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  • 1.
    Algilani, Samal
    et al.
    Örebro universitet.
    James, Inger
    Kihlgren, Annica
    Örebro universitet.
    Experiencing Participation in Health Care: “Through the Eyes of Older Adults”2016In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 6, no 1, p. 62-77Article in journal (Refereed)
    Abstract [en]

    Background: Patient participation is well understood by health care professionals but not many studies have focused on the older adults and their perceptions of patient participation. Aim and Objectives: To report an analysis of the concept of participation from the perspective of the older adult. Design: Concept analysis. Methods: An integrative review approach was undertaken and the searches were limited from January 2003 to December 2014, guiding question was; “what constitutes patient participation according to the older adult?” Results: Through the eyes of the older adults, a two-way communication should be initiated by the staff. Equality and sharing power between older adults and staffs was perceived as a precondition. Been given time was an essential issue, implying that older adults wished to have enough time from staffs and be in the right context surrounded by the appropriate environment in order to experience participation. Conclusion: In order to experience participation for older adults, it is important that the health care professionals are aware of how and in what ways they can contribute to participation among older adults. The need or wish to create participation is not enough; the health care professional needs to see and understand participation through the older adult’s eyes. Thus, a person-centered nursing approach is relevant for the health care professional in order to both give and maintain the experience of participation to the older adult.

  • 2.
    Algilani, Samal
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    James, Inger
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Kihlgren, Annica
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Experiencing Participation in Health Care: “Through the Eyes of Older Adults”2016In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 6, no 1, p. 62-77Article, review/survey (Refereed)
    Abstract [en]

    Background: Patient participation is well understood by health care professionals but not many studies have focused on the older adults and their perceptions of patient participation.

    Aim and Objectives: To report an analysis of the concept of participation from the perspective of the older adult. Design: Concept analysis.

    Methods: An integrative review approach was undertaken and the searches were limited from January 2003 to December 2014, guiding question was; “what constitutes patient participation according to the older adult?”

    Results: Through the eyes of the older adults, a two-way communication should be initiated by the staff. Equality and sharing power between older adults and staffs was perceived as a precondition. Been given time was an essential issue, implying that older adults wished to have enough time from staffs and be in the right context surrounded by the appropriate environment in order to experience participation.

    Conclusion: In order to experience participation for older adults, it is important that the health care professionals are aware of how and in what ways they can contribute to participation among older adults. The need or wish to create participation is not enough; the health care professional needs to see and understand participation through the older adult’s eyes. Thus, a person-centered nursing approach is relevant for the health care professional in order to both give and maintain the experience of participation to the older adult.

  • 3.
    Anderbro, Therese
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology. Karolinska Institutet, Sweden.
    Moberg, Erik
    Adamson, Ulf
    Lins, Per-Eric
    Johansson, Unn-Britt
    Beliefs and Experiences of Fear of Hypoglycemia and Use of Uncooked Cornstarch before Bedtime in Persons with Type 1-Diabetes2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 8, no 11, article id 88624Article in journal (Refereed)
    Abstract [en]

    Among persons living with type 1-diabetes hypoglycemia and fear of hypoglycemia remain limiting barriers for achieving optimal glucose control and a good quality of life. Fear of hypoglycemia has been found stable over time if not treated. Uncooked cornstarch has been found to reduce the risk of hypoglycemia but has not been studied in relation to fear of hypoglycemia. The aims of this study were to through clinical data, self-reported measures and clinical interviews explore subjects’ experience of using uncooked cornstarch before bedtime and their beliefs and experiences of fear of hypoglycemia. Methods: Mixed methods with both quantitative and qualitative data were used. Self-reported measures of hypoglycemia and fear of hypoglycemia were compared to subjects’ responses during a clinical interview. The interviews were analyzed with a functional behavior analytical approach. Results: A total of five subjects took part in the study. One subject perceived the uncooked cornstarch helpful in reducing hypoglycemia. Several subjects could recall frightening hypoglycemic episodes triggering their fear. Three out of the five subjects reported avoidance behaviors such as excessive self-monitoring of blood glucose or overeating related to fear of hypoglycemia. Conclusions: The uncooked cornstarch was found appetizing but was not perceived as having an effect on BG or hypoglycemia frequency. The clinical interviews confirmed previous research regarding experience of hypoglycemia and fear of hypoglycemia.

  • 4. Anderbro, Therese
    et al.
    Moberg, Erik
    Adamson, Ulf
    Lins, Per-Eric
    Johansson, Unn-Britt
    Sophiahemmet University.
    Beliefs and experiences of fear of hypoglycemiaand use of uncooked cornstarch before bedtime in persons with type 1-diabetes2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 8, p. 795-810Article in journal (Refereed)
    Abstract [en]

    Introduction: Among persons living with type 1-diabetes hypoglycemia and fear of hypoglycemia remain limiting barriers for achieving optimal glucose control and a good quality of life. Fear of hypoglycemia has been found stable over time if not treated. Uncooked cornstarch has been found to reduce the risk of hypoglycemia but has not been studied in relation to fear of hypogly-cemia. The aims of this study were to through clinical data, self-reported measures and clinical interviews explore subjects’ experience of using un-cooked cornstarch before bedtime and their beliefs and experiences of fear of hypoglycemia.

    Methods: Mixed methods with both quantitative and qualita-tive data were used. Self-reported measures of hypoglycemia and fear of hy-poglycemia were compared to subjects’ responses during a clinical interview. The interviews were analyzed with a functional behavior analytical approach.

    Results: A total of five subjects took part in the study. One subject perceived the uncooked cornstarch helpful in reducing hypoglycemia. Several subjects could recall frightening hypoglycemic episodes triggering their fear. Three out of the five subjects reported avoidance behaviors such as excessive self-monitoring of blood glucose or overeating related to fear of hypoglyce-mia. Conclusions: The uncooked cornstarch was found appetizing but was not perceived as having an effect on BG or hypoglycemia frequency. The clinical interviews confirmed previous research regarding experience of hy-poglycemia and fear of hypoglycemia.

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  • 5.
    Andersson, Gunnel
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Kaboru, Berthollet Bwira
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Adolfsson, Annsofie
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. The Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Buskerud & Vestfold University, College, Kongsberg, Norway.
    Namegabe, Edmond Ntabe
    Faculty of Community Health and Development, Université Libre des Pays des Grands Lacs, Goma, Congo Democratic Republic.
    Health Workers’ Assessment of the Frequency of and Caring for Urinary and Fecal Incontinence among Female Victims of Sexual Violence in the Eastern Congo: An Exploratory Study2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, p. 354-360Article in journal (Refereed)
    Abstract [en]

    Background: Throughout the long war that the Democratic Republic of Congo (DRC) has endured,women and children have been depicted as the primary victims of widespread sexual violence. Insome settings women have been raped in entire villages, with devastating physical and psychologicalconsequences, which include sexually transmitted infections such as HIV, trauma and fistulas,as well as social isolation and involuntary pregnancies. The aim of this study was to assess theprevalent perceptions of health professionals on the magnitude of urine and/or fecal incontinenceamong assaulted women, caused by sexual violence, as well as the opinions regarding the type ofcare provided to affected women.

    Methods: The study was part of a larger pilot study that had across-sectional design and a descriptive approach, which explored health professionals’ views regarding their own levels of competence at responding to the health needs of victims of sexual violence, in the form of a semi-structured questionnaire.

    Results: 104 health workers responded to the questionnaire. Nurses reported seeing raped women more frequently on a day-to-day basis (69.2%), in comparison to medical doctors and social workers (11.5%). Urinary incontinence was common according to 79% of health workers, who estimated that up to 15% of the women affected experienced huge amounts of urine leakage. Only 30% of the care seekers underwent in depth investigations, but the majority of the victims were not offered any further examination or appropriate treatments.

    Conclusion: Urinary and fecal incontinence due to urogenital or colorectalfistulas among women exposed to sexual violence is a common in the specified setting, but lack of systematic investigation and appropriate treatment means that the quality of life of the victims may be negatively affected. An improvement in the ability of health workers to manage these complex diagnoses is urgently needed, as well as adequately equipping health services in the affected settings.

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  • 6.
    Axelsson, Malin
    et al.
    Malmö University.
    Persson, Lena
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Höglund Nielsen, Birgitta
    Danmark.
    Living in the wake of Chronic Obstructive Pulmonary Disease and Long-Term Oxygen Therapy2016In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 6, p. 376-385Article in journal (Refereed)
    Abstract [en]

    Background: Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the world. COPD is a progressive disease that could lead to chronic hypoxemia, which requires treatment as domiciliary Long-Term Oxygen Therapy (LTOT). There is a need for increased knowledge about self-care strategies used by individuals living with COPD and LTOT. Objective: The aim was to explore experiences and self-care strategies in patients living with both COPD and LTOT. Sample: The sample consisted of five men and five women diagnosed with COPD being prescribed LTOT for more than one year. Method: Ten interviews were undertaken and analyzed for both manifest and latent content. Results: Living with COPD and LTOT was associated with experiences of guilt although there were doubts about what had caused the lung disease. Both the lung disease and the oxygen therapy had a negative impact on their self-image. Anxiety was expressed when thoughts about the remaining time occurred. There was a constant balance between diminishing abilities and increasing restrictions related to the lung disease and the therapy. In order to compensate for arising imbalance, self-care strategies had been initiated aimed at preserving the present state of health, enabling and facilitating physical activity and promoting a positive attitude. Conclusion: The current study suggests that individuals living with COPD and LTOT are encouraged to adopt self-care strategies directed towards maintaining stability with regard to the lung disease, the oxygen therapy, physical capability and emotional reactions.

