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  • 1. Abdelrazek, Fathya
    et al.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Aly, Magda
    El-Sabour, Mona Abd
    Ibrahim, Naglaa
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Leadership and management skills of first-line managers of elderly care and their work environment2010In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 18, no 6, p. 736-745Article in journal (Refereed)
    Abstract [en]

    Aim To study the leadership and management skills of first-line managers (FLMs) of elderly care and their work environment in Egypt and Sweden. Background FLMs in Egypt and Sweden are directly responsible for staff and quality of care. However, FLMs in Sweden, in elderly care, have smaller units/organizations to manage than do their colleagues in Egypt. Furthermore, family care of the elderly has been the norm in Egypt, but in recent years institutional care has increased, whereas in Sweden, residential living homes have existed for a longer period. Methods A convenience sample of FLMs, 49 from Egypt and 49 from Sweden, answered a questionnaire measuring leadership and management skills, structural and psychological empowerment, job satisfaction and psychosomatic health. Results In both countries, FLMs' perceptions of their leadership and management skills and psychological empowerment were quite high, whereas scores for job satisfaction and psychosomatic health were lower. FLMs had higher values in several factors/study variables in Egypt compared with in Sweden. Conclusion and implications The work environment, both in Egypt and Sweden, needs to be improved to increase FLMs' job satisfaction and decrease stress. The cultural differences and levels of management have an effect on the differences between the two countries.

  • 2.
    Abdelrazek, Fathya
    et al.
    Faculty of Nursing, Suez Canal University, Port-Said, Egypt.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Aly, Magda
    Faculty of Nursing, Suez Canal University, Port-Said, Egypt.
    El-Sabour, Mona Abd
    Faculty of Nursing, Suez Canal University, Port-Said, Egypt.
    Ibrahim, Naglaa
    Faculty of Nursing, Suez Canal University, Port-Said, Egypt.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Leadership and management skills of first-line managers of elderly care and their work environment2010In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 18, no 6, p. 736-745Article in journal (Refereed)
    Abstract [en]

    Aim To study the leadership and management skills of first-line managers (FLMs) of elderly care and their work environment in Egypt and Sweden. Background FLMs in Egypt and Sweden are directly responsible for staff and quality of care. However, FLMs in Sweden, in elderly care, have smaller units/organizations to manage than do their colleagues in Egypt. Furthermore, family care of the elderly has been the norm in Egypt, but in recent years institutional care has increased, whereas in Sweden, residential living homes have existed for a longer period. Methods A convenience sample of FLMs, 49 from Egypt and 49 from Sweden, answered a questionnaire measuring leadership and management skills, structural and psychological empowerment, job satisfaction and psychosomatic health. Results In both countries, FLMs' perceptions of their leadership and management skills and psychological empowerment were quite high, whereas scores for job satisfaction and psychosomatic health were lower. FLMs had higher values in several factors/study variables in Egypt compared with in Sweden. Conclusion and implications The work environment, both in Egypt and Sweden, needs to be improved to increase FLMs' job satisfaction and decrease stress. The cultural differences and levels of management have an effect on the differences between the two countries.

  • 3. Albinsson, A
    et al.
    Krantz, Margaretha
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Lundvall, A
    Engberg, IB
    Proportion of Swedish school nurses' time devoted to different health care activities1996In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 4, no 5, p. 281-288Article in journal (Refereed)
  • 4. Aljuaid, Mohammed
    et al.
    Elmontsri, Mustafa
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Rawaf, Salman
    Majeed, Azeem
    Psychometric evaluation of the Arabic language person-centred climate questionnairestaff version2018In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 26, no 4, p. 449-456Article in journal (Refereed)
    Abstract [en]

    AimTo evaluate the psychometric properties of the Arabic language person-centred climate questionnairestaff version. BackgroundThere have been increasing calls for a person-centred rather than a disease-centred approach to health care. A limited number of tools measure the extent to which care is delivered in a person-centred manner, and none of these tools have been validated for us in Arab settings. MethodThe validated form of the person-centred climate questionnairestaff version was translated into Arabic and distributed to 152 health care staff in teaching and non-teaching hospitals in Saudi Arabia. Statistical estimates of validity and reliability were used for psychometric evaluation. ResultsItems on the Arabic form of the person-centred climate questionnairestaff version had high reliability (Cronbach's alpha .98). Cronbach's alpha values for the three sub-scales (safety, everydayness and community), were .96, .97 and .95 respectively. Internal consistency was also high and measures of validity were very good. ConclusionArabic form of the person-centred climate questionnairestaff version provides a valid and reliable way to measure the degree of perceived person-centredness. Implications for nursing managementThe tool can be used for comparing levels of person-centredness between wards, units, and public and private hospitals. The tool can also be used to measure the extent of person-centredness in health care settings in other Arab countries.

  • 5.
    Alnes, Rigmor Einang
    et al.
    Department of Health Science, Aalesund University College, Aalesund, Norway; Center for Care Research, Steinkjer, Norway.
    Kirkevold, Marit
    Institute of Health and Society, Department of Nursing Science, University of Oslo, Oslo, Norway; Institute of Public Health, Aarhus University, Aarhus, Denmark.
    Skovdahl, Kirsti
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Health Science, Aalesund University College, Aalesund, Norway.
    The influence of the learning climate on learning outcomes from Marte Meo counselling in dementia care2013In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 21, no 1, p. 130-140Article in journal (Refereed)
    Abstract [en]

    AIM:   To identify factors that affected the learning outcomes from Marte Meo counselling (MMC).

