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  • 1.
    Hedman, Karl
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Jönköping University, School of Education and Communication, HLK, Learning Practices inside and outside School (LPS), Communication, Culture & Diversity @ JU (CCD@JU).
    Encouraging student participation in intercultural classroom interaction2019Conference paper (Other academic)
  • 2.
    Hedman, Karl
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Global Studies, School of Education and Communication, Jönköping University.
    Managing Emotions in Swedish Medical Emergency Calls2016In: IMPACT Journal, Vol. 2, p. 1-12Article in journal (Other academic)
    Abstract [en]

    This study is a conversation analytic and ethnographic examination of recurrent emotion management practices of interaction in Swedish medical emergency calls. The study expands the analytical focus in past research on emergency calls between emergency call operators and callers to pre-hospital emergency care interaction on the phone between nurses, physicians and callers. The investigation is based on ethnographic fieldwork in an emergency control centre in a Swedish metropolitan area. The data used for the study consists of audio recordings of medical emergency calls and ethnographic fieldnotes, observations and interviews in the emergency control centre. The analysis reveals four fundamental types of emotion management practices that emergency call-takers use to help people in crisis: (1) call-takers keep themselves calm when managing callers’ social displays of emotions; (2) promising ambulance assistance or other types of assistance; (3) providing problem solving presentations including emergency response measures to concerns of callers, and (4) emphasising the positive to create and maintain hope for callers. The findings generated from this study will be useful in emergency call-taker training in carrying out emotion management procedures in medical emergency calls and add to the larger research programmes on on-telephone interaction between healthcare professionals and citizen callers.

  • 3.
    Hedman, Karl
    Lund university.
    Managing Medical Emergency Calls2016Doctoral thesis, monograph (Other academic)
    Abstract [en]

    This dissertation is a conversation analytic examination of recurrent practices of interaction in medicalemergency calls. The study expands the analytical focus in past research on emergency calls betweenemergency call operators and callers to pre-hospital emergency care interaction on the phone betweennurses, physicians and callers. The investigation is based on ethnographic fieldwork in a Swedish emergencycontrol centre. The data used for the study consists primarily of audio recordings of medical emergency calls.Fundamental procedures in medical emergency calls examined in the dissertation are: (1) questioning; (2)emotion management; (3) risk management and (4) instruction giving. Emergency call-takers ask questions toelicit descriptions by callers of what is happening and to manage symptoms of patients to help keep them safeuntil ambulance crews arrive. In the questioning practice about acutely ill or injured patients call-takers usemainly yes-no questions and clarify problems by questioning callers making a distinction between defined andundefined problems. The analysis reveals four core types of emotion management practices: (1) call-takerskeep themselves calm when managing callers’ social displays of emotions; (2) promising ambulanceassistance; (3) providing problem solving presentations including emergency response measures to concernsof callers, and (4) emphasising the positive to create hope for callers. Call-takers use seven key procedures tomanage risk in medical emergency calls: (1) risk listening through active listening after actual and possiblerisks; (2) risk questioning; (3) risk identification; (4) risk monitoring; (5) risk assessment; (6) making decisionsabout elicited risk and (7) risk reduction. Instruction giving using directives and recommendations isaccomplished by call-takers in four main ways: (1) acute flow maintaining instruction giving when callers areprocedurally out of line; (2) measure oriented instructions for patient care and emergency responsemanagement; (3) organisational response instructions and (4) summarising instruction giving. Callers routinelyacknowledge risk identifications and follow instructions delivered by call-takers to examine statuses and lifesigns of patients such as breathing, movement and pulse, and perform basic first aid and emergency responsemeasures.The findings generated from this study will be useful in emergency call-taker training in carrying out interactiveprocedures in medical emergency calls and add to the larger research programmes on on-telephoneinteraction between professionals and citizen callers. This is an essential book for pre-hospital emergency careproviders and institutional interaction researchers and students.

  • 4.
    Hedman, Karl
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Strengths and support of older people affected by precarity in South Louisiana2019In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 14, no 2, article id e12232Article in journal (Refereed)
    Abstract [en]

    Background 

    Few empirical studies have examined strengths and support of older people in circumstances of precarity. A better understanding of this problem has the potential to contribute to the development of care planning and delivery. 

    Purpose

    To investigate how older people deal with episodes of precarity in South Louisiana. 

    Method

    More than 300 hours of participant observation and interviews were conducted with 20 predominantly older African American women in a housing complex for low-income older persons and two senior citizen centers. 

    Results

    The findings demonstrate five central negative conditions of precarity that older people had to manage: (1) loss and discontinuity of home-based health care services, (2) stress after loss or disruption of social support, (3) problems of poverty, (4) cognitive impairment and declining health, and (5) stress of eviction. Strengths and support that older people used were as follows: (1) spiritual faith, (2) psychological strengths, (3) spiritual relationships, (4) family support, (5) friendships of love and friendships of helpfulness, (6) care and support performed by home-based services, (7) senior center and housing complex activities, (8) church memberships and activities, and (9) grocery store and café contacts. 

    Conclusion

    Home-based services were not sufficient to prevent and reduce precarity for older people because of a lack of and discontinuities in these services.

    Implications for practice

    This study adds to the literature about precarity among community-based older people by demonstrating gaps in care support and medication access. The findings suggest that ongoing state funding and support by home-based services are necessary to support frail older people in precarious living conditions to survive and handle stressful life events by reducing vulnerability and enhancing strengths and supportive resources of older people. 

