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  • 51.
    Kjellström, Sofia
    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).
    Mitchell, Ann
    School of Health, Well-being and Social Care, The Open University, Walton Hall, Milton Keynes, UK.
    Health and healthcare as the context for participatory action research2019In: Action Research, ISSN 1476-7503, E-ISSN 1741-2617, Vol. 17, no 4, p. 419-428Article in journal (Other academic)
    Abstract [en]

    Participatory action research (PAR) is a social, practical and collaborative process in which the building of relationships with participants is crucial. It has two distinct features, one is community based and driven to generate knowledge or understanding about what will bring about change; the other is its quality improvement cycle, whereby the actions, reactions, interventions and change are monitored, reviewed and adjusted according to the response. In practical terms, PAR methodology is carried out as a series of planning, acting, observing and evaluating cycles; in other words, reflection and reflexivity are inherent in the process. The challenges of engaging with PAR are to ensure that participants are encouraged to collaborate fully with the process and drive the process, power imbalances are discussed and the recognition that change and action may not always be possible. There are also challenges when studies are written up in a reflexive manner because being reflexive is not as straightforward as it seems. It involves deep introspection, as the researchers become aware of how their own agenda, experiences and motivation can contribute to interactions with participants and potentially influence the knowledge and actions created.

    This specially themed issue draws nine papers together to enrich our understanding of PAR and action-oriented research for transformations (Bradbury et al., 2019b). The aspiration in this presentation is to consider future directions in the domain of healthcare. In relation to the Action Research Journal’s vision, researchers should aim to develop Sustainable Development Goals when engaging in credible quality improvement projects that are monitored and adaptable in the relevant setting (Bradbury et al., 2019a). Our emphasis is therefore to concentrate more on reflexivity, transformation and the implications when developing future studies.

  • 52.
    Kjellström, Sofia
    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.
    Ross, Sara
    Older persons’ reasoning about responsibility for health: variations and predictions2011In: The International Journal of Aging & Human Development, ISSN 0091-4150, E-ISSN 1541-3535, Vol. 73, no 2, p. 99-124Article in journal (Refereed)
    Abstract [en]

    With many Western societies structured for adults to live longer and take responsibility for their health, it is valuable to investigate how older persons reason about this demand. Using mixed methods, this pilot studied how older persons reason about responsibility for health and their responsibility as a patient. Interviews with a small Swedish sample of (65-84 years) were analyzed for qualitative characteristics, and quantitative complexity in reasoning. Using adult development theory, we predicted at least three different stages of performance in reasoning. Results indicated four different stages: two where there is no actual reasoning about health and responsibility, and two where reasoning does occur, each qualitatively different. Results suggest a long-standing blind spot in health studies, that older people do not comprehend responsibility issues in the same way. There are significant implications for closing this gap between demand to take responsibility and capabilities to do so.

  • 53.
    Kjellström, Sofia
    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.
    Ross, Sara N
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Research ethics in dissertations: ethical issues and complexity of reasoning2010In: Journal of Medical Ethics, ISSN 0306-6800, E-ISSN 1473-4257, Vol. 36, no 7, p. 425-430Article in journal (Refereed)
  • 54.
    Kjellström, Sofia
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Sjölander, Per
    Akademi Norr, Storuman, Sweden.
    The level of development of nursing assistants' value system predicts their views on paternalistic care and personal autonomy2014In: International Journal of Ageing and Later Life, ISSN 1652-8670, E-ISSN 1652-8670, Vol. 9, no 1, p. 35-68Article in journal (Refereed)
    Abstract [en]

    The quality of care is substantially influenced by the staff‘s value priorities. The purpose of this study was to identify and characterize value systems among nursing assistants and nurses’ aides, and to assess relations between their value systems and views on good care. A cross-sectional, quantitative study in a Swedish municipality was performed (N226). Three distinct value systems were identified, and they corresponded to early (n121), middle (n88), and late (n17) conventional stages ofego development. Early conventional value systems emphasized strict rules, routines and working conditions of staff, while middle and, in particularly, late conventional value systems stressed individualization and autonomy of older people. Assessment of value system, socio-demographic, and occupational variables showed that the value systems had a stronger predictive impact on views on care ethics, participation, and autonomy. The results indicate that staff with late conventional value systems prioritized older persons’ exercise of autonomy, while paternalism held priority in staff with early conventional value systems.

