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Publications (10 of 82) Show all publications
Bradbury, H. & Kjellström, S. (2019). Awakening to human centered interaction. Dialogue with Sofia Kjellström [blog post].
Open this publication in new window or tab >>Awakening to human centered interaction. Dialogue with Sofia Kjellström [blog post]
2019 (English)Other (Other (popular science, discussion, etc.))
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-45853 (URN)
Note

Published 2019 on the blog AR+.

Available from: 2019-09-09 Created: 2019-09-09 Last updated: 2019-09-09Bibliographically approved
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)000461439900015 ()28766395 (PubMedID)2-s2.0-85062835004 (Scopus ID)
Available from: 2017-09-08 Created: 2017-09-08 Last updated: 2019-08-30Bibliographically approved
Areskoug Josefsson, K. & Kjellström, S. (2019). Ethics and sexual health: Exploration of the ethical code of conduct for physiotherapists concerning sexual health in clinical practice. Physiotherapy Theory and Practice, 35(11), 1015-1026
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
2019 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 35, no 11, p. 1015-1026Article in journal (Refereed) Published
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, 2019
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: 2019-09-25
Kjellström, S., Areskoug Josefsson, K., Andersson-Gäre, B., Andersson, A.-C., Ockander, M., Käll, J., . . . Robert, G. (2019). Exploring, measuring and enhancing the coproduction of health and well-being at the national, regional and local levels through comparative case studies in Sweden and England: the 'Samskapa' research programme protocol. BMJ Open, 9(7), Article ID e029723.
Open this publication in new window or tab >>Exploring, measuring and enhancing the coproduction of health and well-being at the national, regional and local levels through comparative case studies in Sweden and England: the 'Samskapa' research programme protocol
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 7, article id e029723Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION:

Cocreation, coproduction and codesign are advocated as effective ways of involving citizens in the design, management, provision and evaluation of health and social care services. Although numerous case studies describe the nature and level of coproduction in individual projects, there remain three significant gaps in the evidence base: (1) measures of coproduction processes and their outcomes, (2) mechanisms that enable inclusivity and reciprocity and (3) management systems and styles. By focusing on these issues, we aim to explore, enhance and measure the value of coproduction for improving the health and well-being of citizens.

METHODS AND ANALYSIS:

Nine ongoing coproduction projects form the core of an interactive research programme ('Samskapa') during a 6-year period (2019-2024). Six of these will take place in Sweden and three will be undertaken in England to enable knowledge exchange and cross-cultural comparison. The programme has a longitudinal case study design using both qualitative and quantitative methods. Cross-case analysis and a sensemaking process will generate relevant lessons both for those participating in the projects and researchers. Based on the findings, we will develop explanatory models and other outputs to increase the sustained value (and values) of future coproduction initiatives in these sectors.

ETHICS AND DISSEMINATION:

All necessary ethical approvals will be obtained from the regional Ethical Board in Sweden and from relevant authorities in England. All data and personal data will be handled in accordance with General Data Protection Regulations. Given the interactive nature of the research programme, knowledge dissemination to participants and stakeholders in the nine projects will be ongoing throughout the 6 years. External workshops-facilitated in collaboration with participating case studies and citizens-both during and at the end of the programme will provide an additional dissemination mechanism and involve health and social care practitioners, policymakers and third-sector organisations. 

