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Mutual trust is a prerequisite for nurses’ sense of safety and work satisfaction – Mobile Integrated Care Model: A qualitative interview study
Jönköping University, School of Health and Welfare, HHJ. Studies on Integrated Health and Welfare (SIHW). School of Health Sciences, University of Skövde, Skövde, Sweden.ORCID iD: 0000-0001-6484-9239
School of Health Sciences, University of Skövde, Skövde, Sweden; College of Nursing, University of Rhode Island, Kingston, RI, USA.
Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. School of Health Sciences, University of Skövde, Skövde, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-6305-8993
School of Health Sciences, University of Skövde, Skövde, Sweden.
2023 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 43, no 1Article in journal (Refereed) Published
Abstract [en]

An increasing number of older persons have complex health care needs. This, along with the organizational principle of remaining at home, emphasizes the need to develop collaborations among organizations caring for older persons. A health care model developed in Sweden, the Mobile Integrated Care Model aims to promote work in teams across organizations. The aim of the study was to describe nurses’ experiences in working and providing health care in the Mobile Integrated Care Model in the home with home health care physicians. Semi-structured interviews were conducted with 18 nurses and analyzed through qualitative content analysis. The method was compliant with the COREQ checklist. A mutually trusting collaboration with physicians, which formed person-centered care, created work satisfaction for the nurses. Working within the Mobile Integrated Care Model was negatively impacted by being employed by different organizations, lack of time to provide health care, and physicians’ person-centered work abilities.

Place, publisher, year, edition, pages
Sage Publications, 2023. Vol. 43, no 1
Keywords [en]
home care, home care physician, home nursing, integrated care, person-centered care
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-64231DOI: 10.1177/20571585211062166Scopus ID: 2-s2.0-85133410284Local ID: GOA;;64231OAI: oai:DiVA.org:hj-64231DiVA, id: diva2:1858382
Funder
The Kamprad Family Foundation, 20190175Available from: 2024-05-16 Created: 2024-05-16 Last updated: 2025-01-21Bibliographically approved
In thesis
1. Within an integrated home health care model: Registered nurses’, physicians’, patients’ and their next of kin’s perspectives
Open this publication in new window or tab >>Within an integrated home health care model: Registered nurses’, physicians’, patients’ and their next of kin’s perspectives
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Many older patients receive health care from several different healthcare organizations, which may lead uncertainty about the responsibility for their healthcare needs. Integrated care has been argued to aid the healthcare system by addressing the challenge of the complex care needs of older patients with multiple health problems. Previous research has stated that integrated care models often have been developed with a focus on a single diagnosis, which risks overlooking the extensive and complex care needs of older patients. Prior research has also expressed the need to deepen knowledge about how integrated care models influence health care professionals, patients and their next of kin. Moreover, it is important to understand how the COVID-19 pandemic affected integrated care models which may expand knowledge about integrated home health care in crisis situations.

The overall aim is to study expectations, perceptions and experiences of integrated home health care through the perspective of registered nurses, physicians, patients and their next of kin.

Inductive qualitative designs where data was collected through interviews and field notes in the setting of the mobile integrated care model with a home health care physician (MICM) with registered nurses, physicians and patients and next of kin. Analysis was conducted using qualitative content analysis, phenomenography, and thematic analysis.

The emphasis on person-centered care in the MICM was evident in the perceptions of the healthcare professionals about the patients and their next of kin, whom they viewed as persons, not simply recipients of health care. Differences were found in the health care provided in the MICM and in comparison, to other healthcare organizations which did not align with the person-centered care ethics. However, providing health care to patients in their own home benefited the provision of person-centered care – the value base of the MICM. The MICM was created with the goal of implementing individually tailored and coherent health care with increased continuity. The healthcare professionals viewed individual medical healthcare plans as co-created with each patient, and yet no patient could recall participating in this co-creation. The coherency of the MICM was regarded as having been improved by teamwork between the registered nurse and the home healthcare physician. Collaborations with other healthcare professionals rarely occurred and should be improved in the future. Participants reported varying experiences of continuity in the MICM, which influenced the possibility of building relationships. Providing continuity with a home healthcare physician for patients is therefore preferable. The work described in this thesis was conducted during the COVID-19 pandemic. The thesis provides unique insights into an integrated care model during a crisis situation, which the healthcare system may face in similar or different ways in the future. The MICM was upheld as the best way to work in home health care, especially as patients and their next of kin regarded the model as making their daily lives easier.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2024. p. 104
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 136
Keywords
home health care, home health care physician, municipality nursing, integrated care, person-centered care, qualitative content analysis, phenomenography, thematic analysis
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-64232 (URN)978-91-88669-47-6 (ISBN)978-91-88669-48-3 (ISBN)
Public defence
2024-06-05, G110, University of Skövde, Skövde, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2024-05-16 Created: 2024-05-16 Last updated: 2024-06-04Bibliographically approved

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Hovlin, LinaDahl Aslan, Anna K.

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