Co-development of client involvement in health and social care services: examining modes of interaction.

PURPOSE: The involvement of clients in service encounters and service development has become a central principle for contemporary health and social care organizations. However, in day-to-day work settings, the shift toward client involvement is still in progress. We examined how health and social care professionals, together with clients and managers, co-develop their conceptions of client involvement and search for practical ways in which to implement these in organizational service processes. DESIGN/METHODOLOGY/APPROACH: The empirical case of this study was a developmental intervention, the client involvement workshop, conducted in a Finnish municipal social and welfare center. The cultural-historical activity theory (CHAT) framework was used to analyze the development of client involvement ideas and the modes of interaction during the intervention. FINDINGS: Analysis of the collective discussion revealed that the conceptions of client involvement developed through two interconnected object-orientations: Enabling client involvement in service encounters and promoting client involvement in the service system. The predominant mode of interaction in the collective discussion was that of "coordination." The clients' perspective and contributions were central aspects in the turning points from coordination to cooperation; professionals crossed organizational boundaries, and together with clients, constructed a new client involvement-based object. This suggests that client participation plays an important role in the development of services. ORIGINALITY/VALUE: The CHAT-based examination of the modes of interaction clarifies the potential of co-developing client-involvement-based services and highlights the importance of clients' participation in co-development.

Being Heard, Exerting Influence, or Knowing How to Play the Game? Expectations of Client Involvement among Social and Health Care Professionals and Clients.

Contemporary social and health care services exhibit a significant movement toward increasing client involvement in their own care and in the development of services. This major cultural change represents a marked shift in the client's role from a passive patient to an active empowered agent. We draw on interaction-oriented focus group research and conversation analysis to study workshop conversations in which social and health care clients and professionals discussed "client involvement". Our analysis focuses on the participants' mutually congruent or discrepant views on the topic. The professionals and clients both saw client involvement as an ideal that should be promoted. Although both participant groups considered the clients' experience of being heard a prerequisite of client involvement, the clients deviated from the professionals in that they also highlighted the need for actual decision-making power. However, when the professionals invoked the clients' responsibility for their own treatment, the clients were not eager to agree with their view. In addition, in analyzing problems of client involvement during the clients' and professionals' meta-talk about client involvement, the paper also shows how the "client involvement" rhetoric itself may, paradoxically, sometimes serve to hinder here-and-now client involvement.

Effects of a cognitive ergonomics workplace intervention (CogErg) on cognitive strain and well-being: a cluster-randomized controlled trial. A study protocol.

BACKGROUND: Cognitively straining conditions such as disruptions, interruptions, and information overload are related to impaired task performance and diminished well-being at work. It is therefore essential that we reduce their harmful consequences to individual employees and organizations. Our intervention study implements practices for managing the cognitive strain typical to office work tasks and working conditions in offices. We will examine the effects of a cognitive ergonomics intervention on working conditions, workflow, well-being, and productivity. METHODS/DESIGN: The study is a stratified cluster randomized trial. The clusters are work units, for example, teams or offices. The four participating organizations entered a total of 36 clusters, and we invited all 1169 knowledge employees of these units to participate. We randomly allocated the clusters into an intervention group (cognitive ergonomics) or an active control group (recovery supporting). We invited an additional 471 participants to join a passive control group only for baseline and follow-up measurements, with no intervention. The study consists of a baseline survey and interviews and observations at the workplace, followed by an intervention. It starts with a workshop defining the specific actions for the intervention implementation stage, during which we send task reminder questionnaires to all employees to support behaviour change at the individual and team levels. The primary outcome measure is perceived frequency of cognitive strain from working conditions; the secondary outcome measures include subjective cognitive load, well-being, workflow/productivity, and cognitive stress symptoms. Process evaluation uses the quantitative and qualitative data obtained during the implementation and evaluation phases. The baseline measurements, intervention phase, and end-of-treatment measurements are now complete, and follow-up will continue until November 2019. DISCUSSION: There is a need to expand the research of cognitive strain, which poses a considerable risk to work performance and employee well-being in cognitively demanding tasks. Our study will provide new information about factors that contribute to such strain. Most importantly, the results will show which evidence-based cognitive ergonomic practices support work performance in knowledge work, and the project will provide concrete examples of how to improve at work. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03573674. Registered 29 June 2018.

Employee Satisfaction With Working Space and Its Association With Well-Being-A Cross-Sectional Study in a Multi-Space Office.

Introduction: Different kinds of shared and activity-based offices are common today and employees' experiences, perceived health, well-being, satisfaction, and productivity have been studied in different types and sizes of environments. Objectives: In this study we aimed to determine employee satisfaction with a multi-space office. We also aimed to find associations between satisfaction with working space and both individual and social well-being. Methods: A total of 91 employees from a multi-space office shared by six municipality-owned companies answered a self-administered questionnaire. Frequencies, percentages, averages, and minimum and maximum values are used to describe the results. We used cross-tabulation and Pearson's Chi-Square test to study the associations and linear regression analysis to create a model describing the variability of workspace satisfaction. Results: The employees were most satisfied with the workspace furniture (82% of respondents) and most dissatisfied with workspace acoustics (44%). Workspace satisfaction was associated with self-satisfaction, good self-perceived future work ability, and good recovery. As regards social factors, workspace satisfaction was associated with good atmosphere among colleagues and good social capital. Satisfaction with acoustics was also associated with good self-perceived future work ability, recovery, and good social capital. Social capital best explained the general variation in workplace satisfaction. Conclusions: Many individual- and social-related well-being outcomes, and especially social capital, were associated with workspace satisfaction. To maintain workplace satisfaction and well-being, attention should be paid to the design, functionality, and management of the used workspaces.