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
case study, codesign, coproduction, healthcare, social care, adult, article, cultural factor, England, human, organization, physician, quantitative analysis, scientist, Sweden, wellbeing
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-46421 (URN)10.1136/bmjopen-2019-029723 (DOI)000485269700101 ()31350253 (PubMedID)2-s2.0-85070675953 (Scopus ID)GOA HHJ 2019;HHJIMPROVEIS (Local ID)GOA HHJ 2019;HHJIMPROVEIS (Archive number)GOA HHJ 2019;HHJIMPROVEIS (OAI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2018-01431
Available from: 2019-10-02 Created: 2019-10-02 Last updated: 2019-10-11Bibliographically approved
Robert, G., Kjellström, S., Areskoug Josefsson, K., Andersson-Gäre, B., Andersson, A.-C., Ockander, M., . . . Donetto, S. (2019). Exploring, measuring and enhancing the co-production of health and wellbeing at the national, regional and local levels through comparative case studies in Sweden and England: The 'Samskapa' research programme (study protocol). In: : . Paper presented at 14th ESA Conference, Europe and Beyond: Boundaries, Barriers and Belonging, 20-23 August 2019, Manchester, UK.
Open this publication in new window or tab >>Exploring, measuring and enhancing the co-production of health and wellbeing at the national, regional and local levels through comparative case studies in Sweden and England: The 'Samskapa' research programme (study protocol)
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2019 (English)Conference paper, Oral presentation only (Refereed)
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-45081 (URN)
Conference
14th ESA Conference, Europe and Beyond: Boundaries, Barriers and Belonging, 20-23 August 2019, Manchester, UK
Available from: 2019-06-25 Created: 2019-06-25 Last updated: 2019-06-25Bibliographically approved
Avby, G. & Kjellström, S. (2019). LearnOvation: an intervention to foster exploration and exploitation behaviour in health care management in daily practice. BMC Health Services Research, 19(1), Article ID 319.
Open this publication in new window or tab >>LearnOvation: an intervention to foster exploration and exploitation behaviour in health care management in daily practice
2019 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 19, no 1, article id 319Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Innovation has been identified as an important engine for improving the quality, productivity and efficiency of health care. Little is known about how to stimulate innovation capacity in primary health care in general; even less is known about how specific interventions should be designed to support managements' work with practice-based innovations. Research has shown that if managers and teams are excellent at handling the challenges of production (exploitation) and development (exploration), they are better at innovation. The aim of the study is to develop a dynamic management support programme to increase innovation leadership skills in daily practice.

METHODS: The study has an interactive approach that allows the need for empirical and theoretical knowledge to emerge and merge, and a quasi-experimental cross-over design. Eight primary health care centres will participate in the study. In the first phase, the management teams at four health care centres will participate in the intervention, and the other four centres will serve as a control group. Thereafter, the units will switch places and the control group will experience the intervention. All staff at the 8 units will answer questionnaires at four points in time (before, during, after, 6 months later) to evaluate the effects of the intervention.

DISCUSSION: The study will contribute to knowledge on how to organize processes of innovation and support exploitation and exploration behaviours by co-producing and testing a tailor-made management support programme for innovation work in primary health care. An expected long-term effect is that the support system will be disseminated to other centres both within and beyond the participating organizations.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Experimental cross-over design, Exploitation, Exploration, Health care research
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-43775 (URN)10.1186/s12913-019-4152-8 (DOI)000468786300007 ()31113453 (PubMedID)2-s2.0-85066506650 (Scopus ID)GOA HHJ 2019 (Local ID)GOA HHJ 2019 (Archive number)GOA HHJ 2019 (OAI)
Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-06-17Bibliographically approved
Kjellström, S. & Golino, H. (2019). Mining concepts of health responsibility using text mining and exploratory graph analysis. Scandinavian Journal of Occupational Therapy, 26(6), 395-410
Open this publication in new window or tab >>Mining concepts of health responsibility using text mining and exploratory graph analysis
2019 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 26, no 6, p. 395-410Article in journal (Refereed) Published
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, 2019
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)000466582700001 ()29792082 (PubMedID)2-s2.0-85047374766 (Scopus ID)HOA HHJ 2019;HHJIMPROVEIS (Local ID)HOA HHJ 2019;HHJIMPROVEIS (Archive number)HOA HHJ 2019;HHJIMPROVEIS (OAI)
Available from: 2018-06-04 Created: 2018-06-04 Last updated: 2019-06-07Bibliographically approved
Kjellström, S., Stålne, K. & Törnblom, O. (2019). Nya perspektiv på individuell och kollektiv ledarskapsutveckling i komplexa organisationer. Jönköping: Jönköping University, School of Health and Welfare
Open this publication in new window or tab >>Nya perspektiv på individuell och kollektiv ledarskapsutveckling i komplexa organisationer
2019 (Swedish)Report (Refereed)
Abstract [sv]

