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Papers by Christina C. Wieczorek
Health Sociology Review, 2015
ABSTRACT Health promotion, as one tool of hospital managers to reorient hospitals towards more cl... more ABSTRACT Health promotion, as one tool of hospital managers to reorient hospitals towards more client-oriented healthcare services, has been emphasized for almost three decades. Yet, it is recognized that change in hospitals is challenging and is more desired than substantially enacted. To overcome organizational challenges, health promotion has, so far, adapted organizational change strategies primarily applied in business organizations. However, in this paper, it is argued that such strategies do not adequately reflect the nature of hospitals as ‘professional organizations’. To gain a better understanding of the challenges for health promotion reorientation, this paper combines well-established theories from the sociology of professions and organizational science. These theories provide a useful framework that advances the role of professionals as powerful agents within any reorientation efforts in hospitals. This framework guided the narrative review of empirical literature on critical dimensions along which professionals engage with reorientation efforts in hospitals. Accordingly, specific managerial strategies to facilitate health promotion reorientation are formulated. With its theoretical underpinnings and related empirical studies, the paper offers a new perspective on the challenges of implementing health promotion and proposes strategies that may help hospital managers to push forward health promotion reorientation in their organizations.
Pravention Und Gesundheitsforderung, 2014
BMC health services research, 2016
The health benefits of breastfeeding for mothers and babies are well documented in the scientific... more The health benefits of breastfeeding for mothers and babies are well documented in the scientific literature. Research suggests that support of breastfeeding during pre- and postnatal maternity care is an important determinant of breastfeeding initiation and duration. To support and promote breastfeeding on maternity units, the Baby-Friendly Hospital Initiative (BFHI) was launched in 1991. In Austria, however, less than one fifth of hospitals with a maternity unit are currently BFHI-certified. Implementation of BFHI and adjunct changes in work practices seem to represent a major challenge to maternity units. This article builds upon previous research that has identified a number of facilitators of and barriers to BFHI implementation in Austria. A major barrier has been the lack of intra- and inter-professional collaboration. Therefore, this article investigates the ways in which different healthcare professionals struggle to work together to successfully integrate the BFHI into prac...
Prävention und Gesundheitsförderung, 2015
ABSTRACT Hintergrund und Ziele: Der Artikel stellt die Ergebnisevaluation eines in Österreich zwi... more ABSTRACT Hintergrund und Ziele: Der Artikel stellt die Ergebnisevaluation eines in Österreich zwischen 2011 und 2013 durchgeführten, vom Österreichischen Netzwerk Gesundheitsfördernder Krankenhäuser (ONGKG) koordinierten Roll-out der von WHO und UNICEF initiierten „Baby-friendly Hospital Initiative“ (BFHI) dar. Zentrales Ziel war es, BFHI in Österreich bekannter zu machen und mehr Einrichtungen gemäß den Baby-friendly-Kriterien zu zertifizieren. Vor dem Hintergrund der ökonomischen Krise der letzten Jahre orientierten sich die Ziele des Roll-out an aus dem Fundraising entlehnten Modellen der stufenweisen Heranführung an Investitionsthemen. Material und Methoden: Die begleitende Evaluation folgte Dietschers Modell der Funktionalität und Effektivität von Setting-Netzwerken in der Gesundheitsförderung. Für die Evaluation wurde ein Methodenmix eingesetzt, zwei Fragebogenerhebungen unter leitenden geburtshilflichen Mitarbeitern 2012 und 2013 und deskriptiv-vergleichende Auswertungen steuerten wesentliche Daten bei. Ergebnisse und Diskussion: Insgesamt wurden die Ziele des Roll-out erreicht. Die Anzahl zertifizierter Einrichtungen konnte um 25 % gesteigert werden, die Orientierung des Roll-out an Fundraisingkonzepten scheint sich bewährt zu haben. Die Netzwerkstrategie der personellen Kapazitätsentwicklung aus Dietschers Modell spielte für die aktive Involvierung von Geburtshilfen eine besonders wichtige Rolle. Trotz Koordination des Roll-out durch das ONGKG konnten Mitgliedseinrichtungen dieses Netzwerks nicht stärker für BFHI motiviert werden als andere Einrichtungen.