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  • 7.
    Axelsson, Malin
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Persson, Lena
    Höglund-Nielsen, Birgitta
    Living in the Wake of Chronic Obstructive Pulmonary Disease and Long-Term Oxygen Therapy2016In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 6, p. 376-385Article in journal (Refereed)
    Abstract [en]

    Background: Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the world. COPD is a progressive disease that could lead to chronic hypoxemia, which requires treatment as domiciliary Long-Term Oxygen Therapy (LTOT). There is a need for increased knowledge about self-care strategies used by individuals living with COPD and LTOT. Objective: The aim was to explore experiences and self-care strategies in patients living with both COPD and LTOT. Sample: The sample consisted of five men and five women diagnosed with COPD being prescribed LTOT for more than one year. Method: Ten interviews were undertaken and analyzed for both manifest and latent content. Results: Living with COPD and LTOT was associated with experiences of guilt although there were doubts about what had caused the lung disease. Both the lung disease and the oxygen therapy had a negative impact on their self-image. Anxiety was expressed when thoughts about the remaining time occurred. There was a constant balance between diminishing abilities and increasing restrictions related to the lung disease and the therapy. In order to compensate for arising imbalance, self-care strategies had been initiated aimed at preserving the present state of health, enabling and facilitating physical activity and promoting a positive attitude. Conclusion: The current study suggests that individuals living with COPD and LTOT are encouraged to adopt self-care strategies directed towards maintaining stability with regard to the lung disease, the oxygen therapy, physical capability and emotional reactions.

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  • 8.
    Björk, Annette
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Rönngren, Ylva
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Selander, John
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hellzen, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Perspectives on Everyday Suffering among People with Adult Attention Deficit Hyperactivity Disorder and Concurrent Mental Disorders2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, p. 583-598Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the perceptions of everyday suffering among adults with attention deficit hyperactivity disorder (ADHD) and comorbid mental disease. Directed content analysis guided by Eriksson’s theory on human suffering was performed on data from 20 individual interviews. Expressions of both suffering and well-being were identified; the former centred on loneliness and related to life, illness, and care, which supported Eriksson’s theory, whereas expressions of well-being related to ADHD diagnosis and supportive social relationships. Nevertheless, results indicate the need to expand those expressions in order to better contribute to developing a supportive rehabilitation regimen that can provide more interpersonal care.

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  • 9.
    Brink, Eva
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Fredriksson-Larsson, Ulla
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Alsén, Pia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Lång, Marianne
    Department of Cardiology, NU Hospital Group, Trollhättan, Sweden.
    Cliffordson, Christina
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Development of a Tool for Assessment of Post-Myocardial Infarction Fatigue2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 08, no 11, p. 811-822Article in journal (Refereed)
    Abstract [en]

    Introduction: After treatment for myocardial infarction (MI) quite a few persons will experience different symptoms, including fatigue, during the recovery phase. The aim of the present study was to construct the multidimensional Post-Myocardial Infarction Fatigue (PMIF) scale, based on empirical data gathered in coronary heart disease contexts. Methods: The construction of the post-MI fatigue scale was conducted in seven steps, ending in a psychometric evaluation of the internal structure of the scale, using confirmatory factor analysis, as well as testing of convergent and discriminant validity, using correlational analysis, in a sample of 141 persons treated for MI. Results: The results showed that the PMIF scale represents three dimensions: physical, cognitive and emotional fatigue. It was also found that the scale is suitable for summing the items to obtain a total score representing a post-MI global fatigue dimension. Conclusion: The PMIF is a brief and easily completed scale for identifying persons experiencing post-MI fatigue. Early identification of fatigue, together with health behavior support, might prevent progression toward a more severe state of fatigue.

  • 10.
    Brink, Eva
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg.
    Skott, Carola
    University of Gothenburg, Institute of Health and Care Sciences.
    Caring about symptoms in person-centred care2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 8, p. 563-567Article in journal (Refereed)
    Abstract [en]

    In the present article, we emphasize the symptom experience perspective in person-centred care and discuss barriers to implementation of this approach. There are obstacles to overcome: the diversity of understandings of symptoms in clinical settings, the current biomedical discourse and the incompleteness of symptom research. Since the 19th century, the bio-medical perspective has been powerful in conceptualizing symptoms in terms of pathology and diagnosis. Many diagnoses conjure up preconceived notions about the persons receiving them. This perspective may influence person-centred care negatively. Yet symptoms often mean something beyond the diagnosis. Recognizing this discrepancy, it is crucial that we consider a perspective that starts from each person’s symptom experience, thus complementing the biomedical perspective. Using the notion caring about symptoms, we advocate a person-centred approach that includes a symptom experience perspective. This requires that health-care professionals be skilled in listening to patient narratives and acquire knowledge about how symptom experiences can be individually expressed and interpreted. Listening to symptom experiences may give insights into the personal meaning of illness as well as information about bodily and social restrictions caused by symptom distress. In this way, caring about symptoms will improve the prerequisites for establishing person-centred care planning.

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  • 11.
    Brodin, Kerstin
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Häggström, Marie
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Intraoperative Care of the Conscious Patient from the Perspective of the Operating Theatre Nurse: A Grounded Theory2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, no 9, p. 1086-1099Article in journal (Refereed)
    Abstract [en]

    Introduction: Intraoperative care includes a unique knowledge of how to

    perform a safe and effective surgery procedure. Surgery performed under regional

    or local anaesthesia allows the patient to remain conscious during the

    procedure and is rather common in Swedish healthcare today. Aim: The aim

    was to obtain a deeper understanding of the main concerns of operating theatre

    nurses (OTN) when caring for conscious patients during the intraoperative

    phase. Methods: Interviews were conducted with 23 OTNs from five different

    hospitals in Sweden and analysed according to grounded theory. Findings:

    The main concern among the OTNs was to take the patient in consideration.

    The core category “achieve and maintain ethical treatment of patients”

    in the operating theatre (OT) was a strategy used throughout the intraoperative

    process. Ethical treatment was described as moral behaviour at

    different levels and included the team’s behaviour, respectful and individualised

    patientcare, and the working-morale of the professionals. Being vigilant

    and being flexible were the categories related to the core category. The OTNs

    constantly assessed where to pay most attention as they balanced between the

    needs of the patient, the team, and the surgery procedure. Conclusion: It is

    important that every patient is taken into consideration and that ethical principles

    are held to the highest standards in the OT. A familiar team can facilitate

    that. The complex skills that operating theatre nurses develop can be

    added to explain important competencies within the profession.

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  • 12.
    Broström, Anders
    et al.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Department of Nursing Science, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Sunnergren, Ola
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Medicine and Health Sciences. Department of ENT, Ryhov Hospital, Jönköping, Sweden.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. School of Health and Caring Sciences, Faculty of Health, Social Work and Behavioural Sciences, Linnaeus University, Kalmar, Sweden.
    Johansson, Peter
    Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Fridlund, Bengt
    Department of Nursing Science, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Svanborg, Eva
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Department of Nursing Science, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Undiagnosed obstructive sleep apnea in hypertensive outpatients in primary care —  Associations with sleep complaints, depressive symptoms and global perceived health2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, ISSN 2162-5336, Vol. 03, no 06, p. 445-452Article in journal (Refereed)
    Abstract [en]

    Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjective sleep complaints, depressive symptoms and global perceived health. Design: Cross-sectional design focusing on nursing care outcomes of obstructive sleep apnea. Setting: Four primary care health centres in Sweden. PATIENTS: 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed hypertension (BP > 140/90). Main Outcome Measures: Prevalence of OSA and depressive symptoms, and association of OSA to sleep complaints, depressive symptoms and global perceived health. RESULTS: Mild, moderate and severe OSA was seen among 29%, 16% and 14% of patients, respectively. Depressive symptoms were seen in 16% of the total group, with a higher prevalence among men, compared to women, 21% vs. 12%. No differences were found regarding blood pressure, estimated sleep need, sleep sufficiency index, insomnia symptoms, daytime sleepiness or depressive symptoms with respect to different degrees of OSA. Apnea-hypopnea index was significantly associated to perceived health after adjustment for gender and comorbidities, but when depressive symptoms and non-restorative sleep were added to the model, 33% of the variance in global perceived health was explained. Conclusion: OSA is highly prevalent among patients with hypertension in primary care and does together with sleep complaints and depressive symptoms have a negative impact on global perceived health. Hypertensive patients without subjective sleep complaints or depressive symptoms may still have OSA

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  • 13.
    Broström, Anders
    et al.
    Jönköping University ; Linköping University Hospital.
    Sunnergren, Ola
    Linköping University ; Ryhov Hospital, Jönköping.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Johansson, Peter
    Linköping University ; Linköping University Hospital.
    Nilsen, Per
    Linköping University.
    Fridlund, Bengt
    Jönköping University.
    Svanborg, Eva
    Jönköping University ; Linköping University.
    Undiagnosed obstructive sleep apnea in hypertensive outpatients in primary care: Associations with sleep complaints, depressive symptoms and global perceived health2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 6, p. 445-452Article in journal (Refereed)
    Abstract [en]

    Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjective sleep complaints, depressive symptoms and global perceived health. Design: Cross-sectional design focusing on nursing care outcomes of obstructive sleep apnea. Setting: Four primary care health centres in Sweden. PATIENTS: 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed hypertension (BP > 140/90). Main Outcome Measures: Prevalence of OSA and depressive symptoms, and association of OSA to sleep complaints, depressive symptoms and global perceived health. RESULTS: Mild, moderate and severe OSA was seen among 29%, 16% and 14% of patients, respectively. Depressive symptoms were seen in 16% of the total group, with a higher prevalence among men, compared to women, 21% vs. 12%. No differences were found regarding blood pressure, estimated sleep need, sleep sufficiency index, insomnia symptoms, daytime sleepiness or depressive symptoms with respect to different degrees of OSA. Apnea-hypopnea index was significantly associated to perceived health after adjustment for gender and comorbidities, but when depressive symptoms and non-restorative sleep were added to the model, 33% of the variance in global perceived health was explained. Conclusion: OSA is highly prevalent among patients with hypertension in primary care and does together with sleep complaints and depressive symptoms have a negative impact on global perceived health. Hypertensive patients without subjective sleep complaints or depressive symptoms may still have OSA.

