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  • 1.
    Abdel, Mariam
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Sech Mousa, Sarmpel
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Chefers och ledarskapets utmaningar inom laboratoriemedicinverksamheten under pandemin2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sveriges hälso- och sjukvården står inför stora förändringar det senaste decenniet med anledning av olika händelser såsom digitaliseringen och pandemier. Covid-19-pandemin har orsakat enorma omställningar de senaste två åren uppger Coronakomissionen (SOU 2021:89) i sin rapport. En av de verksamheter som stod inför stora utmaningar inom hälso- och sjukvården var laboratoriemedicin. Syftet med studien är att belysa första linjens chefers utmaningar inom laboratoriemedicinverksamheteten när det gäller ledarskapet och arbetsmiljöutmaningar och hur dessa hanterades under covid-19-pandemin. Metoden som användes var kvalitativ metod med induktiv ansats och datainsamlingen genomfördes i form av semistrukturerade intervjuer med sex första linjens chefer inom laboratoriemedicinverksamheten. Resultatet presenteras i form av kategorier som har kommit fram genom analys av datamaterialet och presenteras utifrån studiens frågeställningar. Studiens resultatvisar att första linjens chefer inom laboratoriemedicinverksamheteten hanterade flera utmaningar under pandemin som bland annat var det stort informationsflödet, bemanningsproblem, arbetsmiljöutmaningar och slitna medarbetarna som behövde stöttas mentalt. Olika strategier har använts av cheferna med stöd av deras chefskollegor samt medarbetarna för att kunna hantera de här utmaningarna. Vidare forskning behövs både för chefers arbetsmiljö i ovan nämnd verksamhet samt för medarbetarnas arbetsmiljö i syfte att kunna belysa ytterligare de problem som finns samt att hitta olika hållbara lösningar.

  • 2. Abdon, Nils Johan
    et al.
    Bergfeldt, Lennart
    Herlitz, Johan
    University of Borås, School of Health Science.
    Hjärtstopp utlöst av läkemedel kanske vanligare än vi tror2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 8, p. 521-525Article in journal (Refereed)
  • 3. Abrahamsson, Birgitta
    et al.
    Berg, Marie-Louise U.
    Jutengren, Göran
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Jonsson, Annikki
    To recommend the local primary health-care centre or not: What importance do patients attach to initial contact quality, staff continuity and responsive staff encounters?2015In: International Journal for Quality in Health Care, ISSN 1353-4505, Vol. 27, no 3, p. 196-200Article in journal (Other academic)
    Abstract [en]

    Objective: This study aims to examine the circumstances associated with patients’ tendencies to recommend a primary care centre, based on four hypotheses, the initial contact’s quality, care relationship continuity, treatment encounter responsiveness and whether the significance of encounter responsiveness differs depending on whether the patient has been seeing a nurse or physician. Design: The study is based on the patient’ self-reported responses, retrieved from the Swedish National Patient Survey. The design is cross-sectional, and data were analysed using a binary logistic regression. Setting: Data were collected from three primary healthcare centres in the region of Västra Götaland, Sweden. Participants: A total of 362 patients (62% females) having visited any of three publicly run healthcare centres in September 2010 constitute the analytical sample. Participants were fairly evenly distributed across all age groups. Main Outcome Measures: Recommendation was captured by patients’ binary responses to the question: Would you recommend the visited primary healthcare centre? Results: The hypotheses involving initial contact quality, care relationship continuity and treatment encounter responsiveness were supported by the analyses. The latter was strongly associated with patient tendency to recommend the primary healthcare centre. However, the profession (nurse or physician) involved in the treatment encounter made no difference for the predictive significance of encounter responsiveness for a patient’s tendency to recommend the healthcare centre. Conclusions: Striving for stable and responsive patient/staff relationships and an open approach towards patients are potentially successful strategies for primary healthcare centres seeking to attract new patients and maintain current ones. (PsycINFO Database Record (c) 2015 APA, all rights reserved)(journal abstract)

  • 4.
    Ademovic, Mevlida
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Cederlund, Anna
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Psykisk ohälsa hos första linjens chefer inom vård och omsorg: En litteraturöversikt2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    First-line managers have a demanding position. For exemple as they often need to convey the management's decisions that they themselves do not decide on and at the same time have a good relationship with their employees. Many first-line managers choose to resign. The purpose of the study is to describe nurse managers' experiences of what in the work creates mental strain. A general literature study. 10 qualitative studies were reviewed and compiled into a result of 1 main theme and 3 sub-themes. The result presents the main theme: Difficult role to shoulder, was mainly about the complexity of the role of first-line manager, which often means having to be accountable to both management and employees. It also emerged that first-line managers need increased support in administration and stronger support from management. First-line managers also felt that they needed more education, especially in finance. The first-line manager often lack mandate to implement changes, but frequently needs to convey decisions that they themselves have not made. First-line managers who have received more support resources have proven to be more satisfied in their work role. More education is something that nursing managers who have terminated their employment have wished they had received. 

  • 5. Adriansson, C
    et al.
    Suserud, Björn-Ove
    University of Borås, School of Health Science.
    Bergbom, I
    The use of topical anaesthesia at children's minor lacerations: an experimental study2004In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 12, no 2, p. 74-84Article in journal (Refereed)
    Abstract [en]

    Background: In a great many situations within health care and treatment, children are subjected to unnecessary pain and suffering. When local anaesthetics is to be administered the child can experience this as incomprehensible especially when the nursing staff assures the child that no pain would be felt, only to discover soon after, that it actually did hurt at the moment of anaesthetic infiltration. The soothing of pain during the suturing of wounds in emergency wards can be reduced, ensuring that unnecessary pain in the cafe-and-treatment process is mot meted out to children. In order to prevent this (subjection to unnecessary pain), and by improving accepted practice, it was interesting to investigate whether children felt pain at the time of infiltration anaesthesia following the initial topical anaesthesia. Aim: The aim of the present study was to investigate the effects of introductory topical anaesthesia using Xylocain solution dropped in the wound prior to a definitive infiltration-anaesthesia. An experimental, prospective design was used where children were included in either an experimental group or a control group. The experimental group (n=10) were given a Xylocain solution while the control group (n=10) received physiological Sodium solution. Data collection for the study was made by making VAS estimates and by interviews. Result: The study shows that a certain alleviation of pain does occur when using Xylocain but no statistically significant difference exists between the two groups. Irrespective of whether the children received an introductory topical anaesthesia with Xylocain or Sodium solution at the time of infiltration anaesthesia, they expressed pain in connection with infiltration. The study also shows that many children express fear and anxiety. Conclusion: Current research highlights the difficulties involved in offering children a really satisfactory form of pain relief in connection with infiltration anaesthesia and suturing of wounds. It is urgent to throw more light on children’s pain, both from a nursing and from a medical point of view. No statistically significant difference was found in children’s reported pain, after treatment with Xylocain but the solution can have a positive effect at the time of the infiltration jab, but a larger study needs to be done in order to establish this firmly.

  • 6.
    Agic, Alma
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Norlander Ekberg, Erika
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Inget sitter i väggarna – Organisationskultur och ledarskap: Vägen till hållbart ledarskap inom vård och omsorg2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In Sweden, there is a collective goal of providing high-quality and equitable care on equal terms for all. The health and social care sector faces significant future challenges in the area of competence maintenance in order to be able to provide high-quality care. To attract and retain a workforce, it is of great importance to prioritize work environment management and strengthen leadership. An organization’s perspective on leadership impacts which managers are recruited and the conditions for how leadership is created and developed. Taking into consideration the size of work groups, mission statement, economic challenges and comparatively weak organizational support, first line managers within health and social care have complex assignments in comparison with managers in other sectors. Organizations within the health and social care sector have finalized values as a part of their marketing philosophy and the organizational culture desired by leadership, while workplaces have developed their own cultures and norms, which leads to first line managers being placed in the difficult position of balancing between these cultures. Previous research has demonstrated that sustainable leadership is of great importance for organizations, workplaces, and first line managers.   

    The purpose of this study was to, with a focus on health and social care, investigate to what extent the reciprocal relationship between leadership, psychological security, diverse organizational cultures and work cultures promotes sustainable leadership.  

    The method of this study is a qualitative one, based on interviews conducted with six first line managers from different areas within the health and social care sector, with the goal of investigating their experiences in order to gain an increased understanding of how organizational culture and workplace culture affect and are affected by leadership. We have analyzed and summarized these interviews in relation to the following categories: organizational culture, workplace culture, psychological security, leadership and sustainable leadership.  

    The results demonstrate a significant distinction between organizational culture and workplace culture, as well as their impact on first line managers and their leadership. Furthermore, they demonstrate that first line managers feel that leadership becomes less sustainable in relation to organizational culture, but more sustainable in relation to workplace culture. First line managers work extensively with the implementation of sustainable workplace cultures, where they stress the importance of a present and trustbased leadership.

