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  • 251.
    Berggren, Ingela
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Severinsson, Elisabeth
    Vestfold University College, Tönsberg, Norway.
    The State of the Science of Clinical Supervision in Europe 2010In: Routledge handbook of clinical supervision : fundamental international themes   / [ed] Cutcliffe, John, Hyrkäs, Kristiina, Milton Park, Abingdon, Oxon. UK: Routledge , 2010, p. 327-337Chapter in book (Other academic)
  • 252.
    Bergh, Anne-Louise
    et al.
    University of Borås.
    Friberg, Febe
    University of Stavanger.
    Persson, Eva
    Lund University.
    Dahlborg Lyckhage, Elisabeth
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Perpetuating ‘New Public Management’ at the expense of nurses’ patient education: a discourse analysis2015In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 22, no 3, p. 190-201Article in journal (Refereed)
    Abstract [en]

    This study aimed to explore the conditions for nurses’ daily patient education work by focusing on managers’ way of speaking about the patient education provided by nurses in hospital care. An explorative, qualitative design with a social constructionist perspective was used. Data were collected from three focus group interviews and analysed by means of critical discourse analysis. Discursive practice can be explained by the ideology of hegemony. Due to a heavy workload and lack of time, managers could ‘see’ neither their role as a supporter of the patient education provided by nurses, nor their role in the development of nurses’ pedagogical competence. They used organisational, financial, medical and legal reasons for explaining their failure to support nurses’ provision of patient education. The organisational discourse was an umbrella term for ‘things’ such as cost-effectiveness, which were prioritised over patient education. There is a need to remove managerial barriers to the professional development of nurses’ patient education. Managers should be responsible for ensuring and overseeing that nurses have the prerequisites necessary for providing patient education as well as for enabling continuous reflective dialogue and opportunities for learning in practice.

  • 253.
    Bergh Johnsen, Nathalie
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Rosander, Emelie
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Kvinnors upplevelser av att få en bröstcancerdiagnos: en litteraturbaserad studie2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: One of nine women will at some point in life be treated for breast cancer. When a woman receives a cancer diagnosis, it can be a trigger of a life crisis, which manifests itself in different phases: shock phase, reaction phase, processing phase and reorientation phase. Breast cancer affects the women's lifeworld and create suffering.

    Aim: The aim of this study was to describe women's experiences of receiving a breast cancer diagnosis. Method: This is a literature-based study of twelve qualitative articles. The articles was analyzed according to a qualitative content analysis of Graneheim and Lundman (2004).

    Results: The findings of this study were that women with a newly-diagnosed breast cancer went through a life crisis while diagnosed. Three themes emerged; 1: 'To receive the diagnosis of breast cancer'. Subthemes that emerged in this theme was; 'To be in shock', 'Fear of the disease progress and its consequences', and 'Uncertainty about the future'. 2: 'Strategies to master the new life situation'. Subthemes was; 'Activities to manage everyday life', 'Trust in spirituality' and 'To accept the diagnosis'. 3: 'The inherent meaning of support'. Subthemes was; 'The importance of health professionals supportive and informative role' and 'The significance of family and friend's support'. Conclusion: Receiving a breast cancer diagnosis is manifested as multifaceted and had a great impact on women's lives. Spirituality had a great significance for women's life-world. How the diagnosis was received, was highly individual.

  • 254.
    Bergh, Madeleine
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Carlson, Elisabeth
    Malmö högskola. Fakulteten Hälsa och samhälle.
    Friberg, Febe
    Sahlgrenska akademin vid Göteborgs universitet.
    Gedda, Birgitta
    University West, Department of Nursing, Health and Culture.
    Häggström, Eva
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Pilhammar, Ewa
    Sahlgrenska akademin vid Göteborgs universitet.
    Pedagogik inom vård och handledning2012 (ed. 2., [rev.] uppl.)Book (Other academic)
  • 255.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Is being physically active the key to a good quality of life for patients living with Fontan circulation?2016In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 11, p. 1257-1258Article in journal (Other academic)
  • 256.
    Berghammer, Malin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. Sahlgrenska Academy, Institute of Medicine.
    Brink, Eva
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Rydberg, Annika M.
    University of Umeå, Department of Clinical Sciences, Pediatrics.
    Dellborg, Mikael
    Sahlgrenska Academy, Institute of Medicine.
    Ekman, Inger
    University of Gothenburg, Centre for Person-Centred Care.
    Committed to Life: Adolescents’ and Young Adults’ Experiences of Living with Fontan Circulation2015In: Congenital Heart Disease, ISSN 1747-079X, E-ISSN 1747-0803, Vol. 10, no 5, p. 403-412Article in journal (Refereed)
    Abstract [en]

    Background Single ventricle defects are among the most complex congenital heart defects and the development of advanced surgical procedures in recent decades has created the first generation of adolescents and young adults living with this condition. Yet little is known about how these individuals experience life and what impact the heart defect has on their life in general. Objective The aim was to illuminate and gain a deeper understanding of adolescents’ and young adults’ experiences of living with a surgically palliated univentricular heart. Design Seven open-ended in-depth interviews were conducted, transcribed, and analyzed according to the henomenological hermeneutical method. All adolescents and young adults operated before 1995 according to the Fontan procedure or the total cavo-pulmonary connection procedure at one pediatric cardiology unit were included in the study. They were 17–32 years of age (median age 22 years). Results The interpretation of the interview transcripts showed that the participants experienced living with a surgically palliated univentricular heart in terms of feeling exceptional, strong, and healthy. This was supported by two structural analyses, where three themes emerged: happiness over being me, focusing on possibilities, and being committed to life. Conclusion Living with a Fontan circulation included negative experiences but the analyses clearly demonstrated a feeling of being strong and healthy. An appreciation of having survived and being committed to life was found to be an integral part of the development of the interviewees’ existential growth. This probably strengthens them further in their ability to balance expectations and hurdles in life. This study provides valuable insights into the experience of patients after the Fontan procedure and the importance of a positive health care environment throughout their lives.

