Table 4

Theme: Context

Category

Sub-category

Group


Explicit strategy: adopters (unit I)

Explicit strategy: non-adopters (units II-III)

Implicit strategy: non-adopters (units IV-VI)


Working conditions

Work load

"We are the same work force ... we follow routines as usual ... some days there's more to do and others less - it depends on how many patients there are and how many are on duty." (Others, unit I)

"Of course things go up and down along with how many patients we have and how things flow ... so it's been, I suppose, normal." (Nurse, unit II)

"It has been, I suppose, a fairly strained situation actually, so much so that there's no time for more than what absolutely must be done, you must make priorities."

(Nurse, unit IV)

Organi-zational change

"Moreover, there are some new things constantly popping up on the computer to be learned." (Nurse, unit I)

"It is neither something that has arisen or disappeared." (Nurse, unit II)

"We had to introduce a new operative computer system while at the same time, reorganize home care." (GP, unit V)

"We haven't had a manager for several months ... just got a new manager. That is, I guess, the greatest change." (GP, unit III)

"An unbelievable amount has happened here ... doctors in private practice ceased January 1 and we have also gotten a new telephone system." (Others, unit VI)

Staff situation

"We are basically well manned..." (GP, unit I)

"Many district nurses have been on sick leave lately." (GP, unit III)

"Then we hired in doctors here and were... understaffed ... and new personnel has come in ... the nursing staff was also renewed." (Others, unit VI)

"Our manager has been sick and absent quite a lot because of that, and that has, of course, been a factor." (GP, unit II)

Emotional

Loss of control/frustration

"We have gotten by, I suppose." (Nurse, unit III)

"Our wings have been clipped."

(Nurse, unit V)

"It affects the work environment, you could say, there is a higher stress level in some way, and more ... just that you can't feel that you can influence your work environment, either, so to speak, are factors you can't really steer ..." (GP, unit IV)

Hope

"And we have, I suppose, learned that we can't spend all our energy complaining." (Nurse, unit V)

"I feel, although, that things have stabilised now - not so much uneasiness amongst the patients." (Nurse, unit VI)


Quotations supporting the results of the different categories, according to groups based on adoption and implementation strategy.

[...], some words left out; ..., hesitation; [ ] author comment.

Carlfjord et al. BMC Family Practice 2010 11:60   doi:10.1186/1471-2296-11-60

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