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Rosenkvist, Urban
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Publications (10 of 89) Show all publications
Holmström, I., Röing, M., Veg, A. & Rosenqvist, U. (2014). Educating Swedish telenurses to improve caller experience: Reflections on a pilot study. Clinical Nursing Studies, 2(2), 61-73
Open this publication in new window or tab >>Educating Swedish telenurses to improve caller experience: Reflections on a pilot study
2014 (English)In: Clinical Nursing Studies, ISSN 2324-7959, Vol. 2, no 2, p. 61-73Article in journal (Refereed) Published
Abstract [en]

Telenurses employed at Swedish Healthcare Direct offer triage recommendations and self-care advice to the general public over the telephone on a wide range of health problems. Their understanding of work and ability to communicate are essential for callers’ adherence to recommendations and satisfaction with the service. This paper presents and reflects upon an educational intervention for Swedish telenurses which aimed to improve caller experience. Twelve telenurses participated. Six were randomised to an intervention group, the other six to a reference group. The nurses in the intervention group individually listened to, and reflected on their authentic calls together with one of the researchers on five to six separate occasions. Callers’ experiences were surveyed using a postal questionnaire sent within 48 hours of their call, both before and after the intervention. Descriptive and comparative statistics as well as content analysis were used in the analysis of the questionnaires. The most striking finding was that the educational intervention did not seem to have any effect on outcomes of the telenurses calls. Other findings revealed that a large group of callers, about 20%, did not find the call useful and only 50% to 60% of the callers reported that they had learned something from the call. Callers’ most frequent unfulfilled expectations centred on not being referred to a physician, and a perceived low level of competence among telenurses. The modest impact of the intervention on the services of telenursing may have been due to the participating nurses, the organisation, or the design of the intervention. Lessons have been learned that need to be taken into account in future and more large scale studies.

Keywords
Caller satisfaction, Educational intervention, Reflection, Telenursing, Sweden
National Category
Medical and Health Sciences
Research subject
Health Care Research
Identifiers
urn:nbn:se:uu:diva-220698 (URN)10.5430/cns.v2n2p61 (DOI)
Available from: 2014-03-19 Created: 2014-03-19 Last updated: 2018-06-26Bibliographically approved
Röing, M., Rosenqvist, U. & Holmström, I. (2013). Threats to patient safety in telenursing as revealed in Swedish telenurses' reflections on their dialogues. Scandinavian Journal of Caring Sciences, 27(4), 969-976
Open this publication in new window or tab >>Threats to patient safety in telenursing as revealed in Swedish telenurses' reflections on their dialogues
2013 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 969-976Article in journal (Refereed) Published
Abstract [en]

Telenursing is a rapidly expanding actor in the Swedish healthcare system, as in other Western nations. Although rare, tragic events occur within this context, and are reminders of the importance of giving patient safety the highest priority. As telenurses' main sources of information are their dialogues with the callers, the provision of safe care can depend on the quality of this dialogue. The aim of this study was to identify issues that could threaten patient safety in telenurses' dialogues with callers. As part of an educational intervention, a researcher visited a sample of six telenurses five to six times at their workplace to listen to and discuss, together with the telenurses, their dialogues with callers in stimulated recall sessions. Each call and the following discussion between researcher and telenurse was tape-recorded and transcribed as text, resulting in a total of 121 calls. Qualitative content analysis of the reflections and following discussions revealed that threats to patient safety could be related to the surrounding society, to the organisation of telenursing, to the telenurse and to the caller. This study gives insight into significant problem areas that can affect patient safety in telenursing in Sweden. Issues that need to be focused on in telenursing educational programmes and future research are suggested, as well as the need for organisational development.

Keywords
telenursing, communication, patient safety, qualitative content analysis, Sweden
National Category
Medical and Health Sciences
Research subject
Health Care Research
Identifiers
urn:nbn:se:uu:diva-159277 (URN)10.1111/scs.12016 (DOI)000328140200023 ()
Available from: 2011-09-26 Created: 2011-09-26 Last updated: 2017-12-08Bibliographically approved
Boll, M. & Rosenqvist, U. (2011). Variations in how physiotherapists understand their work on organizational and societal levels. Physiotherapy Research International, 16(2), 101-108
Open this publication in new window or tab >>Variations in how physiotherapists understand their work on organizational and societal levels
2011 (English)In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 16, no 2, p. 101-108Article in journal (Refereed) Published
Abstract [en]

