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Kullén Engström, Agneta
Publications (10 of 12) Show all publications
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: 2018-01-04Bibliographically 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
Sundler J, A., Bisholt, B., Ohlsson, U., Björk, M., Kullén Engström, A. & Gustafsson, M. (2014). Student nurses' experiences of the clinical learning environment in relation to the organization of supervision: A questionnaire survey. Nurse Education Today, 34(4), 661-666
Open this publication in new window or tab >>Student nurses' experiences of the clinical learning environment in relation to the organization of supervision: A questionnaire survey
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2014 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 34, no 4, p. 661-666Article in journal (Refereed) Published
Abstract [en]

Aim The aim was to investigate student nurses' experiences of the clinical learning environment in relation to how the supervision was organized. Background The clinical environment plays an essential part in student nurses' learning. Even though different models for supervision have been previously set forth, it has been stressed that there is a need both of further empirical studies on the role of preceptorship in undergraduate nursing education and of studies comparing different models. Method A cross-sectional study with comparative design was carried out with a mixed method approach. Data were collected from student nurses in the final term of the nursing programme at three universities in Sweden by means of a questionnaire. Results In general the students had positive experiences of the clinical learning environment with respect to pedagogical atmosphere, leadership style of the ward manager, premises of nursing, supervisory relationship, and role of the nurse preceptor and nurse teacher. However, there were significant differences in their ratings of the supervisory relationship (p < 0.001) and the pedagogical atmosphere (p 0.025) depending on how the supervision was organized. Students who had the same preceptor all the time were more satisfied with the supervisory relationship than were those who had different preceptors each day. Students' comments on the supervision confirmed the significance of the preceptor and the supervisory relationship. Conclusion The organization of the supervision was of significance with regard to the pedagogical atmosphere and the students' relation to preceptors. Students with the same preceptor throughout were more positive concerning the supervisory relationship and the pedagogical atmosphere.

Place, publisher, year, edition, pages
Churchill Livingstone, 2014
Keywords
Questionnaire, Preceptors, Supervision, Clinical placement, Clinical learning environment, Clinical education, Student nurses, Hållbar vårdvetenskap
National Category
Medical and Health Sciences Nursing
Research subject
Integrated Caring Science
Identifiers
urn:nbn:se:hb:diva-1789 (URN)10.1016/j.nedt.2013.06.023 (DOI)000333781600031 ()23850574 (PubMedID)2320/13271 (Local ID)2320/13271 (Archive number)2320/13271 (OAI)
Available from: 2015-11-13 Created: 2015-11-13 Last updated: 2017-12-01Bibliographically approved
Blomberg, K., Bisholt, B., Kullén Engström, A., Olsson, U., Sundler J, A. & Gustafsson, M. (2014). Swedish nursing students' experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education. Journal of Clinical Nursing, 23(15-16), 2264-2271
Open this publication in new window or tab >>Swedish nursing students' experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education
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2014 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 15-16, p. 2264-2271Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: To describe nursing students' experience of stress during clinical practice and evaluate the risk of stress in relation to the clinical setting characteristics and the organisation of the clinical education. BACKGROUND: Stress during clinical practice is well documented, but there is a lack of knowledge concerning whether the clinical setting characteristics and the organisation of the education make a difference. DESIGN: A cross-sectional study with evaluative design. METHODS: Data were collected by means of a numerical rating scale for the assessment of stress and questions about the clinical setting characteristics and the organisation of the education. One hundred and eighty-four students who had completed their final year on the nursing programme at three universities in Sweden were included. RESULTS: Nearly half of the students (43%) experienced high level of stress during clinical practice. Measured by decision in the tree analysis, the absolute risk of stress was 57% in students with placements in hospital departments, as compared to 13% in students with placements in other clinical settings. The risk of stress increased to 71% if the students with placement in a hospital took the national clinical final examination. Performance of practice in a hospital department overcrowded with patients was also associated with increased risk of stress. The organisation of supervision and number of students at the clinical placement had an effect on the experience of stress, but did not prove to be risk factors in the analysis. CONCLUSIONS: The risk of stress in nursing students during their clinical practice differs depending on clinical setting characteristics. The taking of the national clinical final examination could be a source of stress, but this requires further investigation. RELEVANCE TO CLINICAL PRACTICE: It is important that supervisors are aware that students in hospital departments overcrowded with patients are at risk of stress and may have increased need of support.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Ltd., 2014
Keywords
clinical education, clinical placement, nursing education, nursing students, risk factors, stress
National Category
Medical and Health Sciences
Research subject
Integrated Caring Science
Identifiers
urn:nbn:se:hb:diva-2043 (URN)0.1111/jocn.12506 (DOI)24393384 (PubMedID)2320/14666 (Local ID)2320/14666 (Archive number)2320/14666 (OAI)
Available from: 2015-11-13 Created: 2015-11-13 Last updated: 2017-08-23Bibliographically approved
Kullén Engström, A. & Axelsson, R. (2010). The double spiral of change: experiences of privatization in a Swedish hospital. International Journal of Health Planning and Management, 25(2), 156-168
Open this publication in new window or tab >>The double spiral of change: experiences of privatization in a Swedish hospital
2010 (English)In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, ISSN ISSN 0749-6753, EISSN 1099-1751, Vol. 25, no 2, p. 156-168Article in journal (Refereed) Published
Abstract [en]

