Ann Catrine Eldh

• R.N., MSSc., PhD.
• Professor at Linköping University

Background Appropriately and comprehensive applying implementation frameworks is one of the key challenges in implementation science resulting in increased use of multiple implementation frameworks within projects. This is particularly true for frameworks such as PARIHS/i-PARIHS. Therefore, this systematic review aimed to examine if and why the PAR...

Background The transfer of innovations into healthcare is laden with challenges. Although healthcare professionals are expected to adopt and fulfil new policies, a more person-centered healthcare with conditions for preference-based patient participation is anticipated. Methods The aim of the study was to evaluate two implementation strategies for...

Background First-line managers have a unique role and potential in encouraging the use of evidence-based clinical practice guidelines (CPGs) and thus serve the provision of safe patient care. In acute and planned hospital care, effective yet safeguarded nursing procedures are a necessity. Little is currently known about how first-line managers enga...

Rationale Patient participation should encapsulate the individual's resources and needs, though such standards remain rationed for people living with a long‐term health concern like kidney failure. Aims To illustrate what patient participation signified to patients and staff in kidney care, and whether an agreed or disagreed conceptualisation occu...

Urinary retention is a healthcare complication putting patients at risk of unnecessary suffering and harm. Orthopaedic patients are known to face an increased such risk, calling for evidence-based preoperative assessment and corresponding measures to prevent bladder problems. The aim of this study was to evaluate healthcare professionals’ adherence...

Aim: The purpose of this study was to address the need to improve opportunities for patient participation in their health and health services. This paper reports if and how patients' preferences matched their experiences of participation in treatment for hypertension in primary healthcare, and what factors were linked with having had opportunities...

Aim(s) To explore first‐line managers' experience of guideline implementation in orthopaedic care during the COVID‐19 pandemic. Design A descriptive, qualitative study. Methods Semi‐structured interviews with 30 first‐line nursing and rehabilitation managers in orthopaedic healthcare at university, regional and local hospitals. The interviews wer...

Background One approach to promoting healthy lifestyle behaviors is to target students with digital interventions. One of these is the digital intervention Buddy. This study aimed to understand why college and university students’ chose to participate in a digital multiple lifestyle behavior intervention trial (Buddy), and their subsequent experien...

Objective: To estimate the effects of an interactive web-based support system via mobile phone on preference-based patient participation in patients with hypertension treated in primary care (compared with standard hypertensive care only). Design: A parallel group, non-blinded, randomized controlled trial, conducted October 2018-February 2021. B...

Introduction The implementation and evaluation of patient participation to obtain high‐quality transitional care for older people is an international priority. Intermediate care (IC) services are regarded as an important part of the patient's pathway from the specialist to the primary care levels, bridging the gap between the hospital and the home....

Background Following anterior cruciate ligament reconstruction (ACLR), many athletes do not return to their sport, often driven by concerns about re-injury. Psychological support strategies might help, but are not routinely included in rehabilitation after ACLR. The BAck iN the Game (BANG) intervention is a 24-week eHealth program delivered via sma...

Background: Among those elements establishing decent quality of care from a patient perspective, opportunities to participate in accord with one's individual needs and preferences are central. To date, little is known the extent of preference-based patient participation in kidney care, and what facilitates optimal conditions. This study investigat...

Background: It has been suggested that nursing shift-to-shift handover should be a more team-based dialogue with and for the patient rather than about a patient. Aim: The aim of this study was to evaluate patient participation in relation to the implementation of the person-centered handover (PCH). Method: A pretest-posttest design was used wi...

Background The transfer of innovations into healthcare is laden with challenges. Although healthcare professionals are expected to adopt and fulfil new policies, a more person-centered healthcare, with conditions allowing preference-based patient participation is anticipated. Methods The aim of the study was to evaluate two implementation strategi...

Background: Urinary retention is a common complication associated with hip surgery. There are easily available, evidence-based clinical practice guidelines prescribing how to prevent both urinary retention and other voiding issues, by means of bladder monitoring and risk assessments. A detected lack of adherence to such guidelines increases risks...

