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  • 201. Berfenstam, Ragnar
    et al.
    Smedby, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Om sjuklighet och sjukvårdskonsumtion1963In: Medlemsblad för SSF:s Rikssektion för distriktssköterskor, Vol. 1, p. 23-26Article in journal (Other (popular science, discussion, etc.))
  • 202. Berfenstam, Ragnar
    et al.
    Smedby, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Sjuklighet och vårdkonsumtion: Redogörelse för en pågående undersökning1963In: Tidskrift för Allmän Försäkring, Vol. 2, p. 73-76Article in journal (Refereed)
  • 203. Berg, B
    et al.
    Bredberg, G
    Korpela, M
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    [The effect of an otologist at the health care centre]1980In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 77, no 18, p. 1752-54Article in journal (Refereed)
  • 204. Berg, B
    et al.
    Bredberg, G
    Korpela, M
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Vad betyder en öronspecialist vid vårdcentral?: En vårdnivåstudie inom ramen för Tierpsprojektet1980Report (Other academic)
  • 205.
    Berg, Karin
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hedengran, Kristina
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Enhetschefers och distriktssköterskors upplevelser av beredskap inför en stor olycka eller katastrof - en intervjustudie i primärvården 2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In order to provide good and accessible healthcare in case of emergencies and disasters, an emergency plan based on planning, training and practice is required. Special care must be prepared to deal with both the ”small everyday accident” but also the major accident and disaster. The purpose of this study was to examine how unit managers and districtnurses in primary care in two municipalities in Jämtland county experience themselves prepared in case of a disaster or a major accident which requires emergency care facilities outside the unit. The aim was also to examine how emergency preparedness is a priority for the unit managers. An interview study has been carried out with three unitmanagers and five districtnurses. The interviews were analyzed with qualitative content analysis. Based on the analysis two categories were created: 'feeling of security "and" organization "and four sub-categories of" security "," priority "," ability "and" knowledge ". Major findings was that all the interview participants wished to have exercises to feel more prepared for a major accident. For the time being, no practice in disaster preparedness is carried out.

  • 206. Berg, Katarina
    et al.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköpings universitet, Ersta Sköndal University College .
    Kjellgren, Karin
    Postoperative recovery from the perspective of day surgery patients: A phenomenographic study.2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 12, p. 1630-1638Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Today, many patients undergo surgical procedures in a day surgery setting. The shift from inpatient care to care at the patients' own home following discharge places various demands on patients and their families during the recovery process. There is a need for knowledge of how the postoperative recovery process is perceived, as research indicates a lack of support for patients managing recovery at home. OBJECTIVE: To explore day surgery patients' different perceptions of postoperative recovery. DESIGN: A qualitative design with a phenomenographic approach was used. METHODS AND SETTINGS: Semi-structured interviews with 31 patients undergoing an orthopaedic, general or urologic day surgical procedure were carried out face to face at the patients' homes, 11-37 days post-discharge. Patients were recruited from two day surgery settings: one private unit and one unit associated with a local county hospital. RESULTS: The patients perceived postoperative recovery as comprising internal and external prerequisites and implying changes in ordinary life with varying levels of support. The effective production at the day surgery unit was perceived as having an impact on patients' prerequisites for recovery. The results are elucidated in three descriptive categories: 'Conditions for recovery at home', 'The rollback to ordinary life' and 'Being a cog in a flow of care'. CONCLUSIONS: The postoperative phase seems to be a weak link in day surgery care. From the patients' perspective, postoperative recovery following day surgery implies extensive responsibility at home. Patients need knowledge and understanding concerning what constitutes the normal range in recovery and how to manage self-care following their specific surgical procedure.

  • 207.
    Berg, Marie
    et al.
    Centre for Person-Centred Care (GPCC), Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Linden, Karolina
    Centre for Person-Centred Care (GPCC), Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Adolfsson, Annsofie
    Örebro University, School of Health Sciences.
    Sparud Lundin, Carina
    Centre for Person-Centred Care (GPCC), Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Ranerup, Agneta
    Department of Applied Information Technology, University of Gothenburg, Gothenburg, Sweden.
    Web-Based Intervention for Women With Type 1 Diabetes in Pregnancy and Early Motherhood: Critical Analysis of Adherence to Technological Elements and Study Design2018In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 20, no 5, article id el60Article in journal (Refereed)
    Abstract [en]

    Background: Numerous Web-based interventions have been implemented to promote health and health-related behaviors in persons with chronic conditions. Using randomized controlled trials to evaluate such interventions creates a range of challenges, which in turn can influence the study outcome. Applying a critical perspective when evaluating Web-based health interventions is important.

    Objective: The objective of this study was to critically analyze and discuss the challenges of conducting a Web-based health intervention as a randomized controlled trial.

    Method: The MODIAB-Web study was critically examined using an exploratory case study methodology and the framework for analysis offered through the Persuasive Systems Design model. Focus was on technology, study design, and Web-based support usage, with special focus on the forum for peer support. Descriptive statistics and qualitative content analysis were used.

    Results: The persuasive content and technological elements in the design of the randomized controlled trial included all four categories of the Persuasive Systems Design model, but not all design principles were implemented. The study duration was extended to a period of four and a half years. Of 81 active participants in the intervention group, a maximum of 36 women were simultaneously active. User adherence varied greatly with a median of 91 individual log-ins. The forum for peer support was used by 63 participants. Although only about one-third of the participants interacted in the forum, there was a fairly rich exchange of experiences and advice between them. Thus, adherence in terms of social interactions was negatively affected by limited active participation due to prolonged recruitment process and randomization effects. Lessons learned from this critical analysis are that technology and study design matter and might mutually influence each other. In Web-based interventions, the use of design theories enables utilization of the full potential of technology and promotes adherence. The randomization element in a randomized controlled trial design can become a barrier to achieving a critical mass of user interactions in Web-based interventions, especially when social support is included. For extended study periods, the technology used may need to be adapted in line with newly available technical options to avoid the risk of becoming outdated in the user realm, which in turn might jeopardize study validity in terms of randomized controlled trial designs. Conclusions: On the basis of lessons learned in this randomized controlled trial, we give recommendations to consider when designing and evaluating Web-based health interventions.

