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Svedberg, P., Arvidsson, S., Larsson, I., Carlsson, I.-M. & Nygren, J. M. (2019). Barriers and Enablers Affecting Successful Implementation of the Electronic Health Service Sisom: Multicenter Study of Child Participation in Pediatric Care. Journal of Medical Internet Research, 21(11), 1-15, Article ID 14271.
Open this publication in new window or tab >>Barriers and Enablers Affecting Successful Implementation of the Electronic Health Service Sisom: Multicenter Study of Child Participation in Pediatric Care
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2019 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 21, no 11, p. 1-15, article id 14271Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Children's participation in health care is one of the most important components in the management of their disease. Electronic health (eHealth) services that are adapted to the needs of children have the potential for restructuring how children and professionals work together. Therefore, a digital interactive assessment and communication tool, Sisom, was developed to give children aged between 6 and 12 years a voice in their own health care. However, the implementation of eHealth services such as Sisom in daily practice in pediatric health care is rarely investigated. OBJECTIVE: The aim of this study was to explore the process of implementing Sisom for children in pediatric care in Sweden. More specifically, the study aimed to (1) evaluate whether the implementation strategy was conducted as planned, (2) understand the barriers and facilitators of the implementation strategy in pediatric care settings, (3) gain insight into how professionals work with the specific intervention, and (4) gain insight into the usefulness and effects of the intervention from the professionals' perspectives. METHODS: A process evaluation design was used to study the implementation of Sisom at 4 pediatric care centers in Sweden. An extensive amount of qualitative and quantitative data was collected before, during, and after the intervention through self-report checklists, memos, and interviews with professionals. In total, 46 children, aged between 6 and 13 years, participated. The children used Sisom on two occasions during 6 months. When they used Sisom, a printed report formed the basis for a forthcoming dialogue between professionals, children, and their parents. RESULTS: To our knowledge, this is the first implementation study of an eHealth communication tool aimed at strengthening children's participation in pediatric health care. Key factors for successful implementation were alignment of the solution with the values and goals of the organization, health care professionals' beliefs in the usefulness and usability of the solution, and health care professionals' willingness to change their professional roles guided by the solution. CONCLUSIONS: The results from the study show that it is possible to restructure health care delivery toward a child-centered approach, if there is a willingness and preparedness in the organization to implement an eHealth solution with the aim of restructuring the way of working with children's participation. ©Petra Svedberg, Susann Arvidsson, Ingrid Larsson, Ing-Marie Carlsson, Jens M Nygren.

Place, publisher, year, edition, pages
Toronto: JMIR Publications, Inc., 2019
Keywords
children, eHealth, health care, quality improvement, diffusion of innovation, implementation science
National Category
Nursing Pediatrics Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hh:diva-41026 (URN)10.2196/14271 (DOI)000452782500038 ()30533057 (PubMedID)2-s2.0-85074656706 (Scopus ID)
Available from: 2019-11-24 Created: 2019-11-24 Last updated: 2019-11-25Bibliographically approved
Svedberg, P., Arvidsson, S., Larsson, I., Carlsson, I.-M. & Nygren, J. M. (2019). Barriers And Enablers for Successful Implementation of the eHealth Service Sisom for Improved Child Participation in Paediatric Care - A Multi-Centre Study. Paper presented at 51th Congress of the International Society of Paediatric Oncology (SIOP), Lyon, France, October 23-36, 2019. Pediatric Blood & Cancer, 66(S4), S112-S112
Open this publication in new window or tab >>Barriers And Enablers for Successful Implementation of the eHealth Service Sisom for Improved Child Participation in Paediatric Care - A Multi-Centre Study
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2019 In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Pediatric blood and cancer, Vol. 66, no S4, p. S112-S112Article in journal (Refereed) Accepted
Place, publisher, year, edition, pages
Hoboken, NJ: John Wiley & Sons, 2019
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hh:diva-40803 (URN)000488458001098 ()
Conference
51th Congress of the International Society of Paediatric Oncology (SIOP), Lyon, France, October 23-36, 2019
Available from: 2019-10-28 Created: 2019-10-28 Last updated: 2019-10-31
Svedberg, P., Arvidsson, S., Larsson, I., Carlsson, I.-M. & Nygren, J. M. (2019). Barriers And Enablers for Successful Implementation of the eHealth Service Sisom for Improved Child Participation in Paediatric Care - A Multi-Centre Study. In: : . Paper presented at SIOP 2019.
Open this publication in new window or tab >>Barriers And Enablers for Successful Implementation of the eHealth Service Sisom for Improved Child Participation in Paediatric Care - A Multi-Centre Study
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2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
Keywords
eHealth service, participation, child, healthcare
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-40828 (URN)
Conference
SIOP 2019
Available from: 2019-11-03 Created: 2019-11-03 Last updated: 2019-11-07
Vinblad, E., Svedberg, P., Nygren, J. M., Lönn, M., Olsson, E. & Larsson, I. (2019). Children and young people’s experiences of participation in pediatric rehabilitation: a qualitative study. Paper presented at 31st Annual Meeting of the European Academy of Childhood Disability Conference (EACD), Paris, France, May 23-25, 2019. Developmental Medicine & Child Neurology, 61(S2)
Open this publication in new window or tab >>Children and young people’s experiences of participation in pediatric rehabilitation: a qualitative study
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2019 (English)In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 61, no S2Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Introduction: Creating a healthcare system of justice requires a child-centered care where children and young people, regardless of disability, are allowed to participate in their own rehabilitation. The aim of this study was to explore children and young people’s experiences of participation in pediatric rehabilitation.

