I ett palliativt sammanhang, nära livets slut, utmanas och hotas den trygga vardagen. Det blir särskilt viktigt att bevara och trygga delar av vardagen, både för den som ska lämna och för dem som stannar kvar. Med avstamp i vardagen, den vanliga lunken och vanorna, synliggör författarna arbetsterapiprofessionens ansvarsområde i den palliativa vården. Författarna använder genomgående ValMO-modellens begrepp och teoretiska resonemang för att beskriva människors vardag och görande, och samband med hälsa och livskvalitet i livets slutskede. Varje avsnitt illustreras med fallbeskrivningar för att synliggöra situationer som arbetsterapeuten kan möta. Fallbeskrivningar används också för att beskriva arbetsterapeutens ansvar, åtgärder och roll i teamet. Arbetsterapi inom palliativ vård är skriven för arbetsterapeuter och arbetsterapistudenter som arbetar eller kommer att arbeta med palliativ vård.

BACKGROUND: People with late effects of polio (LEoP) may need rehabilitation to manage everyday life but knowledge of the benefits of interdisciplinary rehabilitation is limited. OBJECTIVE: To evaluate changes in performance and satisfaction with performance of activities among people with LEoP following interdisciplinary rehabilitation. METHODS: A pre-post retrospective study based on data on 102 participants with LEoP from a rehabilitation clinic. Changes in performance and satisfaction with performance of daily activities before and after interdisciplinary rehabilitation were assessed with the Canadian Occupational Performance Measure (COPM). RESULTS: There were statistically significant increases in the mean performance and mean satisfaction with performance COPM scores from admission to discharge. Twenty-three percent and 19% of the participants, respectively, had improved their performance and satisfaction with performance, 25% and 26% of the participants had no changes, and 19% and 22% of the participants, respectively, rated their performance and satisfaction lower at discharge compared to admission. CONCLUSION: Interdisciplinary rehabilitation can enhance self-rated performance and satisfaction with performance of daily activities among people with LEoP. Future studies of rehabilitation for people with LEoP should use a prospective design and capture the participants’ process of change related to their rehabilitation period. © 2024 – The authors. Published by IOS Press.

Background: The electronic medication administration record (eMAR) is an eHealth system that has replaced the traditional paper-based medication administration used in many healthcare settings. Research has highlighted that eHealth technologies can change working methods and professional roles in both expected and unexpected ways. To date, there is sparse research that has explored how nurses and nurse assistants (NA) in home healthcare experience eMAR in relation to their work environment. Aim: The aim was to explore how nurses and nurse assistants experienced their work environment, in terms of job-demand, control, and support in a Swedish home healthcare setting where an electronic medication administration record had been implemented to facilitate delegation of medical administration. Method: We took a qualitative approach, where focus groups were used as data collection method. The focus groups included 16 nurses and nine NAs employed in a Swedish municipality where an eMAR had been implemented 6 months before the first focus groups were performed. The analysis adapted the job-demand-control-support model, by condensing the professionals' experiences into the three categories of demand, control, and support, in alignment with the model. Results: NAs experienced high levels of job demand and low levels of job control. The use of the eMAR limited NAs' ability to control their work, in terms of priorities, content, and timing. In contrast, the nurses described demands as high but manageable, and described having a high level of control. Both professions found the eMar supportive. Conclusion: Nurses and NAs in home healthcare experienced changes in their work environment regarding demand, control, and support when an eMAR was implemented to facilitate delegation of medical administration. In general, nurses were satisfied with the eMAR. However, NAs felt that the eMAR did not cover all aspects of their daily work. Healthcare organisations should be aware of the changes that digitalisation processes entail in the work environment of nurses and NAs in home healthcare. © 2024 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

Background

The implementation of e-health is transforming healthcare. The acknowledged benefits of digitalization are quality improvement, patient empowerment, and increased efficiency. The mobility of e-health makes it especially suitable for home healthcare. eMar is a common e-health technology used in Swedish home healthcare. Decisions about technology design are governed by developers’ perceptions of intended users. These perceptions can be identified in the description and promotion of a specific product.

Purpose

The purpose of the presentation is to contribute to increased knowledge about the values entailed in a specific eMar used in Swedish home healthcare, and furthermore to discuss how these values conform with existing national missions such as people-centered care.

Method

Information consisting of sales materials about a specific eMar used in several Swedish municipalities has been analyzed through critical discourse analysis to visualize values embedded in the eMar.

