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Kullén Engström, Agneta
Publications (10 of 18) Show all publications
Fallman, S. L., Dellve, L. & Kullén Engström, A. (2022). Managerial approaches for maintaining low levels of sick leave: A qualitative study. Journal of Nursing Management
Open this publication in new window or tab >>Managerial approaches for maintaining low levels of sick leave: A qualitative study
2022 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim

The aim of this study was to identify first-line managers' approaches for maintaining low levels of sick leave among health care employees.

Introduction

One challenge in health care is the high level of sick leave among employees. High work demands and conflicting pressures characterize the work situation of both employees and first-line managers, with potential negative effects on work-related health.

Method

First-line managers at units with low and/or decreasing sick leave were interviewed. Thematic analysis was used to analyse the data.

Results

The managers took a holistic approach in meeting their employees' broader needs, and they were balancing high organisational demands through insubordination. To keep sick leave rate low, they created possibilities for the employees to influence their own working life through a present, visible and trustful leadership.

Conclusion

Managers responsible for units with low sick leave seemed to utilize a holistic approach with focus on their employees and prioritized needs of their employees before organisational demands from top management. Implications for nursing management First-line managers in health care can have impact on sick leave among their employees and create good working conditions, despite pressure from their superiors.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
employee, first-line manager, flexibility, health care, sick leave, WORKING-CONDITIONS, NURSE MANAGERS, HEALTH, CARE, LEADERSHIP, SATISFACTION, ABSENTEEISM, ABSENCE, IMPACT, LIFE
National Category
Work Sciences Business Administration Social Work
Identifiers
urn:nbn:se:hb:diva-27965 (URN)10.1111/jonm.13678 (DOI)000802159000001 ()35560674 (PubMedID)2-s2.0-85130896396 (Scopus ID)
Available from: 2022-06-07 Created: 2022-06-07 Last updated: 2022-11-24Bibliographically approved
Fallman, S. L. & Kullén Engström, A. (2020). Har organisatoriska förutsättningar och ledarskapsstrategier betydelse för att främja låg sjukfrånvaro inom hälso- och sjukvården?. Socialmedicinsk Tidskrift, 97(1)
Open this publication in new window or tab >>Har organisatoriska förutsättningar och ledarskapsstrategier betydelse för att främja låg sjukfrånvaro inom hälso- och sjukvården?
2020 (Swedish)In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 97, no 1Article in journal (Refereed) Published
Abstract [sv]

Studien syftar till att undersöka om det finns gemensamma organisatoriska förutsättningar och ledarskapsstrategier som kännetecknar enheter inom hälso- och sjukvården som har låg sjukfrånvaro. För att undersöka detta intervjuades första linjens chefer, ansvarig för enheten. Urvalet gjordes utifrån enheternas sjukfrånvaro under åren 2013-2016. Data analyserades med kvalitativ innehållsanalys. Resultatet visar att dessa chefer arbetar under en del organisatoriska krav som de upplever som försvårande. De lyckas trots det att skapa förutsättningar för låg sjukfrånvaro och gör det genom ett aktivt ledarskap som har fokus på medarbetarna. De hade tydliga strategier för att förebygga och hantera sjukfrånvaro och de var lyhörda och flexibla inför medarbetarnas önskemål om att lägga tillrätta sin arbetssituation. Den övergripande slutsatsen är att de intervjuade cheferna tycks vara i en position där de kan påverka medarbetarnas arbetssituation och i slutändan deras sjukfrånvaro. En god idé för överordnad ledning verkar vara att stötta chefer i ett aktivt arbete att stärka förutsättningar för medarbetare samt att öka chefers inflytande över frågor som rör lokala arbetsförhållanden.

Keywords
Första linjens chefer; Ledarskapsstrategier; Organisatoriska förutsättningar, Sjukfrånvaro, Hälso- och sjukvården, Medarbetare
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hb:diva-24673 (URN)
Projects
Centrum för välfärdsstudier
Available from: 2021-01-15 Created: 2021-01-15 Last updated: 2021-01-15
Bergerum, C., Kullén Engström, A., Thor, J. & Wolmesjö, M. (2020). Patient involvement in quality improvement - a 'tug of war' or a dialogue in a learning process to improve healthcare?. BMC Health Services Research, 20(1), Article ID 1115.
Open this publication in new window or tab >>Patient involvement in quality improvement - a 'tug of war' or a dialogue in a learning process to improve healthcare?
2020 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 20, no 1, article id 1115Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Co-production and co-design approaches to quality improvement (QI) efforts are gaining momentum in healthcare. Yet, these approaches can be challenging, not least when it comes to patient involvement. The aim of this study was to examine what might influence QI efforts in which patients are involved, as experienced by the patients and the healthcare professionals involved.