    BACKGROUND:   Although MMC has shown promising results regarding learning outcomes for staff working in dementia-specific care units, the outcomes differ.

    METHOD:   Twelve individual interviews and four focus group interviews with staff who had participated in MMC were analysed through a qualitative content analysis.

    RESULTS:   The learning climate has considerable significance for the experienced benefit of MMC and indicate that this learning climate depends on three conditions: establishing a common understanding of the content and form of MMC, ensuring staff's willingness to participate and the opportunity to do so, and securing an arena in the unit for discussion and interactions.

    CONCLUSION:   Learning outcomes from MMC in dementia-specific care units appear to depend on the learning climate in the unit. Implication for nursing management  The learning climate needs attention from the nursing management when establishing Marte Meo intervention in nursing homes. The learning climate can be facilitated through building common understandings in the units regarding why and how this intervention should take place, and by ensuring clarity in the relationship between the intervention and the organization's objectives.

  • 6.
    Andersson, Inger S.
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Lindgren, Margareta
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Perceptions of nursing care quality, in acute hospital settings measured by the Karen instruments2013In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 21, no 1, p. 87-93Article in journal (Refereed)
    Abstract [en]

    Aims The objectives of this study were to measure the quality of nursing care from the perspectives of patients and personnel and to compare these perspectives. Background The perception of quality in nursing care is affected by patient needs and it is common that patients and personnel disagree on the nature of the quality. Thus, it is important to measure the quality from both perspectives. Method A total of 95 patients and 120 personnel from surgical and medical wards at a hospital in Sweden participated. The Karen instruments were used for data collection. A scale index was used for comparison of the perspectives. Results The patients and personnel were satisfied with the quality of care and there were no obvious differences in the total index. The different subscales indicated areas of lower care quality in need of improvement. Conclusion The quality of the care seemed to be satisfactory from the perspectives of both the patients and the personal. Further analysis from the subscale or a variable level is needed to define areas of lower care quality. Implications for Nursing Management Measurements have to be carried out continuously to guarantee care quality over time, as a result of organisational changes and financial cutbacks.

  • 7.
    Andreasson, Jörgen
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Eriksson, Andrea
    Dellve, Lotta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Health care managers' views on and approaches to implementing models for improving care processes.2015In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834Article in journal (Refereed)
    Abstract [en]

    AIM: To develop a deeper understanding of health-care managers' views on and approaches to the implementation of models for improving care processes.

    BACKGROUND: In health care, there are difficulties in implementing models for improving care processes that have been decided on by upper management. Leadership approaches to this implementation can affect the outcome.

    METHOD: In-depth interviews with first- and second-line managers in Swedish hospitals were conducted and analysed using grounded theory.

    RESULTS: 'Coaching for participation' emerged as a central theme for managers in handling top-down initiated process development. The vertical approach in this coaching addresses how managers attempt to sustain unit integrity through adapting and translating orders from top management. The horizontal approach in the coaching refers to managers' strategies for motivating and engaging their employees in implementation work.

    CONCLUSION AND IMPLICATIONS FOR NURSING MANAGEMENT: Implementation models for improving care processes require a coaching leadership built on close manager-employee interaction, mindfulness regarding the pace of change at the unit level, managers with the competence to share responsibility with their teams and engaged employees with the competence to share responsibility for improving the care processes, and organisational structures that support process-oriented work. Implications for nursing management are the importance of giving nurse managers knowledge of change management.

  • 8.
    Andreasson, Jörgen
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Health care managers' views on and approaches to implementing models for improving care processes2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 2Article in journal (Refereed)
    Abstract [en]

    Aim: To develop a deeper understanding of health-care managers' views on and approaches to the implementation of models for improving care processes. Background: In health care, there are difficulties in implementing models for improving care processes that have been decided on by upper management. Leadership approaches to this implementation can affect the outcome. Method: In-depth interviews with first- and second-line managers in Swedish hospitals were conducted and analysed using grounded theory. Results: 'Coaching for participation' emerged as a central theme for managers in handling top-down initiated process development. The vertical approach in this coaching addresses how managers attempt to sustain unit integrity through adapting and translating orders from top management. The horizontal approach in the coaching refers to managers' strategies for motivating and engaging their employees in implementation work. Conclusion and implications for nursing management: Implementation models for improving care processes require a coaching leadership built on close manager-employee interaction, mindfulness regarding the pace of change at the unit level, managers with the competence to share responsibility with their teams and engaged employees with the competence to share responsibility for improving the care processes, and organisational structures that support process-oriented work. Implications for nursing management are the importance of giving nurse managers knowledge of change management.

  • 9.
    Antierens, Alain
    et al.
    CNO, BZIO Rehabilitation Hospital, Ostend, Belgium; Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; School of Health Sciences, University of Surrey, Guilford, UK; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland.
    Verhaeghe, Sofie
    Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
    Myny, Dries
    CNO, BZIO Rehabilitation Hospital, Ostend, Belgium; CNO, OLV van Lourdes Hospital, Waregem, Belgium.
    Van Hecke, Ann
    Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    How much of Toyota's philosophy is embedded in health care at the organisational level? A review2018In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 26, no 4, p. 348-357Article, review/survey (Refereed)
    Abstract [en]

    AIMS: Identify which of Toyota's principles are reported in health care institutions at the organisational level and to identify the type of reported outcomes related to the effectiveness of lean production reported in these studies.

