| 1. |
- Hedegaard, Joel, et al.
(författare)
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Communicative Construction of Native versus Non-Native Swedish Speaking Patients in Consultation Settings
- 2014
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Ingår i: Scandinavian Journal of Public Administration. - 2001-7405. ; 17:4, s. 21-47
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, we examine patient-centered care through analyzing communicative constructions of patients, on the basis of their native language, in consultations with physicians. Whereas patient-centered care is of current interest in health care, research has not addressed its implications in this dimension. Previous studies indicate that non-native Swedish speaking patients, experience substandard interpersonal treatment far more than native Swedish speaking patients. Our findings show that the non-native Swedish speaking patients presented themselves as participating, whereas the native Swedish speaking patients presented themselves as amenable. The physicians responded in two different ways, argumentatively towards the non-native Swedish speaking patients and acknowledging vis-à-vis the native Swedish speaking patients. When decisions and conclusions were made by the patients and physicians, this resulted in preservation of the status quo in the consultations with the non-native Swedish speaking patients, while the corresponding result with the native Swedish speaking patients was monitoring of their health status. So, whereas the non-native Swedish speaking patients actually were model patient-centered care patients, physicians were more amenable towards the native Swedish speaking patients. We suggest that patient-centered care is desirable, but its practical application must be more thoroughly scrutinized from both a patient and a health care worker perspective.
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| 2. |
- Siouta, Eleni, et al.
(författare)
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Interactional resistance between patients with atrial fibrillation and cardiologists in consultation on treatment with warfarin: the value of shared decision-making
- 2012
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Ingår i: The International Journal of Person Centered Medicine. - 2043-7730 .- 2043-7749. ; 2:3, s. 427-436
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Rationale: Atrial fibrillation (AF) increases the risk of stroke and it can be reduced by treatment with warfarin. Some patients consider that warfarin is a stressful treatment with undesired effects and the perceived barriers include unwillingness to take it. Knowledge of patients resisting warfarin treatment may be useful for the potential threat to maintaining shared decision-making in the consultation as a central tenet of person-centered medicine. Aims and objectives: To identify how patients resist treatment with warfarin and how cardiologists respond to patients’ resistance. The co-constructive perspective of this work analyses the consultations by emphasizing the clinical communication strategies of both patients and cardiologists. Method: Eleven videotaped consultations, in 4 different hospitals, were selected for analysis. Treatment interactions regarding warfarin between patients with AF and cardiologists were analysed, according to the methodology of conversation analysis. Results: There were 4 types of resistance from patients for accepting treatment with warfarin. These included “Giving reasons for their resistance”, “Suggestion of another treatment option by the patient”, “Stating a treatment preference” and “Questioning or challenging the cardiologist’s treatment recommendation”. The cardiologists’ responses to the patients’ resistance included “Repeating the treatment recommendation”, “Negotiation with the patient”, “Providing additional information on the recommended treatment” and “Extending the explanation for the purpose of taking the treatment”. Conclusions: By showing resistance, patients are thought to want to participate in their treatment decisions and an awareness of patients’ resistance to treatment enables cardiologists to address the patients’ experience-based views on their treatment and individual concerns as part of clinical strategies to increase the person-centeredness of medical intervention.
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| 3. |
- Hedegaard, Joel, et al.
(författare)
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Gendered communicative construction of patients in consultation settings
- 2014
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Ingår i: Women & health. - : Informa UK Limited. - 0363-0242 .- 1541-0331. ; 54:6, s. 513-529
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to explore the communication in consultations between patients and health care staff from a gender perspective. We used 23 tape-recorded consultations between patients with Atrial Fibrillation and 5 nurses and 5 physicians at cardiac outpatient clinics at 6 different hospitals in southern Sweden during autumn 2009 to explore the verbal gendered constructions of patients. Through critical discourse analysis, we revealed that the male patients tended to describe their ailments with performance-oriented statements, whereas the female patients usually used emotional-oriented statements. The staff downplayed the male patients' questions and statements, while they acknowledged concern toward the female patients. Both the patients and the staff made conclusions according to a mutual construction. Male patients were constructed as competent, and female patients as fragile through gender-stereotypical communication. Open-ended statements and questions enabled consultations to be less limited by gender stereotypes.
