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Publications (10 of 69) Show all publications
Lundberg, K., Kjellström, S. & Sandman, L. (2019). Dual loyalties: Everyday ethical problems of registered nurses and physicians in combat zones. Nursing Ethics, 26(2), 480-495
Open this publication in new window or tab >>Dual loyalties: Everyday ethical problems of registered nurses and physicians in combat zones
2019 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 26, no 2, p. 480-495Article in journal (Refereed) Published
Abstract [en]

Background:

When healthcare personnel take part in military operations in combat zones, they experience ethical problems related to dual loyalties, that is, when they find themselves torn between expectations of doing caring and military tasks, respectively.

Aim:

This article aims to describe how Swedish healthcare personnel reason concerning everyday ethical problems related to dual loyalties between care and military tasks when undertaking healthcare in combat zones.

Design:

Abductive qualitative design.Participants and research context:Individual interviews with 15 registered nurses and physicians assigned for a military operation in Mali.

Ethical considerations:

The participants signed up voluntarily, and requirements for informed consent and confidentiality were met. The research was approved by the Regional Ethics Review Board in Gothenburg (D no. 816-14; 24 November 2014).

Findings:

Three main categories emerged: reasons for not undertaking combat duties, reasons for undertaking combat duties and restricted loyalty to military duties, and 14 subcategories. Reasons for not undertaking combat duties were that it was not in their role, not according to ethical codes or humanitarian law or a breach towards patients. Reasons for undertaking combat duties were that humanitarian law does not apply or has to be treated pragmatically or that it is a case of force protection. Shortage of resources and competence were reasons for both doing and not doing military tasks. Under some circumstances, they could imagine undertaking military tasks: when under threat, if unseen or if not needed for healthcare duties.

Discussion/conclusion:

These discrepant views suggest a lack of a common view on what is ethically acceptable or not, and therefore we suggest further normative discussion on how these everyday ethical problems should be interpreted in the light of humanitarian law and ethical codes of healthcare personnel and following this, further training in ethical reflection before going on military operations.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Codes of ethics; dual loyalties; empirical approaches; ethical problems; ethics education; ethics of care/care ethics; military ethics; military nursing; nursing ethics; professional ethics; qualitative research; theory/philosophical perspectives; topic areas
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-37236 (URN)10.1177/0969733017718394 (DOI)XYZ ()28766395 (PubMedID)2-s2.0-85062835004 (Scopus ID)
Available from: 2017-09-08 Created: 2017-09-08 Last updated: 2019-03-22Bibliographically approved
Avby, G., Kjellström, S. & Andersson Bäck, M. (2019). Tending to innovate in Swedish primary health care: a qualitative study. BMC Health Services Research, 19(1), Article ID 42.
Open this publication in new window or tab >>Tending to innovate in Swedish primary health care: a qualitative study
2019 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 19, no 1, article id 42Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Policymakers in many countries are involved in system reforms that aim to strengthen the primary care sector. Sweden is no exception. Evidence suggests that targeted financial micro-incentives can stimulate change in certain areas of care, but they do not result in more radical change, such as innovation. The study was performed in relation to the introduction of a national health care reform, and conducted in Jönköping County Council, as the region's handling of health care reforms has attracted significant national and international interest. This study employed success case method to explore what enables primary care innovations.

METHODS: Five Primary Health Care Centres (PHCCs) were purposively selected to ensure inclusion of a variety of aspects, such as size, location, ownership and regional success criteria. 48 in-depth interviews with managers and staff at the recruited PHCCs were analysed using content analyses. The COREQ checklist for qualitative studies was used to assure quality standards.

RESULTS: This study identified three types of innovations, which break with previous ways of organizing work at these PHCCs: (1) service innovation; (2) process innovation; and (3) organizational innovation. A learning-oriented culture and climate, comprising entrepreneurial leadership, cross-boundary collaboration, visible and understandable performance measurements and ability to adapt to external pressure were shown to be advantageous for innovativeness.