  • 55.
    Kjellström, Sofia
    et al.
    Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health. Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Sjölander, Per
    Akademi Norr, Storuman.
    The relationship between nursing staff's value systems and their views on good care2014In: Age Well: Challenges for Individuals and Society. Program, 2014Conference paper (Refereed)
  • 56.
    Kjellström, Sofia
    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). Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Sjölander, Per
    Arctic Research Centre, Umeå University, Umeå, Sweden.
    Almers, Ellen
    Jönköping University, School of Education and Communication, HLK, School Based Research, Sustainable Development and Science education.
    McCall, Mary E.
    Samuel Merritt University, USA.
    Value systems among adolescents: Novel method for assessing level of ego-development2017In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 58, no 2, p. 150-157Article in journal (Refereed)
    Abstract [en]

    Children's value systems develop through youth and influence attitudes and actions. But there is a lack of appropriate measures for children and adolescents. The objective of this study was to construct and validate a questionnaire that reveals distinct value systems among adolescents, and to evaluate the identified value systems’ relationship to degree of ego-development and moral development. A quantitative study in a Swedish School with ages 12 through 16 (grades 6 to 9) was performed (N = 204). A set of pattern recognition statistical analyses has been used to identify different profiles of values systems and demonstrate that these systems can be arranged in a hierarchical order similar to other development. Results revealed three value systems in this sample. The identified value systems reflect different degrees of moral and ego-development among children in the study. Three distinct value systems were identified: the first (n = 9) and the second value systems (n = 35) correspond to pre-conventional stages, and the third value system (n = 155) corresponds to early conventional stages of ego development. Ego development scoring of test statements to assess stages. The value system was significantly related to moral development in the personal interest and the maintaining norms schemas of the Defining Issues Test (DIT). However, many students did not complete the entire DIT, so those results should be looked at with caution. It appears that this new test (Test for Adolescent Value Systems – TAVS) does relate to an established ego development rating scale.

  • 57.
    Kjellström, Sofia
    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). Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Stålne, Kristian
    Malmö University.
    Adult development as a lens: Applications of adult development theories in research2017In: Behavioral Development Bulletin, ISSN 0934-2575, E-ISSN 1942-0722, Vol. 22, no 2, p. 266-278Article in journal (Refereed)
    Abstract [en]

    Adult development (AD) theories have a great potential for use in providing perspective and create new understanding of societal problems and challenges. The use of AD as a lens provides insights into people’s qualitative, different ways of thinking, talking, and acting. The theories are used by researchers and practitioners with various backgrounds in several different scientific domains. The aim of this article is to provide an overview of different approaches on how theories of AD are applied in research, with a focus on the potential of using it and how to eliminate the possibility of reproducing existing knowledge. The results consist of 6 approaches of how AD is currently presented and used in research: introductory work, creating and refining stages, making comparisons with established models, tracing the dynamics of promoting development, analysis of mismatches in adult life, and societal and organizational development. There are several promising avenues for future research by using a combination of these approaches as a way forward to promote the development of this scientific field.

  • 58.
    Kjellström, Sofia
    et al.
    Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health. Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Stålne, Kristian
    Institutionen för byggvetenskaper, Lunds Tekniska Högskola.
    Komplexitet för kvalitet i lärande och undervisning: bedömning av komplexa problem och studenters resonemang2011In: Högre Utbildning, ISSN 2000-7558, E-ISSN 2000-7558, Vol. 1, no 1, p. 15-26Article in journal (Refereed)
    Abstract [en]

    One of the aims of higher education is to teach students to solve complex problems, but what is the complexity of problems and the reasoning of students? The Model of Hierarchical Complexity (MHC) is a theory applicable to all domains in which information is organized and accounts for increases in behavioral complexity which includes cognitive or reasoning complexity. The paper is a theoretical introduction to MHC as a tool for teaching in higher education. The model clarifies and shows the gap between the complexity in the subject and the students understanding of the same subject. We also discuss how to support the development of more complex reasoning in students.

  • 59.
    Kjellström, Sofia
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Stålne, Kristian
    Lunds tekniska högskola.
    Hamer, Rebecca
    International Baccalaureate.
    van Rossum, Erik
    Twente University.
    Almers, Ellen
    Jönköping University, School of Education and Communication, HLK, School Based Research, Sustainable Development and Science education.
    A developmental questionnaire on knowing and learning2014Conference paper (Refereed)
    Abstract [en]

    Are students and teachers up to the developmental challenge of teaching and learning the exceptional capabilities needed to address the complex issues of our time? Issues such as moving towards a sustainable development of society are typically quite complex and ill-structured. In order for higher education to provide opportunities for intellectual growth and development among students, a key issue besides complex thinking is to acknowledge the different epistemological beliefs of teachers and students, such as conceptions of teaching and learning, that may influence the teaching and learning experience and so the quality of the learning outcome.