  • 14.
    Bäcklund, Kajsa
    et al.
    Blekinge County Hospital, Sweden.
    Persson, Karoline
    Blekinge County Hospital, Sweden.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Intensive care nurses’ experiences of caring for intubated patients under light sedation: a qualitative study2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 8, no 7, p. 473-484Article in journal (Refereed)
    Abstract [en]

    Introduction: Previous studies have shown that a light sedation level is beneficial for intubated patients in the Intensive care unit (ICU). 

    Aim: This study aimed to describe intensive care nurses’ experiences of caring for intubated patients under light sedation. 

    Methods: This study was an explorative descriptive qualitative study. Data were collected from 12 intensive care nurses by three focus group interviews and analyzed using qualitative content analysis. 

    Findings: Five categories emerged from the data: 1) the importance of verbal communication and the nurses’ presence, 2) feelings of frustration and heavy workload, 3) assessment of patients’ pain and anxiety, 4) the nurses’ desire for the development of guidelines, and 5) being inspired by the care. 

    Conclusion: The study found that intensive care nurses were positive towards light sedation care but the organization of care did not support them as the patients cared for with light sedation treatments demanded their physical presence at patients’ bed site.

  • 15.
    Carlander (Goliath), Ida
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Sandberg, Jonas
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Hellström, Ingrid
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Constructing family identity close to death2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 5, p. 379-388Article in journal (Refereed)
    Abstract [en]

    Daily life close to death involves physical, psychological, and social strain, exposing patients and their family members to major transitions affecting relational patterns and identity. For the individual family member, this often means sharing life with a changing person in a changing relationship, disrupting both individual identity and family identity. Our aim was to deepen the understanding of individual experiences that are important in constructing family identity close to death at home. We performed a secondary analysis of qualitative data collected through 40 interviews with persons with life-threatening illness and the family members who shared everyday life with them. The analysis resulted in interpretive descriptions which provided three patterns important for creating family identity, which we here call “we-ness” close to death. The patterns were: being an existential person, being an extension of the other, and being together in existential loneliness. Together, these three patterns seemed to play a part in the construction of family identity; we-ness, close to death. One important finding was the tension between the search for togetherness in “we-ness” while dealing with an existential loneliness, which seemed to capture an essential aspect of being a family of which one member is dying.

  • 16. Carlander, Ida
    et al.
    Ternestedt, Britt-Marie
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Hellström, Ingrid
    Constructing family identity close to death2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 5, p. 379-388Article in journal (Refereed)
    Abstract [en]

    Daily life close to death involves physical, psychological, and social strain, exposing patients and their family members to major transitions affecting relational patterns and identity. For the individual family member, this often means sharing life with a changing person in a changing relationship, disrupting both individual identity and family identity. Our aim was to deepen the understanding of individual experiences that are important in constructing family identity close to death at home. We performed a secondary analysis of qualitative data collected through 40 interviews with persons with life-threatening illness and the family members who shared everyday life with them. The analysis resulted in interpretive descriptions which provided three patterns important for creating family identity, which we here call “we-ness” close to death. The patterns were: being an existential person, being an extension of the other, and being together in existential loneliness. Together, these three patterns seemed to play a part in the construction of family identity; we-ness, close to death. One important finding was the tension between the search for togetherness in “we-ness” while dealing with an existential loneliness, which seemed to capture an essential aspect of being a family of which one member is dying.

  • 17.
    Carlander, Ida
    et al.
    Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden.
    Sandberg, Jonas
    Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden.
    Hellström, Ingrid
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden.
    Constructing family identity close to death2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 5, p. 379-388Article in journal (Refereed)
    Abstract [en]

    Daily life close to death involves physical, psychological, and social strain, exposing patients and their family members to major transitions affecting relational patterns and identity. For the individual family member, this often means sharing life with a changing person in a changing relationship, disrupting both individual identity and family identity. Our aim was to deepen the understanding of individual experiences that are important in constructing family identity close to death at home. We performed a secondary analysis of qualitative data collected through 40 interviews with persons with life-threatening illness and the family members who shared everyday life with them. The analysis resulted in interpretive descriptions which provided three patterns important for creating family identity, which we here call “we-ness” close to death. The patterns were: being an existential person, being an extension of the other, and being together in existential loneliness. Together, these three patterns seemed to play a part in the construction of family identity; we-ness, close to death. One important finding was the tension between the search for togetherness in “we-ness” while dealing with an existential loneliness, which seemed to capture an essential aspect of being a family of which one member is dying.

  • 18.
    Condelius, Anna
    et al.
    Lund University, Lund, Sweden.
    Jakobsson, Ulf
    Lund University, Malmö, Sweden.
    Karlsson, Staffan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing. Lund University, Lund, Sweden.
    Exploring the Implementation of Individual Care Plans in Relation to Characteristics of Staff2016In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 6, no 8, p. 582-590Article in journal (Refereed)
    Abstract [en]

    The aim was to explore the implementation of individual care plans in municipal elderly care in relation to characteristics of staff. Data regarding characteristics of staff were derived through a questionnaire distributed to all staff working in the care for older people, (N = 908, n = 245) in four municipalities in Sweden. The number of care plans established during a one-year period was collected through a contact person in each municipality. In total 47 individual care plans were es-tablished during the study year. Significantly more staff in the municipality that had the most number of established individual care plans agreed that there had been sufficient education (p = 0.017), sufficient time (p = 0.002) and routines established regarding individual care plans (p = 0.014) and had a significantly better job satisfaction (p = 0.001), compared to staff in the other municipalities. Implementation leaders may need to take the working conditions and the percep-tion of available resources among staff into consideration in the on-going process of implementing individual care plans.

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  • 19.
    Drott, Jenny
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Starkhammar, Hans
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Börjeson, Sussanne
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Oxaliplatin induced neurotoxicity among patients with colorectal cancer: documentation in medical records - a pilot study2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, p. 265-274Article in journal (Refereed)
    Abstract [en]

    Patients with colorectal cancer (CRC) can have chemotherapy with oxaliplatin postoperatively.Oxaliplatin can cause acute and chronic neurotoxicity. It is important to be aware of neurotoxicside effects so they can be documented and action taken at an early stage. The study aimed toidentify and explore neurotoxic side effects documented in the medical records of patients withcolorectal cancer treated with oxaliplatin-based adjuvant chemotherapy. Data in this study weremedical records; presenting documentation about patients treated at the University Hospital inthe south of Sweden between 2009 and 2010. A summative content analysis approach was used toexplore the neurotoxic side effects. Identification and quantification of the content of medical recordswere carried out by using a study-specific protocol. “Cold sensitivity” and “tingling in thehands” were the most frequently documented neurotoxicity-related terms in the medical records.This identification was followed by interpretation. Three categories were identified in the interpretivepart of the study: acute, chronic, and degree of neurotoxicity. The results show the importanceof awareness of neurotoxic side effects so that they can be documented and action taken atan early stage. The documentation could be more reliable if patient-reported structured measurementswere used, combined with free descriptions in the medical records. Being able to followthe progression of the symptoms during and after treatment would improve patient’s safety andalso quality of life. The protocol that we developed and used in this review of medical records maybe helpful to structure the documentation in the electronic system for documentation of neurotoxicityside effects.

     

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  • 20.
    Estev, Bibi
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Hommel, Ami
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Registered Nurses’ Perceptions of Factors Contributing to Trust-Based Public Management2020In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 10, no 11, p. 1126-1141Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to illuminate registered nurses’ (RNs) perceptions of Trust-Based Public Management (TBPM) in Swedish health care. Design: This study follows a phenomenografic approach guided by Ference Marton’s philosophy. Methods: Semi-structured interviews were used to identify variations in RNs’ perceptions of TBPM. Between February and April 2019, 24 RNs from five Swedish public healthcare departments participated in the study. Results: The results show that none of the participants had previously heard about the work of the Swedish Delegation for TBPM. The study revealed perceptions those politicians and managers were absent from the workplace, that power had been displaced to HR, and that perceptions of trust in the leadership and of working to guidelines varied. Perceptions varied between RNs employed by the municipalities and by the hospitals concerning administration, the time allotted for work, cooperation, and education.

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  • 21.
    Fläckman, Birgitta
    et al.
    Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden.
    Skovdahl, Kirsti
    Faculty for Health Sciences, Buskerud and Vestfold University College, Drammen, Norway.
    Fagerberg, Ingegerd
    Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden; Faculty for Health Sciences, Buskerud and Vestfold University College, Drammen, Norway.
    Kihlgen, Mona
    Centre for Caring Sciences, Örebro University Hospital, Örebro, Sweden.
    Kihlgren, Annica
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Consequences of working in eldercare during organizational changes and cut backs while education and clinical supervision was provided: a mixed methods study2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 9, p. 813-827, article id 1440527Article, review/survey (Refereed)
    Abstract [en]

    Background: Reorganization and downsizing can disrupt a competent staff and conflicts can arise between what the employee is being asked to do and their knowledge and competences. Reduced job satisfaction among nursing home staff with increased workload and strain can occur.                                                                                                   

    Aim and Objectives: The aim was to investigate the organizational climate and prevalence of burnout symptoms among caregivers over time in three Swedish nursing homes (NH I-III) undergoing organizational changes, while education and clinical supervision were provided. Design: The study design combines qualitative and quantitative methods in a longitudinal two-year follow-up project in NH I-III.                                                                   

    Methods: Support through education and clinical supervision was provided for caregivers only at NH I and NH II. At NH I-III caregiver self-assessments and interviews were completed and analysed three different times. Results: NH I revealed improvement and increased innovation over time, while NH II showed a decline with no ability to implement new knowledge. NH III retained a more status quo.                                                                             

    Conclusions: Organizational changes and cutbacks, occurring at different times, appeared to cause major stress and frustration among the three personnel groups. They felt guilty about not meeting their perceived obligations, seemed to have lost pride in their work but kept struggling. The changes seemed to over-shadow attempts to improve working conditions through education and clinical supervision initially.                                               

    Implications for practice: It will be important to learn from reorganizations and the consequences they will have for the staff and quality of care. Important topics for future research are to study financial cutbacks and changes in organizational processes in care of older people to be able to develop a more person centered care for older people.

