| 1. |
- Alvinius, Aida, et al.
(författare)
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Managing Boundaries in Integrated Care : A Qualitative Study of Collaboration between Municipalities and County Councils in Sweden
- 2016
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Ingår i: International Journal of Organization Theory and Behavior. - Highland Beach, Florida, USA : PrAcademics Press. - 1093-4537 .- 1532-4273. ; 19:2, s. 139-165
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Tidskriftsartikel (refereegranskat)abstract
- Swedish healthcare has undergone continuous development over several decades. Today, legal responsibility is shared on the local and regional levels, i.e. between municipalities and county councils. The purpose of the present study is to gain a deeper understanding of boundary spanning roles and strategies involved in municipal and county council collaboration. A grounded theory approach was used. Fifteen informants from several Swedish health care authorities were interviewed. A tension exists between preserving boundary strategies that stifle collaboration and boundary spanning strategies that facilitate it. The way boundary spanners manage their role is assumed to influence the centre of gravity for this tension and thus the combination of favourable boundary spanning strategies and favourable boundary spanning roles is one way of getting the current form of collaboration to work.
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| 8. |
- Larsson, Gerry, et al.
(författare)
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Analysis of the decision making process leading to appendectomy : A grounded theory study
- 2004
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Ingår i: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 45:5, s. 449-454
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to develop a theoretical understanding of the decision-making process leading to appendectomy. A qualitative interview study was performed in the grounded theory tradition using the constant comparative method to analyze data. The study setting was one county hospital and two local hospitals in Sweden, where 11 surgeons and 15 surgical nurses were interviewed. A model was developed which suggests that surgeons’ decision making regarding appendectomy is formed by the interplay between their medical assessment of the patient's condition and a set of contextual characteristics. The latter consist of three interacting factors: (1) organizational conditions, (2) the professional actors’ individual characteristics and interaction, and (3) the personal characteristics of the patient and his or her family or relatives. In case the outcome of medical assessment is ambiguous, the risk evaluation and final decision will be influenced by an interaction of the contextual characteristics. It was concluded that, compared to existing, rational models of decision making, the model presented identified potentially important contextual characteristics and an outline on when they come into play.
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| 9. |
- Larsson, Gerry, et al.
(författare)
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Changes over time in the importance patients ascribe to different aspects of care : On the need to improve person-centeredness
- 2012
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Ingår i: The International Journal of Person Centered Medicine. - United Kingdom : The University of Buckingham Press. - 2043-7730 .- 2043-7749. ; 2:3, s. 482-490
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Tidskriftsartikel (refereegranskat)abstract
- Rational and aim: Knowledge of which aspects of care are more important to patients is crucial for health providers. The aim of the work presented here was to explore changes over time in patients’ preferences in hospital and in out-patient settings.Method: Cross-sectional data were collected among patients at a number of Swedish hospital wards and out-patient clinics in 2003, 2004, 2005 and 2008 (N = 46,525). Data for men and women were analysed separately. The main outcome measure consisted of replies to the questionnaire “Quality from the Patient’s Perspective” (QPP) (numerous references).Results: (1) Subjective importance (preference) ratings increased throughout the time period studied, (2) in-patients gave higher ratings than out-patients and (3) women gave higher ratings than men, particularly in out-patient settings.Conclusion: The increase over time in ratings of the importance ascribed to different aspects of care may reflect a general trend towards strengthened consciousness among citizens as consumers of care and is an important index for improving the person-centeredness of clinical services.
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| 10. |
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| 11. |
- Larsson, Gerry, et al.
(författare)
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Quality improvement measures based on patient data : Some psychometric issues
- 2003
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Ingår i: International Journal of Nursing Practice. - 1322-7114 .- 1440-172X. ; 9:5, s. 294-299
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Tidskriftsartikel (refereegranskat)abstract
- Existing methods for handling patients’ opinions as a basis for quality improvement measures tend to be too sophisticated for practical nursing and/or weak psychometrically. An Index of Measures was developed by combining patients’ perceptions of actual care conditions with the subjective importance they ascribed to these conditions. Data from Swedish somatic inpatients (n = 4002) indicated that this index gave added value compared to patients’ ratings of actual care conditions only. Interpretation of the Index of Measures focused on the proportion of patients who receive the value ‘deficiency.’ This value is obtained if a given patient has a subjective importance rating on a given item which is higher than the mean subjective importance score for the whole patient group on that item, as well as a perceived reality rating on the item in question which is lower than the mean perceived reality rating for the whole group on that item. Guidelines are suggested on when improvement actions are necessary and when they are not necessary.