Numerous endeavours to ensure that day-to-day healthcare is both evidence-based and person-centred have generated extensive, although partial, comprehension of what guarantees quality improvement. To address quality issues, researchers and clinicians have developed several strategies as well as implementation theories, models, and frameworks. Howev...

Introduction Unhealthy lifestyle behaviors such as unhealthy diets, low physical activity levels, smoking, and harmful alcohol consumption are common in student populations, which constitute a large group of young adults. As unhealthy lifestyle behaviors are associated with future disease and premature mortality, most commonly from cardiovascular d...

The importance of patients taking an active role in their healthcare is recognized internationally, to improve safety and effectiveness in practice. There is still, however, some ambiguity about the conceptualization of that patient role; it is referred to interchangeably in the literature as engagement, involvement, and participation. The aim of t...

With the growing demand for primary care, provision needs to be efficient, yet retain person-centred and integrated care. Digital communication is suggested as a way to settle these aspects, although there is insufficient knowledge regarding the end-user's perspective. The aim of this study was to describe patients’ experiences of digital communica...

Background: Quality cancer care necessitates opportunities for patient participation, supposedly recognizing the individual's preferences and experiences for being involved in their health and healthcare issues. Previous research shows that surgical cancer patients wish to be more involved, requiring professionals to be sensitive of patients' needs...

Periodontal disease is the most common disease in dogs over 3 years of age. In dogs, as in humans, daily tooth brushing, as a means of active dental home care, is considered the gold standard for prophylaxis and prevention of periodontal disease progression. However, the performance of adequate tooth brushing is insufficient in dogs. There is no fu...

While context is a vital factor in any attempt to study knowledge translation or implement evidence in healthcare, there is a need to better understand the attributes and relations that constitute context. A recent study by J. Squires et al. investigates such attributes and definitions, based on 39 stakeholder interviews across Australia, Canada, t...

Background Patient participation is considered central for good healthcare. Yet, the concept is not fully understood when it comes to patients' experiences of participation in conjunction with their preferences, particularly in long‐term healthcare. The aim of this study was to investigate the extent and variation of preference‐based patient partic...

Background The Onset PrevenTIon of urinary retention in Orthopaedic Nursing and rehabilitation, OPTION, project aims to progress knowledge translation vis-à-vis evidence-based bladder monitoring in orthopaedic care, to decrease the risk of urinary retention, and voiding complications. Urinary retention is common whilst in hospital for hip surgery....

Background While increasingly discussed in somatic care, the concept of patient participation remains unsettled in psychiatric care, potentially impeding person‐centred experiences. Objective To describe outpatient psychiatric care patients’ conceptualization of patient participation. Design An exploratory survey. Setting and participants Patien...

Purpose Quality healthcare necessitates opportunities for patient participation. The study aim was to investigate the level of preference-based patient participation in surgical upper abdominal cancer care based on patients’ reports of their preferences and experiences of patient participation. Methods A cross-sectional design was used, and patient...

Background The use of e-visits in health care is progressing rapidly worldwide. To date, studies on the advantages and disadvantages of e-consultations in the form of chat services for all inquiries in primary care have focused on the perspective of health care professionals (HCPs) rather than those of end users (patients). Objective This study ai...

BACKGROUND The use of e-visits in health care is progressing rapidly worldwide. To date, studies on the advantages and disadvantages of e-consultations in the form of chat services for all inquiries in primary care have focused on the perspective of health care professionals (HCPs) rather than those of end users (patients). OBJECTIVE This study ai...

Background Despite a growing body of knowledge about eHealth innovations, there is still limited understanding of the implementation of such tools in everyday primary care. Objective The objective of our study was to describe health care staff’s experience with a digital communication system intended for patient-staff encounters via a digital rout...

Qualitative studies are often found to be accompanied by quotations from interviews or similar data sources. As with any methodological tradition, it is essential to critically explore the general principle of including quotations in scientific papers: what is the purpose and justification for including quotations? Are there standards and, in that...

Background: The Promoting Action on Research Implementation in Health Services (PARIHS) framework was developed two decades ago and conceptualizes successful implementation (SI) as a function (f) of the evidence (E) nature and type, context (C) quality, and the facilitation (F), [SI = f (E,C,F)]. Despite a growing number of citations of theoretica...

