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Search: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Hälsovetenskaper) hsv:(Hälso och sjukvårdsorganisation hälsopolitik och hälsoekonomi) > (2010-2019) > (2013)

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1.
  • Andersson, Anders-Petter, 1969-, et al. (author)
  • Designing empowering vocal and tangible interaction :
  • 2013
  • In: The International conference on new interfaces for musical expression. - Kaejeon, Korea : Seoul National University. ; , s. 406-412
  • Conference paper (peer-reviewed)abstract
    • Our voice and body are important parts of our self-experience, and our communication and relational possibilities. They gradually become more important for Interaction Design due to increased development of tangible interaction and mobile communication. In this paper we present and discuss our work with voice and tangible interaction in our ongoing research project RHYME. The goal is to improve health for families, adults and children with disabilities through use of collaborative, musical, tangible media. We build on the use of voice in Music Therapy and on a humanistic health approach. Our challenge is to design vocal and tangible interactive media that through use reduce isolation and passivity and increase empowerment for the users. We use sound recognition, generative sound synthesis, vibrations and cross-media techniques to create rhythms, melodies and harmonic chords to stimulate voice-body connections, positive emotions and structures for actions.
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2.
  • Andersson, Anders-Petter, 1969-, et al. (author)
  • Vocal and tangible technology for music and health
  • 2013
  • In: Book of abstracts. - Oslo : The Norwegian Academy of Music. ; , s. 24-24
  • Conference paper (peer-reviewed)abstract
    • Our voice and body are important parts of our self-expression and self-experience. They are also essential for our way to communicate and build relations cross borders like abilities, ages, locations, backgrounds and cultures. Voice and tangibility gradually become more important when developing new music technology for the Music Therapy and the Music and Health fields, due to new technology possibilities that have recently arisen. For example smartphones, computer games and networked, social media services like Skype. In this paper we present and discuss our work with voice and tangible interaction in our ongoing research project. The goal is to improve health for families, adults and children with severe disabilities through use of collaborative, musical, tangible sensorial media. We build on use of voice in Music Therapy and studies by Lisa Sokolov, Diane Austin, Kenneth Bruscia and Joanne Loewy. Further we build on knowledge from Multi-sensory stimulation and on a humanistic health approach. Our challenge is to design vocal and tangible, sensorially stimulating interactive media, that through use reduce isolation and passivity and increase empowerment for all the users. We use sound recognition, generative sound synthesis, vibrations and cross- media techniques, to create rhythms, melodies and harmonic chords to stimulate body- voice connections, positive emotions and structures for actions. The reflections in this paper build on action research methods, video observations and research-by-design methods. We reflect on observations of families and close others with children with severe disabilities, interacting in three vocal and tangible installations.
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3.
  • Andersson, Johanna, et al. (author)
  • Assessing outcome in collaboration : the impact of assessment on collaboration practice
  • 2013
  • In: Critical Management Studies Conference 2013.
  • Conference paper (other academic/artistic)abstract
    • Today the concept of efficiency is a guiding light in public management. Increased efficiency is thought to control spending and provide better services. Two approaches to achieve this are through assessments such as evaluation and audits; and collaboration between different actors. Collaboration can imply e.g. networks or partnerships and vary in intensity and formality. Regardless of form, collaborative efforts are generally thought to achieve services better adapted to address complex social problems, and diminishing overlaps and unclear responsibilities caused by fragmentation. Assessments are used to determine whether or not a program or a service is efficient, but the act of assessment itself is also intended to increase efficiency. Thus, the act of assessment influences the practice it is assessing. Furthermore, in order to be assessed, a program or a service has to be “evaluable”, which may also influence practice. Collaboration is often a solution to previous sector failure, and at the same time it is perceived as difficult to both achieve and sustain. Assessments are used as a tool to determine whether or not collaborative advantage is achieved and if the investments in collaboration should be pursued.Assessments of collaboration are a challenge since it confronts the regular vertical forms of organizing and thereby the focus of assessment. The challenge can be boiled down to the question of what collaborative arrangements can, and should, be held accountable for.Based on an ethnographic study and two years of field work, this question is critically analyzed with an example from Sweden. The financial coordination of rehabilitation measures act came into effect in 2004, and regulates the construction of coordination associations. The foundation of an association is a pooled budget to which all members, four different public authorities in the field of vocational rehabilitation, contribute. An important condition behind the law was the notion that public services were not adapted to, and therefore had trouble handling, some groups with complex problems needing support from two or more organizations at the same time. The overall, and ultimate, aim with financial coordination is to improve the working ability in the target population. Though the objective of the associations is, according to the law, to support collaboration, finance efforts within the collected area of responsibility and evaluate these efforts. The financed efforts may be both operative and strategic, and should in some way complement the operations of the member organizations or aim at development of new knowledge or methods. The associations have no power to make decisions of authority in relation to the target population, which