  • 257.
    Berghammer, Malin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Johansson, B.
    Umea University, Department of Public Health and Clinical Medicine, Umea, Sweden.
    Mattson, E.
    Karolinska University Hospital, Department of Cardiology, Stockholm, Sweden.
    Moons, P.
    The Sahlgrenska Academy at Gothenburg University, Institute of health and caring sciences, Gothenburg, Sweden;.
    Dellborg, M.
    University of Gothenburg, Institute of medicine, Sahlgrenska Academy, Gothenburg, Sweden.
    Exploration of disagreement between the patient’s self reported limitations and limitations assessed by caregivers in adults with congenital heart disease2018In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 39, no Suppl 1, article id 2406Article in journal (Refereed)
    Abstract [en]

    Background: The New York Heart Association (NYHA) classification is applied in a wide spectrum of heart diseases including adult patients with congenital heart disease (ACHD). The NYHA-class assessment is often based on the evaluation by the caregiver, but to what extent it correlates with the patient's view of their function is not fully known.Purpose: To investigate the relation between the patient's self-reported physical limitations, symptoms, other heart defect related factors and NYHA-class assessed by the caregiver.Methods: Eligible patients (n=333, age 39.2±13.6 years) were identified and randomly selected from the national registry for CHD. All of the patients completed a standardized questionnaire measuring different PRO-domains. By combing self-reported data with registry data including NYHA-class, analyses of agreement of physical limitations were performed.Results: Almost 30% of the patients rated their limitations higher compared to the NYHA-class estimated by the caregiver. Patients with self-reported limitations and their NYHA-class underestimated by caregivers, more often reported symptoms, anxiety, lower health and worked fewer hours/week compared to other patients with CHD. There were no differences regarding sex, type of symptoms, prescribed medications, or complexity of cardiac lesion. In patients without self-reported limitations agreement with NYHA-class estimated by caregivers was 97%.Conclusion: Adult patients with CHD and self-reported limitations may not be correctly identified by the care-giver. Instruments for patient reported outcomes might improve the assessment of physical limitations and could further improve the correctness in evaluating the patient's status.

  • 258.
    Berghammer, Malin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. The Sahlgrenska Academy at University of Gothenburg, Institute of Medicine, Gothenburg, Sweden.
    Mattsson, Eva
    Karolinska University Hospital, Department of Cardiology, Stockholm, Sweden.
    Johansson, Bengt
    Umeå University, Department of Public Health and Clinical Medicine, Umeå, Sweden.
    Moons, Philip
    University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Dellborg, M.
    The Sahlgrenska Academy at University of Gothenburg, Institute of Medicine, Gothenburg, Sweden.
    Comparison of participants and non-participants in patient-reported outcome surveys: the case of Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study2017In: Cardiology in the Young, ISSN 1047-9511, E-ISSN 1467-1107, Vol. 27, no 3, p. 427-434Article in journal (Refereed)
    Abstract [en]

    Background: The last decade has seen a vast increase in the use of patient-reported outcomes. As patient-reported outcomes are used in order to capture patients’ perspectives of their health and illness, it is a prerequisite for accurate patient-reported outcome evaluations to use representative samples. In order to evaluate representativeness, the present study focussed on the comparison between participants and non-participants in the Swedish branch of the international study APPROACH-IS (Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease – International Study), regarding demographic, clinical, and health status characteristics. Methods: Eligible patients for APPROACH-IS were identified and selected from SWEDCON, the Swedish registry for congenital heart disease (CHD). Overall, 912 eligible patients were identified, of whom 471 participated, 398 did not participate, and 43 were either unreachable or declined to participate in APPROACH-IS. The participants and non-participants were compared in terms of statistical significance and effect sizes. Results: Significant differences were observed between participants and non-participants for sex, age, primary diagnosis, number of cardiac operations, and fatigue; however, the effect sizes were in general small, except for the difference in primary diagnosis. No differences between the two groups were found in number of catheterisations, implanted device, the distribution of NYHA functional class, or health status and symptoms. Conclusions: This study shows that participants and non-participants are relatively comparable groups, which confirms the representativeness of the participants. The Swedish data from APPROACH-IS can therefore be reliably generalised to the population of adults with CHD in Sweden. © Cambridge University Press 2016

  • 259.
    Bergholm, Daniel
    et al.
    University West, Department of Nursing, Health and Culture.
    Möller, Hannes
    University West, Department of Nursing, Health and Culture.
    Mer liv till åren och inte enbart fler år till livet: Kan en ökad fysisk styrka och explosivitet bidra till en ökad livskvalitet?2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Research on Sarcopenia shows that muscle atrophy affects the physical functioning during aging and can be prevented by various forms of strength training. Research on muscle atrophy aroused our interest in strength training for older adults and also the strength training effects on quality of life.

    Aim: The aim of this study is to investigate whether an increase in physical strength and explosiveness contributes to a better quality of life in people aged between 55 and 65 years.

    Method: This has been explored with inspiration from action research in a group of fifteen participants. Data was collected with the instruments MuscleLab, SF-36v2 and memos.

    Results: Nine participants showed an increase in power development and six participants showed a decrease. Quality of life has increased in all eight categories for the group as a whole, meaning that both the physical and mental health has increased in the group.

    Conclusion: Increased strength and explosiveness does not, in our case, necessarily mean a better quality of life, but we consider that the change in quality of life rather depends on a higher level of activity in itself. This is because the strength of the group as a whole increased only marginally, but that quality of life has increased all the more.

  • 260.
    Berglind, Betty
    University West, Department of Nursing, Health and Culture.
    Sjuksköterskans omvårdnad av patienter med myelomatos och associerad kronisk smärta: en litteraturstudie2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Multiple myeloma is a malignant incurable cancer disease associated with severe chronic pain. The nurse has several important roles in the management of patients with multiple myeloma. This study focuses on nurse´s roles including the caring of pain relief.

    Aim: The aim of this study was to elucidate the nurse’s role in giving care to patients with multiple myeloma and associated chronic pain.

    Method: This literature study was based on scientific articles.

    Results: The nurse is in a key position to facilitate ongoing adequate pain and psychosocial assessment of patients with multiple myeloma. The study presents ways of relieving pain and suffering via different ways of caring management. Five themes emerged: communication, support, distraction, information and education, pain assessment and evaluation. The nurse´s roles are acknowledged, and associated ethical dilemmas are presented. Knowledge about how to decrease pain and suffering by non-pharmacological means, improves the nurse´s possibility to manage difficult situations in patients with incurable cancer.

  • 261.
    Berglund, Britta
    et al.
    Karolinska University Hospital, Nursing Division, Department of Medical and Surgical Gastroenterology.
    Mattiasson, Anne-Cathrine
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Randers, Ingrid
    Sophiahemmet University College.
    Dignity not fully upheld when seeking health care: Experiences expressed by individuals suffering from EhlersDanlos syndrome2010In: Disability and Rehabilitation, ISSN 0963-8288, Vol. 32, no 1, p. 1-7Article in journal (Refereed)
    Abstract [en]

    AIM: The principle of human dignity has assumed importance in ethics and constitutional law throughout the 20th century in the Western world. It calls for respect of each individual as unique, and of treating him or her as a subject, never as a mere object. As such, the principle constitutes an ethical cornerstone in health care. Patients suffering from Ehlers-Danlos syndrome (EDS) challenge medical care and knowledge in health-care professionals' as symptoms sometimes are vague. Individuals with this disorder have reported not being respected when seeking health care.