Patients and methods: The study had a descriptive design with a qualitative content analysis approach. Interviews were conducted with 20 children (6-17 years old, 9 girls and 11 boys) and 8 young people (18-30 years old, 6 women and 2 men) with intellectual disabilities, physical disabilities or autism spectrum disorders.

Results: Three categories emerged that reflected children and young people’s experiences of participation in pediatric rehabilitation: to be included; to be empowered; and to feel supported. To be included meant that children and young people are respected, listened to and involved in shared decision-making. To be empowered comprised autonomy, responsibility and understanding as essential aspects for participation. To feel supported meant that children and young people described their parents as facilitators for enabling participation by supporting communication and being a bridge between child and professionals.

Conclusion: To increase participation, children need support in communication with the healthcare professionals in a way that they feel respected, empowered and able to be included in decisions concerning their own pediatric rehabilitation. This result constitutes an important step in the development of a forthcoming digital communication and decision tool, with the main objective to increase participation, for children with disabilities.

Place, publisher, year, edition, pages
Chichester: , 2019
Keywords
child, participation
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-39492 (URN)
Conference
31st Annual Meeting of the European Academy of Childhood Disability Conference (EACD), Paris, France, May 23-25, 2019
Note

Conference Poster

Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-09-30Bibliographically approved
Teleman, B., Karsson, C., Svedberg, P., Vinblad, E., Larsson, I. & Nygren, J. M. (2019). Co-construction of child personas in the development of a digital communication support system for increased participation in pediatric habilitation. Paper presented at 31st Annual Meeting of the European Academy of Childhood Disability (EACD), Paris, France, May 23-25, 2019. Developmental Medicine & Child Neurology, 61(S2), 17-17
Open this publication in new window or tab >>Co-construction of child personas in the development of a digital communication support system for increased participation in pediatric habilitation
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2019 (English)In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 61, no S2, p. 17-17Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Introduction: Digital communication support systems have great potential to facilitate the provision of child-centered care where children and young people are allowed and enabled to participate in planning and decision-making in their own habilitation. The aim of this study was to co-construct child personas together with children and young adults from pediatric habilitation for the design of a digital communication support system.

Patients and methods: The child, parent and practitioner perspectives on goals, needs and behaviours in relation to participation in pediatric habilitation were characterized based on interviews with 20 children (6-17 years old) and 8 young people (18-30 years old) with intellectual disabilities, physical disabilities or autism spectrum disorders, 17 parents (aged 31-62 years) and 10 practitioners. Data were interpreted and explained together with children from the interviews (n=14) in two explorative design workshops and a validation workshop.

Results: We present findings and insights on how to co-construct child personas in the context of pediatric habilitation. The work resulted in three personas with different priorities that model the behaviors, attitudes, and goals of three user archetypes tailored for developing digital communication support systems in this particular use context.

Conclusion: By applying our progressive steps of data collection and analysis, we arrive at authentic child-personas that are now used to design and develop a digital communication support system for the particular goals, needs and behaviors of children in pediatric habilitation.