    BACKGROUND: No scientific research has been conducted to determine which of Toyota's principles are embedded in health care systems. This knowledge is needed to perform targeted adjustments in health care.

    EVALUATION: Sixty studies were identified for the final analysis.

    KEY ISSUE(S): Some Toyota Way principles appear more deeply embedded in health care institutions than others are.

    CONCLUSION: Not all principles of Toyota's philosophy and production system were embedded in the studies in this review. The type of reported outcomes at the organisational level was diverse.

    IMPLICATIONS FOR NURSING MANAGEMENT: This literature review increases our knowledge about how many (and which) of the Toyota Way principles are embedded in health care. This knowledge may support reflection by nursing managers about how the full range of lean management principles could be embedded at the managerial and/or operational level.

  • 10.
    Antierens, Alain
    et al.
    CNO, BZIO Rehabilitation Hospital, Ostend, Belgium; Faculty of Medicine and Health Sciences, Department of public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Ireland.
    Verhaeghe, Sofie
    Faculty of Medicine and Health Sciences, Department of public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium.
    Van Hecke, Ann
    Faculty of Medicine and Health Sciences, Department of public Health, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; Staff member Nursing Department, Ghent University Hospital, Belgium.
    Wanted in health care: Lean experts with a broad perspective2019In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, no 6, p. 1332-1336Article in journal (Refereed)
    Abstract [en]

    AIM: To reflect on Lean experts' perspective on components of Lean management in health care and its implications for practice.

    BACKGROUND: The involvement of Lean experts is one of the key success factors of a sustainable Lean transformation in health care.

    EVALUATION: Thirteen Lean experts participated in two focus groups. They all had experience in the implementation of Lean in healthcare organizations.

    KEY ISSUES: Lean experts all seem to have a unique perspective on Lean management in health care. Experts without a healthcare degree appear to focus more on the entire management system, where experts with a nursing degree seem to concentrate more on the soft Lean principles.

    CONCLUSION: The description of Lean and its components in health care differed between Lean experts. Their professional background appears to have an influence.

    IMPLICATIONS FOR NURSING MANAGEMENT: In selecting a Lean expert, nurse managers may want to gauge what elements the Lean expert tends to emphasize. It seems plausible to opt for a Lean expert without a healthcare degree to accomplish the Lean transformation as they have a broader view on Lean. It may also be useful for managers to involve several Lean experts, all with complementary perspectives and backgrounds.

  • 11. Antonsson, Helen
    et al.
    Eriksson Korjonen, Susanne
    Rosengren, Kristina
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    First-line managers’ experiences of alternative modes of funding in elderly care in Sweden2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 6, p. 737-747Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to describe first-line managers’ experiences of alternative modes of funding elderly care in two communities in western Sweden.

     Background: A growing elderly population demands alternative modes of funding elderly care for better outcomes for patients and better efficiency as it is publicly funded through taxation.

     Methods: The study comprised a total of eight semi-structured interviews with first-line managers working within elderly care. The interviews were analysed using manifest qualitative content analysis. Respect for the individuals was a main concern in the study.

     Results: One category, quality improvement, and four subcategories freedom of choice, organisational structure, quality awareness and market forces effects were identified to describe first-line managers’ experiences of the operation of elderly care.

     Conclusions: Quality improvement was an important factor to deal with when elderly care was operated in different organisational perspectives, either private or public. The first-line manager is a key person for developing a learning organisation that encourages both staff, clients and their relatives to improve the organisation. Moreover, person-centred care strengthens the client’s role in the organisation, which is in line with the government’s goal for the quality improvement of elderly care. However, further research is needed on how quality improvement could be developed when different caregivers operate in the same market in order to improve care from the elderly perspective.

    Implications for nursing management: This study highlights alternative modes of funding elderly care. The economical perspectives should not dominate without taking care of quality improvement when the operation of elderly care is planned and implemented. Strategies such as a learning organisational structure built on person-centred care could create quality improvement in elderly care.

  • 12.
    Arman, Rebecka
    et al.
    School of Business, Economics and Law, University of Gothenburg.
    Dellve, Lotta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Wikström, Ewa
    Törnström, Linda
    What health care managers do: applying Mintzberg's structured observation method2009In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 17, no 6, p. 718-729Article in journal (Refereed)
    Abstract [en]

    Aim The aim of the present study was to explore and describe what characterizes first- and second-line health care managers' use of time. Background Many Swedish health care managers experience difficulties managing their time. Methods Structured and unstructured observations were used. Ten first- and second-line managers in different health care settings were studied in detail from 3.5 and 4 days each. Duration and frequency of different types of work activities were analysed. Results The individual variation was considerable. The managers' days consisted to a large degree of short activities (<9 minutes). On average, nearly half of the managers' time was spent in meetings. Most of the managers' time was spent with subordinates and <1% was spent alone with their superiors. Sixteen per cent of their time was spent on administration and only a small fraction on explicit strategic work. Conclusions The individual variations in time use patterns suggest the possibility of interventions to support changes in time use patterns. Implications for nursing management A reliable description of what managers do paves the way for analyses of what they should do to be effective.

