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  • 1.
    Almers, Ellen
    et al.
    Jönköping University, School of Education and Communication, HLK, Learning Practices inside and outside School (LPS), Sustainability Education Research (SER).
    Askerlund, Per
    Jönköping University, School of Education and Communication, HLK, Learning Practices inside and outside School (LPS), Sustainability Education Research (SER).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Why forest gardening for children? Swedish forest gardeneducators' ideas, purposes, and experiences2018In: The Journal of Environmental Education, ISSN 0095-8964, E-ISSN 1940-1892, Vol. 49, no 3, p. 242-259Article in journal (Refereed)
    Abstract [en]

    Utilizing forest gardens as urban settings for outdoor environmental education in Sweden is a new practice. These forest gardens combine qualities of a forest, e.g., multi-layered polyculture vegetation, with those of a school garden, such as accessibility and food production. The study explores both the perceived qualities of forest gardens in comparison to other outdoor settings and forest garden educators’ ideas, purposes, and experiences of activities in a three-year forest gardening project with primary school children. The data were collected through interviews and observations and analyzed qualitatively. Four reported ideas were to give children opportunities to: feel a sense of belonging to a whole; experience self-regulation and systemic dependence; experience that they can co-create with non-human organisms; and imagine possible transformation of places. Four pedagogical forest garden features are discussed.

  • 2.
    Andersson Bäck, Monica
    et al.
    University of Gothenburg.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Avby, Gunilla
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Identity work of successful primary care managers and competing institutional logics2017Conference paper (Refereed)
  • 3.
    Andersson Bäck, Monica
    et al.
    University of Gothenburg.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Avby, Gunilla
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Medical manager hybrids for handling institutional complexity and change in primary care2017Conference paper (Refereed)
    Abstract [en]

    Introduction: This article deals with hybrid persons combining medical professionalism and management for handling institutional complexity and change in primary care. Primary care and identity are in transition in many western countries, in Sweden emphasized by the 2007 reform for patient choice and competition. Research has shown that embedded hybrid actors, familiar and socialized in a field and to its logics, tend to be influential for handling complexity and change. Yet hydrids and their enactment in primary care is an underexplored area.

    Aim: The aim is to contribute to our understanding of hybrid persons and how they are combining medical professionalism and management in primary care, while managing complexity and change.

    Material and methods: In a case study of six successful primary healthcare centers, public and private, covering 56 interviews and observations with various professions, two medical managers ‘hybrids’ showed to be particularly interesting. These were analyzed in-depth, including analysis of staff’s and colleagues’ experiences and contrasted by other managers and hybrids. For the analysis we draw on institutional logic perspective (Thornton, Occasion & Lounsbury 2012) in order to capture preconditions as well as enactment of such change agents.

    Results/conclusions: The hydrids contributed to innovation, creativity and learning in their primary care centres. At their workplace, coherence and a good ambience coexisted with feelings of high work pace and lacking role clarity among the multidisciplinary staff. Categorized in line with McGivern and colleagues(2015) term as ‘willing hybrids’, the persons studied revealed high ambitions to challenge existing institutional order giving professionalism new forms, while seeking to innovate practices and division of work among healthcare staff in primary care. By doing so the hybrids integrated professionalism and managerialism and were influential in reframing problems and solutions, which aligned several logics at play. However several obstacles related to professional as well as bureaucratic issues appeared along the way.

  • 4.
    Areskoug Josefsson, Kristina
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Avby, Gunilla
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Andersson Bäck, Monica
    Department of Social Work, University of Gothenburg, Gothenburg, Sweden.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Workers’ experiences of healthy work environment indicators at well-functioning primary care units in Sweden: a qualitative study2018In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 36, no 4, p. 406-414Article in journal (Refereed)
    Abstract [en]

    Objective: Staff experiences of healthy work environment (HWE) indicators at primary care units can assist in understanding why some primary care units function better than others. The aim of the study was to create increased understanding of how workers experienced HWE indicators at well-functioning primary care units.

    Design: Fifty in-depth interviews with staff at six primary care units in Sweden were analysed with deductive content analysis, revisiting a systematic review of HWE indicators.

    Results: The study presents additional perspectives on staff experiences of HWE indicators at well-functioning primary care units. The included primary care units (PCU) shared a similar pattern of work environment indicators, with unique solutions and strategies to meet shared challenges. Staff at the included PCUs were encouraged to work to create and sustain a HWE, but each domain (indicator) also provided challenges that the staff and organisation needed to meet. The results suggest that useful approaches for a healthy work environment could be to address issues of organisational virtuousness, employee commitment and joy at work.

    Conclusions: Both managers and staff are encouraged to actively work not only to create and sustain an HWE but also to promote organisational virtuousness, employee commitment, joy at work and to increase the performance at work, which is of benefit to staff, patients and society.

    Key Points

    • Staff at well-functioning primary care units (PCUs) experienced healthy work environments
    • The included PCUs shared a similar pattern of work environment indicators, with unique solutions and strategies to meet shared challenges.
    • Staff at the included PCUs were encouraged to work to create and sustain a healthy work environment, but each domain (indicator) also provided challenges that the staff and organisation needed to meet.
    • The results suggest that useful approaches for a healthy work environment could be to address issues of organisational virtuousness, employee commitment and joy at work.
  • 5.
    Areskoug Josefsson, Kristina
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Ethics and sexual health: Exploration of the ethical code of conduct for physiotherapists concerning sexual health in clinical practice2019In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 35, no 11, p. 1015-1026Article in journal (Refereed)
    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. 