  • 22.
    Fläckman, Birgitta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Skovdahl, Kirsti
    Faculty for Health Sciences, Buskerud and Vestfold University College, Drammen, Norway.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences. Department of Neurobiology, Care Sciences and Society, Karolinska institutet.
    Kihlgren, Mona
    Centre for Caring Sciences, Örebro University Hospital.
    Kihlgren, Annica
    School of Health and Medical Sciences, Örebro University.
    Consequences of working in elder care during changes and cutbacks in the organisation while education and clinical supervision was provided: A mixed methods study2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 9, p. 813-827Article in journal (Refereed)
    Abstract [en]

    Background: Reorganization and downsizing can disrupt a competent staff and conflicts can arise between what the employee is being asked to do and their knowledge and competences. Reduced job satisfaction among nursing home staff with increased workload and strain can occur. Aim and Objectives: The aim was to investigate the organizational climate and prevalence of burnout symptoms among caregivers over time in three Swedish nursing homes (NH I-III) undergoing organizational changes, while education and clinical supervision were provided. Design: The study design combines qualitative and quantitative methods in a longitudinal two-year follow-up project in NH I-III. Methods: Support through education and clinical supervision was provided for caregivers only at NH I and NH II. At NH I-III caregiver self-assessments and interviews were completed and analysed three different times. Results: NH I revealed improvement and increased innovation over time, while NH II showed a decline with no ability to implement new knowledge. NH III retained a more status quo. Conclusions: Organizational changes and cutbacks, occurring at different times, appeared to cause major stress and frustration among the three personnel groups. They felt guilty about not meeting their perceived obligations, seemed to have lost pride in their work but kept struggling. The changes seemed to over-shadow attempts to improve working conditions through education and clinical supervision initially. Implications for practice: It will be important to learn from reorganizations and the consequences they will have for the staff and quality of care. Important topics for future research are to study financial cutbacks and changes in organizational processes in care of older people to be able to develop a more person centered care for older people.

  • 23.
    Fredriksson-Larsson, Ulla
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Cardiac Self-Efficacy and Fatigue One Year Post-Myocardial Infarction2019In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 9, no 4, p. 396-407Article in journal (Refereed)
    Abstract [en]

    Background: Patients and clinicians report that fatigue post-myocardial infraction (MI) is a bothersome symptom during recovery. Aim: The objective of this study was to explore whether there is a relationship between fatigue, cardiac self-efficacy, stress, breathlessness and physical activity one year post-MI. Method: Data were collected from a sample of patients diagnosed with MI one year earlier (n = 125) who responded to a questionnaire package measuring fatigue, cardiac self-efficacy, physical activity and the symptoms breathlessness and stress. Correlation and regression analyses were preformed to evaluate which factors were related to fatigue. Results: The results showed that cardiac self-efficacy was associated with fatigue (r = −0.611, p = 0.01) and the regression model, controlling for breathlessness and stress, showed an explained variance of 72% one year post-MI. Physical activity was not significant in this model and did not predict fatigue during this time period. Conclusion: Post-MI fatigue-relief support should rely not only on identification of fatigue and other concurrent symptoms, but also on identification of cardiac self-efficacy.

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  • 24.
    Fredriksson-Larsson, Ulla
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden..
    Brink, Eva
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden..
    Jonsdottir, Ingibjörg H.
    University of Gothenburg, Institute of Stress Medicine, Sahlgrenska Academy, , Gothenburg, Sweden..
    Grankvist, Gunne
    University West, Department of Social and Behavioural Studies, Division of Psychology and Organisation Studies.
    Alsén, Pia
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    The single-item measure of stress symptoms after myocardial infarction and its association with fatigue.2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, p. 345-353Article in journal (Refereed)
    Abstract [en]

    Surviving a myocardial infarction (MI) can be a stressful event entailing challenges in daily life during the recovery period. Experiencing fatigue symptoms post-MI has been described as bothersome and occurs in nearly half of patients four months and two years after MI. The aetiology of fatigue disorder is unclear, but research has shown that fatigue plays an important role in the relationship between stress and perceived poor health. Previous findings indicate that having access to an easily administered stress measurement is worthwhile both in the clinic and in research. The single-item measure of stress symptoms has not been validated in persons treated for MI. The aim was to validate the single-item measure of stress symptoms and to explore its association with fatigue in a sample of persons treated for MI. Methods: 142 respondents completed the questionnaires of the Multidimensional Fatigue Inventory-20, the single-item measure of stress symptoms and the Perceived Stress Scale-10 (PPS-10) two months post-MI. Correlation analysis and t-tests were used to validate the single-item stress measure and its association with post-MI fatigue. Results: The convergent validity of the single-item measure of stress symptoms was confirmed. In analyses of relations between stress and fatigue, it was found that the single-item stress measure was strongly associated with both the global fatigue score and all four fatigue dimension scores (general, physical and mental fatigue as well as reduced activity). Conclusion: The single-item measure of stress symptoms was found to be a valid measure of post-MI stress. Also, the measure was useful in assessing associations between stress and fatigue and could therefore indicate that post-MI fatigue experiences should be further explored in full using multidimensional fatigue assessmen

  • 25. Fridlund, Bengt
    et al.
    Andersson, Ewa
    Bala, Sidona-Valentina
    Dahlman, Gull-Britt
    Kristensson Ekwall, Anna
    Glasdam, Stinne
    Hommel, Ami
    Lindberg, Catharina
    Persson, Eva I
    Rantala, Andreas
    Sjöström-Strand, Annica
    Wihlborg, Jonas
    Lund University.
    Samuelson, Karin
    Essentials of Teamcare in Randomized Controlled Trials of Multidisciplinary or Interdisciplinary Interventions in Somatic Care: A Systematic Review2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, no 5, p. 1089-1101Article in journal (Refereed)
    Abstract [en]

    Background: Teamcare should, like all patient care, also contribute to evidence-based practice (EBP). Randomized controlled trials (RCTs) focusing on teamcare have been performed but no study has addressed its essentials. How far this EBP has progressed in different health aspects is generally established in systematic reviews of RCTs. Aim: The aim is to determine the essentials of teamcare including the nurse profession in RCTs of multi- or interdisciplinary interventions in somatic care focusing on the stated context, goals, strategies, content as well as effectiveness of quality of care. Methods: A systematic review was performed according to Cochrane review as- sumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligi- bility criteria. The PRISMA statement guided the data selection process of 27 articles from PubMed and CINAHL. Results: Eighty-five percent of RCTs in somatic care showed a positive effectiveness of teamcare interventions, of which interdisciplinary ones showed a greater effectiveness compared with the multidisciplinary approach (100% vs 76%). Also theory-based RCTs presented higher positive effectiveness (85%) compared with non-theory-based RCTs (79%). The RCTs with posi- tive effectiveness showed greater levels for professional-centered ambition in terms of goals and for team-directed initiatives in terms of strategy, and a significantly higher level for patient-team interaction plans in terms of content was shown. Conclusions: Teamcare RCTs are still grounded in the multidisciplinary approach having a professional-centered ambition while interdisciplinary

  • 26.
    Fridlund, Bengt
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Andersson, Ewa K.
    Department of Health Sciences, Lund University, Sweden.
    Bala, Sidona-Valentina
    Department of Health Sciences, Lund University, Sweden.
    Dahlman, Gull-Britt
    Department of Health Sciences, Lund University, Sweden.
    Ekwall, Anna K.
    Department of Health Sciences, Lund University, Sweden.
    Glasdam, Stinne
    Department of Health Sciences, Lund University, Sweden.
    Hommel, Ami
    Department of Health Sciences, Lund University, Sweden.
    Lindberg, Catharina
    Department of Health Sciences, Lund University, Sweden.
    Persson, Eva I.
    Department of Health Sciences, Lund University, Sweden.
    Rantala, Andreas
    Department of Health Sciences, Lund University, Sweden.
    Sjöström-Strand, Annica
    Department of Health Sciences, Lund University, Sweden.
    Wihlborg, Jonas
    Department of Health Sciences, Lund University, Sweden.
    Samuelson, Karin
    Department of Health Sciences, Lund University, Sweden.
    Essentials of teamcare in randomized controlled trials of multidisciplinary or interdisciplinary interventions in somatic care: A systematic review2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 12, p. 1089-1101Article, review/survey (Refereed)
    Abstract [en]

    Background: Teamcare should, like all patient care, also contribute to evidence-based practice (EBP). Randomized controlled trials (RCTs) focusing on teamcare have been performed but no study has addressed its essentials. How far this EBP has progressed in different health aspects is generally established in systematic reviews of RCTs.

    Aim: The aim is to determine the essentials of teamcare including the nurse profession in RCTs of multi- or interdisciplinary interventions in somatic care focusing on the stated context, goals, strategies, content as well as effectiveness of quality of care.

    Methods: A systematic review was performed according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data selection process of 27 articles from PubMed and CINAHL.

    Results: Eighty-five percent of RCTs in somatic care showed a positive effectiveness of teamcare interventions, of which interdisciplinary ones showed a greater effectiveness compared with the multidisciplinary approach (100% vs 76%). Also theory-based RCTs presented higher positive effectiveness (85%) compared with non-theory-based RCTs (79%). The RCTs with positive effectiveness showed greater levels for professional-centered ambition in terms of goals and for team-directed initiatives in terms of strategy, and a significantly higher level for patient-team interaction plans in terms of content was shown.

    Conclusions: Teamcare RCTs are still grounded in the multidisciplinary approach having a professional-centered ambition while interdisciplinary approaches especially those that are theory-based appear to be essential with regard to positive effectiveness and preferable when person-centered careis applied.