    PURPOSE: To describe encounters in health-care situations when individuals suffering from EDS experienced that their dignity was not fully upheld. A further aim was to describe the long-term consequences of these experiences.

    METHOD: A study-specific questionnaire was designed, where individuals with EDS described their encounters with health care from a personal perspective.

    RESULTS: After qualitative content analysis, the following five categories were identified: 'Being ignored and belittled by health-care professionals,' 'Being assigned psychological and/or psychiatric explanations', 'Being treated and considered merely as an object', 'Being trespassed in one's personal sphere' and 'Being suspected of family violence'. Consequences of these encounters were 'Mistrusting the physician' and 'Risking bad health'.

    CONCLUSIONS: The memory of not being respected is substantial for individuals with EDS and can last for years. As a result, lack of trust for the health-care system is created and they may experience difficulties in future encounters with health care. Therefore, health-care professionals should base their actions on norms that protect human dignity and confirm each patient as a unique human being with resources and abilities to master their own life.

  • 262.
    Berglund, Christin
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Stake, Emma
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Tillsammans kämpar vi mot cancer som en familj: En litteraturbaserad studie om barns erfarenheter av att ha en förälder med diagnostiserad cancer2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Every year 3000-4000 children in Sweden loses a parent due to accident and illness which means that every day nine children suffer from losing one of the most important person in their life. Cancer is expected to increase from 14 million to 22 million over the next two decades, in the future it will become increasingly common for nurses to meet a child whose parent has cancer. Aim: The aim of this study was to illuminate children's experiences of having a parent diagnosed with cancer. Method: A literature-based study based on eight articles from the databases Cinahl and ProQuest was chosen, read, reviewed and analyzed according to Friberg's analyzing model. Results: Five themes with 11 sub-themes emerged; "Feeling need of support", "The world turns upside down", "Cancer is equal to death", "Changed outlook on life" and "Putting words into feelings". According to young people's perspective the crisis resulted in a positive way of life. Conclusion: Children's anxiety and fear is the greatest when the parent get the diagnosis and future forecast. It is important to provide a safe support since the children's world is turned upside down.

  • 263.
    Berglöv, Louise
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Söderqvist, Anna
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Personcentrerad vård inom BVC2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Person centered care (PCC) is about understanding the totality of individuals' lives and what context they are in. Therefore, flexibility can be seen as an important feature in specialist nurses work with PCC at the child health center (CHC). Today, PCC is recognized in healthcare and shows good results, however, there is a resistance among the professionals. Research on PCC in child health care is deficient, while at the same time studies show that children do not feel respected.

    Aim: The aim of the study was to describe child health nurses view of person centered care with focus on the child in relation to the parents.

    Method: Nine individual semistructured interviews with specialist nurses were conducted and data analyzed through qualitative content analysis.

    Results: The specialist nurses all agreed that PCC was about seeing the child and the parents, meeting them here and now and always having the child in focus. Allowing the child to participate and to share their stories was a prerequisite for working person centered. The specialist nurses also considered that their own professional experience played a crucial role. There were also obstacles and difficulties, the reasons for that were several, but most often was it about ignorance and uncertainty.

    Conclusion: The fact that the focus always on the child and that the specialist nurse always assumes the best interests of the child is the most important when it comes to PCC at the CHC. Family focused care and person centered care complement each other where it is up to the specialist nurse to decide which of them who is the most important in the current situation.

  • 264.
    Bergman, Adam
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Westbring, Emelie
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Föräldrars behov av stöd från sjuksköterskan2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background When a child is in need for care, they are mostly accompanied by their parents. In the meeting with the family, the nurse has to give comfort, attention and support to everyone, not least the parents. Due to swedish law it is the nurse’s responsability to give information and encourage good care. The parents needs to have support to be involved and feel safe in the care of their child. To achieve all of this, the nurse has a big responsability to see each person as a unique individual. Aim The aim of this study was to describe parents' need of support from the nurse when their child requires care at hospital.  Method A literature-base study has been made of qualitative articles retrieved from database Cinahl. The studies were found used systematic searches. The result of a total of eight scientific articles from different countries around the world were compiled. Results The themes highlight what kind of support parents need when their child requires care at hospital. To be a confidence-giving nurse, to be guided as a parent, to be involved, individually adapted information, education about the child’s condition and a functional communication were highlighted in the study. The main themes were- "An involved nurse" and "Verbal and non verbal support for the parents".  Conclusion Parents are in need of support when their child is in need of care. Each parent is unique and the support must be built from each individual parent. The relationship between parents and nurse could be important for the support and for the involvement of the parents.

  • 265.
    Bergman, Annika
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Våga välja lämna ifrån sig makten: att möjliggöra ökad delaktighet för patienter som behndlas med dialys2013Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 266.
    Bergman, Annika
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Gustavsson, Anna-Lena
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Ökad kunskap hos sjuksköterskor om orsaker till bristande följsamhet förbättrar patienters delaktighet2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In today’s health care it’s most common to treat an illness with a kind of pharmaceutical preparation. But lack of resources, given information and bad communication and collaboration between the patient and the nursing staff can lead to a patient unwilling to follow the doctor’s prescription. This does not just affect the individual patient’s health but it can also result in consequences for other people and the whole society. The purpose of this study was to analyse studies about the concepts compliance and concordance in order to illustrate why patients with chronic illnesses fail to follow their prescriptions. Our method has been to read and analyse the methods and results of articles out of the perspective similarities and differences of the concepts compliance and concordance. It was hard to keep the concepts separated because of their similar meanings. Our result shows that the method used was interviews with questionnaires which has been analysed on the basis of the qualitative studies’ themes and categories. The quantitative articles’ data were displayed statistically. Our analyse showed that patients often lack knowledge about their medical treatment which affects their attitudes and can lead to bad compliance and concordance. As a nurse it’s therefore important to identify the cause that affects the patient. The nursing staff’s goal ought thus to be to get the patient involved as much as possible in their self-care. If the patient is involved in hers/his treatment, it’s more likely that they feel a responsibility towards themselves and therefore gets a better quality of life.

