Co-creating a process of user involvement and shared decision-making in coordinated care planning with users and caregivers in social services

Knutsson, Ola; Schön, Ulla‐Karin

doi:10.1080/17482631.2020.1812270

Cited by 15 publications

(30 citation statements)

References 25 publications

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“…Participates also discussed external factors hindering participation in social work encounters, such as the social services laws and routines and strict budgets, indicating that they also have an understanding of the conditions of the social services. The undeniable value of practical knowledge in social work encounters has been expressed in previous research (Knutsson & Schön, 2020 ; Laitila et al, 2011 ). From that perspective, the broad user knowledge illustrated in our model becomes an asset to social service collaboration.…”

Section: Discussionmentioning

confidence: 85%

“…The wide variety of needs and shifting abilities among users in social services are obstacles to implementing user participation (Knutsson & Schön, 2020 ). In line with this argument, substance misuse and certain types of mental illness can lead to an impairment of the individual’s decision-making ability (Kovacs et al, 2017 ; Mallorquí-Bagué et al, 2016 ; Spencer et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

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How do users with comorbidity perceive participation in social services? A qualitative interview study

Jones

Jess

Schön

2021

International Journal of Qualitative Studies on Health and Well

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Purpose: This study aims to construct a theoretical framework that explains how users with comorbidity of substance use and mental illness/neuropsychiatric disorders portray user participation in social work encounters. Methods: To construct this framework a constructivist grounded theory approach was used with semi-structured qualitative interviews with 12 users. Results: The main concern of the participants was the low trust in the social services and perceiving that this lack of trust is mutual. Establishing mutual trust is a social process that cuts through the whole framework. In the framework, prerequisites for participation are explained. The prerequisites are users being motivated and having the willingness to stop using drugs and receiving support, making use of user and staff knowledge and decisionmaking abilities and accessing help and support. Conclusion: Unlike previous frameworks, the model describes participation as a social process and does not explain participation at different levels of power. The results suggest that staff need to be aware of low trust perceptions and work on establishing mutual trust. In addition, the staff need to see each user as an individual and consider how the user would prefer to be involved in decision-making.

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Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

How do users with comorbidity perceive participation in social services? A qualitative interview study

Jones

Jess

Schön

2021

International Journal of Qualitative Studies on Health and Well

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“…Berglund et al (2012) found that professionals tended to steer the care planning meeting towards predefined goals and that issues that were brought up by the older person were neglected if they did not fit into these predefined goals. Knutsson (2020) found that professionals tend to ignore what the person is saying at the meeting and not to take this seriously. The alternatives in care were presented from the perspective of the professionals only.…”

Section: Discussion Of the Resultsmentioning

confidence: 99%

Exploring shared care plans for older people regarding fulfillment of policy requirements and shared decision making - A qualitative study

Condelius

Andersson

2021

RASP

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The aim was to explore the documentation in shared care plans regarding the fulfilment of policy requirements and shared decision-making. The sample consists of 15 shared care plans established for older people in Sweden. The analysis was performed using directed content analysis. The requirements in the Swedish law and the 15 indicators of shared decision making (SDM) in the Multifocal Approach to the Sharing in SDM inventory was used to define the main categories. The policy requirements were fulfilled to a varied extent. All the care plans were established in collaboration between the municipality and the county council, but social services were not represented in six of them. The older person and next of kin were present at 14 of the care planning meetings. The individual’s agreement to the establishment was documented in ten of the plans but how and what the person had agreed to was not specified further. The headings focused at the policy requirements and did not support a care planning process, or a documentation based on SDM. Six out of 15 indicators of SDM were reflected. The decision-making process needs to be acknowledged more in the process of establishing shared care plans for older people.

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“…SDM has been evaluated in randomized controlled trials (Stovell et al 2016) showing promising evidence that SDM supports users towards empowerment, even if these evaluations so far have been carried out in psychiatric encounters. There is also a certain 'fit' between the SDM components and stated quality criteria in the Swedish Social Services Act, as well as statutory care planning (Nykänen 2019;Knutsson and Schön 2020).…”

Section: Why Should Sdm Be Offered?mentioning

confidence: 99%

“…As mentioned earlier in this paper, the core principles of SDM are considered to resemble the core values of social work, namely, striving for equality, fairness and just distribution of power, in this case in decision-making situations (Levin, Gewirtz, and Cribb 2017). It is about creating conditions for cooperation between the client and the staff and that the client should be able to participate in decision-making (Knutsson and Schön 2020;SFS 2001, 453). It may thus be claimed that there is a good ideological fit between SDM and the core values stated for social work or social services.…”

Section: Is Sdm Appropriate For the Social Services And If So How?mentioning

confidence: 99%

Shared decision making in social services – some remaining questions

Nykänen

Schön

Björk

2021

Nordic Social Work Research

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Recent years have seen increased emphasis on person-centring and user involvement in healthcare delivery and social services. In Sweden, the rights of users to participate in and influence care planning and services are stipulated in the Social Services Act, the Health Care Act and the Patient Law. Shared decision making (SDM) is presented as a supportive collaboration between users and staff, drawing on users' preferences and values as well as the best available evidence to discuss options and reach a consensus on care decisions. However, studies on the implementation of SDM in somatic care illustrate challenges, such as staff trying to persuade users to agree to a particular option rather than offering opportunities to discuss various alternatives. The Swedish National Board of Health and Welfare recommend that SDM should be offered in social services support in relation to certain groups. However, the imperative that 'SDM should be offered in the social services' raises questions; in addition to the question of how SDM should be understood, we need to account for why SDM should be offered, who should offer SDM, when it should be offered, to whom and regarding which decisions. The questions concern justification as well as clarifications. The aim of this article is threefold: to discuss SDM and its components; to deliberate upon what SDM may imply to the social services and finally, to suggest some preconditions that should be present for an implementation of SDM.

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Co-creating a process of user involvement and shared decision-making in coordinated care planning with users and caregivers in social services

Abstract: Schön (2020) Co-creating a process of user involvement and shared decision-making in coordinated care planning with users and caregivers in social services,

Cited by 15 publications

References 25 publications

How do users with comorbidity perceive participation in social services? A qualitative interview study

How do users with comorbidity perceive participation in social services? A qualitative interview study

Exploring shared care plans for older people regarding fulfillment of policy requirements and shared decision making - A qualitative study

Shared decision making in social services – some remaining questions

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