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Granqvist K, Ahlstrom L, Karlsson J, Lytsy B, Erichsen A. Central aspects when implementing an electronic monitoring system for assessing hand hygiene in clinical settings: A grounded theory study. J Infect Prev 2024; 25:51-58. [PMID: 38584715 PMCID: PMC10998548 DOI: 10.1177/17571774241230678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 01/21/2024] [Indexed: 04/09/2024] Open
Abstract
Background New technologies, such as electronic monitoring systems, have been developed to promote increased adherence to hand hygiene among healthcare workers. However, challenges when implementing these technologies in clinical settings have been identified. Aim The aim of this study was to explore healthcare workers' experiences when implementing an electronic monitoring system to assess hand hygiene in a clinical setting. Method Interviews with healthcare workers (registered nurses, nurse assistants and leaders) involved in the implementation process of an electronic monitoring system (n = 17) were conducted and data were analyzed according to the grounded theory methodology formulated by Strauss and Corbin. Results Healthcare workers' experiences were expressed in terms of leading and facilitating, participating and contributing, and knowing and confirming. These three aspects were merged together to form the core category of collaborating for progress. Leaders were positive and committed to the implementation of the electronic monitoring system, endeavouring to enable facilitation and support for their co-workers (registered nurses and nurse assistants). At the same time, co-workers were positive about the support they received and contributed by raising questions and demands for the product to be used in clinical settings. Moreover, leaders and co-workers were aware of the objective of implementing the electronic monitoring system. Conclusion We identified dynamic collective work between leaders and co-workers during the implementation of the electronic monitoring system. Leadership, participation and knowledge were central aspects of enhancing a collaborative process. We strongly recommend involving both ward leaders and users of new technologies to promote successful implementation.
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Affiliation(s)
- Karin Granqvist
- Department of Anaesthesia, Surgery and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden
- The Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Linda Ahlstrom
- The Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Jon Karlsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Birgitta Lytsy
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Sweden
| | - Annette Erichsen
- The Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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Alexiou E, Wijk H, Åkerström M, Jonsdottir IH, Degl' Innocenti A, Ahlstrom L. Worry perception and its association with work conditions among healthcare workers during the first wave of the COVID-19 pandemic: a web-based multimethod survey at a university hospital in Sweden. BMJ Open 2024; 14:e080248. [PMID: 38382952 PMCID: PMC10882285 DOI: 10.1136/bmjopen-2023-080248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVES In this study, we explored healthcare workers' (HCWs) worry perception and its association with their work situation during the first wave of the COVID-19 pandemic. DESIGN A web-based multimethods survey including multiple choice and open-ended questions was used. SETTING The study was conducted at a university hospital in Sweden. PARTICIPANTS All HCWs who were working during the first wave of the COVID-19 pandemic in March-June 2020 were eligible. HCWs (n=6484, response rate=41%) from 69 departments fulfilled the study inclusion criteria and responded to the survey. Of them, we analysed data from the 3532 participants who replied to the open-ended questions (54% of the respondents). MAIN OUTCOMES MEASURES Worry perception and its association with work conditions among HCWs. RESULTS 29% (n=1822) and 35% (n=2235) of the responding HCWs experienced a daily or more than daily strong worry of being infected or infecting others with SARS-CoV-2. This finding could be further confirmed and explored with themes from the qualitative results: 'ambiguity of feeling safe and secure', 'being obliged to adapt to a new reality' and 'into the unknown'. The themes consisted of 6 main categories and 15 subcategories. The findings revealed that the two main drivers of worry perceived by HCWs were lack of personal protective equipment and fear of bringing the virus home to their families and friends. CONCLUSIONS Worries of getting infected are common among HCWs during crises such as the COVID-19 pandemic. Several factors are raised that plausibly could minimise the negative effects of worry among HCWs. Thus, effective preventive work plans should be created, promoted and communicated in order to minimise the effects of such crises and support HCWs. By focusing on effective communication and preparedness, including access to relevant protective equipment and providing general support to HCWs, the work environment and patient care could be sustained during a crisis such as the COVID-19 pandemic.
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Affiliation(s)
- Eirini Alexiou
- Department of Forensic Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
- Center for Ethics, Law, and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Wijk
- Department of Quality Strategies, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Magnus Åkerström
- Institute of Stress Medicine, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- Institute of Stress Medicine, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alessio Degl' Innocenti
- Center for Ethics, Law, and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Regionhälsan, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
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Granqvist K, Ahlstrom L, Karlsson J, Lytsy B, Andersson AE. Hand hygiene in a clinical setting: evaluation of an electronic monitoring system in relation to direct observations. Am J Infect Control 2024:S0196-6553(24)00052-X. [PMID: 38272313 DOI: 10.1016/j.ajic.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/19/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND This study evaluated the accuracy of an electronic monitoring system for assessing hand hygiene in a clinical setting in relation to direct observations. METHOD An electronic monitoring system was installed on a surgical ward at a tertiary hospital in Sweden. Hand hygiene events registered by the system were compared with direct observations conducted simultaneously by a trained observer following the World Health Organization's "My five moments for hand hygiene". A 4-step protocol was developed to evaluate the system's ability to accurately monitor hand hygiene in a clinical setting. RESULTS A total of 947 opportunities for hand hygiene were observed during June - Dec 2019. Of these, 484 opportunities were correctly captured by the electronic monitoring system and included in the calculations for accuracy. Sensitivity was 90.2% with a positive predictive value of 95.7%, while the specificity was 50.0% with a negative predictive value of 29.0%. Overall accuracy was 87.1%. CONCLUSION Evaluating technical systems assessing hand hygiene in clinical settings is hampered by several challenges. The 4-step protocol helped to identify the limitations and strengths of the evaluated EMS, revealing high accuracy while also detecting systematic errors.