  • 6.
    Areskoug Josefsson, Kristina
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). VID Specialized University, Stavanger, Norway.
    Nordin, Annika
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Trust and self-efficacy as enablers and products of co-production in health and welfare services2021In: Processual perspectives on the co-production turn in public sector organizations / [ed] Anja Overgaard Thomassen & Julie Borup Jensen, Hershey, PA: IGI Global, 2021, p. 42-58Chapter in book (Refereed)
    Abstract [en]

    Health and welfare services are facing major challenges, including impaired efficiency in meeting the complex needs of users. To face these challenges, there is a need to develop new ways of working, such as co-production. It is a challenge to enable and enhance inclusive co-productive processes, but trust and self-efficacy are key concepts for success. Trust and self-efficacy can be considered as both enablers and products of co-production and are thus important to acknowledge together with contextual factors and to act upon at all organizational levels, starting with individual patients and users.

  • 7.
    Askerlund, Per
    et al.
    Jönköping University, School of Education and Communication, HLK, School Based Research, Sustainable Development and Science education.
    Almers, Ellen
    Jönköping University, School of Education and Communication, HLK, School Based Research, Sustainable Development and Science education.
    Hyltse-Eckert, Yvonne
    Jönköping University, School of Education and Communication, HLK, School Based Research, Sustainable Development and Science education.
    Avery, Helen
    Jönköping University, School of Education and Communication, HLK, School Based Research, Sustainable Development and Science education.
    Kjellström, Sofia
    Jönköping University, School of Health Science.
    The Nordic forest garden: An educational opportunity for learning about ecological and emotional relationships between organisms2014In: Education for sustainable development: only big words for politicians or a responsibility for education workers?, 2014Conference paper (Refereed)
    Abstract [en]

    Ecosystem services as a perspective on ecological processes is highlighted in the new  curriculum for Biology in years 4-9 in Sweden. The ecosystem service-approach implies  an anthropocentric perspective in education and  an unidirectional view on the purpose and value of other organisms than humans. This study is part of a larger project exploring an educational situation in which 27 seven to eight year-olds participate in creating mini-projects in a forest garden in order to strengthen ecosystem services such as pollination. A forest garden is an edible polyculture landscape with different layers of vegetation. The forest garden is designed to maximise the yield of useful plants while minimizing the input of energy and resources, human labor included (Crawford, 2009). While planning for and establishing a forest garden there is a need to adapt to specific local conditions. The ground must be prepared  in a way that makes best use of the solar energy and waterflow through the area and the plants should be placed so that they promote each another.  This demands reflection and knowledge about relationships between different kinds of plants but also about relationships between plants and animals. The aim of this substudy is to describe how the children perceive their own relationships to other organisms, as well as how they perceive the relationships between different other organisms. This is investigated in focus group interviews  with seven to eight year-olds. Also field notes, video recordings and photos from the children's visits in the forest garden have been collected. The videos and photos have been used for stimulated re-call (Stough, 2001) in a second focus group interview. The data will be analyzed qualitatively (Patton, 2002). In addition to providing insights about the children's perceptions, the project will give examples of  how a Nordic forest garden can be used in an educational context. Preliminary findings show cognitive/emotional/moral/ themes describing how children perceive relationships between organisms.

  • 8.
    Avby, Gunilla
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Engström, Annika
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Bergmo-Prvulovic, Ingela
    Jönköping University, School of Education and Communication, HLK, Lifelong learning/Encell.
    Fabisch, Anna
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Shaping leadership development systems to the work context2022Conference paper (Refereed)
    Abstract [en]

    The paper seeks to identify patterns of leadership development in different organization contexts with the aim of contributing to improved understanding of how the context shapes the leadership development system (LDS).

    Design/methodology/approach: This study is based on the initial phase of a 4-year collaborative research project on LDSs. Data was collected in the five collaborative partner organizations and based on four data sources: 1) company visits; 2) internal documentation; 3) external information (websites); and 4) company presentations at an on-line workshop.

    Findings: The results show a strong focus on individual leader development, and at least partly, confirms the under-use of developmental assignments and relationships as shown in previous studies. All organizations outsource leadership development to different degrees. However, leadership development is not only structured through different methods, it is also dependent on the organization context in the form of leader forums and meetings. An identified pattern is that the smaller organizations are more dependent on external resources, and the larger organizations tailor company-wide programs for their unique needs together with external consultants. Furthermore, the LDS is believed to be an effective change agent in the adaptive process of transforming.

    Originality: This study contributes to the research on leadership development by advancing the current understanding of how leadership development interacts with the context of the organization.

    Practical implications: This study highlights the need for leaders and HR professionals to acknowledge contextual issues when choosing practices used for developing the leadership in the organization.

  • 9.
    Avby, Gunilla
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    ”Inga bevis för att chefer blir bättre av att gå på kurs”2020In: Dagens Nyheter, ISSN 1101-2447, no 2021-04-22Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Ingress: 

    Två forskare: Risken är att cheferna efter en kurs får en mer idealiserad bild av sin roll som inte stämmer med vardagens verklighet.

    En vanligt förekommande uppfattning är att chefer och ledare utvecklas bäst genom att gå på kurs. Men det finns ingen evidens för att det är det bästa sättet att utveckla ledarskapets kompetens.

  • 10.
    Avby, Gunilla
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Innovationskraft i vardagens processer2020In: Chefer och ledare i vården, ISSN 1404-4684, no 4, p. 24-27Article in journal (Other academic)
    Abstract [sv]

    Forskningen visar återkommande att 70 procent av olika typer av utvecklingssatsningar misslyckas. Särskilt utmanande blir det i komplexa organisationer. Hur ser innovationsklimatet ut i din verksamhet? Och vad säger forskningen om att leda innovation och förändring?

  • 11.
    Avby, Gunilla
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    LearnOvation: an intervention to foster exploration and exploitation behaviour in health care management in daily practice2019In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 19, no 1, article id 319Article in journal (Refereed)
    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.

