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Sundström, M., Petersson, P., Rämgård, M., Varland, L. & Blomqvist, K. (2018). Health and social care planning in collaboration in olderpersons’ homes: the perspectives of older persons, familymembers and professionals. Scandinavian Journal of Caring Sciences, 32(1), 147-156
Open this publication in new window or tab >>Health and social care planning in collaboration in olderpersons’ homes: the perspectives of older persons, familymembers and professionals
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2018 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 1, p. 147-156Article in journal (Refereed) Published
Abstract [en]

Providing health and social care to older persons is challenging, since older persons often have multiple diseases and a complex health situation. Hence many professions and organisations are involved. Lack of interprofessional and interorganisational collaboration leads to fragmented care. Care planning meetings before hospital discharge have long been used to overcome this fragmentation, but meetings conducted at the hospital have limitations in identifying long-term needs at home. A new model for health and social care planning in collaboration (HSCPC) in older persons' homes was introduced in two Swedish municipalities. The aim of this study was to gain a deeper understanding of the HSCPC-meeting from the perspectives of older persons, family members, and professionals. Ten care planning meetings from two municipalities were consecutively included. Interviews in retrospect with ten older persons, eight family members, and ten groups of professionals who had attended the HSCPC-meeting at home were analysed with a hermeneutic approach. Four themes emerged: unspoken agendas and unpreparedness, security and enhanced understanding, asymmetric relationships, and ambiguity about the mission and need for follow-up. The comprehensive interpretation is that the professionals handled the HSCPC-meeting mainly as a routine task, while the older persons and family members viewed it as part of their life course. Older persons are in an inferior institutional, cognitive and existential position. However, meeting together in the home partly reduced their inferior position. Findings from this study provide some general suggestions for how HSCPC-meetings should be designed and developed: attention of power relations, the importance of meeting skills and follow-up.

Keywords
Care planning; collaboration; elderly; family; hermeneutic; home care; life course; person-centred; qualitative study
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hkr:diva-16816 (URN)10.1111/scs.12440 (DOI)000426524200014 ()28543670 (PubMedID)
Available from: 2017-05-31 Created: 2017-05-31 Last updated: 2018-04-03Bibliographically approved
Larsen, A., Broberger, E. & Petersson, P. (2017). Complex caring needs without simple solutions: the experience of interprofessional collaboration among staff caring for older persons with multimorbidity at home care settings. Scandinavian Journal of Caring Sciences, 31(2), 342-350
Open this publication in new window or tab >>Complex caring needs without simple solutions: the experience of interprofessional collaboration among staff caring for older persons with multimorbidity at home care settings
2017 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 2, p. 342-350Article in journal (Refereed) Published
Abstract [en]

Background: Older persons with multimorbidity being cared for at home often have complex needs which can´t be met by one player. Interprofessional collaboration is therefore considered necessary if care is to be organised according to the needs of the elderly. To achieve coherent healthcare, municipalities and regions need to develop this area.

Aim: The aim of the study was to illustrate how various professionals belonging to homemaker services, home care services in municipality and Hospital-Based Home Care Services experience their collaboration in caring for older persons with multimorbidity.

Method: Eleven informants took part in the study and individual interviewed. The material was analysed using a hermeneutic data analysis.

Result: The result shows that collaboration between players contains various types of experiences which influence not only the staff who are involved in collaboration but also the result of the collaboration itself. The informants´ experience of collaboration was defined by trust and distrust and by security and insecurity. These influenced both the staff who were involved in collaboration and the result of collaboration itself.

Conlusion: Complex situations could not be solved with simple models. Instead a flexible approach appears necessary with focus shifted from structures to interpersonal relations and interactions. Therefor the different professions have to work as a transprofessional team where close interactions, flexibility and improvisation is a key to success.   

Relevance to clinical practice: A transprofessional approach to teamwork collaboration can blur professional boundaries and take the competence of all staff into account when home health care to older people with multimorbidity is to be provided by multiple caregivers. This is suggested as an approach with potential to provide high quality and safe care to a vulnerable population.

