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Furenbäck, I. & Johansson, P. (2017). Social services support groups for children as next of kin – methods and goals. In: : . Paper presented at 2nd International Young Carers Conference: "Every child has the right to...", Malmö, Sweden, May 29-31, 2017.
Open this publication in new window or tab >>Social services support groups for children as next of kin – methods and goals
2017 (English)Conference paper, Oral presentation only (Refereed)
Abstract [en]

Children as next of kin are now regarded as a risk group in social services. A common effort for these children is support groups for children with similar problems, for example families with abuse, mental or physical illness. Most support groups are run municipally but also by county/regional bodies, non-profit organizations and churches, and sometimes the municipality works jointly with other organizations. Knowledge of support groups’ methods and results is limited and National Board of Health and Welfare recommends social services to implement systematic monitoring as part of evidence-based practice, EBP. Before this monitoring it is important to have knowledge and understanding of the goals of the support groups and how the work proceeds. The aim of this presentation is to elucidate the social services’ support groups for children as next of kin, to ascertain the goals and what is central in the work of support groups. With a participatory action research approach, a qualitative study was performed in 2015/2016. Seven Swedish municipalities took part and 23 people were interviewed, 18 group leaders and five managers.

Objectives/Outcomes: The respondents stated that the support group’s purpose was educational but they could have therapeutic effects. The goals of support groups addressed the children but in some cases also the family. The goals of the seven groups can be divided into three levels: 1) Acquiring knowledge; 2) Learning to cope with different situations; 3) Emotional processing. Support groups used manual-based methods, mixed methods and methods that they themselves had devised. The methods were the starting point, but other aspects were perceived as central to the performance: a) flexibility; b) preparation; c) cooperation with parents; d) professional approach. Flexibility meant not using the method rigorously but adapting it to the target group and modifying it according to what the group leader considered important. Preparatory work meant that the group leaders met parents and children several times before the support effort started. These talks emphasized the priority of the group sessions, getting participants to realize that it can be laborious, and starting collaboration with parents. Collaboration with the parents was deemed crucial; if the support group did not work it was mainly due to parents’ resistance. Children’s group leaders worked to create trust in parents. A professional approach meant being observant and confronting what happened in the group. The seven support groups aimed to help key aspects of these children’s lives and development generally for all children as next of kin. The group leaders’ work was based on methods, but they decided how to use these in practice. A manual-based approach could be implemented in different ways depending on the group leaders, the situation and the children’s needs.

Keywords
Children as next of kin, Systematic follow-up
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-67911 (URN)
Conference
2nd International Young Carers Conference: "Every child has the right to...", Malmö, Sweden, May 29-31, 2017
Projects
Systematisk uppföljning av stödinsatser till Barn som anhöriga
Funder
Swedish National Board of Health and Welfare
Available from: 2017-09-11 Created: 2017-09-11 Last updated: 2017-09-18Bibliographically approved
Johansson, P., Furenbäck, I. & Carlsund, Å. (2017). To implement systematic follow up: challengers and experiences from a case study. In: : . Paper presented at 2nd International Young Carers Conference: "Every child has the right to...", Malmö, Sweden, May 29-31, 2017.
Open this publication in new window or tab >>To implement systematic follow up: challengers and experiences from a case study
2017 (English)Conference paper, Oral presentation only (Refereed)
Abstract [en]

Many Swedish children are growing up with difficulties in the family, and it is common that this children as next of kin have a higher incidence of mental illness and poor school performance. There is a risk that in these families occur secrecy, rapid unpredictable changes and reverse liability and role distributions. The children can have difficulty understanding what is happening and may feel anxiety, fear, guilt and shame. Much of the child's energy can be focused on family problems, preventing their own development and impacting negatively on well-being. Even though the situation for children as next of kin may differ in many ways, their needs may be similar in several respects. Swedish social care services provide various forms of support and interventions for these children; however, there is little knowledge of the results of the support given. The basic idea of support group activities is that children from similar domestic situation will meet and support one another, can take advantage of the knowledge of group leaders and that the children have the opportunity to talk about their situation. A support group for children is both a preventive and promotive effort; intervention aims to prevent ill health but also improves the mental health and social situation of the children. Systematic follow up is a part of evidence-based practice, which is in turn based on systematic knowledge from the user's experience, scientific knowledge and professional experience. Systematic follow up in the context of children as next of kin is about continuously exploring their needs and obtaining whether the child had adequate support, need more support, or whether there is a need for other support. A single case study was conducted in 2015/2016 of one organization, within municipal care, that provides support in the form of group activities for children as next of kin. The target group was healthy children aged 6-12 years whose parents or siblings had a serious medical condition or disability. The study approach was participatory action research, where the group leaders collaborate with the researchers, in order to implement systematic follow up. Data were collected from the group leaders through interviews, meetings, documents and notes.