  • 208.
    Berg, Noora
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health.
    Al-Janabi, Thair
    National Institute for Health and Welfare.
    Santalahti, Päivi
    National Institute for Health and Welfare.
    Kuinka tukea terveydenhuollon ammattilaisia, jotka ovat turvapaikanhakijoina tai pakolaisina Suomessa?2017In: Journal of Social Medicine, ISSN 0355-5097, Vol. 54, no 3, p. 244-246Article in journal (Other (popular science, discussion, etc.))
  • 209.
    Bergdahl, Elisabeth
    et al.
    Erstaköndal Högskola.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Ersta Sköndal Univ Coll, Dept Palliat Care Res, Stockholm, Sweden.
    Ternestedt, Britt-Marie
    Ersta Sköndal Högskola.
    Elmberger, Eva
    Ersta Sköndal Högskola.
    Andershed, Birgitta
    Ersta Sköndal Högskola.
    Co-creating possibilities for patients in palliative care to reach vital goals: a multiple case study of home-care nursing encounters2013In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 20, no 4, p. 341-351Article in journal (Refereed)
    Abstract [en]

    Co-creating possibilities for patients in palliative care to reach vital goals – a multiple case study of home-care nursing encountersThe patient’s home is a common setting for palliative care. This means that we need to understand current palliative care philosophyand how its goals can be realized in home-care nursing encounters (HCNEs) between the nurse, patient and patient’srelatives. The existing research on this topic describes both a negative and a positive perspective. There has, however, been areliance on interview and descriptive methods in this context. The aim of this study was to explore planned HCNEs in palliativecare. The design was a multiple case study based on observations. The analysis includes a descriptive and an explanation buildingphase. The results show that planned palliative HCNEs can be described as a process of co-creating possibilities for thepatient to reach vital goals through shared knowledge in a warm and caring atmosphere, based on good caring relations. However,in some HCNEs, co-creation did not occur: Wishes and needs were discouraged or made impossible and vital goals werenot reached for the patients or their relatives. Further research is needed to understand why. The co-creative process presentedin this article can be seen as a concretization of the palliative care ideal of working with a person-centered approach.

  • 210.
    Bergerum, Carolina
    Jönköping University, School of Health Science, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Quality Improvement in a Maternity Ward and Neonatal Intensive Care Unit. What are staff and patients' experiences of Experience-based Co-design?: Part 1: A qualitative study2012Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: Recent focus on quality and patient safety has underlined the need to involve patients in improving healthcare. “Experience-based Co-design” (EBCD) is an approach to capture and understand patient and staff (i. e. users) experiences, identifying so called “touch points” and then working together equally in improvement efforts.

    Purpose:This article elucidates patient (defined as the mother-newborn couple with next of kin) and staff experiences following improvement work carried out according to EBCD in a maternity ward and neonatal intensive care unit (NICU) in a small, acute hospital in Sweden.

    Method: An experience questionnaire, derived from the EBCD approach tool set, was used for continuously evaluating each event of the EBCD improvement project. Furthermore, a focus group interview with staff and in-depth interviews with mother-father couples were held in order to collect and understand the experiences of working together according to EBCD. The analysis and interpretation of the interview data was carried through using qualitative, problem-driven content analysis. Themes, categories and sub-categories presented in this study constitute the manifest and latent content of the participants’ experiences of Experience-based Co-design.

    Results:The analysis of the experience questionnaires, prior to the interviews, revealed mostly positive experiences of the participation. Both staff and patient participants stated generally happy, involved, safe, good and comfortable experiences following each event of the improvement project so far.

    Two themes emerged during the analysis of the interviews. For staff participants the improvement project was a matter of learning within the microsystem through managing practical issues, moving beyond assumptions of improvement work and gaining a new way of thinking. For patients, taking part of the improvement project was expressed as the experience of involvement in healthcare through their participation and through a sense of improving for the future.

    Discussion: This study confirms that, despite practical obstacles for participants, the EBCD approach to improvement work provided an opportunity for maternity ward /NICU care being explored respectfully at the experience level, by assuring the sincere sharing of useful information within the microsystem continuously, and by encouraging and supporting the equal involvement of both staff and patients. Staff and patients wanted and were able to contribute to the EBCD process of gathering information about their experiences, analyzing and responding to collected data, and engaging themselves in improving the same. Furthermore, the EBCD approach provided staff and patients the opportunity of learning within the microsystem. Nevertheless, the responsibility of the improvement work remained the responsibility of the healthcare professionals.

  • 211.
    Berglund, Alexandra
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Olin, Hedvig
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    FYSS och FaR i Stockholms innerstad: Erfarenheter, inställning och önskemål inför arbete med FaR2005Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpStudent thesis
    Abstract [en]

    Aim:

    The aim of this study was to look at the experience, attitude and needs in the primary care in the city of Stockholm in order to work with FaR (physical activity by prescription) and the book FYSS (Physical activity in health prevention and medical treatment). Another purpose was to make a suggestion for a model of how the primary care may work with FaR, for example with a co-ordinator function.

    Method:

    A questionnaire was handed out to 13 healthcare centres at Kungsholmen, Norrmalm, Vasastaden, City, Östermalm, Hjorthagen and Gärdet. 119 questionnaires were answered and handed in. The people participating in the study were doctors and nurses. One person at BKV, SLL, (BKV decides what the healthcare in Stockholm should focus on and not) was interviewed, to find out how they look upon obstacles, possibilities and if and how FaR and FYSS is an alternative in SLL.

    Results:

    The study showed that the big majority were in favour of working with FaR an FYSS both in health prevention and health care. Many of those who participated in the study wanted more information and education. About half of the respondents knew what FYSS respectively FaR were. 104 answered that they gave an oral recommendation to their patients. Only 14 prescribed written recommendations. A majority were in favour of working with written recommendations, motivating conversations, working with a co-ordinator and applying some kind of health test. Another result from the study was that there are a lot of questionmarks when it comes to helping the patient to start with a suitable activity, motivation and evaluation. Interestingly 82 of the respondents did not see any obstacles working with FaR. The most frequent obstacles suggested were insecurity of where to send the patient, insecurity of how to work with the process of prescription and the lack of time.