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  • 27. Fridlund, Bengt
    et al.
    Andersson, Ewa K.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Bala, Sidona-Valentina
    Dahlman, Gull-Britt
    Ekwall, Anna K.
    Glasdam, Stinne
    Hommel, Ami
    Lindberg, Catharina
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Persson, Eva I.
    Rantala, Andreas
    Sjöström-Strand, Annica
    Wihlborg, Jonas
    Samuelson, Karin
    Essentials of Teamcare in Randomized Controlled Trials of Multidisciplinary or Interdisciplinary Interventions in Somatic Care: A Systematic Review2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, ISSN 2162-5344, Vol. 12, no 5, p. 1089-1101Article, review/survey (Refereed)
    Abstract [en]

    Background: Teamcare should, like all patient care, also contribute to evidence-based practice (EBP). Randomized controlled trials (RCTs) focusing on teamcare have been performed but no study has addressed its essentials. How far this EBP has progressed in different health aspects is generally established in systematic reviews of RCTs. Aim: The aim is to determine the essentials of teamcare including the nurse profession in RCTs of multi- or interdisciplinary interventions in somatic care focusing on the stated context, goals, strategies, content as well as effectiveness of quality of care. Methods: A systematic review was performed according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data selection process of 27 articles from PubMed and CINAHL. Results: Eighty-five percent of RCTs in somatic care showed a positive effectiveness of teamcare interventions, of which interdisciplinary ones showed a greater effectiveness compared with the multidisciplinary approach (100% vs 76%). Also theory-based RCTs presented higher positive effectiveness (85%) compared with non-theory-based RCTs (79%). The RCTs with positive effectiveness showed greater levels for professional-centered ambition in terms of goals and for team-directed initiatives in terms of strategy, and a significantly higher level for patient-team interaction plans in terms of content was shown. Conclusions: Teamcare RCTs are still grounded in the multidisciplinary approach having a professional-centered ambition while interdisciplinary approaches especially those that are theory-based appear to be essential with regard to positive effectiveness and preferable when person-centered careis applied.

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  • 28.
    Fridlund, Bengt
    et al.
    Lund University, Sweden;, Jönköping University, Sweden.
    Andersson, Ewa K.
    Lund University, Sweden;Blekinge Institute of Technology, Sweden.
    Bala, Sidona-Valentina
    Lund University, Sweden.
    Dahlman, Gull-Britt
    Lund University, Sweden.
    Ekwall, Anna K.
    Lund University, Sweden.
    Glasdam, Stinne
    Lund University, Sweden.
    Hommel, Ami
    Lund University, Sweden.
    Lindberg, Catharina
    Lund University, Sweden;Blekinge Institute of Technology, Sweden.
    Persson, Eva I.
    Lund University, Sweden.
    Rantala, Andreas
    Lund University, Sweden.
    Sjöström-Strand, Annica
    Lund University, Sweden.
    Wihlborg, Jonas
    Lund University, Sweden.
    Samuelson, Karin
    Lund University, Sweden.
    Essentials of teamcare in randomized controlled trials of multidisciplinary or interdisciplinary interventions in somatic care: A systematic review2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 12, p. 1089-1101Article, review/survey (Refereed)
    Abstract [en]

    Background: Teamcare should, like all patient care, also contribute to evidence-based practice (EBP). Randomized controlled trials (RCTs) focusing on teamcare have been performed but no study has addressed its essentials. How far this EBP has progressed in different health aspects is generally established in systematic reviews of RCTs.

    Aim: The aim is to determine the essentials of teamcare including the nurse profession in RCTs of multi- or interdisciplinary interventions in somatic care focusing on the stated context, goals, strategies, content as well as effectiveness of quality of care.

    Methods: A systematic review was performed according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data selection process of 27 articles from PubMed and CINAHL.

    Results: Eighty-five percent of RCTs in somatic care showed a positive effectiveness of teamcare interventions, of which interdisciplinary ones showed a greater effectiveness compared with the multidisciplinary approach (100% vs 76%). Also theory-based RCTs presented higher positive effectiveness (85%) compared with non-theory-based RCTs (79%). The RCTs with positive effectiveness showed greater levels for professional-centered ambition in terms of goals and for team-directed initiatives in terms of strategy, and a significantly higher level for patient-team interaction plans in terms of content was shown.

    Conclusions: Teamcare RCTs are still grounded in the multidisciplinary approach having a professional-centered ambition while interdisciplinary approaches especially those that are theory-based appear to be essential with regard to positive effectiveness and preferable when person-centered careis applied.

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  • 29.
    Fridlund, Bengt
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. ADULT.
    Baigi, Amir
    The Sahlgrenska Academy, Göteborg University.
    Developing and establishing the psychometric properties of an Ethos towards Wellness Questionnaire (EtWeQ)2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 7, p. 538-547Article in journal (Refereed)
    Abstract [en]

    Aim: Validated instruments exist measuring parts of personal health, ill-health and lifestyle, but there are few, if any, instruments “grasping the big picture” of wellness and ethos. Accordingly the aim was to develop and establish the psychometric properties of 74-item Ethos towards Wellness Questionnaire (EtWeQ) with regards to content and construct validity, as well as homogeneity and stability reliability. 

    Methods: A questionnaire based on a methodological and developmental design was sent out twice with a four week gap between, on 221 healthy middle-aged participants in four steps: item generating, content validating, statistical analyzing and establishing the final questionnaire. 

    Results: The substantial base, consisting of content validity resulted in, besides basic characteristics, six well-defined and sufficient indexes comprising of; two health indexes (healthiness and ill-healthiness), three life context indexes (work, family, spare time), and one brief comprehensive index (ethos). The three life context as well as the ethos indexes at an ordinal scale level, identified overall satisfactory communalities of >0.30, factor loadings > 0.30, and factor total variance > 50% with regard to construct validity. The homogeneity reliability, in terms of Cronbach’s alpha coefficient > 0.70, at both occasions with a four week gap between, as well as the stability reliability in terms of intraclass correlation coefficient > 0.70, were also considered satisfactory in the same indexes. 

    Conclusions: This newly developed, and likely the only questionnaire focusing on “grasping the big human picture”, was based on both a philosophical reasoning and empirical recommendations of wellness, is shown to be a valid and reliable measurement in screening or in follow-up of healthy people’s wellness and ethos.

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  • 30.
    Fridlund, Bengt
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden; School of Health Sciences, Jönköping University, Jönköping, Sweden .
    Jönsson, A. C.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Andersson, E. K.
    Department of Health Sciences, Lund University, Lund, Sweden; School of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Bala, S.-V.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Dahlman, G.-B.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Forsberg, A.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Glasdam, S.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Hommel, A.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Kristensson, A.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Lindberg, C.
    Department of Health Sciences, Lund University, Lund, Sweden; School of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sivberg, B.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Sjöström-Strand, A.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Wihlborg, J.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Samuelson, K.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Essentials of Nursing Care in Randomized Controlled Trials of Nurse-Led Interventions in Somatic Care: A Systematic Review2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 04, no 03, p. 181-197Article, review/survey (Refereed)
    Abstract [en]

    Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP). How far this EBP has progressed in different health aspects is usually established by systematic reviews of RCTs. Nurse-led RCTs exist but no study has addressed the essentials of nursing care. Aim: The aim was therefore to determine the essentials of nurses’ interventions by means of nurse-led RCTs in somatic care focusing on the stated context, goals, content, strategies as well as the nurse’s role related to effectiveness. Methods: A systematic review was realized according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data extraction process (n<span "="" style="box-sizing: border-box; padding: 0px; margin: 0px; color: rgb(35, 35, 35); font-family: Verdana, Arial, Helvetica, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: justify; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; font-size: 10pt;"> =<span "="" style="box-sizing: border-box; padding: 0px; margin: 0px; color: rgb(35, 35, 35); font-family: Verdana, Arial, Helvetica, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: justify; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; font-size: 10pt;"> 55) from PubMed and CINAHL. Results: Of the RCTs in somatic care, 71% showed a positive effectiveness of nurse-led interventions, of which the nurse had a significant role with regard to being the main responsible in 67% of the studies. Also, 47% of the RCTs presented a theoretical standpoint related to the nurse-led interventions and most prominent were international evidence-based guidelines. Goals were found to have either a patient-centered or a professional-centered ambition. Strategies were based on patient-directed initiatives, nurse-patient-directed initiatives or nurse-directed initiatives, while contents were built upon either a patient-nurse interaction or a nursing management plan. Conclusions: This review underlines the necessity of a holistic view of a person, as nurse-led RCTs comprising a patient-centered ambition, patient-directed initiative and patient-nurse interaction plan showed beneficial nursing care effectiveness, particularly if theory-based. In a nurse-led RCT, a basic theoretical perspective is advantageous as well as to elucidate the role of the nurse in relation to the estimated effects.

  • 31.
    Fridlund, Bengt
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. ADULT.
    Jönsson, A-C
    Andersson, EK
    Bala, S-V
    Dahlman, G-B
    Forsberg, A
    Glasdam, S
    Hommel, A
    Kristensson, A
    Lindberg, C
    Sivberg, B
    Sjöström-Strand, A
    Wihlborg, J
    Samuelson, K
    Essential of nursing care in randomized controlled trials of nurse-led interventions in somatic care: A systematic review2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 3, p. 181-197Article in journal (Refereed)
    Abstract [en]

    Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP). How far this EBP has progressed in different health aspects is usually established by systematic reviews of RCTs. Nurse-led RCTs exist but no study has addressed the essentials of nursing care. Aim: The aim was therefore to determine the essentials of nurses’ interventions by means of nurse-led RCTs in somatic care focusing on the stated context, goals, content, strategies as well as the nurse’s role related to effectiveness. Methods: A systematic review was realized according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data extraction process (n = 55) from PubMed and CINAHL. Results: Of the RCTs in somatic care, 71% showed a positive effectiveness of nurse-led interventions, of which the nurse had a significant role with regard to being the main responsible in 67% of the studies. Also, 47% of the RCTs presented a theoretical standpoint related to the nurse-led interventions and most prominent were international evidence-based guidelines. Goals were found to have either a patient-centered or a professional-centered ambition. Strategies were based on patient-directed initiatives, nurse-patient-directed initiatives or nurse-directed initiatives, while contents were built upon either a patient-nurse interaction or a nursing management plan. Conclusions: This review underlines the necessity of a holistic view of a person, as nurse-led RCTs comprising a patient-centered ambition, patient-directed initiative and patient-nurse interaction plan showed beneficial nursing care effectiveness, particularly if theory-based. In a nurse-led RCT, a basic theoretical perspective is advantageous as well as to elucidate the role of the nurse in relation to the estimated effects.