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| 12. |
- Larsson, Gerry, et al.
(författare)
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Quality of care : Relationships between the perceptions of elderly home care users and their caregivers
- 1998
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Ingår i: International Journal of Social Welfare. - : Wiley. - 1369-6866 .- 1468-2397 .- 0907-2055. ; 7:3, s. 252-258
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to study the relationship between elderly home care users', and their caregivers', perceptions of the quality of care. The sample consisted of 151 matched elderly home care user-caregiver pairs in a Swedish municipality. The elderly home care users were interviewed and their caregivers filled in questionnaires using an established, theory-based instrument. Results showed that the elderly home care users evaluated most care components more favourably than their caregivers. On ratings of the various care components' subjective importance to the caretaker, the caregivers consistently scored higher than the elderly home care users. Within the subset of elderly home care users who received help at least twice a day, there were greater similarities between caregivers and caretakers. The results are related to comparable research and discussed in terms of caregivers' needs to legitimize their professional identity and actions.
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| 13. |
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| 14. |
- Larsson, Gerry, et al.
(författare)
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Quality of care and service as perceived by adults with developmental disabilities, their parents, and primary caregivers
- 2001
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Ingår i: Mental retardation (Washington, D.C. Print). - 0047-6765. ; 39:4, s. 249-258
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Tidskriftsartikel (refereegranskat)abstract
- How adults with developmental disabilities perceive quality of the care and service they receive was investigated and these perceptions compared with those of their parents and primary caregivers. The sample was 34 adults with developmental disabilities, one of their parents, and their primary caregiver, all from a small Swedish municipality. We adapted Quality From the Patient's Perspective by using simple words and fewer response choices. Results showed it was possible to assess how adults with developmental disabilities evaluated actual care and service conditions. Evaluations of the subjective importance ascribed to these conditions proved too difficult. A high degree of similarity was found in ratings of perceived reality of care and service conditions by the adults with developmental disabilities, their parents, and caregivers.
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| 15. |
- Larsson, Gerry, et al.
(författare)
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Refinement of the questionnaire 'quality of care from the patient's perspective' using structural equation modelling
- 1998
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712 .- 0000-0000. ; 12:2, s. 111-118
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Tidskriftsartikel (refereegranskat)abstract
- In 1994, the questionnaire 'Quality of Care from the Patient's Perspective' (QPP) was developed using a conventional factor analytical approach (Wilde et al. 1994). The items and conceptual framework of this questionnaire were derived from a theoretical model, which, in turn, was developed from qualitative patient interviews, using a grounded theory method of analysis (Wilde et al. 1993). The aims of this study were to develop further the dimensionality of the QPP using structural equation modelling combined with advances in factor analysis modelling, and to refine the instrument. This comparatively new methodology extracts more information out of questionnaire data and is considered to be superior to traditional scaling methods. The sample consisted of 611 somatic inpatients from four departments at a Swedish hospital. Data collected with the QPP were explored with the new tool tracing the dimensions postulated in the theoretical model underlying the QPP. A nested factor model was developed fulfilling statistical criteria for adjustment between model and data. The model consists of a general factor and 16 subordinate factors. Most of the original QPP scales were reproduced with the new statistical technique. However, some content changes were made which appear to bring the QPP scales closer to patients' meaning representations of the area. Some changes were also made to the response format, changes which appear to strengthen the psychometric properties of the instrument. The refined QPP will hopefully contribute to a more differentiated picture of quality of care when applied in the field. All scales, items, and response formats of the revised QPP are presented in an appendix.
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| 18. |
- Larsson, Gerry, et al.