  • 13.
    Arman, Rebecka
    et al.
    Sahlgrenska akademin, Göteborgs universitet.
    Dellve, Lotta
    Sahlgrenska akademin, Göteborgs universitet.
    Wikström, Ewa
    Sahlgrenska akademin, Göteborgs universitet.
    Törnström, Linda
    Sahlgrenska akademin, Göteborgs universitet.
    What health care managers do: Applying Mintzberg’s structured observation method2009In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 17, no 6, p. 718-729Article in journal (Refereed)
    Abstract [en]

     Aim The aim of the present study was to explore and describe what characterizes first-and second-line health care managers' use of time. Background Many Swedish health care managers experience difficulties managing their time. Methods Structured and unstructured observations were used. Ten first-and second-line managers in different health care settings were studied in detail from 3.5 and 4 days each. Duration and frequency of different types of work activities were analysed. Results The individual variation was considerable. The managers' days consisted to a large degree of short activities (<9 minutes). On average, nearly half of the managers' time was spent in meetings. Most of the managers' time was spent with subordinates and <1% was spent alone with their superiors. Sixteen per cent of their time was spent on administration and only a small fraction on explicit strategic work. Conclusions The individual variations in time use patterns suggest the possibility of interventions to support changes in time use patterns. Implications for nursing management A reliable description of what managers do paves the way for analyses of what they should do to be effective.

  • 14. Arvidsson, B
    et al.
    Fridlund, Bengt
    Lunds universitet.
    Factors influencing nurse supervisor competence: a critical incident analysis study2005In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 13, no 3, p. 231-237Article in journal (Refereed)
  • 15. Arvidsson, B
    et al.
    Löfgren, H
    Fridlund, Bengt
    Högskolan i Halmstad.
    Psychiatric nurses' conceptions of how a group supervision programme in nursing care influences their professional competence: a 4-year follow-up study2001In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 9, no 3, p. 161-171Article in journal (Refereed)
  • 16. Arvidsson, B
    et al.
    Löfgren, H
    Fridlund, Bengt
    Högskolan i Halmstad.
    Psychiatric nurses' conceptions of how group supervision in nursing care influences their professional competence2000In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 8, no 3, p. 175-185Article in journal (Refereed)
  • 17. Arvidsson, B
    et al.
    Skärsäter, I
    Oijervall, J
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Process-oriented group supervision implemented during nursing education: nurses' conceptions 1 year after their nursing degree2008In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 16, no 7, p. 868-875Article in journal (Refereed)
    Abstract [en]

    AIM: To describe the variation in how nurses conceive process-oriented group supervision, implemented during nursing education, 1 year after their nursing degree. BACKGROUND: Process-oriented group supervision can be an effective support system for helping nursing students and nurses to reflect on their activities. METHODS: A descriptive qualitative design was chosen for the study. Conceptions were collected through interviews with 18 strategically selected Swedish nurses in 2005. RESULTS: Three descriptive categories comprising seven conceptions were emerged. Supportive actions comprised: a sense of security, belonging and encouragement. Learning actions involved: sharing and reflecting while developmental actions described: enabling professional identity and facilitating personal development. CONCLUSIONS: Process-oriented group supervision has a lasting influence on nurses' development. The possibility to reflect over new stances during nursing education was a prerequisite for the provision of high-quality care. Process-oriented group supervision can make an important contribution to nursing education. IMPLICATIONS FOR NURSING MANAGEMENT: Process-oriented group supervision provides nurses with the strength to achieve resilience to stress in their work. It may lead to autonomy as well as clarity in the nurse's professional function. This indicates the need for nurse managers to organize reflective group supervision as an integral part of the nurse's work.

  • 18.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Department of Nursing, Lund University, Lund, Sweden.
    Factors influencing nurse supervisor competence: a critical incident analysis study2005In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 13, no 3, p. 231-237Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to identify factors related to critical incidents that influence the competence of nurse supervisors. Nurse supervisors require considerable competence in order to help supervisees to reflect on their clinical work and to interpret the needs of the patient. A qualitative approach involving the critical incident technique was used. Critical incidents were collected by means of self-reports from 25 nurse supervisors. Two main areas emerged: a professional and a personal stance. The professional stance described the nurse supervisors’ awareness of the importance of creating a secure learning environment and facilitating reflection. The supervisors structured the material and created awareness of fundamental nursing values. The second main area, personal stance, described the nurse supervisors’ behaviour when they gave the participating nurses the opportunity to work through the experiences gained in the daily provision of nursing care. Although they experienced lack of self-assurance during the supervision session, they also expressed security regarding their own performance as nurse supervisors. Nurse supervisors need to include more nursing theory and focus on the nursing process as well as being aware of their own shortcomings and resources. One way for the supervisior to scrutinize his/her actions is to discuss and examine them with a more experienced nurse supervisor colleague.

  • 19.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Löfgren, H.
    Department of Educational and Psychological Research, School of Education, Malmö University, Malmö, Sweden .
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Psychiatric nurses' conceptions of how a group supervision programme in nursing care influences their professional competence: a 4-year follow-up study2001In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 9, no 3, p. 161-171Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of the study was to describe, after 4 years, psychiatric nurses' conceptions of how a 2-year group supervision programme within nursing care had influenced their professional competence.

    BACKGROUND: The intention of group supervision in nursing care is to understand nurses' experiences within real care settings and to structure these in a professional and personal context.

    METHODS: Ten psychiatric nurses participated in a 2-year group supervision programme. They were interviewed 4 years after the group supervision was ended. Data were analysed according to the phenomenographic method.

