<strong>Aim:</strong> The aim of this study was to illuminate registered nurses’ (RNs) perceptions of Trust-Based Public Management (TBPM) in Swedish health care. Design: This study follows a phenomenogra...<strong>Aim:</strong> The aim of this study was to illuminate registered nurses’ (RNs) perceptions of Trust-Based Public Management (TBPM) in Swedish health care. Design: This study follows a phenomenografic approach guided by Ference Marton’s philosophy. <strong>Methods:</strong> Semi-structured interviews were used to identify variations in RNs’ perceptions of TBPM. Between February and April 2019, 24 RNs from five Swedish public healthcare departments participated in the study. <strong>Results: </strong>The results show that none of the participants had previously heard about the work of the Swedish Delegation for TBPM. The study revealed perceptions those politicians and managers were absent from the workplace, that power had been displaced to HR, and that perceptions of trust in the leadership and of working to guidelines varied. Perceptions varied between RNs employed by the municipalities and by the hospitals concerning administration, the time allotted for work, cooperation, and education.展开更多
Background: Teamcare should, like all patient care, also contribute to evidence-based practice (EBP). Randomized controlled trials (RCTs) focusing on teamcare have been performed but no study has addressed its essenti...Background: Teamcare should, like all patient care, also contribute to evidence-based practice (EBP). Randomized controlled trials (RCTs) focusing on teamcare have been performed but no study has addressed its essentials. How far this EBP has progressed in different health aspects is generally established in systematic reviews of RCTs. Aim: The aim is to determine the essentials of teamcare including the nurse profession in RCTs of multi- or interdisciplinary interventions in somatic care focusing on the stated context, goals, strategies, content as well as effectiveness of quality of care. Methods: A systematic review was performed according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data selection process of 27 articles from PubMed and CINAHL. Results: Eighty-five percent of RCTs in somatic care showed a positive effectiveness of teamcare interventions, of which interdisciplinary ones showed a greater effectiveness compared with the multidisciplinary approach (100% vs 76%). Also theory-based RCTs presented higher positive effectiveness (85%) compared with non-theory-based RCTs (79%). The RCTs with positive effectiveness showed greater levels for professional-centered ambition in terms of goals and for team-directed initiatives in terms of strategy, and a significantly higher level for patient-team interaction plans in terms of content was shown. Conclusions: Teamcare RCTs are still grounded in the multidisciplinary approach having a professional-centered ambition while interdisciplinary approaches especially those that are theory-based appear to be essential with regard to positive effectiveness and preferable when person-centered careis applied.展开更多
文摘<strong>Aim:</strong> The aim of this study was to illuminate registered nurses’ (RNs) perceptions of Trust-Based Public Management (TBPM) in Swedish health care. Design: This study follows a phenomenografic approach guided by Ference Marton’s philosophy. <strong>Methods:</strong> Semi-structured interviews were used to identify variations in RNs’ perceptions of TBPM. Between February and April 2019, 24 RNs from five Swedish public healthcare departments participated in the study. <strong>Results: </strong>The results show that none of the participants had previously heard about the work of the Swedish Delegation for TBPM. The study revealed perceptions those politicians and managers were absent from the workplace, that power had been displaced to HR, and that perceptions of trust in the leadership and of working to guidelines varied. Perceptions varied between RNs employed by the municipalities and by the hospitals concerning administration, the time allotted for work, cooperation, and education.
文摘Background: Teamcare should, like all patient care, also contribute to evidence-based practice (EBP). Randomized controlled trials (RCTs) focusing on teamcare have been performed but no study has addressed its essentials. How far this EBP has progressed in different health aspects is generally established in systematic reviews of RCTs. Aim: The aim is to determine the essentials of teamcare including the nurse profession in RCTs of multi- or interdisciplinary interventions in somatic care focusing on the stated context, goals, strategies, content as well as effectiveness of quality of care. Methods: A systematic review was performed according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data selection process of 27 articles from PubMed and CINAHL. Results: Eighty-five percent of RCTs in somatic care showed a positive effectiveness of teamcare interventions, of which interdisciplinary ones showed a greater effectiveness compared with the multidisciplinary approach (100% vs 76%). Also theory-based RCTs presented higher positive effectiveness (85%) compared with non-theory-based RCTs (79%). The RCTs with positive effectiveness showed greater levels for professional-centered ambition in terms of goals and for team-directed initiatives in terms of strategy, and a significantly higher level for patient-team interaction plans in terms of content was shown. Conclusions: Teamcare RCTs are still grounded in the multidisciplinary approach having a professional-centered ambition while interdisciplinary approaches especially those that are theory-based appear to be essential with regard to positive effectiveness and preferable when person-centered careis applied.