  • 12.
    Avby, Gunilla
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Utforska och kontrollera för innovation i vardagen – två praktiska exempel [video]2020Other (Other (popular science, discussion, etc.))
  • 13.
    Avby, Gunilla
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Öka innovationskraften i vardagens processer [video]2020Other (Other (popular science, discussion, etc.))
  • 14.
    Avby, Gunilla
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Andersson Bäck, Monica
    University of Gothenburg.
    A reform as a lever for innovation and professionalism?2017Conference paper (Refereed)
    Abstract [en]

    Introduction: Consistently with international trends, managerial reforms and incentive systems in Sweden have been introduced to achieve quality improvement and increased efficiency in welfare services. 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 service transformations or innovation.

    Aim: In this study we explore how organizational performance are changing within the context of a patient choice reform in primary healthcare.

    Material and Methods: This qualitative study is based on 48 semi-structured interviews with various professions (managers, physicians, nurses, physical- and occupational therapists, care administrators, and nurse assistants) at five PHCCs, conducted as part of a study designed to explore financial incentives and motivation in PHC in Sweden. The PHCCs were purposively selected to ensure the inclusion of both public and private facilities. All centers had a longstanding reputation for good leadership and high quality care. 

    Results: The findings show how professional fields and traits were dissolving and changing, triggering the emergence of innovative solutions in practice. Through ongoing negotiations of professional boundaries new practices unfolded and professionalism increasingly was achieved through contextual conditions. The expanding and changing of professional boundaries as shown in the study are implied to stimulate innovative processes. Thus, the main findings suggest that innovative practices developed as a relationship between contextual conditions and professionalism. E.g. nurses and physical therapists remitted patients directly to the hospital, multiprofessional teams for patient groups with joint needs handled patients that previous needed hospital care, and nurse assistants became responsible for summing patients with minor hypertension for blood pressure controls and consultations.

    Conclusions: The reform seemed to act as a lever for innovation and professionalism under certain conditions. How work is organized and managed is a contextual factor that not only affects work circumstances, but also provides conditions for innovation and professionalism. Impartial to governments’ ambitions to improve their responsiveness to the needs of citizens by altering market rules, new provider models may be of little assistance in achieving the desired effect on health sector reform outcomes if suitable contextual conditions are missing.

  • 15.
    Avby, Gunilla
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Andersson Bäck, Monica
    Department of Social Work, University of Gothenburg, Göteborg, Sweden.
    Tending to innovate in Swedish primary health care: a qualitative study2019In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 19, no 1, article id 42Article in journal (Refereed)
    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.

  • 16.
    Avby, Gunilla
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Andersson Bäck, Monica
    University of Gothenburg.
    Transforming primary healthcare: Exploring a new provider model as a lever for innovation and professionalism2017Conference paper (Refereed)
  • 17.
    Avby, Gunilla
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Andersson Bäck, Monica
    Göteborgs universitet.
    Areskoug Josefsson, Kristina
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Andersson-Gäre, Boel
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Sparf, Anette
    Siljehult, Mats
    Samarbete bygger en stark primärvård2017In: Dagens Nyheter 2017-08-17, ISSN 1101-2447Article in journal (Other (popular science, discussion, etc.))
  • 18.
    Bergmo-Prvulovic, Ingela
    et al.
    Jönköping University, School of Education and Communication, HLK, Lifelong learning/Encell.
    Avby, Gunilla
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Engström, Annika
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Fabisch, Anna
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Exploring Social Representations of Leadership Development: Designing for Work-Integrated Learning2022Conference paper (Refereed)
  • 19.
    Bergmo-Prvulovic, Ingela
    et al.
    Jönköping University, School of Education and Communication, HLK, Lifelong learning/Encell.
    Avby, Gunilla
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Stockholm University.
    Engström, Annika
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Fabisch, Anna
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Exploring Social Representations of Leadership Development: Designing for Work-Integrated Learning2022In: International Conference on Work Integrated Learning: Abstract Book, Trollhättan: University West , 2022, p. 83-86Conference paper (Refereed)
    Abstract [en]

    This paper explored social representations of leadership and leadership development shaping an organizations leadership development system (LDS). This study is based on the initial phase of a 4-year collaborative research project on LDSs, adopting an interactive research approach to co-produce knowledge through joint meetings and learning workshops (Ellström et al., 2020). The research project involves researchers from different disciplines, and five organizations operating in different business domains. The participating organizations vary in terms of size, strategies, markets, processes, products, and ways of organizing, but they all share a common interest in how to develop sustainable approaches to leadership development. An LDS encompasses all the metho ds and practices in an organization that contribute to developing and producing effective leaders (McCauley et al 2010). The importance of understanding the characteristics of the context the LDS is embedded in has been highlighted in a previous study (Avby et al., 2022), and serve as a point-of-reference in this study. However, less is known of what underlying assumptions an LDS is based upon. This study paid attention to the underlying values, ideas, and perspectives on leadership and leadership development that shape an organizations’ ways of thinking, communicating, and acting in the LDS. We suggest that the potential to develop a more deliberate practice of leadership development was enhanced by exploring and articulating the tacit knowledge and assumpt ions that an LDS rests upon.

    Aim

    The aim of this study was to explore how socially and contextually shaped assumptions on leadership and leadership development can be visualized and practically applied to develop the leadership in the organization. The question addressed was how the awareness of underlying assumptions can support the methods and practices applied, and in what way the disclosing of underlying ideas, values and practices may foster work -integrated learning?