Findings

Preliminary results show that the provider of the specific eMar describes care in terms borrowed from the industrial sector, such as shift changes and production of care. Good and safe care is defined as the right person receiving the right medicine at the right time. Furthermore, the app is advertised as a tool for monitoring assuming that the performance of tasks can be influenced through the remote control of the employee. The eMar is described as representing new and modern technologies that are expected to raise the status of healthcare professions and facilitate the recruitment of employees.

Svensk primärvård står inför stora utmaningar med en åldrande befolkning och ett ökat antal personer som vårdas i hemmet (Landers et al., 2016). Digital teknik implementeras med förhoppning om att förbättra kommunikationen mellan vårdpersonal och underlätta möjligheterna till egenvård och tillgänglighet för patienter (Socialstyrelsen, 2021). Tidigare studier visar att användningen av digital teknik kan förändra det professionella landskapet (Petersson, 2020) och påverka arbetsmiljö och arbetets innehåll (Ertner, 2019). Trots att teknik som implementeras inom vården bör vara anpassad till hälso- och sjukvårdspersonalens arbete och värderingar (Palmer et al., 2019; Reed et al., 2019) är sjuksköterskor sällan involverade i beslut kring utformning eller implementering av ny teknik (von Gerich et al., 2022). Det behövs mer kunskap om hur digitaliseringen kan ske i samproduktion med sjuksköterskor och utformas så att en god arbetsmiljö bibehålls.

Presentationen syftar till att beskriva sjuksköterskors arbete och arbetsmiljö inom hemsjukvården och hur dessa kunskaper kan användas vid utvecklingen och implementeringen av framtida digital teknik.

Individuella semi-strukturerade intervjuer har genomförts med 20 sjuksköterskor som arbetar på vårdcentral och inom hemsjukvård i två halländska kommuner. Intervjuerna har analyserats genom kvalitativ innehållsanalys (Hsieh & Shannon, 2005). Implementeringsteoretiska ramverk används för att undersöka hur kunskapen kan inkorporeras vid innovation och implementering av digitala tekniker inom vårdverksamheter (Nilsen, 2015).

Preliminära resultat kommer att presenteras vid konferensen.

Referenser

Ertner, S. M. (2019). Enchanting, evoking, and affecting: the invisible work of technology implementation in homecare. Nordic Journal of Working Life Studies, 9(S5), 33-47.

Hsieh, H.-F., & Shannon, S. E. (2005). Three Approaches to Qualitative Content Analysis. Qualitative health research, 15(9), 1277-1288.

Landers, S., Madigan, E., Leff, B., Rosati, R. J., McCann, B. A., Hornbake, R., MacMillan, R., Jones, K., Bowles, K., Dowding, D., Lee, T., Moorhead, T., Rodriguez, S., & Breese, E. (2016). The Future of Home Health Care: A Strategic Framework for Optimizing Value. Home Health Care Management & Practice, 28(4), 262-278.

Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation science : IS, 10(1), 53-53.

Palmer, V. J., Weavell, W., Callander, R., Piper, D., Richard, L., Maher, L., Boyd, H., Herrman, H., Furler, J., & Gunn, J. (2019). The Participatory Zeitgeist: an explanatory theoretical model of change in an era of coproduction and codesign in healthcare improvement. Medical humanities, 45(3), 247-257.

Petersson, L. (2020). Paving the way for transparency: How eHealth technology can change boundaries in healthcare Lund University].

Reed, J. E., Howe, C., Doyle, C., & Bell, D. (2019). Successful healthcare improvements from translating evidence in complex systems (SHIFT-Evidence): simple rules to guide practice and research. International journal for quality in health care, 31(3), 238-244.

Socialstyrelsen. (2021). E-hälsa och välfärdsteknik i kommunerna 2021. Uppföljning av den digitala utvecklingen i socialtjänsten och den kommunala hälso-och sjukvården.

von Gerich, H., Moen, H., Block, L. J., Chu, C. H., DeForest, H., Hobensack, M., Michalowski, M., Mitchell, J., Nibber, R., & Olalia, M. A. (2022). Artificial Intelligence-based technologies in nursing: A scoping literature review of the evidence. International Journal of Nursing Studies, 127, 104153.