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Affiliation(s)
- Karin Granqvist
- Department of Anaesthesia, Surgery and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Jon Karlsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Birgitta Lytsy
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Sweden
| | - Annette Erichsen Andersson
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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Rasmussen B, Holton S, Wynter K, Phillips DJ, David JL, Rothmann MJ, Skjoeth MM, Wijk H, Frederiksen K, Ahlstrom L, Anderson JE, Harris R, Conolly A, Kent B, Maben J. Letter to editor. J Adv Nurs 2023; 79:2774-2775. [PMID: 37332127 DOI: 10.1111/jan.15632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 06/20/2023]
Affiliation(s)
- Bodil Rasmussen
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia
- Faculty of Health, Institute of Health Transformation, Deakin University, Geelong, Australia
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Sara Holton
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia
- Faculty of Health, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Karen Wynter
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia
- Faculty of Health, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - David J Phillips
- Faculty of Health, School of Nursing and Midwifery, Geelong, Australia
| | - Jennifer L David
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia
| | - Mette Juel Rothmann
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Odense University Hospital, Odense, Denmark
| | | | - Helle Wijk
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kirsten Frederiksen
- Department of Public Health - Department of Science in Nursing, Aarhus University, Aarhus, Denmark
| | - Linda Ahlstrom
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Quality Strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Janet E Anderson
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Ruth Harris
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Anna Conolly
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Bridie Kent
- Faculty of Health, School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | - Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
- Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia
- Discipline of Nursing, College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
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Veje M, Linden K, Sengpiel V, Carlsson Y, Jonsdottir IH, Degl'Innocenti A, Ahlstrom L, Wijk H, Akerstrom M. Working conditions for healthcare workers at a Swedish university hospital infectious disease department during the COVID-19 pandemic: barriers and facilitators to maintaining employee wellbeing. Front Psychol 2023; 14:1183084. [PMID: 37275708 PMCID: PMC10233109 DOI: 10.3389/fpsyg.2023.1183084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/04/2023] [Indexed: 06/07/2023] Open
Abstract
Background Healthcare workers (HCWs) at infectious disease departments have held the frontline during the COVID-19 pandemic. This study aimed to identify barriers and facilitators to maintaining the employees' wellbeing that may be used to increase preparedness for future pandemics within ID Departments. Methods In September 2020, a web-based survey on demographics and work environment was distributed to all HCWs at the Infectious Disease Department at Sahlgrenska University Hospital. Results were compared with a pre-COVID-19 survey from October 2019. A quantitative analysis of the overall effects of the pandemic on the working conditions of HCWs was conducted; in addition, a qualitative content analysis of open-ended responses was performed. Results In total, 222 and 149 HCWs completed the pre-COVID-19 and COVID-19 surveys (84 and 54% response rate), respectively. Overall, we found significant changes regarding increased workload, lack of emotional support in stressful work situations, and inability to recover after shifts. These factors correlated both with younger age and concern of becoming infected. The open-ended answers (n = 103, 69%) revealed five generic categories (Workload; Organizational support; Worry and ethical stress; Capability; and Cooperation and unity) with a total of 14 identified factors representing plausible individual and organizational-level barriers or facilitators to sustained employee wellbeing. Conclusion Younger HCWs as well as those expressing worries about contracting the infection were found to be particularly affected during the COVID-19 pandemic and these groups may require additional support in future outbreaks. Factors both increasing and decreasing the pandemic-induced negative health consequences for HCWs were identified; this knowledge may be utilized in the future.
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Affiliation(s)
- Malin Veje
- Department of Infectious Diseases, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
- Institute of Biomedicine, Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Verena Sengpiel
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
- Center of Perinatal Medicine and Health, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Ylva Carlsson
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
- Center of Perinatal Medicine and Health, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alessio Degl'Innocenti
- Center for Ethics, Law, and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Gothia Forum for Clinical Trials, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Quality Strategies, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Magnus Akerstrom
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Björk L, Corin L, Akerstrom M, Jonsdottir IH, Innocenti AD, Wijk H, Ahlstrom L. Under pressure - The working situation of Swedish healthcare managers during the first wave of COVID-19. Front Psychol 2023; 13:1052382. [PMID: 36710753 PMCID: PMC9874142 DOI: 10.3389/fpsyg.2022.1052382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction The aim of this study is to provide insight into the psychosocial work situation of hospital managers during the first wave of the COVID-19 pandemic. Methods Mixed-effect modelling was used on survey data on job demands, job resources, job motivation, and work-life balance among over 500 managers working in 55 departments of a large Swedish university hospital in 2019 and 2020. Responses from 6011 employees were then used to stratify the analysis for COVID-19 exposure. Inductive content analysis was applied to open-ended questions on the managers' views on organisational prerequisites during the onset of the pandemic. Results The proportion of managers reporting difficulties with role clarity, quantitative demands, decision-making authority, and emotional support, time for recovery at work, motivation deficits, or problems with work-life balance clearly increased during the first wave of the pandemic. The proportion of managers reporting negative responses was higher in departments with high COVID-19 exposure. The qualitative analysis shows that overall governance in terms of clear, fair, and well-communicated routines, resource allocation, and division of responsibilities constituted an important framework for managerial during the crisis. First-line managers also require a mandate to re-organize their roles and their teams to successfully adapt to the situation. Organisational and social support was also important resources. Discussion This is the first study investigating healthcare managers' work situation during the first wave of the COVID-19 pandemic in a Swedish context. As expected, it indicates an increasingly strained work situation during the crisis, but it also provides findings on organisational prerequisites that allow healthcare managers to cope with stressful situations. In line with previous research on organisational resilience, the study provides suggestions for how higher-level managers can act in order to provide front-line managers with the organisational prerequisites they need to adapt, learn and develop successfully during times of unpredictability, insecurity, and rapid change in order to offer the best possible support to health care workers.