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  • 32. Fridlund, Bengt
    et al.
    Jönsson, A.C.
    Andersson, Ewa
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Bala, S.-V.
    Dahlman, G.-B.
    Forsberg, A.
    Glasdam, S.
    Krstensson, A.
    Lindberg, Catharina
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Sivberg, B.
    Essentials of Nursing Care in Randomized Controlled Trials of Nurse-Led Interventions in Somatic Care: A Systematic Review2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 3, p. 181-197Article in journal (Refereed)
    Abstract [en]

    Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP). How far this EBP has progressed in different health aspects is usually established by systematic reviews of RCTs. Nurse-led RCTs exist but no study has addressed the essentials of nursing care. Aim: The aim was therefore to determine the essentials of nurses’ interventions by means of nurse-led RCTs in somatic care focusing on the stated context, goals, content, strategies as well as the nurse’s role related to effectiveness. Methods: A systematic review was realized according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data extraction process (n = 55) from PubMed and CINAHL. Results: Of the RCTs in somatic care, 71% showed a positive effectiveness of nurse-led interventions, of which the nurse had a significant role with regard to being the main responsible in 67% of the studies. Also, 47% of the RCTs presented a theoretical standpoint related to the nurse-led interventions and most prominent were international evidence-based guidelines. Goals were found to have either a patient-centered or a professional-centered ambition. Strategies were based on patient-directed initiatives, nurse-patient-directed initiatives or nurse-directed initiatives, while contents were built upon either a patient-nurse interaction or a nursing management plan. Conclusions: This review underlines the necessity of a holistic view of a person, as nurse-led RCTs comprising a patient-centered ambition, patient-directed initiative and patient-nurse interaction plan showed beneficial nursing care effectiveness, particularly if theory-based. In a nurse-led RCT, a basic theoretical perspective is advantageous as well as to elucidate the role of the nurse in relation to the estimated effects.

    Download full text (pdf)
    FULLTEXT01
  • 33.
    Fridlund, Bengt
    et al.
    Lund University, Sweden;Jönköping University, Sweden .
    Jönsson, A.C.
    Lund University, Sweden.
    Andersson, Ewa K.
    Blekinge Institute of Technology, Sweden;Lund University, Sweden.
    Bala, S.-V.
    Lund University, Sweden.
    Dahlman, G.-B.
    Lund University, Sweden.
    Forsberg, A.
    Lund University, Sweden.
    Glasdam, S.
    Lund University, Sweden.
    Kristensson, A.
    Lund University, Sweden.
    Lindberg, Catharina
    Lund University, Sweden;Blekinge Institute of Technology, Sweden.
    Sivberg, B.
    Lund University, Sweden.
    Sjöström-Strand, A.
    Lund University, Sweden.
    Wihlborg, J.
    Lund University, Sweden.
    Samuelson, K.
    Lund University, Sweden.
    Essentials of Nursing Care in Randomized Controlled Trials of Nurse-Led Interventions in Somatic Care: A Systematic Review2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 3, p. 181-197Article, review/survey (Refereed)
    Abstract [en]

    Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP). How far this EBP has progressed in different health aspects is usually established by systematic reviews of RCTs. Nurse-led RCTs exist but no study has addressed the essentials of nursing care. Aim: The aim was therefore to determine the essentials of nurses’ interventions by means of nurse-led RCTs in somatic care focusing on the stated context, goals, content, strategies as well as the nurse’s role related to effectiveness. Methods: A systematic review was realized according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data extraction process (n = 55) from PubMed and CINAHL. Results: Of the RCTs in somatic care, 71% showed a positive effectiveness of nurse-led interventions, of which the nurse had a significant role with regard to being the main responsible in 67% of the studies. Also, 47% of the RCTs presented a theoretical standpoint related to the nurse-led interventions and most prominent were international evidence-based guidelines. Goals were found to have either a patient-centered or a professional-centered ambition. Strategies were based on patient-directed initiatives, nurse-patient-directed initiatives or nurse-directed initiatives, while contents were built upon either a patient-nurse interaction or a nursing management plan. Conclusions: This review underlines the necessity of a holistic view of a person, as nurse-led RCTs comprising a patient-centered ambition, patient-directed initiative and patient-nurse interaction plan showed beneficial nursing care effectiveness, particularly if theory-based. In a nurse-led RCT, a basic theoretical perspective is advantageous as well as to elucidate the role of the nurse in relation to the estimated effects.

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    fulltext
  • 34. Fridlund, Bengt
    et al.
    Jönsson, Ann-Cathrin
    Andersson, Ewa
    Bala, Sidona-Valentina
    Dahlman, Gull-Britt
    Forsberg, Anna
    Glasdam, Stinne
    Hommel, Ami
    Kristensson Ekwall, Anna
    Lindberg, Catharina
    Sivberg, Bengt
    Sjöström-Strand, Annica
    Wihlborg, Jonas
    Lund University.
    Samuelson, Karin
    Essentials of Nursing Care in Randomized Controlled Trials of Nurse-Led Interventions in Somatic Care: A Systematic Review2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 3, p. 181-197Article in journal (Refereed)
    Abstract [en]

    Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP).How far this EBP has progressed in different health aspects is usually established by systematic reviews of RCTs. Nurse-led RCTs exist but no study has addressed the essentials of nursing care. Aim: The aim was therefore to determine the essentials of nurses’ interventions by means of nurse-led RCTs in somatic care focusing on the stated context, goals, content, strategies as well as the nurse’s role related to effectiveness. Methods: A systematic review was realized according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data extraction process (n = 55) from PubMed and CINAHL. Results: Of the RCTs in somatic care, 71% showed a positive effectiveness of nurse-led interventions, of which the nurse had a significant role with regard to being the main responsible in 67% of the studies. Also, 47% of the RCTs presented a theoretical standpoint related to the nurse-led interventions and most prominent were international evidence-based guidelines. Goals were found to have either a patient-centered or a professional-centered ambition. Strategies were based on patient-directed initiatives, nurse-patient-directed initiatives or nurse-directed initiatives, while contents were built upon either a patient-nurse interaction or a nursing management plan. Conclusions: This review underlines the necessity of a holistic view of a person, as nurse-led RCTs comprising a patient-centered ambition, patient-directed initiative and patient-nurse interaction plan showed beneficial nursing care effectiveness, particularly if theory-based. In a nurse-led RCT, a basic theoretical perspective is advantageous as well as to elucidate the role of the nurse in relation to the estimated effects.

  • 35.
    Gabrielsson, Hanna
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences. Stiftelsen Spinalis.
    Karlberg Traav, Malin
    Ersta Sköndal University College, Department of Health Care Sciences. Universitetssjukhuset Örebro.
    Cronqvist, Agneta
    Ersta Sköndal University College, Department of Health Care Sciences.
    Reflections on Health of Young Adults with Spina Bifida: The Contradictory Path towards Well-Being in Daily Life2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 4, p. 303-312Article in journal (Refereed)
    Abstract [en]

    Background: An individual with SB needs to deal with long standing illnesses and is often viewed as having a disability that needs to be compensated for. This medical condition is an example of malfunction of the body, though congenital, and could be seen as an outside-perspective to the individual human being. It is important that the required medical treatment is offered to an individual with SB, but such medical treatment alone would not encompass the full health spectrum for an individual in this specific situation. A question to be raised is how this specific group of individuals experience health.

    Aim: To describe the experience of daily life for young adults with SB through a theoretical lens of health.

    Method: This qualitative study was conducted using a reflective lifeworld approach with an interpretive part. In the lifeworld theory it is understood that all our doings, feelings and thoughts are experienced through the lifeworld. The interview questions were open and non-standardised.

    Findings: The main theme was formulated as The contradictory path towards well-being in daily life, and was constructed on the sub-themes: Not understanding and taking responsibility for the lower body, Having people standing behind me—not being allowed to grow up myself, Compared to people like me, I usually do well, I thought it would work out by itself, and A lack of structure in daily life.

    Conclusion: The study indicates that young adults with SB have a diminished health and well-being and that they have a contradictory path to travel towards independency which is of great concern for this group of individuals. Differences in views of independence constitute a problem and it is important for health care providers to be aware of the individuals’ perspective on independence. This notion is something that needs to be taken into account when designing support programs for these individuals.

  • 36.
    Gabrielsson, Hanna
    et al.
    Spinalis Clinic, Rehab Station Stockholm, Stockholm, Sweden; Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden.
    Karlberg-Traav, Malin
    Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden; ENT Department, Örebro University Hospital, Örebro, Sweden.
    Cronqvist, Agneta
    Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden..
    Reflections on Health of Young Adults with Spina Bifida: The Contradictory Path towards Well-Being in Daily Life2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 4, p. 303-312Article in journal (Refereed)
    Abstract [en]

    Background: An individual with SB needs to deal with long standing illnesses and is often viewed as having a disability that needs to be compensated for. This medical condition is an example of malfunction of the body, though congenital, and could be seen as an outside-perspective to the individual human being. It is important that the required medical treatment is offered to an individual with SB, but such medical treatment alone would not encompass the full health spectrum for an individual in this specific situation. A question to be raised is how this specific group of individuals experience health.

    Aim: To describe the experience of daily life for young adults with SB through a theoretical lens of health.

    Method: This qualitative study was conducted using a reflective lifeworld approach with an interpretive part. In the lifeworld theory it is understood that all our doings, feelings and thoughts are experienced through the lifeworld. The interview questions were open and non-standardised.

    Findings: The main theme was formulated as The contradictory path towards well-being in daily life, and was constructed on the sub-themes: Not understanding and taking responsibility for the lower body, Having people standing behind me—not being allowed to grow up myself, Compared to people like me, I usually do well, I thought it would work out by itself, and A lack of structure in daily life.

    Conclusion: The study indicates that young adults with SB have a diminished health and well-being and that they have a contradictory path to travel towards independency which is of great concern for this group of individuals. Differences in views of independence constitute a problem and it is important for health care providers to be aware of the individuals’ perspective on independence. This notion is something that needs to be taken into account when designing support programs for these individuals.