Place, publisher, year, edition, pages
Chichester: Wiley-Blackwell Publishing Inc., 2019
Keywords
Co-construction, digital communication tool, participation, personas
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-39493 (URN)10.1111/dmcn.14244 (DOI)
Conference
31st Annual Meeting of the European Academy of Childhood Disability (EACD), Paris, France, May 23-25, 2019
Note

Oral presentation 37

Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-10-02Bibliographically approved
Vinblad, E., Larsson, I., Lönn, M., Olsson, E., Nygren, J. M. & Svedberg, P. (2019). Development of a Digital Decision Support Tool to Aid Participation of Children With Disabilities in Pediatric Rehabilitation Services: Explorative Qualitative Study. JMIR Formative Research, 3(4), Article ID 14493.
Open this publication in new window or tab >>Development of a Digital Decision Support Tool to Aid Participation of Children With Disabilities in Pediatric Rehabilitation Services: Explorative Qualitative Study
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2019 (English)In: JMIR Formative Research, Vol. 3, no 4, article id 14493Article in journal (Refereed) Published
Abstract [en]

Background: Building a health care system in accordance with the rule of law requires child-centered care, where children and young people, regardless of ability, are allowed to participate in visits with their health care professionals. As part of an overall project focusing on developing and implementing a digital decision support tool to increase the participation of children with disabilities in pediatric rehabilitation, this study brings new knowledge as to how this specific patient group views participation.

Objective: The aim of this formative study was to explore the experiences of children and young people with disabilities concerning increasing their participation in the pediatric rehabilitation services.

Methods: The formative study had an explorative design, based on a latent qualitative content analysis with an inductive approach. Interviews were conducted with 20 children (6-17 years) and 8 young people (19-30 years) with disabilities about their experiences of participation in pediatric rehabilitation services.

Results: A total of 3 categories emerged reflecting the participants’ possibilities of participation in the pediatric rehabilitation services: to feel involved, to feel independent, and to work in partnership. To feel involved meant being listened to and being connected, to feel independent meant being admitted and being enabled, and to work in partnership meant being supported and being able to entrust others with the decision making. With the overall theme moving toward empowerment of children in pediatric rehabilitation, a true feeling of participation can be experienced.

Conclusions: The views of children and young people with disabilities are that children should be given the prerequisites for empowerment by being allowed to feel involved and independent as well as to work in partnership to experience true participation in the pediatric rehabilitation services. This finding is essential in the design of a digital decision support tool based on the children’s needs and perspectives. © Elin Vinblad, Ingrid Larsson, Maria Lönn, Emma Olsson, Jens M Nygren, Petra Svedberg. Originally published in JMIR Formative Research (http://formative.jmir.org), 02.10.2019

Place, publisher, year, edition, pages
Toronto: JMIR Publications, 2019
Keywords
child; child care; decision making; eHealth; disabled children; patient participation; rehabilitation; qualitative research
National Category
Other Health Sciences
Identifiers
urn:nbn:se:hh:diva-40708 (URN)10.2196/14493 (DOI)31579015 (PubMedID)
Available from: 2019-10-14 Created: 2019-10-14 Last updated: 2019-10-14
Vinblad, E., Larsson, I., Lönn, M., Olsson, E., Nygren, J. M. & Svedberg, P. (2019). Development of a Digital Decision Support Tool to Aid Participationof Children With Disabilities in Pediatric Rehabilitation Services: Explorative Qualitative Study. JMIR Formative Research, 3(4), Article ID e14493.
Open this publication in new window or tab >>Development of a Digital Decision Support Tool to Aid Participationof Children With Disabilities in Pediatric Rehabilitation Services: Explorative Qualitative Study
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2019 (English)In: JMIR Formative Research, E-ISSN 2561-326X, Vol. 3, no 4, article id e14493Article in journal (Refereed) Published
Abstract [en]

Background: Building a health care system in accordance with the rule of law requires child-centered care, where children andyoung people, regardless of ability, are allowed to participate in visits with their health care professionals. As part of an overallproject focusing on developing and implementing a digital decision support tool to increase the participation of children withdisabilities in pediatric rehabilitation, this study brings new knowledge as to how this specific patient group views participation.

Objective: The aim of this formative study was to explore the experiences of children and young people with disabilities concerning increasing their participation in the pediatric rehabilitation services.

Methods: The formative study had an explorative design, based on a latent qualitative content analysis with an inductive approach. Interviews were conducted with 20 children (6-17 years) and 8 young people (19-30 years) with disabilities about their experiences of participation in pediatric rehabilitation services.