(författare)
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Sörmlandskuppen : kartläggning av vårdkvalitet vid syncentralen vid Mälarsjukhuset i Eskilstuna 1998
- 1998
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- En kartläggning gjordes 1998 vid syncentralen, Mälarsjukhuset i Eskilstuna, av patienternas och personalens upplevelse av vårdens kvalitet. Personalens upplevelser av psykosocial arbetsmiljö och av egna stressrelaterade symptom kartlades också. Deltagare var 115 patienter (55 % svarsfrekvens) och 8 anställda (100 % svarsfrekvens). Flertalet patienter, liksom personalen, är tillfredsställda med huvuddelen av vården. Många, såväl patienter som personal, är mindre tillfredsställda med att patienterna inte kan delta i beslut om rehabilitering, att kontinuiteten i habilitering/rehabilitering brister, och att de inte får information om övriga tillgängliga habiliterings/rehabiliteringsresurser. Ett åtgärdsförslag presenteras.
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| 19. |
- Larsson, Gerry, et al.
(författare)
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Sörmlandskuppen : kartläggning av vårdkvalitet vid ortopedtekniska avdelningen Aktiv ortopedteknik Sörmland AB, vid Mälarsjukhuset i Eskilstuna 1998
- 1998
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- En kartläggning gjordes 1998 vid ortopedtekniska avdelningen Aktiv ortopedteknik Södermanland AB, vid Mälarsjukhuset i Eskilstuna, av patienternas och personalens upplevelse av vårdens kvalitet. Personalens upplevelser av psykosocial arbetsmiljö och av egna stressrelaterade symptom kartlades också. Deltagarna var 115 patienter (57 % svarsfrekvens) och 7 anställda (54 % svarsfrekvens). Flertalet patienter, liksom personalen, är tillfredsställda med huvuddelen av vården. Många av såväl patienter som personal är dock mindre tillfredsställda med väntetiden, med att telefonframkomligheten är för låg och med att inte personalen har efterfrågat hur hjälpmedlet fungerat. Ett åtgärdsförslag presenteras som handlar om uppläggningen av enskilda patienters habilitering/rehabilitering.
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| 20. |
- Larsson, Gerry, et al.
(författare)
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Sörmlandskuppen : kartläggning av vårdkvalitet vid hörcentralen och pedagogiska hörselvården vid Mälarsjukhuset i Eskilstuna 1998
- 1998
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- En kartläggning gjordes 1998 vid hörcentralen och pedagogiska hörselvården vid Mälarsjukhuset i Eskilstuna av patienternas och personalens upplevelse av vårdens kvalitet. Personalens upplevelser av den psykosociala arbetsmiljön och av egna stressrelaterade symptom kartlades också. Deltagarna var 152 patienter (64 % svarsfrekvens) och 19 anställda (100 % svarsfrekvens). Flertalet patienter, liksom personalen, är tillfredsställda med huvuddelen av vården. Många, såväl patienter som personal, är mindre tillfredsställda med telefonframkomligheten. Väntetiden för fortsatt hjälp efter det inledande hörseltestet är för lång. Ett åtgärdsförslag presenteras som handlar om uppläggningen av enskilda patienters habilitering/rehabilitering.
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| 21. |
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| 22. |
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| 23. |
- Larsson, Gerry, Professor, 1952-, et al.
(författare)
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Vårdkvalitet och patienttillfresställelse
- 2017. - 2
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Ingår i: Kvalitetsarbete för bättre och säkrare vård. - Stockholm : Studentlitteratur AB. - 9789144116181 ; , s. 79-106
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Bokkapitel (refereegranskat)
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| 24. |
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| 25. |
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| 26. |
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| 27. |
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| 28. |
- Larsson, Gerry, et al.
(författare)
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Är patienten nöjd?
- 1995
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Ingår i: Läkartidningen, 92, 1587-1590. ; 92, s. 1587-1590
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Tidskriftsartikel (refereegranskat)
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| 29. |
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| 30. |
- Raty, L.K.A., et al.