ObjectivesPrivatization is a trend in countries with a public health system. It involves organizational change, a cultural transformation and changes for the employees as well as a more strictly controlled work. The objective of this study is to describe, analyse and interpret how privatization is perceived by the employees of a health care organization in Sweden. Methodology In-depth interviews have been performed with physicians, paramedics, secretaries, nurses, assistant nurses and local managers, in all 14 respondents, after a private entrepreneur had taken over the management of a hospital. The interviews were tape-recorded and have been analysed and interpreted following a grounded theory approach. Findings The transcribed interviews show that trust is a core category and linked with emotions, commitment and security. The analysis shows that employees' experience of privatization within a health care organization differs and is full of nuances and complexities. Conclusion A simultaneous virtuous and a vicious circle of experiences and reactions may describe how employees experience privatization. It can also be concluded that leadership is an important factor in the success of organizational change.

Place, publisher, year, edition, pages
John Wiley & Sons Ltd., 2010
Keywords
health care, privatization, employees' experiences, qualitative method
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hb:diva-8134 (URN)10.1002/hpm.968 (DOI)2320/9816 (Local ID)2320/9816 (Archive number)2320/9816 (OAI)
Available from: 2015-12-22 Created: 2015-12-22 Last updated: 2017-12-01Bibliographically approved
Kullén Engström, A. (2009). Ledarskap och medarbetarskap vid strukturella förändringar i hälso- och sjukvården. (Doctoral dissertation). Nordiska högskolan för folkhälsovetenskap Göteborg, Sverige
Open this publication in new window or tab >>Ledarskap och medarbetarskap vid strukturella förändringar i hälso- och sjukvården
2009 (Swedish)Doctoral thesis, monograph (Other academic)
Abstract [sv]

Bakgrund och syfte Inom hälso- och sjukvården har krav på ökad effektivitet, tillgänglighet och höjd kvalitet, samt en minskad ekonomisk ram, krävt förändringar i hälso- och sjukvårdssystemet. Ett syfte med denna avhandling är att utifrån professionellas upplevelser och erfarenheter belysa den praktiska innebörden av begreppet effektivitet i hälso- och sjukvården. Ett annat syfte är att utifrån olika perspektiv belysa ledarskap och medarbetarskap i samband med strukturella förändringar inom hälso- och sjukvården. Metod Avhandlingen bygger på fyra delstudier (I – IV) genomförda med hjälp av en kvalitativ forskningsansats. Delstudie I bygger på intervjuer kring begreppet effektivitet med strategiskt utvalda representanter för en organisations tre beslutsnivåer. Delstudie II och III bygger på intervjuer med medarbetare från olika professioner som deltagit i två olika sjukhussammanslagningar. I delstudie IV intervjuades medarbetare om sina upplevelser i anslutning till privatisering av en hälso- och sjukvårdsorganisation. Resultat Då en gemensam definition av begreppet effektivitet saknas i en organisation ges olika aktörer utrymme att göra sin egen tolkning, vilket kan påverka måluppfyllelsen på ett negativt sätt. Vid strukturförändringar är det viktigt att medarbetare ges möjlighet till såväl delaktighet som att kunna balansera sina åtagande i processen. Det är även av vikt att medarbetare i en förändringsprocess har tillit till ledningen och organisationen. Strukturförändringar kan samtidigt innebära spännande utmaningar och nya möjligheter till utveckling. Slutsatser Strukturella förändringar inom hälso- och sjukvården, i syfte att effektivisera, är komplexa och mångfacetterade. Samtidigt är begreppet effektivitet mångtydigt och svårutvärderat. Det påverkas av såväl struktur och ledarskap som medarbetarskap. En förändringsprocess påverkar både ledarskap och medarbetarskap. Framgångsfaktorer är medarbetarnas möjlighet till delaktighet och balans, samt deras tillit till såväl struktur som ledarskap.