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Affiliation(s)
- Lisa Björk
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden,*Correspondence: Lisa Björk, ✉
| | - Linda Corin
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Akerstrom
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingibjörg H. Jonsdottir
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alessio Degl Innocenti
- Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health (CELAM), Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Region Västra Götaland, Sahlgrenska University Hospital, Gothia Forum for Clinical Trials, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Quality Strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden,Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Orthopedics, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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Akerstrom M, Carlsson Y, Sengpiel V, Veje M, Elfvin A, Jonsdottir IH, Degl'Innocenti A, Ahlstrom L, Wijk H, Linden K. Working conditions for hospital-based maternity and neonatal health care workers during extraordinary situations - A pre-/post COVID-19 pandemic analysis and lessons learned. Sex Reprod Healthc 2022; 33:100755. [PMID: 35853385 PMCID: PMC9273518 DOI: 10.1016/j.srhc.2022.100755] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 06/29/2022] [Accepted: 07/07/2022] [Indexed: 11/16/2022]
Abstract
Objective The aim of this study was to investigate how the changed work routines during the COVID-19 pandemic has been affecting the working environment for hospital-based maternity and neonatal health care workers, and to identify preventive measures to be used in future situations when health care organizations are under pressure. Methods All maternity and neonatal health care workers in a Swedish university hospital were surveyed during October 2019 and September 2020. The data was analyzed by document analysis of implemented changes in working routines, a quantitative analysis of the overall effects on the working conditions, and a qualitative analysis of open-ended responses. Results A total of 660 maternity and neonatal health care workers completed the pre-COVID-19 survey (74% response rate) and 382 the COVID-19 survey (35% response rate). Lack of personal protective equipment, worry about becoming infected, uncertainty whether implemented changes were enough, and challenges in communicating updated routines had negative effects on maternity and neonatal health care workers’ working conditions. Team spirit and feeling valued by peers had a positive effect. Conclusions Results suggest that negative effects on maternity and neonatal health care workers’ health can partly be prevented in future critical situations by creating a work climate that acknowledges the employees’ worry about being infected, securing adequate pre-conditions for managers, creating a strong psychosocial safety climate and systematically improving the working conditions for the maternity and neonatal health care workers, as well as maintaining the positive perceived effects of increased team spirit and feeling valued by peers.
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Affiliation(s)
- Magnus Akerstrom
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
| | - Ylva Carlsson
- Region Västra Götaland, Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden; Centre of Perinatal Medicine and Health, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Verena Sengpiel
- Region Västra Götaland, Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden; Centre of Perinatal Medicine and Health, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Malin Veje
- Region Västra Götaland, Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Elfvin
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Department of Paediatrics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Alessio Degl'Innocenti
- Centre for Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Gothia Forum for Clinical Trials, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Department of Quality Strategies, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
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Granqvist K, Ahlstrom L, Karlsson J, Lytsy B, Andersson AE. Learning to interact with new technology: Health care workers' experiences of using a monitoring system for assessing hand hygiene - a grounded theory study. Am J Infect Control 2022; 50:651-656. [PMID: 34610392 DOI: 10.1016/j.ajic.2021.09.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Recently, innovative technologies for hand hygiene (HH) monitoring have been developed to improve HH adherence in health care. This study explored health care workers' experiences of using an electronic monitoring system to assess HH adherence. METHODS An electronic monitoring system with digital feedback was installed on a surgical ward and interviews with health care workers using the system (n = 17) were conducted. The data were analyzed according to grounded theory by Strauss and Corbin. RESULTS Health care workers' experiences were expressed in terms of having trust in the monitoring system, requesting system functionality and ease of use and becoming aware of one's own performance. This resulted in the core category of learning to interact with new technology, summarized as the main strategy when using an electronic monitoring system in clinical settings. The system with digital feedback improved the awareness of HH and individual feedback was preferable to group feedback. CONCLUSIONS Being involved in using and managing a technical innovation for assessing HH adherence in health care is a process of formulating a strategy for learning to interact with new technology. The importance of inviting health care workers to participate in the co-design of technical innovations is crucial, as it creates both trust in the innovation per se and trust in the process of learning how to use it.
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Caous JS, Malchau KS, Petzold M, Fridell Y, Malchau H, Ahlstrom L, Grant P, Andersson AE. Instrument tables equipped with local unidirectional airflow units reduce bacterial contamination during orthopedic implant surgery in an operating room with a displacement ventilation system. Infect Prev Pract 2022; 4:100222. [PMID: 35722048 PMCID: PMC9198428 DOI: 10.1016/j.infpip.2022.100222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 05/18/2022] [Indexed: 11/26/2022] Open
Abstract
Background Airborne bacteria present in the operating room may be a cause of surgical site infection, either contaminating the surgical wound directly, or indirectly via e.g. surgical instruments. The aim of this study was to evaluate if instrument and assistant tables equipped with local unidirectional airflow reduce bacterial contamination of the instrument area to ultra clean levels, during orthopedic implant surgery in an operating room with displacement ventilation. Methods Local airflow units of instrument and assistant tables were either active or inactive. Colony forming units were sampled intraoperatively from the air above the instruments and from instrument dummies. A minimum of three air samples and two-three samples from instrument dummies were taken during each surgery. Samples were incubated on agar for total aerobic bacterial count. The mean air and instrument contamination during each surgery was calculated and used to analyze the difference in contamination depending on use of local airflow or not. All procedures were performed in the same OR. Results 188 air and 124 instrument samples were collected during 48 orthopedic implant procedures. Analysis showed that local unidirectional airflow above the surgical instruments significantly reduced the bacterial count in the air above assistant table (P<0.001) and instrument table (P=0.002), as well as on the instrument dummies from the assistant table (P=0.001). Conclusions Instrumentation tables equipped with local unidirectional airflow protect the surgical instruments from bacterial contamination during orthopedic implant surgery and may therefore reduce the risk of indirect wound contamination.
