| 1. |
- Ahlström, Gerd, et al.
(författare)
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Encounters in close care relations from the perspective of personal assistants working with persons with severe disablility.
- 2010
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Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 18:2, s. 180-188
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden adults with major and sustainable disabilities can be granted publicly financed support in the form of personal assistance after assessment and decision-making in accordance with government rules. The purpose of the present study was to explore more deeply the encounters in close care relations between personal assistants and disabled persons of working age, as well as the prerequisites for and obstacles to the success of such encounters, this from the perspective of the personal assistants. Thirty-two personal assistants (22- to 55-year old) who worked for 32 persons with serious neurological diseases living at home were interviewed. The transcribed unstructured interviews were qualitatively analysed using latent content analysis. The analyses resulted in five main themes: Perceptive awareness, Entering into the other's role, Mutuality, Handling the relationship and Personal difficulties facing the assistant. These themes illustrated that a prerequisite for the encounter's being meaningful is that the assistant should be able to observe and understand the unique needs of the disabled person. The assistant must furthermore be able to put herself/himself into the other person's position. It is also important that the personal chemistry between the assistant and the disabled person should be good. Being able to share feelings and interests with the functionally impaired person provides the assistant with positive emotional confirmation of a good relationship. A distressing dilemma the assistant faces is that of distinguishing between the working relationship and the personal friendship. In this borderline area are found experiences, feelings and events that the assistant may view as negative or even unacceptable. This study contributes to the understanding of the complexity underlying the daily community care of disabled persons with an extensive need for care and assistance.
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| 2. |
- Godfrey, Marjorie M., et al.
(författare)
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Coaching interprofessional health care improvement teams: the coachee, the coach and the leader perspectives.
- 2014
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 22:4, s. 452-464
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Tidskriftsartikel (refereegranskat)abstract
- Aim To investigate health care improvement team coaching activities from the perspectives of coachees, coaches and unit leaders in two national improvement collaboratives. Background Despite numerous methods to improve health care, inconsistencies in success have been attributed to factors that include unengaged staff, absence of supportive improvement resources and organisational inertia. Methods Mixed methods sequential exploratory study design, including quantitative and qualitative data from interprofessional improvement teams who received team coaching. The coachees (n = 382), coaches (n = 9) and leaders (n = 30) completed three different data collection tools identifying coaching actions perceived to support improvement activities. Results Coachees, coaches and unit leaders in both collaboratives reported generally positive perceptions about team coaching. Four categories of coaching actions were perceived to support improvement work: context, relationships, helping and technical support. Conclusions All participants agreed that regardless of who the coach is, emphasis should include the four categories of team coaching actions. Implications for nursing management Leaders should reflect on their efforts to support improvement teams and consider the four categories of team coaching actions. A structured team coaching model that offers needed encouragement to keep the team energized, seems to support health care improvement.
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| 3. |
- Magnusson, Lina, et al.
(författare)
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Experiences of Providing Prosthetic and Orthotic Services In Sierra Leone - The Local Staff’s Perspective
- 2013
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Konferensbidrag (refereegranskat)abstract
- Introduction: In Sierra Leone, West Africa, there are many people with disabilities in need of rehabilitation services after a long civil war. The aim of this qualitative study was to explore the experiences of prosthetic and orthotic service delivery in Sierra Leone from the local staff’s perspective.Method: Fifteen prosthetic and orthotic technicians representing all the rehabilitation centres providing prosthetic and orthotic services in Sierra Leone were interviewed. The interviews were transcribed and subjected to latent content analysis.Results: One main theme emerged: Sense of inability to deliver high-quality prosthetic and orthotic services. This main theme was generated from eight sub-themes: Desire for professional development; Appraisals of work satisfaction and norms; Patients neglected by family; Limited access to the prosthetic and orthotic services available; Problems with materials and machines; Low public awareness concerning disabilities; Marginalisation in society and Low priority by the government.Discussion There is a need for educating more prosthetic and orthotic staff to a category I or II level in Sierra Leone. To increase access to prosthetic and orthotic services there is a need to focus on making materials available for the fabrication of prosthetic and orthotic devices and to facilitate transport for patients to reach the services.Conclusions:The findings illustrated traditional beliefs about the causes of disability and that the public’s attitudes need to change in order to include and assign value to people with disabilities. Support from international organizations was considered necessary as well as educating more prosthetic and orthotic staff to a higher level.Magnusson L, Gerd Ahlström G. Experiences of Providing Prosthetic and Orthotic Services in Sierra Leone — the Local Staff’s Perspective. Disability and Rehabilitation. Accepted for publication February 2012
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| 4. |
- Magnusson, Lina, et al.