    Design and methods

    From a social representation theory approach (Moscovici, 2001, Jovchelovitch, 2007, Markova, 2003, BergmoPrvulovic, 2015), underlying assumptions of leadership and leadership development were explored. In the collaborative project an initial mapping of the participating organizations’ LDSs has been co nducted, based on different sources of data. The results of this mapping have been presented through a metaphorical analysis (Avby et al., 2022), in which the participating organizations are described with certain metaphors of their LDS. This study paid specific attention to the organization entitled The Self-Managing Team, and added to the initial stage of mapping LDSs by exploring the underlying assumptions that underpins the expressions and formulations on leadership and leadership development found in the organization’s documents, websites, formulations in meetings and strategies. The exploration of social representations of LDSs was based upon the free association method (Abric, 1995), further developed, and used in studies exploring social representations of similar abstract and complex phenomena, such as career (Bergmo-Prvulovic, 2013: 2015). The method consists of questions, words and series of words given to the respondents who spontaneously write down their immediate associations towards a specific concept and complex phenomenon with a gradual deepening of questions related to specific words, series of words. In this study, a digital enquiry was created in Esmaker. The enquiry was designed to ask for respondents spontaneous, immediate thoughts on words, and series of words related to leadership and leadership development. The gradually deepening of questions, were designed by paying attention to the five dimensions of representations suggested by Jovchelovitch (2007), by exploring who are concerned, why and for what leadership is needed, what is the content 84 of leadership, when it works and doesn’t work, when and how it occurs as well who is responsible, whose engagement and what conditions are needed. This study was based on 19 respondents’ answers a ll member in the Self-Managing Team. They were selected by the organization, as identified having important roles and functions in the company’s LDS. A facilitator in the organization introduced an online enquiry with 12 questions, given one by one to the respondents, providing 1-2 minutes for each. The respondents wrote down their associations to each question, some background data, and questions about leadership identity. The analytical procedure was made according to qualitative content analysis method as the basic procedure of qualitatively exploring social representations (Bergmo-Prvulovic, 2013; 2015). Expressions were numbered with a certain code for each respondent related to each answered question, thereafter each textual units were condensed, meaning units were coded and grouped into constitutive elements that builds up preliminary and primary themes generating a web of social representations of LDS for the group of respondents.

    Preliminary results

    The results disclosed a web of underlying social representations shaping the LDS in The Self-Managing Team. The social representations shape a basic, contextually characterized system of values, ideas, and practices, on which the company at present form their LDS. Given the collaborative design of the project, the results were fed back to the organization to validate the analytical procedure, as well as to support the designing for work -integrated learning and further knowledge use in the organization. The results revealed the respondents’ assumptions on leadership, leadership development, and self-leadership. These assumptions are clearly anchored in the organization’s aim to build in self-management, as a collective way of working with leadership. However, the existing knowledge base encloses both commonalities and contradictions that needs to be further highlighted to create a sustainable LDS. Results showed both stable representations, that occur repeatedly throughout the material, and dynamic social rep resentations, that express a negotiating character between different views, or as being antinomies of thoughts. By identifying and raising awareness of ambiguities deriving from the results, a base of designing for reflective work-integrated learning was provided. A joint learning process to discuss how the results could be utilized as a tool for work-integrated learning was initiated. Some challenges were recognized, and the organization especially addressed the need to work with a second step of workplace reflection. A first learning cycle was initiated to be continuously developed by involving the employees in the process. In all, the contribution of the study explains the basis of leadership development practice, which unnoticed might create ambiguity in service delivery. The mapping of social representations of an LDS can be utilized as a tool for a more deliberate leadership development practice and highlight possibilities and challenges that need to be addressed for integrating methods and practices in everyday work.

  • 20.
    Boström, Martina
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Björklund, Anita
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Older persons have ambivalent feelings about the use of monitoring technologies2013In: Information Technology and Disabilities, E-ISSN 1073-5127, Vol. 25, no 2, p. 117-125Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: As they age, older persons prefer to continue to live in their own homes. Sensors in the environment and/or bodily worn systems that monitor people might contribute to an increased sense of safety and security at home, but also raise concerns about the loss of privacy by surveillance. Little is known about how older persons, living at home independently and stating good health, perceive monitoring technology in terms of personal privacy.

    OBJECTIVE: to identify and describe how older persons, perceive monitoring technology in terms of personal privacy.

    METHOD: A qualitative study based on five focus group interviews was used. Concepts of "freedom" and "surveillance" were used as content areas in the data analysis.

    RESULTS: The results comprised three categories of ambivalence; "independence vs. security", "privacy vs. intrusion", and "in the best interest of me vs. in the best interest of others". These three categories merged into the overarching theme "maintaining a sense of self" which illustrates a desire to maintain control of one's life as long as possible.

    CONCLUSIONS: Older persons generally have positive feelings and attitudes toward technology and strive to maintaining a sense of self as long as possible, by having control. They stated high value to privacy, but valued being watched over if it ensured security. To feel good and bad about monitoring technologies, rather than good or does not necessarily lead to feelings of conflict.

  • 21.
    Boström, Martina
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Malmberg, Bo
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Björklund, Anita
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Personal emergency response system (PERS) alarms may induce insecurity feelings2011In: Gerontechnology, ISSN 1569-1101, Vol. 10, no 3, p. 140-145Article in journal (Refereed)
    Abstract [en]

    (PERS) alarms have been used in Sweden since 1974 to enable older people to age safely at home. Despite this long use, we found no studies describing independent older users’ opinions of these devices.

    Aim Our aim was to describe how people living in Swedish independent senior housing perceive the alarms and to highlight their wishes for further developments and innovations.

    Methods We conducted five focus group interviews with residents of senior housing who used or had used a PERS alarm and analysed the data qualitatively for latent content.

    Results The data analysis revealed five themes in participants’ opinions and feelings about the PERS alarms: (i) safety, (ii) anxiety, (iii) satisfaction, (iv) being informed, and (v) older persons as active innovators.

    Conclusion The 40-year-old Swedish PERS used in senior housing seems to limit rather than liberate users in their daily lives and cause feelings of insecurity rather than security. Older Swedish people require a more personalized alarm with a built-in positioning system that would allow them a greater range of movement beyond their homes.