Background: Although patient participation is strongly associated with high quality of healthcare, valid means to measure and report a comprehensive notion of patient participation are scarce. The Patient Preferences for Patient Participation (4Ps) is a new healthcare practice and research tool, comprising patients' preferences as well as experien...

Background: Safe health care of good quality depends on structured and unceasing efforts to progress, promoting strategies tailored to the context, including elements such as patients' preferences. Although patient participation is a common concept in health care, there is yet limited understanding of the factors that facilitate and hinder it in a...

BACKGROUND Despite a growing body of knowledge about eHealth innovations, there is still limited understanding of the implementation of such tools in everyday primary care. OBJECTIVE The objective of our study was to describe health care staff’s experience with a digital communication system intended for patient-staff encounters via a digital rout...

Background: The uptake of evidence-based knowledge in practice is influenced by context. Observations are suggested as a valuable but under-used approach in implementation research for gaining a holistic understanding of contexts. Aim: The aim of this paper is to demonstrate how data from observations can provide insights about context and evide...

Background and objective End‐stage renal disease (ESRD) affects a multitude of aspects in the patient's daily life, often entailing their own involvement in various aspects of the treatment. Although patient participation is a core health‐care value, what the concept signifies is not yet fully known. The purpose of this paper is to conceptualize pa...

Background: Leadership is critical to supporting and facilitating the implementation of evidence-based practices in health care. Yet, little is known about how to develop leadership capacity for this purpose. The aims of this study were to explore the (1) feasibility of delivering a leadership intervention to promote implementation, (2) usefulness...

Background: Health care practice needs to be underpinned by high quality research evidence, so that the best possible care can be delivered. However, evidence from research is not always utilised in practice. This study used the Promoting Action on Research Implementation in Health Services (PARIHS) framework as its theoretical underpinning to test...

Aim To investigate what registered nurses (RNs) with a PhD working in clinical practice experience in terms of their role, function and work context. Background Previous studies have shown that RNs with a graduate degree contribute to better and safer care for patients. However, little is known about what further academic schooling of RNs, at PhD...

Background Health care practice needs to be underpinned by high quality research evidence, so that the best possible care can be delivered. However, evidence from research is not always utilised in practice. This study used the Promoting Action on Research Implementation in Health Services (PARIHS) framework as its theoretical underpinning to test...

Background Facilitation is a promising implementation intervention, which requires theory-informed evaluation. This paper presents an exemplar of a multi-country realist process evaluation that was embedded in the first international randomised controlled trial evaluating two types of facilitation for implementing urinary continence care recommenda...

Background: Self-management strategies are crucial to patients with long-term conditions and can presumably promote patient participation, given that to patients, patient participation connotes opportunities for self-care (along with being engaged in an exchange of knowledge, a phrasing of joint goals and planning of care). So far, limited attenti...

A preventive herd health approach will most likely reduce incidences of clinical and subclinical disease. Swedish veterinary organizations offer specific veterinary herd health management (HHM) programs, but these services are not used to a large extent. The aim of this study was to investigate dairy farmers’ experience of HHM and the conditions fo...

Rationale, aims, and objectives: The risk of developing urinary incontinence (UI) is associated with older age and hip surgery. There has been limited focus on factors that promote evidence-based UI practice in the orthopaedic context. The aim of this study was to evaluate an implementation intervention to support evidence-based practice for UI in...

Background There is increasing awareness that regardless of the proven value of clinical interventions, the use of effective strategies to implement such interventions into clinical practice is necessary to ensure that patients receive the benefits. However, there is often confusion between what is the clinical intervention and what is the implemen...

Objective: Patient participation is facilitated by patients' ability to take responsibility for and engage in health issues. Yet, there is limited research as to the promotion of these aspects of patient participation in long-term healthcare interactions. This paper describes patient participation as experienced by patients with chronic obstructiv...

Objective: To investigate the use of data from national quality registries (NQRs) in local quality improvement as well as purported key factors for effective clinical use in Sweden. Design: Comparative descriptive: a web survey of all Swedish hospitals participating in three NQRs with different levels of development (certification level). Setti...

Background In a previous trial in Vietnam, a facilitation strategy to secure evidence-based practice in primary care resulted in reduced neonatal mortality over a period of three years. While little is known as to what ensures sustainability in the implementation of community-based strategies, the aim of this study was to investigate factors promot...