Detta forskningsprojekt om ledarskapsutveckling i företag finansierades av KK-stiftelsen och genomfördes under 2017-2019 av forskare från Jönköping University, från Malmö universitet och med de deltagande företagen Sandvik, Svenska Spel och NCC. Syftet med forskningsprojektet var att undersöka hur ledarskapsutveckling kan bedrivas och användas för att utveckla företagens förmåga att hantera en komplex omgivning. Forskningsprojektet var samproducerande i och med att forskare tillsammans med företagen utforskade olika perspektiv på hur ledarskapsutveckling bedrivs och kan bedrivas på ett systematiskt vis. Ledarskapsutvecklingen studerades i ett avgränsat sammanhang hos Sandvik och Svenska Spel gällande nyligen genomförda organisationsförändringar och hos NCC gällande hur man organiserar för att hantera stora projekt.Ledarskapsutveckling kan dels innebära en utveckling av ledarna som individer i termer av kompetenser som krävs för att utföra sitt arbete som ledare eller av vidare förhållningssätt till ledarrollen som kan vara formell eller informell. Begreppet involverar även utvecklingen av ett kollektivt ledarskap där ledarskapet fördelar sig över en grupp, avdelning eller hel organisation. Forskningsprojektets samproducerande forskningsansats kan ses som ett exempel på när sådant kollektivt ledarskap utövas av deltagarna.

Forskningsprojektet resulterade i akademiska publikationer såväl som ett antal utvecklingsprojekt i företagen. De akademiska resultaten var följande fyra forskningsartiklar:

Studie 1: Perspektiv på ledarskapsutveckling, som bygger på intervjuer med ledare från de olika företagen och beskriver sex olika perspektiv och sätt att förstå ledarskapsutveckling som ordnats efter ökad komplexitet.

Studie 2: Metoder för ledarskapsutveckling, som ger en översikt över olika metoder för ledarskapsutveckling. En pilotversion av en dialogkarta skapades som kan vara användbar för att ledare såväl som HR-personal ska kunna få en överblick över möjliga sätt att systematiskt stödja ledarskapsutvecklingen.

Studie 3: Komplexa organisationer som driver ledarskapsutveckling, som beskriver hur två av företagen, Sandvik och Svenska Spel, har genomfört organisationsförändringar som ökat komplexiteten i organisationsstrukturerna på ett liknande sätt. Förändringarna har gett upphov till nya ledarroller och tillfällen för utveckling av ledarna som berörs samt utveckling av ett mer kollektivt ledarskap.

Studie 4: Ett ramverk för ledarskapsutveckling, som introducerar hur ledarskapsutvecklingen kan förstås ur fyra olika perspektiv: individens utveckling, kollektivets utveckling, den strukturella utvecklingen och uppgiftens komplexitet.

För företagen resulterade forskningsprojektet i utvecklingsaktiviteter och lärande. Några lärdomar och rekommendationer är att organisationer bör involvera inte bara ledare utan även medarbetare i aktiviteter kring ledarskapsutveckling, initiera6diskussioner kring vad gott ledarskap och ledarskapsutveckling innebär, utveckla inte bara individer utan också det kollektiva ledarskapet, samt att ledarskapsutveckling inte bara sker vid enstaka kurser eller insatser utan kan ske vid det dagliga arbetet, exempelvis vid förändringar i arbetsuppgifter, roller eller organisatoriska förändringar. I detta forskningsprojektet har vi sett det som en central uppgift för en ledare, utöver att leda och bidra till verksamhetens mål, att kontinuerligt och systematiskt stödja den egna och kollegors ledarskapsutveckling. I en föränderlig värld finns inte något slutgiltigt svar på vad ett önskvärt ledarskap är – ledarskapet behöver ständigt utvecklas.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2019. p. 29
Series
Arbetsrapporter från Hälsohögskolan ; 01
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-44707 (URN)
Funder
Knowledge Foundation
Available from: 2019-06-20 Created: 2019-06-20 Last updated: 2019-06-20Bibliographically approved
Karltun, J., Karltun, A., Havemose, K. & Kjellström, S. (2019). Positioning the study of first line managers’ resilient action strategies. In: 8th REA Symposium on Resilience Engineering: Scaling up and Speeding up: Proceedings. Paper presented at 8th REA Symposium on Resilience Engineering: Scaling up and Speeding up, Kalmar, Sweden, June 24-27, 2019.
Open this publication in new window or tab >>Positioning the study of first line managers’ resilient action strategies
2019 (English)In: 8th REA Symposium on Resilience Engineering: Scaling up and Speeding up: Proceedings, 2019Conference paper, Published paper (Refereed)
Abstract [en]