Results: A total of 3 categories emerged reflecting the participants’ possibilities of participation in the pediatric rehabilitation services: to feel involved, to feel independent, and to work in partnership. To feel involved meant being listened to and being connected, to feel independent meant being admitted and being enabled, and to work in partnership meant being supported andbeing able to entrust others with the decision making. With the overall theme moving toward empowerment of children in pediatric rehabilitation, a true feeling of participation can be experienced.

Conclusions: The views of children and young people with disabilities are that children should be given the prerequisites for empowerment by being allowed to feel involved and independent as well as to work in partnership to experience true participation in the pediatric rehabilitation services. This finding is essential in the design of a digital decision support tool based on the children’s needs and perspectives. © Elin Vinblad, Ingrid Larsson, Maria Lönn, Emma Olsson, Jens M Nygren, Petra Svedberg.

Place, publisher, year, edition, pages
Toronto: JMIR Publications, 2019
Keywords
child, child care, decision making, eHealth, disabled children, patient participation, rehabilitation, qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-40881 (URN)10.2196/14493 (DOI)31579015 (PubMedID)2-s2.0-85073394999 (Scopus ID)
Available from: 2019-11-08 Created: 2019-11-08 Last updated: 2019-11-29Bibliographically approved
Malm, K., Bergman, S., Bremander, A., Larsson, I. & Andersson, M. L. E. (2019). Discussions of lifestyle habits as an integral part of care management: a cross-sectional cohort study in patients with established rheumatoid arthritis in Sweden. Rheumatology Advances in Practice, 3(2), Article ID rkz039.
Open this publication in new window or tab >>Discussions of lifestyle habits as an integral part of care management: a cross-sectional cohort study in patients with established rheumatoid arthritis in Sweden
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2019 (English)In: Rheumatology Advances in Practice, E-ISSN 2514-1775, Vol. 3, no 2, article id rkz039Article in journal (Refereed) Published
Abstract [en]

Objectives: The primary aim was to determine whether patients with RA recalled having discussions concerning lifestyle habits during their health-care visits. The secondary aim was to study the association between patients' reported lifestyle and their wish to discuss it.

Methods: A postal questionnaire sent to 1542 eligible patients from the Better Anti-Rheumatic Pharmacotherapy (BARFOT) study included questions on lifestyle habits (physical activity, diet, smoking and alcohol), on whether these were discussed during health-care visits and on whether there was an interest in such discussions.

Results: A total of 1061 patients (68%) responded [mean age 67 (s.d. 13) years, 73% women]. Half of the patients (49%) recalled discussions on physical activity, and 23% recalled discussions about diet. Those who reported health-enhancing levels of physical activity were more likely to discuss physical activity with their health professionals. Likewise, patients who reported having a non-traditional mixed diet were more likely to discuss diet. Smoking was discussed with 25% of the patients, more often with current smokers than with non-smokers (32 vs 17%; P < 0.001). Alcohol was discussed with 17% of the patients. Of those patients who reported having hazardous drinking habits, 77% had not discussed alcohol use with any health professional.

Conclusion: Discussions about lifestyle were recalled by half of the patients with established RA. There is a need for improvement, because lifestyle habits may affect the long-term outcome in a chronic disease, such as RA. Patient education concerning lifestyle habits should be an integral part of care management and an interactive process. © Malm et al. 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology.

Place, publisher, year, edition, pages
Oxford: Oxford University Press, 2019
Keywords
rheumatoid arthritis, lifestyle, habits, physical activity, diet, smoking, alcohol, discussion
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hh:diva-40912 (URN)10.1093/rap/rkz039 (DOI)31701084 (PubMedID)
Funder
Swedish Rheumatism Association
Note

Other funders: County Council of Halland Research Fund & Norrbacka-Eugenia Foundation