  • 267.
    Bergman, Cassandra
    et al.
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Hektor, Micaela
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Svenska gymnasieelevers drogvanor2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Studies indicate that drug use has increased the last 12 years among Swedish high school students. There is also a clear gender difference in the frequency of drug use where male high school students use more often drugs than female students. There is a difference in the risk factors between the genders. Biological factors are dominant riskfactors for men's drug use while for females there are more dominant environmental riskfactors. It's of high importance to asses updated information about adolescents' drug use habits, because drug use can lead to sever and chronic mental ill-health, criminal behaviors and social marginalization.

    Aim: The aim of the present study is to measure the drug use habits and describe it by gender and age in a sample of Swedish high school students.

    Method: The study used descriptive and comparative statistical (Shapiro-Wilks test, Spearman correlation and Mann-Whitney U-test) methods. Information assessed from 280 Swedish high school students about their drug use habits with the instrument Drug Use Disorders Identification Test (DUDIT). Previously validated cut-off ≥ 6 for male and ≥ 2 points for female students were used to identify students with drug related problems/dependence.

    Results: The result showed that about 10 % of the Swedish high school students have some form of drug use habit. The male students scored higher than the female students concerning their drug use habits (they used drugs in a greater extent) meanwhile the female students showed a drug related problems/dependence in a younger age than their male classmates. According the previously validated cutoffs about 4% of male and 8% of female high school students have drug related problems/dependence.

    Conclusion: In a sample of Swedish high school students male students reported more serious drug use habits than female students, while a larger proportion of the female students had drug related problems/ dependence, which also emerged in earlier ages than in their male classmates. The study raises the question of the need of a new validation of the cut-off for a gender specific identification for Swedish adolescents with drug related problems/dependence.

  • 268.
    Bergman, Emelie
    et al.
    University West, Department of Health Sciences, Nursing Programme.
    Tynkkinen, Tanya
    University West, Department of Health Sciences, Nursing Programme.
    Faktorer som påverkar ungdomars återfall i drogmissbruk2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Drugs have been around for ages. Previous studies show that drug use among young people is a problem that exists in large parts of the world. In Europe, 11.2% of young adults aged 15-24 have used cannabis in 2011. A survey conducted in Swedish schools shows that drug abuse is the number of students using drug increase but consumption is increasing. Objective: The aim of this study was to describe factors that affect relapse in drug abuse among young people. Method: A literature review of 10 scientific articles from the years 2003 to 2015 were used in which various factors that affect relapse in adolescents discerned.

    Results: The factors that affect a relapse can vary from individual to individual and therefore it is difficult to point out one single factor. The factors found to counteract a relapse is physical health, physical activity, treatment and the environment surrounding youth including engagement of family. Conclusions: The interaction of influencing factors is complex and indicates that no factor alone can be considered as anti-relapse into drug abuse. The study shows that several factors need to cooperate to prevent a relapse, such as the environment and the emotional state of the youth. Interacting factors have been shown to minimize the risk of recurrence.

  • 269.
    Bergqvist Boström, Ewa
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Nilsson Wicke, Lena
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Att lyssna är att stödja: Sjuksköterskors erfarenheter av patienter med utmattningssyndrom2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Mental illness where fatigue syndrome is one of the diagnoses is an increasing problem. Many persons with fatigue syndrome experience abandonment and do not achieve the help they need and are entitled to. Time for conversation and self-care is an important part of rehabilitation where primary healthcare and occupational healthcare have a prominent role Aim: This study's purpose was to explore what experience that nurses in primary and occupational healthcare had of patients with fatigue syndrome. Method: Eight nurses from primary and occupational healthcare were interviewed using semi-structured questions. The interview material was analyzed using content analysis. Results: A theme listening and two categories gatekeeper and create comprehensibility emerged. All nurses had initially long conversations with the patients, but their experience differed. Some of the nurses told that they were important to the patients and others indicated that they were not working with this patient group. Conclusion: All nurses describes that what they do means that they are listening to the patients at the same time that several of them not explicit express it as a support. That can be interpreted as the relation part of nursing are invisible for the nurses who does not perceive their listening valuable for the patients.

  • 270.
    Bergqvist, Caroline
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Tingberg, Sofia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    En fråga med dolda svar: en registerstudie2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Since 2008 there is a law stating that patients who do not require institutional forensic psychiatric care may be moved to non-institutional forensic care, with special conditions. RättspsyK is a national quality register where all of the 25 forensic care units in Sweden collect information about their patients and their care. Previous analysis showed that a considerable amount of patients continue to receive institutional forensic psychiatric care despite they are assessed and found ready to move onto non-institutional forensic care. Aim: The objective of this study was to identify factors affecting why patients were still in institutional forensic care despite assessed to be ready for non-institutional forensic care.Method: First, yearly assessment of each patient between 2009 and 2014 was drawn from the RättspsyK register. Answers to the specific question, Question 10, were analyzed with descriptive statistics and were planned to be used in regression analyses as dependent variable. Result: 1900 patients were included. During analyses the fact that answers to this question were not trustable was found, therefore no exact prevalence of inpatients kept in institutional forensic care despite assessed ready for non-institutional care could be determined. Other information revealed that lack of housing and lack of collaboration were the most frequent reasons for this phenomenon. Conclusion: The present study could not give answer to the original question, but pointed out avalidity problem in the Swedish Forensic Psychiatry Register. The result calls for caution and for the need of validation of RättspsyK register.

  • 271.
    Bergqvist, Christer
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Faktorer som patienter upplever påverkar följsamheten av den ickefarmakologiska behandlingen vid hypertoni2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In this work hypertension was considered by the author to be of great concern. The work initially defined hypertension including pathophysiology, occurrence, risk factors and treatment. Self care in the form of lifestyle changes was recognized as a substantial part of the treatment for hypertensive patients. Health as a concept was discussed and Dorothea Orems self care theory was used as a basis for the study. The nurse`s role was described as helping the patient develop and maintain self-care. Aim: The aim of this study was to investigate factors that patients perceived as influential when it came to self-management of hypertension. Metod: The method used was an analysis of qualitative research developed by Friberg (2006). Nine scientific articles were analyzed to identify themes and subthemes. Results: Eleven subthemes and five themes that described what patients felt effecting their selfcare were identified. The themes that was spawned were: lifestyle which included the subthemes culture and living conditions; support which included the subthemes relation with health care and social support; attitude which included the subthemes self-esteem, engagement and responsibility; competence which included the subthemes information and advice and knowledge and information and the final theme perceived health which included the subthemes symptoms and comorbidity. Conclusions: The conclusions drawn from this work was that there were a lot of different factors that patients believed facilitated or inhibited their self-care and that it was important for nurses to consider that in the care relation with patients suffering from hypertension.