International breastfeeding journal, 2015
The Baby-Friendly Hospital Initiative (BFHI) aims to promote and support breastfeeding. Globally,... more The Baby-Friendly Hospital Initiative (BFHI) aims to promote and support breastfeeding. Globally, around 20,000 facilities have been designated Baby-Friendly. In Austria, however, only 16% of the maternity units have received BFHI-certification. Internationally, few studies have investigated facilitating or hindering factors for BFHI implementation. The need to extend BFHI-certification rates has been investigated previously, but little is known about why maternity units decide to become BFHI-certified, how BFHI is installed at the unit level, and which factors facilitate or impede the operation of the BFHI in Austria and how barriers are overcome. Using a qualitative approach, (health) professionals' perceptions of the selection, installation, as well as facilitators of and barriers to the BFHI were investigated. 36 semi-structured interviews with persons responsible for BFHI implementation (midwives, nurses, physicians, quality manager) were conducted in three Austrian materni...
Prävention und Gesundheitsförderung, 2014
Health Sociology Review, 2015
Health promotion, as one tool of hospital managers to reorient hospitals towards more clientorien... more Health promotion, as one tool of hospital managers to reorient hospitals towards more clientoriented healthcare services, has been emphasized for almost three decades. Yet, it is recognized that change in hospitals is challenging and is more desired than substantially enacted. To overcome organizational challenges, health promotion has, so far, adapted organizational change strategies primarily applied in business organizations. However, in this paper, it is argued that such strategies do not adequately reflect the nature of hospitals as ‘professional organizations’. To gain a better understanding of the challenges for health promotion reorientation, this paper combines well-established theories from the sociology of professions and organizational science. These theories provide a useful framework that advances the role of professionals as powerful agents within any reorientation efforts in hospitals. This framework guided the narrative review of empirical literature on critical dimensions along which professionals engage with reorientation efforts in hospitals. Accordingly, specific managerial strategies to facilitate health promotion reorientation are formulated. With its theoretical underpinnings and related empirical studies, the paper offers a new perspective on the challenges of implementing health promotion and proposes strategies that may help hospital managers to push forward health promotion reorientation in their organizations.
Link:
http://www.tandfonline.com/doi/abs/10.1080/14461242.2015.1041541?journalCode=rhsr20#.Vbo0-LXkT94
Following the trend in most developed countries, in Austria the oldest old are the fastest growin... more Following the trend in most developed countries, in Austria the oldest old are the fastest growing population group. Among this group, there is a high prevalence of multimorbidity, functional impairment, dementia, and psychiatric conditions. While health promotion (HP) has been considered relevant in coping with the challenges of an aging population, it has so far been viewed as a foreign concept in relation to the oldest old, especially those living in residential aged care (RAC) facilities. Although there is an acknowledgement that HP should be integrated into routine nursing, there has been little research on how professionals working in RAC interpret and implement HP. In this study, thirteen semi-structured interviews were carried out with professionals from four major Austrian RAC providers. Data was analyzed using thematic analysis. The findings show that, typically, professionals understand HP as a concept that is oriented towards maintaining potentials and resources, thereby promoting self-determination, autonomy, and social integration, including frail and functionally impaired elderly residents. However, data analysis also revealed a gap between the conceptual understanding and positive attitudes towards HP and its implementation in practice. Implementation of HP seems to occur in isolated cases, related to specific health issues. It seems that more complex HP approaches, especially the ‘settings approach’, are hardly practiced. To implement more comprehensive and systematic HP in Austrian RAC, support from external HP agencies as well as changes in financial incentives are needed.
