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1 – 10 of over 8000Vanessa Pinfold, Ceri Dare, Sarah Hamilton, Harminder Kaur, Ruth Lambley, Vicky Nicholls, Irene Petersen, Paulina Szymczynska, Charlotte Walker and Fiona Stevenson
The purpose of this paper is to understand how women with a diagnosis of schizophrenia or bipolar disorder approach medication decision making in pregnancy.
Abstract
Purpose
The purpose of this paper is to understand how women with a diagnosis of schizophrenia or bipolar disorder approach medication decision making in pregnancy.
Design/methodology/approach
The study was co-produced by university academics and charity-based researchers. Semi-structured interviews were conducted by three peer researchers who have used anti-psychotic medication and were of child bearing age. Participants were women with children under five, who had taken anti-psychotic medication in the 12 months before pregnancy. In total, 12 women were recruited through social media and snowball techniques. Data were analyzed following a three-stage process.
Findings
The accounts highlighted decisional uncertainty, with medication decisions situated among multiple sources of influence from self and others. Women retained strong feelings of personal ownership for their decisions, whilst also seeking out clinical opinion and accepting they had constrained choices. Two styles of decision making emerged: shared and independent. Shared decision making involved open discussion, active permission seeking, negotiation and coercion. Independent women-led decision making was not always congruent with medical opinion, increasing pressure on women and impacting pregnancy experiences. A common sense self-regulation model explaining management of health threats resonated with women’s accounts.
Practical implications
Women should be helped to manage decisional conflict and the emotional impact of decision making including long term feelings of guilt. Women experienced interactions with clinicians as lacking opportunities for enhanced support except in specialist perinatal services. This is an area that should be considered in staff training, supervision, appraisal and organization review.
Originality/value
This paper uses data collected in a co-produced research study including peer researchers.
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Maria Bendtsen Kronkvist, Karl-Anton Forsberg, Margareta Rämgård, Mikael Sandlund, Tove Janarv and Patrik Dahlqvist Jönsson
The purpose of this study was to describe mental health professionals’ experiences of changes in attitudes towards, and knowledge about, users of mental health-care recovery and…
Abstract
Purpose
The purpose of this study was to describe mental health professionals’ experiences of changes in attitudes towards, and knowledge about, users of mental health-care recovery and decisional participation in clinical practice after an educational intervention.
Design/methodology/approach
Users of mental health care want to participate in decisions regarding their own mental health care. Shared decision-making as a method is coherent with recovery orientation in mental health services and results in better-informed patients and fewer conflicts regarding decisions. A qualitative intervention study was designed to evaluate changes in attitudes and knowledge about mental health recovery in Sweden. Nine participants were interviewed, and the data were analysed by content analysis.
Findings
Three categories were generated from the analysis: Increased theoretical knowledge, changing attitudes about practical approaches and the significance of social factors in recovery.
Originality/value
When shared decision-making is to be implemented in mental health, professionals need to gain knowledge about recovery and need to adopt changed roles as health professionals. Educational interventions therefore seem necessary if such changes are to happen.
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Maria Bendtsen Kronkvist, Patrik Dahlqvist Jönsson, Karl-Anton Forsberg and Mikael Sandlund
The purpose of this study is to describe participation in decision-making among service users with severe mental illness.
Abstract
Purpose
The purpose of this study is to describe participation in decision-making among service users with severe mental illness.
Design/methodology/approach
Service users want to participate in decision-making and in the planning of their care. There are widely known methods, such as shared decision-making, that could be used to facilitate service user participation. Three focus group interviews were conducted with the participation of 14 persons with mental illness and/or substance abuse who were service users at two Swedish Homes for Care and Residence (HVB). Data were analyzed by qualitative content analysis.
Findings
Two themes emerged: service users’ involvement in decisions is hampered by the professionals’ approach and adequate information and experience of participation means greater empowerment.
Research limitations/implications
Although it is known that service users would like to have more influence, and that methods like shared decision-making are recommended to empower service users and improve the decision process, research on these matters is limited.
Practical implications
This study reveals that there is a need of more systematic decisional support, such as shared decision-making, so that service users can be seen as important persons not only in guidelines and policy documents but also in clinical practice.
Social implications
The findings indicate that service users do not participate in decisions systematically, although policies, guidelines and laws providing that service users should be offered an active part in decision-making with regard to their care and treatment.
Originality/value
Although it is known that service users would like to have more influence, and that methods like shared decision-making are recommended to empower service users and improve their decision process, research on these matters is limited. The findings indicate that service users do not participate in decisions systematically, even though policies, guidelines and laws are in place stipulating that service users should be offered an active part in decision-making with regard to their own care and treatment. The results of this project bring improvement opportunities to light.
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Matteo Cristofaro, Christopher P. Neck, Pier Luigi Giardino and Christopher B. Neck
This study aims to investigate the relationship between shared leadership (SL) and decision quality, utilizing shared leadership theory (SLT) and behavioral decision theory (BDT)…
Abstract
Purpose
This study aims to investigate the relationship between shared leadership (SL) and decision quality, utilizing shared leadership theory (SLT) and behavioral decision theory (BDT). The authors will explore the mediating role of “decision comprehensiveness” in the SL–decision quality linkage. Additionally, the authors will examine how individual “self-leadership” and “debate” among team members moderate the relationship between SL and decision comprehensiveness.