  • 37.
    Gabrielsson, Hanna
    et al.
    Rehab Station Stockholm, Sweden; Ersta Sköndal University College, Sweden.
    Karlberg-Traav, Malin
    Ersta Sköndal University College, Sweden; Örebro University Hospital, Sweden.
    Cronqvist, Agneta
    Ersta Sköndal University College, Sweden..
    Reflections on Health of Young Adults with Spina Bifida: The Contradictory Path towards Well-Being in Daily Life2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 4, p. 303-312Article in journal (Refereed)
    Abstract [en]

    Background: An individual with SB needs to deal with long standing illnesses and is often viewed as having a disability that needs to be compensated for. This medical condition is an example of malfunction of the body, though congenital, and could be seen as an outside-perspective to the individual human being. It is important that the required medical treatment is offered to an individual with SB, but such medical treatment alone would not encompass the full health spectrum for an individual in this specific situation. A question to be raised is how this specific group of individuals experience health.

    Aim: To describe the experience of daily life for young adults with SB through a theoretical lens of health.

    Method: This qualitative study was conducted using a reflective lifeworld approach with an interpretive part. In the lifeworld theory it is understood that all our doings, feelings and thoughts are experienced through the lifeworld. The interview questions were open and non-standardised.

    Findings: The main theme was formulated as The contradictory path towards well-being in daily life, and was constructed on the sub-themes: Not understanding and taking responsibility for the lower body, Having people standing behind me—not being allowed to grow up myself, Compared to people like me, I usually do well, I thought it would work out by itself, and A lack of structure in daily life.

    Conclusion: The study indicates that young adults with SB have a diminished health and well-being and that they have a contradictory path to travel towards independency which is of great concern for this group of individuals. Differences in views of independence constitute a problem and it is important for health care providers to be aware of the individuals’ perspective on independence. This notion is something that needs to be taken into account when designing support programs for these individuals.

  • 38.
    Hajdarevic, Senada
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rasmussen, Birgit H
    Department of Health Sciences, Lund University, Lund, Sweden.
    Fransson, Per
    Umeå University, Faculty of Medicine, Department of Nursing.
    You Need to Know More to Understand My Scoring on the Survey: Free-Text Comments as Part of a PROM-Survey of Men with Prostate Cancer2016In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 6, no 5, p. 365-375Article in journal (Refereed)
    Abstract [en]

    Prostate cancer and its treatment have long-term implications for men's lives. We aimed to describe the content, extent, and frequency of written comments to the open-ended question, "Further comments?" in the patient-reported outcome measures questionnaire. During the study period, 897 men participated; 372 wrote 747 free-text comments in the questionnaire. These comments were analysed using qualitative content analysis and were grouped into four categories: 1) prostate cancer's influence on health; 2) clarifications of answers to the survey; 3) descriptions of well-being despite the cancer; and 4) experiences of care and the need for contact with health care. The distribution of the comments shifted over time. The open-ended question not only allowed the participants to explain their other responses and describe important aspects of their lives during and after treatment, something not normally covered by a questionnaire, but it also indicated their experiences of health care services along the patients' PC-trajectory. This further raises the issue of including an open-ended item in a forced-choice survey into the ethical realm to ensure that proper care is taken of participants’ answers and thoughts.

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  • 39.
    Harrefors, Christina
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lundquist, Anders
    Department of Statistics, Umeå University.
    Lundquist, Bengt
    Department of Statistics, Umeå University.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Professional caregivers’ perceptions on the prerequisites for and consequences of people with mild dementia using a digital photo diary2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 1, p. 42-54Article in journal (Refereed)
    Abstract [en]

    Research is currently ongoing to investigate the use of assistive technology by people with mild dementia to support independent living at home. The aim of this study was to describe professional caregivers’ perceptions on the prerequisites for and consequences of people with mild dementia using a digital photo diary to facilitate their talks about daily events with their family members. A questionnaire was sent out to 582 participants (response rate 70.1%) to elucidate the professional caregivers’ perceptions on the use of the digital photo diary. The questionnaire contained both quantitative and qualitative data and was analyzed with descriptive statistics, factor analysis, multivariate analysis of covariance and qualitative content analysis. This study reports the results related to prerequisites and consequences of using the photo diary. The results from the factor analysis revealed four factors: Trust, Vulnerability, Dependency/Independency and Control. The qualitative content analysis resulted in five categories: Immediate implementation after receiving a diagnose is required, Relatives’ participation is a necessity, Strengthened self-esteem and meaningful everyday life, Increased alienation and a feeling of isolation and Assistive digital devices provide opportunities. The theme was interpreted as: Personalization and the preservation of dignity. The conclusion that can be drawn from this study is that the participants had an overall positive view of the usage of this specific digital photo diary for people suffering from dementia, but rigorous considerations needs before implementation of the device and regularly follow ups if dignity is to be maintained for people with dementia.

  • 40.
    Hellström, Amanda
    et al.
    Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
    Condelius, Anna
    Department of Health Sciences, Lund University, Lund, Sweden.
    Willman, Ania
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden & Department of Care Science, Malmö University, Malmö, Sweden.
    Fagerström, Cecilia
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden & Blekinge Centre of Competence, Karlskrona, Sweden.
    The Rhythm of the Unit Is the Pace of Life: A Study of Everyday Activities and Sleep in Swedish Residential Care2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, p. 697-706Article in journal (Refereed)
    Abstract [en]

    Social and physical activities can improve sleep in older people. However, living in a residential care facility has been associated with a limited potential for activities and increased inactivity, reflected in poor sleep among residents. In turn, poor sleep can impair physical and mental functions. This paper explores sleep habits and everyday activities at three residential care facilities and investigates the link between sleep habits and everyday activities from the perspective of the residents. Data were collected through observations of daily life and interviews with residents. The results showed that fixed times during the day reduced daytime sleep and motivated them to go to the day room, thus enabling social interaction. More impaired residents spent more time in the day room napping or being less active. The residents stated that going outdoors was a desired activity, thought to improve sleep. However, the activity did not occur to the extent the residents wished for. Maintaining mobility and influence over daily activities together with regularity seemed to improve sleep. Awareness among staff of the need for stimulating and enriching activities, as well as access to bright light is requisite. Specific consideration should be given to residents who have difficulties communicating their wishes and/or impaired mobility. Copyright © 2015 Hellström et al. and Scientific Research Publishing Inc.

  • 41. Hellström, Amanda
    et al.
    Condelius, Anna
    Willman, Ania
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Fagerström, Cecilia
    The Rhythm of the unit is the pace of life: a study of everyday activities and sleep in Swedish residential care2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 8, p. 697-706Article in journal (Refereed)
    Abstract [en]

    Social and physical activities can improve sleep in older people. However, living in a residential care facility has been associated with a limited potential for activities and increased inactivity, reflected in poor sleep among residents. In turn, poor sleep can impair physical and mental functions. This paper explores sleep habits and everyday activities at three residential care facilities and investigates the link between sleep habits and everyday activities from the perspective of the residents. Data were collected through observations of daily life and interviews with residents. The results showed that fixed times during the day reduced daytime sleep and motivated them to go to the day room, thus enabling social interaction. More impaired residents spent more time in the day room napping or being less active. The residents stated that going outdoors was a desired activity, thought to improve sleep. However, the activity did not occur to the extent the residents wished for. Maintaining mobility and influence over daily activities together with regularity seemed to improve sleep. Awareness among staff of the need for stimulating and enriching activities, as well as access to bright light is requisite. Specific consideration should be given to residents who have difficulties communicating their wishes and/or impaired mobility.

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    FULLTEXT01
  • 42.
    Hellström, Amanda
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Condelius, Anna
    Lund University.
    Willman, Ania
    Blekinge Institute of Technology;Malmö University.
    Fagerström, Cecilia
    Blekinge Institute of Technology;Blekinge Centre of Competence.
    The rhythm of the unit is the pace of life: a study of everyday activities and sleep in Swedish residential care2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 8, p. 697-706Article in journal (Refereed)
    Abstract [en]

    Social and physical activities can improve sleep in older people. However, living in a residential care facility has been associated with a limited potential for activities and increased inactivity, reflected in poor sleep among residents. In turn, poor sleep can impair physical and mental functions. This paper explores sleep habits and everyday activities at three residential care facilities and investigates the link between sleep habits and everyday activities from the perspective of the residents. Data were collected through observations of daily life and interviews with residents.

    The results showed that fixed times during the day reduced daytime sleep and motivated them to go to the day room, thus enabling social interaction. More impaired residents spent more time in the day room napping or being less active. The residents stated that going outdoors was a desired activity, thought to improve sleep. However, the activity did not occur to the extent the residents wished for. Maintaining mobility and influence over daily activities together with regularity seemed to improve sleep. Awareness among staff of the need for stimulating and enriching activities, as well as access to bright light is requisite. Specific consideration should be given to residents who have difficulties communicating their wishes and/or impaired mobility.

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    fulltext
  • 43.
    Henriksson, Catrin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Judy, Arnetz
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Herlitz, Johan
    Karlsson, Jan-Erik
    Svensson, Leif
    Thuresson, Marie
    Zedig, Crister
    Wernroth, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Lindahl, Bertil
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Knowledge about Acute Myocardial Infarction (AMI) and attitudes to medical care seeking: a comparison between patients and the general public2012In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 2, no 4, p. 372-378Article in journal (Refereed)
    Abstract [en]

    Background:

    Patients with acute myocardial infarction often have long decision times before seeking medical care. The decision time is influenced by knowledge of AMI-symptoms, psychological factors and the response of people near the patient to the symptoms.

    Aim:

    To investigate and compare the knowledge of AMI, intended actions in response to AMI-symptoms and attitudes toward seeking medical care of patients and the general public.

    Method:

    This was a multicentre study with descriptive and comparative design, using questionnaires as an instrument. The population consisted of AMI-patients and representatives of the general public.