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    fulltext
  • 7.
    Ahl, Caroline
    et al.
    University of Borås, School of Health Science.
    Hjälte, L
    Johansson, C
    Wireklint-Sundström, Birgitta
    University of Borås, School of Health Science.
    Jonsson, Anders
    University of Borås, School of Health Science.
    Suserud, Björn-Ove
    University of Borås, School of Health Science.
    Culture and care in the Swedish ambulance services2005In: Emergency Nurse, ISSN 1354-5752, E-ISSN 2047-8984, Vol. 13, no 8, p. 30-36Article in journal (Refereed)
  • 8.
    Ahl, Caroline
    et al.
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Jansson, L
    Making up one’s mind: Patients Experiences of Calling an Ambulance2006In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 14, no 1, p. 11-19Article in journal (Refereed)
    Abstract [en]

    The issue of the inappropriate use of ambulance transport and care has mainly been studied from the professionals’ and caregivers’ perspective, with few studies focusing on the patient and his/her experiences. To further understand whether patients use ambulance care in an inappropriate manner and, if so, why, it is important to obtain an overall picture of the patients’ existential situation at the time they call an ambulance. The aim of this study was to analyse and describe patients’ experiences related to the decision to call an ambulance and the wait for it to arrive. The design was explorative, and twenty informants aged between 34 and 82 years were interviewed. Qualitative content analyses were performed. The findings showed that calling for an ambulance is a major decision that is preceded by hesitation and attempts to handle the situation by oneself. Our conclusion is that the definition of inappropriate use of valuable health care resources should not be based solely on the professionals’ point of view but also take account of the patients’ reactions when they experience a threat to their life and health.

  • 9. Ahlstrom, Linda
    et al.
    Hagberg, Mats
    Dellve, Lotta
    University of Borås, School of Health Science.
    Workplace Rehabilitation and Supportive Conditions at Work: A Prospective Study2013In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 23, no 2, p. 248-260Article in journal (Refereed)
    Abstract [en]

    Purpose To investigate the impact of rehabilitation measures on work ability and return to work (RTW), specifically the association between workplace rehabilitation/supportive conditions at work and work ability and RTW over time, among women on long-term sick leave. Methods Questionnaire data were collected (baseline, 6 and 12 months) from a cohort of women (n = 324). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability index (WAI), work ability score and working degree. These analyses were performed with different models; the explanatory variables for each model were workplace rehabilitation, supportive conditions at work and time. Results The individuals provided with workplace rehabilitation and supportive conditions (e.g. influence at work, possibilities for development, degree of freedom at work, meaning of work, quality of leadership, social support, sense of community and work satisfaction) had significantly increased WAI and work ability score over time. These individuals scored higher work ability compared to those individuals having workplace rehabilitation without supportive conditions, or neither. Additionally, among the individuals provided with workplace rehabilitation and supportive conditions, working degree increased significantly more over time compared to those individuals with no workplace rehabilitation and no supportive conditions. Conclusion The results highlight the importance of integrating workplace rehabilitation with supportive conditions at work in order to increase work ability and improve the RTW process for women on long-term sick leave.

  • 10.
    Aidemark, Jan
    et al.
    Linnaeus University.
    Askenäs, Linda
    Linnaeus University.
    Nygårdh, Annette
    Jönköping University, HHJ, Avdelningen för omvårdnad.
    Strömberg, Anna
    Linköping University.
    User involvement in the co-design of self-care support systems for heart failure patients2015In: Procedia Computer Science, E-ISSN 1877-0509, Vol. 64, p. 118-124Article in journal (Refereed)
    Abstract [en]

    In this paper the nature of user involvement in a co-design process will be explored. The outlines of a research project aiming at developing support systems for self-care inpatients suffering from chronic heart failure will be presented. The project is planned to perform a co-design effort where users (patients and healthcare professionals) will be given the opportunity to influence the development of support systems. We will discuss a number of possibilities and challenges that lie in the design of this kind of project and also some findings from its early stages. This report presents the experiences of users’ input, which are discussed in the context of previous research on benefits of user contributions in systems development.

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    FULLTEXT01
  • 11.
    Alexandersson, Therese
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Johansson Thunebro, Anna
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Undersökning av undersköterskeprofessionen i äldreomsorgen: Med fokus på arbetsmiljö, yrkesroll och legitimation2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Inom äldreomsorgen arbetar undersköterskor och vårdbiträden sida vid sida, det finns inga skillnader mellan deras arbetsområde och arbetsuppgifter. Det enda som skiljer yrkesgrupperna åt är utbildningsnivå och titel. Deras arbetssituation inom äldreomsorgen kan vara mycket komplex på många sätt genom de oreglerade yrkesroller som råder. Arbetsuppgifterna är åtskilliga och det ställs höga krav på undersköterskor/vårdbiträden. Det behövs en tydligare struktur om vad som ingår i yrkesrollerna, med fokus på arbetsområden, ansvarsområden samt även vilken kompetens arbetsgivaren kan förvänta sig av yrkesgrupperna. Socialdepartementet har gjort en utredning kring undersköterskeyrket och beslutat om att ge undersköterskor en skyddad yrkestitel som bygger på ett nationellt utbildningsprogram. Beslutet kommer att träda i kraft 1 januari 2023. Ett nationellt yrkespaket innehållande 800 poäng från vård och omsorgsprogrammet har tagits fram för vårdbiträden. Tidigare forskning vittnar om att undersköterskor upplever kompetensbrist inom omvårdnadsområdet. Forskning visar även på en slitsam arbetsmiljö samt vikten av tydliga yrkesroller.

    Denna studie syftar till att studera undersköterskeprofessionen med fokus på arbetsmiljö, yrkesroll och en undersköterskelegitimation. Studien är en kvantitativ tvärsnittsstudie där 70 enkäter delats ut med tillhörande bilaga, genom ett tillfällighetsurval. Resultatet bygger på data från 61 insamlade enkäter plus bilaga. Data har analyserats i Statistical Product and Service Solutions (SPSS), som presenterats i frekvenstabeller och korstabeller. Resultatet visar på att över majoriteten av respondenterna upplever en stressad arbetsmiljö som resulterar i fysisk utmattning. Respondenterna upplever även att möjligheten att påverka sin arbetssituation är obefintlig. Resultatet styrker tidigare forskning om undersköterskornas otydliga yrkesroll. När det kommer till frågan om en undersköterskelegitimation, är respondenterna mycket positiva där de tror att en legitimation kan bidra till en ökad patientsäkerhet. 

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    K2021:9
  • 12. Almerud, S
    et al.
    Alapack, R.J.
    Fridlund, Bengt
    Växjö University.
    Ekebergh, Margaretha
    Växjö University.
    Beleuguered by technology: Care in technologically intense environments2008In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 9, no 1, p. 55-61Article in journal (Refereed)
    Abstract [en]

    Modern technology has enabled the use of new forms of information in the care of critically ill patients. In intensive care units (ICUs), technology can simultaneously reduce the lived experience of illness and magnify the objective dimensions of patient care. The aim of this study, based upon two empirical studies, is to find from a philosophical point of view a more comprehensive understanding for the dominance of technology within intensive care. Along with caring for critically ill patients, technology is part of the ICU staff's everyday life. Both technology and caring relationships are of indispensable value. Tools are useful, but technology can never replace the closeness and empathy of the human touch. It is a question of harmonizing the demands of subjectivity with objective signs. The challenge for caregivers in ICU is to know when to heighten the importance of the objective and measurable dimensions provided by technology and when to magnify the patients’ lived experiences, and to live and deal with the ambiguity of the technical dimension of care and the human side of nursing.

  • 13. Almerud, S
    et al.
    Alapack, R.J.
    Fridlund, Bengt
    Växjö University.
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Caught in an Artificial Split: A Phenomenological Study of Being a Caregiver in the Technologically Intense Environment2007In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 24, no 2, p. 130-136Article in journal (Refereed)
    Abstract [en]

    A symbiotic relationship exists between technology and caring, however, technologically advanced environments challenge caregivers. The aim of this study is to uncover the meaning of being a caregiver in the technologically intense environment. Ten open-ended interviews with intensive care personnel comprise the data. A phenomenological analysis shows that ambiguity abounds in the setting. The act of responsibly reading and regulating instruments easily melds the patient and the machinery into one clinical picture. The fusion skews the balance between objective distance and interpersonal closeness. The exciting captivating lure of technological gadgets seduces the caregivers and lulls them into a fictive sense of security and safety. It is mind-boggling and heart-rending to juggle ‘moments’ of slavish mastery and security menaced by insecurity in the act of monitoring a machine while caring for a patient. Whenever the beleaguered caregiver splits technique from human touch, ambiguity decays into ambivalence. Caring and technology become polarized. Everyone loses. Caregiver competence wanes; patients suffer. The intensive care unit should be technologically sophisticated, but also build-in a disclosive space where solace, trust, and reassurance naturally happen. Caring professionals need to balance state-of-the-art technology with integrated and comprehensive care and harmonize the demands of subjectivity with objective signs.