(författare)
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Psychosocial aspects of health in adolescence : The influence of gender, and general self-concept
- 2005
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Ingår i: Journal of Adolescent Health. - : Elsevier BV. - 1054-139X .- 1879-1972. ; 36:6
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to describe age and gender differences in psychosocial aspects of health in adolescents. A further aim was to explore if self-rated behavior problems varied with the adolescents' general self-concept and sense of coherence. Methods: Questionnaires on self-rated psychosocial aspects of health were answered by 282 (n = 282/390) randomly selected adolescents, aged 13-22 years (M 17.9/18.0). The instruments used were "I think I am (ITIA)," "Youth Self Report (YSR)," "Sense of coherence (SOC)," and "Family APGAR." Differences between males and females (cross-individual grouping) were analyzed using nonparametric tests. A cluster analysis was performed using a three-cluster solution to identify and describe profiles (person-centered grouping). Results: Compared with males, adolescent females scored less favorably on self-esteem (ITIA) (p =. 028), reported more behavior problems (YSR) (p =. 000), and showed a lower sense of coherence (SOC) (p =. 003). The differences were most evident in the age group 15-17 years. The three clusters significantly differed from each other regarding how high proportions of problems the adolescents of each profile reported. Conclusions: Compared with male adolescents, adolescent females experienced a poorer psychosocial health in somatic, depressive, and internalizing areas. The result indicated that psychological factors had a major impact on the proportions of problems that the adolescents reported. © 2005 Society for Adolescent Medicine. All rights reserved.
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| 31. |
- Räty, Lena, 1948-, et al.
(författare)
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Epilepsy patients' Conceptions of Epilepsy as a Phenomenon
- 2009
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Ingår i: Journal of Neuroscience Nursing. - Philadelphia, USA : Lippincott Williams & Wilkins. - 0888-0395 .- 1945-2810. ; 41:4, s. 201-210
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Tidskriftsartikel (refereegranskat)abstract
- This study addressed epilepsy patients' conceptions of epilepsy as a phenomenon and emotions related to those conceptions. Nineteen outpatients were interviewed, and data were analyzed according to the phenomenographical methodology. Patients described epilepsy in six qualitatively different ways: Epilepsy is (a) an illness related to physical disturbances, (b) a condition related to physical disturbances, (c) a mental disturbance related to lack of mental capacity, (d) a handicap related to psychological and/or social aspects, (e) an identity related to being an epileptic, and (f) a punishment. The emotions confidence, happiness, hope, and annoyance were related to epilepsy as an illness or a condition, whereas shame, fear, sorrow, and guilt were related to the other four categories. This study indicated that, to patients, the phenomenon of epilepsy is above all a psychosocial nature and in that dimension closely related to negative emotions.
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| 32. |
- Räty, Lena K.A, et al.
(författare)
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The relationship between illness severity, sociodemographic factors, general self-concept, and illness-specific attitude in Swedish adolescents with epilepsy
- 2004
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Ingår i: Seizure. - : Elsevier BV. - 1059-1311 .- 1532-2688. ; 13:6, s. 375-382
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to describe the relationship between the epilepsy condition (illness severity), sociodemographic factors, general self-concept, and illness-specific attitude in adolescents with uncomplicated epilepsy.Methods: Adolescents, aged 13–22, fulfilling criteria registered in four Swedish hospitals, answered questionnaires (n=149). The instruments “I think I am” and “Sense of coherence” measured the patients’ general self-concept. The “Child Attitude Toward Illness Scale” measured illness-specific attitude. A summary score (index) calculated from seizure frequency, seizure type, and antiepileptic drug (AED) with side effects measured “Illness Severity”.Results: Illness severity was significantly related to the participants’ general self-concept, as well as to their attitude toward their condition; i.e. higher illness severity scores were correlated with lower sense of coherence (SOC), poorer self-esteem, and a more negative attitude towards the epilepsy condition. Females had more severe illness according to the Illness Severity Index, with almost 80% found in the moderate and high severity groups as compared to 63% of males in the moderate/high severity groups.Conclusions: It was concluded that the severity of the epilepsy condition was related to the adolescents’ general self-concept and illness-specific attitude, but further research is needed to understand the causality of the relationship. The brief assessment of illness severity, constructed and used in this study should be addressed and developed further.
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| 33. |
- Räty, L., et al.