    The full text will be freely available from 2020-03-12 00:00
  • 5.
    Hedman, Karl
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Henning, Cecilia
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Svensson, Lars A.
    Department of Social and Behavioral Studies, University West, Trollhättan, Sweden.
    Empowering older people in different contexts through social ties2019In: Creating empowerment in communities: Theory and practice from an international perspective / [ed] T. Anme, Hauppauge, New York: Nova Science Publishers, Inc., 2019Chapter in book (Refereed)
    Abstract [en]

    A better understanding of insecure living circumstances and the relational world of older people has the potential to contribute to the development of care planning and delivery. This chapter examines conditions of precarity and empowering social ties of older people in community sites. The study used ethnographic methods to understand the lived experiences of 20 older people that was predominantly female and African American in Baton Rouge in the U.S. State of Louisiana. The ethnographic fieldwork for this investigation was conducted from 2013 to 2018 through participant-observations and open-ended interviews in three community sites in Baton Rouge. The field data was analyzed using social network and empowerment frameworks. The social ties of older people in Louisiana were compared with a previous study on social ties of older people in two Swedish senior centers. The analysis focuses self-, peer- and community empowerment levels and how they protect against precarity of older people.

    The findings from studying different community sites of older people in Louisiana demonstrate that the key social support ties that provided a buffer against precarity of older people were close friendships made in community sites and spiritual faith ties to God. Conditions of precarity and sources of stress of older people in Louisiana were constant threats of discontinuity of home-based health care services, prescription and medication access, not affording health care and other social problems of poverty, cognitive impairment and declining health.

    In Louisiana, self- and peer empowerment of older people were strong, but community empowerment through home-based health care services were not enough to prevent and reduce precarity of older people. Toward the background that Sweden can be considered to have a comprehensive social welfare system it is easier to see examples of empowerment of older people on all three levels. Self- and community empowerment were the strongest when studying examples of community sites for older people. In the Swedish study, the social network of older people was dominated by thin ties between senior peers. Community sites are needed as completent to ageing at home. In Louisiana, strong (thick) ties of older people were dominant.

    For the older people in Louisiana to receive consistent home-based health care services was not a given but required an ongoing active and joint effort by older people, family caregivers and friends. Policy implications of this study are that ongoing care support by family caregivers, friends and home-based health care services and medication access without gaps are needed to reduce and protect against precarity of older people. Self-empowerment should be supported by not only peer but also community empowerment.

  • 6.
    Hedman, Karl
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Torgé, Cristina Joy
    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).
    Räddningstjänstens suicidpreventionsarbete i Region Jönköpings län2018Conference paper (Other academic)
  • 7.
    Hedman, Karl
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Torgé, Cristina Joy
    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).
    Suicide prevention services in Jönköping, Sweden2019Conference paper (Other academic)
  • 8. Karlsson, Gunilla
    et al.
    Hedman, Karl
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health Science, HHJ. ADULT.
    Views on patient safety by operations managers in somatic hospital care: a qualitative analysis2011In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 1, no 3, p. 33-42Article in journal (Refereed)
    Abstract [en]

    Healthcare outcome is to achieve optimal health for each patient. It is a well-known phenomenon that patients suffer from care injuries. Operations managers have difficulties in seeing that the relationship between safety culture, values and attitudes affects the medical care to the detriment of the patient. The aim was to describe the views on patient safety by operations managers and the establishment of patient safety and safety culture in somatic hospital care. Four open questions were answered by 29 operations managers in somatic hospital care. Data analysis was carried out by deductive qualitative content analysis. Operations managers found production to be the most important goal, and patient safety was linked to this basic mission. Safety work meant to achieve optimal health outcomes for each patient in a continuous development of operations. This was accomplished by pursuing a high level of competence among employees, having a functioning report system and preventing medical errors. Safety culture was mentioned to a smaller extent. The primary target of patient safety work by the operations managers was improving care quality which resulted in fewer complications and shorter care time. A change in emphasis to primary safety work is necessary. To accomplish this increased knowledge of communication, teamwork and clinical decision making are required.

  • 9.
    Siouta, Eleni
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Hedberg, Berith
    Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Hedman, Karl
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Interactional resistance between patients with atrial fibrillation and cardiologists in consultation on treatment with warfarin: the value of shared decision-making2012In: The International Journal of Person Centered Medicine, ISSN 2043-7730, E-ISSN 2043-7749, Vol. 2, no 3, p. 427-436Article in journal (Refereed)
    Abstract [en]

    Rationale: Atrial fibrillation (AF) increases the risk of stroke and it can be reduced by treatment with warfarin. Some patients consider that warfarin is a stressful treatment with undesired effects and the perceived barriers include unwillingness to take it. Knowledge of patients resisting warfarin treatment may be useful for the potential threat to maintaining shared decision-making in the consultation as a central tenet of person-centered medicine.

    Aims and objectives: To identify how patients resist treatment with warfarin and how cardiologists respond to patients’ resistance. The co-constructive perspective of this work analyses the consultations by emphasizing the clinical communication strategies of both patients and cardiologists.

    Method: Eleven videotaped consultations, in 4 different hospitals, were selected for analysis. Treatment interactions regarding warfarin between patients with AF and cardiologists were analysed, according to the methodology of conversation analysis.

    Results: There were 4 types of resistance from patients for accepting treatment with warfarin. These included “Giving reasons for their resistance”, “Suggestion of another treatment option by the patient”, “Stating a treatment preference” and “Questioning or challenging the cardiologist’s treatment recommendation”. The cardiologists’ responses to the patients’ resistance included “Repeating the treatment recommendation”, “Negotiation with the patient”, “Providing additional information on the recommended treatment” and “Extending the explanation for the purpose of taking the treatment”.

    Conclusions: By showing resistance, patients are thought to want to participate in their treatment decisions and an awareness of patients’ resistance to treatment enables cardiologists to address the patients’ experience-based views on their treatment and individual concerns as part of clinical strategies to increase the person-centeredness of medical intervention.

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