  • 14. Almerud, S
    et al.
    Alapack, R.J.
    Fridlund, Bengt
    Växjö University.
    Ekebergh, Margaretha
    Växjö University.
    Of vigilance and invisibility: being a patient in technologically intense environments2007In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 12, no 3, p. 151-158Article in journal (Refereed)
    Abstract [en]

    Equipment and procedures developed during the past several decades have made the modern intensive care unit (ICU) the hospital’s most technologically advanced environment. In terms of patient care, are these advances unmitigated gains? This study aimed to develop a knowledge base of what it means to be critically ill or injured and cared for in technologically intense environments. A lifeworld perspective guided the investigation. Nine unstructured interviews with intensive care patients comprise its data. The qualitative picture uncovered by a phenomenological analysis shows that contradiction and ambivalence characterized the entire care episode. The threat of death overshadows everything and perforates the patient’s existence. Four inter-related constituents further elucidated the patients’ experiences: the confrontation with death, the encounter with forced dependency, an incomprehensible environment and the ambiguity of being an object of clinical vigilance but invisible at the personal level. Neglect of these issues lead to alienating ‘moments’ that compromised care. Fixed at the end of a one-eyed clinical gaze, patients described feeling marginalized, subjected to rituals of power, a stranger cared for by a stranger. The roar of technology silences the shifting needs of ill people, muffles the whispers of death and compromises the competence of the caregivers. This study challenges today’s caregiving system to develop double vision that would balance clinical competence with a holistic, integrated and comprehensive approach to care. Under such vision, subjectivity and objectivity would be equally honoured, and the broken bonds re-forged between techne, ‘the act of nursing’, and poesis, ‘the art of nursing’.

  • 15.
    Alonso, Rocio
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Srour, Hanan
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    "Utbildningen gav bekräftelse och förståelse för det egna ledarskapet": en kvalitativ intervjustudie av första linjens chefers upplevelser av arbetet som chef inom hälso- och sjukvården efter genomgången ledarskapsutbildning2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Ledarskapsutbildningar har på senare tid blivit allt vanligare att erbjuda chefer samtidigt som studier visar att dessa utbildningar behöver vara förankrade med den organisation där de erbjuds. Utöver utbildning spelar de organisatoriska förutsättningarna en betydande roll i utövandet av ett gott ledarskap. Syftet med studien är att ta del av första linjens chefers upplevelser av arbetet som chef inom hälso- och sjukvården efter genomgången ledarskapsutbildning. Detta med fokus på chefers upplevelser av ledarskapsutövande och huruvida det finns främjande eller hindrande faktorer i utövandet av ett gott ledarskap. Vi valde att fokusera på första linjens chefer inom hälso- och sjukvården som tagit del av en ledarskapsutbildning de senaste fem åren. Elva informanter intervjuades kring deras upplevelser av genomgången ledarskapsutbildning samt deras erfarenheter av ledarskap i den organisation som de var verksamma inom. Utifrån syftet valdes en kvalitativ intervjustudie med induktiv ansats som metod för den här studien. Resultatet visade att utbildningen både gav självkännedom och nätverkande med andra chefer. Vidare skildrade informanterna upplevelsen av sina erfarenheter med arbetet inom hälso- och sjukvården i ljuset av stora arbetsgrupper och den inverkan detta haft på utövandet av ledarskapet. Informanterna lyfte omfattande utmaningar i ledarskapet utifrån arbetsplatser de arbetat på som haft begränsade resurser, stora arbetsgrupper, detaljstyrning och administrativ belastning. Slutsatsen av studien är att ledarskapsutbildningar bidrar med positiva resultat. Hälso- och sjukvården behöver dock se över de organisatoriska förhållandena som råder för första linjens chefer, för att möjliggöra utövandet av ett gott ledarskap.

     

  • 16.
    Alvestorm, Anneli
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lidén, Anneli
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Chefsbyten inom äldreomsorgen: En intervjustudie kring hur första linjens chefers arbete med verksamhetsutveckling inom äldreomsorgen påverkas av chefsbyten2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Forskning visar att 20 procent av första linjens chefer inom äldreomsorgen slutar på sin arbetsplats inom två år. Arbetet som chef är komplext och en stor del av arbetstiden innefattar möten och administrativa arbetsuppgifter. Verksamhetsutveckling är en ständigt pågående process i äldreomsorgen där första linjens chef arbetar för resultat av en god vård- och omsorg. Forskning kring hållbart ledarskap visar att tillgången till stöd i arbetet har påverkan på det egenupplevda arbetsförhållandet. Syftet med studien är att undersöka om första linjens chefers arbete med verksamhetsutveckling påverkas av chefsbyten.

    I studien valdes en kvalitativ metod med semistrukturerade intervjuer för att lyfta fram första linjens chefers upplevelser och erfarenheter. Totalt deltog åtta chefer i studien som alla är verksamma inom äldreomsorg. Intervjuerna analyserades i en kvalitativ innehållsanalys. Resultatet redovisar ett huvudtema: hur verksamhetsutveckling påverkas av chefsbyten. Huvudtemat redovisas vidare i tre underteman: förutsättningar i arbetet som chef, kvalitetsarbete och ökad arbetsbelastning. I diskussionen framkommer likheter och skillnader i relation till tidigare forskning och chefers upplevelser. Chefsbyten och tillgång till stöd påverkar arbetet med verksamhetsutveckling och visar sig vara betydelsefullt för såväl arbetsmiljö, organisationens hållbarhet och utveckling. Arbetsbelastning ökar för chefer och arbetsgrupper blir otrygga och saknar stabilitet. Tillgången till stöd ser olika ut och är ytterligare en faktor som påverkar arbetet med verksamhetsutveckling. 

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    K2022:8
  • 17.
    Alwén, Erzsébet
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Wessman, Carin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Kommunernas rekryteringsprocess: HR i praktiken2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Rekryteringsprocessens utformning och utövande är helt avgörande för att verksamheten ska kunna fortsätta att utvecklas samt nå uppsatta mål och visioner. Hur arbetsgivare rekryterar på ett professionellt och tillförlitligt sätt kräver kompetens. Organisationer idag har i regel en egen personalavdelning som inriktar sig på att rekrytera nya medarbetare. Många organisationer som anställer personer i betydande positioner använder sig av externa rekryteringsföretag. Rekrytering är en omfattande och kostnadskrävande process, men att göra rekryteringsprocessen rätt från början kan bli förhållandevis billigare än en felrekrytering. Rätt person på rätt plats kräver planering och framförhållning för att den tilltänkta ska kunna matcha in perfekt förtjänsten.

    Syftet är att beskriva rekryteringsprocessen inom kommunalt verksamhetsområde och i vilken utsträckning befintliga HRM processer upplevs som ett stöd i arbetet för enhetschefer inom rekrytering. Åtta intervjuer med informanter i ledande befattning inom den kommunala organisationens sociala sektor har genomförts. Studiens resultat visar på svårigheter i många delar under hela rekryteringsprocessen. Detta orsakas delvis av lagföreskrifter och delvis utav huruvida den rekryterande chefen anser sig behöva följa den utav strategisk Human Resource personal utarbetade rekryteringsprocessen.

    I vilken utsträckning cheferna tog hjälp av Human Resource avdelningen eller bemanningsenheten vid rekrytering varierade i omfattning bland deltagarna. Gemensamt för kommunerna var att det i samband med en chefsrekrytering lades ner mer resurser i form av tid och pengar på att det skulle bli rätt. Författarna fick en känsla av att rekryterande enhetschefer i större utsträckning kontaktade ansvarig Human Resource personal i samband med arbetsrättsliga processer och inte i lika stor utsträckning i samband med själva rekryteringsprocessen.

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    K2015:56
  • 18.
    Amoding, Caroline
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Friman, Amelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Vårdledarskapets påverkan av sjuksköterskors val att stanna kvar eller lämna arbetsplatsen: En integrativ litteraturstudie2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    There is a global shortage of nurses. Many choose to leave the nursing profession due to various reasons. The nursing profession is complex and entails great responsibility and requires competence. Despite the fact that many nurses have left their profession, they are generally very positive about nursing as a career. Staff turnover among nurses is a challenge for healthcare, which also affects the quality of care and the work environment. In order to reduce staff turnover, it is of great importance that the care manager commits to keeping nurses in the workplace. The aim of this study was to highlight the influence of care leadership on nurses' choice to stay or leave the workplace. The study is an integrative literature study and emerged through an inductive content analysis. Databases used CINAHL and PubMed. Results were taken from 20 scientific articles between the years 2012–2022. In order for the nurses to enjoy their work, there needed to be an available care manager who knew his staff. The nurses needed to have the opportunity for competence development and professional challenges. There needed to be a demonstrated humanity and caring understanding from the care manager and the nurses wanted to receive feedback on their work. Clear communication and support from the care manager was important for the nurses to want to stay at the workplace. Lack of support and understanding from the care managers were factors that contributed to the nurses choosing to leave their workplace. The inductive approach produced three main categories: Organizational work management design, development opportunities and supportive environment. These areas were found to be of importance in the nurses' decision to stay or leave.

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    fulltext
  • 19.
    Andersson, Andréa
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Tegelmark, Linnea
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Genomsyras omvårdnadsarbetet av den nationella värdegrunden i Äldreomsorgen?2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    2011 skrevs den nationella värdegrunden i socialtjänstlagen. Med denna bestämmelse skulle det bli tydligare med de etiska normer och värden som skulle ligga till grund för vård-och omsorgen i Sverige. Värdegrundens innehåll handlar om att Sveriges äldreomsorg skall inriktas så att den äldre får leva ett värdigt liv och känna välbefinnande. Den nationella värdegrunden har nu varit aktiv i åtta år och frågan är om omvårdnadsarbetet genomsyras av dess innehåll gentemot brukaren? Syftet med studien var att undersöka om brukaren anser att beviljade insatser samt dess utförande genomsyras av den nationella värdegrunden. Analysen av framarbetat material har gjorts med kvalitativ innehållsanalys med grund i semistrukturerade intervjuer. I analysen framträdde tre huvudkategorier; välbefinnande, bemötande och självbestämmande. Med efterföljande nio underkategorier; trygghet, god vård, engagerad personal, attityd, kompentens, lyhörd, delaktighet, individanpassning och kontroll. Utifrån dessa kategorier påvisades att graden av delaktighet och självbestämmande hos brukarna varierade. Resultatet visar på att brukaren helst vill välja vilka av omvårdnadspersonalen som skall utföra insatserna. I diskussionen förs fram att respondenterna upplever att de inte alltid är delaktiga i hur och när insatser utförs.