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| 4. |
- Gransjön Craftman, Åsa, et al.
(författare)
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Experiences of home care assistants providing social care to older people : A context in transition
- 2018
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Ingår i: International Journal of Older People Nursing. - : Wiley. - 1748-3735 .- 1748-3743. ; 13:4
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim was to describe home care assistants' (HCA) experiences of providing social care in older people's own homes.BACKGROUND: With the increase in average life expectancy and related growth of the elder population, addressing geriatric care needs has become an increasingly vital issue. However, the frontline workforce faces major challenges in meeting these needs, including a lack of trained professionals entering the field.DESIGN: A qualitative inductive design was used.METHODS: A descriptive, qualitative study using focus group interviews and content analysis.FINDINGS: The findings revealed that HCAs are active in an area facing challenges due to an older home-dwelling generation. Transfer of tasks should be reviewed considering changes to the workforce's skill mix brought on by task shifting.CONCLUSIONS: Certain prerequisites are needed to enable unlicensed assistive personnel to perform a good job; they also need to receive affirmation that they are a crucial workforce carrying out multifaceted tasks. To improve and maintain the pull factors of social care work, it is crucial to clarify how older people's requirements influence the daily care relation.IMPLICATIONS FOR PRACTICE: The findings highlight HCAs' blurred responsibility when providing nursing and care to older people with multiple chronic conditions and functional disabilities. Increasing expectations are placed upon HCAs to cope with practical situations that are theoretically outside the bounds of social care. The findings contribute knowledge to further development of collaboration between social and health care providers as well as the important affirmation of this unlicensed personnel group in transition. A long-term plan is therefore needed to provide HCAs with the skills and tools they need to deliver care and support to older people with a variety of needs.
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| 5. |
- Blomgren Mannerheim, Ann, et al.
(författare)
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Parents’ experiences of caring responsibility for their adult child with schizophrenia
- 2016
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Ingår i: Schizophrenia Research and Treatment. - : Hindawi Limited. - 2090-2085 .- 2090-2093.
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Tidskriftsartikel (refereegranskat)abstract
- As a consequence of the latest psychiatry-related reform in Sweden and its implementation, relatives and family members have taken over from the formal healthcare system significant responsibility for the care of persons with a mental disability and illness. The aim of this study was to systematically describe and analyze the experiences of parents' informal care responsibility. The questions were, what are the experiences around parents' informal care activities and responsibilities and how do parents construct and manage their caring responsibility and with what consequences? Semistructured in-depth interviews were conducted (16 hours of recorded material) with eight parents who were all members of the Interest Association for Schizophrenia (Intresseforeningen for Schizofreni (IFS)) in Sweden. A mixed hermeneutic deductive and inductive method was used for the interpretation of the material. The parents endow their informal caring responsibility with meaning of being a good, responsible, and accountable parent with respect to their social context and social relationships as well as with respect to the psychiatric care representatives. In this tense situation, parents compromise between elements of struggle, cooperation, avoidance, and adaption in their interaction with the world outside, meaning the world beyond the care provision for their child, as well as with the world inside themselves.
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| 6. |
- Hellström Muhli, Ulla, et al.