Objectives/Outcomes: Data collection is ongoing but preliminary findings can describe the implementation process of systematic follow up in four phases: enthusiasm, confusion, fumbling and decision.

Keywords
Children as next of kin, Systematic follow-up
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-67913 (URN)
Conference
2nd International Young Carers Conference: "Every child has the right to...", Malmö, Sweden, May 29-31, 2017
Projects
Systematisk uppföljning av stödinsatser till barn som anhöriga
Funder
Swedish National Board of Health and Welfare
Available from: 2017-09-11 Created: 2017-09-11 Last updated: 2017-09-19Bibliographically approved
Furenbäck, I. & Johansson, P. (2016). Implementering av systematisk uppföljning inom socialtjänsten – en konflikt mellan två logiker. In: : . Paper presented at NORDPRO-konferensen 2016, Lund, Sweden, 27-28 oktober, 2016.
Open this publication in new window or tab >>Implementering av systematisk uppföljning inom socialtjänsten – en konflikt mellan två logiker
2016 (Swedish)Conference paper, Oral presentation only (Refereed)
National Category
Social Work
Research subject
Social Sciences, Social Work
Identifiers
urn:nbn:se:lnu:diva-53838 (URN)
Conference
NORDPRO-konferensen 2016, Lund, Sweden, 27-28 oktober, 2016
Projects
Barn som anhöriga och systematisk uppföljning
Available from: 2016-06-17 Created: 2016-06-17 Last updated: 2018-05-17Bibliographically approved
Persson, L., Furenbäck, I. & Jakobsson, L. (2014). A new model for dealing with patients who frequently arrive spontaneously at hospital emergency departments requiring health care: A pilot study. International Journal of Nursing & Clinical Practices, 1, Article ID 103.
Open this publication in new window or tab >>A new model for dealing with patients who frequently arrive spontaneously at hospital emergency departments requiring health care: A pilot study
2014 (English)In: International Journal of Nursing & Clinical Practices, ISSN 2394-4978, Vol. 1, article id 103Article in journal (Refereed) Published
Abstract [en]

Background: Patients who repeatedly seek care directly at hospital based somatic emergency departments take up a large proportion of health care resources, at the same time they appear to experience low satisfaction with the care they receive. The purposes of this pilot study were to describe: I) the development of a team model for taking care of frequent visitors to a somatic hospital based ED; II) Eventual changes, over six months, in costs and patients’ health care utilization related to pilot testing the model and III), the team’s experiences of implementing the model.

Methods: A mixed method convergent parallel design was used.

Results: The development of the model began as a top-down process and later on into a bottom-up approach once the inter-professional team became involved. The new model functioned as a support for all 12 patients included in the study and collectively their visits decreased by a total of 73 visits (55%).

Conclusion: The inference quality description is that a management induced project may be accepted and actively applied when those involved experience freedom to structure the project. Increased communication between different professionals within the hospital and between different caregivers such as ED, primary health care and community social- and health-care, increases the possibility for the patients to be cared for in a sustainable and non-fragmented way.

