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  • 1.
    Bergerum, Carolina
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Kullén Engström, Agneta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Thor, Johan
    Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, P.O. Box 1026, S-55111, Jönköping, Sweden.
    Wolmesjö, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Patient involvement in quality improvement - a 'tug of war' or a dialogue in a learning process to improve healthcare?2020In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 20, no 1, article id 1115Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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  • 2.
    Bisholt, Birgitta
    et al.
    University of Borås, School of Health Science.
    Ohlsson, Ulla
    University of Borås, School of Health Science.
    Kullén Engström, Agneta
    University of Borås, School of Health Science.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Gustafsson, Margareta
    University of Borås, School of Health Science.
    Nursing students' assessment of the learning environment in different clinical settings2014In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 14, no 3, p. 304-310Article in journal (Refereed)
    Abstract [en]

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

  • 3. Blomberg, Karin
    et al.
    Bisholt, Birgitta
    Kullén Engström, Agneta
    University of Borås, School of Health Science.
    Olsson, Ulla
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Gustafsson, Margareta
    Swedish nursing students' experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 15-16, p. 2264-2271Article in journal (Refereed)
    Abstract [en]

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

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  • 4. Blomberg, Karin
    et al.
    Isaksson, Ann-Khristin
    Allvin, Renée
    Bisholt, Birgitta
    Ewertsson, Mona
    Kullén Engström, Agneta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ohlsson, Ulla
    Sundler Johansson, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Gustafsson, Margareta
    Work stress among newly graduated nurses in relation to workplace and clinical group supervision2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 1, p. 80-87Article in journal (Refereed)
    Abstract [en]

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

  • 5.
    Bremer, Anders
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Kullén Engström, Agneta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Fredman, Margareta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Jonasson, Lise-Lotte
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Jutengren, Göran
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Karlsson, Per-Åke
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Sandman, Lars
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Wolmesjö, Maria (Editor)
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ledarskap i äldreomsorgen: att leda integrerat värdeskapande i en röra av värden och förutsättningar2016Report (Refereed)
    Abstract [sv]

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

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

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

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

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

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

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  • 6.
    Fallman, Sara L.
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. School of Engineering Sciences in Chemistry, Biotechnology, and Health, KTH Royal Institute of Technology, Stockholm, Sweden.
    Dellve, L
    Department of Sociology and Work Science, Gothenburg University, Gothenburg, Sweden.
    Kullén Engström, Agneta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Managerial approaches for maintaining low levels of sick leave: A qualitative study2022In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834Article in journal (Refereed)
    Abstract [en]

    Aim

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

    Introduction

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

    Method

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

    Results

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

    Conclusion

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

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  • 7.
    Fallman, Sara L.
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Kullén Engström, Agneta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Har organisatoriska förutsättningar och ledarskapsstrategier betydelse för att främja låg sjukfrånvaro inom hälso- och sjukvården?2020In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 97, no 1Article in journal (Refereed)
    Abstract [sv]

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

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  • 8.
    Gustafsson, Margareta
    et al.
    Örebro Universitet.
    Kullén Engström, Agneta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ohlsson, Ulla
    Örebro Universitet.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Bisholt, Birgitta
    Karlstad universitet.
    Nurse teacher models in clinical education from the perspective of student nurses - A mixed method study2015In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, no 12, p. 1289-1294Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

  • 9.
    Kullén Engström, Agneta
    [external].
    Ledarskap och medarbetarskap vid strukturella förändringar i hälso- och sjukvården2009Doctoral thesis, monograph (Other academic)
    Abstract [sv]

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

  • 10.
    Kullén Engström, Agneta
    et al.
    [external].
    Axelsson, L
    The concept of effectiveness--a blind alley? A study of different interpretations in a Swedish county council2001In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, Vol. 16, no 1, p. 61-71Article in journal (Refereed)
    Abstract [en]

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

  • 11.
    Kullén Engström, Agneta
    et al.
    [external].
    Axelsson, L
    Edgren, L
    Management vs symbolic leadership and hospitals in transition: a Swedish example2000In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 8, no 3, p. 167-173Article in journal (Refereed)
    Abstract [en]