Keywords
Multimorbidity, Collaboration, Teamwork, Hermeneutic, Hospital based home care services, Home care services
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hkr:diva-15438 (URN)10.1111/scs.12352 (DOI)000404644100015 ()27439763 (PubMedID)
Available from: 2016-05-13 Created: 2016-05-13 Last updated: 2017-08-21Bibliographically approved
Näslund, A. & Peterson, P. (2016). Förebyggande hembesök i Osby kommun: åtgärder äldre personer utfört efter hembesöket. Kristianstad: Kristianstad University Press
Open this publication in new window or tab >>Förebyggande hembesök i Osby kommun: åtgärder äldre personer utfört efter hembesöket
2016 (Swedish)Report (Other academic)
Abstract [sv]

Samhället står inför förändringar som innebär att andelen personer över 65 år har ökatoch över tid även de närmsta åren kommer att öka. För att möta den ökande andelenäldre i samhället behövs förebyggande insatser. Ett sätt att arbeta förebyggande äratt göra hembesök som syftar till att bibehålla självständighet och god hälsa. Osbykommun har sedan 2006 arbetat förebyggande med att besöka 75 åringar i ordinärtboende. För att kunna utvärdera effekten av verksamheten i Osby behövs det kunskapom hur personerna förhåller sig till rekommendationer som ges och vilka åtgärder devidtar. Denna studie syftade till att undersöka vilka åtgärder äldre personer utfört efteratt de fått ett förebyggande hembesök. En kvantitativ ansats valdes för att utförastudien. Enkäter sändes ut till 147 personer som fått förebyggande hembesök under6 månader. Frågorna som ställdes handlade om säkerhet i hemmet, träning och rörelse,mat och måltider samt kontakter angående hälsa. Svarsfrekvens var 83 personervilket motsvarar 56%. Analyser av enkäten gjordes i analysverktyget SPSS utifrånsignifikansprövning enligt McNemar och logistisk regression. Statistik togs fram på hurmånga som utfört åtgärder innan besöket och hur åtgärderna ökade efter rekommendationernasom lämnats under samtalet. Resultatet visade att signifikans uppmättespå flera områden runt säkerhet i hemmet och träning och rörelse. Flera av de som fåttförebyggande hembesök utförde åtgärder efter besöket inom dessa områden. Majoritetenav de äldre rörde på sig aktivt efter besöket och flertalet genomförde åtgärdersom förbättrade säkerheten i hemmet. Ingen signifikans framkom i de logistiska regressionernamellan kön, ålder, ensam/sammanboende eller läge på bostaden och deberoende variablerna, det vill säga insatser gällande säkerhet i hemmet, träning ochrörelse, mat och måltider samt kontakter angående hälsa. Studien har ett litet urvalvilket gör det svårt att dra slutsatser utifrån de framkomna resultaten. På det antalindivider som besvarat enkäten framkom att samtalet hade effekt och att åtgärderutfördes efter de rekommendationer som gavs. Distriktssjuksköterskorna påverkar desom besökts till att bli delaktiga runt förändringar i sin vardag. Vidare behövs fler studierför att resultatet ytterligare ska kunna säkerställas.

Place, publisher, year, edition, pages
Kristianstad: Kristianstad University Press, 2016. p. 36
Series
Forskningsplattformen för Hälsa i samverkan, ISSN 1652-9979 ; 3
Keywords
Förebyggande hembesök, äldre personer, prevention, hälsa
National Category
Nursing
Identifiers
urn:nbn:se:hkr:diva-16375 (URN)
Available from: 2016-12-28 Created: 2016-12-28 Last updated: 2016-12-29
Lamminsaari, T. & Peterson, P. (2016). Uppsökande verksamhet i Osby kommun: Äldre personers perspektiv. Kristianstad: Kristianstad University Press
Open this publication in new window or tab >>Uppsökande verksamhet i Osby kommun: Äldre personers perspektiv
2016 (Swedish)Report (Other academic)
Abstract [sv]

Syftet med denna studie var att beskriva äldres upplevelser och erfarenheter av uppsökandeverksamhet i Osby kommun. Förebyggande hälsoinsatser för äldre bedrivs iSverige med olika benämningar. I Osby kommun bedrivs de med benämning uppsökandeverksamhet. Uppsökande verksamhet med förebyggande insatser och råd kanstärka äldres egenvård och skjuta upp funktionsnedsättning samt förbättra den äldrepersonens välbefinnande och livskvalitet. Ur samhällsekonomiskt perspektiv kan uppsökandeverksamhet också minska kostnader för vård och omsorg på sikt.Metoden är en kvalitativ intervjuundersökning med öppna frågor. Studien genomfördesunder juni- november år 2015 och tio äldre personer intervjuades. Av dessa var detfem kvinnor och fem män. Intervjuerna analyserades enligt Graneheim och Lundmanskvalitativa innehållsanalys.I resultatet framkom två kategorier och sju subkategorier. Essenserna som hittadesfrån intervjuerna var: förväntningar, tillit i mötet, attityder till förändring, information,utförarens kompetens och personlighet, vikten av relation och kreativitet. Resultatetvisar tydligt att äldre upplever arbetet med uppsökande verksamhet värdefullt och villse detta arbete fortsätta.Denna studie ger utan tvekan stöd att utföra uppsökande verksamhet och uppsökandeverksamhet kan ses som en redskap för de äldre att skapa bra förutsättningar att bevarahälsan och ger möjlighet till ett aktivt och självständigt liv.