Health Sociology Review, 2015
ABSTRACT Health promotion, as one tool of hospital managers to reorient hospitals towards more cl... more ABSTRACT Health promotion, as one tool of hospital managers to reorient hospitals towards more client-oriented healthcare services, has been emphasized for almost three decades. Yet, it is recognized that change in hospitals is challenging and is more desired than substantially enacted. To overcome organizational challenges, health promotion has, so far, adapted organizational change strategies primarily applied in business organizations. However, in this paper, it is argued that such strategies do not adequately reflect the nature of hospitals as ‘professional organizations’. To gain a better understanding of the challenges for health promotion reorientation, this paper combines well-established theories from the sociology of professions and organizational science. These theories provide a useful framework that advances the role of professionals as powerful agents within any reorientation efforts in hospitals. This framework guided the narrative review of empirical literature on critical dimensions along which professionals engage with reorientation efforts in hospitals. Accordingly, specific managerial strategies to facilitate health promotion reorientation are formulated. With its theoretical underpinnings and related empirical studies, the paper offers a new perspective on the challenges of implementing health promotion and proposes strategies that may help hospital managers to push forward health promotion reorientation in their organizations.
Pravention Und Gesundheitsforderung, 2014
BMC health services research, 2016
The health benefits of breastfeeding for mothers and babies are well documented in the scientific... more The health benefits of breastfeeding for mothers and babies are well documented in the scientific literature. Research suggests that support of breastfeeding during pre- and postnatal maternity care is an important determinant of breastfeeding initiation and duration. To support and promote breastfeeding on maternity units, the Baby-Friendly Hospital Initiative (BFHI) was launched in 1991. In Austria, however, less than one fifth of hospitals with a maternity unit are currently BFHI-certified. Implementation of BFHI and adjunct changes in work practices seem to represent a major challenge to maternity units. This article builds upon previous research that has identified a number of facilitators of and barriers to BFHI implementation in Austria. A major barrier has been the lack of intra- and inter-professional collaboration. Therefore, this article investigates the ways in which different healthcare professionals struggle to work together to successfully integrate the BFHI into prac...
Prävention und Gesundheitsförderung, 2015
ABSTRACT Hintergrund und Ziele: Der Artikel stellt die Ergebnisevaluation eines in Österreich zwi... more ABSTRACT Hintergrund und Ziele: Der Artikel stellt die Ergebnisevaluation eines in Österreich zwischen 2011 und 2013 durchgeführten, vom Österreichischen Netzwerk Gesundheitsfördernder Krankenhäuser (ONGKG) koordinierten Roll-out der von WHO und UNICEF initiierten „Baby-friendly Hospital Initiative“ (BFHI) dar. Zentrales Ziel war es, BFHI in Österreich bekannter zu machen und mehr Einrichtungen gemäß den Baby-friendly-Kriterien zu zertifizieren. Vor dem Hintergrund der ökonomischen Krise der letzten Jahre orientierten sich die Ziele des Roll-out an aus dem Fundraising entlehnten Modellen der stufenweisen Heranführung an Investitionsthemen. Material und Methoden: Die begleitende Evaluation folgte Dietschers Modell der Funktionalität und Effektivität von Setting-Netzwerken in der Gesundheitsförderung. Für die Evaluation wurde ein Methodenmix eingesetzt, zwei Fragebogenerhebungen unter leitenden geburtshilflichen Mitarbeitern 2012 und 2013 und deskriptiv-vergleichende Auswertungen steuerten wesentliche Daten bei. Ergebnisse und Diskussion: Insgesamt wurden die Ziele des Roll-out erreicht. Die Anzahl zertifizierter Einrichtungen konnte um 25 % gesteigert werden, die Orientierung des Roll-out an Fundraisingkonzepten scheint sich bewährt zu haben. Die Netzwerkstrategie der personellen Kapazitätsentwicklung aus Dietschers Modell spielte für die aktive Involvierung von Geburtshilfen eine besonders wichtige Rolle. Trotz Koordination des Roll-out durch das ONGKG konnten Mitgliedseinrichtungen dieses Netzwerks nicht stärker für BFHI motiviert werden als andere Einrichtungen.