    FINDINGS: Six description categories emerged: a feeling of job satisfaction; gaining knowledge and competence; gaining a sense of security in nursing situations; a feeling of personal development; realizing the value of supervision; and a sense of professional solidarity.

    CONCLUSIONS: The findings of the 4-year follow-up showed that a group supervision programme in nursing care had lasting influences on the psychiatric nurses' professional competence in the form of a pronounced professional identity and an integrated nursing care perspective. Group supervision contributes to maintaining the strength and energy needed to carry on working, which makes continuing supervision necessary.

    IMPLICATIONS: An important research implication could be to investigate the type of knowledge that ought to be developed within group supervision in nursing care.

    © 2001 Blackwell Science Ltd.

  • 20.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Löfgren, H.
    Department of Educational and Psychological Research, School of Education, Malmö University, Malmö, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Psychiatric nurses' conceptions of how group supervision in nursing care influences their professional competence2000In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 8, no 3, p. 175-185Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of the study was to describe, after 1 and 2 years respectively, psychiatric nurses' conceptions of how group supervision within nursing care influenced their professional competence.

    BACKGROUND: The intention of group supervision in nursing care is to understand nurses' experiences within real care settings and to structure these in a professional and personal context.

    THE STUDY: Ten psychiatric nurses participated in the group supervision. They were interviewed on two occasions: after 1 and 2 years, respectively.

    FINDINGS: The data analysis was influenced by the phenomenographic approach and provided four description categories: a feeling of job satisfaction; acquiring knowledge and competence; gaining a sense of security in nursing situations; and a feeling of personal development.

    CONCLUSIONS: In supervision, practice and theory are integrated, resulting in enhanced nursing competence among the participants. Supervision should be an integrated part of nursing work and regarded as a means of quality assurance. A long-term follow-up could give valuable proof that group supervision in nursing care has a lasting effect on nurses' professional competence.

  • 21.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Skärsäter, Ingela
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Science, Göteborg, Sweden.
    Öijervall, Jörgen
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Process-oriented group supervision implemented during nursing education: nurses’ conceptions 1 year after their nursing degree2008In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 16, no 7, p. 868-875Article in journal (Refereed)
    Abstract [en]

    AIM: To describe the variation in how nurses conceive process-oriented group supervision, implemented during nursing education, 1 year after their nursing degree. BACKGROUND: Process-oriented group supervision can be an effective support system for helping nursing students and nurses to reflect on their activities. METHODS: A descriptive qualitative design was chosen for the study. Conceptions were collected through interviews with 18 strategically selected Swedish nurses in 2005. RESULTS: Three descriptive categories comprising seven conceptions were emerged. Supportive actions comprised: a sense of security, belonging and encouragement. Learning actions involved: sharing and reflecting while developmental actions described: enabling professional identity and facilitating personal development. CONCLUSIONS: Process-oriented group supervision has a lasting influence on nurses' development. The possibility to reflect over new stances during nursing education was a prerequisite for the provision of high-quality care. Process-oriented group supervision can make an important contribution to nursing education. IMPLICATIONS: for Nursing Management Process-oriented group supervision provides nurses with the strength to achieve resilience to stress in their work. It may lead to autonomy as well as clarity in the nurse's professional function. This indicates the need for nurse managers to organize reflective group supervision as an integral part of the nurse's work.

  • 22.
    Athlin, Elsy
    et al.
    Karlstad University, Department of Nursing.
    Larsson, Maria
    Karlstad University, Department of Nursing.
    Söderhamn, Olle
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    A model for a national clinical final examination in the Swedish bachelor programme in nursing2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 1, p. 90-101Article in journal (Refereed)
    Abstract [en]

    Aim To describe the development and evaluation of a model for a national clinical final examination in the bachelor nursing education.

    Background After the transfer of nursing education to the academy, concerns have been raised among nurses, nurse leaders, lecturers and researchers about the nursing students clinical competence at the entrance to professional life.

    Methods During 2003 to 2005, a collaborative project was carried out between four universities and adjunctive health-care areas supplying clinical placements in Sweden. A two-part examination was agreed upon comprising a written theoretical test and a bedside test. An assessment tool for the bedside test was created. Nursing students, nurses and clinical lecturers participated voluntarily in the evaluation.

    Results The model was highly appreciated, and its relevance, usability, and validity were considered quite good for the assessment of nursing students clinical competence at the final stage of their education. Several deficiencies were revealed, which led to further development of the model.

    Conclusions and implications for nursing management The development and first evaluation of the model proved encouraging for further use, but it needs further evaluation. Involvement of nursing managers is necessary in order to satisfy new demands on competence and staffing of clinical nurses.

  • 23.
    Athlin, Elsy
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Larsson, Maria
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Söderhamn, Olle
    Universitetet i Agder.
    A model for national clinical final examination in the Swedish bachelor programme in nursing2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 1, p. 90-101Article in journal (Refereed)
    Abstract [en]

    Aim To describe the development and evaluation of a model for a national clinical final examination in the bachelor nursing education. Background  After the transfer of nursing education to the academy, concerns have been raised among nurses, nurse leaders, lecturers and researchers about the nursing students’ clinical competence at the entrance to professional life. Methods  During 2003 to 2005, a collaborative project was carried out between four universities and adjunctive health-care areas supplying clinical placements in Sweden. A two-part examination was agreed upon comprising a written theoretical test and a bedside test. An assessment tool for the bedside test was created. Nursing students, nurses and clinical lecturers participated voluntarily in the evaluation. Results  The model was highly appreciated, and its relevance, usability, and validity were considered quite good for the assessment of nursing students’ clinical competence at the final stage of their education. Several deficiencies were revealed, which led to further development of the model. Conclusions and implications for nursing management  The development and first evaluation of the model proved encouraging for further use, but it needs further evaluation. Involvement of nursing managers is necessary in order to satisfy new demands on competence and staffing of clinical nurses.