Place, publisher, year, edition, pages
Kristianstad: Kristianstad University Press, 2016. p. 35
Series
Forskningsplattformen för Hälsa i samverkan, ISSN 1652-9979 ; 4
Keywords
Äldre personer, uppsökande verksamhet, upplevelser, förebyggande
National Category
Nursing
Identifiers
urn:nbn:se:hkr:diva-16376 (URN)
Available from: 2016-12-28 Created: 2016-12-28 Last updated: 2016-12-29Bibliographically approved
Rämgård, M., Blomqvist, K. & Petersson, P. (2015). Developing health and social care planning in collaboration. Journal of Interprofessional Care, 29(4), 354-358
Open this publication in new window or tab >>Developing health and social care planning in collaboration
2015 (English)In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 29, no 4, p. 354-358Article in journal (Refereed) Published
Abstract [en]

Collaboration between different professions in community care for older people is often both difficult and complex. In this project, a participatory action research (PAR) was conducted in order to support the professions involved in the care for older people to develop individualized health and social care plans. Cases from daily work were discussed in different professional groups over a period of one year. A key finding was that lack of knowledge regarding the other professions' field of expertise and their underlying professional culture and values was a barrier in their collaboration. However, as the continuous reflective dialogue process progressed, the participants began to reflect more about the importance of collaboration as a prerequisite to achieve the best possible care for the recipient. This process of reflection led to the often complex needs of the care recipients being given a more central position and thus care plans being better tailored to each person's needs.5

Keywords
Interprofessional collaboration, action research, health and social care
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hkr:diva-13497 (URN)10.3109/13561820.2014.1003635 (DOI)000359817300010 ()25633427 (PubMedID)
Available from: 2015-02-09 Created: 2015-02-09 Last updated: 2017-12-04Bibliographically approved
Augustinsson, S. & Petersson, P. (2015). On discharge planning  : dynamic complex processes – uncertainty, surprise and standardisation. Journal of Research in Nursing, 20(1), 39-53
Open this publication in new window or tab >>On discharge planning  : dynamic complex processes – uncertainty, surprise and standardisation
2015 (English)In: Journal of Research in Nursing, ISSN 1744-9871, E-ISSN 1744-988X, Vol. 20, no 1, p. 39-53Article in journal (Refereed) Published
Abstract [en]

How can discharge planning (DP) for patients who require care in the home following a period in hospital be understood and developed through the lenses of complexity theory? With the help of complexity theory and practice-based narrative research this study discloses the formal routines and complex dynamic practices that are associated with DP. A study of the literature established that there was an almost total absence of complexity-theoretical perspectives on interpreting and developing DP.                 

The researchers collected narratives about the DP processes using qualitative interviews with the nurses responsible for this in a hospital ward: these were audio-recorded and transcribed verbatim. They also participated in and documented meetings where these nurses, as a group, discussed DP.                 

The findings show that nurses have to continuously deal with uncertainty, surprises and the unknown. They have to make sense and take charge of dynamic complex events and new knowledge, and manage complex relations and information. The researchers argue that looking upon practice from the lenses of complexity theory, and therefore accepting the complexity of practice, could facilitate the development of nurses' skills in order to guarantee good quality in DP.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hkr:diva-11499 (URN)10.1177/1744987114564257 (DOI)
Available from: 2013-12-20 Created: 2013-12-20 Last updated: 2017-12-06Bibliographically approved
Blom, L., Petersson, P., Hagell, P. & Westergren, A. (2015). The SBAR model for communication between health care professionals: a clinical intervention pilot study.. International Journal of Caring Sciences, 8(3), 530-535
Open this publication in new window or tab >>The SBAR model for communication between health care professionals: a clinical intervention pilot study.
2015 (English)In: International Journal of Caring Sciences, ISSN 1791-5201, E-ISSN 1792-037X, Vol. 8, no 3, p. 530-535Article in journal (Refereed) Published
Abstract [en]

Background: SBAR has been suggested as a means to avoid unclear communication between health care professionals and in turn enhance patient safety in the healthcare sector.