    Conclusion:

    In this study it was concluded that there is a big interest in working with FaR. Today there is a lack of effective working methods and activities to send the patients to. Earlier studies have shown that for FaR to work successfully it requires education in FaR and FYSS for the health care staff, motivating conversations with the patients, a co-ordinator with contacts with the prophylaxis and a follow up

  • 212.
    Berglund, Anna
    et al.
    Uppsala University, National Centre for Knowledge on Men.
    Lindmark, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Preconception health and care (PHC)a strategy for improved maternal and child health2016In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 121, no 4, p. 216-221Article, review/survey (Refereed)
    Abstract [en]

    Maternal health status before pregnancy is a decisive factor for pregnancy outcomes and for risk for maternal and infant complications. Still, maternity care does not start until the pregnancy is established and in most low-income settings not until more than half of the pregnancy has passed, which often is too late to impact outcomes. In Western societies preconception care (PCC) is widely recognized as a way to optimize women's health through biomedical and behavioural changes prior to conception with the aim of improving pregnancy outcomes. But the content of PCC is inconsistent and limited to single interventions or preconception counselling to women with chronic illnesses. It has been suggested that PCC should be extended to preconception health and care (PHC), including interventions prior to pregnancy in order to optimize women's health in general, and thereby subsequent pregnancy outcomes, the well-being of the family, and the health of the future child. With this definition, almost every activity that can improve the health of girls and women can be included in the concept. In the World Health Report of 2005 a longitudinal approach to women's wellness and reproductive health was highlighted, and the World Health Organization has proposed a more comprehensive maternal and child health care, also including psychosocial issues and intimate partner violence. The present article gives an overview of the recent literature and discusses contents and delivery of PCC/PHC in Western as well as low-income countries. The article puts special emphasis on why violence against women is an issue for PHC.

  • 213.
    Berglund, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Sundstrom, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Treatment effect expressed as the novel Delay of Event measure is associated with high willingness to initiate preventive treatment - A randomized survey experiment comparing effect measures2016In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 99, no 12, p. 2005-2011Article in journal (Refereed)
    Abstract [en]

    Objectives: This study aimed to investigate patients' willingness to initiate a preventive treatment and compared two established effect measures to the newly developed Delay of Events (DoE) measure that expresses treatment effect as a gain in event-free time. Methods: In this cross-sectional, randomized survey experiment in the general Swedish population, 1079 respondents (response rate 60.9%) were asked to consider a preventive cardiovascular treatment. Respondents were randomly allocated to one of three effect descriptions: DoE, relative risk reduction (RRR), or absolute risk reduction (ARR). Univariate and multivariate analyses were performed investigating willingness to initiate treatment, views on treatment benefit, motivation and importance to adhere and willingness to pay for treatment. Results: Eighty-one percent were willing to take the medication when the effect was described as DoE, 83.0% when it was described as RRR and 62.8% when it was described as ARR. DoE and RRR was further associated with positive views on treatment benefit, motivation, importance to adhere and WTP. Conclusions: Presenting treatment effect as DoE or RRR was associated with a high willingness to initiate treatment. Practice implications: An approach based on the novel time-based measure DoE may be of value in clinical communication and shared decision making.

  • 214.
    Berglund Kristiansson, Elisabeth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Vårdrelaterade infektioner - ett folkhälsoproblemGes patienten möjlighet att påverka?2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 215. Bergman, Caroline
    et al.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. University of Borås, Sweden.
    Skagert, Katrin
    Exploring communication processes in workplace meetings: A mixed methods study in a Swedish healthcare organization2016In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 54, no 3, p. 533-541Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: An efficient team and a good organizational climate not only improve employee health but also the health and safety of the patients. Building up trust, a good organizational climate and a healthy workplace requires effective communication processes. In Sweden, workplace meetings as settings for communication processes are regulated by a collective labor agreement. However, little is known about how these meetings are organized in which communication processes can be strengthened. OBJECTIVE: The aim of this study was to explore communication processes during workplace meetings in a Swedish healthcare organization. METHODS: A qualitatively driven, mixed methods design was used with data collected by observations, interviews, focus group interviews and mirroring feedback seminars. Data were analyzed using descriptive statistics and conventional content analysis. RESULTS: The communication flow and the organization of the observed meetings varied in terms of physical setting, frequency, time allocated and duration. The topics for the workplace meetings were mainly functional with a focus on clinical processes. Overall, the meetings were viewed not only as an opportunity to communicate information top down but also a means by which employees could influence decision-making and development at the workplace. CONCLUSIONS: Workplace meetings have very distinct health-promoting value. It emerged that information and the opportunity to influence decisions related to workplace development are important to the workers. These aspects also affect the outcome of the care provided.

  • 216.
    Bergman, Mats A.
    et al.
    Sodertorn Univ, Stockholm, Sweden..
    Johansson, Per
    Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation.
    Lundberg, Sofia
    Umea Univ, Umea Sch Business & Econ, Dept Econ, S-90187 Umea, Sweden..
    Spagnolo, Giancarlo
    Univ Roma Tor Vergata, Ctr Econ Policy Res, EIEF, Stockholm Sch Econ SITE, Rome, Italy..
    Privatization and quality: Evidence from elderly care in Sweden2016In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 49, p. 109-119Article in journal (Refereed)
    Abstract [en]

    Non-contractible quality dimensions are at risk of degradation when the provision of public services is privatized. However, privatization may increase quality by fostering performance-improving innovation, particularly if combined with increased competition. We assemble a large data set on elderly care services in Sweden between 1990 and 2009 and estimate how opening to private provision affected mortality rates - an important and not easily contractible quality dimension - using a difference-in-difference in-difference approach. The results indicate that privatization and the associated increase in competition significantly improved non-contractible quality as measured by mortality rates.

  • 217.
    Bergman, Mats A.
    et al.
    Södertörns Högskola.
    Johansson, Per
    Uppsala University.
    Lundberg, Sofia
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Economics.
    Spagnolo, Giancarlo
    Stockholm School of Economics.
    Privatization and quality: evidence from elderly care in Sweden2016In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 49, p. 109-119Article in journal (Refereed)
    Abstract [en]

    Non-contractible quality dimensions are at risk of degradation when the provision of public services is privatized. However, privatization may increase quality by fostering performance-improving innovation, particularly if combined with increased competition. We assemble a large data set on elderly care services in Sweden between 1990 and 2009 and estimate how opening to private provision affected mortality rates – an important and not easily contractible quality dimension – using a difference-in-difference-in-difference approach. The results indicate that privatization and the associated increase in competition significantly improved non-contractible quality as measured by mortality rates. 

  • 218. Bergman, Mats
    et al.
    Granlund, David
    Umeå University, Faculty of Social Sciences, Department of Economics.
    Rudholm, Niklas
    Reforming the Swedish pharmaceuticals market: consequences for costs per defined daily dose2016In: International Journal of Health Economics and Management, ISSN 2199-9023, E-ISSN 2199-9031, Vol. 16, no 3, p. 201-214Article in journal (Refereed)
    Abstract [en]

    In 2009 and 2010, the Swedish pharmaceuticals market was reformed. One of the stated policy goals was to achieve low costs for pharmaceutical products dispensed in Sweden. We use price and sales data for off-patent brand-name and generic pharmaceuticals to estimate a log-linear regression model, allowing us to assess how the policy changes affected the cost per defined daily dose. The estimated effect is an 18 % cost reduction per defined daily dose at the retail level and a 34 % reduction in the prices at the wholesale level (pharmacies’ purchase prices). The empirical results suggest that the cost reductions were caused by the introduction of a price cap, an obligation to dispense the lowest-cost generic substitute available in the whole Swedish market, and the introduction of well-defined exchange groups. The reforms thus reduced the cost per defined daily dose for consumers while being advantageous also for the pharmacies, who saw their retail margins increase. However, pharmaceutical firms supplying off-patent pharmaceuticals experienced a clear reduction in the price received for their products.