  • 24.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifer y, La Trobe University, Melbourne, VIC, Australia.
    Towards person-centredness in aged-care: exploring the impact of leadership2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 6, p. 766-774Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the association between leadership behaviours among managers in aged care, and person‐centredness of care and the psychosocial climate.

    Background: Theory suggests that leadership is important for improving person‐centredness in aged care, however, empirical evidence is lacking.

    Methods: A cross‐sectional design was used to collect data from Swedish aged care staff (= 3661). Valid and reliable questionnaires assessing leadership behaviours, person‐centeredness of care and the psychosocial climate were used. Data were analysed using multiple linear regression including interaction terms.

    Results: Leadership behaviours were significantly related to the person‐centredness of care and the psychosocial climate. The level of person‐centredness of care moderated the impact of leadership on the psychosocial climate.

    Conclusions and implications for nursing management: The leadership behaviour of managers significantly impacts person‐centred care practice and contributes to the psychosocial climate for both staff and residents in aged care. This study is the first empirically to confirm that middle managers have a central leadership role in developing and supporting person‐centred care practice, thereby creating a positive psychosocial climate and high quality care.

  • 25.
    Berg, Agneta
    et al.
    Kristianstad University, Department of Health Sciences.
    Kisthinios, Marianne
    Department of Health and Society, Malmö University.
    Are supervisors using theoretical perspectives in their work?: a descriptive survey among Swedish-approved clinical supervisors2007In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 15, no 8, p. 853-861Article in journal (Refereed)
    Abstract [en]

    Aim The aim of the study was to explore the theoretical perspectives in use by approved clinical nursing supervisors in Sweden.

    Background. For the time being, we know little of the theoretical perspectives in use on a daily basis by the clinical nursing supervisors in Sweden.

    Methods. A questionnaire (n = 49) and follow-up telephone interviews (n = 14) were used. Data analysis was made by descriptive statistics and qualitative content analysis.

    Results. The result from the questionnaire showed that the supervisors often used and combined different theoretical perspectives with origins in nursing, education and psychology. Surprisingly, one-fourth of the respondents did not state any nursing theoretical perspective in use during clinical nursing supervision. The result from the interviews revealed that the theory of Katie Eriksson (1987) was the most commonly used nursing perspective.

    Conclusion. As the overall aim for clinical nursing supervision is to improve nursing for the patient/family, the supervisor's competence in nursing is essential. Given this fact, and that only three-quarters of the approved clinical nursing supervisors stated a use of theoretical nursing perspective when supervising, there is obviously a need for further investigations in this area. In addition, there is also a need for approved Swedish clinical nursing supervisors, to further become aware of the theoretical perspective in use that supports their clinical nursing supervision. Clinical nursing supervision is a multifaceted activity that needs to be supported by different nursing theoretical perspectives including physical, emotional, intellectual, spiritual as well as socio-cultural aspects.

  • 26.
    Berg, Agneta
    et al.
    Lund University, Centre of Caring Sciences.
    Welander Hansson, Ulla
    HälsoSam, Eslöv.
    Dementia care nurses experiences of systematic clinical group supervision and supervised individually planned nursing care2000In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 8, no 6, p. 357-368Article in journal (Refereed)
    Abstract [en]

    AimTo reveal 13 nurses' experiences of systematic clinical group supervision and supervised individually planned nursing care, while working with people suffering from severe dementia.

    BackgroundClinical supervision is a major issue in nursing, however empirical knowledge of the subject is limited. Nurse's narrations about their experiences may extend the knowledge available and serve as a basis for creating models of support systems for nurses in their care provision.

    MethodsOpen-ended interviews were performed and the text was analysed through content analysis. A questionnaire was used to evaluate the views of the effects of clinical supervision.

    FindingsTwo main themes were found. Confirmed uniqueness included two sub-themes: confirming the nurses as a person and as a professional and confirming the patient as a unique human being. Consolidated sense of community included three sub-themes: closer relationship between the nurses, changed organization of nursing care and improved individualizing in routines of nursing care. The questionnaire result showed improvements in co-operation and in providing professional nursing care and personal development.

    ConclusionInterventions to improve working conditions for the nurses and care quality for the patients may well focus the core process, i.e. feedback and support for the nurse–patient interaction and person-orientated nursing care, taking into account the constellation and conditions of the group.