  • 272.
    Bergqvist, Karin
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Johansson, Anders
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Att arbeta med tolk vid bedömningar: sjuksköterskors upplevelser av kvalitén2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Studies show that when nurses are experiencing problems in the care of non-Swedish speaking patients, it is often due to obstacles in the communication. Studies also show that a prerequisite for adequate care is that there is a basis for a direct communication. Nurses perceive interpreters as an important link to the patient when they do not share a mutual language, the nurses perceive interpreters as a bridge in the conversation.

    Aim:

    The purpose of the study is to describe nurses' experiences of the quality of assessments done with the help of an interpreter.

    Method:

    The study was conducted through interviews with ten nurses, working at psychiatric clinics. Qualitative content analysis was used for the analysis, which resulted in five categories.

    Results:

    The analysis resulted in one theme: "it´s the interpreter who tells me and have not the feeling that the patient has" and five categories: "shades of the language", "conversation structure", "the interpreter's competence", "interpreting implementing" and "the interpreter's gender and origin". The nurses experience working with interpreters as a challenge. The difficulty of working with the help of an interpreter is that the nurse cannot see the spoken word in connection with the patient's body language. Communication through an interpreter also felt unnatural and the interpreter's participation is perceived as a filter.

    Conclusion:

    The quality of the assessments were not perceived as good with the interpreter as without, however, there was no risk to patient safety.

  • 273.
    Bergström, Emma
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Davallius, Johanna
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Upptäckt av kvinnomisshandel: Hinder och möjligheter i vården2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Domestic violence is a growing problem. Nurses in emergency departments often meet abused women when seeking healthcare for injuries. The woman often concealed the true reason for seeking medical attention and nurses also avoided asking. Consequently many failed to be discovered and further abuse were at risk. The aim of this literary review was to illuminate the hindrance and possibilities in health care to discover domestic violence. Eleven articles were analyzed. Hindrance to discover domestic violence was attitudes among nurses, lack of knowledge concerning the importance of communication skills and risk factors for domestic violence when enhanced attention was needed. The presence of the partner, feelings of shame and insecurity were also hindrance for the women to tell. There were cultural differences what was considered as domestic violence. There were also lack of resources and time. Guidelines and screening were often absent even though it was an efficient way to discover domestic violence. Education was requested by nurses and improved their sense of security when meeting abused women. Nurses and health care organizations have both an obligation to be updated about and using best practice. In a time of lacking resources it is even more important. Then there are increasing possibilities to discover abused women and be able to give them proper attention. This decreases the risk of further discrimination of abused women in health care.

  • 274.
    Berholt, Camilla
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Lilienberg, Ann-Charlotte
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Psykisk ohälsa hos intagna med självriktad aggressivitet: Effekt av 10 veckors yoga2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Mental ill-health is common among prisons inmates. More than half of inmates in Swedish prisons suffer from different psychiatric problems that untreated can contribute to aggressive behaviors, including self-directed aggressive behaviors such as self-harm, suicide attempt or completed suicide. Evidence shows that participation in yoga exercise may improve mental health in the general but even in prison inmates population. The effect of yoga on self-directed aggressive behavior in prison inmates population has not yet been specifically studied, according to our knowledge.

    Aim: To examine the self-reported prevalence of psychiatric diagnoses by gender among prison inmates, and to study the effect of 10 weeks yoga on the prevalence and severity of self-directed aggression in this population.

    Method/Study population: From nine prisons in Sweden, 211 inmates participated voluntarily in the 10 weeks of study. They were randomized into two groups, one yoga group in which inmates participated in 90 minutes of hatha yoga once every week and a control group including those who were placed into a waiting list for yoga and asked to participate in 90 minutes of physical activity of free choice, once a week during the study.

    Results: Major depression, substance use disorder, anxiety disorder, and attention deficit hyperactivity disorder were the most common psychiatric diagnoses among inmates. The prevalence of many psychiatric diagnoses was significantly higher in female inmates than in male inmates. Both yoga and freely chosen physical activity reduced self-directed aggression during incarceration, but the improvement was better in the group that preformed yoga.

    Conclusion: The study provides evidence that yoga made on a regular basis have a positive effect on reducing self-directed aggression. Since no side effects of yoga exercise have previously or in this study detected, it can be concluded that yoga can be effective measure to increase inmates well-being.

  • 275.
    Berlin, Anita
    et al.
    Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden.
    Rosander, Michael
    Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.
    Forslund Frykedal, Karin
    University West, Department of Social and Behavioural Studies, Division for Educational Science and Languages. Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.
    Barimani, Mia
    Department of Women and Children’s Health, Karolinska Institute, Solna, Sweden.
    Walk the talk: Leader behavior in parental education groups2018In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 20, no 2, p. 173-180Article in journal (Refereed)
    Abstract [en]

    Expectant and new parents are offered parental education groups as a way to support their transition to parenthood. Group leadership in these groups has been found to be challenging. Using a qualitative and summative design, the aim of the present study was to investigate how health professionals describe their role in parental education groups compared to their actual behavior. Thirteen health professional leaders in antenatal and child health services were interviewed. These descriptions were compared with the leaders' actual behavior in video and audio-recordings of 16 different group sessions. The results revealed that regardless of how the leaders described their role, they acted as experts and left little time to parents for discussions and active participation. In particular, leaders who described themselves as discussion leaders did not "walk the talk"; that is, they did not do what they said they do when leading groups. That could be explained by lack of professional awareness, group leadership, and pedagogical skills. In order to provide high-quality parental support, leaders need training in group leadership and pedagogy combined with supervision and support on a regular basis.

  • 276.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology. University West, Department of Social and Behavioural Studies, Division of Social Work and Social Pedagogy.
    Artefakters organiserande funktion2016In: Team i vård, behandling och omsorg: Erfarenheter och reflektioner / [ed] Johan Berlin, Håkan Sandberg, Lund: Studentlitteratur AB, 2016, 2:a, p. 227-248Chapter in book (Refereed)
  • 277.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Beställarstyrning av hälso- och sjukvård: - Om människor, marginaler och miljoner2006Doctoral thesis, monograph (Other academic)
  • 278.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Common incentives for teamwork: the unspoken contract´s significance2014In: Team Performance Management, ISSN 1352-7592, E-ISSN 1758-6860, Vol. 20, no 1/2, p. 65-80Article in journal (Refereed)
    Abstract [en]

    Purpose - The purpose of this article was to identify and study common incentives for teamwork.