Background and Purpose. Many physiotherapists have moved from treating persons on individual and group levels to working in different service positions on organizational and societal levels within healthcare organizations. The present study has investigated how physiotherapists working on those levels understand their job. The aim of the study was to describe variations in physiotherapists' understanding of their work on organizational and societal levels within healthcare organizations. The research question was: how do physiotherapists understand their work on organizational and societal levels? Method. A phenomenographic approach was chosen. Physiotherapists working in different positions on organizational and societal levels were interviewed. Results. Among our 21 informants we found three logically interrelated categories: 'exploring and performing an assignment', 'interactive learning and balancing support' and 'moving within a continually changing structure'. These three categories of descriptions formed an outcome space of ways of understanding work on organizational and societal levels within healthcare organizations. Conclusions. The findings in this study can be used as tools in professional discussions on how ways of understanding work have an impact on how work is performed and how change is achieved.

Keywords
career, phenomenography, professional discourse, tacit knowledge
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-125505 (URN)10.1002/pri.484 (DOI)20658472 (PubMedID)
Available from: 2010-05-20 Created: 2010-05-20 Last updated: 2017-12-12Bibliographically approved
Fahlén, M. & Rosenqvist, U. (2010). Snomed CT kan ge vårdens journalsystem gemensam röst: Internationell referensterminologi nu redo för praktiska test. Läkartidningen, 107(11), 760-763
Open this publication in new window or tab >>Snomed CT kan ge vårdens journalsystem gemensam röst: Internationell referensterminologi nu redo för praktiska test
2010 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 11, p. 760-763Article in journal (Refereed) Published
Abstract [sv]

Snomed CT är en medicinsk terminologi som nyligen har presenterats i vårt land liksom i flera andra länder. Med hjälp av en stor och detaljerad begreppsapparat ska detaljer inom vården kunna följas. Snomed CT ger förhoppningar om att integrationen mellan olika system blir bättre. Automatisk översättning från användarens journalsystem till Snomed CT är en metod som kan lösa problemen. Praktiska exempel som demonstrerar integrationen behöver komma i gång.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-125586 (URN)20402267 (PubMedID)
Available from: 2010-05-24 Created: 2010-05-24 Last updated: 2017-12-12Bibliographically approved
Bastholm Rahmner, P., Gustafsson, L. L., Holmström, I., Rosenqvist, U. & Tomson, G. (2010). Whose job is it anyway?: Swedish general practitioners' perception of their responsibility for the patient's drug list.. Annals of Family Medicine, 8(1), 40-46
Open this publication in new window or tab >>Whose job is it anyway?: Swedish general practitioners' perception of their responsibility for the patient's drug list.
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2010 (English)In: Annals of Family Medicine, ISSN 1544-1709, E-ISSN 1544-1717, Vol. 8, no 1, p. 40-46Article in journal (Refereed) Published
Abstract [en]

PURPOSE

Information about the patient's current drug list is a prerequisite for safe drug prescribing. The aim of this study was to explore general practitioners' (GPs) understandings of who is responsible for the patient's drug list so that drugs prescribed by different physicians do not interact negatively or even cause harm. The study also sought to clarify how this responsibility was managed.

METHODS

We conducted a descriptive qualitative study among 20 Swedish physicians. We recruited the informants purposively and captured their view on responsibility by semistructured interviews. Data were analyzed using a phenomenographic approach.

RESULTS

We found variation in understandings about who is responsible for the patient's drug list and, in particular, how the GPs use different strategies to manage this responsibility. Five categories emerged: (1) imposed responsibility, (2) responsible for own prescriptions, (3) responsible for all drugs, (4) different but shared responsibility, and (5) patient responsible for transferring drug information. The relation between categories is illustrated in an outcome space, which displays how the GPs reason in relation to managing drug lists.

CONCLUSIONS

The understanding of the GP's responsibility for the patient's drug list varied, which may be a threat to safe patient care. We propose that GPs are made aware of variations in understanding responsibility so that health care quality can be improved.