  • 27.
    Berggren, Ingela
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Severinsson, Elisabeth
    University of Stavanger, Faculty of Social Sciences.
    The significance of nurse supervisors' different ethical decision-making styles2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 8, p. 637-43Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The role of the nurse supervisor is very important, because of his/her ability to influence the atmosphere within the clinical nursing supervision group. AIM: To present and interpret nurse supervisors' different ethical decision-making styles. METHOD: A hermeneutic interpretation of three studies on nurse supervisors' different ethical decision-making styles. RESULTS: The significance of the nurse supervisor's ethical decision-making style is reflected in the awareness of their responsibility for creating a relationship with the supervisee. The supervisors focus on ensuring safety, integrating theoretical knowledge and clinical practice, willingness and preparedness to supervise on the substance of nursing, sharing the supervisees' feelings and challenging them, reflecting on the content of clinical nursing supervision as well as promoting justice and integrity in clinical nursing supervision. CONCLUSIONS: The interpretation highlights the importance of the nurse supervisor's style for the outcome of clinical nursing supervision, as they are role models for the supervisees. There is a need for further research to explore the advantages and disadvantages of nurse supervisors' different ethical decision-making styles, especially in relation to the influence of clinical nursing supervision on the quality of care and various support systems.

  • 28.
    Bergh, Anne-Louise
    University of Borås, School of Health Science.
    Registered nurses’ perceptions of conditions for patient education: focusing on organizational, environmental and professional cooperation aspects.2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 6, p. 758-770Article in journal (Refereed)
    Abstract [en]

    AIM: To describe nurses' perceptions of conditions for patient education, focusing on organisational, environmental and professional cooperation aspects, and to determine any differences between primary, municipal and hospital care. BACKGROUND: Although patient education is an important part of daily nursing practice, the conditions for this work are unclear and require clarification. METHOD: A stratified random sample of 701 (83%) nurses working in primary, municipal and hospital care completed a 60-item questionnaire. The study is part of a larger project. The study items relating to organisation, environment and professional cooperation were analysed using descriptive statistics, non-parametric tests and content analysis. RESULTS: Conditions for patient education differ. Nurses in primary care had better conditions and more managerial support, for example in the allocation of undisturbed time. CONCLUSIONS: Conditions related to organisation, environment and cooperation need to be developed further. In this process, managerial support is important, and nurses must ask for better conditions in order to carry through patient education. IMPLICATIONS FOR NURSING MANAGEMENT: Managerial support for the development of visible patient education routines (e.g. allocation of time, place and guidelines) is required. One recommendation is to designate a person to oversee educational work.

  • 29.
    Berglund, Mia
    et al.
    Univ Skövde.
    Sjögren, Reet
    Mälardalen University, School of Health, Care and Social Welfare.
    Ekebergh, Margaretha
    Linneuniv.
    Reflect and learn together - when two supervisors interact in the learning support process of nurse education2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 2, p. 152-158Article in journal (Refereed)
    Abstract [en]

    Aim To describe the importance of supervisors working together in supporting the learning process of nurse students through reflective caring science supervision. Background A supervision model has been developed in order to meet the need for interweaving theory and practice. The model is characterized by learning reflection in caring science. A unique aspect of the present project was that the student groups were led by a teacher and a nurse. Method Data were collected through interviews with the supervisors. The analysis was performed with a phenomenological approach. Results The results showed that theory and practice can be made more tangible and interwoven by using two supervisors in a dual supervision. The essential structure is built on the constituents 'Reflection as Learning Support', 'Interweaving Caring Science with the Patient's Narrative', 'The Student as a Learning Subject' and 'The Learning Environment of Supervision'. Conclusion The study concludes that supervision in pairs provides unique possibilities for interweaving and developing theory and practice. Implications for nursing management The supervision model offers unique opportunities for cooperation, for the development of theory and practice and for the development of the professional roll of nurses and teachers.

  • 30.
    Berglund, Mia
    et al.
    University of Skövde, School of Life Sciences.
    Sjögren, Reet
    School of Health Care and Social Welfare, Mälardalen University, Västerås/Eskilstuna, Sweden.
    Ekebergh, Margaretha
    Department of Health and Caring Sciences, Linnéuniversitetet, Växjö, Sweden.
    Reflect and learn together - when two supervisors interact in the learning support process of nurse education2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 2, p. 152-158Article in journal (Refereed)
    Abstract [en]

    Aim  To describe the importance of supervisors working together in supporting the learning process of nurse students through reflective caring science supervision.

    Background  A supervision model has been developed in order to meet the need for interweaving theory and practice. The model is characterized by learning reflection in caring science. A unique aspect of the present project was that the student groups were led by a teacher and a nurse.

    Method  Data were collected through interviews with the supervisors. The analysis was performed with a phenomenological approach.

    Results  The results showed that theory and practice can be made more tangible and interwoven by using two supervisors in a dual supervision. The essential structure is built on the constituents ‘Reflection as Learning Support’, ‘Interweaving Caring Science with the Patient’s Narrative’, ‘The Student as a Learning Subject’ and ‘The Learning Environment of Supervision’.

    Conclusion  The study concludes that supervision in pairs provides unique possibilities for interweaving and developing theory and practice.

    Implications for nursing management  The supervision model offers unique opportunities for cooperation, for the development of theory and practice and for the development of the professional roll of nurses and teachers.

  • 31. Berglund, Mia
    et al.
    Sjögren, Reet
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Reflect and learn together: when two supervisors interact in the learning support process of nurse education2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 2, p. 152-158Article in journal (Refereed)
    Abstract [en]

    Aim  To describe the importance of supervisors working together in supporting the learning process of nurse students through reflective caring science supervision. Background  A supervision model has been developed in order to meet the need for interweaving theory and practice. The model is characterized by learning reflection in caring science. A unique aspect of the present project was that the student groups were led by a teacher and a nurse. Method  Data were collected through interviews with the supervisors. The analysis was performed with a phenomenological approach. Results  The results showed that theory and practice can be made more tangible and interwoven by using two supervisors in a dual supervision. The essential structure is built on the constituents ‘Reflection as Learning Support’, ‘Interweaving Caring Science with the Patient’s Narrative’, ‘The Student as a Learning Subject’ and ‘The Learning Environment of Supervision’. Conclusion  The study concludes that supervision in pairs provides unique possibilities for interweaving and developing theory and practice. Implications for nursing management  The supervision model offers unique opportunities for cooperation, for the development of theory and practice and for the development of the professional roll of nurses and teachers.