(författare)
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The relationship between illness severity, sociodemographic factors, general self-perception and illness-specific attitude in Swedish young people with epilepsy
- 2004
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Ingår i: Seizure. - : Elsevier BV. - 1059-1311 .- 1532-2688. ; 13:6, s. 375-382
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to describe the relationship between the epilepsy condition (illness severity), sociodemographic factors, general self-concept, and illness-specific attitude in adolescents with uncomplicated epilepsy. Methods: Adolescents, aged 13–22, fulfilling criteria registered in four Swedish hospitals, answered questionnaires (n=149). The instruments “I think I am” and “Sense of coherence” measured the patients’ general self-concept. The “Child Attitude Toward Illness Scale” measured illness-specific attitude. A summary score (index) calculated from seizure frequency, seizure type, and antiepileptic drug (AED) with side effects measured “Illness Severity”. Results: Illness severity was significantly related to the participants’ general self-concept, as well as to their attitude toward their condition; i.e. higher illness severity scores were correlated with lower sense of coherence (SOC), poorer self-esteem, and a more negative attitude towards the epilepsy condition. Females had more severe illness according to the Illness Severity Index, with almost 80% found in the moderate and high severity groups as compared to 63% of males in the moderate/high severity groups. Conclusions: It was concluded that the severity of the epilepsy condition was related to the adolescents’ general self-concept and illness-specific attitude, but further research is needed to understand the causality of the relationship. The brief assessment of illness severity, constructed and used in this study should be addressed and developed further.
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| 34. |
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| 35. |
- Wilde, B., et al.
(författare)
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Quality of care from a patient perspective : A grounded theory study
- 1992
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Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 7:2, s. 113-120
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to develop a theoretical understanding of quality of care from a patient perspective, using a grounded theory approach. Thirty-five interviews were conducted with a sample of 20 adult hospitalized patients (mean age: 60 years) in a clinic for infectious diseases. Data were analysed according to the constant comparative method. A model was formulated according to which quality of care can be understood in the light of two conditions, the resource structure of the care organization and the patient's preferences. The resource structure of the care organization consists of person-related and physical- and administrative environmental qualities. The patient's preferences have a rational and a human aspect. Within this framework, patients' perceptions of quality of care may be considered from four dimensions: the medical-technical competence of the caregivers; the physical-technical conditions of the care organization; the degree of identity-orientation in the attitudes and actions of the caregivers and the socio-cultural atmosphere of the care organization. The model is discussed in relation to existing theories in the field.
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| 36. |
- Wilde, B., et al.
(författare)
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Quality of care from the elderly person's perspective : Subjective importance and perceived reality
- 1995
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Ingår i: Aging. - 1945-4589. ; 7:2, s. 140-149
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to carry out a theoretically-based survey of elderly persons' perceptions of quality of care, in terms of their evaluations of actual care conditions, as well as the subjective importance they ascribe to these. The sample consisted of 428 elderly (> or = 60 years) persons, in four different care environments: a geriatric department (N = 51); persons receiving home nursing (N = 111); nursing homes (N = 111); and service homes (N = 154) in two Swedish cities. Data were collected by way of personal interviews, structured from the questionnaire, Quality from the Patients' Perspective (QPP). The QPP is theory-based and consists of 40 items covering 17 factors. Each item was evaluated in two ways by the respondent: assessment of perceived reality, and evaluation of subjective importance (Likert scales). The results show that personal characteristics, such as age, sex, and self-rated health, had a limited effect on reports of what were regarded as highly important care characteristics, as well as on ratings of actual care conditions. Psychological well-being was strongly related to perceived reality ratings: a favorable well-being covaried with favorable ratings and vice versa. Considerable differences were noted in both types of ratings when the four types of care environments were compared. On the subjective importance scales, persons living in service homes reported lower scores, particularly on the scales designed to measure the medical-technical competence of the caregivers. On the perceived reality scales, the participants in service homes and the geriatric department scored lower.
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| 37. |
- Wilde, B., et al.