  • 219. Bergman, U
    et al.
    Boethius, G
    Swartling, P G
    Isacson, D
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Teratogenic effects of benzodiazepine use during pregnancy1990In: Journal of Pediatrics, ISSN 0022-3476, E-ISSN 1097-6833, Vol. 116, no 3, p. 490-92Article in journal (Refereed)
  • 220.
    Bergmark, Magnus
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Bejerholm, Ulrika
    Lunds universitet, Institutionen för hälsovetenskaper..
    Markström, Urban
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Policy Changes in Community Mental Health: Interventions and Strategies Used in Sweden over 20 Years2017In: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515, Vol. 51, no 1, p. 95-113Article in journal (Refereed)
    Abstract [en]

    The deinstitutionalization of mental health care has changed the responsibilities of involved authoritiesand has led to a continuous need for new treatment forms and interventions. This articledescribes this development in Europe, and in particular how these new conditions have been handledin Sweden over the past 20 years at the level of governmental policy-making. Three major policydocuments from 1994, 2009 and 2012 were included in this study. To increase our understandingof the policies’ contents, we have used theoretical concepts concerning governance,implementation and political risk management. Although our main interest was to find out howthe government handles interventions for users of the mental health care system, we found that thepolicy work is progressing stepwise. The first document, from the deinstitutionalization era, did notdiscuss interventions clearly. Instead, it was mainly concerned with both practical and economicalareas of responsibility. The second document, from the post-deinstitutionalization era, was morefocused on what services should be delivered to the users, while the most recently published documentto a greater extent addressed the question of how the support is supposed to be designed. The trendin European community mental health policy has been to advocate services in open forms that areintegrated into the society’s other care systems. This is also the case in Sweden, and continuous workis being done by the government to find strategies to support the development, and to meet the needs atboth political and local levels.

  • 221.
    Bergnest, Helena
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Löfberg, Sandra
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Hur gynnas äldre av fysisk aktivitet?: en studie om förekomst, styrning och tillämpning av fysisk aktivitet för äldre på äldreboenden2008Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning

    Syftet med denna studie är att undersöka förekomst, styrning och tillämpning av fysisk aktivitet för äldre på äldreboenden i Stockholms län. Syftet utmynnar i följande frågeställningar:

    ·        Hur ofta och i vilken form utövas fysisk aktivitet på äldreboenden?

    ·        Hur motiveras vikten av fysisk aktivitet på äldreboenden?

    ·        Vilka argument finns för att fysisk aktivitet inte används i större utsträckning på äldreboenden?

    ·        Hur iscensätts fysisk aktivitet på följande tre nivåer: lagar, kommunala styrdokument samt tillämpning på äldreboenden?

     

    Metod: Studien har utförts på äldreboenden i fyra kommuner i Stockholms län. Materialet har samlats in med hjälp av enkäter som skickats ut till enhetschef eller motsvarande på 45 äldreboenden. Av dessa svarade 71 procent på enkäten. I relevanta lagar och styrdokument har även riktlinjer för fysisk aktivitet för äldre på äldreboenden undersökts för att sedan med hjälp av enkätsvaren iscensättas på formulerings-, transformerings- och realiseringsarenan.

     

    Resultat: Den aktivitet som används främst på äldreboenden är promenad/stavgång och de flesta erbjuder det en eller fler gånger i veckan. Rörelse- och balansträning samt motionsgymnastik erbjuds även de i en större utsträckning. Hos många äldreboenden pågår aktiviteter i cirka 30 minuter. De största faktorerna till varför äldre ska utöva fysisk aktivitet på äldreboenden är för att bibehålla moment i vardagen, minska skaderisken samt öka fysisk- och mental hälsa. Två stora faktorer till att äldreboenden inte använder sig mer av fysisk aktivitet beror på tidsbrist hos personalen samt att de äldre är oengagerade till att utöva fysisk aktivitet. Resultatet visar även att det går att tillämpa Göran Lindes läroplansteori angående formulerings-, transformerings- och realiseringsarenan vad det gäller lagar, kommunala styrdokument och tillämpning på äldreboenden.

     

    Avslutande reflektion: Fysisk aktivitet är en mycket viktig del för att bidra till en bättre livskvalitet hos de äldre. Fysisk aktivitet erbjuds mer eller mindre på alla äldreboenden i studien men förekommer dock inte på den nivå som är behövlig. Om detta beror på att det är otydliga direktiv i lagar och styrdokument eller brist på kunskap etc., är något att beakta.

  • 222.
    Bergström, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Skeen, Sarah
    Duc, Duong M.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Blandon, Elmer Zelaya
    Estabrooks, Carole
    Gustavsson, Petter
    Hoa, Dinh Thi Phuong
    Kallestal, Carina
    Målqvist, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Nga, Nguyen Thu
    Persson, Lars-Åke
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Pervin, Jesmin
    Peterson, Stefan Swartling
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Rahman, Anisur
    Selling, Katarina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Squires, Janet E.
    Tomlinson, Mark
    Waiswa, Peter
    Wallin, Lars
    Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings2015In: Implementation Science, ISSN 1748-5908, E-ISSN 1748-5908, Vol. 10, article id 120Article in journal (Refereed)
    Abstract [en]

    Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.

  • 223. Bergström, Eva
    et al.
    Dahlberg, Lena
    Dalarnas forskningsråd.
    Edkvist, Ingela
    Dalarnas forskningsråd.
    Anhörigvårdares vardag: En kunskapsöversikt kring äldres anhöriga2002Report (Other academic)
    Abstract [sv]

    Denna rapport ger en översiktlig presentation av forskningen kring anhörigas insatser och behov av stöd. Dessutom presenteras de stödformer som erbjuds från kommuner och frivilligorganisationer. Därefter redovisas två studier av hur anhöriga upplever olika former av stöd. I den ena studien intervjuas några anhöriga i Vansbro kommun. I den andra studien intervjuas några anhöriga vars närstående deltar i verksamheten vid Gagnefs kommuns centrum för anhörigstöd. De anhöriga delar med sig av sina erfarenheter av olika stödformer och beskriver också vilket stöd de saknar.