    Aim To describe, analyse and interpret symbolic leadership in Swedish public hospitals. Background Swedish hospitals are undergoing major structural changes. Hospitals are amalgamated in order to increase productivity and accessibility and reduce health care costs. Method In-depth interviews have been performed with 54 politicians, senior civil servants, medical directors and trade union representatives at nine hospitals. The interviews have been analysed and interpreted following a grounded theory approach. Findings The results show that leadership is manifested in two dimensions—management and symbolic leadership. The management dimension comprises general leadership aspects like planning, regulation and control. In the symbolic leadership dimension, the leader acts as a guide, inspirer and visionary. Leaders consider they are acting in two large arenas: a public arena and a hospital arena. In the public arena their professional competence is thought to be most important and in the hospital arena their social competence. Conclusions Structural changes in Swedish hospitals have forced the actors to come out into the public arena, where they increasingly meet the media and have to defend budget cut-backs. This reduces their manoeuvring space in the hospital arena. When leaders work as a team, and make full use of their symbolic role, this helps to promote the process of transition. Symbolic leadership has a potential to increase the role repertory for not least the head nurse.

  • 12.
    Kullén Engström, Agneta
    et al.
    [external].
    Axelsson, R
    The double spiral of change: experiences of privatization in a Swedish hospital2010In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, ISSN ISSN 0749-6753, EISSN 1099-1751, Vol. 25, no 2, p. 156-168Article in journal (Refereed)
    Abstract [en]

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

  • 13.
    Kullén Engström, Agneta
    et al.
    [external].
    Rosengren, K
    Axelsson, L
    The staff's experience of structural changes in the health and medical service in western Sweden1999In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 7, no 5, p. 289-298Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The structure and contents of the health and medical service have changed in recent years. The merger of Norra Alvsborgs and Uddevalla hospitals into one local district under one leadership (the NU medical service) is a Swedish example of a structural change. AIMS: This study intends to describe and analyse the staff's experience of a recently accomplished structural change in the local district NU medical service in the western part of Sweden. METHODS: This study has been carried out from a qualitative point of view inspired by grounded theory. From a theme guide with specific questions, 31 interviews were carried out with staff working in the NU medical service. FINDINGS: Four categories emerged from the body of interviews: 'participation', 'doubts', 'anxiety' and 'faith'. 'Participation' was defined as an overall core category, and was related to the other categories. The categories 'doubts', 'anxiety' and 'faith' were related to sub-categories and affected by the overall category 'participation'. CONCLUSIONS: The overall results point to the importance of participation of staff members concerned. The role of the leadership when undergoing structural changes is considered as a major factor to make other staff members participate.

  • 14.
    Kullén Engström, Agneta
    et al.
    [external].
    Rosengren, K
    Hallberg, L
    Balancing involvement: employees' experiences of merging hospitals in Sweden2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 38, no 1, p. 11-18Article in journal (Refereed)
    Abstract [en]

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

  • 15.
    Sundler J, Annelie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Bisholt, Birgitta
    Ohlsson, Ulla
    Björk, Maria
    Kullén Engström, Agneta
    University of Borås, School of Health Science.
    Gustafsson, Margareta
    Student nurses' experiences of the clinical learning environment in relation to the organization of supervision: A questionnaire survey2014In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 34, no 4, p. 661-666Article in journal (Refereed)
    Abstract [en]

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

  • 16.
    Wolmesjö, Maria
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Kullén Engström, Agneta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Att våga släppa taget2019In: Brukardelaktighet och inflytande i äldreomsorg / [ed] Maria Wolmesjö, Lund: Studentlitteratur AB, 2019, 1:1, p. 43-57Chapter in book (Refereed)
  • 17.
    Wolmesjö, Maria
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Kullén Engström, Agneta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Balanserad delaktighet och inflytande2019In: Brukardelaktighet och inflytande i äldreomsorg / [ed] Maria Wolmesjö, Lund: Studentlitteratur AB, 2019, 1:1, p. 103-110Chapter in book (Refereed)
  • 18.
    Wolmesjö, Maria
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Kullén Engström, Agneta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. University of Borås, School of Health Science.
    Balanserad delaktighet och inflytande2019In: Brukardelaktighet och inflytande i äldreomsorg. / [ed] Maria Wolmesjö, Lund: Studentlitteratur AB, 2019, p. 105-111Chapter in book (Refereed)
1 - 18 of 18
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