodsQualitative interview study of stakeholders in the quadruple helix project, thus practitioners (healthcare workers, system developers, end-users) and academics (researchers).3. ResultsThe co-design model is transferred to practice when used by practice. For that it must be understood by all stakeholders. There are many ways to understand the model and to communicate the learnings from using it. Issues remain to get the model transferred completely. Researchers are also exposed to difficulties by having to balance the theoretical model against the practical process of co-design.4. DiscussionsThe transfer of the co-design model has been successful as the model have been used in a setting intended for it. Technology/knowledge transfer theories are considered, but still issues in order to succeed transferring the model remains. The knowledge bearers must be included early and all the way through the model transfer, and the diversity of the stakeholders and their professions must be carefully considered. For instance, end-users and technicians in several cases have disparate affiliations in social systems, and thus not a common ground for communicating the transfer issues. Another issue is that the transfer is slowed down if representing stakeholder is not the decision maker.5. ConclusionsThe stakeholders are early adopters of the co-design model and they are all affected by explained and perceived attributes, decisions, time, communication channels and the nature of their social systems. It is motivated to consider the complexity surrounding the co-design model.
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| 30. |
- Wolmesjo, Maria, et al.
(författare)
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Co-production for shared value-based care to increase the quality of life of older persons in Swedish eldercare
- 2022
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 22
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- According to national values in the Swedish social service act, the older person, who receive social service and care, should, as far as possible, be part of the decisions made on the caregiving. The older person should be given preconditions to live a life in dignity and maintain their independency and autonomy. The care provided should be of good quality and the older person and her/his relatives should be met with a good approach.Former studies on eldercare have shown shortcomings in the way the work was organized and lack of routines for staff members. Research on first line managers in eldercare showed, person centred care is depending on a good working environment and a low level of stress. User participation is valued as important but organisational issues, lack of formal education and a need of administrative support is needed to work with a value-based leadership. There is a need to find new solutions on how managers can work through a value-based leadership to increase the quality of life of older persons.Aim of this study therefore was to inspire, follow and evaluate the implementation of a person-centered approach in two municipal eldercare organizations in the south part of Sweden. Focus was on values and organizational changes towards an increased quality of life of older persons in need of social care. Further on focus was to develop an attractive work and healthy work environment and a sustainable leadership.Study design was based on participatory research, where managers, staff members and older persons from different eldercare organizations took part in developing the research questions and participated in questionnaire-studies, individual and focus groups interviews and Future workshops, which were followed up in reflection groups. Booth qualitative and quantitative methods thereby were used. A reference group with representatives from the different organisations and external representatives from eldercare and researchers was created and took an active part in the project process from the early beginning. Due to the restrictions during Covid-19-pandemic, follow up meetings were done digitally.Results point out important factor which hindered versus made the implementation of person-centred care possible, can be related to the organisational structure and the organisational culture. Important was, a clear value needed to be expressed at all organisational levels. This was shown by support from politicians and high managers to first line managers, which made their work with the implementation easier. Further on, reflection groups and an ongoing dialogue on values and ethical dilemmas among staff-members was important. Together the staff-members expressed a common will to include the older people in different decision of the daily work and care-giving activities. Further on results point out the Future workshop supported a creative process where staff members were able to come up with “own” ides and solutions to increase a value-based and co-creative care with high quality, which was able to fulfil in the different organisations.
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