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Nedlund, Ann-CharlotteORCID iD iconorcid.org/0000-0003-0204-4536
Publications (10 of 70) Show all publications
Strand, L., Sandman, L., Persson, E., Andersson, D., Nedlund, A.-C. & Tinghög, G. (2024). Withdrawing versus Withholding Treatments in Medical Reimbursement Decisions: A Study on Public Attitudes. Medical decision making
Open this publication in new window or tab >>Withdrawing versus Withholding Treatments in Medical Reimbursement Decisions: A Study on Public Attitudes
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2024 (English)In: Medical decision making, ISSN 0272-989X, E-ISSN 1552-681XArticle in journal (Refereed) Published
Abstract [en]

BackgroundThe use of policies in medical treatment reimbursement decisions, in which only future patients are affected, prompts a moral dilemma: is there an ethical difference between withdrawing and withholding treatment?DesignThrough a preregistered behavioral experiment involving 1,067 participants, we tested variations in public attitudes concerning withdrawing and withholding treatments at both the bedside and policy levels.ResultsIn line with our first hypothesis, participants were more supportive of rationing decisions presented as withholding treatments compared with withdrawing treatments. Contrary to our second prestated hypothesis, participants were more supportive of decisions to withdraw treatment made at the bedside level compared with similar decisions made at the policy level.ImplicationsOur findings provide behavioral insights that help explain the common use of policies affecting only future patients in medical reimbursement decisions, despite normative concerns of such policies. In addition, our results may have implications for communication strategies when making decisions regarding treatment reimbursement.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
experiment, priority setting, health policy, equivalence thesis
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Economics
Identifiers
urn:nbn:se:liu:diva-205746 (URN)10.1177/0272989x241258195 (DOI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, Forte
Available from: 2024-07-01 Created: 2024-07-01 Last updated: 2024-07-01
Nedlund, A.-C. & Österholm, J. H. (2023). Att engagera sig, organisera sig och skapa guldkant för äldre: Volontärorganisationen Resurspoolen som en mångsidig aktör för att förebygga och bryta ofrivillig ensamhet i det lokala samhället. Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Att engagera sig, organisera sig och skapa guldkant för äldre: Volontärorganisationen Resurspoolen som en mångsidig aktör för att förebygga och bryta ofrivillig ensamhet i det lokala samhället
2023 (Swedish)Report (Other academic)
Abstract [sv]

Denna rapport har tagits fram på uppdrag av Resurspoolen – Frivilliga uppdrag i Linköping. Uppdraget bestod i att dokumentera volontärernas erfarenhet av vilken betydelse äldre medborgare, som organiserar sig i Resurspoolens verksamhet, kan ha för att förebygga ofrivillig ensamhet och social isolering bland äldre personer. Uppdraget hade också en framåtsyftande ansats gällande hur Resurspoolen kan komma att utvecklas utifrån volontärernas perspektiv.

Civilsamhällets betydelse inom välfärdssamhället är högaktuell i nationell politik där frivilligorganisationer lyfts fram som en central aktör för att hantera välfärdssystemets utmaningar och ansträngda situation. Medborgare som organiserar sig gemensamt antas fylla en allt större roll i gränsytan mot det offentliga stödsystemet. Samtidigt har ofrivillig ensamhet bland äldre personer lyfts fram av staten som särskilt allvarlig, varför statsbidrag har riktats till kommuner och det civila samhället för att förebygga och bryta ofrivillig ensamhet.

Rapporten har särskilt fokus på de äldre frivilliga volontärerna som engagerar sig. En viktig komponent är deras arbete, intresse och fortsatta engagemang för att skapa en kontinuitet i genomförandet av olika insatser och i den ömsesidiga relationen – vid aktiviteter mellan äldre, inom organisationen och mellan volontärorganisationen och andra aktörer. Rapporten belyser också arbetet med att skapa aktiviteter och mötesplatser för äldre personer, varav många lever i social ensamhet.

Rapporten kan således sättas in i ett större sammanhang genom att bidra med kunskap om hur en volontärorganisation – Resurspoolen – har en mångsidig funktion för det lokala samhället i att uppmärksamma och ge socialt stöd, sällskap, skapa gemenskap och social hållbarhet bland Linköpings medborgare.