(författare)
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Patient-Involvement in Consultation for Atrial-Fibrillation : The Cardiologists’ Perspective
- 2019
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Ingår i: International Journal of Health Care Quality Assurance. - : Emerald Group Publishing Limited. - 0952-6862 .- 1758-6542. ; 32:4, s. 765-776
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose was to analyse the accounts of Swedish cardiologists concerning patient involvement in consultations for atrial fibrillation (AF). The questions were: (i) how cardiologists handle and provide scope for patient involvement in medical consultations regarding AF treatment and (ii) how cardiologists describe their familiarity with shared decision-making.Design/Methodology/Approach: A descriptive study was designed. Ten (n=10) interviews with cardiologists at four Swedish hospitals were held and a qualitative content analysis was performed on the collected data.Findings: The analysis shows cardiologists´ accounts of (i) persuasive practice, (ii) protective practice, (iii) professional role, and (iv) medical craftsmanship when it comes to patient involvement and shared decision-making.Conclusions: - The term “shared decision-making” implies a concept of not only making one decision but also ensuring that it is finalised with a satisfactory agreement between both parties involved, the patient as well as the cardiologist. - In order for the idea of patient involvement to be fulfilled, the two parties involved must have equal power, which can never actually be guaranteed.Practical implications: Cardiologists should prioritise patient involvement and participation in decision-making regarding AF treatment decisions in consultations when trying to meet the request of patient involvement.Originality/value: Theoretically, we have learned that the patient involvement and shared decision-making requires the ability to see patients as active participants in the medical consultation process.
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| 7. |
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| 8. |
- Omerov, Pernilla, et al.
(författare)
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Homeless persons' experiences of health- and social care : A systematic integrative review
- 2020
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Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 28:1, s. 1-11
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Forskningsöversikt (refereegranskat)abstract
- Homelessness is associated with high risks of morbidity and premature death. Many interventions aimed to improve physical and mental health exist, but do not reach the population of persons experiencing homelessness. Despite the widely reported unmet healthcare needs, more information about the barriers and facilitators that affect access to care for persons experiencing homelessness is needed. A systematic integrative review was performed to explore experiences and needs of health- and social care for persons experiencing homelessness. The following databases were searched: AMED, ASSIA, Academic Search Complete, CINAHL, Cochrane library, Nursing and Allied Database, PsycInfo, PubMed, Scopus and Web of Science Core Collection. Twenty-two studies met the inclusion criteria of empirical studies with adult persons experiencing homelessness, English language, and published 2008-2018. Fifty percent of the studies were of qualitative and quantitative design, respectively. Most studies (73%) were conducted in the United States (n=11) and Canada (n=5). The analysis resulted in three themes Unmet basic human needs, Interpersonal dimensions of access to care, and Structural and organizational aspects to meet needs. The findings highlight that persons in homelessness often must prioritize provision for basic human needs, such as finding shelter and food, over getting health- and social care. Bureaucracy and rigid opening hours, as well as discrimination and stigma, hinder these persons' access to health- and social care.
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| 9. |
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| 10. |
- Östlund, Lena, et al.
(författare)
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A Swedish study about how staff reason and act when they suspect domestic abuse perpetrated by relatives of persons with dementia
- 2024
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Ingår i: European Journal of Social Work. - : Taylor & Francis. - 1369-1457 .- 1468-2664. ; 27:2, s. 387-400
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Tidskriftsartikel (refereegranskat)abstract
- Older persons with dementia have several risk factors for being exposed to domestic abuse, for example dependency on others to manage daily life. The purpose of the study was to explore how staff act and reason when suspecting domestic abuse perpetrated by informal caregivers of persons with dementia. Eight semi-structured group interviews were conducted with staff (n = 39) working with persons with dementia living in their ordinary homes. A thematic analysis generated two themes; Missing a map for guidance and Being left to one’s own inner compass for direction indicating that staff experienced a lack of guidelines and protocols to work from when suspecting abuse. This resulted in staff taking actions based on their own norms, values, and experiences when suspecting domestic abuse. Not knowing how to act risks leading to staff ending up doing nothing or being unable to identify effective interventions, accompanied by feelings of guilt and ethical stress. The results highlight the necessity of providing staff with tools for how to act when they suspect domestic abuse, such as collaboration with others, colleagues, and other organisations where different options for interventions can emerge.
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