Design/methodology/approach
The authors tested the hypothesized moderated mediation model using a sample of 506 professionals employed in 112 research and development (R&D) teams, along with their direct managers from large Italian firms. To examine the relationships, the authors employed confirmatory factor analyses and path analyses. In order to address endogeneity concerns, the authors incorporated an instrumental variable, namely delegation, into the analysis.
Findings
SL positively influences decision quality, mediated by decision comprehensiveness, where teams include comprehensive information in decision-making. The level of debate among team members positively moderates the SL–decision comprehensiveness relationship. High levels of self-leadership can harm SL by reducing decision comprehensiveness, indicating a downside. However, low or moderate levels of self-leadership do not harm decision comprehensiveness and can even benefit SL.
Originality/value
This is the first work to investigate the relationship between SL and decision quality, shedding light on the mechanisms underlying this association. By integrating SLT and BDT, the authors provide insights into how managers can make higher-quality decisions within self-leading teams. Moreover, this research makes a distinct contribution to the field of self-leadership by delineating its boundaries and identifying a potentially negative aspect within the self-influence process.
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Hsing-Er Lin, Rachel Sheli Shinnar, Yongchuan Shi and Dan Hsu
This study explores the role of polychronic temporal orientation and decision-making decentralization on founders' perceptions of entrepreneurial self-efficacy (ESE).
Abstract
Purpose
This study explores the role of polychronic temporal orientation and decision-making decentralization on founders' perceptions of entrepreneurial self-efficacy (ESE).
Design/methodology/approach
Longitudinal survey data were collected from 141 business founders in China.
Findings
Findings suggest that decision-making decentralization is positively associated with founders' ESE. In addition, a polychronic temporal orientation is positively related to ESE, and this relationship is mediated by decision-making decentralization.
Originality/value
This study adds to existing knowledge on ESE and temporal related issues by presenting empirical evidence that explains how and why the temporal orientation context and the practice of decision-making decentralization can shape ESE perceptions among venture founders.
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Paolo Canonico, Ernesto De Nito, Vincenza Esposito, Gerarda Fattoruso, Mario Pezzillo Iacono and Gianluigi Mangia
The paper focuses on how knowledge visualization supports the development of a particular multiobjective decision-making problem as a portfolio optimization problem in the context…
Abstract
Purpose
The paper focuses on how knowledge visualization supports the development of a particular multiobjective decision-making problem as a portfolio optimization problem in the context of interorganizational collaboration between universities and a large automotive company. This paper fits with the emergent knowledge visualization literature because it helps to explain decision-making related to the development of a multiobjective optimization model in Lean Product Development settings. We investigate how using ad hoc visual tools supports knowledge translation and knowledge sharing, enhancing managerial judgment and decision-making.
Design/methodology/approach
The empirical case in this study concerns the setting up of a multiobjective decision-making model as a portfolio optimization problem to analyze and select alternatives for upgrading the lean production process quality at an FCA plant.
Findings
The study shows how knowledge visualization and the associated tools work to enable knowledge translation and knowledge sharing, supporting decision-making. The empirical findings show why and how knowledge visualization can be used to foster knowledge translation and sharing among individuals and from individuals to groups. Knowledge visualization is understood as both a collective and interactional process and a systematic approach where different players translate their expertise, share a framework and develop common ground to support decision-making.
Originality/value
From a theoretical perspective, the paper expands the understanding of knowledge visualization as a system of practices that support the development of a multiobjective decision-making method. From an empirical point of view, our results may be useful to other firms in the automotive industry and for academics wishing to develop applied research on portfolio optimization.
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Erno Salmela and Janne Huiskonen
The purpose of this paper is to promote decision-making structures between the customer and the supplier in a highly uncertain environment. This phenomenon of demand-supply chain…
Abstract
Purpose
The purpose of this paper is to promote decision-making structures between the customer and the supplier in a highly uncertain environment. This phenomenon of demand-supply chain synchronisation includes sharing of high-quality and timely demand and supply information in order to improve the quality and speed of decision-making.
Design/methodology/approach
The study was carried out as an abductive case study, which started from empirical observations that did not match the prior theoretical framework. Through abductive reasoning and empirical experiments, the prior framework was extended to a new synchronisation model and tools that better accommodate the observed need.
Findings
A new co-innovation toolbox was developed to create common understanding of demand-supply chain synchronisation between the customer and the supplier. The toolbox includes Demand Visibility Point-Demand Penetration Point, Supply Visibility Point–Supply Penetration Point and Integrative Synchronisation tools.
Research limitations/implications
The study extends the current models and tools of demand-supply chain synchronisation. With the new toolbox, the development needs of decision-making structures can be identified more comprehensively than with the current tools.
Practical implications
The developed visual toolbox helps partners create a common understanding of problems and development possibilities in demand-supply chain synchronisation in a highly uncertain environment. Common understanding is a starting point for changing decision-making structures to improve the overall performance of a demand-supply chain.
