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Bergerum, C., Johan, T., Josefsson, K. & Wolmesjö, M. (2019). How might patient involvement in healthcare quality improvement efforts work—A realist literature review. Health Expectations, 00(00), 1-13
Open this publication in new window or tab >>How might patient involvement in healthcare quality improvement efforts work—A realist literature review
2019 (English)In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 00, no 00, p. 1-13Article in journal (Refereed) Published
Abstract [en]

Introduction This realist literature review, regarding active patient involvement in healthcare quality improvement (QI), seeks to identify possible mechanisms that contribute to success or failure. Furthermore, the paper outlines key considerations for organising and supporting patient involvement in healthcare QI efforts.

 

Methods Two literature searches were performed. Altogether, 1,204 articles from a healthcare context were screened, focusing on improvement efforts that involve patients, healthcare professionals and/or managers and leaders. Among these, 107 articles fulfilled the chosen study selection criteria and were further analysed. 18 articles underwent a full realist review. In the realist synthesis, context-mechanism-outcome configurations were articulated as middle-range theories and organised thematically to generate a program theory on how active patient involvement in QI efforts might work.

 

Results The articles exhibited a diversity of patient involvement approaches at different levels of healthcare organisations. To be successful, organisations’ support of QI efforts that actively involved patients tailored the QI efforts to their context to achieve the desired outcomes, and involved the relevant microsystem members. Furthermore, it promoted interaction and partnership within the microsystem, and supported the behavioural change that follows.

Conclusion This realist synthesis generates a program theory for active patient involvement in QI efforts; active patient involvement can be a tool (resource), if tailored for interaction and partnership (reasoning), that leads to behaviour change (outcome) within healthcare QI efforts. The theory explains essential resource and reasoning mechanisms, and outcomes that together form guidance for healthcare organisations when managing active patient involvement in QI efforts.

Keywords
clinical microsystem, co‐design, co‐production, healthcare management, healthcare organization, patient involvement, quality improvement, realist review
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-21020 (URN)10.1111/hex.12900 (DOI)
Available from: 2019-05-16 Created: 2019-05-16 Last updated: 2019-05-24Bibliographically approved
Jonasson, L.-L., Lindö, P., Lindh, T. & Josefsson, K. (2019). Life situation and participation as experienced by adult patients in palliative home care. Nursing and Palliative Care
Open this publication in new window or tab >>Life situation and participation as experienced by adult patients in palliative home care
2019 (English)In: Nursing and Palliative CareArticle in journal (Refereed) Published
Abstract [en]

Background: Many patients are currently cared for at the end-of-life stage at home, and the number is expected to increase. The patient’s participation is a prerequisite for good care, which also relates to ethical principles and evidence-based action. Aim: To describe adult patients’ experiences of their life situation and their participation in palliative home care. Method: A reflective lifeworld approach and a phenomenological meaning analysis were conducted. Six adult patients in palliative home care were interviewed in Sweden during 2018. Results: One essential meaning and five elements of that meaning describe adult patients’ life situations and participation in their palliative home care. The essential meaning referred to needing and endeavouring to live as usual and taking responsibility for life. The five essential elements were: The home should be my home, where I know who is coming through the door; I should know when help is coming and be included when decisions are made; routines should be maintained, but without booking up tomorrow; accept death, feel hope, and plan for relatives after my death; and be aware that death is imminent, but not know when it will come. Conclusions: Participation in palliative home care can be maintained and improved by caregivers behaving as guests in the patient’s home, building up the patient’s trust, showing consideration for patients and their relatives, promoting patients living everyday life as they previously had, asking about the patient’s habits, and giving patients time and continuity in the caregiving relationship. Education should focus on how to have supportive conversations with a patient who is dying and preparing for death.

Keywords
adult patients, end-of-life, interview, life situation, palliative home care, participation
National Category
Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-21192 (URN)
Available from: 2019-06-12 Created: 2019-06-12 Last updated: 2019-06-17Bibliographically approved
Jakobsson, M., Josefsson, K. & Högberg, K. (2019). Reasons for sleeping difficulties as perceived by adolescents.. In: : . Paper presented at School Nurses International Conference, Stockholm 22-26 juli 2019..
Open this publication in new window or tab >>Reasons for sleeping difficulties as perceived by adolescents.
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hb:diva-21654 (URN)
Conference
School Nurses International Conference, Stockholm 22-26 juli 2019.
Available from: 2019-08-23 Created: 2019-08-23 Last updated: 2019-08-26Bibliographically approved
Jakobsson, M., Josefsson, K., Jutengren, G., Sandsjö, L. & Högberg, K. (2019). Sleep duration and sleeping difficulties among adolescents, and their associations with school stress, self-perception and technology use.. In: : . Paper presented at School Nurses International Conference, Stockholm, 22-26 juli 2019..
Open this publication in new window or tab >>Sleep duration and sleeping difficulties among adolescents, and their associations with school stress, self-perception and technology use.
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2019 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hb:diva-21650 (URN)
Conference
School Nurses International Conference, Stockholm, 22-26 juli 2019.
Available from: 2019-08-23 Created: 2019-08-23 Last updated: 2019-08-26Bibliographically approved
Jakobsson, M., Josefsson, K., Jutengren, G., Sandsjö, L. & Högberg, K. (2019). Sleep duration and sleeping difficulties among adolescents: Exploring associations with school stress, self-perception, and technology use. Scandinavian Journal of Caring Sciences, 33(1), 197-206, Article ID SCS12621.
Open this publication in new window or tab >>Sleep duration and sleeping difficulties among adolescents: Exploring associations with school stress, self-perception, and technology use
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2019 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 1, p. 197-206, article id SCS12621Article in journal (Refereed) Published
Abstract [en]