BACKGROUND: Sick leave due to stress-related ill-health is increasing and is often caused by occupational imbalance. These types of issues tend to affect both the ability to work and cope with everyday life, as well as the overall experience of health, negatively. There is still little knowledge on how to prepare people and workplaces for the return-to-work process after participation in a work rehabilitation program due to stress and occupational ill-health. Therefore, this study aimed to describe what is needed to achieve a balanced everyday life that includes paid work as experienced by individuals who had participated in a ReDO® intervention due to occupational imbalance and ill-health. METHODS: The concluding notes from 54 informants' medical records were used for qualitative content analysis. The informants had participated in an occupational therapy group intervention to promote occupational health and regain full work capacity. RESULTS: The analysis resulted in one major theme and four categories describing how the informants perceive that they must take control of their everyday life as a whole. By doing so, they need to work with structurization and prioritization, social interaction, boundary setting, and occupational meaningfulness. CONCLUSION: The study indicates a highly relational process, where it is impossible to divide life into private and work, and presupposes balance in everyday life in multiple dimensions. Its contribution includes the formulation of perceived needs in the transition between intervention and return to work and could, through further research, be used to generate a more effective and sustainable return- and rehabilitation models. © 2023. The Author(s).

Introduction: Stress-related ill-health is one of the fastest-growing reasons for sick leave and an extensive societal problem. It affects the individual, the workplace, and society at large. People can experience stress in all areas of everyday life and often cope by stopping prioritizing themselves. Agenda 2030 third goal aims to promote good health and well-being for all and ensure people's opportunity to reach their full potential and contribute to society's development. However, the focus is often on interventions to rehabilitate people back from ill health, not to promote their health.

The aim was to explore what the risk factors, and what promotes well-being in people with stress-related ill-health from both a work and everyday perspective.

Method Through mixed methods with both quantitative tree analysis of 218 people before entering a work rehabilitation program, and qualitative content analysis of concluding notes of 54 people after the intervention a compilation was made.  

Results The findings of the studies show a highly relational process, where it is impossible to divide life into private and work, and presupposes balance in everyday life in multiple dimensions. It also indicates that risk factors aren’t about gender, age, or education- but about complex occupational patterns in daily life and a lack of social context.

Conclusion: Work and everyday life are highly intertwined. Perhaps the key to promoting our health and preventing stress-related ill-health is not to scale down on occupations and sleep more, but to add more meaningful occupations that give us a sense of participation and fellowship.

Background: Despite high demand, mental health services in primary care in Ireland are underdeveloped. People with mild/moderate anxiety, depression and unspecified psychological distress are frequently seen in primary care settings, mostly by general practitioners (GPs). Occupational therapists have the potential to contribute to service-provision with interventions specially designed for the targeted group e.g. the Redesigning Daily Occupations programme (ReDO-10).Aims/objectivesThis study aimed to explore the feasibility of a future RCT of the ReDO-10 programme in Ireland and the contextual factors that would influence future implementation.

Material and methods: Using a multi-phase, mixed-method design, qualitative and quantitative data were gathered from key stakeholders: ReDO-10 participants (n = 10), GPs (n = 9) and occupational therapists (n = 2). Acceptability, satisfaction, cultural fit and demand were explored, as well as methodological issues such as appropriateness of recruitment methods, outcome measures and randomization.

Results: ReDO-10 was acceptable to participants who reported improvements in their occupational patterns and valued the group-based format. GPs and occupational therapists welcomed the intervention, but acknowledged the limitations of time and resources in the Irish primary care context.

Conclusions: ReDO-10 is feasible to explore in a future RCT in Ireland and this study provides important context for future implementation and/or research. © 2021 Scandinavian Journal of Occupational Therapy Foundation.

Increased use of digital technologies in healthcare offers healthcare professionals multiple ways to perform tasks and interact with patients and colleagues. We used the JDCS model to identify employee´s well-being in relation to the use of an eMar. The analysis indicated that the specific technology influenced the work environment for registered nurses and nursing assistants in different ways.

Everything a person does generates a unique experience of occupational value, and occupational values can in turn generate meaning in life. Doing creative activities positively influences subjective health and well-being. This article provides information about how and to what extent people diagnosed with mental illness experienced occupational value when participating in an intervention with creative activities. Thirty-three participants provided data within a mixed-methods design. Data were analyzed by quantitative non-parametric statistical methods and qualitative directed content analysis. Interventions with creative activities enable a high degree of experienced occupation value and are associated with all dimensions in the occupational value triad. © 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.