     

    We will present a newly constructed epistemological beliefs questionnaire, concerning views on knowledge and learning. The questionnaire consists of 6 domains (a good study book, discussions, application of knowledge, responsibility for learning, understanding, good teaching), with 6 items in each domain, which are rated and ranked. The questionnaire is based on adult developmental theory (e.g. van Rossum & Hamer, 2010), where the developmental trajectory goes from a view of knowledge as being true or false and provided by the teacher as authority, to a view that emphasizes the constructed and contextual nature of knowledge – allowing teachers to adapt the teaching to the context and the student’s developmental level.

     

    In the spring of 2014, this questionnaire and a previously developed value system questionnaire will be sent to all teachers at Jönköping University (JU). The epistemological beliefs questionnaire is to be analysed with multivariate methods such as a multivariate pattern recognition method and factor analysis. Previous analyses of the value system questionnaire, using corresponding methods, have resulted in an identification of several developmental stages of values, and the epistemological beliefs questionnaire is expected to yield a similar result. Results from the two questionnaires will be compared in order to investigate the relationship between values and epistemological assumptions.

  • 60.
    Kjellström, Sofia
    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).
    Stålne, Kristian
    Malmö universitet.
    Törnblom, Oskar
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. KTH Royal Institute of Technology, Stockholm, Sweden.
    Nya perspektiv på individuell och kollektiv ledarskapsutveckling i komplexa organisationer2019Report (Refereed)
    Abstract [sv]

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

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

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

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

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

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

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

  • 61.
    Kjellström, Sofia
    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). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Stålne, Kristian
    Lunds tekniska högskola.
    Törnblom, Oskar
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Department of Industrial Economics and Management, KTH Royal Institute of Technology.
    The qualitative different understandings of leadership development as a potential tool for the good organization2017Conference paper (Refereed)
  • 62.
    Kjellström, Sofia
    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). Jönköping University, School of Education and Communication, HLK, Learning Practices inside and outside School (LPS).
    Törnblom, Oskar
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Department of Industrial Economics and Management, KTH Royal Institute of Technology, Stockholm, Sweden.
    Stålne, Kristian
    Department of Materials Science and Applied Mathematics, Malmö University, Sweden.
    A dialogue map of leader and leadership development methods: A communication tool2020In: Cogent Business and Management, Vol. 7, no 1, article id 1717051Article in journal (Refereed)
    Abstract [en]

    The dialogue map is a new pedagogical framework that provides an overview of leader and leadership development methods and is designed to facilitate dialogues about how to promote leadership development. The aim was to create and test a dialogue map. This was accomplished through an iterative process using the literature, experts on leadership development, 45 interviews, 16 questionnaire responses and 6 workshops in three large organizations with managers, professionals and human resources experts. The dialogue map is designed as a table with five categories: developmental relationships, developmental assignments, feedback-intensive processes, education and self-development activities. Each category consists of individual leader development methods and collective leadership development methods. Thirty three methods are presented. The pilot test showed that the dialogue map increased awareness about available methods and enabled more deliberate choices regarding development activities. The dialogue map contributes by providing a systematic overview of collective leadership development, not only individual leadership development. Leadership development becomes more democratized because it focuses on activities that can be done in daily work, inside and outside work, at both an individual and collective level. 

  • 63.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health.
    Bülow, Pia H.
    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. ADULT. Department of Social Work, University of the Free State, Bloemfontein, South Africa.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Rönning, Helén
    Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ahlstrand, Inger
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Fransson, Eleonor I.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Gunnarsson, Nina
    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).
    Henricson, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    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).
    Sandgren, Anna
    Center for Collaborative Palliative care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    The use of the concept of transition in different disciplines within health and social welfare: An integrative literature review2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 3, p. 664-675Article, review/survey (Refereed)
    Abstract [en]

    Aims

    To continuing the quest of the concept of transition in nursing research and to explore how the concept of transition is used in occupational therapy, oral health and social work as well as in interdisciplinary studies in health and welfare, between 2003–2013.

    Design

    An integrative literature review.

    Methods

    PubMed, CINAHL, PsycINFO, DOSS, SocIndex, Social Science Citation Index and AMED databases from 2003–2013 were used. Identification of 350 articles including the concept of transition in relation to disciplines included. Assessment of articles are in accordance to Meleis' typologies of transition by experts in each discipline. Chosen key factors were entered into Statistical Package for the Social Sciences (SPSS).

    Results

    Meleis' four typologies were found in all studied disciplines, except development in oral health. The health‐illness type was the most commonly explored, whereas in social work and in occupation therapy, situational transitions dominated.

