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

View Article: PubMed Central - PubMed

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 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.

No MeSH data available.


Condensed presentation of data sampling, theory development, and chronological study timeline.
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Related In: Results  -  Collection

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Figure 0002: Condensed presentation of data sampling, theory development, and chronological study timeline.

Mentions: Figure 2 outlines study progress in three areas: data sampling, theoretical concepts in focus, and chronological timing of study events. Milestones in the audit trail were the two project reports written, reflecting the emerging theory. Both reports were distributed broadly in the ND care pathway. Conclusions and inductions made from the dialogue conference were submitted to all participants. Results were presented at several managerial levels and theory contents in some respects informed organizational policy. We believe that the study had transparency with possibilities for participants to provide feedback and follow theory development.


Integrating care for neurodevelopmental disorders by unpacking control: A grounded theory study
Condensed presentation of data sampling, theory development, and chronological study timeline.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016529&req=5

Figure 0002: Condensed presentation of data sampling, theory development, and chronological study timeline.
Mentions: Figure 2 outlines study progress in three areas: data sampling, theoretical concepts in focus, and chronological timing of study events. Milestones in the audit trail were the two project reports written, reflecting the emerging theory. Both reports were distributed broadly in the ND care pathway. Conclusions and inductions made from the dialogue conference were submitted to all participants. Results were presented at several managerial levels and theory contents in some respects informed organizational policy. We believe that the study had transparency with possibilities for participants to provide feedback and follow theory development.

View Article: PubMed Central - PubMed

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 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.

No MeSH data available.