International breastfeeding journal, 2015
The Baby-Friendly Hospital Initiative (BFHI) aims to promote and support breastfeeding. Globally,... more The Baby-Friendly Hospital Initiative (BFHI) aims to promote and support breastfeeding. Globally, around 20,000 facilities have been designated Baby-Friendly. In Austria, however, only 16% of the maternity units have received BFHI-certification. Internationally, few studies have investigated facilitating or hindering factors for BFHI implementation. The need to extend BFHI-certification rates has been investigated previously, but little is known about why maternity units decide to become BFHI-certified, how BFHI is installed at the unit level, and which factors facilitate or impede the operation of the BFHI in Austria and how barriers are overcome. Using a qualitative approach, (health) professionals' perceptions of the selection, installation, as well as facilitators of and barriers to the BFHI were investigated. 36 semi-structured interviews with persons responsible for BFHI implementation (midwives, nurses, physicians, quality manager) were conducted in three Austrian materni...
Prävention und Gesundheitsförderung, 2014
Health Sociology Review, 2015
Health promotion, as one tool of hospital managers to reorient hospitals towards more clientorien... more Health promotion, as one tool of hospital managers to reorient hospitals towards more clientoriented healthcare services, has been emphasized for almost three decades. Yet, it is recognized that change in hospitals is challenging and is more desired than substantially enacted. To overcome organizational challenges, health promotion has, so far, adapted organizational change strategies primarily applied in business organizations. However, in this paper, it is argued that such strategies do not adequately reflect the nature of hospitals as ‘professional organizations’. To gain a better understanding of the challenges for health promotion reorientation, this paper combines well-established theories from the sociology of professions and organizational science. These theories provide a useful framework that advances the role of professionals as powerful agents within any reorientation efforts in hospitals. This framework guided the narrative review of empirical literature on critical dimensions along which professionals engage with reorientation efforts in hospitals. Accordingly, specific managerial strategies to facilitate health promotion reorientation are formulated. With its theoretical underpinnings and related empirical studies, the paper offers a new perspective on the challenges of implementing health promotion and proposes strategies that may help hospital managers to push forward health promotion reorientation in their organizations.
Link:
http://www.tandfonline.com/doi/abs/10.1080/14461242.2015.1041541?journalCode=rhsr20#.Vbo0-LXkT94
Following the trend in most developed countries, in Austria the oldest old are the fastest growin... more Following the trend in most developed countries, in Austria the oldest old are the fastest growing population group. Among this group, there is a high prevalence of multimorbidity, functional impairment, dementia, and psychiatric conditions. While health promotion (HP) has been considered relevant in coping with the challenges of an aging population, it has so far been viewed as a foreign concept in relation to the oldest old, especially those living in residential aged care (RAC) facilities. Although there is an acknowledgement that HP should be integrated into routine nursing, there has been little research on how professionals working in RAC interpret and implement HP. In this study, thirteen semi-structured interviews were carried out with professionals from four major Austrian RAC providers. Data was analyzed using thematic analysis. The findings show that, typically, professionals understand HP as a concept that is oriented towards maintaining potentials and resources, thereby promoting self-determination, autonomy, and social integration, including frail and functionally impaired elderly residents. However, data analysis also revealed a gap between the conceptual understanding and positive attitudes towards HP and its implementation in practice. Implementation of HP seems to occur in isolated cases, related to specific health issues. It seems that more complex HP approaches, especially the ‘settings approach’, are hardly practiced. To implement more comprehensive and systematic HP in Austrian RAC, support from external HP agencies as well as changes in financial incentives are needed.