This paper introduces a study on the action strategies of first line managers (FLMs) using a resilience perspective and the aim is to position the study in the theoretical field of resilience management and engineering. One important key to an organization's long-term competitiveness are the first line managers’ ability to handle the role as a leader in daily work. In the role of a FLM, there are a lot of conflicting objectives to manage, for example, regarding available resources, subordinates’ views versus superiors’, centralized and/or local control, optimization of cost and capability (quality and delivery). Moreover, at the operational level of detail, FLMs have to balance daily deliveries in relation to development activities, i.e. technical development, product development, implementation of new system and management concepts. Regardless of the complexity in work and organisational change over time, a FLM’s most important task is to contribute to a high and stable production output out of an input that is characterized by variability and disturbances. To do so in a sustainable way, the FLMs must develop action strategies about ways of working and problem solving that systematically facilitate coping with the situation and managing their own workload. We consider this as developing resilient actions strategies that allow the FLMs to handle the upcoming problems without getting problems on their own. In this paper we describe and develop the theoretical underpinnings of the study as well as how we position our own research in relation to the different theoretical strands of resilience management. We further suggest some methodological ideas on how to capture the work and nature of first line managers’ resilient action strategies. The focus in our work will thus be on how FLMs handle and can improve the more or less chaotic mix of activities in daily work in a resilient way.

Keywords
First line managers, resilience, manufacturing industry
National Category
Production Engineering, Human Work Science and Ergonomics
Identifiers
urn:nbn:se:hj:diva-45850 (URN)978-91-88898-95-1 (ISBN)
Conference
8th REA Symposium on Resilience Engineering: Scaling up and Speeding up, Kalmar, Sweden, June 24-27, 2019
Available from: 2019-09-09 Created: 2019-09-09 Last updated: 2019-09-20Bibliographically approved
Suutari, A.-M., Areskoug Josefsson, K., Kjellström, S., Nordin, A. & Thor, J. (2019). Promoting a sense of security in everyday life—A case study of patients and professionals moving towards co-production in an atrial fibrillation “learning café”. Health Expectations
Open this publication in new window or tab >>Promoting a sense of security in everyday life—A case study of patients and professionals moving towards co-production in an atrial fibrillation “learning café”
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2019 (English)In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background

An improvement initiative sought to improve care for atrial fibrillation (AF) patients; many felt insecure about how to cope with AF.

Objective

To reveal AF patients' and professionals' experiences of pilot-testing a Learning Café group education programme, aimed at increasing the patients' sense of security in everyday life.

Design

Using an organizational case study design, we combined quantitative data (patients' sense of security) and qualitative data (project documentation; focus group interviews with five patients and five professionals) analysed using inductive qualitative content analysis.

Setting

AF patients and a multiprofessional team at a cardiac care unit in a Swedish district hospital.

Improvement activities

Two registered nurses invited AF patients and partners to four 2.5-hour Learning Café sessions. In the first session, they solicited participants' questions about life with AF. A physician, a registered nurse and a physiotherapist were invited to address these questions in the remaining sessions.

Results

AF patients reported gaining a greater sense of security in everyday life and anticipating a future shift from emergency care to planned care. Professionals reported enhanced professional development, learning more about person-centredness and gaining greater control of their own work situation. The organization gained knowledge about patient and family involvement.

Conclusions

The Learning Café pilot test?exemplifying movement towards co-production through patient-professional collaboration?generated positive outcomes for patients (sense of security), professionals (work satisfaction; learning) and the organization (better care) in line with contemporary models for quality improvement and with Self-Determination Theory. This approach merits further testing and evaluation in other contexts.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
atrial fibrillation, coping behaviours, co-production, health-care quality improvement, patient education, Self-Determination Theory
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-45651 (URN)10.1111/hex.12955 (DOI)000482497000001 ()31433546 (PubMedID)2-s2.0-85070880105 (Scopus ID)
Funder
Futurum - Academy for Health and Care, Jönköping County Council, SwedenForte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2019-08-22 Created: 2019-08-22 Last updated: 2019-10-01
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8952-8773

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