Originality/value
The new toolbox is both more comprehensive and more detailed than the previous tools.
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Taina Hannele Kanninen, Arja Häggman-Laitila, Tarja Tervo-Heikkinen and Tarja Kvist
The purpose of this study is to describe council structure, its benefits, supportive and obstructive factors and developmental needs as a part of shared governance in a university…
Abstract
Purpose
The purpose of this study is to describe council structure, its benefits, supportive and obstructive factors and developmental needs as a part of shared governance in a university hospital.
Design/methodology/approach
This is a descriptive study, where semi-structured interviews with 12 nurses was conducted in 2014 and documents from 75 council meetings from 2009 to 2014 were gathered and analyzed. Qualitative content analysis method was used on the data.
Findings
The study hospital has been developing nursing shared governance with unique structure and processes of councils. Professors and university researchers act as chair and members are voluntary nursing staff. The factors supporting the councils are nurse managers’ support, enthusiastic personnel and neighboring university. The factors obstructing the councils are lack of time, understanding and skills. The work of the councils benefits the organization by improving patient care, harmonizing nursing practices and informing decision-making. The council’s developmental needs were more visibility, concentration into everyday problems and interprofessionality.
Research limitations/implications
Applying nursing shared governance structures into an organization improves the professional practice environment of nursing personnel.
Practical implications
The study hospital has its own, unique council structure. It did not cover the whole hospital or all of the nursing personnel, but it is already producing promising results. It should be given an official status and more support from nurse managers, and it should be developed into an inter-professional discussion. The results presented here indicate that shared governance, even, in its early stage, contributes positively to the quality of care, harmonizes nursing practices and informs decision-making. Applying shared governance structures into an organization improves the professional practice environment of nursing personnel. The study showed concrete supporting and obstructing factors that should be notified in nursing leadership.
Originality/value
Despite the extensive empirical studies on nursing shared governance, there is very little research on councils in the Scandinavian countries.
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Tom A.E. Aben, Wendy van der Valk, Jens K. Roehrich and Kostas Selviaridis
Inter-organisational governance is an important enabler for information processing, particularly in relationships undergoing digital transformation (DT) where partners depend on…
Abstract
Purpose
Inter-organisational governance is an important enabler for information processing, particularly in relationships undergoing digital transformation (DT) where partners depend on each other for information in decision-making. Based on information processing theory (IPT), the authors theoretically and empirically investigate how governance mechanisms address information asymmetry (uncertainty and equivocality) arising in capturing, sharing and interpreting information generated by digital technologies.
Design/methodology/approach
IPT is applied to four cases of public–private relationships in the Dutch infrastructure sector that aim to enhance the quantity and quality of information-based decision-making by implementing digital technologies. The investigated relationships are characterised by differing degrees and types of information uncertainty and equivocality. The authors build on rich data sets including archival data, observations, contract documents and interviews.
Findings
Addressing information uncertainty requires invoking contractual control and coordination. Contract clauses should be precise and incentive schemes functional in terms of information requirements. Information equivocality is best addressed by using relational governance. Identifying information requirements and reducing information uncertainty are a prerequisite for the transformation activities that organisations perform to reduce information equivocality.
Practical implications
The study offers insights into the roles of both governance mechanisms in managing information asymmetry in public–private relationships. The study uncovers key activities for gathering, sharing and transforming information when using digital technologies.
Originality/value
This study draws on IPT to study public–private relationships undergoing DT. The study links contractual control and coordination as well as relational governance mechanisms to information-processing activities that organisations deploy to reduce information uncertainty and equivocality.
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Hannele Roponen, Elina Fonsén, Tuulikki Ukkonen-Mikkola and Raisa Ahtiainen
This study examines the social organizational structure of one early childhood education (ECE) center in Finland and the relationship between this structure and the roles and the…
Abstract
Purpose
This study examines the social organizational structure of one early childhood education (ECE) center in Finland and the relationship between this structure and the roles and the responsibilities of the members of the organization.
Design/methodology/approach
The research is a qualitative case study with ethnographic features. Its variables for content analysis are based on Henry Mintzberg's theory of organizational design.
Findings
The study's results show that the organizational structure of the ECE center follows the organizational configuration of a Professional bureaucracy and that the multiprofessional teams follow the configuration of a Simple structure. The structures for centralization and decentralization are suitable for a professional bureaucracy, but the roles of the members of the organization and the processes for shared decision-making lack clarification. The shortage of qualified ECE teachers disrupts the function of the organization and the work of ECE leaders.
Research limitations/implications
The educational background of subjects may have affected the findings.
Originality/value
The study uses Henry Mintzberg's organizational structure theory to evaluate how and why power is distributed and activities are coordinated at the ECE center. The results also show what parts of the organization pose challenges that most commonly disrupt the organization's operations. With these findings, it is possible to expand the understanding of roles and responsibilities in the currently reforming ECE environment and what ECE centers need to function effectively. The study is part of a larger research project and will be continued to examine the leadership culture of the ECE center.
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