METHODS: This study involved a qualitative design inspired by the constructivist grounded theory. In one mid-sized Swedish hospital's patient process organisation, data was collected from six QI teams that involved patients in their QI efforts, addressing care paths for patients with transient, chronic and/or multiple parallel diagnoses. Field notes were collected from participant observations during 53 QI team meetings in three of the six patient processes. Individual, semi-structured interviews were conducted with 12 patients and 12 healthcare professionals in all the six QI teams.

RESULTS: Patients were involved in QI efforts in different ways. In three of the QI teams, patient representatives attended team meetings regularly. One team consulted patient representatives on a single occasion, one team collected patient preferences structurally from individual interviews with patients, and one team combined interviews and a workshop with patients. The patients' and healthcare professionals' expressions of what might influence the QI efforts involving patients were similar in several ways. QI team members emphasized the importance of organisational structure and culture. Furthermore, they expressed a desire for ongoing interaction between patients and healthcare professionals in healthcare QI.

CONCLUSIONS: QI team members recognised continuous dialogue and collective thinking by the sharing of experiences and preferences between patients and healthcare professionals as essential for achieving better matches between healthcare resources and patient needs in their QI efforts. Significant structural and cultural aspects of performing QI in complex hospital organisations were considered to be obstructions to progress. Therefore, to sustain learning and behaviour change through QI efforts at the team level, a deeper understanding of how structural and cultural aspects of QI promote or prevent success appears essential.

Place, publisher, year, edition, pages
BioMed Central, 2020
Keywords
Clinical microsystem, Co-production, Healthcare organisation, Patient involvement, Quality improvement
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-24418 (URN)10.1186/s12913-020-05970-4 (DOI)000597317900003 ()33267880 (PubMedID)2-s2.0-85096952307 (Scopus ID)
Available from: 2020-12-14 Created: 2020-12-14 Last updated: 2022-09-15
Wolmesjö, M. & Kullén Engström, A. (2019). Att våga släppa taget (1:1ed.). In: Maria Wolmesjö (Ed.), Brukardelaktighet och inflytande i äldreomsorg: (pp. 43-57). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Att våga släppa taget
2019 (Swedish)In: Brukardelaktighet och inflytande i äldreomsorg / [ed] Maria Wolmesjö, Lund: Studentlitteratur AB, 2019, 1:1, p. 43-57Chapter in book (Refereed)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2019 Edition: 1:1
Keywords
brukare, delaktighet, inflytande, chefer, ledarskap, äldreomsorg
National Category
Social Sciences
Identifiers
urn:nbn:se:hb:diva-22277 (URN)978-91-44-13139-9 (ISBN)
Available from: 2019-12-19 Created: 2019-12-19 Last updated: 2020-01-09Bibliographically approved
Wolmesjö, M. & Kullén Engström, A. (2019). Balanserad delaktighet och inflytande (1:1ed.). In: Maria Wolmesjö (Ed.), Brukardelaktighet och inflytande i äldreomsorg: (pp. 103-110). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Balanserad delaktighet och inflytande
2019 (Swedish)In: Brukardelaktighet och inflytande i äldreomsorg / [ed] Maria Wolmesjö, Lund: Studentlitteratur AB, 2019, 1:1, p. 103-110Chapter in book (Refereed)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2019 Edition: 1:1
Keywords
etiska dilemman, modell för ledarskapande, brukardelaktighet, inflytande, ledarskapare, brukarskapare
National Category
Social Sciences
Identifiers
urn:nbn:se:hb:diva-22282 (URN)978-91-44-13139-9 (ISBN)
Available from: 2019-12-19 Created: 2019-12-19 Last updated: 2020-01-09Bibliographically approved
Wolmesjö, M. & Kullén Engström, A. (2019). Balanserad delaktighet och inflytande. In: Maria Wolmesjö (Ed.), Brukardelaktighet och inflytande i äldreomsorg.: (pp. 105-111). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Balanserad delaktighet och inflytande
2019 (Swedish)In: Brukardelaktighet och inflytande i äldreomsorg. / [ed] Maria Wolmesjö, Lund: Studentlitteratur AB, 2019, p. 105-111Chapter in book (Refereed)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2019
Keywords
brukardelaktighet, inflytande, äldreomsorg, ledarskap
National Category
Medical and Health Sciences Social Sciences Other Social Sciences
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-24525 (URN)978-91-44-13139-9 (ISBN)
Available from: 2020-12-31 Created: 2020-12-31 Last updated: 2021-01-12Bibliographically approved
Bremer, A., Kullén Engström, A., Fredman, M., Jonasson, L.-L., Jutengren, G., Karlsson, P.-Å. & Sandman, L. (2016). Ledarskap i äldreomsorgen: att leda integrerat värdeskapande i en röra av värden och förutsättningar. Borås: Högskolan i Borås
Open this publication in new window or tab >>Ledarskap i äldreomsorgen: att leda integrerat värdeskapande i en röra av värden och förutsättningar
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2016 (Swedish)Report (Refereed)
Abstract [sv]

Det övergripande syftet med denna rapport är att beskriva chefers etiska värderingar, dilemman och organisatoriska förutsättningar för att bedriva ett värdebaserat ledarskap i såväl kommunal som privat äldreomsorg.