Abstract [en]

This report has been written on behalf of Resurspoolen - Frivilliga uppdrag i Linköping. The aim was to document the volunteers' experience of the importance of older citizens, who organise themselves in the Resurspoolen’s activities, in preventing loneliness and social isolation among older people. The project also had a forward-looking approach regarding how the work by Resurspoolen can be further developed and improved.

The importance of civil society in the welfare society has been raised in Swedish national politics, where voluntary organisations have been highlighted as a key player in managing the challenged situation that the welfare system is facing. Citizens who organise themselves are assumed to play an increasingly important role at the interface with the public support system. At the same time, preventing loneliness among older people has been highlighted as a prioritised area by the state where municipalities and civil society have been pointed out as key actors to prevent loneliness. 

The report focuses on the older volunteers who get involved, get organised with the effort to give “an extra flavour to older people’s life”. An important component is their work, interest, and continued commitment to create activities targeting older people, many of whom live in social isolation. and to create collaboration, between older people within the organisation, and between the volunteer organisation and other actors in the local society. 

The report can also be placed in a broader context as it contributes with knowledge about how a volunteer organisation – Resurspoolen – has a versatile function for the local community, providing social support, social inclusion and shaping social sustainability among Linköping’s citizens.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2023. p. 38
Keywords
Äldre, Ensamhet, Ofrivillig ensamhet
National Category
Social Work Health Sciences
Identifiers
urn:nbn:se:liu:diva-194250 (URN)10.3384/9789180752688 (DOI)9789180752671 (ISBN)9789180752688 (ISBN)
Available from: 2023-05-30 Created: 2023-05-30 Last updated: 2023-10-03Bibliographically approved
Issakainen, M., Mäki-Petäjä-Leinonen, A., Heimonen, S., Nedlund, A.-C., Astell, A., Boger, J., . . . Nygård, L. (2023). Experiences of influencing one's own life when living with working-age dementia. Ageing & Society, 43(8), 1934-1953, Article ID PII S0144686X21001525.
Open this publication in new window or tab >>Experiences of influencing one's own life when living with working-age dementia
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2023 (English)In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 43, no 8, p. 1934-1953, article id PII S0144686X21001525Article in journal (Refereed) Published
Abstract [en]

Having opportunities to make decisions and choices regarding one's life is crucial when living with dementia. This inter-disciplinary study draws on the concept of relational autonomy to explore how working-age people living dementia seek to influence their lives, and what makes it easier or more difficult for them in their everyday life. The data consist of three focus group discussions conducted with 12 retired adults who developed dementia while still employed. The results illuminate various resources that enable a person to (a) handle their difficulties at work and related consequences with dignity, (b) manage everyday tasks and live a fulfilling life, and (c) fight the stigma associated with (working-age) dementia. Challenges related to these aspects reported by the participants reveal gaps and obstacles that impede the full realisation of the rights of people living with early onset dementia. This research highlights the need for workplace education for different stakeholders, equal and ongoing access to guidance and counselling for younger people who live with dementia, and an effort by society as a whole to eradicate stigma.

Place, publisher, year, edition, pages
Cambridge University Press, 2023
Keywords
Public Health, Environmental and Occupational Health, Geriatrics and Gerontology, Arts and Humanities (miscellaneous), Social Psychology, Health(social science)
National Category
Other Social Sciences Health Sciences
Identifiers
urn:nbn:se:liu:diva-180830 (URN)10.1017/s0144686x21001525 (DOI)000742554300001 ()
Funder
Academy of Finland, 318848Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-02303
Note

Funding: Academy of FinlandAcademy of FinlandEuropean Commission [314749, 318848]; Swedish Council for Health, Working Life and Welfare, FORTE [2017-02303]; Canadian Institute for Health ResearchCanadian Institutes of Health Research (CIHR) [MYB155683]; Ontario Shores Research Chair in Dementia Well-being

Available from: 2021-11-03 Created: 2021-11-03 Last updated: 2023-11-07Bibliographically approved
Brüggemann, J., Guntram, L. & Nedlund, A.-C. (2023). On difficult patients and informal complaints.
Open this publication in new window or tab >>On difficult patients and informal complaints
2023 (English)Other (Other (popular science, discussion, etc.))
Abstract [en]

Thinking critically about the role of complaint in patient care, Jelmer Brüggemann, Lisa Guntram and Ann-Charlotte Nedlund explore the ’difficult patient’ as a medical humanities concept.

