Cargando…
From Threatening Chaos to Temporary Order through a Complex Process of Adaptation: A Grounded Theory Study of the Escalation of Intensive Care during the COVID-19 Pandemic
To ensure high-quality care, operationalize resilience and fill the knowledge gap regarding how to improve the prerequisites for resilient performance, it is necessary to understand how adaptive capacity unfolds in practice. The main aim of this research was to explain the escalation process of inte...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10649734/ https://www.ncbi.nlm.nih.gov/pubmed/37947575 http://dx.doi.org/10.3390/ijerph20217019 |
_version_ | 1785135619500933120 |
---|---|
author | Göras, Camilla Lohela-Karlsson, Malin Castegren, Markus Condén Mellgren, Emelie Ekstedt, Mirjam Bjurling-Sjöberg, Petronella |
author_facet | Göras, Camilla Lohela-Karlsson, Malin Castegren, Markus Condén Mellgren, Emelie Ekstedt, Mirjam Bjurling-Sjöberg, Petronella |
author_sort | Göras, Camilla |
collection | PubMed |
description | To ensure high-quality care, operationalize resilience and fill the knowledge gap regarding how to improve the prerequisites for resilient performance, it is necessary to understand how adaptive capacity unfolds in practice. The main aim of this research was to explain the escalation process of intensive care during the first wave of the pandemic from a microlevel perspective, including expressions of resilient performance, intervening conditions at the micro-meso-macrolevels and short- and long-term consequences. A secondary aim was to provide recommendations regarding how to optimize the prerequisites for resilient performance in intensive care. A grounded theory methodology was used. First-person stories from different healthcare professionals (n70) in two Swedish regions were analyzed using the constant comparative method. This resulted in a novel conceptual model (including 6 main categories and 24 subcategories), and 41 recommendations. The conclusion of these findings is that the escalation of intensive care can be conceptualized as a transition from threatening chaos to temporary order through a complex process of adaptation. To prepare for the future, the components of space, stuff, staff, system and science, with associated continuity plans, must be implemented, anchored and communicated to actors at all levels of the system. |
format | Online Article Text |
id | pubmed-10649734 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-106497342023-11-03 From Threatening Chaos to Temporary Order through a Complex Process of Adaptation: A Grounded Theory Study of the Escalation of Intensive Care during the COVID-19 Pandemic Göras, Camilla Lohela-Karlsson, Malin Castegren, Markus Condén Mellgren, Emelie Ekstedt, Mirjam Bjurling-Sjöberg, Petronella Int J Environ Res Public Health Article To ensure high-quality care, operationalize resilience and fill the knowledge gap regarding how to improve the prerequisites for resilient performance, it is necessary to understand how adaptive capacity unfolds in practice. The main aim of this research was to explain the escalation process of intensive care during the first wave of the pandemic from a microlevel perspective, including expressions of resilient performance, intervening conditions at the micro-meso-macrolevels and short- and long-term consequences. A secondary aim was to provide recommendations regarding how to optimize the prerequisites for resilient performance in intensive care. A grounded theory methodology was used. First-person stories from different healthcare professionals (n70) in two Swedish regions were analyzed using the constant comparative method. This resulted in a novel conceptual model (including 6 main categories and 24 subcategories), and 41 recommendations. The conclusion of these findings is that the escalation of intensive care can be conceptualized as a transition from threatening chaos to temporary order through a complex process of adaptation. To prepare for the future, the components of space, stuff, staff, system and science, with associated continuity plans, must be implemented, anchored and communicated to actors at all levels of the system. MDPI 2023-11-03 /pmc/articles/PMC10649734/ /pubmed/37947575 http://dx.doi.org/10.3390/ijerph20217019 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Göras, Camilla Lohela-Karlsson, Malin Castegren, Markus Condén Mellgren, Emelie Ekstedt, Mirjam Bjurling-Sjöberg, Petronella From Threatening Chaos to Temporary Order through a Complex Process of Adaptation: A Grounded Theory Study of the Escalation of Intensive Care during the COVID-19 Pandemic |
title | From Threatening Chaos to Temporary Order through a Complex Process of Adaptation: A Grounded Theory Study of the Escalation of Intensive Care during the COVID-19 Pandemic |
title_full | From Threatening Chaos to Temporary Order through a Complex Process of Adaptation: A Grounded Theory Study of the Escalation of Intensive Care during the COVID-19 Pandemic |
title_fullStr | From Threatening Chaos to Temporary Order through a Complex Process of Adaptation: A Grounded Theory Study of the Escalation of Intensive Care during the COVID-19 Pandemic |
title_full_unstemmed | From Threatening Chaos to Temporary Order through a Complex Process of Adaptation: A Grounded Theory Study of the Escalation of Intensive Care during the COVID-19 Pandemic |
title_short | From Threatening Chaos to Temporary Order through a Complex Process of Adaptation: A Grounded Theory Study of the Escalation of Intensive Care during the COVID-19 Pandemic |
title_sort | from threatening chaos to temporary order through a complex process of adaptation: a grounded theory study of the escalation of intensive care during the covid-19 pandemic |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10649734/ https://www.ncbi.nlm.nih.gov/pubmed/37947575 http://dx.doi.org/10.3390/ijerph20217019 |
work_keys_str_mv | AT gorascamilla fromthreateningchaostotemporaryorderthroughacomplexprocessofadaptationagroundedtheorystudyoftheescalationofintensivecareduringthecovid19pandemic AT lohelakarlssonmalin fromthreateningchaostotemporaryorderthroughacomplexprocessofadaptationagroundedtheorystudyoftheescalationofintensivecareduringthecovid19pandemic AT castegrenmarkus fromthreateningchaostotemporaryorderthroughacomplexprocessofadaptationagroundedtheorystudyoftheescalationofintensivecareduringthecovid19pandemic AT condenmellgrenemelie fromthreateningchaostotemporaryorderthroughacomplexprocessofadaptationagroundedtheorystudyoftheescalationofintensivecareduringthecovid19pandemic AT ekstedtmirjam fromthreateningchaostotemporaryorderthroughacomplexprocessofadaptationagroundedtheorystudyoftheescalationofintensivecareduringthecovid19pandemic AT bjurlingsjobergpetronella fromthreateningchaostotemporaryorderthroughacomplexprocessofadaptationagroundedtheorystudyoftheescalationofintensivecareduringthecovid19pandemic |