  • 64.
    Lundberg, Kristina
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Borås University.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Jonsson, Anders
    School of Health Sciences, University of Borås, SE-50190 Borås, Sweden.
    Sandman, Lars
    School of Health Sciences, University of Borås, SE-50190 Borås, Sweden.
    Experiences of Swedish military medical personnel in combat zones: adapting to competing loyalties2014In: Military medicine, ISSN 0026-4075, E-ISSN 1930-613X, Vol. 179, no 8, p. 821-826Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    The aim of this qualitative study is to explore the Swedish military personnel's experience of what it means to perform a caring role in a combat zone. This study assesses the challenges faced by military medical personnel in the context of a combat zone.

    METHODS:

    The design was descriptive with a qualitative inductive approach. Twenty military medical personnel (physicians, nurses, and combat lifesavers) were interviewed individually. They had been involved in international military operations between 2009 and 2012. This study was analyzed using qualitative content analysis.

    RESULTS:

    The analysis produced four categories: being in a primarily noncaring organization, caring in emotionally charged relationships, lacking an open dialog about expectations of killing and having to prioritize scarce resources.

    CONCLUSIONS:

    This study shows that medical personnel easily adapt to a military setting. They care but also perform other tasks when they are in a combat zone. The medical personnel want to give care to host nation but use drugs they can spare.

  • 65.
    Lundberg, Kristina
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Högskolan i Borås.
    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).
    Jonsson, Anders
    Sandman, Lars
    Gathering intelligence or providing medical care on military operations: an ethical problem for Swedish licensed medical personnel (LMP)in combat zones2017In: Journal of Military Ethics, ISSN 1502-7570, E-ISSN 1502-7589Article in journal (Refereed)
  • 66.
    Lundberg, Kristina
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Högskolan i Borås.
    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).
    Sandgren, Anna
    Unifying loyalty: a grounded theory about tactical officers’ (TOs) challengewhen leading licensed medical personnel (LMP) in combat zonesManuscript (preprint) (Other academic)
  • 67.
    Lundberg, Kristina
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. University of Borås, 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). Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Sandman, Lars
    University of Borås, Sweden.
    Dual loyalties: Everyday ethical problems of registered nurses and physicians in combat zones2019In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 26, no 2, p. 480-495Article in journal (Refereed)
    Abstract [en]

    Background:

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

    Aim:

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

    Design:

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

    Ethical considerations:

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

    Findings:

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

    Discussion/conclusion:

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

  • 68.
    Martina, Boström
    et al.
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Kjellström, Sofia
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Malmberg, Bo
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, 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.

  • 69.
    Nordström, Erik
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of 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).
    Hedberg, Berith
    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.
    Agenda för samverkan eller verksamhetens agenda? Om professionellas erfarenheter av samverkan enligt samordnad individuell plan (SIP)2016In: Socialvetenskaplig tidskrift, ISSN 1104-1420, no 1, p. 37-57Article in journal (Refereed)
    Abstract [en]

    Agenda for collaboration or an agency agenda? Professionals’ experiences of colla­boration according to a coordinated individual plan (CIP)

    An increasing number of children and adolescents develop complex needs that require simultaneous action by different professionals. Several reports state that efforts for these children and adolescents have become increasingly specialized and fragmented. Since 2010, there are statutory requirements for collaboration according to a coordinated individual plan (SIP) between health care and social services. Pre-school and school can after regional agreement be involved in the co-ordination as equal partner. Collaboration in line with CIP is expected to offset the fragmentation for benefit of the service users’ ability to monitor and comprehend interventions. The aim was to investigate professionals’ experiences of CIP. The study consists of qualitative analysis of 12 focus group interviews with a total of 71 staff with different professions in health care, education and social services about their experiences of CIP. The results indicate that the participants act according to their core mission: nurturing, teaching and investigation. Two main categories with four sub-categories each appeared in the analysis. The main category, hindering factors, contains the categories: different mandates and requirements, requirements for presence initiative, questioning and censure, and timelines and prioritization. The main category of facilitating factors contains the categories: similar interpretation of common agreement, mutual respect and shared learning, common terminology and documentation, and willingness to collaborate. The analysis indicate that CIP was perceived as alternating between, on the one hand, a pro-active and service-focused tool, and on the other hand, a competing and compelling professional instrument.