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  • 22.
    Bradbury, Hilary
    et al.
    AR+ Action Research Plus Foundation.
    Glenzer, Kent
    Middlebury Institute of International Studies, USA.
    Apgar, Marina
    Institute of Development Studies, Sussex University, UK.
    Embury, Dusty C.
    Wright State University, USA.
    Friedman, Victor
    Emek Yezreel College, Israel.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Larrea, Miren
    Orkestra Institute, Deusto University, Spain.
    Childers-McKee, Cherese
    Northeastern University, USA.
    Hsia, Hsiao-Chuan
    Shih Hsin University, Taiwan.
    Ortiz, Alfredo
    Middlebury Institute of International Studies, USA.
    Gray, Paul
    Boston College, USA.
    Ku, Hok Bun
    The Hong Kong Polytechnic University, Hong Kong.
    Parenti, Melissa
    Northeastern University, USA.
    Traeger, James
    Hult Ashridge Business School, UK.
    Warwick, Rob
    Chichester University, UK.
    Devecha, Simon
    Independent Scholar-Practitioner, Australia.
    Action Research Journal’s seven quality choicepoints for action oriented research for transformations2020In: Action Research, ISSN 1476-7503, E-ISSN 1741-2617, Vol. 18, no 1, p. 3-6Article in journal (Other academic)
  • 23. Bradbury, Hilary
    et al.
    Glenzer, Kent
    Ku, Ben
    Columbia, Dusty
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Aragón, Alfredo Ortiz
    Warwick, Rob
    Traeger, James
    Apgar, Marina
    Friedman, Victor
    Hsia, Hsiao Chuan
    Lifvergren, Svante
    Gray, Paul
    What is good action research: Quality choice points with a refreshed urgency2019In: Action Research, ISSN 1476-7503, E-ISSN 1741-2617, Vol. 17, no 1, p. 14-18Article in journal (Other academic)
  • 24. Bradbury, Hilary
    et al.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Awakening to human centered interaction. Dialogue with Sofia Kjellström [blog post]2019Other (Other (popular science, discussion, etc.))
  • 25.
    Ericsson, Iréne
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Hellström, Ingrid
    Linköping University, Sweden.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Sliding interactions: An ethnography about how persons with dementia interact in housing with care for the elderly.2011In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 10, no 4, p. 523-538Article in journal (Refereed)
    Abstract [en]

    This ethnography describes how persons with dementia interact with cognitively intact persons in housing with care for the elderly. The results, drawing upon 31 observation sessions and nine interviews, are described under the following themes, which were interpreted from the standpoint of social interaction theory: interaction with expression of satisfaction, disorientation, and dissociation. Interaction provided satisfaction, but did not always reflect a positive experience. Awareness in persons with dementia seemed to be greater than others perceived and, as a result, interaction was adversely affected by frequent well-intentioned corrections and comments. Participation in interaction can be encouraged and feelings of indignation avoided by assuming that persons with dementia are aware of their situation and how others behave toward them. Sensitivity is required to interpret individuals' expressions of desire not to participate, while simultaneously it is important to try to interpret why they want to refrain.

  • 26.
    Ericsson, Iréne
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Hellström, Ingrid
    Linköping University.
    Creating relationships with persons with moderate to severe dementia2013In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 12, no 1, p. 63-79Article in journal (Refereed)
    Abstract [en]

    The study describes how relationships are created with persons with moderate to severe dementia. The material comprises 24 video sequences of Relational Time (RT) sessions, 24 interviews with persons with dementia and eight interviews with professional caregivers. The study method was Constructivist Grounded Theory. The categories of 'Assigning time', 'Establishing security and trust' and 'Communicating equality' were strategies for arriving at the core category, 'Opening up', which was the process that led to creating relationships. Both parties had to contribute to create a relationship; the professional caregiver controlled the process, but the person with dementia permitted the caregiver’s overtures and opened up, thus making the relationship possible. Interpersonal relationships are significant to enhancing the well-being of persons with dementia. Small measures like RT that do not require major resources can open paths to creating relationships.

  • 27.
    Fabisch, Anna
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, HHJ, Department for Quality Improvement and Leadership. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Ockander, Marlene
    Jönköping University, School of Health and Welfare, HHJ, Department for Quality Improvement and Leadership. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Avby, Gunilla
    Stockholm Univ, Dept Educ, Stockholm, Sweden.
    Transformations towards an integrated leadership development system: A longitudinal study in a high-performing public organization2024In: Leadership, ISSN 1742-7150, E-ISSN 1742-7169Article in journal (Refereed)
    Abstract [en]

    Leadership development (LD) plays a significant role in achieving high-quality performance and business results, but there is little research on how leadership development itself evolves as the organization develops. This study explores how a leadership development system evolved over 30 years, during a time when the organization became increasingly high performing. Through reflexive thematic analysis of organizational documents and interviews with top managers and practitioners, the study provides a rich longitudinal description of the evolvement. The results revealed three pervasive changes of the leadership development system: 1) from a system for business-specific learning to one for system-wide learning; 2) from a system for personal development to one for customer-oriented quality development; and 3) from a leadership development system consisting of leadership development programs to one that is integrated into regular meetings and uses simple rules. These changes supported the gradual transformation of the leadership development from being independent to becoming integrated in the wider system, supporting the business system. The findings offer a unique insight into how an organization transitioned from individual leader development towards promoting collective aspects of leadership development. The study provides two main theoretical contributions that support the perspective of viewing leadership development as integrated within organizational development. Firstly, we present a more multifaceted way of understanding leadership development, wherein managers and employees, customer outcomes, and business advancement are seen as mutually developing. Secondly, we introduce two new critical points that complement previous descriptions of an advanced leadership development system: It is system wide (not only business specific) and customer oriented (not only leader/participant oriented).

  • 28.
    Gabrielsson-Järhult, Felicia
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Areskoug Josefsson, Kristina
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Telemedicine consultations with physicians in Swedish primary care: a mixed methods study of users' experiences and care patterns2021In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 39, no 2, p. 204-213Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The study aimed to explore users' experiences and care patterns concerning telemedicine consultations with physicians in Swedish primary care from 2017 to 2019.

    Design and participants: A mixed methods study involving 26 qualitative interviews with users of telemedicine consultations from a national sample, complemented by a quantitative registry study of data from 10,400 users in a Swedish region.