National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-52327 (URN)10.15344/2394-4978/2014/103 (DOI)
Available from: 2016-04-29 Created: 2016-04-29 Last updated: 2016-05-02Bibliographically approved
Furenbäck, I. (2013). Improving the quality of care through communication arena. In: Internation Journal of Integrated Care: Vol 13, Iss 18. Paper presented at World Congress on Integrated Care 2013, Singapore, November 7-9, 2013. , Vol 13, Iss 8(8)
Open this publication in new window or tab >>Improving the quality of care through communication arena
2013 (English)In: Internation Journal of Integrated Care: Vol 13, Iss 18, 2013, Vol. Vol 13, Iss 8, no 8Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Purpose: Collaboration has become an increasingly more common strategy when developing care sectors while, coincidentally, experience and research show that collaboration development may be problematic in itself. This study aims to achieve better understanding of collaboration processes.

Method: A local project that aimed at improving the quality of healthcare and social care by developing the co-operation between organizations took place in Sweden, and by using participatory action research, PAR, this process was followed between 2004 and 2008. Material was gathered through participant observation from the perspective of patients, relatives, staff, managers and politicians. A descriptive narrative was compiled and a hermeneutic interpretation was performed.

Results: Initially, the development of collaboration was impeded due to lack of communication between the participants from various levels within the organizations. With the support of PAR, communication arenas were arranged to handle social interaction as well as different perspectives and conflicts, which led to improved collaboration within the organizations as well as between the care organizations.

Conclusion: Development of collaboration between organizations reflects how collaboration within one organization works. Collaboration is a social and interpersonal phenomenon, and readily available communication arenas are crucial for its development.

Keywords
collaboration, processes, social interaction, communication arenas
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-52324 (URN)000343384300033 ()
Conference
World Congress on Integrated Care 2013, Singapore, November 7-9, 2013
Available from: 2016-04-29 Created: 2016-04-29 Last updated: 2016-05-02Bibliographically approved
Furenbäck, I. (2012). Utveckling av samverkan: ett deltagarorienterat aktionsforskningsprojekt inom hälso- och sjukvård. (Doctoral dissertation). Göteborg: Nordiska högskolan för folkhälsovetenskap
Open this publication in new window or tab >>Utveckling av samverkan: ett deltagarorienterat aktionsforskningsprojekt inom hälso- och sjukvård
2012 (Swedish)Doctoral thesis, monograph (Other academic)
Abstract [sv]

Syfte: Det övergripande vetenskapliga syftet med denna avhandling att nå en ökad förståelse om samverkansprocesser.

Ansats och metoder: Studien har bedrivits genom deltagarorienterad aktionsforskning inom hälso- och sjukvården i Hässleholm. Aktörer på verksamhetsfältet har strävat efter att utveckla samverkan för att tillsammans kunna utveckla närsjukvård. Forskningen har genererat kunskap utifrån lokala omständigheter att tjäna som underlag för beslut om att genomföra praktiska förändringar i verksamheten. En kombination av olika metoder har använts för att generera empiriskt material, där den huvudsakliga metoden har varit deltagande observationer med dialog. Därutöver har intervjuer och granskning av dokument använts samt en forskningscirkel, som är en speciell metod inom deltagarorienterad aktionsforskning. Studien har haft en hermeneutisk ansats och tolkningar har gjorts med stöd av olika teoretiska perspektiv och modeller. Kurt Lewins fältteori har utgjort en övergripande teoretisk ram för studien.

Resultat: En ökad förståelse om den studerade samverkansprocessen kunde nås genom att beskriva och tolka skeenden som antogs ha påverkat utvecklingen av samverkan. Processen beskrevs både utifrån vertikal och horisontell integrering inom och mellan organisationer. Beskrivningen innefattade komponenter som fanns både inom arbetsprocesser och sociala processer. Den studerade samverkansprocessen delades in i delprocesser där var och en del innehöll en viss typ av aktivitet som genomfördes för att stödja utvecklingen av samverkan. Två olika strategier för utvecklingen av samverkan identifierades och illustrerades genom olika modeller: den linjära hierarkiska modellen respektive den dynamiska modellen. Den sistnämnda utvecklades genom aktionsforskningen.