 

Aim: to evaluate hospital-based health care professionals experiences from using the Situation, Background, Assessment and Recommendation (SBAR) communication model.

 

Methodology: A quantitative, descriptive, comparative pre- and post-intervention questionnaire-based pilot study before and after the implementation of SBAR at surgical hospitals wards. Open comments to questionnaire items were analyzed qualitatively.

 

Results: The introduction of SBAR increased the experience of having a well-functioning structure for oral communication among health care professionals regarding patients’ conditions. Qualitative findings revealed the categories: Use of SBAR as a structure, Reporting time, Patient safety, and Personal aspects.

 

Conclusions: SBAR is perceived as effective to get a structure of the content in patient reports, which may facilitate patient safety.

Keywords
SBAR, communication, health care professionals, patient safety
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hkr:diva-15019 (URN)
Available from: 2015-11-16 Created: 2015-11-16 Last updated: 2017-12-01Bibliographically approved
Sundström, M., Blomqvist, K., Petersson, P. & Rämgård, M. (2014). Factors for improving Health and Social Care Planning in Collaboration (HSCPC): a Participatory Action Research project. Oral presentation at Nordic Conference in Nursing Research. Odense 2014. In: : . Paper presented at Nordic Conference in Nursing Research.
Open this publication in new window or tab >>Factors for improving Health and Social Care Planning in Collaboration (HSCPC): a Participatory Action Research project. Oral presentation at Nordic Conference in Nursing Research. Odense 2014
2014 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Objective: A recent project to develop Health and Social Care Plannings in Collaboration (HSCPC) resulted in a new model for care plannings in older persons’ homes. After having used the model for about six months, the management and participating professionals asked researchers for support to evaluate the model. In particular they wanted to know how the older persons experienced the HSCPC and how the model could be improved.

Methodology: We used a Participatory Action Research approach and invited older persons, their relatives and professionals who had participated in HSCPC. The older persons and their relatives were interviewed individually two weeks after the HSCPC and the profes- sionals from the same care planning took part in focus groups. The professionals and the management were also invited to participate in feedback sessions.

Results: Older persons, relatives and professionals expressed an overall positive attitude to HSCPC. In particular they appreciated that the meeting was held in the older persons’ homes and that the older persons were able to express their own experiences and wishes. Preparation of the meeting, communications skills during the meeting and follow up’s were areas that should be improved. During the feed- back sessions, professionals and management came up with ideas of how to handle improvement needs.

Conclusion: The initial development project became an established part of everyday practice characterized by an endeavor to make continuous improvements. Thus, it could be viewed as a triple-helix project.

National Category
Nursing
Identifiers
urn:nbn:se:hkr:diva-13410 (URN)
Conference
Nordic Conference in Nursing Research
Projects
Erfarenheter av vård och omsorgsplanering i samverkan
Available from: 2015-01-15 Created: 2015-01-15 Last updated: 2015-01-19Bibliographically approved
Petersson, P., Blomqvist, K. & Rämgård, M. (2014). Using participatory action research in the development of a model for health and social care planning in collaboration. In: : . Paper presented at Nordic Conference in Nursing Research - Methods and Networks for the future, 10-12 June 2014, Odense, Denmark.
Open this publication in new window or tab >>Using participatory action research in the development of a model for health and social care planning in collaboration
2014 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hkr:diva-13152 (URN)
Conference
Nordic Conference in Nursing Research - Methods and Networks for the future, 10-12 June 2014, Odense, Denmark
Available from: 2014-10-28 Created: 2014-10-28 Last updated: 2014-12-07Bibliographically approved
Blomqvist, K. & Petersson, P. (2014). Vårdkedjans aktörer och organisering (2ed.). In: Anna Ehrneberg & Lars Wallin (Ed.), Omvårdnadens grunder: ansvar och utveckling (pp. 167-196). Lund: Studentlitteratur
Open this publication in new window or tab >>Vårdkedjans aktörer och organisering
2014 (Swedish)In: Omvårdnadens grunder: ansvar och utveckling / [ed] Anna Ehrneberg & Lars Wallin, Lund: Studentlitteratur, 2014, 2, p. 167-196Chapter in book (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Lund: Studentlitteratur, 2014 Edition: 2
National Category
Nursing
Identifiers
urn:nbn:se:hkr:diva-11374 (URN)978-91-44-08354-4 (ISBN)
Available from: 2013-12-08 Created: 2013-12-08 Last updated: 2014-12-07Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-3393-7484

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