  • 70.
    Nordström, Karin
    et al.
    Jönköping University, School of Education and Communication, HLK, Disciplinary Research.
    Juth, Niklas
    Stockholm Centre of Healthcare Ethics, Karolinska Institute, Stockholm, Sweden.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Meijboom, Franck L.B.
    Department of Philosophy, Ethics Institute, Utrecht University, Utrecht, The Netherlands.
    Görman, Ulf
    Jönköping University, School of Education and Communication.
    Values at stake: autonomy, responsibility, and trustworthiness in relation to genetic testing and personalized nutrition advice2013In: Genes & Nutrition, ISSN 1555-8932, E-ISSN 1865-3499, Vol. 8, no 4, p. 365-372Article in journal (Refereed)
    Abstract [en]

    Personalized nutrition has the potential to enhance individual health control. It could be seen as a means to strengthen people’s autonomy as they learn more about their personal health risks, and receive dietary advice accordingly. We examine in what sense personalized nutrition strengthens or weakens individual autonomy. The impact of personalized nutrition on autonomy is analyzed in relation to responsibility and trustworthiness. On a societal level, individualization of health promotion may be accompanied by the attribution of extended individual responsibility for one’s health. This constitutes a dilemma of individualization, caused by a conflict between the right to individual freedom and societal interests. The extent to which personalized nutrition strengthens autonomy is consequently influenced by how responsibility for health is allocated to individuals. Ethically adequate allocation of responsibility should focus on prospective responsibility and be differentiated with regard to individual differences concerning the capacity of adults to take responsibility. The impact of personalized nutrition on autonomy also depends on its methodological design. Owing to the complexity of information received, personalized nutrition through genetic testing (PNTGT) is open to misinterpretation and may not facilitate informed choices and autonomy. As new technologies, personalized nutrition and PNTGT are subject to issues of trust. To strengthen autonomy, trust should be approached in terms of trustworthiness. Trustworthiness implies that an organization that develops or introduces personalized nutrition can show that it is competent to deal with both the technical and moral dimensions at stake and that its decisions are motivated by the interests and expectations of the truster.

  • 71.
    Norrman Brandt, Eva
    et al.
    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, Ann-Christine
    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).
    A transformational change process by a post heroic leader2018Conference paper (Refereed)
  • 72.
    Norrman Brandt, Eva
    et al.
    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, Ann-Christine
    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 future trip: A story of transformational change2019In: Journal of Organizational Change Management, ISSN 0953-4814, E-ISSN 1758-7816, Vol. 32, no 7, p. 669-686Article in journal (Refereed)
    Abstract [en]

    Purpose – The study of successful transformational change processes in organizations has been limited. The aim was to understand a change process and the type of change that occurred in a pharmaceutical company in Sweden 2005–2014.

    Method – An interactive research design was used, and semi-structured interviews were conducted with 19 individuals, asking about their views on the change journey. Meetings and dialogue with leaders from the organization also took place. Observations from feedback meetings with leaders were included in the analysis. The results were analysed using a time-ordered display identifying key events, interpreted by a theoretical lens determining the type of change over a period of 10 years.

    Findings – This was a transformational change caused by external pressure, supported by visionary and transparent leadership, collaborative methods aiming at broad involvement, and systemic understanding. The results indicated a 40% increase in productivity and altered organizational design and culture. Sense-making activities, persistent adoption of quality improvement tools, dispersed power, and sequential change activities underpinned the success.

    Practical implications – The results provide insight into the processes of transformational change. Change leaders were provided with knowledge, inspiration and insight when facing transformations.

    Social implications – Increased prevalence of transformational change calls for new organizational competencies and altered roles for leaders and employees. There is a need for new ways of developing competence and new recruitment policies for leaders.

    Originality/value – This case presents unique empirical evidence of a successful cultural transformation led by a leader using post-conventional principles.

  • 73.
    Norrman Brandt, Eva
    et al.
    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, Ann-Christine
    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).
    Transformational change by a post-conventional leader2019In: Leadership & Organization Development Journal, ISSN 0143-7739, E-ISSN 1472-5347, Vol. 40, no 4, p. 457-471Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this paper is to examine people’s experience of a change process and if and how post-conventional leadership principles are expressed in the change process.

    Design/methodology/approach: The study used a retrospective exploratory qualitative design. In total, 19 semi-structured interviews and 4 workshops were conducted and analyzed in accordance with a thematic qualitative analysis.

    Findings: The post-conventional leadership appears to have facilitated an organizational transformation where explorative work methods aimed at innovation and improvement as well as holistic understanding was used. Dispersed power and mandate to employees, within set frames and with clear goals, created new ways of organizing and working. The leader showed personal consideration, acknowledged the importance of the emotionally demanding aspects of change and admitted the leader’s own vulnerability. Balance between challenge and support created courage to take on new roles and responsibilities. Most employees thrived and grew with the possibilities given, but some felt lack of support and clear directions.