(författare)
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Quality of care from the patient's perspective : Development of a patient centered questionnaire based on a grounded theory model
- 1994
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Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 8:1, s. 39-48
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Tidskriftsartikel (refereegranskat)abstract
- In a previous study (Wilde et al. 1993), we developed a model of quality of care from a patient perspective using a grounded theory approach. The aim of the present study was to derive an instrument from this model. A questionnaire, Quality from Patients' Perspective (QPP), was developed which consisted of 56 items. Each item was evaluated in two ways by the respondent; assessment of perceived reality and evaluation of subjective importance (Likert scales). A personal quality of care index was computed on the basis of the relationship between these two scores. The QPP was tested on two samples, patients with infectious diseases (n = 147, mean age: 60 years) and nursing students (n = 103, mean age: 27 years). Patient's scores were factor analysed (principal factoring with oblique rotation) and 17 factors were extracted. Subgroups of patients were compared and correlations were computed between factor scores and self-rated health and well-being. Students also responded to a short form of the QPP (41 items) and personality scales. Correlations between these sets of variables were computed. The QPP was discussed in relation to existing scales.
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| 38. |
- Wilde-Larsson, B., et al.
(författare)
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Advanced home care : Can patients' opinions on the quality of care be replaced by those of family members
- 2004
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 13:2, s. 226-233
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Tidskriftsartikel (refereegranskat)abstract
- Background. Advanced medical care in the patient's home setting is becoming more common. Many of the patients who receive this kind of care have severe illnesses and are unable to respond to questions about the quality of care. The research question was: are the patients’ opinions congruent with those of family members?Aim. To explore and compare the relationship between patients’ perception of the quality of care and close family members’ perception of this care as well as their perception of the patients’ perception.Methods. Sixty-seven patients receiving advanced home care, 82 family members (54 matched patient + family member pairs) participated. Data were collected using a short version of the quality from the patient's perspective questionnaire modified to advanced home care.Results. A high degree of perceptual congruence was found between patients and their family members. The similarity was also high between family members’ own opinion and their appraisal of how the patient perceived the care. A subgroup of family members who met the patient once a week or less often deviated from this pattern.Conclusion. Patients’ views on the quality of care are congruent with the opinions of family members if they meet every day (live together) and share the same everyday and care-related experiences. The results can be understood in the light of empathic accuracy theory.Relevance to clinical practice. The findings of this study have important implications for clinical nursing practice. Family members’ perception of the quality of care may be a valuable data source for nurses in the case of advanced home care if the patient and family member share the same everyday, care-related experiences, otherwise family members’ perception tend to be more critical than those of the patients themselves.
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| 39. |
- Wilde-Larsson, Bodil, et al.
(författare)
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Begreppet vårdkvalitet
- 1994
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Ingår i: I G. Udén (Red.), Kvalitets-säkring inom omvårdnad: Olika perspektiv (sid 37-46). - Lund : Studentlitteratur. ; , s. 37-46
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Bokkapitel (refereegranskat)
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| 40. |
- Wilde-Larsson, Bodil, 1951-, et al.
(författare)
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Birthgiving women's feelings and perceptions of quality of intrapartal care : a nationwide Swedish cross-sectional study
- 2011
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 20:7-8, s. 1168-1177
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Tidskriftsartikel (refereegranskat)abstract
- Aim. The aim was to explore the relationships between the feelings of women who give birth and several birth-related care conditions, the womens' socio-demographic background, personality and perceptions of the quality of intrapartum care. Background. Childbirth is a highly significant emotional event for women and it is an explicit goal that each woman should have a positive childbirth experience. Design. The nationwide study is cross-sectional and was conducted at Swedish maternity units over two months in 2007. Methods. The study group consisted of 739 women (63% response rate). A dimensionality analysis of six emotion items was performed using structural equation modelling (SEM). Non-parametric tests and generalised linear mixed effects model analyses were used to study relationships and to make subgroup comparisons. Results. In the SEM analysis, a positive and a negative feeling factor were identified. Strong associations between the feeling factors and the womens' perceptions of the quality of care were found, particularly in regard to the so-called identity-oriented approach of the midwives and other health professionals. In addition, a higher intensity of negative feelings was associated with a personality pattern characterised by extraversion, emotional instability and lower degree of conscientiousness, a lower level of education and having had delivery through Caesarean section. Conclusions. The positive and negative feelings of women who give birth strongly covary with the women's perception of the quality of their intrapartum care. This pertains in particular to information issues, the midwives showing commitment, empathy and respect, being present during labour and allowing the women to actively participate as much as they want to. Relevance to clinical practice. Subgroup differences indicate that midwives should pay increased attention to childbearing women who have primary school education only, a lower emotional stability and/or deliver through Caesarean section.