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10
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Rasmussen B, Holton S, Wynter K, Phillips DJ, David JL, Rothmann MJ, Skjoeth MM, Wijk H, Frederiksen K, Ahlstrom L, Anderson JE, Harris R, Conolly A, Kent B, Maben J. We're on mute! Exclusion of nurses' voices in national decisions and responses to COVID-19: An international perspective. J Adv Nurs 2022; 78:e87-e90. [PMID: 35352392 PMCID: PMC9111388 DOI: 10.1111/jan.15236] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Bodil Rasmussen
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.,Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia.,Institute of Health Transformation, Faculty of Health, Deakin University, Geelong, Australia.,Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Sara Holton
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.,Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia.,Institute of Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Karen Wynter
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.,Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia.,Institute of Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - David J Phillips
- Faculty of Health, School of Nursing and Midwifery, Geelong, Australia
| | - Jennifer L David
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.,Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia
| | - Mette Juel Rothmann
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Odense University Hospital, Odense, Denmark
| | - Mette Maria Skjoeth
- Odense University Hospital, Odense, Denmark.,Sundhed.dk, Copenhagen, Denmark
| | - Helle Wijk
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kirsten Frederiksen
- Department of Public Health - Department of Science in Nursing, Aarhus University, Aarhus, Denmark
| | - Linda Ahlstrom
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Quality Strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Janet E Anderson
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Ruth Harris
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
| | - Anna Conolly
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Bridie Kent
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Jill Maben
- School of Health Sciences, University of Surrey, Guildford, United Kingdom.,Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia.,Discipline of Nursing, College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
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11
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Rydberg EM, Insulan J, Rolfson O, Mohaddes M, Ahlstrom L. Knowledge support for ankle fractures in the Swedish Fracture Register - a qualitative study of physicians' experiences. BMC Health Serv Res 2022; 22:382. [PMID: 35321701 PMCID: PMC8941301 DOI: 10.1186/s12913-022-07799-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background The aim of this study is to investigate the experiences of physicians presented with a knowledge support system while registering data on ankle fractures in the Swedish Fracture Register. The present study aims to answer the following research questions: • “How is receiving knowledge support while registering a fracture in the Swedish Fracture Register experienced by the physicians using it?”. • “Can a feeling of increased usability of a quality register be achieved by providing the user with real-time feedback?”. Methods A total of 20 physicians using the Swedish Fracture Register were recruited using a purposive sampling strategy. Qualitative content analysis was performed on individual semi-structured interviews performed in May and June 2020. Results The present study demonstrates that the knowledge support system in the Swedish Fracture Register was perceived by the physicians as strengthening the evidence base and improving the quality of ankle fracture treatment. The knowledge support system was evaluated as a good tool for validating clinical decisions and managing the information that needs to be processed to make informed decisions. Conclusions The present study affirms that being provided with knowledge support is appreciated by physicians, increase value for work and enhance the initiative to register. The physicians experienced that the knowledge support provided an appreciated validation of the clinical decisions taken and a feeling of improved care. When incorporating knowledge support into an NQR, consideration must be given to physicians’ fears of becoming overly reliant on a template and losing control of the clinical base.
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Affiliation(s)
- Emilia Möller Rydberg
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Göteborgsvägen 31, SE-431 80 Mölndal, Gothenburg, Sweden.
| | - Johan Insulan
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ola Rolfson
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Göteborgsvägen 31, SE-431 80 Mölndal, Gothenburg, Sweden
| | - Maziar Mohaddes
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Göteborgsvägen 31, SE-431 80 Mölndal, Gothenburg, Sweden
| | - Linda Ahlstrom
- Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Göteborgsvägen 31, SE-431 80 Mölndal, Gothenburg, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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12
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Frödin M, Ahlstrom L, Gillespie BM, Rogmark C, Nellgård B, Wikström E, Erichsen Andersson A. Effectiveness of implementing a preventive urinary catheter care bundle in hip fracture patients. J Infect Prev 2022; 23:41-48. [PMID: 35340925 PMCID: PMC8941588 DOI: 10.1177/17571774211060417] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 08/31/2021] [Indexed: 11/17/2022] Open
Abstract
Background Urinary catheter (UC)–associated infections are one of the most common
preventable healthcare-associated infections (HAIs) and they frequently
occur in older, frail populations. Aim The study aim was to describe the incidence of UC-associated infection in
elderly patients undergoing hip fracture surgery after implementing a
preventive care bundle. Methods A longitudinal prospective study using a before-and-after design. The bundle
was theory driven and involved the co-creation of a standard operational
procedure, education and practical training sessions. Prospectively
collected registry data were analysed. Univariable statistics and
multivariable logistic regressions were used for analyses. Results 2,408 patients with an acute hip fracture were included into the study. There
was an overall reduction in UC catheter associated-associated urinary tract
infections, from 18.5% (n = 75/406) over time to 4.2%
(n = 27/647). When adjusting for all identified
confounders, patients in phase 4 were 74% less likely to contract an
UC-associated infection (OR, 0.26; 95% CI, 0.15–0.45, p
< 0.0001). Discussion Bundled interventions can reduce UC-associated infections substantially, even
in elderly frail patients. Partnership and co-creation as implementation
strategies appear to be promising in the fight against HAI.