    Practical implications: Inspiration from this case on work methods and involvement of employees can be used on other change efforts.

    Social implications: This study provides knowledge on leadership capabilities needed for facilitation of transformational change.

    Originality/value: Few transformational change processes by post-conventional leaders are thoroughly described, and this study provides in-depth descriptions of post-conventional leadership in transformational change. 

  • 74.
    Norrman Brandt, Eva
    et al.
    Jönköping University, School of Health Science, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Kjellström, Sofia
    Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health. Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Sjölander, Per
    Akademi Norr, Storuman.
    Stålne, Kristian
    Lunds tekniska högskola.
    Leader capabilities in the 21st century2014Conference paper (Refereed)
    Abstract [en]

    We know from decades of empirical research in adult development that leaders at more advanced stages of development are more effective than their counterparts in carrying out a variety of leaderships’ tasks, but also that few leaders have these advanced level of leadership (Joiner & Josephs 2007; Torbert 1987). But are leaders up to the task of handling complex issues at work? Knowing that the complexity and speed of change requires higher levels of adult development it seems obvious that there is a need for supporting managers to develop their level of development and maybe recruit leaders with a higher level of development. There is a need for research focusing on the link between adult ego development in leaders and transformational leadership (McCauley, Drath, Palus, O´Connor&Baker 2006), and studies on leader-follower interaction.

    The aim of this study is firstly to examine the correlation between leadership behaviors, value systems and complexity, and secondly if the correlation between self report and subordinates evaluation of leadership are higher for individuals with more advanced levels of value systems and/or levels of leadership.

    Participants are managers in 4 Scandinavian organizations in different market segments including municipalities. The mangers are invited to answer a basic web survey including three instruments: a value system questionnaire (Sjölander et al.2013); Developmental Leadership Questionnaire which is a hierarchical test based on the theory of transformational leadership and it measures leadership behaviors through a self-evaluation and a 360 test where subordinates evaluate leadership of the manager; and a complexity test. Some managers do only the self-evaluation and some a full 360 feedback test. The study is carried out in the spring 2014 and preliminary results will be presented.

  • 75.
    Ramírez-Pasillas, Marcela
    et al.
    Jönköping University, Jönköping International Business School, JIBS, Business Administration.
    Almers, Ellen
    Jönköping University, School of Education and Communication, HLK, School Based Research, Sustainable Development and Science education.
    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. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Stagell, Ulrica
    Jönköping University, School of Education and Communication, HLK, School Based Research, Sustainable Development and Science education.
    Towards Multiple Approaches on Education for Sustainability: A case study of a Swedish University2015In: 8th World Environmental Education Congress – WEEC 2015, Gothenburg, 29th of June - 2nd of July, 2015, World Environmental Education Congress (WEEC) , 2015Conference paper (Refereed)
    Abstract [en]

    Introduction: While current debates on higher education are concerned with “what are we actually teaching in Education for sustainable development“ (Kopnina and Meijers 2014) or “how can we evaluate what we teach“, there is a lack of research addressing how universities are enabling change and developing new higher education approaches. Dominant educational structures across the world are based on fragmentation rather than connections and synergy to achieve a holistic approaches to education for sustainability (Wals, 2009). Education for sustainability calls for new kinds of collective learning that are centered on a transmissive nature (i.e. learning as reproduction) but rather on a transformative nature (i.e. learning as change). Embodying an active care for sustainability on higher education implies having an education for sustainability that includes socialization for democratic skills and values, and the development of a personal- and collective sense of competence (Chawla and Flanders Cushing, 2007).

    Objectives: The aim of this paper is to explore how a university create approaches on education for sustainability by engaging – or not its faculty and students, and how such approaches support or not authentic sustainable citizenship. To fulfil this purpose, we rely on theory of situated learning (Lave and Wenger, 1991) and communities of practices (Wenger, 2011) to move beyond static approaches to more dynamic approaches on education for sustainability.

    Methods: We conducted a case study (Eisenhardt, 1989; Miles and Huberman, 1984; Yin 1984) to investigate how approaches to education for sustainability were changed and built in Jönkoping University. As the study progressed, there was a mixture of inductive and deductive research strategies. This means that theoretical development occurred by combining the perspectives and observation of actors with existing literature. We interviewed strategically chosen persons and analyzed official documents.

    Results: The study revealed the processes for stimulating education for sustainability in a university that allowed each school to define freely its approach to sustainability. As a result, communities of practices stimulating situated learning were originated at the university. There were a myriad of ‘working’ approaches and degrees of prioritization on education for sustainability. Such approaches emerged following different rationales. In a bottom-up rationale, institutional entrepreneurs/faculty members and students created smaller communities of practices linked to their courses and activities. In a top-down rationale a school included principles promoting sustainability. Finally, a mix rationale moved in-between those approaches.