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| 41. |
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| 42. |
- Wilde-Larsson, B., et al.
(författare)
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Development of a short form of the Quality from the Patient's Perspective (QPP) questionnaire
- 2002
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 11:5, s. 681-687
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Tidskriftsartikel (refereegranskat)abstract
- • Patients' views on the quality of care are important and it is desirable that these can be assessed using short, yet valid and reliable instruments.• The aim of the work reported here was to develop and test a short version of an established questionnaire: Quality from the Patient's Perspective (QPP).• Patients (n=162, 79% response rate) receiving care at medical and surgical departments in two Swedish hospitals responded to the original QPP as well as to a newly developed short version. An ethical research committee approved the study.• Pearson correlations were computed between the long and short forms and differences between means were analysed with t-tests. Reliability was estimated by computing Cronbach alpha coefficients.• Correlations of acceptable size were found between the short form and the original QPP. The short form also had acceptable reliability coefficients.• The strengths of the work are that the items in the short version are derived from a patient perspective and are formulated in words used by patients; the items still have a theoretical foundation, which makes the interpretation of results more meaningful; global formulations such as `What do you think about your care?' have been avoided; the short format should make the questionnaire more attractive for many patients to respond to.• Limitations are that results indicate that the short form does not fully measure what the long form does. Therefore, when the short form is used in practice, a two-step procedure is suggested, where a follow-up is done with a selection of items from the original long form. This selection could be restricted to areas where problems may be suspected, based on the results from the short form.
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| 43. |
- Wilde-Larsson, Bodil, et al.
(författare)
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Implementation of patient-focused care : Before-after effects on work climate and quality of care in the eyes of patients and providers
- 2014
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Ingår i: International Journal of Health Care Quality Assurance. - 0952-6862 .- 1758-6542. ; 27, s. 594-604
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Tidskriftsartikel (refereegranskat)abstract
- Purpose– The purpose of this paper is to evaluate an organizationally oriented, patient-focused care (PFC) model's effects on care quality and work climate.Design/methodology/approach– The study has a before-after (PFC implementation) design. The sample included 1,474 patients and 458 healthcare providers in six participating wards before and after PFC implementation, plus five additional randomly chosen wards, which only featured in the post-assessment.Findings– No pre-post differences were found regarding care perceptions or provider work climate evaluations. Statistically significant improvements were noted among provider care evaluations. Using aggregate-level ward data, multiple regression analyses showed that high adherence to PFC principles and a positive work climate contributed significantly to variance among care quality ratings.Research limitations/implications– Among healthcare providers, questions related to specific PFC aspects during evenings, nights and weekends had to be dropped owing to a low response rate.Practical implications– An important requirement for both practice and research is to tailor PFC to various health and social care contexts.Originality/value– The study is large-scale before-after PFC model review, where patient and provider data were collected using well-established measurements.
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| 44. |
- Wilde-Larsson, Bodil, 1951-, et al.
(författare)
-
Implementation of patient-focused care : before-after effects
- 2014
-
Ingår i: International Journal of Health Care Quality Assurance. - : Emerald Group Publishing Limited. - 0952-6862 .- 1758-6542. ; 27:7, s. 594-604
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeThe purpose of this paper is to evaluate an organizationally oriented, patient-focused care (PFC) model's effects on care quality and work climate. Design/methodology/approach The study has a before-after (PFC implementation) design. The sample included 1,474 patients and 458 healthcare providers in six participating wards before and after PFC implementation, plus five additional randomly chosen wards, which only featured in the post-assessment.FindingsNo pre-post differences were found regarding care perceptions or provider work climate evaluations. Statistically significant improvements were noted among provider care evaluations. Using aggregate-level ward data, multiple regression analyses showed that high adherence to PFC principles and a positive work climate contributed significantly to variance among care quality ratings. Research limitations/implications Among healthcare providers, questions related to specific PFC aspects during evenings, nights and weekends had to be dropped owing to a low response rate. Practical implications An important requirement for both practice and research is to tailor PFC to various health and social care contexts. Originality/valueThe study is large-scale before-after PFC model review, where patient and provider data were collected using well-established measurements.