  • 224.
    Bergström, Gunnar
    et al.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
    Lohela-Karlsson, M.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Kwak, L.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Bodin, Lennart
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Jensen, I.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Torgén, Margareta
    Department of Medical Science, Uppsala University, Uppsala, Sweden.
    Nybergh, L.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden..
    Preventing sickness absenteeism among employees with common mental disorders or stress-related symptoms at work: Design of a cluster randomized controlled trial of a problem-solving based intervention versus care-as-usual conducted at the Occupational Health Services2017In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, no 1, article id 436Article in journal (Refereed)
    Abstract [en]

    Background: Common mental disorders (CMDs) are among the leading causes of sick leave in Sweden and other OECD countries. They result in suffering for the individual and considerable financial costs for the employer and for society at large. The occupational health service (OHS) can offer interventions in which both the individual and the work situation are taken into account. The aim of this paper is to describe the design of a study evaluating the effectiveness of an intervention given at the OHS to employees with CMDs or stress-related symptoms at work. In addition, intervention fidelity and its relation to the outcome will be assessed in a process analysis.

    Methods: The study is designed as a cluster randomized trial in which the participating OHS consultants are randomized into either delivering the intervention or performing care as usual. Employees with CMDs or stress-related symptoms at work are recruited consecutively by the OHS consultants. The intervention aims to improve the match between the employee and the job situation. Interviews are held individually with the employee and the nearest supervisor, after which a joint meeting with both the employee and the supervisor takes place. A participatory approach is applied by which the supervisor and the employee are guided by the OHS consultant and encouraged to actively take part in problem solving concerning the work situation. Outcomes will be assessed at baseline and at six and 12 months. A long-term follow-up at 3 years will also be performed. The primary outcome is registered sickness absence during a 1-year period after study inclusion. Secondary outcomes are mental health and work ability. The intervention's cost effectiveness, compared to treatment as usual, both for society and for the employer will be evaluated. A process evaluation by both the OHS consultants and the employee will be carried out.

    Discussion: The study includes analyses of the effectiveness of the intervention (clinical and economic) as well as an analysis of its implementation at the participating OHSs. Possible methodological challenges such as selection bias and risk of contamination between OHS consultants delivering the experimental condition and consultants giving usual care are discussed.

  • 225.
    Bergström, Jennie
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Blum, Alexandra
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    En kvinnas tysta hemlighet: En studie om våldsutsatta kvinnors upplevelser2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 226.
    Bergström, Kristine
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Fysisk aktivitet och motivationsfaktorer bland anställda inom vårdsektorn2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 227.
    Bergthorsdottir, R
    et al.
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Nilsson, A G
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Gillberg, P
    Shire, Danderyd, Sweden.
    Ekman, Bertil
    Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Wahlberg, Jeanette
    Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Health-Related Quality of Life In Patients With Adrenal Insufficiency Receiving Plenadren Compared With Immediate-Release Hydrocortisone.2015In: Value in Health, ISSN 1098-3015, E-ISSN 1524-4733, Vol. 18, no 7, p. A616-Article in journal (Refereed)
    Abstract [en]

    Background

    Previous studies in patients with primary adrenal insufficiency (PAI) on conventional replacement therapy suggest decreased health-related quality of life (HRQoL), and that patients report more frequently fatigue, increased anxiety and inability to work compared to background population.

    Objectives

    To study self-reported health status with EQ-5D in patients with PAI. Patients treated with Plenadren (modified-release hydrocortisone) were compared with patients treated with immediate release hydrocortisone (IRHC) replacement therapy.

    Methods

    This was a cross-sectional, multi-centre, non-interventional survey of patients with PAI receiving Plenadren or immediate release hydrocortisone (IRHC) replacement.

    Subjects

    One hundred thirty-four adult patients with PAI of whom 36 (19 females [53%]) were treated with Plenadren and 98 (77 females [79%]) were treated with IRHC, were included.

    MAIN OUTCOME MEASURE

    HRQoL described by the EQ-5D, a generic preference-based measure of health.

    RESULTS

    Patients on Plenadren and on IRHC had a mean ± SD age of 53.1 ± 12.7 years and 48.0 ± 13.1 years, respectively (P=0.043). The majority of the patients were diagnosed more than 5 years ago (69%). The mean ± SD daily Plenadren and IRHC doses were 27.0 ± 6.8 mg and 26.6 ± 10.9 mg, respectively (P=0.807). 47% of the Plenadren patients had been receiving Plenadren and 82% of the IRHC patients had been receiving IRHC for more than 3 years. Patients receiving Plenadren had better HRQoL measured by the EQ-5D questionnaire compared to patients replaced with IRHC (0.76 ± 0.18 vs 0.68 ± 0.18, respectively [P=0.040]).

    CONCLUSIONS

    Replacement therapy with Plenadren in patients with PAI confers measurable benefit on HRQoL relative to IRHC as estimated by the EQ-5D questionnaire, and may therefore be advantageous when compared to IRHC substitution.

  • 228.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Artefakters organiserande funktion2016In: Team i vård, behandling och omsorg: Erfarenheter och reflektioner / [ed] Johan Berlin, Håkan Sandberg, Lund: Studentlitteratur AB, 2016, 2:a, p. 227-248Chapter in book (Refereed)
  • 229.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Common incentives for teamwork: the unspoken contract´s significance2014In: Team Performance Management, ISSN 1352-7592, E-ISSN 1758-6860, Vol. 20, no 1/2, p. 65-80Article in journal (Refereed)
    Abstract [en]

    Purpose - The purpose of this article was to identify and study common incentives for teamwork.

    Design/methodology/approach - The study was designed as a case study. The case consists of teamwork at a univer-sity hospital. At the hospital, ten psychiatric teams were studied for a period of four years (2008-2011). Each team was followed for 12–18 months. Data were collected through interviews (n = 48) and observations (n = 52) of the teamwork at treatment conferences.

    Findings - The common incentives identified consist of shared responsibility, appreciation and long-sightedness. The incidence of a silent contract is highlighted as an explanation for the team's cohesion.

    Research limitations/implications - The study is conducted in a public organisation within one field. The results should therefore be interpreted with some caution.

    Practical implications - The study is useful for practitioners to understand the importance of common incentives as a collective driving force. By developing well-adapted common incentives, the practical work can be developed, refined and improved.

    Originality/value - The significance of common incentives and the unspoken contract in the team is identified.

  • 230.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Doctors’ functional leadership inpsychiatric healthcare teams: a reversible leadership logic2015In: Team Performance Management, ISSN 1352-7592, E-ISSN 1758-6860, ISSN 1362-7592, Vol. 21, no 3/4, p. 159-180Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this paper was to study how psychiatric doctors practise leadership in multidisciplinary healthcare teams. The paper seeks to answer the question: How do psychiatric doctors lead multidisciplinary teams during treatment conferences?