Available from: 2019-11-12 Created: 2019-11-12 Last updated: 2019-11-27Bibliographically approved
Van der Elst, K., Bremander, A., De Groef, A., Larsson, I., Mathijssen, E. G. .., Vriezekolk, J. E., . . . van Eijk-Hustings, Y. J. .. (2019). European Qualitative research project on Patient-preferred outcomes in Early Rheumatoid Arthritis (EQPERA): rationale, design and methods of a multinational, multicentre, multilingual, longitudinal qualitative study. BMJ Open, 9(3), Article ID e023606.
Open this publication in new window or tab >>European Qualitative research project on Patient-preferred outcomes in Early Rheumatoid Arthritis (EQPERA): rationale, design and methods of a multinational, multicentre, multilingual, longitudinal qualitative study
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 3, article id e023606Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Including the patient perspective is important to achieve optimal outcomes in the treatment of rheumatoid arthritis (RA). Ample qualitative studies exist on patient outcomes in RA. A Belgian study recently unravelled what matters most to patients throughout the overwhelming and rapidly evolving early stage of RA. The present study, European Qualitative research project on Patient-preferred outcomes in Early Rheumatoid Arthritis (EQPERA) was created to contribute to a more universal understanding of patient-preferred health and treatment outcomes by integrating the perspectives of patients with early RA from three European countries.

METHODS AND ANALYSIS: In EQPERA, a qualitative, explorative, longitudinal study will be implemented in The Netherlands and Sweden, parallel to the methods applied in the previously conducted Belgian study. In each country, a purposive sample of patients with early RA will be individually interviewed 3-6 months after start of the initial RA treatment and subsequently, the same participants will be invited to take part in a focus group 12-18 months after RA treatment initiation. Data collection and analysis will be independently conducted by the local research teams in their native language. A meta-analysis of the local findings will be performed to explore and describe similarities, differences and patterns across countries.

ETHICS AND DISSEMINATION: Ethics approval was granted by the responsible local ethics committees. EQPERA follows the recommendations of the Declaration of Helsinki. Two main papers are foreseen (apart from the data reporting on the local findings) for peer-reviewed publication.

© Author(s) (or their employer(s)) 2019.

Place, publisher, year, edition, pages
London, UK: BMJ Publishing Group Ltd, 2019
Keywords
longitudinal study, patient preference, qualitative research, rheumatoid arthritis
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-39485 (URN)10.1136/bmjopen-2018-023606 (DOI)000413181404498 ()30918031 (PubMedID)2-s2.0-85063639513 (Scopus ID)
Funder
Swedish Rheumatism AssociationRegion Skåne
Note

Funding: Bristol-Myers Squibb, Fonds voor Wetenschappelijk Reuma Onderzoek (fund for Scientific Rheumatism Research) (Belgium), & Southern Health Care Region (Sweden)

Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-11-29Bibliographically approved
Holmqvist, G., Roxberg, Å., Larsson, I. & Lundqvist-Persson, C. (2019). Expressions of vitality affects and basic affects during art therapy and their meaning for inner change. International Journal of Art Therapy, 24(1), 30-39
Open this publication in new window or tab >>Expressions of vitality affects and basic affects during art therapy and their meaning for inner change
2019 (English)In: International Journal of Art Therapy, ISSN 1745-4832, Vol. 24, no 1, p. 30-39Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to describe the occurrence of vitality affects and basic affects and to shed light on their importance in terms of patients’ inner change through art therapy. In an earlier study, where 17 women were interviewed about inner change through art therapy, a secondary deductive content analysis of images and statements was performed exploring the presence of vitality affects and basic affects. Nine of the 17 interviews contained clear descriptions of vitality affects and basic affects in the intersubjective communication between the patient and the therapist; these affects were also mirrored in the patients’ painted images. Three cases are used to illustrate the result and how affects are related to inner change. These three cases differ from each other in that they describe vitality affects either; arising from the art therapist’s empathetic verbal or non-verbal response, from a particular experience in nature, or from the interpreted symbolic language of the image. The common denominator identified as uniting the three cases was the intersubjective communication with the therapist. This study indicates that image making in art therapy gives rise to vitality affects and basic affects that contribute to inner change. It also indicates the importance of having trust in both the method and the art therapist. © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

Place, publisher, year, edition, pages
Abingdon: Routledge, 2019
Keywords
Art therapy, vitality affects, basic affects, intersubjectivity, deductive content analysis
National Category
Other Medical Sciences Psychiatry
Identifiers
urn:nbn:se:hh:diva-35589 (URN)10.1080/17454832.2018.1480639 (DOI)2-s2.0-85049599402 (Scopus ID)
Note

As manuscript in thesis. Funding: This work was supported by FOU, Skaraborgs Hospital, Skövde [VGSKAS-663501], and Skaraborgs Institute for Research and Development, Skövde [09/1032].

Available from: 2017-11-29 Created: 2017-11-29 Last updated: 2019-02-28Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-4341-660X

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