Place, publisher, year, edition, pages
Nordiska högskolan för folkhälsovetenskap Göteborg, Sverige, 2009
Series
NHV Reports and Doctor of Public Health-Theses, ISSN 0283-1961 ; 2009:6
Keywords
grounded theory, hälso- och sjukvård, effektivitet, sammanslagningar, privatisering
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hb:diva-8135 (URN)2320/9819 (Local ID)978-91-85721-66-5 (ISBN)2320/9819 (Archive number)2320/9819 (OAI)
Available from: 2015-12-22 Created: 2015-12-22
Kullén Engström, A., Rosengren, K. & Hallberg, L. (2002). Balancing involvement: employees' experiences of merging hospitals in Sweden. Journal of Advanced Nursing, 38(1), 11-18
Open this publication in new window or tab >>Balancing involvement: employees' experiences of merging hospitals in Sweden
2002 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 38, no 1, p. 11-18Article in journal (Refereed) Published
Abstract [en]

Background. The health care of today stands in front of demands on financial and structural changes. New technology and global economy are forces driving on the change process. Aims. The aim of this study is to describe and broaden the understanding of the employees' experience of being involved in a merger between two health care districts in Sweden. Methods. This study was carried out from a qualitative approach according to the grounded theory tradition. From a theme guide with specific questions, 31 interviews were carried out with employees working in the health care. Findings. Five categories emerged from the body of interviews: balancing involvement, trust respect, challenge and commitment. Balancing involvement was defined as an overall core category related to the other categories. The categories trust, respect, challenge and commitment were related to subcategories and affected the core category balancing involvement. Conclusions. The overall findings point to the importance of balancing the employees' involvement in order to reach goal fulfilment change in a merger process.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Ltd., 2002
Keywords
change, health care personnel, involvement, mergers, qualitative method, management, politicians
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hb:diva-8133 (URN)10.1046/j.1365-2648.2002.02141.x (DOI)2320/9815 (Local ID)2320/9815 (Archive number)2320/9815 (OAI)
Available from: 2015-12-22 Created: 2015-12-22 Last updated: 2017-10-02Bibliographically approved
Kullén Engström, A. & Axelsson, L. (2001). The concept of effectiveness--a blind alley? A study of different interpretations in a Swedish county council. International Journal of Health Planning and Management, 16(1), 61-71
Open this publication in new window or tab >>The concept of effectiveness--a blind alley? A study of different interpretations in a Swedish county council
2001 (English)In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, Vol. 16, no 1, p. 61-71Article in journal (Refereed) Published
Abstract [en]

Swedish health care organizations are experiencing pressure to make ever greater efforts to rationalize and to increase effectiveness in the way they plan and provide services. In order to gain a better understanding of the current practice of the three groups of key actors in Swedish health care—politicians, senior civil servants and operational managers—and their perception of effectiveness, a study was carried out in a Swedish county council using both qualitative and quantitative methods. While in general the concept of effectiveness is thought of as crucial, it is not clearly or uniformly defined within the organization. Each of the three groups defines the concept in a way that reflects their own function, which may lead efforts to achieve effectiveness into a blind alley.

Place, publisher, year, edition, pages
John Wiley & Sons Ltd., 2001
Keywords
business development, effectiveness, resource management, planning, rationalization, responsibility, qualitative methods
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hb:diva-8132 (URN)10.1002/hpm.610 (DOI)2320/9813 (Local ID)2320/9813 (Archive number)2320/9813 (OAI)
Available from: 2015-12-22 Created: 2015-12-22 Last updated: 2017-10-02Bibliographically approved
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