    Design/methodology/approach: Six psychiatric teams were studied at a university hospital. Each team was observed over a period of 18 months, and data were collected during four years (2008-2011). Data were collected through interviews with doctors (n19) and observations (n30) of doctors’ work in multidisciplinary psychiatric teams.

    Findings: Doctors in a multidisciplinary team use either self-imposed or involuntary leadership style. Oscillating between these two extremes was a strategy for handling the internal tensions of the team.

    Research limitations/implications: The study was a case study, performed during treatment conferences at psychiatric wards in a university hospital. This limitation means that there is cause for some caution in generalising the results.

    Practical implications: The results are useful for understanding leadership in multidisciplinary medical teams. By understanding the reversible logic of leadership, cooperation and knowledge sharing can be gained, which means that a situation of mere peaceful coexistence can be avoided. Understanding the importance of the informal contract makes it possible to switch leadership among team members. A reversible leadership with an informal contract makes the team less vulnerable. The team’s professionals can thus easily handle dif cult situations and internal tensions, facilitating leadership and management of multidisciplinary teams.

    Originality/value: Doctors in multidisciplinary psychiatric teams use reversible leadership

    logic.

  • 231.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies.
    How doctors practice teamleadership2014Conference paper (Refereed)
    Abstract [en]

    Purpose: The overall purpose of the article was to study how doctors practise leadership in multidisciplinary teams. The article seeks to answer the question: Which approach do doctors use to lead multidisciplinary psychiatric teams?

    Methodology: Six psychiatric teams were studied at a university hospital. Each team was followed for eighteen months. Data were collected during a period of four years (2008–2011). Data were collected through interviews with doctors (n = 19) and observations (n = 30) of doctors’ work in a multidisciplinary psychiatric team.

    Findings: Doctors in a multidisciplinary team use either self-imposed or involuntary leadership. Oscillating between these two extremes is called reversible leadership.

    Research limitations: The study was performed at a psychiatric ward during treatment conferences in a university hospital. This limitation means that there is cause for some caution in interpreting the results.

    Practical implications: The results are useful for understanding leadership in multidisciplinary teams within the health and medical care system. The reversible leadership means that doctors can more easily oscillate from difficult situations and deal with internal tensions, facilitating leadership and management of the multidisciplinary team in the intended direction.

    Originality / value: Doctors in multidisciplinary psychiatric teams use reversible leadership.

  • 232.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Ledarskap och beslutsfattande i psykiatriska team: om sammanhållning, sortering och kontroll2015 (ed. 1)Book (Other academic)
    Abstract [en]

    This study is about leadership and decision-making in psychiatric teams. To manage healthcare, cross-organisational work has been used as a working method in teamwork.

    The overall aim of the study was to study how leadership and decision-making are applied in psychiatric teams. The issues addressed are: to describe and to understand how leadership in psychiatric teams is applied, to describe and to understand how decision-making in psychiatric teams is applied, explain why there are potential differences between talk and practice, and to explain why teamwork is applied in psychiatry.

    The study's theoretical framework is based on the challenges that arise when teamwork is organised in a multi-professional context. In the study, decision theory, leadership theory and new institutional theory are used to help to link together and provide explanations for behaviour patterns of professions.

    The study's data were collected between 2008–2011 through interviews, observations and document studies. Total study consists of 101 interviews with 111 informants. Observations have been done of 10 teams on 132 occasions for a total of 230 hours. Observations have focused on the teamwork carried out in the treatment conferences.

    The study shows that: 1) there is an informal contract in teams that governs who does what in different situations, 2) doctors applied a reversible leadership where they alternated between the involuntary and the self-imposed, 3) teams used decision norms that are governed by situation-specific micro-codes, 4) there is an episodic culture which decreased the incentive to provide preventive and long-term treatment, 5) teamwork was used to provide the opportunity for solidarity, classification and control, and 6) there was no striving for perfection in decision-making; instead, the teams were satisfied with an acceptable level that everyone could agree on.

  • 233.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies.
    Läkare som teamledare: En studie av reversibelt ledarskap2013Conference paper (Refereed)
    Abstract [sv]

    SammanfattningSyfte: Syftet med artikeln är att beskriva och problematisera läkares ledarskap i team. Arti-keln syftar till att besvara frågan; Hur utövar läkare ledarskap i team?Design/metod: Studien är designad i form av en fallstudie. Sex psykiatriska team har stude-rats vid ett universitetssjukhus. Varje team har följts under 18 månader. Datainsamlingen har gjorts under totalt fyra år (2008-2011). Data har samlats in genom intervjuer med läkare (n=19) och observationer (n=60) av läkares arbete i team.Resultat: Läkares ledarskap i team utövas i en dualistisk pendlingsprocess mellan självpåta-get och ofrivilligt, vilket benämns reversibelt ledarskap.Begränsningar: Studien är gjord på psykiatriska avdelningar i en organisation. Det finns därför anledning till viss försiktighet vid tolkningen av resultaten.Praktiska implikationer: Resultaten är användbara för att förstå teamledarskapets dualism. Reversibelt ledarskap kan leda till ökad osäkerhet och försvaga teamets proaktiva förmåga.Originalitet: Läkarens ledarskap i team lyfts fram som reversibelt, antingen självpåtaget och frivilligt, eller påtvingat och ofrivilligt.Nyckelord:

  • 234.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Synchronous work - myth or reality?: a critical study of teams in health and medical care2010In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 16, no 6, p. 1314-1321Article in journal (Refereed)
    Abstract [en]

    Abstract Rationale, aims and objectives  In this article, ideal conceptions about teamwork are tested. The research question posed is: How are teams in psychiatry formed? Three theoretical concepts that distinguish groups from teams are presented: sequentiality, parallelism and synchronicity. The presumption is that groups cooperate sequentially and teams synchronously, while the parallel work mode is a transitional form between group and team. Methods  Three psychiatric outpatient teams at a university hospital specialist clinic were studied. Data were collected through 25 personal interviews and 82 hours of observations. The data collection was carried out over 18 months (2008–2009). Results  Results show: (1) that the three theoretical distinctions between group and team need to be supplemented with two intermediate forms, semiparallel and semisynchronous teamwork; and (2) that teamwork is not characterized by striving towards a synchronous ideal but instead is marked by an adaptive interaction between sequential, parallel and synchronous working modes. Conclusions  The article points to a new intermediate stage between group and team. This intermediate stage is called semiparallel teamwork. The study shows that practical teamwork is not characterized by a synchronous ideal, but rather is about how to adaptively find acceptable solutions to a series of practical problems. The study emphasizes the importance of the team varying between different working modes, so-called semisystematics.