    Conclusion: We propose that considering those rationales in a single university promotes communities of practice as well as authentic sustainable citizenship.

  • 76.
    Robert, Glenn
    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). King's College, London, UK.
    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).
    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).
    Andersson, Ann-Christine
    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).
    Ockander, Marlene
    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).
    Käll, Jacob
    McGrath, Jane
    Donetto, Sara
    Exploring, measuring and enhancing the co-production of health and wellbeing at the national, regional and local levels through comparative case studies in Sweden and England: The 'Samskapa' research programme (study protocol)2019Conference paper (Refereed)
  • 77.
    Sandman, Lars
    et al.
    Linköpings universitet.
    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).
    Etikboken: Etik för vårdande yrken2018 (ed. 2)Book (Other academic)
    Abstract [sv]

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

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

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

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

  • 78.
    Sandman, Lars
    et al.
    Borås högskola.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Etikboken: Etik för vårdande yrken2013 (ed. 1)Book (Other academic)
    Abstract [sv]

    Boken är en heltäckande etikbok för den som arbetar med vårdande och där etikkunskaper ges möjlighet att fördjupas. Författarna beskriver en stor mängd etiska teorier, begrepp och infallsvinklar på etik inom vården och illustrerar tillämpningen av dessa genom flera konkreta exempel. Boken visar hur etiska problem kan analyseras mer i detalj samt hur arbete med konkreta etiska frågor inom vården kan ske. Syftet med boken är att ge en verktygslåda för att hantera de etiska problemställningar som anställda ställs inför i vårdandet. Med boken följer även ett digitalt material som ger möjlighet att bättre tillägna sig kunskaper från boken genom frågor och provtenta. Likaså ger det digitala materialet instruktion för hur man kan använda rollspel som ett instrument i etikreflektionen.

    Etikboken vänder sig till studenter som kommer att arbeta med vårdande uppgifter och med att befrämja andra personers hälsa. Det kan vara olika vårdutbildningar såsom sjuksköterskor, sjukgymnaster och arbetsterapeuter. Den passar också för vidare- och specialistutbildning av yrkesverskamma inom området, men kan också med fördel användas av yrkesverksamma i sin dagliga verksamhet.

  • 79.
    Silén, Marit
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Christensson, Lennart
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Sidenvall, Birgitta
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Svantesson, Mia
    Centre for Care Science, Örebro universitet.
    What actions promote a positive ethical climate? A critical incident study of nurses’ perceptions2012In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 19, no 4, p. 501-512Article in journal (Refereed)
    Abstract [en]

    There is a lack of qualitative studies exploring the phenomenon of positive ethical climate and what is perceived as promoting it. Therefore, the aim of this study was to explore and describe actions that acute care ward nurses perceive as promoting a positive ethical climate. The critical incident technique was used. Interviews were conducted with 20 nurses at wards where the ethical climate was considered positive, according to a previous study. Meeting the needs of patients and next of kin in a considerate way, as well as receiving and giving support and information within the work group, promoted a positive ethical climate. Likewise, working as a team with a standard for behaviour within the work group promoted a positive ethical climate. Future research needs to investigate other conditions that might also promote a positive ethical climate.

  • 80.
    Silén, Marit
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Svantesson, Mia
    Universitetssjukhuset Örebro samt Karlskoga lasarett, Örebro läns landsting.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Sidenvall, Birgitta
    Jönköping University, School of Health and Welfare.
    Christensson, Lennart
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Moral distress and ethical climate in a Swedish nursing context:perceptions and instrument usability2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 23-24, p. 3483-3493Article in journal (Refereed)
    Abstract [en]

    Aim. The aim was fivefold: to describe Swedish nurses' perceptions of moral distress and determine whether there were differences in perceptions depending on demographic characteristics and to describe the usability of the Moral Distress Scale in a Swedish context. Further, the aim was to describe Swedish nurses' perceptions of ethical climate and the relationship between moral distress and ethical climate.

    Background. Moral distress has been studied for more than two decades and the Moral Distress Scale is the most widely used instrument for measuring it. Moral distress has mainly been studied in relation to nurses' characteristics, but increasing attention has been paid to contextual aspects, such as ethical climate, that could be associated with moral distress.

    Design. Descriptive, with a quantitative approach.

    Methods. The study used two questionnaires: the Moral Distress Scale and the Hospital Ethical Climate Survey. The study was carried out at two hospitals in Sweden and included 249 nurses.