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Affiliation(s)
- Maria Frödin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Brigid M. Gillespie
- School of Nursing and Midwifery, Griffith University, Gold Coast, QLD, Australia
- Gold Coast University Hospital and Health Service, Southport, QLD, Australia
| | - Cecilia Rogmark
- Department of Orthopedics, Skane University Hospital, Lund University, Malmö, Sweden
- Swedish Hip Arthroplasty Register, Registercentrum VGR, Gothenburg, Sweden
| | - Bengt Nellgård
- Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ewa Wikström
- School of Business, Economics and Law, Department of Business Administration, University of Gothenburg, Gothenburg, Sweden
| | - Annette Erichsen Andersson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopedics, Sahlgrenska University Hospital, Gothenburg, Sweden
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13
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Jonsdottir IH, Degl'Innocenti A, Ahlstrom L, Finizia C, Wijk H, Åkerström M. A pre/post analysis of the impact of the COVID-19 pandemic on the psychosocial work environment and recovery among healthcare workers in a large university hospital in Sweden. J Public Health Res 2021; 10. [PMID: 34278769 PMCID: PMC8715269 DOI: 10.4081/jphr.2021.2329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 05/26/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The impact of the COVID-19 pandemic on workload, mental health, and well-being of healthcare workers, and particularly those on the front-line, has received considerable attention. DESIGN AND METHODS We surveyed hospital employees about their working environment during the pandemic and identified departments which were negatively affected in comparison to the pre-pandemic situation, as well as factors contributing to this. Setting and participants We surveyed all hospital employees at Sahlgrenska University Hospital, Sweden in September 2020 and compared results across departments and to the results of a large employee survey from October 2019. RESULTS The overall impact of the pandemic on perceived working conditions and possibility for recovery differed among departments. During the pandemic, healthcare workers working with COVID-19 patients reported poorer working environments than other employees. Factors significantly related to perception of work environment and recovery during the pandemic included worries of being infected, departmental transfer, and having insufficient access to personal protective equipment. Men reported better working conditions than women in all, but one item and higher age was related to better perceived working environment. CONCLUSIONS Our results indicate that the pandemic differentially affects hospital departments and underscores the multifactorial nature of this topic. Contributing factors to poor perceived working environment could be addressed at times of high workload, such as during the pandemic, including providing appropriate support to managers, ensuring possibility for recovery during working hours, and acknowledging worries about infection. Young healthcare workers and staff who are relocated due to the pandemic warrant special attention.
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Affiliation(s)
- Ingibjörg H Jonsdottir
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg.
| | - Alessio Degl'Innocenti
- Centre for Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg; Region Västra Götaland, Sahlgrenska University Hospital, Gothia Forum for Clinical Trials, Gothenburg.
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg; Region Västra Götaland, Sahlgrenska University Hospital, Department of Orthopaedics, Gothenburg.
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; Region Västra Götaland, Sahlgrenska University Hospital, Department of Research, Development, Education and Innovation, Sahlgrenska University Hospital, Gothenburg .
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg.
| | - Magnus Åkerström
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg.
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14
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Ahlstrom L, Holmberg C. A comparison of three interactive examination designs in active learning classrooms for nursing students. BMC Nurs 2021; 20:59. [PMID: 33836729 PMCID: PMC8033549 DOI: 10.1186/s12912-021-00575-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/22/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Despite the advantages of using active learning strategies in nursing education, researchers have rarely investigated how such pedagogic approaches can be used to assess students or how interactive examinations can be modified depending on circumstances of practice (e.g., in online education). AIMS The aim was to compare three interactive examination designs, all based on active learning pedagogy, in terms of nursing students' engagement and preparedness, their learning achievement, and instructional aspects. METHODS A comparative research design was used including final-year undergraduate nursing students. All students were enrolled in a quality improvement course at a metropolitan university in Sweden. In this comparative study to evaluate three course layouts, participants (Cohort 1, n = 89; Cohort 2, n = 97; Cohort 3, n = 60) completed different examinations assessing the same course content and learning objectives, after which they evaluated the examinations on a questionnaire in numerical and free-text responses. Chi-squared tests were conducted to compare background variables between the cohorts and Kruskal-Wallis H tests to assess numerical differences in experiences between cohorts. Following the guidelines of the Good Reporting of a Mixed Methods Study (GRAMMS), a sequential mixed-methods analysis was performed on the quantitative findings, and the qualitative findings were used complementary to support the interpretation of the quantitative results. RESULTS The 246 students who completed the questionnaire generally appreciated the interactive examination in active learning classrooms. Among significant differences in the results, Cohort 2 (e.g., conducted the examination on campus) scored highest for overall positive experience and engagement, whereas Cohort 3 (e.g., conducted the examination online) scored the lowest. Students in Cohort 3 generally commended the online examination's chat function available for use during the examination. CONCLUSIONS Interactive examinations for nursing students succeed when they are campus-based, focus on student preparation, and provide the necessary time to be completed.
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Affiliation(s)
- Linda Ahlstrom
- Institute of Health and Care Sciences, Section of Learning and Leadership for Health Care Professionals, University of Gothenburg, Arvid Wallgrens Backe, Box 457, 405 30, Gothenburg, Sweden
- Department of Orthopedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christopher Holmberg
- Institute of Health and Care Sciences, Section of Learning and Leadership for Health Care Professionals, University of Gothenburg, Arvid Wallgrens Backe, Box 457, 405 30, Gothenburg, Sweden.
- Department of Psychotic Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden.