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    K2018:51
  • 20.
    Andersson, Gunilla
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Stenmarck, Ulrika
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Konsten att hålla sig frisk: En intervjustudie med medarbetare inom äldreomsorgen2020Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Sick leave and staff turnover is high in the healthcare system where its professionals work environment is very often demanding. Nonetheless, some organizations have succeeded in maintaining low absence due to sickness. What keeps the personnel in these organizations healthy? The aim of this study is to investigate which strategies employees in the public healthcare system apply to maintain their health and what they acknowledge to be a contributive factor for a healthier workplace and a more health promoting work environment. We have, with content analysis as a working tool, reviewed a total of nine health workers interviews.

    The result shows that the employees have developed both strategies and acquired a sort of inner drive that helps them to handle their working situation. What improves their happiness at work are the colleagues, that gives them a sense of security and creates comfort. The importance of the working group is central to the result. Through the creation of routines, by helping and having fun together the group succeeds in pushing through day-to-day challenges. Leadership on the other hand is considered to be relatively inexistent. A balance between recovery and stimulating activities contributes in replenishing energy that health workers consider to be key to guarantee a healthier work-life. The ambition with this study is to provide answers regarding the purpose but also serve as a basis for a discussion from a sustainability perspective. This in order to that organizations in the healthcare business continue developing whilst focusing on promoting health and sustainability as much as possible, both for the present and future generations.

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    M2020:12
  • 21.
    Andersson, Hanna
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hagberg, Linda
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    En intervjustudie av hemtjänstpersonalens upplevelse av sin psykosociala arbetsmiljö2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Den psykosociala arbetsmiljön handlar om måendet på arbetsplatsen i relation till bland annat krav, resurser, fördelning av arbetsuppgifter, ledning, kommunikation, socialt samspel och delaktighet. Det diskuteras ofta i media om svårigheter med personalförsörjning inom äldreomsorgen och signaler om stress från de anställda.

    Syftet med studien var att undersöka hur omvårdnadspersonal inom hemtjänst upplever sin psykosociala arbetsmiljö. För att uppfylla syftet är studien baserad på semistrukturerade intervjuer och det framarbetade materialet har analyserats med hjälp av kvalitativ innehållsanalys. Analysen genererade i fem huvudkategorier; Arbetstrivsel, arbetsuppgifter, ledarskap, samarbete och stress och ett antal underkategorier som namngivits efter innebörd. Utifrån kategorierna framkom att det kollegiala stödet är betydelsefullt på arbetsplatsen för en god arbetsmiljö. Arbetet upplevs som viktigt och det känns meningsfullt att hjälpa andra. Kommunikation och information anses grundläggande utifrån ledarskap och en mer synlig chef önskas. Samarbetet upplevs överlag bra men åsikter framkommer om att det borde kunna fungera bättre. Känsla av stress gör sig påtaglig utifrån att det inte sällan råder tids och personalbrist. I diskussionen förs fram att det finns flera orsaker till fysisk och mental trötthet inom yrkeskategorin och respondenterna upplever flera av dessa i vilket avseende frågan väcks om hur vida de i en förlängning ska orka.

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    K2020:3
  • 22.
    Andersson, Ida
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ljungberg, Nadia
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Möjligheter och hinder i samverkan mellan olika vårdinstanser2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    En av förutsättningarna för en vård av god kvalitét, med hög patientsäkerhet är en fungerande samverkan mellan de inblandade vårdinstanserna. Det går idag att se brister gällande samverkan och hur det inom vården arbetas med ett stuprörstänk, resultatet blir att det finns en risk för att vårdtagaren ”faller mellan stolarna” och insatserna blir fördröjda eller helt uteblir. Författarna ser identifierande av hinder och möjligheter som viktigt för samverkan och i studien görs en begränsning till att studera upplevelsen av samverkan mellan enhetschefer och patientansvariga sjuksköterskor på vård och omsorgsboenden närmare.

    Genom semistrukturerade frågor intervjuades tre enhetschefer och tre patientansvariga sjuksköterskor på vård och omsorgsboenden, materialet analyserades och resultatet av analysen presenteras i tre huvudkategorier och nio subkategorier. Organisatoriska förutsättningar som upplevdes främja god samverkan var närheten till varandra och att befinna sig i samma hus, det i sig underlättar även för de samverkansfrämjande och spontana dialogsituationer som ofta sker. Strukturer och mötesrutiner upplevdes även de vara samverkansfrämjande förutsättningar. Försvårande eller hindrande förutsättningar för samverkan var att trots att enhetschefer och sjuksköterskor har samma arbetsgivare så lyder professionerna under olika organisationer. Sjuksköterskorna upplevde även dokumentationssystemen som ett hinder gällande samverkan då de olika systemen gör att de inte kan ta del av varandras dokumentation. Vad som ytterligare upplevdes som hinder i- och till samverkan, av både enhetschefer och sjuksköterskor var den höga personalomsättningen, sjukfrånvaron och samtidigt höga arbetsbelastningen. 

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    K2022:13
  • 23. Andersson, Johanna
    et al.
    Löfström, Mikael
    University of Borås, School of Business and IT.
    Bihari Axelsson, Susanna
    Axelsson, Runo
    Actor or arena: Contrasting translations of a law on interorganizational integration2012In: Journal of Health Organization & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 26, no 6, p. 778-793Article in journal (Refereed)
    Abstract [en]

    Purpose – A Swedish framework law has enabled integration between public agencies in vocational rehabilitation. With the support of this law, coordination associations can be formed to fund and organize joint activities. The purpose of this study is to describe and analyze how the law has been interpreted and translated into local coordination associations and how local institutional logics have developed to guide the organization of these associations. Design/methodology/approach – Data was collected through observations of meetings within two coordination associations and supplemented with documents. The material was analyzed by compilation and examination of data from field notes, whereupon the most important aspects were crystallized and framed with institutional organization theory. Findings – Two different translations of the law were seen in the associations studied: the association as an independent actor, and as an arena for its member organizations. Two subsequent institutional logics have developed, influencing decisions on autonomy, objectives and rationality for initiating and organizing in the two associations and their activities. The institutional logics are circular, further enhancing the different translations creating different forms of integration. Research implications/limitations – Both forms of integration are legitimate, but the different translations have created integration with different degrees of autonomy in relation to the member organizations. Only a long-term analysis can show whether one form of integration is more functional than the other. Originality/value – This article is based on an extensive material providing insights into a form of interorganizational integration which has been scarcely researched. The findings show how different translations can influence the integration of welfare services.

  • 24.
    Andersson, Karolina
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Stenström Kyobe, Clara
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Upplevd användbarhet av kunskap förvärvad inom högskolestudier på magisternivå: "Vad upplever sig studenterna ha lärt sig och hur?"2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    För fortsatt positiv utveckling av vård- och omsorgssektorn krävs goda ledare med gedigen utbildning. Hållbarheten inom sektorn påverkas av flera faktorer och kräver holistiskt nytänkande. Trots tidigare förändringar och hälsofrämjande ledarskapsstilar väntar flera utmaningar framtidens chefer. För balans mellan krav och resurser och för att öka anställningsbarheten krävs en röd tråd av teori-praktik-vetenskap från utbildningar till arbetsliv. För att kompetens ska upplevas användbar är det nödvändigt att kunna använda den i vardagen inom organisationen. Organisationer behöver skapa gemensam struktur på väg mot samma mål. Magisterutbildningar ska vara utvecklande och hjälp i framtida arbetssituationer och syftet med studien var att undersöka och analysera alumnistudenters upplevda användbarhet av de, under distansutbildningen, förvärvade kunskaperna kring hållbarhet, organisation och hälsofrämjande ledarskap.

    Studien genomfördes med semistrukturerade intervjuer av kvalitativ karaktär och 13 informanter inkluderades och intervjuades. Intervjuerna transkriberades och analyserades systematiskt med tematisk innehållsanalys. Utbildningens upplägg var krävande men avgörande för informanterna. De flesta informanterna gick utbildningen för att höja kompetensen och öka meritvärdet och flera ansåg att kursutbudet behövde vidgas och engagemanget höjas. Utbildningen, vilken resulterade i högskoleexamen, medverkade inte till byte av arbete men däremot till förbättrad livskvalitet. Slutligen ansåg informanterna det viktigt att vara en närvarande, kommunikativ och utvecklingsbar chef, som tar tillvara medarbetarnas kompetens. Dock lyftes omodern organisation och bristande resurser som hämmande. Informanterna belyste sin upplevda svårighet att använda de teoretiska kunskaperna i praktiken, en kunskap som bäst fås då arbete och studier utförs parallellt. I takt med utbildningens stigande ålder uppfattades alumnistudenterna mer kritiska och behov av utveckling av magisterprogrammet uppgavs av desamma. 

