| 1. |
|
|
| 2. |
|
|
| 3. |
- Benkel, Inger, et al.
(author)
-
A Qualitative Study of the Experiences of Parents With an Adult Child Who Has a Severe Disease: Existential Questions Will Be Raised
- 2017
-
In: Inquiry-the Journal of Health Care Organization Provision and Financing. - : SAGE Publications. - 0046-9580 .- 1945-7243. ; 54
-
Journal article (peer-reviewed)abstract
- A prominent existential concept is that elderly parents should naturally become severely ill or die before a younger person does. If the reverse should happen, it may influence the parent's existential view of life. The aim of this study was to investigate the existential issues during illness time. This was a qualitative study with in-depth interviews and was conducted in a University Hospital in western Sweden. Eleven parents agreed to participate in individual interviews at baseline and 1 year later. The total number of interviews completed was 19. The study identified 5 areas according to an existential perspective: life took the wrong path, the age of the child, difficult to see the child as sick, worrying about the child, and the relationship with the adult child. Existential questions are often present in those circumstances and can be raised in conversations with parents. Existential questions began to arise for the parent when the child was diagnosed with the severe illness. The situation of having a severely ill child caused both fear and anxiety that the worst-case scenario they could imagine, that the child will die, might happen. Further research is required on this rarely investigated subject of having an adult child with a severe disease.
|
|
| 4. |
- Bessa, Agustina, et al.
(author)
-
Designing a Pragmatic Intervention to Help Improve the Bladder Cancer Patient Experience
- 2021
-
In: Inquiry. - : Sage Publications. - 0046-9580 .- 1945-7243. ; 58
-
Journal article (peer-reviewed)abstract
- Bladder cancer (BC) is the 10th most common malignancy worldwide and the patient experience is found to be worse than that for patients diagnosed with other cancer types. We aimed to develop a wellbeing intervention to help improve the bladder cancer patient experience by ameliorating their health-related Quality of Life (HRQoL). We followed the 3 phases of the modified Medical Research Council (MRC) Framework for development of complex interventions. Following a systematic review of the literature on mental, sexual, and physical wellbeing, we conducted discussion groups with patients and healthcare professionals on these 3 themes. A consultation phase was then conducted with all relevant stakeholders to co-design a wellbeing intervention as part of a feasibility study. A pragmatic wellbeing feasibility trial was designed based on the hypothesis that a wellbeing program will increase patient awareness and attendance to services available to them and will better support their needs to improve HRQoL. The primary feasibility endpoints are patient attendance to the services offered and changes in HRQoL. The principle of patient centered care has strengthened the commitment to provide a holistic approach to support BC patients. In this study, we developed a wellbeing intervention in collaboration with patients and healthcare professionals to meet an unmet need in terms of the BC patient experience.
|
|
| 5. |
- Blomquist, Karin, et al.
(author)
-
Motivation and Life Circumstances Affecting Living Habits Prior to Gastrointestinal Cancer Surgery- An Interpretative Phenomenological Analysis
- 2023
-
In: Inquiry. - : SAGE PUBLICATIONS INC. - 0046-9580 .- 1945-7243. ; 60
-
Journal article (peer-reviewed)abstract
- The aim was to explore the patients experiences to get insights into their living habits prior to gastrointestinal cancer surgery. An interpretative phenomenological analysis (IPA) approach was used. Six in-depth interviews with participants recruited from a hospital in southeast Sweden. The IPA analysis identified 3 themes: The influence of the cancer diagnosis on awareness and motivation, Life circumstances affecting living habits, and Activities bringing mental strength. The participants expressed their motivation level and circumstances in life. Various types of activities and support promoted physical and mental health. Motivation level and circumstances in life both influence living habits. Various kinds of activities and support promote patients physical and mental health. Nurses need to investigate patients experiences when developing person-centered support to achieve health-promoting behavior prior to cancer surgery.
|
|
| 6. |
- Dahlstrand, Ursula, et al.
(author)
-
Costs Related to Diverting Ileostomy After Rectal Cancer Surgery: A Population-Based Healthcare Cost Analysis Based on Nationwide Registers
- 2023
-
In: Inquiry. - Thousand Oaks, CA : Sage Publications. - 0046-9580 .- 1945-7243. ; 60
-
Journal article (peer-reviewed)abstract
- Low anterior resection for rectal cancer often includes a diverting loop-ileostomy to avoid the severe consequences of anastomotic leakage. Reversal of the stoma is often delayed, which can incur health-care costs on different levels. The aim is to, on population basis, determine stoma-related costs, and to investigate habitual and socioeconomic factors associated to the level of cost. Multi-register design with data from the Swedish Rectal Cancer Registry, the National Prescribed Drug Register, Statistics Sweden and cost-administrative data from the National Board of Health and Welfare. Data was gathered for 3564 patients with rectal cancer surgery 2007 to 2013, for 3 years following the surgery. Factors influencing the cost of inpatient care and stoma-related consumables were assessed with linear regression analyses. All monthly costs were higher for females (consumables P
|
|
| 7. |
- Dellve, Lotta, 1965, et al.