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15
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Alexiou E, Steingrimsson S, Akerstrom M, Jonsdottir IH, Ahlstrom L, Finizia C, Wijk H, Degl'Innocenti A. A Survey of Psychiatric Healthcare Workers' Perception of Working Environment and Possibility to Recover Before and After the First Wave of COVID-19 in Sweden. Front Psychiatry 2021; 12:770955. [PMID: 34912253 PMCID: PMC8666504 DOI: 10.3389/fpsyt.2021.770955] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 10/27/2021] [Indexed: 01/26/2023] Open
Abstract
Objective: This study aimed to investigate the impact of the first wave of the COVID-19 pandemic on perceived working environment, including the possibility to recover, among psychiatric healthcare workers (PHCWs) in comparison with pre-pandemic measures. Method: A link to an anonymous, web-based COVID-19 related survey was sent via email to all PHCWs at a university hospital in Sweden (n = 1,618) in September 2020. The response rate was 38% (566 of 1,507 eligible participants). Working environment survey responses collected in 2019 were used as pre-pandemic comparators. Statistical analyses were performed to assess overall impact over time on work demands, support, motivation, and recovery, stratified by professional role, and considering variables such as access to personal protective equipment. Results: The percentage of individuals responding negatively to statements about working environment increased significantly for most items after the first wave. Similarly, the increase of five of the investigated factors indicated a more negative perception of recovery during the pandemic. Registered nurses reported a greater negative impact of the pandemic on perceived working conditions and ability to recover than other professional groups. PHCWs working with patients with COVID-19 (35%) who reported being worried about becoming infected (12%) or infecting others (17%), or lacking adequate personal protective equipment (22%) were more negatively impacted regarding work environment-related items than those who did not. Conclusions: PHCWs' working environment and possibility for recovery were impacted by the first wave of the COVID-19 pandemic, nurses being most affected. Although psychiatric services do not directly care for patients with severe COVID-19 infection, the results from this study suggests that mental health services should also prepare for future pandemics.
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Affiliation(s)
- Eirini Alexiou
- Department of Psychiatry, Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.,Center for Ethics, Law, and Mental Health, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Steinn Steingrimsson
- Department of Psychiatry, Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.,Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Akerstrom
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden.,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden.,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Research, Development, Education and Innovation, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Quality Strategies, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.,Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Alessio Degl'Innocenti
- Center for Ethics, Law, and Mental Health, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Gothia Forum for Clinical Trials, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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16
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Strömgren M, Eriksson A, Ahlstrom L, Bergman DK, Dellve L. Leadership quality: a factor important for social capital in healthcare organizations. J Health Organ Manag 2018; 31:175-191. [PMID: 28482768 DOI: 10.1108/jhom-12-2016-0246] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this paper is to investigate the relation between leadership and social capital and what qualities of leadership are important for social capital among employees in hospital settings over time. Design/methodology/approach A cohort of employees in hospitals answered a questionnaire at three occasions. Five small (approx. 100-bed) or mid-sized (approx. 500-bed) hospitals were included. The response rate was 54 percent at baseline ( n=865), 59 percent at one-year follow-up ( n=908) and 67 percent at two-year follow-up ( n=632). Findings Repeated measures over time showed differences between groups in levels of social capital with respect to levels of leadership quality. Relation-oriented leadership had the strongest association with social capital. There was evidence that leadership was associated with social capital over time and that different kinds of leadership qualities were associated with social capital. Research limitations/implications This study conducted and analyzed quantitative data, and therefore, there is no knowledge of managers' or employees' own perceptions in this study. However, it would be interesting to compare managers' decreased and increased leadership quality and how such differences affect social capital over time. Practical implications The findings feature the possibility for healthcare leaders to build high quality leadership as an important resource for social capital, by using different leadership orientations under different circumstances. Originality/value The paper showed that leadership was an important factor for building social capital and that different leadership qualities have different importance with respect to certain circumstances.
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Affiliation(s)
- Marcus Strömgren
- Department of Ergonomics, Royal Institute of Technology , Huddinge, Sweden
| | - Andrea Eriksson
- Department of Ergonomics, Royal Institute of Technology , Huddinge, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences , The Sahlgrenska Academy, Gothenburg, Sweden
| | - David Kristofer Bergman
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet , Stockholm, Sweden
| | - Lotta Dellve
- Department of Sociology and Work Science, The Sahlgrenska Academy, Gothenburg, Sweden
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17
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Rydström I, Dalheim Englund L, Dellve L, Ahlstrom L. Importance of social capital at the workplace for return to work among women with a history of long-term sick leave: a cohort study. BMC Nurs 2017; 16:38. [PMID: 28725159 PMCID: PMC5513137 DOI: 10.1186/s12912-017-0234-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/29/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The workplace is an essential source of social capital for many people; it provides mutual support and gives meaning to life. However, few prospective studies have thoroughly investigated the importance of aspects of social capital in the workplace. The aim of this study was to investigate the associations between aspects of social capital (social support, sense of community, and quality of leadership) at the workplace, and work ability, working degree, and vitality among women with a history of long-term sick leave from human service organizations. METHODS A longitudinal cohort study was performed among women with a history of long-term sick leave. The study started in 2005, and the women were followed up at 6 months, 1 year, and 6 years using self-reported questionnaires (baseline n = 283). Linear mixed models were used for longitudinal analysis of the repeated measurements of prospective degree of work ability, working degree, and vitality. Analyses were performed with different models; the explanatory variables for each model were social support, sense of community, and quality of leadership and time. RESULTS Social capital in terms of quality of leadership (being good at solving conflicts and giving high priority to job satisfaction), sense of community (co-operation between colleagues) and social support (help and support from immediate superiors and colleagues) increased the women's work ability score (WAS) as well as working degree over time. Additionally, social capital in terms of quality of leadership increased the women's vitality score over time. CONCLUSIONS A sustainable return-to-work process among individuals with a history of long-term sick leave, going in and out of work participation, could be supported with social support, good quality of leadership, and a sense of community at the workplace. The responsibility for the rehabilitation process can not be reduced to an individual problem, but ought to include all stakeholders involved in the process, such as managers, colleagues, health care services, and the social security agency.
