Jeanette Kirk, Thomas Bandholm, Ove Andersen, Rasmus Skov Husted, Tine Tjørnhøj-Thomsen, Per Nilsen and Mette Merete Pedersen
The aim of this study is to explore and discuss key challenges associated with having stakeholders take part in co-designing a health care intervention to increase mobility in…
Abstract
Purpose
The aim of this study is to explore and discuss key challenges associated with having stakeholders take part in co-designing a health care intervention to increase mobility in older medical patients admitted to two medical departments at two hospitals in Denmark.
Design/methodology/approach
The study used a qualitative design to investigate the challenges of co-designing an intervention in five workshops involving health professionals, patients and relatives. “Challenges” are understood as “situations of being faced with something that needs great mental or physical effort in order to be done successfully and therefore tests a person's ability” (Cambridge Dictionary). Thematic content analysis was conducted with a background in the analytical question: “What key challenges arise in the material in relation to the co-design process?”.
Findings
Two key challenges were identified: engagement and facilitation. These consisted of five sub-themes: recruiting patients and relatives, involving physicians, adjusting to a new researcher role, utilizing contextual knowledge and handling ethical dilemmas.
Research limitations/implications
The population of patients and relatives participating in the workshops was small, which likely affected the co-design process.
Practical implications
Researchers who want to use co-design must be prepared for the extra time required and the need for skills concerning engagement, communication, facilitation, negotiation and resolution of conflict. Time is also required for ethical discussions and considerations concerning different types of knowledge creation.
Originality/value
Engaging stakeholders in co-design processes is increasingly encouraged. This study documents the key challenges in such processes and reports practical implications.
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Anne‐Mette Hjalager, John Houman Sørensen and Rasmus Juul Møberg
This study investigates labour market fluctuations and gender issues in the health and care sector. A large data set from public registers has allowed us to compile a…
Abstract
This study investigates labour market fluctuations and gender issues in the health and care sector. A large data set from public registers has allowed us to compile a comprehensive picture of the job categories that particularly attract men. We find a polarisation of men in the upper and lower positions in the job hierarchy. In the metropolitan area, men tend to be discouraged from taking jobs in the health and care sector, as opposed to the peripheral region, where alternative job offers may be more scarce. A logistic regression analysis shows that (young) age is the major explanatory factor for leaving the health and care sector to find occupation elsewhere. However, gender (male), wage levels (low), marital status (single) and education (none) are also significant. The study discusses seven theoretical perspectives for male and female careers in the health and care sector: The need for flexibility. Destandardising of jobs. Devaluation of feminised work areas. Human capital as a stabiliser. Feminisation. The prospects of boundaryless careers. The spatial dimension.
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Anne Benedicte Juul, Christian Gluud, Jørn Wetterslev, Torben Callesen, Gorm Jensen and Allan Kofoed‐Enevoldsen
To examine the availability and quality of clinical guidelines on perioperative diabetes care in hospital units before and after a randomised clinical trial (RCT) and…
Abstract
Purpose
To examine the availability and quality of clinical guidelines on perioperative diabetes care in hospital units before and after a randomised clinical trial (RCT) and international accreditation.
Design/methodology/approach
Interventional “before‐after” study in 51 units (38 surgical and 13 anaesthetic) in nine hospitals participating in a RCT in the greater Copenhagen area; 27 of the units also underwent international accreditation.
Findings
The proportion of units with guidelines increased from 24/51 (47 percent) units before to 38/51 (75 percent) units after the trial. Among the 27 units without guidelines before the trial, significantly more accredited units compared to non‐accredited units had a guideline after the trial (9/10 (90 percent) compared to 5/17 (29 percent). The quality of the systematic development scale and the clinical scales improved significantly after the trial in both accredited units (both p<0.001) and in non‐accredited units (both p<0.02). The improvement of the systematic development scale was significantly higher in accredited than in non‐accredited units (p<0.01).
Originality/value
The combination of conducting both the DIPOM Trial and international accreditation led to a significant improvement of both dissemination and quality of guidelines on perioperative diabetic care.