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    M2022:64
  • 25.
    Andersson, Ulf
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. University of Borås.
    Andersson Hagiwara, Magnus
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Wireklint Sundström, Birgitta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Andersson, Henrik
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Maurin Söderholm, Hanna
    University of Borås, Faculty of Librarianship, Information, Education and IT. University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Clinical Reasoning among Registered Nurses in Emergency Medical Services: A Case Study2022In: Journal of Cognitive Engineering and Decision Making, ISSN 1555-3434, E-ISSN 2169-5032Article in journal (Refereed)
    Abstract [en]

    In emergency medical services (EMS), the clinical reasoning (CR) of registered nurses (RNs) working in ambulance care plays an important role in providing care and treatment that is timely, accurate, appropriate and safe. However, limited existing knowledge about how CR is formed and influenced by the EMS mission hinders the development of service provision and decision support tools for RNs that would further enhance patient safety. To explore the nature of CR and influencing factors in this context, an inductive case study examined 34 observed patient–RN encounters in an EMS setting focusing on ambulance care. The results reveal a fragmented CR approach involving several parallel decision-making processes grounded in and led by patients’ narratives. The findings indicate that RNs are not always aware of their own CR and associated influences until they actively reflect on the process, and additional research is needed to clarify this complex phenomenon.

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    fulltext
  • 26. Andreasson, J
    et al.
    Jonsson, A
    Suserud, Björn-Ove
    University of Borås, School of Health Science.
    Åström, S
    Ambulance personnel should take pictures at the sites of accidents!2001In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 26-27, no 98, p. 3162-3163Article in journal (Other academic)
    Abstract [sv]

    Bror Gårdelöf och Thomas Blomberg ställer i Läkartidningen 8/01 (sidorna 856-8) frågan om vem som skall fotografera på olycksplats. Per Örtenwall ifrågasätter i Läkartidningen 15/01 (sidorna 1825-6) om olyckan överhuvudtaget skall fotograferas. Författarna är sedan ett år verksamma i ett av de forskningsprojekt i Västra Götalandsregionen som Per Örtenwall nämner. Syftet är att utröna om bilder tagna på olycksplats tillför patienten och vården något av värde.

  • 27.
    Andreasson, Jörgen
    et al.
    University of Borås, School of Health Science.
    Eriksson, Andrea
    Dellve, Lotta
    University of Borås, School of Health Science.
    Health care manager’s views on and approaches to implementing models for care processes.2014Conference paper (Refereed)
    Abstract
  • 28.
    Andreasson, Jörgen
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. 1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    Åhlström, Linda
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Eriksson, Andrea
    1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    The importance of nurse managers’ preconditions and support resources for their attitude and work with improved quality of care2015Conference paper (Refereed)
  • 29. Arman, Rebecka
    et al.
    Wikström, Ewa
    Dellve, Lotta
    University of Borås, School of Health Science.
    Structuration in Managerial Communication Processes2012In: Offentlig Förvaltning. Scandinavian Journal of Public Administration, ISSN 2000-8058, E-ISSN 2001-3310, Vol. 16, no 2, p. 143-163Article in journal (Refereed)
    Abstract [en]

    The aim of this article is to describe and analyse observed managerial communication. The research questions concerned: What characterizes managerial communication practices and the organizational consequences? We make use of structuration theory and view communication as a social interaction process in which temporary structures are negotiated. Ten first- and second-line managers were shadowed. The managers used a combination of structuration of caring, interdependency and accountability typical of health care organizations. The communication practices were related to how new norms of reputation management were institutionalized through structuration. The types of structuration were sometimes contradictory and productive communication was rare or non-existent. The managerial communication practices had consequences for the power and domination and for which issues were signified as part of the agenda. The conclusions can be generalizable to other professional organizations.

  • 30.
    Augustsson, Elisabeth
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Emanuelsson, Susann
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Förfrågningsunderlag: och dess betydelse som kvalitetsindikator för hemtjänst2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Lagen om valfrihet (LOV) infördes bl.a. för att underlätta för fler att starta egna företag inom vård och omsorg, men också för att samhällets medborgare skulle se en ökning av kvalité i utförandet av dessa tjänster. Kommunerna har ansvaret för socialtjänsten och genom att införa LOV ger de uppdraget vidare till en privat utförare. De kvalitetskrav för dem som ansöker om att starta hemtjänst, har kommunerna beskrivit i sina förfrågningsunderlag (FFU).

    Avsikten med studien är att få en bild av hur kommunerna säkerställer en god kvalitet inom hemtjänsten med hjälp av FFU och hur kraven i FFU följs upp. För att få en inblick i hur det kan se ut, sammanställdes kraven i FFU från tio kommuner och med hjälp av tre intervjuer med LOV ansvariga påvisas att kraven som ställs i FFU är olika mellan kommunerna. Kvalité är ett ord vars innebörd är svårfångat och har olika betydelser för olika individer. Samtidigt framgår det att det är ett komplext arbete att följa upp de krav som ställs i FFU och att det är få av kraven som kommunerna följer upp genom att ange uppföljningsmetod i FFU.

    Många kommuner har idag lokala värdegrundsgarantier för att beskriva vilka etiska värden som präglar äldreomsorgen och vad de äldre kan förvänta sig, olika ”löften” som utlovas till medborgarna. Garantierna är dock väldigt olika mellan kommunerna och är många gånger svåra att finna i FFU. I vår diskussion tar vi upp vilka möjligheter kommunen har att följa upp kvalitet i verksamheter som lagts ut på privata aktörer.

    Vår slutsats är att förfrågningsunderlagens betydelse som en kvalitetsindikator kan ifrågasättas.

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    K2017:46
  • 31. Aune, S
    et al.
    Herlitz, Johan
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Bång, Angela
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Characteristics of patients who die in hospital with no attempt at resuscitation2005In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 65, no 3, p. 291-299Article in journal (Refereed)
    Abstract [en]

    Objective: To describe the characteristics, cause of hospitalisation and symptoms prior to death in patients dying in hospital without resuscitation being started and the extent to which these decisions were documented. Materials and methods: All patients who died at Sahlgrenska University Hospital in Göteborg, Sweden, in whom cardiopulmonary resuscitation (CPR) was not attempted during a period of one year. Results: Among 674 patients, 71% suffered respiratory insufficiency, 43% were unconscious and 32% had congestive heart failure during the 24 h before death. In the vast majority of patients, the diagnosis on admission to hospital was the same as the primary cause of death. The cause of death was life-threatening organ failure, including malignancy (44%), cerebral lesion (10%) and acute coronary syndrome (10%). The prior decision of ‘do not attempt resuscitation’ (DNAR) was documented in the medical notes in 82%. In the remaining 119 patients (18%), only 16 died unexpectedly. In all these 16 cases, it was regarded retrospectively as ethically justifiable not to start CPR. Conclusion: In patients who died at a Swedish University Hospital, we did not find a single case in which it was regarded as unethical not to start CPR. The patient group studied here had a poor prognosis due to a severe deterioration in their condition. To support this, we also found a high degree of documentation of DNAR. The low rate of CPR attempts after in-hospital cardiac arrest appears to be justified.

  • 32. Aune, S
    et al.
    Karlsson, T
    Herlitz, Johan
    University of Borås, School of Health Science.
    Evaluation of 2 different instruments for exposing the chest in conjunction with a cardiac arrest2010In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 29, no 5, p. 549-553Article in journal (Refereed)
    Abstract [en]

    Background Time between onset of previous termcardiac arrestnext term and start of treatment is of ultimate importance for outcome. The length of time it takes to expose the previous termchestnext term in out-of-hospital previous termcardiac arrestnext term (OHCA) is not known. We aimed to compare the time from onset of OHCA until the time at which the previous termchestnext term was exposed using previous termanext term new device (S-CUT; ES Equipment, Gothenburg, Sweden) and previous termanext term pair of scissors. Methods In previous termanext term manikin study, the previous term2next term devices were compared in previous termanext term simulated previous termcardiac arrestnext term where the initial step was exposure of the previous termchest.next term The tests were performed using ambulance staff from 3 previous termdifferentnext term ambulance organizations in Western Sweden. Six previous termdifferentnext term types of clothing combinations were used. The primary choices of clothing for analyses were previous termanext term knitted sweater and shirt (indoors) and previous termanext term jacket with buttons, previous termanext term shirt, and previous termanext term college sweater (outdoors). Results The mean difference from onset of OHCA until the previous termchestnext term was exposed when S-CUT was compared with previous termanext term pair of scissors varied between 6 seconds (P = .006) and 63 seconds (P = .004; shorter with the S-CUT), depending on the type of clothing that was used. The mean differences for the clothing that was chosen for primary analyses were 23 and 63 seconds, respectively. Conclusion We found that previous termanext term new device (S-CUT) used for previous termexposing the chestnext term in OHCA was associated with previous termanext term marked shortening of procedure time as compared with previous termanext term pair of scissors.