(författare)
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Experiences of providing prosthetic and orthotic services in Sierra Leone - the local staff's perspective
- 2012
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 34:24, s. 2111-2118
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Tidskriftsartikel (refereegranskat)abstract
- In Sierra Leone, West Africa, there are many people with disabilities in need of rehabilitation services after a long civil war. Purpose: The aim of this qualitative study was to explore the experiences of prosthetic and orthotic service delivery in Sierra Leone from the local staff's perspective. Method: Fifteen prosthetic and orthotic technicians working at all the rehabilitation centres providing prosthetic and orthotic services in Sierra Leone were interviewed. The interviews were transcribed and subjected to latent content analysis. Results: One main theme emerged: sense of inability to deliver high-quality prosthetic and orthotic services. This main theme was generated from eight sub-themes: Desire for professional development; appraisals of work satisfaction and norms; patients neglected by family; limited access to the prosthetic and orthotic services available; problems with materials and machines; low public awareness concerning disabilities; marginalisation in society and low priority on the part of government. Conclusions: The findings illustrated traditional beliefs about the causes of disability and that the public's attitude needs to change to include and value people with disabilities. Support from international organisations was considered necessary as well as educating more prosthetic and orthotic staff to a higher level.
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| 5. |
- Magnusson, Lina, et al.
(författare)
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Malawian prosthetic and orthotic users' mobility and satisfaction with their lower limb assistive device
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 45:4, s. 385-391
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate patients’ mobility and satisfaction with their lower limb prosthetic or orthotic device and related service delivery in Malawi and to compare groups of patients regarding type and level of device and demographics.METHODS: Questionnaires were used to collect self-report data from 83 patients.RESULTS: Ninety percent of prostheses or orthoses were in use by patients, but approximately half of these needed repair. Thirty-nine percent reported pain when using their assistive device. The majority of patients were able to rise from a chair (77%), move around the home (80%), walk on uneven ground (59%) and travel by bus or car (56%). However, patients had difficulties walking up and down hills (78%) and stairs (60%). In general, patients were quite satisfied with their assistive device (mean of 3.9 out of 5) and very satisfied with the service provided (mean of 4.4 out of 5). Access to repairs and servicing were rated as most important, followed by durability and follow-up services. Lack of finances to pay for transport was a barrier to accessing the prosthetic and orthotic centre.CONCLUSION: Patients were satisfied with the assistive device and service received, despite reporting pain associated with use of the device and difficulties ambulating on challenging surfaces.
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| 6. |
- Magnusson, Lina, et al.
(författare)
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Malawian Prosthetic And Orthotic Users’ Performance And Satisfaction With Their Lower Limb Assistive Device
- 2013
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Konferensbidrag (refereegranskat)abstract
- Introduction: This study aimed to investigate patients’ performance and satisfaction with their lower limb prosthetic or orthotic device and their satisfaction with prosthetic and orthotic service delivery in Malawi.Method: Eighty-three patients participated in the study. Questionnaires were used to collect self- reported data.Result: Ninety per cent of prosthetic and orthotic devices were in use. Patients were quite satisfied with their device (mean score of 3.9 out of 5) and very satisfied with the service provided (mean score of 4.4 out of 5). The majority of patients were able to move around the home (80%), rise from a chair (77%), walk on uneven ground (59%) and travel by bus or car (56%). Patients had difficulties or could not walk at all on; stairs (60%) and hills (79%),Thirty-nine percent reported pain when using the assistive device. Forty-eight percent of the devices were in use but needed repairs and 10 % were never used or completely broken. Access to repairs and servicing were rated by patients as most important, followed by durability of the device and follow up services. Lack of finances to pay for transport was a common barrier to accessing the prosthetic and orthotic centre.Discussion: Prosthetic and orthotic devices can be further improved in order to accommodate for ambulation on uneven surfaces, hills and stairs, as well as increasing patients’ ability to walk long distances with reduced pain.Conclusion:Patients were satisfied with the device and service received and the majority of prosthetic and orthotic patients in this study reported increased mobility when using their assistive devices. However, patients reported pain associated with use of the device and difficulties were experienced when walking in hills and on stairs. Costs associated with transport to the prosthetic and orthotic facility prevented them from receiving follow-up and repair services
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| 7. |
- Magnusson, Lina, et al.
(författare)
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Mobility and satisfaction with lower-limb prostheses and orthoses among users in Sierra Leone: A cross-sectional study
- 2014
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 46:5, s. 438-446
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate patients' mobility and satisfaction with their lower-limb prosthetic or orthotic device and related service delivery in Sierra Leone; to compare groups of patients regarding type and level of assistive device, gender, area of residence, income; and to identify factors associated with satisfaction with the assistive device and service. Methods: A total of 139 patients answered questionnaires, including the Quebec User Evaluation of Satisfaction with Assistive Technology questionnaire (QUEST 2.0). Results: Eighty-six percent of assistive devices were in use, but half needed repair. Thirty-three percent of patients reported pain when using their assistive device. Patients had difficulties or could not walk at all on: uneven ground (65%); hills (75%); and stairs (66%). Patients were quite satisfied with their assistive device and the service (mean 3.7 out of 5 in QUEST), but reported 886 problems. Approximately half of the patients could not access services. In relation to mobility and service delivery, women, orthotic patients and patients using above-knee assistive devices had the poorest results. The general condition of the assistive device and patients' ability to walk on uneven ground were associated with satisfaction with the assistive devices and service. Conclusion: Patients reported high levels of mobility while using their device although they experienced pain and difficulties walking on challenging surfaces. Limitations in the effectiveness of assistive devices and limited access to follow-up services and repairs were issues desired to be addressed.