remains with the professionals in the member organizations. Following this, it may be argued that the first target group of the associations is the regular organizations and next, as a secondary target group; the individuals in the target population. This means also that the target population is not the associations’ own but the regular organizations’ target groups. The aim with the associations is thus to contribute to the regular organizations working better in relation to this group. The associations have no tools at their disposal to contribute to the overall goal but the pooled budget. Their responsibility is to construct the budget, distribute the resources and follow up.However, as the findings presented and discussed in this paper show, the associations are generally held accountable to more than that in the frequent assessments being performed on both the associations and the efforts they finance. First, the associations are generally seen by others as being the efforts they finance. This makes the view of them almost like a new organization or authority, even though the efforts actually are organizationally owned and performed by regular organizations. Second, they are held accountable to the aim of improved working ability of the target group, i.e. the overall policy goal. Their objective to support collaboration and the notion that the law was introduced in order to ensure that, through collaboration, those individuals in the intersection of different organizations get the needed help is thus overlooked and focus is turned to effects on individuals.This paper argues that the assessments have highly influenced practice in the associations, and has shifted focus from organizational outcomes such as increased equity and quality of services due to decreased fragmentation, to individual outcomes such as employment and dependency of benefits. These latter outcomes are easier to account for and are also in line with conventional more hierarchical assessments. Since many associations perceive themselves to be questioned due to lacking efficiency, they may start seek legitimacy and thereby behave in line with the focus of assessments and start to “produce” improved working ability instead of supporting collaboration. Furthermore, the assessments and their focus on individuals tend to treat the associations not as a collaborative structure between four actors with a supportive aim, but as a regular organization with authoritative power. When the associations are held accountable for a group’s outcome, this group has been “passed on” from ordinary organizations on to the associations. Organizational outcome related to collaboration is greatly overlooked, in line with the “common wisdom” that collaboration is not an end in itself, and an end in public management collaboration must thus be measured as individual benefit. Increased quality and equity in services are thus outcomes that are not only not being assessed but might also be at risk of being lost with the current assessment focus. Last, there is an evident risk that the narrow and vertical assessment focus increases, instead of decreases, horizontal fragmentation within the welfare system due to its impact on coordination association practice.
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5.
  • Furenbäck, Ingela, 1963- (author)
  • Improving the quality of care through communication arena
  • 2013
  • In: International Journal of Integrated Care. - 1568-4156 .- 1568-4156. ; 13:WCIC Conf Suppl
  • Journal article (other academic/artistic)abstract
    • Purpose: Collaboration has become an increasingly more common strategy when developing care sectors while, coincidentally, experience and research show that collaboration development may be problematic in itself. This study aims to achieve better understanding of collaboration processes.Method: A local project that aimed at improving the quality of healthcare and social care by developing the co-operation between organizations took place in Sweden, and by using participatory action research, PAR, this process was followed between 2004 and 2008. Material was gathered through participant observation from the perspective of patients, relatives, staff, managers and politicians. A descriptive narrative was compiled and a hermeneutic interpretation was performed.Results: Initially, the development of collaboration was impeded due to lack of communication between the participants from various levels within the organizations. With the support of PAR, communication arenas were arranged to handle social interaction as well as different perspectives and conflicts, which led to improved collaboration within the organizations as well as between the care organizations.Conclusion: Development of collaboration between organizations reflects how collaboration within one organization works. Collaboration is a social and interpersonal phenomenon, and readily available communication arenas are crucial for its development.
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7.
  • Nordgren, Lars, et al. (author)
  • The value creation-concept in hospitals : Health values from the patients’ perspective
  • 2013
  • In: Nordisk sygeplejeforskning. - 1892-2678 .- 1892-2686. ; 3:2, s. 105-116
  • Journal article (peer-reviewed)abstract
    • Aim: Based on the concept of value creation the aim was to analyse a sample of patients’ unstructured responses, and to show what the patients perceived to be healthcare values.Method: Using content analysis the patients’ responses to three questions underwent a categorization involving the identification, coding, and emerging of themes.Results: This is good: fellow feeling, receptivity, proficiency, efforts matched to requirements, popular food, informed patients. The theme was professional care. This I would like to change: offer more conventional forms of accommodation, better quality food, better cleaning, more time to their patients, better information, and improved accessibility. The theme was patients want good service when in hospital. Other complaints were linked to care, resulting in; improve personal integrity, friendlier demeanour, more focusing on the individual. The theme was patients expect to be acknowledged and respected by nursing staff. However, the answers did not convey anything essentially new.Conclusion: The patients expressed different values. It is debatable to use service management concepts in healthcare in a simplistic way. Practice implications: Patients’ unstructured answers are of interest in improving the attitudes of the co-workers.