Keywords
Medical humanities, care practices, difficult patient, complaints
National Category
Social Sciences Interdisciplinary
Identifiers
urn:nbn:se:liu:diva-192045 (URN)
Funder
Swedish Research Council, 2020-01594
Available from: 2023-02-28 Created: 2023-02-28 Last updated: 2023-03-07Bibliographically approved
Ågren, A., Krevers, B., Cedersund, E. & Nedlund, A.-C. (2023). Policy Narratives on Palliative Care in Sweden 1974–2018. Health Care Analysis, 31, 99-113
Open this publication in new window or tab >>Policy Narratives on Palliative Care in Sweden 1974–2018
2023 (English)In: Health Care Analysis, ISSN 1065-3058, E-ISSN 1573-3394, Vol. 31, p. 99-113Article in journal (Refereed) Published
Abstract [en]

In Sweden, efforts to govern end-of-life care through policies have been ongoing since the 1970s. The aim of this study is to analyse how policy narratives on palliative care in Sweden have been formulated and have changed over time since the 1970s up to 2018. We have analysed 65 different policy-documents. After having analysed the empirical material, three policy episodes were identified. In Episode 1, focus was on the need for norms, standards and a psychological end-of-life care with the main goal of solving the alleged deficiencies within end-of-life care in hospital settings. Episode 2 was characterised by an emphasis on prioritising end-of-life care and dying at home, and on the fact that the hospice care philosophy should serve as inspiration. In Episode 3, the need for a palliative care philosophy that transcended all palliative care and the importance of systematic follow-ups and indicators was endorsed. Furthermore, human value and freedom of choice were emphasised. In conclusion, the increase of policy-documents produced by the welfare-state illustrate that death and dying have become matters of public concern and responsibility. Furthermore, significant shifts in policy narratives display how notions of good palliative care change, which in turn may affect both the practice and the content of care at the end of life.

Place, publisher, year, edition, pages
Springer, 2023
Keywords
Death denial; Hospice care philosophy; Institutionalised death and dying; Palliative care; Policy narratives
National Category
Other Social Sciences
Identifiers
urn:nbn:se:liu:diva-191137 (URN)10.1007/s10728-022-00449-1 (DOI)000914709100001 ()36650304 (PubMedID)2-s2.0-85146394731 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-01187Linköpings universitet
Note

Funding: FORTE - Swedish Research Council for Health, Working Life and Welfare [dnr: 2017-01187]; Region OEstergoetland, Sweden; Linkoeping University

Available from: 2023-01-19 Created: 2023-01-19 Last updated: 2024-04-11Bibliographically approved
Brüggemann, J., Guntram, L. & Nedlund, A.-C. (2023). The “Difficult Patient”: Dominant Logics and Misfits in Medicine. In: Pranee Liamputtong (Ed.), Handbook of Social Sciences and Global Public Health: (pp. 1-14). Cham: Springer
Open this publication in new window or tab >>The “Difficult Patient”: Dominant Logics and Misfits in Medicine
2023 (English)In: Handbook of Social Sciences and Global Public Health / [ed] Pranee Liamputtong, Cham: Springer, 2023, p. 1-14Chapter in book (Other academic)
Abstract [en]

Medicine is organized around specific kinds of patients. In the cross-section of overarching biomedical narratives, international and national regulations and guidelines, and local practices, a particular kind of “ideal” patient is produced. The ideal patient embraces the larger biomedical paradigm, fits standardized diagnostic or treatment protocols, and behaves in expected and respectful ways. At the same time, its downside is created. Modern medicine’s narrow pathways create all sorts of “difficult patients.” Rather than focusing on the “difficult patient” as a psychological or relational struggle for individual care professionals or patients – a common focus in medical literature and debate – this chapter approaches the “difficult patient” as a phenomenon inherent in the ways in which medicine is organized. It shows how the difficult patient can provide an analytic lens through which individuals can see health care norms and logics in play. In particular, the chapter discusses how the difficult patient comes into being in “misfits” between dominant logics in medicine and individual patient lives and needs.