(author)
-
Silence Among First-Line Managers in Eldercare and Their Continuous Improvement Work During Covid-19
- 2022
-
In: Inquiry-the Journal of Health Care Organization Provision and Financing. - : SAGE Publications. - 0046-9580 .- 1945-7243. ; 59
-
Journal article (peer-reviewed)abstract
- Eldercare sector faced severe needs, and unexplained difficulties, to manage daily work and the continuous improvement of routines at operative levels during Covid-19. First-line managers in eldercare have a key role to facilitate learnings but may be hindered in public, hierarchical organizations. This is the first study on the conditions and importance of silence for managerial work in terms of daily operations and continuous improvement work. To identify first-line managers' silence in eldercare, its contextual and supportive conditions, its reasons and its implications for managerial work with regard to daily operations and continuous improvement work. Mixed-method study based on a questionnaire to first-line managers (n = 189) in Swedish public eldercare in 33 randomly selected municipal organizations and one city. The instruments Communication of Critical Issues at Work, Managers Stress Inventory and Managerial Work and an open question were analyzed using: (1) qualitative coding to explore organizational conditions, (2) descriptive statistics, and (3) stepwise regressions to identify associations. The most common forms of silence were quiescent (based on fear of the consequences of speaking up) and acquiescent (based on resignation and demotivation). Organizational conditions shaping managerial silence were due to strict governance and control in a hierarchical organization, lack of support and participation in decision-making and the experience of not being valued. Managers' silence had a negative impact on managerial work and especially work on continuous improvements. The pandemic also offered space for values of occupational professionalism and learning at operational levels. Organizational conditions of support through superiors and management teams decreased silence. Manager silence is detrimental for continuous improvement work and may arise in organizations with dominant values of organizational professionalism. Supportive conditions based on trust and space for occupational professionalism may be important and should be improved to decrease managerial silence and better support continuous improvements.
|
|
| 8. |
- Eckhardt, Martin, 1974-, et al.
(author)
-
Universal Health Coverage in Marginalized Populations : A Qualitative Evaluation of a Health Reform Implementation in Rural Ecuador
- 2019
-
In: Inquiry. - : Sage Publications. - 0046-9580 .- 1945-7243. ; 56
-
Journal article (peer-reviewed)abstract
- In 2008, Ecuador underwent a major health reform with the aim of universal coverage. Little is known about the implementation of the reform and its perceived effects in rural parts of the country. The aim of this study was to explore the perceived effects of the 2008 health reform implementation, on rural primary health care services and financial access of the rural poor. A qualitative study using focus group discussions was conducted in a rural region in Ecuador, involving health staff, local health committee members, village leaders, and community health workers. Qualitative content analysis focusing on the manifest content was applied. Three categories emerged from the texts: (1) the prereform situation, which was described as difficult in terms of financial access and quality of care; (2) the reform process, which was perceived as top-down and lacking in communication by the involved actors; lack of interest among the population was reported; (3) the effects of the reform, which were mainly perceived as positive. However, testimonies about understaffing, drug shortages, and access problems for those living furthest away from the health units show that the reform has not fully achieved its intended effects. New problems are a challenging health information system and people without genuine care needs overusing the health services. The results indicate that the Ecuadorean reform has improved rural primary health care services. Still, the reform faces challenges that need continued attention to secure its current achievements and advance the health system further.
|
|
| 9. |
- Eklund, Matti, 1974-
(author)
-
Meaning-Constitutivity
- 2007
-
In: Inquiry. - 0046-9580 .- 1945-7243. ; 50, s. 559-574
-
Journal article (peer-reviewed)
|
|
| 10. |
- Ellegård, Lina Maria, et al.
(author)
-
Limited Consequences of a Transition From Activity-Based Financing to Budgeting : Four Reasons Why According to Swedish Hospital Managers
- 2019
-
In: Inquiry: The Journal of Health Care Organization, Provision and Financing. - : SAGE Publications. - 0046-9580 .- 1945-7243. ; 56
-
Journal article (peer-reviewed)abstract
- Activity-based financing (ABF) and global budgeting are two common reimbursement models in hospital care that embody different incentives for cost containment and quality. The purpose of this study was to explore and describe perceptions from the provider perspective about how and why replacing variable ABF by global budgets affects daily operations and provided services. The study setting is a large Swedish county council that went from traditional budgeting to an ABF system and then back again in the period 2005-2012. Based on semistructured interviews with midlevel managers and analysis of administrative data, we conclude that the transition back from ABF to budgeting has had limited consequences and suggest 4 reasons why: (1) Midlevel managers dampen effects of changes in the external control; (2) the actual design of the different reimbursement models differed from the textbook design; (3) the purchasing body's use of other management controls did not change; (4) incentives bypassing the purchasing body's controls dampened the consequences. The study highlights the challenges associated with improvement strategies that rely exclusively on budget system changes within traditional tax-funded and politically managed health care systems.
|
|