Sleep duration and sleeping difficulties among adolescents: exploring associations with school stress, self-perception and technology use

 

Sleeping problems are increasing among adolescents worldwide. This study aimed to describe the prevalence of self-reported sleep duration and sleeping difficulties, as well as to explore their associations with school stress, self-perception, that is how adolescents perceive their appearance and happiness, and technology use among adolescents. Data were collected in 2015 using a questionnaire. A total of 937 ninth grade adolescents, 15–16 years, from a city in western Sweden participated, resulting in a response rate of 83%. The result showed that 55% of the adolescents slept less than the recommended 8 hours per night and 11% had sleeping difficulties. School stress and technology use were associated with short sleep duration. School stress and self-perception were associated with sleeping difficulties. The girls had worse outcomes for sleeping difficulties, school stress, self-perception and technology use than the boys. Based on the results, there is a need for school nurses to implement preventive measures to improve adolescents’ sleep.

Keywords
Adolescents, school nurse, school stress, self-perception, sleep, technology use
National Category
Medical and Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-15107 (URN)10.1111/scs.12621 (DOI)30311255 (PubMedID)2-s2.0-85054857606 (Scopus ID)
Available from: 2018-10-18 Created: 2018-10-18 Last updated: 2019-06-17Bibliographically approved
Jakobsson, M., Josefsson, K. & Högberg, K. (2019). Sömnbrist och sömnsvårigheter hos ungdomar har samband med hög skolstress och låg självuppfattning. Tidskriften Sömn och Hälsa (1), 19-25
Open this publication in new window or tab >>Sömnbrist och sömnsvårigheter hos ungdomar har samband med hög skolstress och låg självuppfattning
2019 (Swedish)In: Tidskriften Sömn och Hälsa, ISSN 2003-234X, no 1, p. 19-25Article in journal (Other (popular science, discussion, etc.)) Published
Place, publisher, year, edition, pages
Kristianstad University Press, 2019
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hb:diva-21652 (URN)
Available from: 2019-08-23 Created: 2019-08-23 Last updated: 2019-09-02Bibliographically approved
Jakobsson, M., Josefsson, K., Jutengren, G., Sandsjö, L. & Högberg, K. (2019). Ungdomars självskattade sömnlängd och sömnsvårigheter - dess samband med skolstress, självuppfattning och teknikanvändning.. In: : . Paper presented at Nätverket Sömn och Hälsa. Kristianstad, 14 mars, 2019..
Open this publication in new window or tab >>Ungdomars självskattade sömnlängd och sömnsvårigheter - dess samband med skolstress, självuppfattning och teknikanvändning.
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2019 (Swedish)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hb:diva-21651 (URN)
Conference
Nätverket Sömn och Hälsa. Kristianstad, 14 mars, 2019.
Available from: 2019-08-23 Created: 2019-08-23 Last updated: 2019-08-26Bibliographically approved
Josefsson, K. & Summer Meranius, M. (2018). Complexity in Daily Living of Older Adults with Multimorbidity: Health, Social and Informal Care Utilization and Costs. HSOA Journal of Gerontology & Geriatric Medicine, 4(017)
Open this publication in new window or tab >>Complexity in Daily Living of Older Adults with Multimorbidity: Health, Social and Informal Care Utilization and Costs
2018 (English)In: HSOA Journal of Gerontology & Geriatric Medicine, E-ISSN 2381-8662, Vol. 4, no 017Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of the study was to describe health, social and informal care utilization and costs for older adults with multimorbidity. The design was descriptive and retrospective.

Methods: The setting was a medium-sized town in an urban area of Sweden and included 10 health centers. Data were collected during 2011 using individual, structured interviews with the informal carers of 20 older adults with multimorbidity. Retrospectively, for a period of 18 months, data were also collected from the older adults’ patient registers and records, as data regarding the costs of their health and social care, in- and out-patient care and municipal care including home services.