Keywords
Medications, drug history, family practice, qualitative research, phenomenography
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-152336 (URN)10.1370/afm.1074 (DOI)000273846800007 ()20065277 (PubMedID)
Available from: 2011-04-28 Created: 2011-04-28 Last updated: 2017-12-11Bibliographically approved
Kunkel, S., Rosenqvist, U. & Westerling, R. (2009). Implementation strategies influence the structure, process, and outcome of quality systems: An empirical study of hospital departments in Sweden. Quality and Safety in Healthcare, 18(1), 49-54
Open this publication in new window or tab >>Implementation strategies influence the structure, process, and outcome of quality systems: An empirical study of hospital departments in Sweden
2009 (English)In: Quality and Safety in Healthcare, ISSN 1475-3898, E-ISSN 1470-7934, Vol. 18, no 1, p. 49-54Article in journal (Refereed) Published
Abstract [en]

Objective: To analyse whether the organisation of quality systems (structure, process, and outcome) is related to how these systems were implemented (implementation prerequisites, cooperation between managers and staff, and source of initiative).

Methods: A questionnaire was developed, piloted and distributed to 600 hospital departments. Questions were included to reflect implementation prerequisites (adequate resources, competence, problem-solving capacity and high expectations), cooperative implementation, source of initiative (manager, staff and purchaser), structure (resources and administration), process (culture and cooperation) and outcome (goal evaluation and competence development). The adjusted response rate was 75%. Construct validity and reliability was assessed by confirmatory factor analysis, and Cronbach alpha scores were calculated. The relationships among the variables were analysed with structural equation modelling with LISREL.

Results: Implementation prerequisites were highly related to structure (0.51) and process (0.33). Cooperative implementation was associated with process (0.26) and outcome (0.34). High manager initiative was related to structure (0.19) and process (0.17). The numbers in parentheses can be interpreted as correlations. Construct validity was good, and reliability was excellent for all factors (Cronbach alpha>0.78). The model was a good representation of reality (model fit p value = 0.082).

Conclusions: The implementation of organisationally demanding quality systems may require managers to direct and lead the process while assuring that their staff get opportunities to contribute to the planning and designing of the new system. This would correspond to a cooperative implementation strategy rather than to top-down or bottom-up strategies. The results of this study could be used to adjust implementation processes.

National Category
Medical and Health Sciences
Research subject
Social Medicine
Identifiers
urn:nbn:se:uu:diva-96707 (URN)10.1136/qshc.2007.023978 (DOI)000263178200010 ()19204132 (PubMedID)
Available from: 2008-02-08 Created: 2008-02-08 Last updated: 2017-12-14Bibliographically approved
Jiang, J., Rosenqvist, U., Wang, H., Koletzko, B., Lian, G., Huang, J. & Greiner, T. (2009). Relationship of parental characteristics and feeding practices to overweight in infants and young children in Beijing, China. Public Health Nutrition, 12(7), 973-978
Open this publication in new window or tab >>Relationship of parental characteristics and feeding practices to overweight in infants and young children in Beijing, China
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2009 (English)In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 12, no 7, p. 973-978Article in journal (Refereed) Published
Abstract [en]

Background Childhood obesity has become a major public health problem in many countries. To explore the risk factors of overweight in infants and young children might be helpful in developing an early overweight intervention strategy. Objective To assess the prevalence of overweight and the relationship of parental characteristics and feeding practices to overweight in infants and young children in Beijing, China. Design Data on weight and length/height were collected on 4654 children aged 1–35 months in twelve communities in Beijing from a cross-sectional study. Overweight was defined as weight-for-length/height ≥2sd above the median of the WHO reference. Two hundred and fifteen families with overweight children and 215 families with normal-weight children were interviewed using a questionnaire to obtain feeding practices. Results The overall prevalence of overweight was 4·7 %. Both parental overweight and low parental education were significantly higher among overweight than normal-weight children. The total energy intake was significantly higher in overweight than in normal-weight children at 12–35 months of age. Compared with normal-weight children, significantly fewer overweight children were breast-fed for at least 4 months. Overweight children were also more likely to have been introduced to infant formula and semi-solid foods during the first 4 months. Conclusion Early prevention strategies should include feeding practices identified as putting children at risk of obesity. These include early cessation of breast-feeding and premature introduction of other foods.

Keywords
Infants and young children, Overweight, Parental overweight, Feeding practices, Breast-feeding, China
National Category
Medical and Health Sciences
Research subject
Health Care Research
Identifiers
urn:nbn:se:uu:diva-17816 (URN)10.1017/S1368980008003509 (DOI)000267087500013 ()18702843 (PubMedID)
Available from: 2008-09-01 Created: 2008-09-01 Last updated: 2017-12-08Bibliographically approved
Kaminsky, E., Rosenqvist, U. & Holmström, I. (2009). Telenurses' understanding of work: detective or educator?. Journal of Advanced Nursing, 65(2), 382-390
Open this publication in new window or tab >>Telenurses' understanding of work: detective or educator?
2009 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 65, no 2, p. 382-390Article in journal (Refereed) Published
Abstract [en]

AIM

This paper is a report of a study to describe the different ways of understanding work among a group of Swedish telenurses.

