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Integrating care for neurodevelopmental disorders by unpacking control : A grounded theory study

Waxegård, Gustaf and Thulesius, Hans LU (2016) In International Journal of Qualitative Studies on Health and Well-being 11.
Abstract

Background: To establish integrated healthcare pathways for patients with neurodevelopmental disorders (ND) such as autism spectrum disorder and attention-deficit hyperactivity disorder is challenging. This study sets out to investigate the main concerns for healthcare professionals when integrating ND care pathways and how they resolve these concerns. Methods: Using classic grounded theory (Glaser), we analysed efforts to improve and integrate an ND care pathway for children and youth in a Swedish region over a period of 6 years. Data from 42 individual interviews with a range of ND professionals, nine group interviews with healthcare teams, participant observation, a 2-day dialogue conference, focus group meetings, regional media... (More)

Background: To establish integrated healthcare pathways for patients with neurodevelopmental disorders (ND) such as autism spectrum disorder and attention-deficit hyperactivity disorder is challenging. This study sets out to investigate the main concerns for healthcare professionals when integrating ND care pathways and how they resolve these concerns. Methods: Using classic grounded theory (Glaser), we analysed efforts to improve and integrate an ND care pathway for children and youth in a Swedish region over a period of 6 years. Data from 42 individual interviews with a range of ND professionals, nine group interviews with healthcare teams, participant observation, a 2-day dialogue conference, focus group meetings, regional media coverage, and reports from other Swedish regional ND projects were analysed. Results: The main concern for participants was to deal with overwhelming ND complexity by unpacking control, which is control over strategies to define patients' status and needs. Unpacking control is key to the professionals' strivings to expand constructive life space for patients, to squeeze health care to reach available care goals, to promote professional ideologies, and to uphold workplace integrity. Control-seeking behaviour in relation to ND unpacking is ubiquitous and complicates integration of ND care pathways. Conclusions: The Unpacking control theory expands central aspects of professions theory and may help to improve ND care development.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ADHD, Autism, Care pathways, Health services, Integrated care, Neurodevelopmental disorders
in
International Journal of Qualitative Studies on Health and Well-being
volume
11
publisher
Co-action Publishing
external identifiers
  • scopus:84989844477
  • wos:000386182700001
ISSN
1748-2623
DOI
10.3402/qhw.v11.31987
language
English
LU publication?
yes
id
787121f2-ee42-4e4b-a12b-673a27eb4d70
date added to LUP
2016-11-17 09:35:33
date last changed
2017-02-17 03:00:13
@article{787121f2-ee42-4e4b-a12b-673a27eb4d70,
  abstract     = {<p>Background: To establish integrated healthcare pathways for patients with neurodevelopmental disorders (ND) such as autism spectrum disorder and attention-deficit hyperactivity disorder is challenging. This study sets out to investigate the main concerns for healthcare professionals when integrating ND care pathways and how they resolve these concerns. Methods: Using classic grounded theory (Glaser), we analysed efforts to improve and integrate an ND care pathway for children and youth in a Swedish region over a period of 6 years. Data from 42 individual interviews with a range of ND professionals, nine group interviews with healthcare teams, participant observation, a 2-day dialogue conference, focus group meetings, regional media coverage, and reports from other Swedish regional ND projects were analysed. Results: The main concern for participants was to deal with overwhelming ND complexity by unpacking control, which is control over strategies to define patients' status and needs. Unpacking control is key to the professionals' strivings to expand constructive life space for patients, to squeeze health care to reach available care goals, to promote professional ideologies, and to uphold workplace integrity. Control-seeking behaviour in relation to ND unpacking is ubiquitous and complicates integration of ND care pathways. Conclusions: The Unpacking control theory expands central aspects of professions theory and may help to improve ND care development.</p>},
  articleno    = {31987},
  author       = {Waxegård, Gustaf and Thulesius, Hans},
  issn         = {1748-2623},
  keyword      = {ADHD,Autism,Care pathways,Health services,Integrated care,Neurodevelopmental disorders},
  language     = {eng},
  month        = {09},
  publisher    = {Co-action Publishing},
  series       = {International Journal of Qualitative Studies on Health and Well-being},
  title        = {Integrating care for neurodevelopmental disorders by unpacking control : A grounded theory study},
  url          = {http://dx.doi.org/10.3402/qhw.v11.31987},
  volume       = {11},
  year         = {2016},
}