A collaborative endeavour to integrate leadership and person-centred ethics: a focus group study on experiences from developing and realising an educational programme to support the transition towards person-centred care.

BACKGROUND: Ensuring the transition towards person-centred care is a growing focus in health and social care systems globally. Presented as an ethical framework for health and social care professionals, such a transition requires strong leadership and organisational changes. However, there is limited guidance available on how to assist health and social care leaders in promoting person-centred practices. In response to this, the Swedish Association of Health Professionals and the University of Gothenburg Centre for Person-Centred Care collaborated to develop an educational programme on person-centred leadership targeting health and social care leaders to support the transition towards person-centred care in Sweden. The aim with this study was to explore programme management members' experiences from the development and realisation of the programme. METHODS: Focus group discussions were conducted, involving 12 members of the programme management team. Data from the discussions were analysed using a structured approach with emphasis the collaborative generation of knowledge through participant interaction. RESULTS: The analysis visualises the preparations and actions involved in programme development and realisation as a collaborative endeavour, aimed at integrating leadership and person-centred ethics in a joint learning process. Participants described the programme as an ongoing exploration, extending beyond its formal duration. Leadership was thoughtfully interwoven with person-centred ethics throughout the programme, encompassing both the pedagogical approach and programme curriculum, to provide leaders with tangible tools for their daily use. CONCLUSIONS: According to our analysis, we conclude that a person-centred approach to both development and realisation of educational initiatives to support person-centred leadership is essential for programme enhancement and daily implementation of person-centred leadership. Our main message is that educational initiatives on the application of person-centred ethics is an ongoing and collaborative process, characterised by an exchange of ideas and collective efforts.

Person-centred care and the work-related health and job satisfaction of health and social care professionals: protocol for a prospective longitudinal cohort study combined with qualitative studies (the PCC@Work project).

BACKGROUND: The interplay of ethical stress, heavy workloads, and job dissatisfaction poses challenges to both the recruitment and retention of health and social care professionals. Person-centred care, rooted in ethical principles, involves collaborative care, and is expected to improve care and job satisfaction. However, prior research on the impact of person-centred care practices on professionals' work-related health and job satisfaction has yielded mixed results, and most studies emanate from residential care. Understanding how person-centred care practices influence health and social care professionals across different care settings thus requires further exploration through rigorous methodology. The overall aim of PCC@Work is to follow, describe, assess, and explore the impact of person-centred care practices in hospital wards, primary care centres and municipal care on health and social care professionals' work-related health and job satisfaction. METHODS: PCC@Work is designed as a prospective, longitudinal cohort study combined with qualitative studies. A web-based questionnaire will be distributed on five occasions within two years to health and social care professionals in the three care settings. In addition, focus groups and interviews will be conducted with a selection of health and social care professionals to explore their experiences of work-related health and job satisfaction in relation to person-centred practices. DISCUSSION: PCC@Work will highlight some of the knowledge gaps on the impact of person-centred care practices regarding work-related health and job satisfaction of health and social care professionals. The uniqueness of the project lies in the multi-method design, combining a prospective longitudinal cohort study with qualitative studies, and the involvement of various professions and settings. This means we will be able to provide a comprehensive and representative understanding of person-centred care practices as a critical component for effective change in the working conditions of health and social care.

Research collaboration with older people as a matter of scientific quality and ethics: a focus group study with researchers in ageing and health.

BACKGROUND: Society is placing increasing demands on collaboration with actors outside the academia to be involved in the research process, and the responsibility for turning this into reality lies with the researchers. As research collaboration is a way to increase the societal relevance of research and since older people have the right to be actively involved in research that concerns them, this study is addressed to researchers who work with and for older people. The purpose of this article is to explore researchers' experiences of research collaboration with the heterogeneous group of older people, from healthy to frail. METHODS: The focus group method was applied based on a qualitative approach that is based on a social constructivist research tradition. It differs from other qualitative methods, such as interviews, in that it encourages interaction between research participants and contributes to shedding light on a collective understanding of the world. A total of 14 researchers participated in four focus groups (three to five participants/group). RESULTS: The results provided support for the overall theme: "Good scientific quality and ethics are balanced against the needs and abilities of older people". This means a balance between the researcher and the older people collaborating with them to receive the best possible scientific quality. This is highlighted in the core category "Positioning for research collaboration" with the subcategories "Involvement or not", "Traditional or innovative thinking" and "Selectivity or representativeness", and the core category "Research collaboration - an ethical issue of power" with the subcategories "Research collaboration a risk for freedom of research", "Research collaboration a risk of abuse of power" and "Discriminatory academic power structures create ethical issues". CONCLUSIONS: Addressing the balancing act of collaborating with older people in research, the findings contribute with an understanding of the importance of researchers' awareness of social and academic structures to minimise the risk of epistemic injustices in research on ageing and health. We want to highlight the researchers' voice and clarify the role that researchers have in terms of the opportunities for older people to become part of the collective understanding of ageing and health and make their voices heard.

Society is increasingly expecting researchers to involve people who are not researchers in their research. To understand how such collaboration could become a reality, this study aimed to explore researchers' experiences of collaborating with older people in research on ageing and health. A total of four focus groups consisting of 14 researchers from two universities were conducted to discuss experiences, approaches, opportunities and obstacles for research collaboration with older people. The results revealed an overarching theme that describes research collaboration as a balancing act with scientific quality and ethics on one side, and the needs and abilities of older people on the other side. This means that researchers need to strike a balance between achieving the highest scientific quality and considering the needs and abilities of older people they are collaborating with. To understand how unethical, it is to not involve older people in research, the concept epistemic injustice has been used. It refers to the systematic exclusion of certain groups from knowledge production and dissemination which can lead to the exploitation of vulnerable populations and the perpetuation of harmful stereotypes. In addressing the challenges of collaborating with older people in research, this study emphasises the importance of researchers being aware of both social and academic structures that might affect whose voices are heard in research. This awareness could help researchers clarify their role in giving older people the opportunity to be part of the collective understanding of ageing and health.

Occupational balance and associated factors among students during higher education within healthcare and social work in Sweden: a multicentre repeated cross-sectional study.

OBJECTIVE: The aim was to explore whether occupational balance is associated with health, health-promoting resources, healthy lifestyle and social study factors among students during higher education within healthcare and social work. DESIGN: The study has a multicentre repeated cross-sectional design. Data were collected via a self-reported, web-based questionnaire based on the validated instruments: the 11-item Occupational Balance Questionnaire (OBQ11), the Sense of Coherence (SOC) Scale, the Salutogenic Health Indicator Scale (SHIS) and five questions from the General Nordic Questionnaire (QPS Nordic) together with questions about general health and lifestyle factors. SETTING: Students at six universities in western Sweden at one of the following healthcare or social work programmes: biomedical scientists, dental hygienists, nurses, occupational therapists, physiotherapists, radiology nurses and social workers. PARTICIPANTS: Of 2283 students, 851 (37.3%) participated. RESULTS: The students experienced that occupational balance increased during education. The total OBQ11 score was higher among students in semesters 4 and 6/7, compared with semester 1 students. Students with higher OBQ11 also reported higher SOC throughout their education, while health seemed to decrease. Students who reported higher levels of OBQ11 reported lower levels of health and well-being in semesters 4 and 6/7, compared with semester 1. There was an opposite pattern for students reporting lower levels of OBQ11. CONCLUSIONS: The association between higher levels of OBQ11 and lower levels of health and well-being is remarkable. There is a need for more research on this contradiction and what it means for students' health and well-being in the long run.