Place, publisher, year, edition, pages
Cham: Springer, 2023
Keywords
Difficult patient, Noncompliance, Sick role, Standardization, Normalization, Active patient, Logics of care
National Category
Social Sciences Interdisciplinary
Identifiers
urn:nbn:se:liu:diva-191021 (URN)10.1007/978-3-030-96778-9_138-1 (DOI)9783030967789 (ISBN)
Funder
Swedish Research Council, 2020-01594
Available from: 2023-01-16 Created: 2023-01-16 Last updated: 2023-02-06Bibliographically approved
Nedlund, A.-C. (2022). Om vikten av legitimitet och rättvisa processer – prioriteringens infrastruktur. In: Lars Sandman (Ed.), Prioriteringscentrum – 20 år i rättvisans tjänst: (pp. 103-118). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Om vikten av legitimitet och rättvisa processer – prioriteringens infrastruktur
2022 (Swedish)In: Prioriteringscentrum – 20 år i rättvisans tjänst / [ed] Lars Sandman, Linköping: Linköping University Electronic Press, 2022, , p. 192p. 103-118Chapter in book (Other academic)
Abstract [sv]

Det här kapitlet handlar om vikten av legitimitet och detdilemma som kan kopplas till legitimitet när prioriteringargörs och gränser sätts i offentligt solidariskt finansieradhälso- och sjukvård. Den som är uppmärksam ser att jaghär väljer att skriva görs och sätts då jag ser prioriteringarsom just aktiviteter, handlingar och göranden – vare sig deär medvetna och systematiska eller det motsatta – där fleraaktörer tillsammans utövar sina färdigheter. Dessa aktörerkan vara kliniska verksamma vårdprofessioner, verksamhetschefer, tjänstepersoner och de medborgarföreträdandepolitikerna. Att arbeta med prioritering involverar mångahänder och är en aktivitet som skapas, organiseras, görs ochpraktiseras. Vi kan här se det i termer av prioriteringarnasinfrastruktur och arkitektur. I kapitlet kommer jag att diskutera legitimitet från ett utåtblickande, inåtblickande ochgenomblickande perspektiv. Utkiksposten, där jag står somkapitelförfattare, är hälso- och sjukvård som organisation.Jag kommer också att ge några exempel som visar på skapandet av legitimitet och dess koppling till dissonans ochresonans i hälso- och sjukvårdssystemet.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2022. p. 192
Keywords
Prioritering inom sjukvården
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-199852 (URN)9789179294144 (ISBN)9789179294137 (ISBN)
Available from: 2023-12-28 Created: 2023-12-28 Last updated: 2024-01-30Bibliographically approved
Nedlund, A.-C. (2022). Politikens räckvidd, innehåll och organisering vid prioriteringar. In: Lars Sandman (Ed.), Prioriteringscentrum – 20 år i rättvisans tjänst: (pp. 89-101). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Politikens räckvidd, innehåll och organisering vid prioriteringar
2022 (Swedish)In: Prioriteringscentrum – 20 år i rättvisans tjänst / [ed] Lars Sandman, Linköping: Linköping University Electronic Press, 2022, , p. 192p. 89-101Chapter in book (Other academic)
Abstract [sv]

Vi börjar med en politisk betraktelse av Hälso- och sjukvårdslagen (HSL):”Målet med hälso- och sjukvården är en god hälsa och engod vård på lika villkor för hela befolkningen. Vården skages med respekt för alla människors lika värde och för denenskilda människans värdighet. Den som har det störstabehovet av hälso- och sjukvård ska ges företräde till vården.”