Det empiriska materialet består av en omfattande enkätstudie till nästan 500 studerande inom ramen för den nationella ledarutbildningen för chefer inom äldreomsorgen vid Högskolan i Borås under perioden 2013 till 2015. Utbildningen gavs på uppdrag av Socialstyrelsen och omfattade 30 högskolepoäng med två års studier på kvartsfart. Samtliga studerande var yrkesverksamma som chefer och ledare inom kommunal eller privat äldreomsorg i södra Sverige. Metoder som använts i bearbetning och analys av materialet är deskriptiva, jämförande och analytiska med regressionsmodeller och SEM-analys.

Resultatet visar på att cheferna – oavsett utbildningsbakgrund, värderade följande etiska värden högst: att inte skada, respekt för individen och rätten till konfidentialitet. Värdedilemman i chefsarbetet är dock vanligt och sammanlänkat med andra utmaningar i arbetet, särskilt med utmaningar som rör hantering över organisationsnivåer (buffertproblem och containerproblem) och av olika ansvarsområden (logikkonflikter). Inom privat verksamhet skattade de medverkande cheferna värdekonflikter och andra utmaningar i lägre grad än chefer inom kommunal verksamhet.

De flesta chefer var nöjda med hur de kunde fullfölja sitt ansvar för utveckling av verksamheten avseende värdegrund, kvalitet, processer, dagligt arbete, brukarmedverkan, brukarsäkerhet och arbetsmiljö. De flesta skattade också att de arbetade i mycket hög grad med strukturering och utveckling av dessa frågor.

Stödresurser minskade upplevelsen av värdekonflikter, men det fanns skillnad i betydelsen relaterat till chefers grundprofession. Det organisatoriska stödet var också tydligare för chefer inom privat verksamhet. Organiserade stödresurser hade stor betydelse för hållbart integrerat och värdeskapande ledarskap samt för aktiva ledningsstrategier. Även sambandet mellan hållbart ledarskap och aktiva ledarstrategier modererades av grundprofession, där sambandet var moderat negativt för chefer med social grundutbildning. Det tycks således finnas ett utbildningsbehov bland äldreomsorgens chefer och behov av ett utvecklat stöd från arbets- HÖGSKOLAN BORÅS HÖGSKOLAN BORÅS 15 givaren då det varierar avseende omfattning, inriktning och nivå mellan kommunal och privat verksamhet.

Sammanfattningsvis har chefer i äldreomsorgen många olika värden, på olika nivåer och utifrån olika perspektiv att förhålla sig till i sitt ledarskap. Att hantera och utveckla förståelse för dessa är utmanande i chefskapet och värdedilemman är vanliga. Majoriteten av cheferna i denna studie beskriver dock generellt en aktiv och god hantering och organisering av dessa. Konstateras att en integrerad förståelse och hantering, samt goda organisatoriska stödresurser tycks bidra till mer hållbart och värdeskapande ledarskap.

Place, publisher, year, edition, pages
Borås: Högskolan i Borås, 2016. p. 138
Series
Vetenskap för profession: rapport, ISSN 1654-6520 ; 35
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hb:diva-9333 (URN)978-91-88269-08-9 (ISBN)978-91-88269-09-6 (ISBN)
Available from: 2016-03-08 Created: 2016-03-08 Last updated: 2019-12-13Bibliographically approved
Blomberg, K., Isaksson, A.-K., Allvin, R., Bisholt, B., Ewertsson, M., Kullén Engström, A., . . . Gustafsson, M. (2016). Work stress among newly graduated nurses in relation to workplace and clinical group supervision. Journal of Nursing Management, 24(1), 80-87
Open this publication in new window or tab >>Work stress among newly graduated nurses in relation to workplace and clinical group supervision
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2016 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 1, p. 80-87Article in journal (Refereed) Published
Abstract [en]

