Evidence map›Paper›PMID 25104917›Full record

ArticleBMC nursing2014

The complexity in the implementation process of empowerment-based chronic kidney care: a case study.

Annette Nygårdh, Dan Malm, Kerstin Wikby, Gerd Ahlström

Abstract read
In one paragraph

Article in BMC nursing, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Annette NygårdhSchool of Health Sciences, Jönköping University, P.O. Box 1026, Jönköping SE-551 11, Sweden.
Dan MalmSchool of Health Sciences, Jönköping University, P.O. Box 1026, Jönköping SE-551 11, Sweden ; Department of Internal Medicine, County Hospital Ryhov, Jönköping SE-55185, Sweden.
Kerstin WikbyLinneus University, Växjö SE- 351 95, Sweden.
Gerd AhlströmDepartment of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 187, Lund SE-221 00, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study is part of an interactive improvement intervention aimed to facilitate empowerment-based chronic kidney care using data from persons with CKD and their family members. There are many challenges to implementing empowerment-based care, and it is therefore necessary to study the implementation process. The aim of this study was to generate knowledge regarding the implementation process of an improvement intervention of empowerment for those who require chronic kidney care.

methodsA prospective single qualitative case study was chosen to follow the process of the implementation over a two year period. Twelve health care professionals were selected based on their various role(s) in the implementation of the improvement intervention. Data collection comprised of digitally recorded project group meetings, field notes of the meetings, and individual interviews before and after the improvement project. These multiple data were analyzed using qualitative latent content analysis.

resultsTWO FACILITATOR THEMES EMERGED: Moving spirit and Encouragement. The healthcare professionals described a willingness to individualize care and to increase their professional development in the field of chronic kidney care. The implementation process was strongly reinforced by both the researchers working interactively with the staff, and the project group. One theme emerged as a barrier: the Limitations of the organization. Changes in the organization hindered the implementation of the intervention throughout the study period, and the lack of interplay in the organization most impeded the process.

conclusionsThe findings indicated the complexity of maintaining a sustainable and lasting implementation over a period of two years. Implementing empowerment-based care was found to be facilitated by the cooperation between all involved healthcare professionals. Furthermore, long-term improvement interventions need strong encouragement from all levels of the organization to maintain engagement, even when it is initiated by the health care professionals themselves.

Indexed as

Case studyEmpowermentHealthcare professionalsImplementation processImprovement interventionIndividualized careInteractive researchQualitative researchQuality of care

Identifiers

PMID25104917
PMCPMC4124497

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