CONCLUSIONS: This qualitative study highlights critical features in practice that support primary care innovation. Managers need to consistently transform and integrate a policy "push" with professionals' understanding and values to better support primary care innovation. Ultimately, the key to innovation is the professionals' engagement in the work, that is, their willingness, capability and opportunity to innovate.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Culture and climate for innovation, Health care reform, Innovation, Leadership, Practice features, Primary care
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-42700 (URN)10.1186/s12913-019-3874-y (DOI)000456156900007 ()30658638 (PubMedID)2-s2.0-85060149714 (Scopus ID)GOA HHJ 2019 (Local ID)GOA HHJ 2019 (Archive number)GOA HHJ 2019 (OAI)
Available from: 2019-01-22 Created: 2019-01-22 Last updated: 2019-02-20Bibliographically approved
Norrman Brandt, E., Kjellström, S. & Andersson, A.-C. (2018). A transformational change process by a post heroic leader. In: : . Paper presented at European Society for Research on Adult Development (ESRAD), ​25th to 27th May 2018, University of Greenwich, London, UK.
Open this publication in new window or tab >>A transformational change process by a post heroic leader
2018 (English)Conference paper, Published paper (Refereed)
National Category
Social Sciences
Identifiers
urn:nbn:se:hj:diva-40478 (URN)
Conference
European Society for Research on Adult Development (ESRAD), ​25th to 27th May 2018, University of Greenwich, London, UK
Available from: 2018-06-18 Created: 2018-06-18 Last updated: 2018-06-18Bibliographically approved
Törnblom, O., Stålne, K. & Kjellström, S. (2018). Analyzing roles and leadership in organizations from cognitive complexity and meaning-making perspectives. Behavioral Development, 23(1), 63-80
Open this publication in new window or tab >>Analyzing roles and leadership in organizations from cognitive complexity and meaning-making perspectives
2018 (English)In: Behavioral Development, ISSN 1942-0722, Vol. 23, no 1, p. 63-80Article in journal (Refereed) Published
Abstract [en]

Organizations can be seen as social systems with hierarchical structures and roles at different levels of complexity with correspondingly different complexity of tasks. This article applies the perspectives of two theories from the field of adult development, namely, the model of hierarchical complexity (MHC) and ego development theory (EDT) to analyze stratified systems theory (SST). Although the theories are not regarded as strictly comparable and commensurable on account of differences in basic assumptions and methods of the theories, the analysis leads to the conclusion that descriptions of role complexity and individual capabilities in SST, to some extent, correspond to descriptions of developmental levels according to the MHC and EDT. Both comparisons support the notion that task and leadership complexity increases with organizational level, and thereby demonstrates support for the existence of qualitatively different levels of leadership. However, based on the methodological choices of the study, it is beyond the scope of the article to validate the key concepts, constructs in SST, as well as provide support or nonsupport for the proposed value of application in practice. Furthermore, we point out the lack of a more thorough analysis and comparison between the theories built on rich empirical material. Nevertheless, we conclude that the MHC, EDT and SST are fruitful lenses that can further the understanding of organizations as social systems with hierarchical structures.

Place, publisher, year, edition, pages
American Psychological Association (APA), 2018
Keywords
role complexity, leadership at different levels, the model of hierarchical complexity, ego development theory, stratified systems theory
National Category
Work Sciences
Identifiers
urn:nbn:se:hj:diva-40407 (URN)10.1037/bdb0000067 (DOI)
Available from: 2018-06-15 Created: 2018-06-15 Last updated: 2018-06-18Bibliographically approved
Stålne, K., Kjellström, S. & Törnblom, O. (2018). Assumptions and distinctions on leadership development in complex roles in the context of more advanced and complex organizational design. In: : . Paper presented at European Society for Research on Adult Development (ESRAD), ​25th to 27th May 2018, University of Greenwich, London, UK.
Open this publication in new window or tab >>Assumptions and distinctions on leadership development in complex roles in the context of more advanced and complex organizational design
2018 (English)Conference paper, Published paper (Refereed)
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-40475 (URN)
Conference
European Society for Research on Adult Development (ESRAD), ​25th to 27th May 2018, University of Greenwich, London, UK
Available from: 2018-06-18 Created: 2018-06-18 Last updated: 2018-06-18Bibliographically approved
Areskoug Josefsson, K. & Kjellström, S. (2018). Ethics and sexual health: Exploration of the ethical code of conduct for physiotherapists concerning sexual health in clinical practice. Physiotherapy Theory and Practice, 1-12
Open this publication in new window or tab >>Ethics and sexual health: Exploration of the ethical code of conduct for physiotherapists concerning sexual health in clinical practice
2018 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, p. 1-12Article in journal (Refereed) Epub ahead of print
Abstract [en]