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| 8. |
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| 9. |
- Magnusson, Lina
(författare)
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Prosthetic and Orthotic Services in Developing Countries
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of this thesis was to generate further knowledge about prosthetic and orthotic services in developing countries. In particular, the thesis focused on patient mobility and satisfaction with prosthetic and orthotic devices, satisfaction with service delivery, and the views of staff regarding clinical practice and education.Methods: Questionnaires, including QUEST 2.0, were used to collect self-reported data from 83 patients in Malawi and 139 patients in Sierra Leone. In addition, 15 prosthetic/orthotic technicians in Sierra Leone and 15 prosthetists/orthotists in Pakistan were interviewed.Results: The majority of patients used their prosthetic or orthotic devices (90% in Malawi, and 86% in Sierra Leone), but half of the assistive devices in use needed repair. Approximately one third of patients reported pain when using their assistive device (40% in Malawi and 34% in Sierra Leone). Patients had difficulties, or could not walk at all, with their prosthetic and/or orthotic device in the following situations; uneven ground (41% in Malawi and 65% in Sierra Leone), up and down hills (78% in Malawi and 75% in Sierra Leone), on stairs (60% in Malawi and 66% in Sierra Leone). Patients were quite satisfied or very satisfied with their assistive device (mean 3.9 in Malawi and 3.7 in Sierra Leone out of 5) and the services provided (mean 4.4 in Malawi and 3.7 in Sierra Leone out of 5), (p<0.001), but reported many problems (418 comments made in Malawi and 886 in Sierra Leone). About half of the patients did not, or sometimes did not, have the ability to access services (71% in Malawi and 40% in Sierra Leone). In relation to mobility and service delivery, orthotic patients and patients using above-knee assistive devices in Malawi and Sierra Leone had the poorest results. In Sierra Leone, women had poorer results than men. The general condition of devices and the ability to walk on uneven ground and on stairs were associated with both satisfaction of assistive devices and service received. Professionals’ views of service delivery and related education resulted in four themes common to Sierra Leone and Pakistan: 1) Low awareness and prioritising of prosthetic and orthotic services; 2) Difficulty managing specific pathological conditions and problems with materials; 3) The need for further education and desire for professional development; 4) Desire for improvements in prosthetic and orthotic education. A further two themes were unique to Sierra Leone; 1) People with disabilities have low social status; 2) Limited access to prosthetic and orthotic services.Conclusion: High levels of satisfaction and mobility while using assistive devices were reported in Malawi and Sierra Leone, although patients experienced pain and difficulties when walking on challenging surfaces. Limitations to the effectiveness of assistive devices, poor comfort, and limited access to follow-up services and repairs were issues that needed to be addressed. Educating prosthetic and orthotic staff to a higher level was considered necessary in Sierra Leone. In Pakistan, prosthetic and orthotic education could be improved by modifying programme content, improving teachers’ knowledge, improving access to information, and addressing issues of gender equality.
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| 10. |
- Nygårdh, Annette
(författare)
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A quality improvement project on empowerment in chronic kidney care : an interactive research approach
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- One way of improving health care has been conceptualized as personcentred care. In person-centred care the concept of empowerment is crucial. This thesis aims was to explore the meaning of empowerment from the perspective of persons with chronic kidney disease (CKD) and their family members and to evaluate the outcomes of an improvement intervention (QI) for the persons with CKD. Furthermore, to explore the implementation of an QI for empowerment in the context of chronic kidney care from a professional perspective. The research was based on an interactive approach in which the findings relating to the experiences of empowerment by persons with CKD and their family members in chronic kidney care were used in developing the QI. The methods of data collection were both qualitative and quantitative. In all, 20 persons with CKD (Study I) and 12 family members (Study II) participated in the interviews. In the quasi-experimental evaluation of the QI, 25 individuals took part in the intervention group and 21 persons in the comparison group (Study III). Twelve healthcare professionals participated in the case study of the QI (Study IV). Empowerment in chronic kidney care for the persons with CKD was described in terms of creation of trust and learning through encounters. The family members of the persons with CKD described empowerment as having the strength to assume responsibility. The outcomes of the QI after 2 years showed significantly higher scores for individualized care in the intervention group than in the comparison group. The facilitators in the QI were the healthcare professionals' moving spirit and encouragement from involved persons. As a barrier, the healthcare professionals referred to the limitation of the organization. In conclusion, the individual’s perspective of empowerment is important, both for quality of care and as a facilitator for QI in chronic kidney care.
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