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| 45. |
- Wilde-Larsson, Bodil, 1951-, et al.
(författare)
-
International comparisons of patients' views on quality of care
- 2005
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Ingår i: International Journal of Health Care Quality Assurance. - : Emerald Group Publishing Limited. - 0952-6862 .- 1758-6542. ; 18:1, s. 62-73
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – To compare patients’ views on quality of care in different countries using a theory-based instrument, while at the same time controlling for the following potential confounders: type of care system (private vs public), type of care (kind of health problem), gender, age, and subjective wellbeing.Design/methodology/approach – Patients capable of communicating in wards (medical and surgical departments) and day surgery departments in England, France, Norway, and Sweden were recruited consecutively, to participate in a programme run by the health-care company Capio. Ward patients: England (n =1,236), France (n =1,051), Norway (n =226), and Sweden (n =428). Day surgery patients: England (n =887), France (n =544), Norway (n =101), and Sweden (n =742). Average response rate across settings: approximately 75 per cent. Patients evaluated the quality of the care they actually received and the subjective importance they ascribed to different aspects of care. The questionnaire “Quality from the patient's perspective” (QPP) was used (modified short version).Findings – Cross-national comparisons were made within each of the two care contexts (wards and day surgery) separately for men and women. Quality of care evaluations were adjusted for age and subjective wellbeing. English and French patients scored significantly higher than Norwegian and Swedish on both kinds of ratings (perceived reality and subjective importance), in both kinds of care contexts, and in both sexes.Originality/value – Cross-national comparisons of patients’ views on care can give meaningful guidance for practitioners only if they are context-specific and if well-known confounders are controlled for.
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| 46. |
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| 47. |
- Wilde Larsson, Bodil, et al.
(författare)
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Kvalitetsmätning med KUPP-instrument
- 2000
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Ingår i: Vårdfacket. - 0347-0911. ; 24:2, s. 46-48
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 48. |
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| 49. |
- Wilde Larsson, B., et al.
(författare)
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Patients' perceptions of quality of care, self-rated functional ability, and health one year after total knee arthroplasty : a follow-up of forty-one patients
- 1999
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Ingår i: Journal of Orthopaedic Nursing. - 1361-3111 .- 1873-4839. ; 3:1, s. 11-17
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore the relationships between two care conditions of patients reveiving total knee arthroplastic surgery: firstly, patients' perceptions of the quality of care and their length of stay in hospital; secondly different indicators of health outcomes — self-rated functional ability and health. The sample consisted of 41 patients (median age 71 years) undergoing total knee arthroplastic surgery during 1995 at the Central Hospital of Karlstad, Sweden. Data were collected from the medical records and by means of telephone interviews and a postal questionnaire. Results show that functional ability (walking ability and need of walking aids) covaried with favourable patient perceptions of the quality of care. Favourable functional ability was also associated with a low need of walking aids before surgery. Self-rated health I year after surgery was not related to any of the measured care conditions or the need of walking aids before surgery.
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| 50. |
- Wilde Larsson, B., et al.
(författare)
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Patients' views on quality of care : Do they merely reflect their sense of coherence
- 1999
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 30:1, s. 33-39
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to explore the relationship between patients’ perceptions of the quality of care and their sense of coherence. The sample consisted of 782 Swedish in-patients at a gynaecological, a medical, an orthopaedic, and a surgical department. The median age was 59 years and 55% of the patients were women. Data were collected using the Quality from the Patient’s Perspective (QPP) Questionnaire and the Sense of Coherence Questionnaire. The QPP consists of 61 items designed to measure the following four quality dimensions: the medical-technical competence and the degree of identity-orientation in the actions of the caregivers, the physical-technical conditions and the socio-cultural atmosphere of the care organization. Each question is posed in two different ways in the QPP; one measures perceived reality of the item in question and one the subjective importance the patient ascribes to it. Results showed that patients’ ratings of perceived reality covaried systematically with their sense of coherence. This was particularly the case on questions rated by experts to be more abstract and emotionally loaded. Patients’ ratings of the subjective importance of the items were weakly related to their sense of coherence. The results are discussed in terms of negative affectivity and culturally shared ideals regarding quality of care.
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