  • 33.
    Avinlin, Tara
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Arbetsmiljö och arbetsrelaterade stressens påverkan på sjuksköterskor och patientsäkerhet inom akutsjukvården: En systematisk litteraturstudie2021Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Today, work-related stress in healthcare, especially for nurses, is a very extensive problem that causes a lot of misery for both patients and nurses. Work-related stress is an interaction that consists of an incorrect adaption between environmental requirements and personal abilities. Severe stress can increase nurses' risk of adverse health risks conditions such as anxiety and depression. Leadership is a key factor in dealing with challenges in healthcare and a process in which an individual influences a group of people to achieve a common goal. It is care provider's obligation to provide good care of quality that complies with the health and medical services act, by preventing injuries. It is also to the employer's advantage to have positive work environments that are characterized by innovative frameworks that focus on recruitment, retention, strategies for further training and promotion, sufficient compensation for employees and sufficient equipment that constitutes a safe workplace.

    The purpose of this study is to investigate how work environment and work-related stress can affect nurses and patient safety in emergency care, from the nurses' perspective. The applied method is a literature study and is based on 16 articles of both qualitative and quantitative nature. Only articles with full text in English that were not older than 10 years were included in this study. The analysis identified four main themes: stressors, deficiencies in the work environment, deficiencies in leadership & compromised patient safety. The study shows that work-related stress not only affects nurses' health and development, but also patient safety. Staff shortages, high workloads and overcrowding are among the highest stress factors in emergency care. Lack of career opportunities and meaning in work are also risk factors that generate stress at work an affect the nurses' health and quality of life. Good leadership within an organization is the key to a healthy and sustainable work environment where employees can maintain patient’s safety and develop their profession.

  • 34.
    Axelsson, C
    et al.
    University of Borås, School of Health Science.
    Borgström, J
    Karlsson, T
    Axelsson, Å
    Herlitz, Johan
    University of Borås, School of Health Science.
    Dispatch codes of out-of-hospital cardiac arrest should be diagnosis related rather than symptom related2010In: European journal of emergency medicine, ISSN 0969-9546, E-ISSN 1473-5695, Vol. 17, no 5, p. 265-269Article in journal (Refereed)
    Abstract [en]

    Objective: To describe the characteristics and outcome in out-of-hospital cardiac arrest (OHCA) in relation to (i) whether OHCA was coded by the dispatcher as a diagnosis or as a symptom and (ii) the delay until the first unit was alerted at the dispatch centre. Methods: OHCA patients in Göteborg, during 17 months, excluding OHCA after calling the rescue team. Results: Among 250 cases, 20% were coded as a diagnosis (i.e. CA) with or without ongoing cardiopulmonary resuscitation (CPR). Dispatch codes for the remaining 200 patients (80%) were mostly symptom related (unconsciousness in 61%, codes related to breathing problems in 10%, other codes in 24% and missing in 5%). Patients in whom the dispatchers coded the call as CA had an earlier start to CPR after collapse (median 2 vs. 10 min; P<0.0001) and a higher rate of bystander CPR (86% vs. 42%; P<0.0001). Furthermore, they tended to have a higher rate of survival to hospital discharge (14.0% vs. 6.5%; P  = 0.09). The median delay until the first unit was alerted was 1.8 min. Survival to hospital discharge was 10.0% if the delay was below median and 6.7% if the delay was above median (P = 0.48). Conclusion: Patients with OHCA who were not coded by dispatchers as such had a long delay to the start of CPR and a low survival. Dispatching according to diagnosis, that is, CA seems to improve these parameters most likely reflecting a more optimal communication between the dispatcher and the caller as well as the rescue team.

  • 35.
    Axelsson, Christer
    University of Borås, School of Health Science.
    Evaluation of various strategies to improve outcome after out-of-hospital cardiac arrest with particular focus on mechanical chest compressions2010Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Cardiopulmonary resuscitation (CPR) skills vary among health care professionals. A previous study revealed that chest compressions were only performed half the time in out-of-hospital cardiac arrest (OHCA). Field conditions and fatigue could be possible explanations. The aim of this thesis was to study the impact of the introduction of mechanical chest compression in OHCA according to survival and its usability and b) passive leg raising (PLR), to augment the artificial circulation, during CPR. ... mer Methods: This thesis is based on a pilot study conducted in the Gothenburg/Mölndal and Södertälje Emergency Medical Service systems in 2003-2005. Witnessed OHCA (adult >18 years) received either mechanical (n=159) or manual (n=169) chest compressions. The pressure of end-tidal carbon dioxide (PETCO2) has been shown to correlate with cardiac output (CO) during CPR. To compare the effect of the different strategies, the PETCO2 was measured, during CPR, with standardised ventilation. Result: PLR during CPR increased the PETCO2 value within 30 seconds. Mechanical active compression-decompression (ACD) CPR, compared with manual compressions, produced the highest mean of initial, minimum and average values of PETCO2. However, mechanical chest compressions did not appear to result in improved survival. Clinical circumstances such as unidentified cardiac arrests (CAs) resulted in a large drop-out in the intervention group or a late start to the intervention in relation to CA. The late start meant that the intervention targeted a high-risk population with a low chance of survival. The majority of identified CAs were coded by the Rescue Co-ordination Centre (RCC) according to symptoms (usually unconsciousness), while the minority were coded according to the diagnosis of CA. Patients coded according to the diagnosis of CA had an earlier start of CPR, a higher rate of bystander CPR and a tendency toward higher survival rates. Conclusion: Since PLR during CPR appears to improve circulation after OHCA, larger studies are needed to evaluate its potential effects on survival. Compared with manual compressions, mechanical ACD CPR produces probably the most effective CPR. However, different clinical circumstances make the device difficult to study outside hospital. Coding a CA according to diagnosis rather than symptoms appears to improve the out-of-hospital care.

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  • 36.
    Axelsson, Marie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Winge, Anna
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Den kommunala enhetschefens organisatoriska och sociala arbetsmiljö: Krav, förväntningar och ansvar2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Studien undersöker den kommunala enhetschefens arbetsmiljö i en västsvensk kommun utifrån organisatorisk- och social arbetsmiljö som hänger samman med ekonomiska, sociala och politiska strukturer. Författarna vill ta reda på hur det är att arbeta i detta komplexa uppdrag med dess krav, förväntningar, ansvar och ekonomiska förutsättningar. Genom en enkätstudie har data samlats in. Totalt lämnades 50 enkäter ut till enhetschefer inom den kommunala äldreomsorgen i en västsvensk kommun. Enhetschefens uppdrag är komplext och genom att undersöka hur uppdraget uppfattas av enhetschefer inom kommunal äldreomsorg ges en bild av yrkesrollens krav, förväntningar och ansvar. Samt hur det påverkas av yrkeserfarenhet och antalet medarbetare.

    Resultatet visade att respondenterna i det stora hela är nöjda med sin organisatoriska och sociala arbetsmiljö. Erfarenhet har betydelse för hur trygg enhetschefen känner sig i uppdraget. Till viss del påverkas uppdraget av antalet medarbetare då enhetschefen inte anser sig ha tillräckligt med tid för sina medarbetare och skulle önska en högre närvaro. En stor del av arbetsdagen ägnas åt att lösa akuta problem och det påverkar övriga arbetsuppgifter som att nå uppsatta mål och långsiktigare strategier framåt. Enhetschefen ska förhålla sig till lagar och riktlinjer men med krav och förväntningar från medarbetare, brukare och anhöriga blir yrkesrollen en utsatt position för arbetsrelaterad stress. Stor del av arbetstiden ägnas åt att lösa akuta problem istället för att arbeta långsiktigt och strategiskt.

  • 37.
    Axelsson, Sofia
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Jonnestedt, Maj
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Rätt förutsättningar leder till hälsofrämjande ledarskap: Chefers förutsättningar inom vård och omsorg2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Vi lever i dag med ett högt tempo i hela samhället vilket visar sig inte minst på våra arbetsplatser. Det höga tempot resulterar därmed också i att många medarbetare mår dåligt på sin arbetsplats och i många fall leder detta till sjukfrånvaro både i kortare och längre perioder. Chefskapet medför stora krav som att medarbetarna ska må bra på sin arbetsplats, fysiskt och inte minst psykiskt. Vad kan då en chef inom vård och omsorg göra för att medarbetarna ska må bra? Vi har valt att titta närmare på det. Närmare bestämt på vilka faktorer som avgör att en chef lyckas med att arbeta hälsofrämjande för att på sikt resultera i att medarbetarna mår bra. Syftet med studien är att komma fram till vilka förutsättningar en chef behöver ha för att ha ett hälsofrämjande ledarskap. Granskningen är en litteraturstudie som grundas på vetenskapliga artiklar, både av kvalitativ och kvantitativ design.

    Efter att granskat de olika artiklarna så visar resultatet behovet av utbildning, handledning och ett organisatoriskt stöd för att lyckas i rollen som chef. Förutsättningarna har en stor betydelse och positiv effekt på hur cheferna hanterar ledarskapet och på sikt bedriver ett hälsofrämjande arbetsklimat på arbetsplatsen. Resultaten visar även att små förändringar genom stöd eller utbildning har avgörande inverkan på personalens hälsa i form av minskad stress, högre närvaro och lägre personalomsättning.