    Results. Both level and frequency of moral distress were low, however level of moral distress was high in situations when the patient was not given safe and proper care. Generally, the frequency of moral distress was lower than the level. Of the situations on the Moral Distress Scale, 13 of the 32 were considered irrelevant by 10-50% of the participants. The more positive the ethical climate was perceived to be, the less frequentely morally distressing situations were reported.

    Conclusions. Since a positive ethical climate was associated with less frequent occurencies of moral distress, it should be investigated what contributes to a positive ethical climate. To be used in a Swedish context, the Moral Distress Scale needs further revision.

    Relevance to clinical practice. Open dialouges at wards are encouraged regarding what practices contribute to a positive ethical climate.

  • 81.
    Sjölander, Per
    et al.
    Void Institute, Sweden.
    Lindström, Nina
    Southern Lapland Research Department, Sweden.
    Ericsson, AnnJessica
    Void Institute, 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.
    A pattern recognition method for disclosing different levels of value system from questionnaire data2014In: The Behavioral Development Bulletin, ISSN 1942-0722, Vol. 19, no 3, p. 112-125Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to describe, test and validate a method for disclosing significant response patterns from questionnaire data, and for classifying individual response profiles into a sequence of significant patterns. The method is based on pattern recognition statistics and probability calculations. The results from the population tested show that the method can disclose characteristic profiles of different value systems, and that these systems can be arranged in a hierarchical order similar to the conventional levels of ego development. It is suggested that this method is applicable to any multiple choice-questionnaire containing a number of items where the response alternatives represent a sequential order, for example, of different levels of development within a psychological domain. The method might be a valuable tool for acquiring information on the distribution of different levels of adult development in large populations, such as in communities and large organizations.

  • 82.
    Stålne, Kristian
    et al.
    Malmö University, Malmö, 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).
    Törnblom, Oskar
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. KTH Royal Institute of Technology, Stockholm, Sweden.
    Assumptions and distinctions on leadership development in complex roles in the context of more advanced and complex organizational design2018Conference paper (Refereed)
  • 83.
    Stålne, Kristian
    et al.
    Institutionen för byggvetenskaper, Lunds Tekniska Högskola.
    Kjellström, Sofia
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Utriainen, Jukka
    Department of Education, University of Jyväskylä, Jyväskylä, Finland.
    Assessing complexity in learning outcomes - a comparison between the SOLO taxonomy and the model of hierarchical complexity2016In: Assessment & Evaluation in Higher Education, ISSN 0260-2938, E-ISSN 1469-297X, Vol. 41, no 7, p. 1033-1048Article in journal (Refereed)
    Abstract [en]

    An important aspect of higher education is to educate students who can manage complex relationships and solve complex problems. Teachers need to be able to evaluate course content with regard to complexity, as well as evaluate students’ ability to assimilate complex content and express it in the form of a learning outcome. One model for evaluating complexity is the Structure of Observed Learning Outcomes (SOLO) taxonomy. The aim of this analysis is to address the limitations of the SOLO taxonomy in detecting the more subtle differences of the learning outcomes and to clarify the concept of learning modes. This is done by analysing the SOLO taxonomy by means of the model of hierarchical complexity (MHC). The two models are compared by examining their respective theoretical background, the definitions and descriptions of the stages of each model, as well as through evaluating examples illustrating the SOLO levels using MHC. The two models can be viewed as compatible, with MHC also being able to put the SOLO taxonomy in an adult development context, thereby emphasising the importance of developing the students’ access to complex thinking.

  • 84.
    Suutari, Anne-Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Department of Internal Medicine and Geriatrics, the Highland Hospital (Höglandssjukhuset), Eksjö, Region Jönköping County, Sweden.
    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).
    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).
    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).
    Thor, Johan
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Promoting a sense of security in everyday life—A case study of patients and professionals moving towards co-production in an atrial fibrillation “learning café”2019In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 22, no 6, p. 1240-1250Article in journal (Refereed)
    Abstract [en]

    Background

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

    Objective

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

    Design

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

    Setting

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

    Improvement activities

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

    Results

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

    Conclusions

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

  • 85.
    Törnblom, Oskar
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. KTH Royal Institute of Technology, Stockholm, Sweden.
    Stålne, Kristian
    Malmö University, Malmö, 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).
    Analyzing roles and leadership in organizations from cognitive complexity and meaning-making perspectives2018In: Behavioral Development, ISSN 1942-0722, Vol. 23, no 1, p. 63-80Article in journal (Refereed)
    Abstract [en]

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

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