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2022. p. 192
Keywords
Prioritering inom sjukvården
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-199851 (URN)9789179294144 (ISBN)9789179294137 (ISBN)
Available from: 2023-12-28 Created: 2023-12-28 Last updated: 2024-01-30Bibliographically approved
Shastri, K., Boger, J., Marashi, S., Astell, A., Dove, E., Nedlund, A.-C., . . . Nygård, L. (2022). Working towards inclusion: Creating technology for and with people living with mild cognitive impairment or dementia who are employed. Dementia, 21(2), 556-578
Open this publication in new window or tab >>Working towards inclusion: Creating technology for and with people living with mild cognitive impairment or dementia who are employed
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2022 (English)In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 21, no 2, p. 556-578Article in journal (Refereed) Published
Abstract [en]

Earlier diagnosis and longer working careers is resulting in more individuals being identified as having Mild Cognitive Impairment or Early Onset Dementia (MCI/EOD) when they are still in the workforce. While there is growing interest in the dementia research community and beyond to develop technologies to support people with dementia, the use of technology for and by people with MCI/EOD in the workplace has had very little attention. This paper presents a two-part study involving interviews and participatory sessions to begin to understand the workplace experiences and the role of technology among people living with MCI/EOD. We present our findings from working with seven people with MCI/EOD and two care partners to explore technology design. Our results indicate several similarities as well as a few differences between MCI/EOD and later-onset dementia with respect to challenges using technology and design considerations for supporting engagement and use of technology. Lessons learned through the process of working with people with MCI/EOD through participatory methods is presented along with recommendations to foster an inclusive, respectful, and empowering experience for participants with MCI/EOD.

Place, publisher, year, edition, pages
Sage Publications, 2022
Keywords
user-centred design; early-onset dementia; mild cognitive impairment; workplace; technology
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-181477 (URN)10.1177/14713012211051885 (DOI)000717189200001 ()34749536 (PubMedID)
Note

Funding Agencies|JTC 2017 as part of the Joint Programming Initiative (JPI) "More Years, Better Lives" (JPI MYBL) initiative; J-Age II - Horizon 2020, the EU Framework Program for Research and Innovation [643850]

Available from: 2021-12-01 Created: 2021-12-01 Last updated: 2022-05-06
Eriksson, T., Levin, L.-Å. & Nedlund, A.-C. (2021). Centrality and compatibility of institutional logics when introducing value-based reimbursement. Journal of Health Organization & Management, 35(9), 298-314
Open this publication in new window or tab >>Centrality and compatibility of institutional logics when introducing value-based reimbursement
2021 (English)In: Journal of Health Organization & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 35, no 9, p. 298-314Article in journal (Refereed) Published
Abstract [en]

Purpose: Using financial incentives has been criticised for putting too much focus on things that can be measured. Value-based reimbursement may better align professional values with financial incentives. However, professional values may differ between actor groups. In this article, the authors identify institutional logics within healthcare-providing organisations. Further, the authors analyse how the centrality and compatibility of the identified logics affect the institutionalisation of external demands.

Design/methodology/approach: 41 semi-structured interviews were conducted with representatives from healthcare providers within spine surgery in Sweden, where a value-based reimbursement programme was introduced. Data were analysed using thematic content analysis with an abductive approach, and a conceptual framework based on neo-institutional theory.

Findings: After the introduction of the value-based reimbursement programme, the centrality and compatibility of the institutional logics within healthcare-providing organisations changed. The logic of spine surgeons was dominating whereas physiotherapists struggled to motivate a higher cost for high quality physiotherapy. The institutional logic of nurses was aligned with spine surgeons, however as a peripheral logic facilitating spine surgery. To attain holistic and interdisciplinary healthcare, dominating institutional logics within healthcare-providing organisations need to allow peripheral institutional logics to attain a higher centrality for higher compatibility. Thus, allowing other occupations to take responsibility for quality and attain the feeling of professional pride.

Originality/value: Interviewing spine surgeons, physiotherapists, nurses, managers and administrators allows us to deepen the understanding of micro-level behaviour as a reaction (or lack thereof) to macro-level decisions.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2021
Keywords
Health Policy, Business, Management and Accounting (miscellaneous)
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-180828 (URN)10.1108/jhom-01-2021-0010 (DOI)000697172500001 ()34535988 (PubMedID)2-s2.0-85114992992 (Scopus ID)
Available from: 2021-11-03 Created: 2021-11-03 Last updated: 2022-05-06Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-0204-4536

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