Interview guides. Interview guides for individual interviews with health system leaders and Focus Group Discussions with former local stakeholder groups. (DOCX)

This study investigated first-line managers’ experience of and responses to a concise leadership intervention to facilitate the implementation of oral care clinical practice guidelines (CPGs) in nursing homes. Leadership is known to be an important element in knowledge implementation but little is known as to what supports managers to facilitate th...

The Patient Preferences for Patient Participation tool (The 4Ps) was developed to aid clinical dialogue and to help patients to 1) depict, 2) prioritise, and 3) evaluate patient participation with 12 pre-set items reiterated in the three sections. An earlier qualitative evaluation of The 4Ps showed promising results. The present study is a psychome...

sbu bereder • rapport 260/2017 Statens beredning för medicinsk och social utvärdering Patientdelaktighet i hälso-och sjukvården Webbpublicerad januari 2017 Planerad slutlig version mars 2017 Observera att detta är en preliminär version. Ändringar kan komma att göras inför den slutliga versionen.

Aims and objectives: To describe what nursing and rehabilitation staff know and do with regard to urinary incontinence and risk of urinary incontinence in patients 65 years or older undergoing hip surgery. Background: Urinary incontinence is a common but often neglected issue for older people. Despite the existence of evidence-based guidelines o...

Objectives While national quality registries (NQRs) are suggested to provide opportunities for systematic follow-up and learning opportunities, and thus clinical improvements, features in registries and contexts triggering such processes are not fully known. This study focuses on one of the world's largest stroke registries, the Swedish NQR Riksstr...

Background: Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers’ leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of...

Background: Emerging evidence focuses on the importance of the role of leadership in successfully transferring research evidence into practice. However, little is known about the interaction between managerial leaders and clinical leaders acting as facilitators (internal facilitators [IFs]) in this implementation process. Aims: To describe the i...

Background: Clinical practical guidelines (CPGs) may enhance evidence-based practice, but require implementation. Computer reminders have previously shown various effects in supporting implementation; in a concomitant study, we found no effect on complications in peripheral venous catheters (PVCs) or registered nurses' (RNs) adherence to a CPG in...

Background: With a pending need to identify potential means to improved quality of care, national quality registries (NQRs) are identified as a promising route. Yet, there is limited evidence with regards to what hinders and facilitates the NQR innovation, what signifies the contexts in which NQRs are applied and drive quality improvement. Suppose...

Even though Swedish national guidelines for stroke care (SNGSC) have been accessible for nearly a decade access to stroke rehabilitation in out-patient health care vary considerably. In order to aid future interventions studies for implementation of SNGSC, this study assessed the feasibility and acceptability of study procedures including analysis...

Background: In the Neonatal health - Knowledge into Practice (NeoKIP) trial in Vietnam, local stakeholder groups, supported by trained laywomen acting as facilitators, promoted knowledge translation (KT) resulting in decreased neonatal mortality. In general, as well as in the community-based NeoKIP trial, there is a need to further understand how...

Current research shows a relationship between healthcare architecture and patient-related outcomes. The planning and designing of new healthcare environments is a complex process. The needs of the various end users of the environment must be considered, including the patients, the patients' significant others, and the staff. The aim of this study w...

Besides a growing demand for safe high-quality care for older people, long-term care (LTC) often struggles to recruit appropriately qualified nursing staff. Understanding what LTC staff value in their work may contribute to a more comprehensive understanding of what can attract staff and support person-centred care. To explore staff experience of t...

An earlier overview of systematic reviews and a subsequent editorial on single-component versus multifaceted interventions to promote knowledge translation (KT) highlight complex issues in implementation science. In this supplemented commentary, further aspects are in focus; we propose examples from (KT) studies probing the issue of single interven...

Background: Through a national policy agreement, over 167 million Euros will be invested in the Swedish National Quality Registries (NQRs) between 2012 and 2016. One of the policy agreement's intentions is to increase the use of NQR data for quality improvement (QI). However, the evidence is fragmented as to how the use of medical registries and t...

Background National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation...