    Results:

    There was good knowledge about typical AMI-symptoms among the participants. The majority thought an AMI always starts suddenly. Patients did not know more about the time-dependency of treatment outcome than the general public. A greater proportion of the general public would contact an additional person before consulting medical professionals.

    Conclusions:

    Patients had no better knowledge about AMI than the general public, but would more commonly act appropriately in case of AMI-symptoms.

  • 44.
    Hjelm, Katarina
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Albin, Björn
    Linnaeus University, Växjö, Sweden.
    Limited focus on the use of health care by elderly migrants - A litterature review2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 6, p. 465-473Article in journal (Refereed)
    Abstract [en]

    Our premise for this literature review is the global demographic change caused by the world’s population living longer and becoming older, and extensive international migration leading to multicultural societies. Increasing age leads to health problems, often long-term or chronic, requiring investments in health care. Worse health and dissimilarities in pattern of morbidity/ mortality have been found in foreign-compared to Swedish-born persons, so it is reasonable to assume that this affects use of health care. The exploratory review focuses on elderly migrants’ (>65 years) use of healthcare. The databases Pub Med, EBSCO, CINAHL and ERIC were searched in 2000-2013. A limited number of studies were found; few had a comparative approach, most were from the USA, and focused on migrants from the former Soviet Union or countries in South-East Asia. A range of factors were identified that influence patterns of health care use: language fluency, ability to communicate, self-reported health status, prevalence of chronic disease, physical distance from care provision, availability of transport to reach care, cost of care, the health insurance system, cultural norms and values regarding different forms of care, level of education, and length of residence in the host country. Most studies treated health care from a general perspective and collected data from community and hospital settings, without analysing usage separately. Some studies indicated elderly migrants making use of health care less than other groups but the pattern is not unambiguous: other studies show that there is an overuse of health care. It is therefore difficult to show any particular pattern, or possible differences in use, regarding community versus in-patient care. Studies focusing on migrants’ actual use of health care are few and further research is needed, especially because elderly people form the largest group of users of health care and will be even larger in the future.

  • 45.
    Hjelm, Katarina
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Dissimilarities in Social Support as  Described by Swedish- and Foreign-Born Persons Diagnosed with Type 2 Diabetes and Living in Sweden2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 3, p. 211-222Article in journal (Refereed)
    Abstract [en]

    Diabetes (DM) requires self-care that is demanding and may cause stress. Social support canbuffer effects of stress. No previous study has been found comparing perceptions of foreign-bornpersons with DM, concerning the content of and need for social support with a population of origin.The aim was to compare the meaning of support and its impact on the life situation in Swedishandforeign-born persons diagnosed with type 2 DM living in Sweden. A purposive sample of 74persons; 34 foreign- and 40 Swedish-born, aged 32 - 80 years, diagnosed with type 2 DM, was included.The foreign-born persons were mostly Middle Eastern and Ex-Yugoslavian refugees. Mixedmethods were used and data were collected by qualitative interviews and quantitative data collectedby the Norbeck Social Support Questionnaire (NSSQ). Studying the figures measured byNSSQ, no significant differences were found according to gender but foreign-born men scoredlower than Swedish, especially in emotional support and aid. The main findings showed that respondents,irrespective of origin, described the meaning of the concept of support mainly as informationsupport in learning to manage DM. However, foreign-born persons also focused onmedical support with regular follow-ups while Swedes emphasized the need for emotional support.Foreign- and Swedish-born persons are in general more similar than dissimilar in describingthe meaning, need and impact of support. Irrespective of origin they want to learn to manage theirdisease and thus desire and need regular follow-up and information immediately from being diagnosed.Further studies are needed as the study is based on a limited sample.

  • 46.
    Holm, Anne Lise
    et al.
    Buskerud & Vestfold University College, The Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Kongsberg, Norway.
    Lyberg, Anne
    Buskerud & Vestfold University College, The Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Kongsberg, Norway.
    Berggren, Ingela
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Åström, Sture
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Severinson, Elisabeth
    Buskerud & Vestfold University College, The Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Kongsberg, Norway.
    Social Capital and Depressive Ill-Health: An Evaluative Approach to the Implementation of the Chronic Care Model (CCM)2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 10, p. 683-694Article in journal (Refereed)
    Abstract [en]

    Background: Social capital has been described as a person's sense of belonging as a result of the number and type of relationships she/he has, in which trust and reciprocity are especially important. Aim: To illuminate older persons' experiences of social capital and depressive ill-health after implementation of the CCM. Methods: Data were collected from nine participants resident in two districts of Norway by means of individual in-depth interviews. A qualitative hermeneutic analysis was performed. Results: Two overall themes, desire for a guardian and a wish for independence despite being dependent, and two themes emerging from the analysis. The first theme—searching for protection was based on three sub-themes overwhelmed by the emotional pain of other people, a sense of exclusion and worries about the future, while the second theme—the need for a relationship with trustworthy persons comprised two sub-themes, namely, emotional pain was not understood and powerlessness to change the situation. The result of this study highlights the need for greater understanding on the part of healthcare professionals of how older persons manage their social relationships. Healthcare professionals require more knowledge about how negative self-beliefs held by older persons suffering from emotional pain, which can lead to reduced ability to trust other people. Another consequence is that fear of being dependent on other people can result in unwillingness to admit the need for help. Conclusion: This study highlights the lack of social capital in older persons who suffer from depressive ill-health. The implementation of the CCM does not appear to improve the situation. Older persons need to be more aware of their social needs and productive interactions in order to protect themselves and obtain support from their social network.

  • 47.
    Hove, Randi
    et al.
    Institute of Nursing, Department of Health and Social Sciences, Bergen University College, Bergen, Norway.
    Fålun, Nina
    Institute of Nursing, Department of Health and Social Sciences, Bergen University College, Bergen, Norway.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Nurses’ experiences of using the Liverpool Care Pathway Plan in hospitalized patients with heart failure in the end-of-life stage: A qualitative content analysis2016In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 6, no 8, p. 591-599Article in journal (Refereed)
    Abstract [en]

    Background: The introduction of care pathway plans for end-of-life cares such as the Liverpool Care Pathway (LCP) reveals a unique possibility for inter professional collaboration. Knowledge of symptom relief and how to meet the patients’ needs at the last stage of the palliative phase are essential for the nurses’ approach and care actions, but the documentation of such implementations is still rare and sometimes criticized.

    Aim: To explore and describe nurses’ experiences of using the LCP plan with patients hospitalized with heart failure at the end-of-life stage. An explorative design was applied, using qualitative content analysis of 20 interviews with nurses practicing the LCP plan in two district hospitals in Norway.

    Results: The nurses found the LCP plan as quality assurance for treatment and care in patients with heart failure in the last hours and days of life. The use of the LCP plan implied: 1) individualized adjustment, 2) symptom relief and 3) a holistic approach.

    Conclusion: Nurses experienced that using the LCP plan as a comprehensive action plan contributed in the decision making process and improved inter professional communication. Using the LCP plan should be seen as a tool to practice individualized and holistic nursing to patients at the end-of-life and their families, as well as a purposeful relief of symptoms associated with heart failure.

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  • 48.
    Hägglund, Doris
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Mooney, Tiffany
    Vårdcentralen Leksand.
    Momats, Emma
    Akutavdelning Mora lasarett.
    Nursing staff´s experiences of providing toilet assistance to elderly nursing home residents with urinary incontinence.2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, no 2, p. 145-157Article in journal (Refereed)
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  • 49.
    Häggström, Marie
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Rising Holmström, Malin
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Establishing Patient Safety in Intensive Care -A Grounded Theory.: Building Trust-Important for Patient Safety2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 07, no 10Article in journal (Refereed)
    Abstract [en]

    Background: The modern intensive care unit (ICU) is a complex and high-risk environment, and even small adverse events and changes may deteriorate the patient’s conditions and eventually cause harm. Many factors can potentially be associated within an increased amount of errors, leading to adverse events. Nurses, nurse managers, and other leaders all play important roles in establishing patient safety. Aim: This study aimed to obtain a deeper understanding of leaders’ and nurses’ main concerns in establishing patient safety in Swedish intensive care units. Method: A grounded theory methodology was used. Data from 15 interviews with leaders and nurses involved in critical care in Sweden were collected, analysed and constant compared. Findings: The main concern in establishing patient safety was promoting quality of care, work engagement, and staffs well-being in strained ICUs. The core category building trust explained how the leaders’ and nurses’ strove for quality of care and wished a healthy, safe work environment. This is further explained in the categories “Being an accessible and able leader”, “Creating knowledge and understanding”, and “Establishing collaborative practice”. Conclusion: Establishing patient safety in the ICU requires that staffs enjoy going to work, have good work relations, are committed and want to stay at the unit. A healthy, salutogenetic unit with a work environment marked by trust provides a better opportunity to establish patient safety, and various leaders have potential to achieve this.

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  • 50.
    Janlöv, Ann-Christin
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Berg, Agneta
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    The nurses’ voice of working in a newly established community based 24-hour support center for people with psychiatric disabilities2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 2, p. 195-201Article in journal (Refereed)
    Abstract [en]

    This study explores the perceptions of a small group of nurses working at a newly established 24-hour community-based service enter (SC) for users with psychiatric disability using a qualitative approach. Since the mental health reform in Sweden in 1995 where the communities (in Sweden called municipalities) were given the responsibility to establish service and support to people with severe psychiatric disabilities, they have struggled in finding suitable forms of these kinds of areas. In 2010, this led to the creation and development of a new center aiming to provide services and support based on the expressed needs of people with physchiatric disability in a community located in southern Sweden. During 2011, a total of three group interviews were performed to capture the employed nurses’ perceptions of this newly established SC. The interview texts were analyzed by way of qualitative content analysis. A first reading of the interview texts revealed that the nurses’ perceptions of the service center were unwaveringly positive but that their beliefs about who the specific target group were differed. The main finding was summarized by the theme: Making a difference—on an individual, professional, and organizational level. The sub themes were: 24-hour availability, unclear assignment, and preventing mental illness. The findings indicate a need for a community round-the-clock service center in this Swedish community and a more clear definition of the target group.

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