  • 235.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies.
    Teamarbete: de gemensamma incitamentens betydelse2013In: Att utveckla vården: Erfarenheter av kvalitet, verksamhetsutveckling och förbättringsarbete / [ed] Eriksson, Nomie, Holgers, Kajsa-Mia, Müllern,Tomas, Lund: Studentlitteratur, 2013, 1, p. 223-245Chapter in book (Refereed)
  • 236.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies.
    Teamarbete: ett livsviktigt samspel2013In: Sjuksköterskans kärnkompetenser / [ed] Leksell, Janeth, Lepp, Margret, Stockholm: Liber, 2013, 1, p. 159-177Chapter in book (Refereed)
  • 237.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    Sahlgrenska Akademin, Göteborgs universitet.
    Collaboration Exercises: the lack of collaborative benefits2014In: International Journal of Disaster Risk Science, ISSN 2095-0055, Vol. 5, no 3, p. 192-205Article in journal (Refereed)
    Abstract [en]

    The purpose of this paper is to study what professional emergency personnel learn during collaboration exercises and the benefits of what they have learned. Observations (n=19) and semistructured interviews (n=32) were carried out in conjunction with major exercises held in Sweden (2007–2012). The results show that exercises tend to be based on its own logic, which differs from actual events. Exercise participants believe that they mainly learn single-track, parallel and path-dependent behavior. The exercises do not facilitate the use of cross-boundary activities. This means that learning as well as benefits of the exercises for actual events is limited. The exercises would be more appropriate if those participating had the opportunity to identify weaknesses, try alternative ways as well as had the opportunity to have comprehensive organizational analyses at the conclusion of the exercises. Based on the results of the study, alternative models for the exercises are suggested that contain elements, which develop collaboration and contribute to learning.

  • 238.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies.
    Carlström, Eric
    Sahlgrenska Akademin, Göteborgs universitet.
    Cultural camouflage: a critical study of how artefacts are camouflaged and mental health policy subverted2015In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, Vol. 30, no 2, p. 111-126Article in journal (Refereed)
    Abstract [en]

    This study identifies hidden artefacts in a public organisation. In contrast to earlier studies, itfocuses on artefacts as concealing rather than conveying meaning. Negligent behaviour causedby an unpopular culture was recognised in five psychiatric wards at a Swedish universityhospital. Data comprising observations (87 h) and interviews (n = 60) were collected over aperiod of 48months (2008–2011). Four different items used in everyday work representing adeeper meaning of the organisation were identified during the observations. The items selectedwere work attire, nametags, keys and restraint beds. These were considered particularly promisingwhen it came to the aim of the study, namely, to find out how artefacts are camouflaged. Theobservations and the interviews revealed that these were controversial and contested artefacts inthe organisation. The study uses the term ‘cultural camouflage’ for behaviour that ignores andconsciously conceals symbols that have negative values. This concept contrasts with previousresearch that shows how artefacts are emphasised and how they contribute to the character ofthe activity in a transparent way. Conservative and backward-looking behaviour among staffprovided one explanation as to why artefacts were concealed. Another was the need to establishharmonious internal interactions.

  • 239.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    Sahlgrenska Akademin, Göteborgs universitet.
    Från mekanistisk till organisk samverkan mellan blåljusorganisationer2013In: Om samverkan: för utveckling av hälsa och välfärd / [ed] Axelsson, Runo, Bihari Axelsson, Susanna, Lund: Studentlitteratur, 2013, 1, p. 237-254Chapter in book (Refereed)
  • 240.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies.
    Carlström, EricSahlgrenska Akademin, Göteborgs universitet.
    Guest editors | Special Issue: Management control, organisation and leadership in the healthcare sector2013Collection (editor) (Refereed)
  • 241.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Samverkan mellan blåljusorganisationer2011 (ed. 1)Book (Other academic)
    Abstract [sv]

    Samverkan mellan olika yrkesprofessioner på en olycksplats är komplicerat. Mycket på grund av att förväntningarna inte alltid överensstämmer med förutsättningarna. I boken problematiseras agerandet på olycksplatsen. Friktionen mellan yrkesprofessioner lyfts fram och olika beteendemönster diskuteras.I boken tar författarna samverkan från retorik till ett praktiskt redskap, något som är möjligt att konkretisera och utföra praktiskt i det dagliga arbetet. Boken utgör samtidigt en introduktion till övningstekniken 3-nivåsamverkan (3-NS).I den här boken bjuds på flera närgångna beskrivningar. Medarbetare från fältet berättar om sina erfarenheter av samverkan, hur den tillämpas, om vilka möjligheter som finns och vilka svårigheter som behöver hanteras.Boken riktar sig till alla som arbetar i eller i anslutning till blåljusorganisationer. Den kan med fördel användas som lärobok för universitets- och högskolestuderande som läser till yrken inom polis, räddningstjänst eller ambulanssjukvård. Boken passar också för vidareutbildning av redan yrkesverksamma. Den kan även med fördel läsas av forskare, tjänstemän och politiker med intresse för hur framtidens blåljusorganisationer ska ledas, organiseras och styras.

  • 242.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. Göteborgs universitet, Sahlgrenska akademin.
    Samverkansövningar: Om lärande och nytta2015 (ed. 1)Book (Other academic)
    Abstract [en]

    This study relates to collaboration exercises, with particular focus on the full-scale exercises between the police, rescue services and ambulance. To succeed in a complex situation, it requires that the personnel’s ability to collaborate across organisations be developed and refined.

    The overall aim of this study was to examine how collaboration is practised and how exercises lead to learning and usefulness. A research summary was initially done in this study. Based on that, a number of key concepts were developed that proved helpful when we followed the Swedish collaboration exercises through interviews and observations. The collected analysis has since been the basis for the design of a new exercise model, 3LC, three-level collaboration. It is based on the experiences we have had in studies of traditional exercises.

    The 3LC exercises that were conducted consisted of two practical sessions and three seminars. Each session was followed by an evaluative seminar with the aim that participants themselves would reflect and develop their patterns of behaviour. The two practical sessions were identical. It gave the participants the opportunity to rehearse and methodically try new approaches. The first exercise session was carried out according to the procedures that normally apply and govern the actions at an actual event. The second exercise session was preceded by a self-critical seminar where participants themselves identified what could be improved for the next exercise session.