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8.
  • Sanneving, Linda, et al. (author)
  • Health system capacity : maternal health policy implementation in the state of Gujarat, India
  • 2013
  • In: Global Health Action. - 1654-9716 .- 1654-9880. ; 6, s. 19629-
  • Journal article (peer-reviewed)abstract
    • Introduction: The Government of Gujarat has for the past couple of decades continuously initiated several interventions to improve access to care for pregnant and delivering women within the state. Data from the last District Family Heath survey in Gujarat in 2007-2008 show that 56.4% of women had institutional deliveries and 71.5% had at least one antenatal check-up, indicating that challenges remain in increasing use of and access to maternal health care services.Objective: To explore the perceptions of high-level stakeholders on the process of implementing maternal health interventions in Gujarat. Method: Using the policy triangle framework developed by Walt and Gilson, the process of implementation was approached using in-depth interviews and qualitative content analysis.Result: Based on the analysis, three themes were developed: lack of continuity; the complexity of coordination; and lack of confidence and underutilization of the monitoring system. The findings suggest that decisions made and actions advocated and taken are more dependent on individual actors than on sustainable structures. The findings also indicate that the context in which interventions are implemented is challenged in terms of weak coordination and monitoring systems that are not used to evaluate and develop interventions on maternal health.Conclusions: The implementation of interventions on maternal health is dependent on the capacity of the health system to implement evidence-based policies. The capacity of the health system in Gujarat to facilitate implementation of maternal health interventions needs to be improved, both in terms of the role of actors and in terms of structures and processes.
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9.
  • Åhgren, Bengt, 1950- (author)
  • Competition-exposed integration : an impossible composition?
  • 2013
  • In: What healthcare can we afford?. ; , s. 106-
  • Conference paper (other academic/artistic)abstract
    • ContextSwedish health care, like many other health care systems, is in a constant development mode to meet never-ending demands for improved efficiency and quality. Competitive and integrative policies are for example concurrently introduced in Swedish primary care; citizens‘ choice of primary care is launched while primary care is expected to integrate its activities with other providers for the creation of =local health care‘. Competition has though a tendency fragment the provision of services. The aim of this study is therefore to explore whether or not these two strategies are compatible in practice.MethodsGroup interviews were conducted at four locations in Sweden. The groups included persons aged between 20 and 45 years, 46 and 64 years and 65 years or over. The interviewees were living either in a big town or in a small community. Altogether, 21 randomly selected individuals participated in the group interviews. A deductive approach was chosen: six question topics were formulated with guidance from a theoretical framework about choice of care. The group interviews were thus semistructured without any predetermined codes. Each group interview took between 1 and 1.5 h to complete. Moreover, the conversations were recorded and transcribed as verbatim reports. As a consequence of the deductive approach, directed content analysis was chosen for the analysis of the group conversations.ResultsChoice of care is executed from the perspectives of being a prospective or current patient, which, in practice, imply choices are performed passive and active respectively. If the later group perceive interpersonal continuity, accessibility and demeanour of health professionals as favourable, they remain faithful to their actively chosen provider. The only condition that seems to trigger this group of patients to reconsider their choices is if they been the subject of bad manners. Those executing passive choices are less faithful to their original choice. When these former prospective patients, often younger persons, are in need of primary care they often disregard their choice if waiting times are shorter at other providers. This group generally prefer accessible service and seldom consider where it is provided. The group of passive choices also include citizens accepting suggestions presented by the authorities, founded on the conviction that ―they know what is best for me.DiscussionMany patients that have made active choices are thus faithful to their choices. This is rare in a consumer-market, which is characterized by high degree of exchangeability of providers; a condition which by and large corresponds with the attitude of those making passive choices. Nevertheless, a majority of patients stay with their choice of provider, often selected among a limited number of options. Moreover, health care providers and patients have long-term relationships, which is typical of a producer-market. In other words, if politicians strive for a competition-exposed primary care, the competition concept ought not to be founded on the theories of a consumer-market. The principles of a producer-market seem instead to be more applicable, which imply that providers will be competitive if they are able to build stable relations with their patients, which, in turn, facilitate for integrative arrangements among health care providers.
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10.
  • Åhgren, Bengt, 1950-, et al. (author)
  • Integrated Care : Pathfindings from Sweden
  • 2013
  • In: Integrated care for Ireland in an international context. - Cork, Ireland : Oak Tree Press. - 9781781190807 - 1781190801 - 9781781191040 - 1781191042 ; , s. 90-102
  • Book chapter (other academic/artistic)
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