    Design/methodology/approach - The study was designed as a case study. The case consists of teamwork at a univer-sity hospital. At the hospital, ten psychiatric teams were studied for a period of four years (2008-2011). Each team was followed for 12–18 months. Data were collected through interviews (n = 48) and observations (n = 52) of the teamwork at treatment conferences.

    Findings - The common incentives identified consist of shared responsibility, appreciation and long-sightedness. The incidence of a silent contract is highlighted as an explanation for the team's cohesion.

    Research limitations/implications - The study is conducted in a public organisation within one field. The results should therefore be interpreted with some caution.

    Practical implications - The study is useful for practitioners to understand the importance of common incentives as a collective driving force. By developing well-adapted common incentives, the practical work can be developed, refined and improved.

    Originality/value - The significance of common incentives and the unspoken contract in the team is identified.

  • 279.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Doctors’ functional leadership inpsychiatric healthcare teams: a reversible leadership logic2015In: Team Performance Management, ISSN 1352-7592, E-ISSN 1758-6860, Vol. 21, no 3/4, p. 159-180Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this paper was to study how psychiatric doctors practise leadership in multidisciplinary healthcare teams. The paper seeks to answer the question: How do psychiatric doctors lead multidisciplinary teams during treatment conferences?

    Design/methodology/approach: Six psychiatric teams were studied at a university hospital. Each team was observed over a period of 18 months, and data were collected during four years (2008-2011). Data were collected through interviews with doctors (n19) and observations (n30) of doctors’ work in multidisciplinary psychiatric teams.

    Findings: Doctors in a multidisciplinary team use either self-imposed or involuntary leadership style. Oscillating between these two extremes was a strategy for handling the internal tensions of the team.

    Research limitations/implications: The study was a case study, performed during treatment conferences at psychiatric wards in a university hospital. This limitation means that there is cause for some caution in generalising the results.

    Practical implications: The results are useful for understanding leadership in multidisciplinary medical teams. By understanding the reversible logic of leadership, cooperation and knowledge sharing can be gained, which means that a situation of mere peaceful coexistence can be avoided. Understanding the importance of the informal contract makes it possible to switch leadership among team members. A reversible leadership with an informal contract makes the team less vulnerable. The team’s professionals can thus easily handle dif cult situations and internal tensions, facilitating leadership and management of multidisciplinary teams.

    Originality/value: Doctors in multidisciplinary psychiatric teams use reversible leadership

    logic.

  • 280.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies.
    How doctors practice teamleadership2014Conference paper (Refereed)
    Abstract [en]

    Purpose: The overall purpose of the article was to study how doctors practise leadership in multidisciplinary teams. The article seeks to answer the question: Which approach do doctors use to lead multidisciplinary psychiatric teams?

    Methodology: Six psychiatric teams were studied at a university hospital. Each team was followed for eighteen months. Data were collected during a period of four years (2008–2011). Data were collected through interviews with doctors (n = 19) and observations (n = 30) of doctors’ work in a multidisciplinary psychiatric team.

    Findings: Doctors in a multidisciplinary team use either self-imposed or involuntary leadership. Oscillating between these two extremes is called reversible leadership.

    Research limitations: The study was performed at a psychiatric ward during treatment conferences in a university hospital. This limitation means that there is cause for some caution in interpreting the results.

    Practical implications: The results are useful for understanding leadership in multidisciplinary teams within the health and medical care system. The reversible leadership means that doctors can more easily oscillate from difficult situations and deal with internal tensions, facilitating leadership and management of the multidisciplinary team in the intended direction.

    Originality / value: Doctors in multidisciplinary psychiatric teams use reversible leadership.

  • 281.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Ledarskap och beslutsfattande i psykiatriska team: om sammanhållning, sortering och kontroll2015 (ed. 1)Book (Other academic)
    Abstract [en]

    This study is about leadership and decision-making in psychiatric teams. To manage healthcare, cross-organisational work has been used as a working method in teamwork.

    The overall aim of the study was to study how leadership and decision-making are applied in psychiatric teams. The issues addressed are: to describe and to understand how leadership in psychiatric teams is applied, to describe and to understand how decision-making in psychiatric teams is applied, explain why there are potential differences between talk and practice, and to explain why teamwork is applied in psychiatry.

    The study's theoretical framework is based on the challenges that arise when teamwork is organised in a multi-professional context. In the study, decision theory, leadership theory and new institutional theory are used to help to link together and provide explanations for behaviour patterns of professions.

    The study's data were collected between 2008–2011 through interviews, observations and document studies. Total study consists of 101 interviews with 111 informants. Observations have been done of 10 teams on 132 occasions for a total of 230 hours. Observations have focused on the teamwork carried out in the treatment conferences.

    The study shows that: 1) there is an informal contract in teams that governs who does what in different situations, 2) doctors applied a reversible leadership where they alternated between the involuntary and the self-imposed, 3) teams used decision norms that are governed by situation-specific micro-codes, 4) there is an episodic culture which decreased the incentive to provide preventive and long-term treatment, 5) teamwork was used to provide the opportunity for solidarity, classification and control, and 6) there was no striving for perfection in decision-making; instead, the teams were satisfied with an acceptable level that everyone could agree on.

  • 282.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies.
    Läkare som teamledare: En studie av reversibelt ledarskap2013Conference paper (Refereed)
    Abstract [sv]

    SammanfattningSyfte: Syftet med artikeln är att beskriva och problematisera läkares ledarskap i team. Arti-keln syftar till att besvara frågan; Hur utövar läkare ledarskap i team?Design/metod: Studien är designad i form av en fallstudie. Sex psykiatriska team har stude-rats vid ett universitetssjukhus. Varje team har följts under 18 månader. Datainsamlingen har gjorts under totalt fyra år (2008-2011). Data har samlats in genom intervjuer med läkare (n=19) och observationer (n=60) av läkares arbete i team.Resultat: Läkares ledarskap i team utövas i en dualistisk pendlingsprocess mellan självpåta-get och ofrivilligt, vilket benämns reversibelt ledarskap.Begränsningar: Studien är gjord på psykiatriska avdelningar i en organisation. Det finns därför anledning till viss försiktighet vid tolkningen av resultaten.Praktiska implikationer: Resultaten är användbara för att förstå teamledarskapets dualism. Reversibelt ledarskap kan leda till ökad osäkerhet och försvaga teamets proaktiva förmåga.Originalitet: Läkarens ledarskap i team lyfts fram som reversibelt, antingen självpåtaget och frivilligt, eller påtvingat och ofrivilligt.Nyckelord:

  • 283.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Synchronous work - myth or reality?: a critical study of teams in health and medical care2010In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 16, no 6, p. 1314-1321Article in journal (Refereed)
    Abstract [en]

    Abstract Rationale, aims and objectives  In this article, ideal conceptions about teamwork are tested. The research question posed is: How are teams in psychiatry formed? Three theoretical concepts that distinguish groups from teams are presented: sequentiality, parallelism and synchronicity. The presumption is that groups cooperate sequentially and teams synchronously, while the parallel work mode is a transitional form between group and team. Methods  Three psychiatric outpatient teams at a university hospital specialist clinic were studied. Data were collected through 25 personal interviews and 82 hours of observations. The data collection was carried out over 18 months (2008–2009). Results  Results show: (1) that the three theoretical distinctions between group and team need to be supplemented with two intermediate forms, semiparallel and semisynchronous teamwork; and (2) that teamwork is not characterized by striving towards a synchronous ideal but instead is marked by an adaptive interaction between sequential, parallel and synchronous working modes. Conclusions  The article points to a new intermediate stage between group and team. This intermediate stage is called semiparallel teamwork. The study shows that practical teamwork is not characterized by a synchronous ideal, but rather is about how to adaptively find acceptable solutions to a series of practical problems. The study emphasizes the importance of the team varying between different working modes, so-called semisystematics.

  • 284.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies.
    Teamarbete: de gemensamma incitamentens betydelse2013In: Att utveckla vården: Erfarenheter av kvalitet, verksamhetsutveckling och förbättringsarbete / [ed] Eriksson, Nomie, Holgers, Kajsa-Mia, Müllern,Tomas, Lund: Studentlitteratur, 2013, 1, p. 223-245Chapter in book (Refereed)
  • 285.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies.
    Teamarbete: ett livsviktigt samspel2013In: Sjuksköterskans kärnkompetenser / [ed] Leksell, Janeth, Lepp, Margret, Stockholm: Liber, 2013, 1, p. 159-177Chapter in book (Refereed)
  • 286.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Blåljusorganisationer på olycksplatsen: om samverkansminimering2009In: Offentlig sektor och komplexitet: om hantering av mål, strategier och professioner / [ed] Adolfsson, Petra & Solli, Rolf, Lund: Studentlitteratur , 2009, p. 59-79Chapter in book (Other academic)
  • 287.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    Sahlgrenska Akademin, Göteborgs universitet.
    Collaboration Exercises: the lack of collaborative benefits2014In: International Journal of Disaster Risk Science, ISSN 2095-0055, Vol. 5, no 3, p. 192-205Article in journal (Refereed)
    Abstract [en]

    The purpose of this paper is to study what professional emergency personnel learn during collaboration exercises and the benefits of what they have learned. Observations (n=19) and semistructured interviews (n=32) were carried out in conjunction with major exercises held in Sweden (2007–2012). The results show that exercises tend to be based on its own logic, which differs from actual events. Exercise participants believe that they mainly learn single-track, parallel and path-dependent behavior. The exercises do not facilitate the use of cross-boundary activities. This means that learning as well as benefits of the exercises for actual events is limited. The exercises would be more appropriate if those participating had the opportunity to identify weaknesses, try alternative ways as well as had the opportunity to have comprehensive organizational analyses at the conclusion of the exercises. Based on the results of the study, alternative models for the exercises are suggested that contain elements, which develop collaboration and contribute to learning.

  • 288.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies.
    Carlström, Eric
    Sahlgrenska Akademin, Göteborgs universitet.
    Cultural camouflage: a critical study of how artefacts are camouflaged and mental health policy subverted2015In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, Vol. 30, no 2, p. 111-126Article in journal (Refereed)
    Abstract [en]

    This study identifies hidden artefacts in a public organisation. In contrast to earlier studies, itfocuses on artefacts as concealing rather than conveying meaning. Negligent behaviour causedby an unpopular culture was recognised in five psychiatric wards at a Swedish universityhospital. Data comprising observations (87 h) and interviews (n = 60) were collected over aperiod of 48months (2008–2011). Four different items used in everyday work representing adeeper meaning of the organisation were identified during the observations. The items selectedwere work attire, nametags, keys and restraint beds. These were considered particularly promisingwhen it came to the aim of the study, namely, to find out how artefacts are camouflaged. Theobservations and the interviews revealed that these were controversial and contested artefacts inthe organisation. The study uses the term ‘cultural camouflage’ for behaviour that ignores andconsciously conceals symbols that have negative values. This concept contrasts with previousresearch that shows how artefacts are emphasised and how they contribute to the character ofthe activity in a transparent way. Conservative and backward-looking behaviour among staffprovided one explanation as to why artefacts were concealed. Another was the need to establishharmonious internal interactions.

  • 289.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    Sahlgrenska Akademin, Göteborgs universitet.
    Från mekanistisk till organisk samverkan mellan blåljusorganisationer2013In: Om samverkan: för utveckling av hälsa och välfärd / [ed] Axelsson, Runo, Bihari Axelsson, Susanna, Lund: Studentlitteratur, 2013, 1, p. 237-254Chapter in book (Refereed)
  • 290.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies.
    Carlström, EricSahlgrenska Akademin, Göteborgs universitet.
    Guest editors | Special Issue: Management control, organisation and leadership in the healthcare sector2013Collection (editor) (Refereed)
  • 291.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Samverkan mellan blåljusorganisationer2011 (ed. 1)Book (Other academic)
    Abstract [sv]

    Samverkan mellan olika yrkesprofessioner på en olycksplats är komplicerat. Mycket på grund av att förväntningarna inte alltid överensstämmer med förutsättningarna. I boken problematiseras agerandet på olycksplatsen. Friktionen mellan yrkesprofessioner lyfts fram och olika beteendemönster diskuteras.I boken tar författarna samverkan från retorik till ett praktiskt redskap, något som är möjligt att konkretisera och utföra praktiskt i det dagliga arbetet. Boken utgör samtidigt en introduktion till övningstekniken 3-nivåsamverkan (3-NS).I den här boken bjuds på flera närgångna beskrivningar. Medarbetare från fältet berättar om sina erfarenheter av samverkan, hur den tillämpas, om vilka möjligheter som finns och vilka svårigheter som behöver hanteras.Boken riktar sig till alla som arbetar i eller i anslutning till blåljusorganisationer. Den kan med fördel användas som lärobok för universitets- och högskolestuderande som läser till yrken inom polis, räddningstjänst eller ambulanssjukvård. Boken passar också för vidareutbildning av redan yrkesverksamma. Den kan även med fördel läsas av forskare, tjänstemän och politiker med intresse för hur framtidens blåljusorganisationer ska ledas, organiseras och styras.