Slutsatser:I ett första skede bedrev deltagarna på fältet samverkan med stöd av den linjära hierarkiska modellen. Denna modell utgör ett tankeschema där samverkan utvecklas i en linjär hierarkisk process. Politiker fattar beslut, chefer planerar och professionella genomför aktiviteterna. Modellen utgår ifrån ett konsensusteoretiskt perspektiv där konflikter betraktas som störande element. Det innebar i detta fall att aktörer inom olika domäner och organisationer undvek varandras olika föreställningsvärldar varpå samverkansprocessen stötte  på hinder i utvecklingen. Aktionsforskningen intervenerade i processen genom arrangera kommunikationsarenor med deltagare från olika domäner och organisationer. Samverkan utvecklades på så sätt utifrån den dynamiska modellen. Denna modell innehåller antaganden om att samverkansprocesser är dynamiska och har sin utgångspunkt i ett konfliktteoretiskt perspektiv där konflikter betraktas som naturliga i processen.

Abstract [en]

Objective: The general scientific objective of this thesis is to reach a greater understanding of processes of collaboration.

Design and methods: The study was conducted through participatory action research within the health services of Hässleholm, Sweden. The people involved, who were participants of different activities related to health care, aimed at developing their collaboration in a collective attempt to facilitate the development of an integrated local health care. Based on local circumstances and perspectives, the research has generated knowledge on which future decisions on how to implement practical changes can be made. A combination of various methods was used to generate empirical material, where the main method was participant observation with dialogue. In addition, interviews and document reviews were conducted as well as the use of collaborative inquiry, which is a specific method within participatory action research. The study was conducted according to a hermeneutic approach and interpretations were supported by various theoretical perspectives and models. Kurt Lewin's field theory constituted a general theoretical frame of reference for the study.

Results: By describing and interpreting the course of events that were presumed to have an impact on the development of collaboration, a greater understanding of the observed collaboration process was achieved. The process was described in terms of vertical as well as horizontal integration within and between organisations. This description included components that were present in work processes as well as social processes. The observed collaboration process was divided into sub-processes, each of them containing a certain type of activity that was performed in support of the development of collaboration. Strategies for development of collaboration were identified and illustrated by different models: the linear hierarchical model and the dynamic model. The latter was developed through action research.

Conclusions: At an initial stage, collaboration among the participants in the field was supported by a linear hierarchical model, which constitutes a mind map where collaboration is developed in a linear hierarchical process. Politicians make decisions, managers make plans and professionals implement activities. The model emanates from a consensus theoretical perspective, where conflicts are regarded as disruptive elements. In this case, participants from various domains and organisations avoided the different conceptual worlds of one another, which led to impediments in the developments of the collaboration process. The action research made it possible to intervene in the process by arranging communication arenas with and for participants from the different domains and organisations. Thus, collaboration came to evolve from a dynamic model, which includes the assumption that collaboration processes are dynamic and is based on a conflict theoretical perspective, where conflicts are regarded as natural aspects of the processes.

Place, publisher, year, edition, pages
Göteborg: Nordiska högskolan för folkhälsovetenskap, 2012. p. 257
Series
NHV Reports and Doctor of Public Health-Theses, ISSN 0283-1961 ; 2012:11
Keywords
Collaboration, processes, participant oriented action research, organisation, conflict, communication arenas, Samverkan, process, deltagarorienterad aktionsforskning, organisation, konflikt, kommunikationsarenor
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-52325 (URN)
Public defence
2012-12-13, Göteborg, 14:16
Supervisors
Available from: 2016-05-10 Created: 2016-04-29 Last updated: 2016-05-10Bibliographically approved
Lindskov, C., Petersson, P., Furenbäck Olsson, I., Johansson, Y. & Pajalic, Z. (2007). Romance versus reality: five doctoral students' experiences of action research in the health care system in Sweden. In: : . Paper presented at Action Research Beyond Borders and Divides.
Open this publication in new window or tab >>Romance versus reality: five doctoral students' experiences of action research in the health care system in Sweden
Show others...
2007 (English)Conference paper, Oral presentation only (Refereed)
National Category
Nursing
Research subject
Medicine
Identifiers
urn:nbn:se:lnu:diva-52326 (URN)
Conference
Action Research Beyond Borders and Divides
Available from: 2012-10-17 Created: 2016-04-29 Last updated: 2017-03-23Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-5612-7698

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