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Affiliation(s)
- Ingela Rydström
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, 501 90 Borås, Sweden
| | - Lotta Dalheim Englund
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, 501 90 Borås, Sweden
| | - Lotta Dellve
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, 501 90 Borås, Sweden.,Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden
| | - Linda Ahlstrom
- Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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18
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Ahlstrom L, Dellve L, Hagberg M, Ahlberg K. Women with Neck Pain on Long-Term Sick Leave-Approaches Used in the Return to Work Process: A Qualitative Study. J Occup Rehabil 2017; 27:92-105. [PMID: 26944045 PMCID: PMC5306228 DOI: 10.1007/s10926-016-9636-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Purpose There are difficulties in the process of return to work (RTW) from long-term sick leave, both in general and regarding sick leave because of neck pain in particular. Neck pain is difficult to assess, problematic to rehabilitate, and hard to cure; and it is not always easy to decide whether the pain is work-related. The outcome of RTW could be dependent upon individuals' approaches, defensive or offensive behaviors, and choices related to their self-efficacy. The aim of this study was to identify approaches used in the RTW process among women with neck pain on long-term sick leave from human service organizations. Methods This is a qualitative descriptive study based on grounded theory. A Swedish cohort of 207 women with a history of long-term sick leave with neck pain from human service organizations answered open-ended written questions at 0, 6, and 12 months, and 6 years; and 16 women were interviewed. Results Individuals expressed their coping approaches in terms of fluctuating in work status over time: either as a strategy or as a consequence. Periods of sick leave were interwoven with periods of work. The women were either controlling the interaction or struggling in the interaction with stakeholders. Conclusions Return to work outcomes may be improved if the fluctuating work status over time is taken into account in the design of rehabilitation efforts for women with a history of long-term sick leave and with chronical musculoskeletal conditions.
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Affiliation(s)
- Linda Ahlstrom
- Department of Public Health and Community Medicine, The Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16, P.O. Box 414, 405 30, Gothenburg, Sweden.
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
- Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Lotta Dellve
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
- Department of Ergonomics, KTH - Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden
| | - Mats Hagberg
- Department of Public Health and Community Medicine, The Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16, P.O. Box 414, 405 30, Gothenburg, Sweden
| | - Karin Ahlberg
- Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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19
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Englund ACD, Rydström I, Dellve L, Ahlstrom L. Social support outside work and return to work among women on long-term sick leave working within human service organizations. Appl Nurs Res 2016; 30:187-93. [PMID: 27091277 DOI: 10.1016/j.apnr.2015.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 06/11/2015] [Indexed: 10/23/2022]
Abstract
AIM To investigate the relationships between return to work and social support outside work among women on long-term sick leave from human service organizations. BACKGROUND Work is an important part of life and is, in general, considered to be supportive of health and wellbeing. Few studies have thoroughly investigated the importance of aspects of social support outside work for return to work. METHODS A cohort of women on long-term sick leave was followed with questionnaires from 2005 to 2012. RESULTS The availability of social attachment increased the women's work ability, return to work, and vitality significantly more over time. There were positive relationships between return to work and seeking support in terms of emotional support and comfort and expressing unpleasant feelings. CONCLUSIONS Important resources to increase return to work can be found in factors outside work, such as close social relationships and support seeking. Thus, it is important to take the woman's whole life situation into account and not focus solely on aspects related to the workplace.
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Affiliation(s)
| | - Ingela Rydström
- Department of Caring Science, Work Life and Social Welfare, University of Borås, 501 90 Borås, Sweden
| | - Lotta Dellve
- School of Technology and Health, KTH Royal Institute of Technology, 100 44 Stockholm, Sweden
| | - Linda Ahlstrom
- Department of Caring Science, Work Life and Social Welfare, University of Borås, 501 90 Borås, Sweden
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Hedén L, Ahlstrom L. Individual response technology to promote active learning within the caring sciences: An experimental research study. Nurse Educ Today 2016; 36:202-206. [PMID: 26515492 DOI: 10.1016/j.nedt.2015.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 09/18/2015] [Accepted: 10/13/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND One major challenge in delivering lectures to large and diverse classes is the maintenance of a high standard of lecturing in order to engage students and increase their participation and involvement. The lecturer's assignment is to arrange and prepare the lecture before teaching, hence enabling students' enhanced learning. Individual response technology could encourage students' active learning and activate higher cognitive levels. OBJECTIVES The aim of this study was to evaluate individual response technology as a complement during lectures for students in higher education, in terms of the students' experiences of participation, engagement, and active learning. Also of interest was whether this technology can be considered a supportive technical system. DESIGN Data were collected through a questionnaire where levels of each condition were reported on a numeric rating scale (0-10) at baseline and after the introduction of individual response technology. To get a broader perspective, two types of lectures (pediatric and statistical) were included, giving a total of four assessment times. PARTICIPANTS The participants comprised 59 students in Bachelor of Nursing program at a Swedish metropolitan university. RESULTS Overall, when individual response technology was used, students reported increased experience of engagement (n=82, mean 6.1 vs. n=65, mean 7.3, p<0.001), participation (n=92, mean 6.1 vs. n=79, mean 7.7, p<0.001), and active learning (n=92, mean 7.3 vs. n=79, mean 8.2 p<0.001). Additionally, the students experienced this technology as a supportive technical system during lectures (mean 6.6 vs. mean 8.1, p<0.001). CONCLUSIONS The use of individual response technology during teaching is one way to enhance students' experiences of engagement, participation, and learning within the caring sciences.