AimsTo report on the development and initial testing of a clinical tool, The Patient Preferences for Patient Participation tool (The 4Ps), which will allow patients to depict, prioritize, and evaluate their participation in health care.Background While patient participation is vital for high quality health care, a common definition incorporating al...

In northern Vietnam the Neonatal health - Knowledge Into Practice (NeoKIP, Current Controlled Trials ISRCTN44599712) trial has evaluated facilitation as a knowledge translation intervention to improve neonatal survival. The results demonstrated that intervention sites, each having an assigned group including local stakeholders supported by a facili...

The literature implies research utilization (RU) to be a multifaceted and complex phenomenon, difficult to trace in clinical practice. A deeper understanding of the concept of RU in a nursing context is needed, in particular, for the development of instruments for measuring nurses' RU, which could facilitate the evaluation of interventions to suppo...

One way to support evidence-based decisions in health care is by clinical guidelines, in particular, in highly specialized care such as intensive care units (ICUs). The aim of this study was to explore the development and dissemination of guidelines regarding mechanical ventilation (MV) in Swedish ICUs, and the use of evidence on MV in guidelines a...

There is emerging evidence that context is important for successful transfer of research knowledge into health care practice. The Alberta Context Tool (ACT) is a Canadian developed research-based instrument that assesses 10 modifiable concepts of organizational context considered important for health care professionals’ use of evidence. Swedish and...

Continuity of care is a key issue in the care for elderly people, for example, those having experienced stroke, particularly with regards to informational and managerial continuity based on patient record data. The study aim was to explore municipal nursing staff's (n=30) perceptions of discharge information provided to them for stroke patients wit...

Research evidence underpins best practice, but is not always used in healthcare. The Promoting Action on Research Implementation in Health Services (PARIHS) framework suggests that the nature of evidence, the context in which it is used, and whether those trying to use evidence are helped (or facilitated) affect the use of evidence. Urinary inconti...

A growing number of middle-aged people are engaged in informal care of their parents while employed. To provide support as employers, co-workers or staff, health care professionals need insight into the experiences of people managing these responsibilities. To elucidate the experience of providing informal care to an ageing parent while managing th...

Aims: To describe the accuracy and continuity of discharge information for patients with eating difficulties after stroke. Background: Eating difficulties are prevalent and serious problems in patients with stroke. Screening for eating difficulties can predict undernutrition and subsequent care needs. For optimal care, information transferred be...

The aim was to elucidate patients' lived experience of the care pathway of going through open surgery for abdominal aortic aneurysm. Open surgical treatment has a great impact on patients' health-related quality of life both before and after treatment. The transition from being independent and asymptomatic to dependent on nursing care can be diffic...

PURPOSE. To depict what patients describe as patient participation and whether descriptions of patient participation are affected by gender, age, healthcare contact, and duration of disease. DATA SOURCES. Current patients ( n = 362) responded to a questionnaire on participation. DATA SYNTHESIS. Patients' descriptions focused on having knowledge, ra...

International and national guidelines on requirements for performing lung recruitment manoeuvres are lacking. This paper presents a nationwide descriptive survey of the occurrence of and conditions for lung recruitment in adult patients treated with mechanical ventilation in intensive care units (ICUs) in Sweden. All ICUs except neurological, cardi...

The aim of this study was to depict patient non-participation as described by a diverse group with recent experiences of being patients. Patient participation is regarded as a primary condition for optimal quality of care, suggesting that non-participation should be avoided. A common understanding of the concept of patient non-participation is need...

This study explored patients' experiences of participation and non-participation in their health care. A questionnaire-based survey method was used. Content analysis showed that conditions for patient participation occurred when information was provided not by using standard procedures but based on individual needs and accompanied by explanations,...

The legislation of many Western countries emphasizes active patient participation. Patients with chronic heart failure (CHF), however, have experienced participation differently from the general interpretation of legal definitions. Education improves uptake of self-management strategies yet knowledge is lacking about support of patients' own resour...

Patient participation is stressed in the health care acts of many western countries yet a common definition of the concept is lacking. The understanding of experiences of patients with chronic heart failure (CHF) who attend nurse-led specialist clinics, a form of care suggested as beneficiary to this group, may promote a better understanding of par...