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    K2018:57
  • 38.
    Baltovic Tuominen, Susanna
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lygren, Moa
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Vad anser sjuksköterskor vara en attraktiv arbetsgivare?: En kvalitativ intervjustudie om hur arbetsgivare inom vård och omsorg kan stärka sitt arbetsgivarvarumärke2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Sweden's Municipalities and Regions and the Statistics Authority (SCB) predict that there will be a shortage of nurses in the future. The need to improve skills supply work exists and one way is to strive towards becoming a more attractive employer with a stronger employer brand. The purpose of the essay is to find out which factors are important for nurses in order for them to consider an employer attractive and want to work there. Seven professional nurses with varying experience in the profession were interviewed and answered open questions regarding, among other things, relationships in the workplace, development opportunities, the experience of what is important in the workplace, the view of the employer and recruitment. The interviews were transcribed and analyzed using a content analysis.

    The result shows that employers need to value their staff. In addition, good leadership is required, which means, among other things, a manager who sees all employees, is fair, makes the employees involved by making use of their skills and ideas. In addition to that, functioning work groups are required that contribute to well-being in the workplace. In order to retain nurses, they need to be able to work with patients, to benefit, to have an adequate salary, to be able to work with development, and to have time and resources to provide good care. Employers need to understand the pride that exists in the nursing profession and that nurses are not only hands in care, but that their biggest motivator in the profession is the patients. Nurses want to be seen as competent employees who can contribute with knowledge and experience, and the employer needs to see, value and above all take advantage of that. These are factors an employer needs to know in order to be able to develop a strong employer brand within healthcare.

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    M2022:68
  • 39.
    Bartholomäus, Christian
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Sepic, Atif
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Evidensbaserat ledarskap: Enskildas och delande chefers väg till hållbarhet?2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Dagens hälso- och sjukvård är präglad av föränderlighet. Kunskap om undersökningar och behandlingsmetoder hinner snabbt åldras och det utvecklas ständigt nya metoder och teorier för att effektivisera, förbättra, förkorta och underlätta för framför allt patienter men också för omvårdnadspersonal. Evidensbaserad vård har under de senaste decennierna fått en allt större betydelse och spelar en stor roll i det dagliga arbetet med patienter. Evidensbaserad vård är också en utav sjuksköterskors kärnkompetenser och stimulerar till utveckling och behandling i enlighet med den senaste forskningen. Men till skillnad från tex sjuksköterskor som baserar sin kompetens på evidens, visar aktuell forskning att evidensbaserat ledarskap ännu inte är integrerat i ledarskapets dagliga arbete och implementeringen är hittills bristfällig.

    Studiens syfte är att jämföra om chefer som är verksamma inom delat ledarskap har bättre förutsättningar att arbeta evidensbaserat än de chefer som är verksamma inom enskilt ledarskap. Dessutom vill författarna undersöka om första linjens chefer känner till och är förtrogna med begreppet evidensbaserat ledarskap och i vilken utsträckning denna modell används för att skapa hållbara processer och beslut. För att besvara studiens frågeställningar användes en webbaserad enkät. Det förelåg ingen signifikant skillnad mellan de cheferna som är verksamma inom delat resp. enskilt ledarskap med avseende på kunskaper samt användningen av evidensbaserat och hållbart ledarskap. Det som var avgörande utifrån studieresultaten var antalet medarbetare som chefer var direkt ansvariga för.

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    M2018:59
  • 40.
    Baruti, Dafina
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Blombrink, Dennise
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Det coachande ledarskapet i vården: En begreppsanalys2023Independent thesis Basic level (Higher Education Diploma (Fine Arts)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Ett begrepp som fått allt mer uppmärksamhet inom ledarskap är det coachande ledarskapet (coaching leadership). Det coachande ledarskapet handlar om att ge förutsättningar så att medarbetarna kan utvecklas vilket man strävar efter i det coachande ledarskapet och nå sin fulla potential. Syftet är att belysa det coachande ledarskapet med hjälp av begreppsanalys utifrån Walker och Avant modell. Resultatet utgörs av en lexikal del och en litterär del som leder till att definiera meningsbärande attribut och sedan till framträdande attribut för att förklara begreppet. I den litterära analysen beskrivs de framträdande attributen som är: utveckling, självständighet, främja engagemang, förutsättningar och kompetensutveckling. Tre fiktiva fallbeskrivningar utformades för att beskriva och förtydliga begreppet. Avslutningsvis diskuteras hur det coachande ledarskapet och dess attribut förhåller sig ur ett ledarskapsperspektiv.  

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    k2023_8
  • 41.
    Bayard, Anna-Stina
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Molin, Malin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Leda närvarande, tydligt och ödmjukt: Intervjuer med medarbetare i primärvården och deras syn på ledarskapet2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    For many people, work is the basis for a good life, where the person thrives and finds a context. Employees are a prerequisite for being able to provide and conduct care and social care. Employees needs need to be met for a sustainable working life. Conditions for managers to maintain health-promoting leadership in todays increasingly pressured care organization can be a challenge. A good working environment with a supportive working climate can form important parts of a sustainable working life. There is a risk that employees needs will be overshadowed when the focus is on finances and new development goals. Leadership is important for employee well-being and commitment in the workplace.

    The purpose of the study is to describe employees perceptions of how the manager can give and show support to employees in primary care. The study has been conducted via seven semi-structured interviews. The results resulted in three categories: present manager, promoting participation in the work group and communication. In order to be able to act sustainably as a manager and be able to rest in the fact that employees can find support in each other, a culture of trust is required in the workplace. A present manager who promotes participation in the work group and has the ability to communicate can strengthen support among employees.

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    M2022:76
  • 42.
    Bedro, Marlen
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ousi, Zahra
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Arbetsglädje hos medarbetare: enhetschefers erfarenheter av att skapa arbetsglädje bland medarbetare på arbetsplatser inom palliativ vård2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Arbetsglädje har många positiva effekter och är av stor betydelse för de anställdas hälsa och nöjdhet hos patienterna och närstående i verksamheterna inom hälso- och sjukvården. En organisations goda arbetsmiljö kan bidra till att medarbetarna är friska och mår bra, vilket motiverar att anställda stannar kvar på sin arbetsplats samt ger ekonomiska framgångar för organisationen. Upplever medarbetare problem i arbetsmiljön och att de inte trivs på arbetsplatsen, leder det till produktionsbortfall.

    Syftet med denna studie är att undersöka vad enhetschefer har för erfarenheter av att skapa arbetsglädje för medarbetare inom verksamheter som arbetar med palliativ vård. Den metod som valdes var en kvalitativ intervjustudie med induktiv ansats. Datainsamlingen bestod av åtta stycken semistrukturerade intervjuer. Resultatet av denna studie visade att det som har betydelse för hur enhetscheferna skapar arbetsglädje för sina medarbetare är följande fyra kategorier: Socialt kapital, medarbetarskap, ledarskap och kommunikation. Respondenterna definierade begreppet arbetsglädje på liknande sätt och ansåg att det var en subjektiv upplevelse.

  • 43. Beillon, Lena Marie
    Att värdera vårdbehov: ett kliniskt dilemma. En studie av nyttjandet av ambulanssjukvård i olika geografiska områden2010Doctoral thesis, monograph (Other academic)
    Abstract [sv]

    De nordiska ländernas hälso- och sjukvård bygger på att sjukvården finns till hands när den behövs. För att ge företräde för de individer som har störst vårdbehov genomförs inom olika verksamheter vårdbehovsprioriteringar. Behovet av prioriteringar tilltar i takt med att efterfrågan på hälso- och sjukvårdens insatser ökar. Skälet till att göra prioriteringar inom hälso- och sjukvården är att upprätthålla en god vård med god effekt till dem som bäst behöver den. Även om hälso- och sjukvården kvantitativt spelar en begränsad roll för folkhälsan, utgör den en viktig del i samhället genom att skapa trygghet. Särskilt betydelsefullt i detta avseende är akutsjukvård varav ambulanssjukvård är en viktig del.

  • 44. Bengtsson, I
    et al.
    Karlson, B
    Herlitz, Johan
    University of Borås, School of Health Science.
    Haglid Evander, M
    Währborg, P
    A 14-year follow-up study of chest pain patients including stress hormones and mental stress at index event2012In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 154, no 3, p. 306-311Article in journal (Refereed)
    Abstract [en]

    Background Knowledge of long-term outcome in chest pain patients is limited. We reinvestigated patients who 14 years earlier had visited the emergency department due to chest pain, and were discharged without hospitalization. Extensive examinations were made at that time on 484 patients including full medical history, exercise test, a battery of stress questions and stress hormone sampling. Methods From a previously conducted chest pain study patients still alive after 14 years were approached. Hospitalization or deaths with a diagnosis of ischemic heart disease or cerebrovascular disease were used as end point. Results During the follow-up period 24 patients had died with a diagnosis of ischemic heart or cerebrovascular disease, and 50 patients had been given such a diagnosis at hospital discharge. Age (OR 1.12, CI 1.06–1.19), previous history of angina pectoris (OR 9.69, CI 2.06–71.61), pathological ECG at emergency department visit (OR 3.27, CI 1.23–8.67), hypertension (OR 5.03, CI 1.90–13.76), smoking (OR 3.04, CI 1.26–7.63) and lipid lowering medication (OR 14.9, CI 1.60–152.77) were all associated with future ischemic heart or cerebrovascular events. Noradrenalin levels were higher in the event group than in the non-event group, mean (SD) 2.44 (1.02) nmol/L versus 1.90 (0.75) nmol/L. When noradrenalin was included in the regression model high maximal exercise capacity was protective of an event (OR 0.986, CI 0.975–0.997). Conclusion In chest pain patients previous history of angina pectoris, hypertension, smoking, pathological ECG at primary examination, and age were the main risk factors associated with future cardiovascular or cerebrovascular events.