Physiotherapists have an important role in sexual health, but there are specific ethical considerations regarding sexuality and the practice of physiotherapy which require serious consideration. This article aims to illustrate how the professional ethical code of physiotherapy can serve as a tool for ethical clinical reasoning regarding sexual health in clinical physiotherapy practice. We analyse the ethical codes for physical therapy, in relation to a definition of sexual health and the declaration of sexual rights. The analysis outlines several ethical considerations crucial in dealing with sexual health, while also acknowledging the critical role of cultural context in any ethical analysis. We conclude that physiotherapists need to practise ethical reasoning and that the ethical code of physiotherapy can act as a point of departure for reflection on thought-provoking ethical dilemmas to improve the practice of physiotherapy and support clients’ overall health. 

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Physical therapy, physiotherapy, rehabilitation, sexual well-being, sexuality, article, clinical practice, ethics, human, physiotherapist, physiotherapy practice, sexual health, thinking, wellbeing
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-40402 (URN)10.1080/09593985.2018.1470209 (DOI)29723127 (PubMedID)2-s2.0-85046416984 (Scopus ID)
Available from: 2018-06-15 Created: 2018-06-15 Last updated: 2018-06-18
Sandman, L. & Kjellström, S. (2018). Etikboken: Etik för vårdande yrken (2ed.). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Etikboken: Etik för vårdande yrken
2018 (Swedish)Book (Other academic)
Abstract [sv]

Detta är en heltäckande etikbok för dig som arbetar med vårdande,från grundläggande kunskaper till fördjupning och reflektion. Du kommer att få ta del av:

  • Beskrivningar av centrala etiska teorier och begrepp.
  • Hur en etisk analys utförs.
  • Konkreta fall från vårdens vardag.
  • Analysinstrument för att hantera etiska problem.
  • Ett digitalt material med frågor, tentamen och rollspel.
  • Etiska dilemman från olika professioners perspektiv.

I den reviderade utgåvan har strukturen i förra upplagans kapitel förbättrats och ett kapitel om att handla mer etiskt i vårdens vardag har lagts till.

Etikboken riktar sig speciellt till sjuksköterskestudenter på grundnivå, men den passar också andra yrkesgrupper som arbetar med vårdande och hälsa i olika former.

Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2018. p. 485 Edition: 2
National Category
Ethics
Identifiers
urn:nbn:se:hj:diva-42560 (URN)9789144120539 (ISBN)
Available from: 2019-01-09 Created: 2019-01-09 Last updated: 2019-01-09Bibliographically approved
Golino, H., Hamer, R., Almers, E. & Kjellström, S. (2018). Measuring epistemological development – a uni- or multidimensional structure?. In: : . Paper presented at European Society for Research on Adult Development (ESRAD), ​25th to 27th May 2018, University of Greenwich, London, UK.
Open this publication in new window or tab >>Measuring epistemological development – a uni- or multidimensional structure?
2018 (English)Conference paper, Published paper (Refereed)
National Category
Social Sciences
Identifiers
urn:nbn:se:hj:diva-40477 (URN)
Conference
European Society for Research on Adult Development (ESRAD), ​25th to 27th May 2018, University of Greenwich, London, UK
Available from: 2018-06-18 Created: 2018-06-18 Last updated: 2018-06-18Bibliographically approved
Kjellström, S. & Golino, H. (2018). Mining concepts of health responsibility using text mining and exploratory graph analysis. Scandinavian Journal of Occupational Therapy, 1-16
Open this publication in new window or tab >>Mining concepts of health responsibility using text mining and exploratory graph analysis
2018 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, p. 1-16Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Occupational therapists need to know about people’s beliefs about personal responsibility for health to help them pursue everyday activities.

