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...

Descripción completa

Detalles Bibliográficos
Autores principales: Göras, Camilla, Lohela-Karlsson, Malin, Castegren, Markus, Condén Mellgren, Emelie, Ekstedt, Mirjam, Bjurling-Sjöberg, Petronella
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