Results: The primary result was that older adults with multimorbidity utilize health and social care from different principals, through different contacts. The results also provide insight into the complexity of these older adults’ daily living. Their 18-month health and social care costs varied between 12,084 and 137,187 Euros. For 12 older adults who utilized informal care, their calculated costs varied between 2,092 and 70,590 Euros.

Conclusion: The conclusion is that the increasing number of older adults with multimorbidity and their health and social care utilization and costs should be taken into account in healthcare policy and the organization of health and social care.

Keywords
Costs, health care utilization, informal care, multimorbidity, older adult, social care utilization
National Category
Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-13712 (URN)10.24966/GGM-8662/10017 (DOI)
Available from: 2018-02-24 Created: 2018-02-24 Last updated: 2018-02-26Bibliographically approved
Josefsson, K., Bomberg, M. & Krans, M. (2018). Creating a sense of security in palliative home care: Interviews with public health nurses. Nursing and Palliative Care, 3(1), 1-6
Open this publication in new window or tab >>Creating a sense of security in palliative home care: Interviews with public health nurses
2018 (English)In: Nursing and Palliative Care, Vol. 3, no 1, p. 1-6Article in journal (Refereed) Published
Abstract [en]

Background: Security is a human need and the home can offer a form of security, while it can be reduced closer to end-of-life. Many patients are cared for at theend-of-life stage in their homes, and the number is expected to increase. The public health nurse works to promote good and safe palliative home care.

Aim: The study’s aim is to describe how public health nurses can create a sense of security for adult patients in palliative home care.

Method: Eight public health nurses working in municipal home care were interviewed in the year 2016 in Sweden. Content analysis was used.

Results: The content analysis resulted in five main categories: patient and relatives, communication, staff, nursing planning and organisation. The results showed thatthe public health nurses created a relationship with patients and relatives through communication and continuity. Moreover, they were available and worked in a teamtowards common goals. The public health nurses’ qualifications, confidence in their professional role, and experience of how care should be organised could create asense of security for the patient and relatives.

Conclusions: The conclusion is that to understand the patient’s life-world requires time and competence development in palliative care. Cooperation betweenmunicipal and county councils should be improved to create a sense of security in palliative home care.

Keywords
home care, interview, municipal home care, palliative care, public health nurse, security
National Category
Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-13787 (URN)10.15761/NPC.1000178 (DOI)
Available from: 2018-03-05 Created: 2018-03-05 Last updated: 2018-03-12Bibliographically approved
Gusdal, A., Josefsson, K., Thor Adolfsson, E. & Martin, L. (2018). Family Health Conversations Conducted by Telephone in Heart Failure Nursing Care: A Feasibility Study. SAGE Open Nursing, 4, 1-13
Open this publication in new window or tab >>Family Health Conversations Conducted by Telephone in Heart Failure Nursing Care: A Feasibility Study
2018 (English)In: SAGE Open Nursing, Vol. 4, p. 1-13Article in journal (Refereed) Published
Abstract [en]

Registered nurses (RNs) in heart failure (HF) nursing care have a key role in providing family support, which positively affects the outcome for the patient. Telephone interventions conducted by RNs have been reported to be successful in HF nursing care, but Family Health Conversations (FamHCs) involving the patient and the family, have not previously been tested. The purpose of the current study was to explore the experiences and feasibility of nurse-led FamHCs conducted by telephone with patients and their family caregivers. A single-group intervention study with a pretest–posttest design was conducted in three regional hospitals that had a nurse-led HF clinic. Five RNs, eight patients, and eight family caregivers participated. Three FamHCs were conducted by telephone with each family every 2 weeks. Qualitative and quantitative data were collected through semi structured interviews and questionnaires. FamHCs improved the nurse–family relationships and relationships within the families and provided RNs with new knowledge about the families. FamHCs conducted by telephone were considered to be feasible for both families and RNs, although RNs preferred fewer and shorter FamHCs. The RNs preferred meeting face-to-face with the families as nonverbal communication between the family members could be missed because of lack of visual input. On the other hand, RNs appreciated to focus entirely on the conversation without the need to perform illness-related routine checks. In conclusion, the advantages of FamHCs conducted by telephone outweighed the disadvantages. Visual contact, provided by video telephony, and a shorter version of the tested FamHC would facilitate the use in HFnursing care.

Place, publisher, year, edition, pages
SAGE Open, 2018
Keywords
advanced practice nurses, chronic illnesses, congenital heart disease, family nursing, heart failure, telenursing
National Category
Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-15435 (URN)10.1177/2377960818803383 (DOI)
Available from: 2018-12-11 Created: 2018-12-11 Last updated: 2018-12-28Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-7117-9808

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