Nordin Annika Maria Margareta, Andersson Gäre Boel, Andersson Ann-Christine
The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University , Jönköping, Sweden and Qulturum, Region Jönköping County, Sweden.
The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University , Jönköping, Sweden and Futurum Academy for Health and Care, Region Jönköping County, Sweden.
Leadersh Health Serv (Bradf Engl). 2018 Oct 1;31(4):371-383. doi: 10.1108/LHS-03-2017-0013. Epub 2018 Jan 10.
Purpose The purpose of this study is to examine and establish how sensemaking develops among a group of external change agents (ECAs) engaged to disseminate a national quality register nationwide in Swedish health care and elderly care. To study the emergent sensemaking, the theoretical concept of cognitive shift has been used. Design/methodology/approach The data collection method included individual semi-structured interviews, and two sets of interviews (initial sensemaking and renewed sensemaking) have been conducted. Based on a typology describing how ECAs interpret their work, structural analyses and comparisons of initial and renewed sensemaking are made and illuminated in spider diagrams. The data are then analyzed to search for cognitive shifts. Findings The ECAs' sensemaking develops. Three cognitive shifts are identified, and a new kind of issue-related cognitive shift, the outcome-related cognitive shift, is suggested. For the ECAs to customize their work, they need to be aware of how they interpret their own work and how these interpretations develop over time. Originality/value The study takes a novel view of the interrelated concepts of sensemaking and sensegivers and points out the cognitive shifts as a helpful theoretical concept to study how sensemaking develops.
目的 本研究的目的是考察并确定在一群负责在瑞典医疗保健和老年护理领域全国范围内推广国家质量登记册的外部变革推动者（ECA）中，意义建构是如何发展的。为了研究这种新兴的意义建构，采用了认知转变这一理论概念。设计/方法/途径 数据收集方法包括个体半结构化访谈，并且进行了两组访谈（初始意义建构和重新意义建构）。基于一种描述ECA如何解释其工作的类型学，对初始意义建构和重新意义建构进行了结构分析和比较，并在蛛网图中加以说明。然后对数据进行分析以寻找认知转变。发现 ECA的意义建构在发展。识别出了三种认知转变，并提出了一种新的与问题相关的认知转变，即与结果相关的认知转变。为了使ECA能够定制他们的工作，他们需要意识到自己如何解释自己的工作以及这些解释如何随时间发展。原创性/价值 该研究对意义建构和意义给予者的相关概念提出了新颖的观点，并指出认知转变是研究意义建构如何发展的一个有用的理论概念。