The aim was to investigate occupational stress among newly graduated nurses in relation to the workplace and clinicla group supervision. Being a newly graduated nurse is particulary stressful. Whar remains unclear is wehter teh workplace and clinical group supervision affect the stress. A cross-sectional comperative study was performed. Data were collected by means of a numerical scale measuring occupational stress, questions about workplace and clinicla group supervision. One hundred and thirteen nusres were included in the study. Conclusions: Newly graduated nurses experience great strss and need support. Nusrse participating in clinical group supervision reported significantly less stress.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Ltd., 2016
Keywords
clinical group supervision, newly graduated nurses, occupational stress, workplace
National Category
Medical and Health Sciences
Research subject
Integrated Caring Science
Identifiers
urn:nbn:se:hb:diva-2042 (URN)10.1111/jonm.12274 (DOI)000368263600021 ()25421164 (PubMedID)2-s2.0-84956505898 (Scopus ID)2320/14664 (Local ID)2320/14664 (Archive number)2320/14664 (OAI)
Available from: 2015-11-13 Created: 2015-11-13 Last updated: 2017-12-01Bibliographically approved
Gustafsson, M., Kullén Engström, A., Ohlsson, U., Sundler J, A. & Bisholt, B. (2015). Nurse teacher models in clinical education from the perspective of student nurses - A mixed method study. Nurse Education Today, 35(12), 1289-1294
Open this publication in new window or tab >>Nurse teacher models in clinical education from the perspective of student nurses - A mixed method study
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2015 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, no 12, p. 1289-1294Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim was to describe and compare the clinical teacher's role in different models of clinical practice from the perspective of student nurses.

DESIGN AND SETTINGS: The study took place in collaboration with two Swedish universities that applied different educational models in clinical practice. A mixed method approach was used. The quantitative part had a comparative design and the qualitative part had a descriptive design.

PARTICIPANTS: The study group consisted of 114 student nurses (response rate 87%). Fifty-three of them had met clinical teachers employed at the university and not participating in the daily clinical work (University Nurse Teachers, UNTs), whilst 61 had met clinical teachers dividing their time between teaching and nursing (Clinical Nurse Teachers, CNTs). Eight students participated in the qualitative part of the study.

METHODS: A questionnaire including the CLES+T scale was used to ascertain the students' perception of the clinical teacher's role, complemented by interviews directed towards an enrichment of this perception.

RESULTS: Students meeting CNTs agreed more strongly than those meeting UNTs that the teacher had the ability to help them integrate theory and practice. Whilst spontaneous meetings between students and CNTs occurred, students mostly met UNTs in seminars. Students meeting UNTs felt alone but did appreciate having someone outside the clinical environment to provide support if they did not get along with their preceptor.

CONCLUSIONS: In the case of UNTs, it is important that they keep their knowledge of clinical issues updated and visit the clinical placement not only for seminars but also to give students emotional support. In the case of CNTs, it is important that they are members of the faculty at the university, take part in the planning of the clinical courses and are able to explain the learning goals to the students.

National Category
Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-8329 (URN)10.1016/j.nedt.2015.03.008 (DOI)000365372700025 ()25846197 (PubMedID)2-s2.0-84946490890 (Scopus ID)
Available from: 2016-01-06 Created: 2016-01-06 Last updated: 2018-12-21Bibliographically approved
Bisholt, B., Ohlsson, U., Kullén Engström, A., Sundler J, A. & Gustafsson, M. (2014). Nursing students' assessment of the learning environment in different clinical settings. Nurse Education in Practice, 14(3), 304-310
Open this publication in new window or tab >>Nursing students' assessment of the learning environment in different clinical settings
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2014 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 14, no 3, p. 304-310Article in journal (Refereed) Published
Abstract [en]

Introduction Nursing students perform their clinical practice in different types of clinical settings. The clinical learning environment is important for students to be able to achieve desired learning outcomes. Knowledge is lacking about the learning environment in different clinical settings. Aim The aim was to compare the learning environment in different clinical settings from the perspective of the nursing students. Design A cross-sectional study with comparative design was conducted. Method Data was collected from 185 nursing students at three universities by means of a questionnaire involving the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) evaluation scale. An open-ended question was added in order to ascertain reasons for dissatisfaction with the clinical placement. Results The nursing students' satisfaction with the placement did not differ between clinical settings. However, those with clinical placement in hospital departments agreed more strongly that sufficient meaningful learning situations occurred and that learning situations were multi-dimensional. Some students reported that the character of the clinical setting made it difficult to achieve the learning objectives. Conclusion In the planning of the clinical placement, attention must be paid to whether the setting offers the student a meaningful learning situation where the appropriate learning outcome may be achieved.

Place, publisher, year, edition, pages
Churchill Livingstone, 2014
Keywords
clinical learning environment, clinical placement, nursing education research, nursing students
National Category
Nursing Learning
Research subject
Integrated Caring Science
Identifiers
urn:nbn:se:hb:diva-2041 (URN)10.1016/j.nepr.2013.11.005 (DOI)000349568100015 ()24355802 (PubMedID)2-s2.0-84902169054 (Scopus ID)2320/14661 (Local ID)2320/14661 (Archive number)2320/14661 (OAI)
Available from: 2015-11-13 Created: 2015-11-13 Last updated: 2017-08-23Bibliographically approved
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