Aim: The study aims to employ state-of-the-art quantitative approaches to understand people’s views of health and responsibility at different ages.

Methods: A mixed method approach was adopted, using text mining to extract information from 233 interviews with participants aged 5 to 96 years, and then exploratory graph analysis to estimate the number of latent variables. The fit of the structure estimated via the exploratory graph analysis was verified using confirmatory factor analysis.

Results: Exploratory graph analysis estimated three dimensions of health responsibility: (1) creating good health habits and feeling good; (2) thinking about one’s own health and wanting to improve it; and 3) adopting explicitly normative attitudes to take care of one’s health. The comparison between the three dimensions among age groups showed, in general, that children and adolescents, as well as the old elderly (>73 years old) expressed ideas about personal responsibility for health less than young adults, adults and young elderly.

Conclusions: Occupational therapists’ knowledge of the concepts of health responsibility is of value when working with a patient’s health, but an identified challenge is how to engage children and older persons. 

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
exploratory graph analysis, health, occupational therapy, Responsibility for health, text mining, adolescent, adult, aged, article, child, confirmatory factor analysis, controlled study, exploratory research, female, groups by age, habit, human, interview, major clinical study, male, mining, occupational therapist, quantitative analysis, responsibility, thinking, young adult
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-39756 (URN)10.1080/11038128.2018.1455896 (DOI)29792082 (PubMedID)2-s2.0-85047374766 (Scopus ID)HHJIMPROVEIS (Local ID)HHJIMPROVEIS (Archive number)HHJIMPROVEIS (OAI)
Available from: 2018-06-04 Created: 2018-06-04 Last updated: 2018-12-07
Hedberg, B., Nordström, E., Kjellström, S. & Josephson, I. (2018). "We found a solution, sort of”: qualitative interview study with children and parents on their experiences of the coordinated individual plan (CIP) in Sweden. Cogent Medicine, 5(1), Article ID 1428033.
Open this publication in new window or tab >>"We found a solution, sort of”: qualitative interview study with children and parents on their experiences of the coordinated individual plan (CIP) in Sweden
2018 (English)In: Cogent Medicine, ISSN 2331-205X, Vol. 5, no 1, article id 1428033Article in journal (Refereed) Published
Abstract [en]

Children and adolescents receiving services from two professional parties may obtain support with a coordinated individual plan (CIP). The Swedish law prescribes that CIP must incorporate service user participation. This study aims to explore children and parents’ experiences of participating in CIP-process to generate knowledge with practical implications of how children and parents may be involved in the CIP-process. A descriptive qualitative interview study with 13 service users was conducted during November 2014 to March 2016. Data were audio-recorded and transcribed, and further subjected to qualitative content analysis. Three main descriptive categories with six subcategories emerged. The category “Struggle for coordination” includes service users’ need for participation which are limited by professionals’ lack of consensus. The category “Alliance for coordination” points out the importance of relationship and personal support to accomplish functional coordination. The category “Structure for coordination” shows how the structure facilitate service user involvement on a high level. Service user involvement seemed limited by professionals’ actions, but could be facilitated by support of professionals working in the child’s daily life. Structured coordination seems to relieve the pressure on parents, as well as children, but CIP needs to be individually tailored to reach its full potential.

Place, publisher, year, edition, pages
Cogent OA, 2018
Keywords
alliances, children, coordinated individual plans, coordination, service user involvement
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-31222 (URN)10.1080/2331205X.2018.1428033 (DOI)
Note

Included in thesis in its submitted form.

Available from: 2016-08-11 Created: 2016-08-11 Last updated: 2019-01-22Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8952-8773

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