    RESULTS: Users mainly described telemedicine consultations as a positive experience and perceived that the service met their current health care needs. Users also valued high accessibility, timesaving, and the contribution to ecological sustainability. Users felt competent about choosing when to use telemedicine consultations, most commonly for less severe health care concerns. This was confirmed by the quantitative results; only a few users had other care contacts within physical primary care before, or after, the telemedicine consultation, attended acute care or phoned 1177 Health Care Guidance.

    CONCLUSIONS: This study provides a rare account of users' experiences of telemedicine consultations. Users expressed satisfaction with this up-to-date use of health care resources for them as individuals, the health care system, and the environment. Telemedicine consultations were perceived as efficient and safe according to users. In addition, the study shows a low degree of further physical contacts in primary care or in acute care related to the telemedicine consultations.

    Key points

    • Users have positive experiences of telemedicine consultations with physicians and experienced that the service had meet their actual needs for health care.
    • Users were mainly satisfied with the service and highlighted the value of high accessibility.
    • Users experienced that telemedicine consultants provided an alternative care service for mostly minor health problems, perceiving them to save time and resources for themselves, the health care system, and the environment.
    • Most telemedicine consultations did not result in additional contacts with 1177 Health Care Guidance, physical visits to primary care, or acute health care.
    • Telemedicine consultations with physicians were mainly used by persons aged 0-30 years and need to be further developed to suit other age groups.
  • 29.
    Gabrielsson-Järhult, Felicia
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Mahmud, Yashar
    Jönköping University, School of Health and Welfare, HHJ, Department for Quality Improvement and Leadership.
    Fristedt, Sofi
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ, Department for Quality Improvement and Leadership.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Hur klickar vi med vården? En vetenskaplig studie av digitala och fysiska vårdkontakter utifrån användarmönster och patienters erfarenheter av primärvård2023Report (Refereed)
    Abstract [sv]

    Patienter och professionella vårdaktörer är i en gemensam förändrings- och lärandeprocess, där vården parallellt med medborgarna och samhället lär sig hantera digitalisering. Under senare år, bl.a. pådrivet av covid-pandemin, har digitaliseringen och införande av nya arbetssätt gått så fort att utvärdering och forskning inte hunnit med i samma takt. Syftet med rapporten ”Hur klickar vi med vården?” är att bidra med aktuell kunskap om patienters användarmönster och erfarenheter av digitala och fysiska kontakter med primärvården. Resultaten är tänkt att användas som faktaunderlag och stöd för vårdens utvecklingsarbete.

    Sveriges Kommuner och Regioner (SKR) tog hösten 2022 initiativet till forskningsprojektet ”Hur klickar vi med vården?”. Uppdraget genomfördes under 2023 av en oberoende forskargrupp på Hälsohögskolan vid Jönköping University. Resultaten är presenterade i två delstudier baserade på registerdata från primärvården och intervjuer med patienter. All registrerad data från den regionala primärvården i Region Jönköpings län och Region Sörmland under perioden januari 2020 – december 2022 har ingått i undersökningen. Data från Region Jönköpings län omfattar ca 352.000 personer vilka sammanlagt hade haft kontakt med primärvården ca 4,2 miljoner gånger, motsvarande för Region Sörmland var ca 245.000 personer som hade haft ca 3,2 miljoner kontakter. I dessa data ingår kontakter med privata helt digitala vårdgivare och för Region Jönköpings län data från 1177 Sjukvårdsrådgivning. I rapporten ingår även 35 kvalitativa intervjuer med ett nationellt urval av patienter. Resultatet av den kvalitativa studien är presenterat som sex teman som beskriver patienters erfarenheter av kontakt med vården.

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  • 30. Golino, Hudson
    et al.
    Hamer, Rebecca
    Almers, Ellen
    Jönköping University, School of Education and Communication, HLK, Learning Practices inside and outside School (LPS), Sustainability Education Research (SER).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Measuring epistemological development – a uni- or multidimensional structure?2018Conference paper (Refereed)
  • 31.
    Golino, Hudson
    et al.
    Department of Psychology, University of Virginia, United States.
    Hamer, Rebecca
    Assessment Research & Design, International Baccalaureate, The Hague, Netherlands.
    Almers, Ellen
    Jönköping University, School of Education and Communication, HLK, Learning Practices inside and outside School (LPS), Sustainability Education Research (SER).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    The structure of the epistemological development in teaching learning questionnaire2019In: Cogent Education, E-ISSN 2331-186X, Vol. 6, no 1, article id 1655211Article in journal (Refereed)
    Abstract [en]

    New measurement of students' learning and teaching concepts is essential for creating constructive alignment in teaching and support formative assessment to promote epistemic development. The Epistemological Development in Teaching Learning Questionnaire (EDTLQ) was developed to meet these needs. In the present study, the factor structure of EDTLQ was examined using a sample of 643 students from a Swedish University. The results show that the correlated six-factor model fits the data the best. The result is consistent with the developmental theory that posits development as a dynamic highly correlated process varying across and within domains. There is a potential to use EDTLQ as a tool for adapting teaching to appropriate levels of understanding within different domains. The EDTLQ is one of the few measurements that can be used to assess students' learning concepts so that education/teaching can be adapted to support students? development of more complex levels of thinking about learning.