    The research project was carried out from 2011 to 2014. A total of 19 collaboration exercises were studied, including 16 full-scale exercises. A total of 97 interviews and 125 hours of observation were carried out in this study. A questionnaire (CLU instrument) was developed, which was answered by 272 exercise participants.

    The study shows that collaborative sessions in the exercises contributed to the participants learning more and having greater usefulness from the exercises. 3LC exercises were perceived to enhance learning by 26 per cent and usefulness by 17 per cent, compared with traditional exercises. Collaborative exercises are benefitted when participants analyse their weaknesses themselves. Repetitive elements where participants try out alternative strategies improve preparedness prior to actual events.

  • 243.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies.
    Carlström, Eric
    Sjuksköterskan som chef och ledare: en utmaning2017In: Pedagogik för sjuksköterskor / [ed] Håkan Sandberg, Lund: Studentlitteratur, 2017, 1, p. 295-313Chapter in book (Refereed)
  • 244.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies.
    Carlström, Eric
    Sahlgrenska Akademin, Göteborgs universitet.
    The dominance of mechanistic behaviour: A critical study of emergency exercises2013In: International Journal of Emergency Management, ISSN 1471-4825, E-ISSN 1741-5071, Vol. 9, no 4, p. 327-350Article in journal (Refereed)
    Abstract [en]

    In this paper, the focus is on emergency exercises between the police, rescue services and ambulance. By practising, it is assumed that the conditions improve for a quick normalisation after an incident. The purpose of this paper is to identify whether the exercises are designed after organic action logic and therefore can be assumed to strengthen the ability to handle emergencies. Data have been collected at two large, regional, full-scale exercises (2008 and 2012). Data collection has been done through observations and document studies. The study shows that mechanistic behaviour is quite prevalent in the two studied exercises. They are time consuming and put little emphasis on practising organic behaviour. Too complex exercise scenarios contribute to a low tempo, long waiting periods and slow implementation. To succeed, the exercises need to have a non-linear time sequence and limited scenarios that invite participants to focus on organisational interfaces.

  • 245.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies.
    Carlström, Eric
    Sahlgrenska akademin, Göteborgs universitet.
    Trender som utmanar traditioner: En hälso- och sjukvård i metamorfos2012In: Offentlig förvaltning : Scandinavian journal of public administration, ISSN 2000-8058, Vol. 16, no 2, p. 3-23Article in journal (Refereed)
    Abstract [en]

    This article reviews the traditions of the health care industry while challenged by trends. Strong professions, ambiguous and contradictory aims, and a lack of resources have contributed to difficulties managing contradictory needs. One way to handle the situation is to introduce systems based on freedom of choice, inter organisational and professional work, and an improved degree of flexibility. The trends are mainly influenced by New Public Management control models. The mixture of new and traditional types of management control has produced organisational hybrids. These organisational hybrids have contributed to organisational tensions from the old as well as the new in an inconsistent but regenerating way.

  • 246.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Blåljusövningar och lärande: - en ny typ av samverkansövning2011Conference paper (Refereed)
  • 247.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. Göteborgs universitet, Sahlgrenska Akademin, Institute of Health and Care Sciences.
    The Three-Level Collaboration Exercise: Impact of Learning and Usefulness2015In: Journal of Contingencies and Crisis Management, ISSN 0966-0879, E-ISSN 1468-5973, Vol. 23, no 4, p. 257-265Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to examine the emergency personnel’s perception of the effects of exercises, with regard to learning and usefulness. The exercises were quasi-experimental and constructed in such a way that employees from different organizations overlapped each other’s tasks. This was accomplished by: having asymmetries included in the scenarios, repeating exercise procedures and testing different strategies, which were discussed at joint seminars. The exercises were compared to a similar study, published in this journal, of nonquasi-experimental but merely traditional exercises. Surveys were distributed and collected from emergency personnel in connection with seven exercises. At the exercises, 94.3% of the personnel thought that the exercises had a focus on collaboration (traditional exercises, 75.6%).

  • 248.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Kastberg, Gustaf
    Lunds universitet, Institutionen för Sevice management.
    Styrning av hälso- och sjukvård2011 (ed. 1)Book (Other academic)
    Abstract [sv]

    I den här boken får du möjlighet att bekanta dig med de styrmodeller som har tillämpats inom vården under de senaste decennierna. Författarna ger en bild av vad de olika modellerna tenderar att leda till på kort respektive lång sikt. Trender, regler, resultat, arbetsfördelning och de speciella förutsättningar som gäller för styrning i professionella organisationer behandlas.Boken riktar sig till utbildningar inom hälso- och sjukvårdsadministration, vårdvetenskap, socialt arbete, arbetsvetenskap, offentlig förvaltning, företagsekonomi och service management samt till praktiskt yrkesverksamma. Den kan även med fördel läsas av forskare, tjänstemän och politiker med intresse för hur framtidens hälso- och sjukvård ska organiseras och styras.

  • 249.
    Berlin, Johan M.
    et al.
    Sahlgrenska Academy, University of Gothenburg, Institute of Health and Care Sciences.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    The 90-Second Collaboration: A Critical Study of Collaboration Exercises at Extensive Accident Sites2008In: Journal of Contingencies and Crisis Management, ISSN 0966-0879, E-ISSN 1468-5973, Vol. 16, no 4, p. 177-185Article in journal (Refereed)
  • 250.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Sandberg, Håkan
    Team i vård, behandling och omsorg: Erfarenheter och reflektioner2016Collection (editor) (Refereed)
    Abstract [sv]

    Team är populära, inte minst inom vård, behandling och omsorg.Trots att det börjar bli en väl etablerad företeelse tycks teamfortfarande stå för förnyelse och nytänkande. Teamarbete harsåledes kommit att få en allt viktigare roll.

    I denna antologi behandlas frågor som: Varför uppstår team? Vadgör team nödvändiga? Vad är utmärkande för olika typer av team? Vad skapar väl fungerande team? Vilka effekter får teamarbete förverksamheten? Du som läsare bjuds på både kritiska betraktelser,utvecklingsspår och verktyg.

    Boken vänder sig till studerande och forskare vid högskolor ochuniversitet samt till praktiskt verksamma inom vård-, behandlingsochomsorgsorganisationer. De olika kapitlen kan läsas friståendeoch ger var för sig en god bild av teamets funktion.

    ---

    Team i vård, behandling och omsorg förmedlar en unikinsikt och förståelse kring teamarbetes betydelse, funktionssätt och utmaningar baserad på omfattande och mångårig forskning. Boken förtjänar därför attanvändas inom alla utbildningar på högskolenivå som är inriktade mot vård- och omsorg.

    Stefan Tengblad, professor i företagsekonomi

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