BACKGROUND

Telenursing is an expanding service in many western countries and telenursing work is likely to be understood in a variety of ways. The way in which a person understands work influences how work is performed. Telenursing demands high levels of competence.

METHOD

A qualitative interview study was conducted during 2004-2005. Twelve of the 20 telenurses working at a call centre in Sweden were interviewed, five of them twice because of organizational changes. The 17 interviews were analysed using a phenomenographic approach.

FINDINGS

Five different categories were identified in the data: (1) Assess, refer and give advice to the caller (2) Support the caller (3) Strengthen the caller (4) Teach the caller and (5) Facilitate the caller's learning. The first category can be seen as a base for telenursing work and was the only category used by some telenurses. The second category has components of traditional caring and the third is a coaching function. The fourth category contains a teaching component, but the fifth is the only category where the caller's learning is in focus. Telenurses who reported the fifth way also included all other ways of understanding work. Hence, this seems to be the most comprehensive way of understanding work.

CONCLUSION

The categories together constitute a telenursing 'workmap'. This 'workmap' can be used for reflection to expand telenurses' current understanding of work, and hence promote competence development. Telenurses need to be aware of their role in public health education.

Keywords
Communication, competence, health education, learning, phenomenography, support, telenursing, workmap
National Category
Medical and Health Sciences
Research subject
Health Care Research
Identifiers
urn:nbn:se:uu:diva-102283 (URN)10.1111/j.1365-2648.2008.04877.x (DOI)000262511300014 ()19040692 (PubMedID)
Funder
Swedish Research Council
Available from: 2009-05-06 Created: 2009-05-06 Last updated: 2017-12-13Bibliographically approved
Bastholm Rahmner, P., Gustafsson, L. L., Larsson, J., Rosenqvist, U., Tomson, G. & Holmström, I. (2009). Variations in understanding the drug-prescribing process: a qualitative study among Swedish GPs. Family Practice, 26(2), 121-127
Open this publication in new window or tab >>Variations in understanding the drug-prescribing process: a qualitative study among Swedish GPs
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2009 (English)In: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, Vol. 26, no 2, p. 121-127Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: A majority of doctor-patient meetings result in the patient getting a prescription. This underlines the need for a high-quality prescription process. While studies have been made on single therapeutic drug groups, a complete study of the physicians' general thought process that comprises the prescription of all drugs still remains to be made. OBJECTIVE: To identify variations in ways of understanding drug prescribing among GPs. METHODS: A descriptive qualitative study was conducted with 20 Swedish physicians. Informants were recruited purposively and their understandings about prescribing were studied in semi-structured interviews. Data were analysed using a phenomenographic approach. RESULTS: Five categories were identified as follows: (A) GP prescribed safe, reliable and well-documented drugs for obvious complaints; (B) GP sought to convince the patient of the most effective drug treatment; (C) GP chose the best drug treatment taking into consideration the patient's entire life situation; (D) GP used clinical judgement and close follow-up to minimize unnecessary drug prescribing and (E) GP prescribed drugs which are cheap for society and environmentally friendly. The categories are interrelated, but have different foci: the biomedical, the patient and the society. Each GP had more than one view but none included all five. The findings also indicate that complexity increases when a drug is prescribed for primary or secondary prevention. CONCLUSIONS: GPs understand prescribing differently despite similar external circumstances. The most significant factor to influence prescribing behaviour was the physician's patient relation approach. GPs may need to reflect on difficulties they face while prescribing to enhance their understandings.

Keywords
Phenomenography, prescribing behaviour, prescribing practice, rational drug prescribing
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-119841 (URN)10.1093/fampra/cmn103 (DOI)
Available from: 2010-03-03 Created: 2010-03-02 Last updated: 2017-12-12Bibliographically approved
Larsson, J., Holmström, I. & Rosenqvist, U. (2008). Burdened by training not by anaesthesia. British Journal of Anaesthesia, 100(4), 560-561
Open this publication in new window or tab >>Burdened by training not by anaesthesia
2008 (English)In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 100, no 4, p. 560-561Article in journal (Refereed) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-152300 (URN)10.1093/bja/aen040 (DOI)000254954900023 ()
Available from: 2011-04-28 Created: 2011-04-28 Last updated: 2017-12-11Bibliographically approved
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