  • 32.
    Greenhalgh, Trisha
    et al.
    University of Oxford, Oxford, England.
    Engebretsen, Eivind
    University of Oslo, Oslo, Norway.
    Bal, Roland
    Erasmus University, Rotterdam, Netherlands.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ, Department for Quality Improvement and Leadership.
    Toward a Values-Informed Approach to Complexity in Health Care: Hermeneutic Review2023In: Milbank Quarterly, ISSN 0887-378X, E-ISSN 1468-0009, Vol. 101, no 3, p. 646-674Article in journal (Refereed)
    Abstract [en]

    Policy Points

    • The concept of value complexity (complexity arising from differences in people's worldviews, interests, and values, leading to mistrust, misunderstanding, and conflict among stakeholders) is introduced and explained.
    • Relevant literature from multiple disciplines is reviewed.
    • Key theoretical themes, including power, conflict, language and framing, meaning-making, and collective deliberation, are identified.
    • Simple rules derived from these theoretical themes are proposed.
  • 33.
    Hedberg, Berith
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Nordström, Erik
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Josephson, Iréne
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    "We found a solution, sort of”: qualitative interview study with children and parents on their experiences of the coordinated individual plan (CIP) in Sweden2018In: Cogent Medicine, ISSN 2331-205X, Vol. 5, no 1, article id 1428033Article in journal (Refereed)
    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.

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  • 34.
    Karltun, Anette
    et al.
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Karltun, Johan
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Coelho, Denis A.
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Havemose, Karin
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, HHJ, Department for Quality Improvement and Leadership. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    The work of first line managers – A key to resilience in manufacturing2023In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 110, article id 103993Article in journal (Refereed)
    Abstract [en]

    First-line managers (FLMs) have a vital role in developing stable output and organizational competitiveness through their ability to manage front-line operations in daily work. It is also well known that FLMs are strong determinants of good ergonomics and well-being for front-line staff. However, research focusing on how FLMs deal with their important role is lacking particularly regarding empirical studies. The focus here is how they deal with uncertainties and disruptive interruptions and develop more resilient performance in daily work – introduced in this article as resilient action strategies.

    This research uses two conceptual frameworks on resilient engineering for analysis of FLM's actions in daily work in two manufacturing companies, to explore how resilient action strategies can be organizationally supported. The study combines analysis of front-line activities with multilevel organizational support based on 30 semi-structured in-depth interviews with FLMs and support functions, 21 workshops as well as policy documents of the two companies. The analysis exemplifies how resilience engineering was enabled in practice in the organizations.

    The study contributes to the empirical understanding of how resilience can be organizationally supported in daily front-line work. Our results show that a developed and consistent infrastructure in companies promotes the emergence of resilient action strategies in front-line work. We propose an extended model for resilient front-line performance enhancement by including coordination as a linking aspect between the earlier suggested resilient potentials – anticipate, monitor, respond and learn. This highlights the importance of both organizational support and coordination between system levels to enable the development of resilient action strategies by FLMs.

  • 35.
    Karltun, Johan
    et al.
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Karltun, Anette
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Havemose, Karin
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Coelho, Denis A.
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Sandback, Annette
    Scania CV AB.
    Handbok för första linjens chefer2022Book (Other academic)
    Abstract [sv]

    Från inledningen: Den här handboken vänder sig framför allt till dig som är första linjens chef i tillverkande industri. Första linjens chef definieras här som den första chefsnivån som har personalansvar. Det är den vanligaste chefspositionen och finns i alla företag med minst en chefsnivå. Det är en oerhört viktig funktion! Även forskningen lyfter fram första linjens chef som en nyckelposition för att skapa en väl fungerande och hållbar produktion.

    Du kanske är helt ny i rollen som chef och då är det här en hjälp till att förstå uppgiften. Eller så är du erfaren chef men ny i företaget, och kan behöva lite tips för att förstå och lyckas i ditt nya jobb. Slutligen hoppas vi erbjuda några guldkorn även för dig som är erfaren chef i ett företag som du känner sedan länge.

    Handboken vänder sig också till dig som har en roll i samarbete med första linjens chefer. Du kanske jobbar i linjen eller är teamledare, dvs ledare utan personalansvar. Du kanske är andra linjens chef eller har en stödfunktion till produktionen med ansvar för skydd och säkerhet, planering, kvalitetsutveckling, tekniskt underhåll, teknikutveckling, produktutveckling, logistik eller HR-funktioner. Vi hoppas att ni alla kan hitta användbara råd och lärdomar i handboken.

    I handboken vill vi tydliggöra arbetsinnehållet för första linjens chefer och hur det kan utvecklas. Vi gör det genom att beskriva rollen och arbetet som första linjens chef. Vi lägger också stor vikt vid att beskriva dynamiken och problemlösningen som hela tiden är närvarande. Dessutom vill vi peka på möjligheterna att systematiskt utveckla förutsättningarna för och förmågan att arbeta som chef i första linjen – så att du kan fungera och må bra i uppgiften på ett hållbart sätt eller stötta den personsom har denna roll. En första linjens chef har stor inverkan på både arbetsmiljön och effektiviteten inom sitt område. Även chefens arbetsmiljö är därför av stor vikt för att nå bra resultat inom dessa områden.

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  • 36.
    Karltun, Johan
    et al.
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Karltun, Anette
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Havemose, Karin
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Coelho, Denis A.
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Sandback, Annette
    Scania CV AB.
    Handbook for front line managers2023Book (Other academic)
    Abstract [en]

    From the introduction: This handbook is aimed primarily at front line managers (FLMs) in manufacturing industries. Frontline manager is defined here as the first management level with personnel responsibility. It is the most common managerial position and is found in all companies that have at least one management level. It is an extremely important role. Research also highlights the FLM as a key position in the creation of well-functioning and sustainable production.

    You may be new to the role of being a manager, if so this book will help you to understand your tasks. If you are an experienced manager but new to the company, you will find some suggestions on how to succeed in your new job. Finally, we hope that we can offer some pearls of wisdom for those of you who are experienced managers in a company you have known for a long time.

    The handbook is also for you who collaborate with FLMs. You may be working in the line or as a team leader, which is a leader without personnel responsibility. You may be a second line manager or have a production support role with responsibility for protection and safety, planning and scheduling, quality development, technical maintenance, technological development, product development, logistics, HR functions or something else. We hope that the handbook will provide you all with useful advice and information.