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Affiliation(s)
- Lena Hedén
- Faculty of Caring Sciences, University of Borås, Borås, Sweden; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | - Linda Ahlstrom
- Faculty of Caring Sciences, University of Borås, Borås, Sweden; Department of Public Health & Community Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Dellve L, Fallman SL, Ahlstrom L. Return to work from long-term sick leave: a six-year prospective study of the importance of adjustment latitudes at work and home. Int Arch Occup Environ Health 2015; 89:171-9. [PMID: 26044671 DOI: 10.1007/s00420-015-1061-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 05/18/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim was to investigate the long-term importance of adjustment latitude for increased work ability and return to work among female human service workers on long-term sick leave. METHODS A cohort of female human service workers on long-term sick leave (>60 days) was given a questionnaire four times (0, 6, 12, 60 months). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability and return to work. RESULTS Having a higher level of adjustment latitude was associated with both increased work ability and return to work. Adjustments related to work pace were strongly associated with increased work ability, as were adjustments to the work place. Having individual opportunities for taking short breaks and a general acceptance of taking short breaks were associated with increased work ability. At home, a higher level of responsibility for household work was related to increased work ability and return to work. Individuals with possibilities for adjustment latitude, especially pace and place at work, and an acceptance of taking breaks had greater increased work ability over time and a greater work ability compared with individuals who did not have such opportunities. CONCLUSIONS This study highlights the importance of opportunities for adjustment latitude at work to increase work ability and return to work among female human service workers who have been on long-term sick leave. The results support push and pull theories for individual decision-making on return to work.
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Affiliation(s)
- Lotta Dellve
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden. .,Ergonomics, School of Technology and Health, KTH - Royal Institute of Technology, Stockholm, Sweden.
| | - Sara L Fallman
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Linda Ahlstrom
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Abstract
PURPOSE To investigate the impact of rehabilitation measures on work ability and return to work (RTW), specifically the association between workplace rehabilitation/supportive conditions at work and work ability and RTW over time, among women on long-term sick leave. METHODS Questionnaire data were collected (baseline, 6 and 12 months) from a cohort of women (n = 324). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability index (WAI), work ability score and working degree. These analyses were performed with different models; the explanatory variables for each model were workplace rehabilitation, supportive conditions at work and time. RESULTS The individuals provided with workplace rehabilitation and supportive conditions (e.g. influence at work, possibilities for development, degree of freedom at work, meaning of work, quality of leadership, social support, sense of community and work satisfaction) had significantly increased WAI and work ability score over time. These individuals scored higher work ability compared to those individuals having workplace rehabilitation without supportive conditions, or neither. Additionally, among the individuals provided with workplace rehabilitation and supportive conditions, working degree increased significantly more over time compared to those individuals with no workplace rehabilitation and no supportive conditions. CONCLUSION The results highlight the importance of integrating workplace rehabilitation with supportive conditions at work in order to increase work ability and improve the RTW process for women on long-term sick leave.
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Affiliation(s)
- Linda Ahlstrom
- Department of Public Health and Community Medicine, The Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16, P.O. Box 414, 405 30, Gothenburg, Sweden.
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Ahlstrom L, Grimby-Ekman A, Hagberg M, Dellve L. The work ability index and single-item question: associations with sick leave, symptoms, and health--a prospective study of women on long-term sick leave. Scand J Work Environ Health 2010; 36:404-12. [PMID: 20372766 DOI: 10.5271/sjweh.2917] [Citation(s) in RCA: 375] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES This study investigated the association between the work ability index (WAI) and the single-item question on work ability among women working in human service organizations (HSO) currently on long-term sick leave. It also examined the association between the WAI and the single-item question in relation to sick leave, symptoms, and health. Predictive values of the WAI, the changed WAI, the single-item question and the changed single-item question were investigated for degree of sick leave, symptoms, and health. METHODS This cohort study comprised 324 HSO female workers on long-term (>60 days) sick leave, with follow-ups at 6 and 12 months. Participants responded to questionnaires. Data on work ability, sick leave, health, and symptoms were analyzed with regard to associations and predictability. Spearman correlation and mixed-model analysis were performed for repeated measurements over time. RESULTS The study showed a very strong association between the WAI and the single-item question among all participants. Both the WAI and the single-item question showed similar patterns of associations with sick leave, health, and symptoms. The predictive value for the degree of sick leave and health-related quality of life (HRQoL) was strong for both the WAI and the single-item question, and slightly less strong for vitality, neck pain, both self-rated general and mental health, and behavioral and current stress. CONCLUSION This study suggests that the single-item question on work ability could be used as a simple indicator for assessing the status and progress of work ability among women on long-term sick leave.
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Affiliation(s)
- Linda Ahlstrom
- Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, S-40530 Gothenburg, Sweden.
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Abstract
Clinically healthy mixed breed dogs (n = 20) were used to determine if a Tris (tromethamine)-buffered test solution, Otinide (Trademark of Dermcare-Vet Pty-Ltd, Australia), containing disodium ethylenediamine tetraacetic acid (EDTA; 1.21 g/L) and polyhexamethylene biguanide (PHMB; 0.22 g/L) caused ototoxicity or vestibular dysfunction. The dogs were randomly assigned to either a control group (group A, n = 10) receiving saline, or a treatment group (group B, n = 10) receiving the test solution. Phase 1 of the study consisted of applying 5.0 mL of saline to both ears of the control group (group A) and 5 mL of test solution to both ears of the test group (group B), for 21 days. A bilateral myringotomy was then performed on each dog under deep sedation. Phase 2 of the study then consisted of applying 2.0 mL of the saline to both ears of the control group (group A) and 2.0 mL of the test solution to both ears of the test group (group B), for 14 days. Throughout the study, dogs were examined for clinical health, and underwent otoscopic, vestibular and auditory examinations. The auditory examinations included brainstem auditory evoked potential (BAEP) threshold and supra-threshold assessments using both click and 8 kHz tone burst stimuli. The absence of vestibular signs and effects on the BAEP attributable to the test solution suggested the test solution could be applied safely to dogs, including those with a damaged tympanic membrane.
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Affiliation(s)
- P C Mills
- School of Veterinary Science, University of Queensland, Brisbane, Queensland, Australia.
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