  • 292.
    Berlin, Johan
    et al.
    Göteborgs universitet / Sahlgrenska akademin.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Samverkan på olycksplatsen: om organisatoriska barriäreffekter2009Book (Other academic)
  • 293.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. Göteborgs universitet, Sahlgrenska akademin.
    Samverkansövningar: Om lärande och nytta2015 (ed. 1)Book (Other academic)
    Abstract [en]

    This study relates to collaboration exercises, with particular focus on the full-scale exercises between the police, rescue services and ambulance. To succeed in a complex situation, it requires that the personnel’s ability to collaborate across organisations be developed and refined.

    The overall aim of this study was to examine how collaboration is practised and how exercises lead to learning and usefulness. A research summary was initially done in this study. Based on that, a number of key concepts were developed that proved helpful when we followed the Swedish collaboration exercises through interviews and observations. The collected analysis has since been the basis for the design of a new exercise model, 3LC, three-level collaboration. It is based on the experiences we have had in studies of traditional exercises.

    The 3LC exercises that were conducted consisted of two practical sessions and three seminars. Each session was followed by an evaluative seminar with the aim that participants themselves would reflect and develop their patterns of behaviour. The two practical sessions were identical. It gave the participants the opportunity to rehearse and methodically try new approaches. The first exercise session was carried out according to the procedures that normally apply and govern the actions at an actual event. The second exercise session was preceded by a self-critical seminar where participants themselves identified what could be improved for the next exercise session.

    The research project was carried out from 2011 to 2014. A total of 19 collaboration exercises were studied, including 16 full-scale exercises. A total of 97 interviews and 125 hours of observation were carried out in this study. A questionnaire (CLU instrument) was developed, which was answered by 272 exercise participants.

    The study shows that collaborative sessions in the exercises contributed to the participants learning more and having greater usefulness from the exercises. 3LC exercises were perceived to enhance learning by 26 per cent and usefulness by 17 per cent, compared with traditional exercises. Collaborative exercises are benefitted when participants analyse their weaknesses themselves. Repetitive elements where participants try out alternative strategies improve preparedness prior to actual events.

  • 294.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Work and Social Pedagogy.
    Carlström, Eric
    Sjuksköterskan som chef och ledare: en utmaning2017In: Pedagogik för sjuksköterskor / [ed] Håkan Sandberg, Lund, 2017, 1, p. 295-313Chapter in book (Refereed)
  • 295.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies.
    Carlström, Eric
    Sahlgrenska Akademin, Göteborgs universitet.
    The dominance of mechanistic behaviour: A critical study of emergency exercises2013In: International Journal of Emergency Management, ISSN 1471-4825, E-ISSN 1741-5071, Vol. 9, no 4, p. 327-350Article in journal (Refereed)
    Abstract [en]

    In this paper, the focus is on emergency exercises between the police, rescue services and ambulance. By practising, it is assumed that the conditions improve for a quick normalisation after an incident. The purpose of this paper is to identify whether the exercises are designed after organic action logic and therefore can be assumed to strengthen the ability to handle emergencies. Data have been collected at two large, regional, full-scale exercises (2008 and 2012). Data collection has been done through observations and document studies. The study shows that mechanistic behaviour is quite prevalent in the two studied exercises. They are time consuming and put little emphasis on practising organic behaviour. Too complex exercise scenarios contribute to a low tempo, long waiting periods and slow implementation. To succeed, the exercises need to have a non-linear time sequence and limited scenarios that invite participants to focus on organisational interfaces.

  • 296.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Traumateam - förenklat flöde eller försvårande hinder?2006In: Hälso- och sjukvårdens ekonomi och logistik (HEL), Göteborg: Sahlgrenska akademin vid Göteborgs universitet , 2006, p. 202-209Chapter in book (Other academic)
  • 297.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies.
    Carlström, Eric
    Sahlgrenska akademin, Göteborgs universitet.
    Trender som utmanar traditioner: En hälso- och sjukvård i metamorfos2012In: Offentlig Förvaltning. Scandinavian Journal of Public Administration, ISSN 2000-8058, E-ISSN 2001-3310, Vol. 16, no 2, p. 3-23Article in journal (Refereed)
    Abstract [en]

    This article reviews the traditions of the health care industry while challenged by trends. Strong professions, ambiguous and contradictory aims, and a lack of resources have contributed to difficulties managing contradictory needs. One way to handle the situation is to introduce systems based on freedom of choice, inter organisational and professional work, and an improved degree of flexibility. The trends are mainly influenced by New Public Management control models. The mixture of new and traditional types of management control has produced organisational hybrids. These organisational hybrids have contributed to organisational tensions from the old as well as the new in an inconsistent but regenerating way.

  • 298.
    Berlin, Johan
    et al.
    Göteborgs universitet / Sahlgrenska akademin. University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Vad övas vid samverkansövningar: - om första initiativeffekt och parallellitet2008In: Nordiske organisasjonsstudier, ISSN 1501-8237, no 4, p. 23-39Article in journal (Other academic)
  • 299.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Blåljusövningar och lärande: - en ny typ av samverkansövning2011Conference paper (Refereed)
  • 300.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. Göteborgs universitet, Sahlgrenska Akademin, Institute of Health and Care Sciences.
    The Three-Level Collaboration Exercise: Impact of Learning and Usefulness2015In: Journal of Contingencies and Crisis Management, ISSN 0966-0879, E-ISSN 1468-5973, Vol. 23, no 4, p. 257-265Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to examine the emergency personnel’s perception of the effects of exercises, with regard to learning and usefulness. The exercises were quasi-experimental and constructed in such a way that employees from different organizations overlapped each other’s tasks. This was accomplished by: having asymmetries included in the scenarios, repeating exercise procedures and testing different strategies, which were discussed at joint seminars. The exercises were compared to a similar study, published in this journal, of nonquasi-experimental but merely traditional exercises. Surveys were distributed and collected from emergency personnel in connection with seven exercises. At the exercises, 94.3% of the personnel thought that the exercises had a focus on collaboration (traditional exercises, 75.6%).

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