    This handbook is intended to clarify the content of FLM’s work and how it can be developed. We do this by describing the role and work of the FLM but also the ever-present dynamics and problem-solving foundin the role. We also want to underscore opportunities for systematically developing the potential for and ability to work as a FLM. To enable you to work and thrive in the role in the long term or support someone else in this role. FLMs have a major impact on both work environment and efficiency within their area. As such, the manager’s work environment is also of great importance for success.

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  • 37.
    Karltun, Johan
    et al.
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Karltun, Anette
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Havemose, Karin
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Karlsson, Magnus
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Studying resilient action strategies of first line managers [Protocol]2021In: Social Science Protocols, E-ISSN 2516-8053, Vol. 4Article in journal (Refereed)
    Abstract [en]

    Background: One important key to an organization’s long-term competitiveness is the ability of first line managers (FLMs) to handle their role as a leader in daily work. FLMs main task is to contribute to a high and stable production output according to customer demands from an input that is characterized by instability and variability. To do so, FLMs must develop resilient action strategies – ways of working and daily problem solving that systematically facilitate to cope with instability. In this study protocol we present a methodological approach developed to evaluate and improve these.

    Methods/Design: The research approach is collaborative and developmental and performed together with two companies. The approach integrates and extends the theory and application of a model on interactive research and a framework on activity analysis. It will be applied using data collection techniques like interviews, diaries, observations, document analysis, and questionnaires. The analysis and development stages will be performed both separate and in collaboration in workshops and the result is planned to end up in the joint writing of a generic handbook on advantageous action strategies for FLMs’.

    Discussion: This study contributes with a new integration of two methodological approaches which provides a novel way to understand and develop dynamic on-the-job behaviour in work settings.

  • 38.
    Karltun, Johan
    et al.
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Karltun, Anette
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Havemose, Karin
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Positioning the study of first line managers’ resilient action strategies2019In: 8th REA Symposium on Resilience Engineering: Scaling up and Speeding up: Proceedings, 2019Conference 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.

  • 39.
    Kjellström , Sofia
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Idéer om ansvar för hälsa: forskning och metoder utifrån ett vuxenlivsutvecklingsperspektivManuscript (Other scientific)
  • 40.
    Kjellström, Sofia
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Ansvar för hälsa och personlig utveckling vid långtidssjukskrivning2007In: Nya vägar till livet, Jönköping: Coompanion Jönköpings län , 2007, p. 36-41Chapter in book (Other academic)
  • 41.
    Kjellström, Sofia
    Linköpings universitet.
    Ansvar, hälsa och människa: en studie av idéer om individens ansvar för sin hälsa2005Doctoral thesis, monograph (Other academic)
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  • 42.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Antagande om ledarskap påverkar lärande [bloggpost]2018Other (Other (popular science, discussion, etc.))
  • 43.
    Kjellström, Sofia
    Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health. Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Delaktighetens etik och ansvar för delaktighet2012In: Delaktighetens praktik: Det professionella samtalets villkor / [ed] Pia Bülow, Daniel Persson Thunqvist, Inger Sandén,, Malmö: Gleerups Utbildning AB, 2012, 1, p. 31-39Chapter in book (Other academic)
  • 44.
    Kjellström, Sofia
    Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health. Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Forskningsetik2012In: Vetenskaplig teori och metod: från idé till examination inom omvårdnad / [ed] Maria Henricson, Lund: Studentlitteratur, 2012, p. 69-94Chapter in book (Other academic)
  • 45.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, HHJ, Department for Quality Improvement and Leadership. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Forskningsetik2023In: Vetenskaplig teori och metod: från idé till examination inom vård- och hälsovetenskap / [ed] M. Henricson, Lund: Studentlitteratur AB, 2023, 3. uppl, p. 61-83Chapter in book (Other academic)
  • 46.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Ger du feedback för att vinna eller lära? [bloggpost]2020Other (Other (popular science, discussion, etc.))
  • 47. Kjellström, Sofia
    Hälsa i bild2003In: Visuella spår: bilder i kultur- och samhällsanalys, 2003Chapter in book (Other academic)
  • 48.
    Kjellström, Sofia
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Kan människor ta ansvar för sin hälsa?2010In: Eget ansvar i vården: ett symposium om medicinsk etik, 16 spetember, Lund, Lund: Medicinsk fakultet, Lunds universitet , 2010, p. 39-46Chapter in book (Other (popular science, discussion, etc.))
  • 49.
    Kjellström, Sofia
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Människors olika komplexa förhållningssätt till hälsa och ansvar2008Conference paper (Other academic)
  • 50.
    Kjellström, Sofia
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Poor quality of reports on informed consent in dissertation2010Conference paper (Refereed)
    Abstract [en]

    Background: Recent research has indicated that ethical concerns are insufficiently dealt with in dissertations. This study examines how research ethics and informed consent is reported in nurses’ dissertations.

    Methods:  Analyses of ethical content and complexity of ethical reasoning in 64 PhD dissertations published by Swedish nurses in 2007.  

    Results: All dissertations, except one, had a section on ethical considerations; however, these were short, lacking in references, and thin on content. Information and informed consent was discussed in (87% of the dissertations). A third of these dissertations explicitly mention the concept of informed consent. A substantial amount of space described the informing phase of research, including details of form of information (written and/or verbal) and type of information. While many ethical concerns, like informed consent, involve systematic concepts or metasystematic principles, the complexity of ethical reasoning in the dissertations was categorized as abstract (6% of the dissertations), formal (84%) and systematic (10%).

    Conclusions : The concept and practice of informed consent is poorly reported in many dissertations. Important ethical concerns are missing and the complexity of reasoning on ethical principles, motives and implications is insufficient. This is partly due to traditions and norms that discount ethical concerns, but probably also reflect the ability of PhD-students and supervisors to handle complexity in general. It is suggested that the importance of ethical considerations is emphasized in graduate and post-graduate studies, and that individuals with capacity to deal with systematic and meta-systematic concepts are recruited to senior research positions.

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