Background Despite the large body of research on sex differences in pain, there is a lack of knowledge about the influence of gender in the patient-provider encounter. The purpose of this study was to review literature on gendered norms about men and women with pain and gender bias in the treatment of pain. The second aim was to analyze the results guided by the theoretical concepts of hegemonic masculinity and andronormativity. Methods A literature search of databases was conducted. A total of 77 articles met the inclusion criteria. The included articles were analyzed qualitatively, with an integrative approach. Results The included studies demonstrated a variety of gendered norms about men's and women's experience and expression of pain, their identity, lifestyle, and coping style. Gender bias in pain treatment was identified, as part of the patient-provider encounter and the professional's treatment decisions. It was discussed how gendered norms are consolidated by hegemonic masculinity and andronormativity. Conclusions Awareness about gendered norms is important, both in research and clinical practice, in order to counteract gender bias in health care and to support health-care professionals in providing more equitable care that is more capable to meet the need of all patients, men and women.

Purpose Conducting research that is both practice- and theory-relevant is important for the service research community. Action research can be a fruitful approach for service researchers studying the transformative role of service research and wanting to make contributions to both the research community and to practical development. By exploring the current use of action research in service research, this study aims to make suggestions for enhancing the contribution to theory and practice development and to propose criteria for research quality for action research in service research. Design/methodology/approach This study builds on a systematic literature review of the use of action research approaches in service research. Findings The study makes three main contributions. First, it posits that any action research project needs to consider the four elements of problem identification, theorization, creating guiding concepts and intervention. Second, based on these elements mirrored in service action research, it outlines and analyzes three approaches to action research (i.e. theory-enhancing, concept developing and practice-enhancing). Third, it suggests a move from instrumental to a more conceptual relevance of the research and elaborates on the criteria for research quality. Originality/value This study contributes to the understanding of how action research may be applied for conducting high-quality collaborative research in services and proposes measures to enhance research quality in action research projects focusing services.

From its inception, the field of quality management (QM) has been characterised by practicedriven development. Although QM has reached maturity as a field of research based on empirical enquiry, its practitioners still struggle to adapt QM implementations to reap their benefits. This study aims to identify their challenges to better understand how contemporary QM research addresses them. We propose approaches to bridge the potential relevance gaps between research and practice. A Delphi study of QM practitioners in Swedish private and public organisations, several of which operate globally, generated 49 challenges. An exploratory factor analysis was performed to cluster these challenges into themes, and the literature was reviewed to investigate how each theme has been addressed in QM research.The empirical investigation identified three themes related to future QM challengesorganisations' adaptability to rapid changes in the business environment, quality as a strategic concern for business owners, and managerial ownership of quality. By analysing these challenges, six propositions for future research were proposed to reduce potential relevance gaps. Future research should focus on how to make QM a strategic concern for owners, and explore how it can contribute to organisational ambidexterity and adaptability. Research should also determine how context influences the way QM is applied, and investigate how it can improve organisational learning and innovation. Finally, research should indicate how top managers can adopt the responsibilities of quality managers, and explore the ways the principal values of QM can be better integrated into organisations.

Digitalisation provides both challenges and opportunities for Quality Management (QM). The purpose of this study is to identify various roles QM practitioners play in digitalisation initiatives to uncover the challenges and potential of QM's digitalisation journey. This issue is addressed through an analytical framework that stresses two dimensions: the exploration and exploitation of digitalised QM processes and value creation, which is performed by the customer or in interactions facilitated by the provider. Through a multiple-case study of four large Swedish organisations, we propose six different challenges and corresponding roles for QM. Further, the study identifies challenges of digitalisation affecting both exploitative and explorative practices throughout an organisation's value creation process. This research contributes to the existing literature with empirical evidence on the challenges induced by digitalisation, an area often discussed but not as often studied empirically.

BackgroundEvidence-based practice for healthy lifestyle promotion in primary health care is supported internationally by national policies and guidelines but implementation in routine primary health care has been slow. Referral to digital interventions could lead to a larger proportion of patients accessing structured interventions for healthy lifestyle promotion, but such referral might have unknown implications for clinicians with patients accessing such interventions. This qualitative study aimed to explore the perceptions of clinicians in primary care on healthy lifestyle promotion with or without digital screening and intervention.MethodsFocus group interviews were conducted at 10 primary care clinics in Sweden with clinicians from different health professions. Transcribed interviews were analyzed using content analysis, with inspiration from a phenomenological-hermeneutic method involving naïve understanding, structural analysis and comprehensive understanding.ResultsTwo major themes captured clinicians’ perceptions on healthy lifestyle promotion: 1) the need for structured professional practice and 2) deficient professional practice as a hinder for implementation. Sub-themes in theme 1 were striving towards professionalism, which for participants meant working in a standardized fashion, with replicable routines regardless of clinic, as well as being able to monitor statistics on individual patient and group levels; and embracing the future with critical optimism, meaning expecting to develop professionally but also being concerned about the consequences of integrating digital tools into primary care, particularly regarding the importance of personal interaction between patient and provider. For theme 2, sub-themes were being in an unmanageable situation, meaning not being able to do what is perceived as best for the patient due to lack of time and resources; and following one’s perception, meaning working from a gut feeling, which for our participants also meant deviating from clinical routines.ConclusionsIn efforts to increase evidence-based practice and lighten the burden of clinicians in primary care, decision- and policy-makers planning the introduction of digital tools for healthy lifestyle promotion will need to explicitly define their role as complements to face-to-face encounters. Our overriding hope is that this study will contribute to maintaining meaningfulness in the patient-clinician encounter, when digital tools are added to facilitate patient behavior change of unhealthy lifestyle behaviors.Electronic supplementary materialThe online version of this article (10.1186/s12875-018-0829-z) contains supplementary material, which is available to authorized users.