  • 45.
    Benson, Ingrid
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Börjesson, Victoria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Enhetschefers arbete med att skapa goda arbetsförhållanden för medarbetare med ADHD: En kvalitativ intervjustudie som lyfter betydelsen av kognitiv arbetsmiljö inom vård och omsorg2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Inom vård och omsorg är arbetskraven höga, vilket har lett till att förekomsten av psykisk ohälsa ökar. Risken att drabbas av ohälsa i arbetslivet är större för medarbetare som har ADHD än för övriga, trots att de har rätt till att få samma möjligheter i arbetet, under samma villkor, som alla andra. Svenskt arbetsliv är välreglerat vad gäller arbetsmiljö och tillgänglighetsaspekter. Forskningen visar att det är lönsamt att inkludera medarbetare med funktionsnedsättning för att optimera verksamheter. Den är däremot begränsad vad gäller hur enhetschefer inom vård och omsorg arbetar för att underlätta för sina medarbetare med ADHD och säkerställa att de, liksom övriga medarbetare, kan få nyttja sin kompetens och hålla sig friska.

    Denna studie syftar till att undersöka enhetschefers arbetserfarenheter och strategier för att skapa goda arbetsförhållanden för medarbetare med ADHD. Studien utgörs av en kvalitativ intervjustudie, i vilken sex transkriberade intervjuer analyserades med hjälp av induktiv innehållsanalys. Resultatet visade att enhetscheferna upplevde en begränsning i sitt arbete med att skapa goda arbetsförhållanden. Det framkom att enhetscheferna hade varierade erfarenheter och använde sig av olika strategier i arbetet men att de inte delgivits någon kompetensutveckling från arbetsgivarens sida. Förhoppningen är att denna uppsats kan bidra till att belysa vikten av kognitiv arbetsmiljö och tillgänglighet för medarbetare med ADHD samt synliggöra behovet av en ökad kunskap om ADHD i arbetslivet, som ett led i arbetet för ökad hållbarhet inom vård och omsorg, där hållbarhet innebär att vårda de resurser som finns i verksamheterna.

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    K2022:14
  • 46.
    Bergerum, Carolina
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Patient and public involvement in hospital quality improvement interventions: the mechanisms, monitoring and management2022Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This dissertation focuses on the mechanisms, monitoring and management of patient and public involvement in hospital quality improvement (QI) interventions. Findings from a literature review generated an initial programme theory (PT) on active patient involvement in healthcare QI interventions (Paper 1). Empirical studies were also undertaken in order to describe what was actually happening in the hospital QI teams and what patients and professionals experience influence their joint involvement (Paper 2), and to compare hospital leaders’ and managers’ experiences of managing QI interventions involving patients and the public (Paper 3). Finally, it was studied how patient-reported measures stimulate patient involvement in QI interventions in practice (Paper 4). The research had a qualitative design. The approach was descriptive and comparative, and the studies were carried out prospectively. Data were collected in two hospital organisations in Sweden and in one hospital organisation in the Netherlands. Data collection methods were a literature search (Paper 1), interviews and field observations (Paper 2 and 3) and data collection meetings (Paper 4). Altogether, 93 team meetings and meetings between the team leaders and management were attended and a total of 20 days of study visits with different forms of meetings were made. Twelve patients, 12 healthcare professionals and 17 and 8 hospital leaders and managers, respectively, participated in the interviews and data collection meetings. Realist synthesis was used to formulate the initial PT (Paper 1). Constructivist grounded theory was used to analyse and describe what was happening in the QI teams and how it was experienced by the team members (Paper 2). To compare hospital leaders’ and managers’ different, contextual meanings in Sweden and the Netherlands, the reflexive thematic analysis informed by critical realism was used (Paper 3). To order, manage and map data from 31 examples of local QI interventions associated to patient-reported measures, the framework method was used (Paper 4). The results formulate a generic PT on the mechanisms, monitoring and management perspectives of co-produced QI interventions in hospital services where patients and the public are involved. The PT provides a hypothesis on the various mechanisms at play and outcomes obtained at the different levels of hospital organisations in the process. It is argued that focus should be on experiences, interaction, relationships and dialogue, integration of context, and the matching of hospital resources to patient and public demands and needs. Subsequently, the outcome will be the resources and reasoning interplay resulting in actions and processes, experiences and knowledge, ‘product’ benefits, emotions, judgements and motivations. Monitoring constitutes an important feedback loop to enable such learnings. The PT aligns the perspectives of the clinical microsystem, improvement science and the service-dominant logic, and has a potential to explain how patient and public involvement in QI interventions might work.

  • 47.
    Bergerum, Carolina
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Johan, Thor
    Jönköping University.
    Josefsson, Karin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Wolmesjö, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    How might patient involvement in healthcare quality improvement efforts work—A realist literature review2019In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 00, no 00, p. 1-13Article in journal (Refereed)
    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.

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  • 48.
    Bergius, Marie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Claesson, Martin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Chefers hantering av mellanmänskliga konflikter inom hälso- och sjukvård: En litteraturöversikt om konflikthanteringsstrategier2021Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In health care organizations, conflicts are inevitable, constantly occurring and a natural part of the workplace. Decreased health in the form of occupational illnesses and stress can be attributed to unhandled workplace conflicts. Despite this, many nurse managers experience discomfort and difficulties with how conflicts should be handled.

    Aim: This study aimed to compile current research and present an overall picture of different conflict management strategies relevant to health care administration during the years 2010-2021. This is to contribute to the sustainable management of interpersonal conflicts in health care in order to promote a health-promoting work environment.

    Method: Systematic literature study with a qualitative approach. The analysis was performed by synthesizing and compiling twelve primary scientific studies with both a qualitative and quantitative approach.

    Results: Our result indicates a causal relationship between demographic factors and the choice of conflict management strategy. Furthermore, the results show that there is an awareness among managers that compromising, integrative and active conflict management generally is the most effective, but some studies indicate that avoidant and dominated strategies is prevalent. The results also show that managers use several different conflict management strategies.

    Conclusion/Discussion: Effective conflict management positively affects occupational health, organizational efficiency, and the quality of care. Therefore, we believe that conflict management should be a priority area for managers and management training in healthcare. There is a lack of studies based on the Swedish context, causation and choice of conflict management strategies, and connection to occupational health. Further research is needed to achieve and enable sustainable and health-promoting leadership. 

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    M2021:53
  • 49.
    Bergqvist, Elin
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Roos, Camilla
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Första linjens chefers upplevelser av kompetensförsörjning inom kommunal äldreomsorg2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Med en ökad andel äldre befolkning ökar behoven av en välfungerande äldreomsorg. Samtidigt är det svårt att både rekrytera och behålla medarbetare med rätt kompetens för att ge en omsorg av god kvalitet. Första linjens chefer är ansvariga för bemanning av sin verksamhet, men har samtidigt bristande organisatoriska förutsättningar. Vilket leder till stora utmaningar inom deras verksamheter. Syftet med denna studie är att undersöka hur första linjens chefer inom kommunala särskilda boenden upplever kompetensförsörjningen inom sin verksamhet. För att besvarar syftet i studien har en kvalitativ metod med induktiv ansats valts med intervjuer. Resultatet grundar sig på tio informanter som arbetar som första linjens chefer på särskilda boenden inom äldreomsorgen i två kommuner i Sverige. Slutsatsen i den här studien är att första linjens chefer inom kommunala särskilda boenden saknar förutsättningar och organisatoriska stöd för att rekrytera och behålla medarbetare med rätt kompetens.

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    M2022:65
  • 50.
    Bergström, Ida
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ellberg, Siri
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Sammanställning av kunskapsläget kring vad som skapar en hälsofrämjande organisatorisk och social arbetsmiljö inom hälso- och sjukvård: En systematisk och integrativ litteraturöversikt2021Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    During the 2000s, the health service has undergone major organizational changes at the same time as they have faced increased demands for high-quality care. This affects the employees' work situation and can lead to increased workload and stress. Research shows that a good organizational and social work environment contributes to well-being. Something that makes people stay. Previous research and employers' efforts have mostly focused on risks and negative factors that contribute to sick leave. A health-promoting perspective, where the organization focuses on what promotes the good in the workplace, creates well-being and promotes organizational and social sustainability over time. Health-promoting environment work needs to take place in several dimensions where the psychosocial work environment is the focus for well-being. Organizational and social work environment is characterized by factors which, unlike the physical work environment, are subjectively abstract and which need to be included in the health promotion work. This study compiles the state of knowledge about what creates a health-promoting organizational and social work environment in health care, through a systematic literature study. The findings that were made were that Organizational conditions and workplace-related resources such as social support, autonomy, purpose (meaningfulness) are key factors in a health-promoting work environment. These interact and overlap systematically. They affect and are influenced by each other both individually and together. This argues that there are many benefits for organizations in investing in employee well-being. Health-promoting organizational and social work must take place within the organization as it constitutes a determinant of employee well-being and well-being. The organization needs to support the individual's autonomy and also offer social support and other supportive functions. The organization needs to involve employees and help them increase their sense of meaning.  

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    M2021:55
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