  • 32. Blomberg, Karin
    et al.
    Isaksson, Ann-Khristin
    Allvin, Renée
    Bisholt, Birgitta
    Ewertsson, Mona
    Kullén Engström, Agneta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ohlsson, Ulla
    Sundler Johansson, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Gustafsson, Margareta
    Work stress among newly graduated nurses in relation to workplace and clinical group supervision2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 1, p. 80-87Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate occupational stress among newly graduated nurses in relation to the workplace and clinicla group supervision. Being a newly graduated nurse is particulary stressful. Whar remains unclear is wehter teh workplace and clinical group supervision affect the stress. A cross-sectional comperative study was performed. Data were collected by means of a numerical scale measuring occupational stress, questions about workplace and clinicla group supervision. One hundred and thirteen nusres were included in the study. Conclusions: Newly graduated nurses experience great strss and need support. Nusrse participating in clinical group supervision reported significantly less stress.

  • 33.
    Blomberg, Karin
    et al.
    Univ Orebro, Sch Hlth & Med Sci, S-70182 Orebro, Sweden..
    Isaksson, Ann-Kristin
    Univ Orebro, Sch Hlth & Med Sci, S-70182 Orebro, Sweden..
    Allvin, Renee
    Univ Orebro, Sch Hlth & Med Sci, S-70182 Orebro, Sweden.;Orebro Univ Hosp, Clin Skills Ctr, Orebro, Sweden..
    Bisholt, Birgitta
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Ewertsson, Mona
    Univ Orebro, Sch Hlth & Med Sci, S-70182 Orebro, Sweden..
    Engstrom, Agneta Kullen
    Univ Boras, Sch Hlth, Boras, Sweden..
    Ohlsson, Ulla
    Univ Orebro, Sch Hlth & Med Sci, S-70182 Orebro, Sweden..
    Johansson, Annelie Sundler
    Univ Skovde, Sch Life Sci, Skovde, Sweden..
    Gustafsson, Margareta
    Univ Orebro, Sch Hlth & Med Sci, S-70182 Orebro, Sweden..
    Work stress among newly graduated nurses in relation to workplace and clinical group supervision2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 1, p. 80-87Article in journal (Refereed)
    Abstract [en]

    Aim The aim was to investigate occupational stress among newly graduated nurses in relation to the workplace and clinical group supervision. Background Being a newly graduated nurse is particularly stressful. What remains unclear is whether the workplace and clinical group supervision affect the stress. Method A cross-sectional comparative study was performed in 2012. Data were collected by means of a numerical scale measuring occupational stress, questions about workplace and clinical group supervision. One hundred and thirteen nurses who had recently graduated from three Swedish universities were included in the study. Results The stress was high among the newly graduated nurses but it differed significantly between workplaces, surgical departments generating the most stress. Nurses who had received clinical group supervision reported significantly less stress. The stress between workplaces remained significant also when participation in clinical group supervision was taken into account. Conclusions Newly graduated nurses experience great stress and need support, especially those in surgical departments. Nurses participating in clinical group supervision reported significantly less stress. Implications for nursing management It is important to develop strategies that help to adapt the work situation so as to give nurses the necessary support. Clinical group supervision should be considered as an option for reducing stress.

  • 34.
    Blomberg, Karin
    et al.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Isaksson, Ann-Kristin
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Allvin, Renée
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden / Clinical Skills Centre, Örebro University Hospital, Örebro, Sweden.
    Bisholt, Birgitta
    Department of Nursing, Karlstad University, Karlstad, Sweden.
    Ewertsson, Mona
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Kullén Engström, Agneta
    School of Health, University of Borås, Borås, Sweden.
    Ohlsson, Ulla
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Sundler, Annelie Johansson
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Gustafsson, Margareta
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Work stress among newly graduated nurses in relation to workplace and clinical group supervision2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 1, p. 80-87Article in journal (Refereed)
  • 35.
    Blomberg, Karin
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Isaksson, Ann-Kristin
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Allvin, Renée
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Clinical Skills Centre, Örebro University Hospital, Örebro, Örebro.
    Bisholt, Birgitta
    Department of Nursing, Karlstad University, Karlstad, Sweden.
    Ewertsson, Mona
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Kullén Engström, Agneta
    School of Health, University of Borås, Borås, Sweden.
    Ohlsson, Ulla
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Sundler, Annelie Johansson
    School of Life Sciences, University of Skövde, Skövde, Sweden.
    Gustafsson, Margareta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Work stress among newly graduated nurses in relation to workplace and clinical group supervision2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 1, p. 80-87Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to investigate occupational stress among newly graduated nurses in relation to the workplace and clinical group supervision.

    Background: Being a newly graduated nurse is particularly stressful. What remains unclear is whether the workplace and clinical group supervision affect the stress.

    Method: A cross-sectional comparative study was performed in 2012. Data were collected by means of a numerical scale measuring occupational stress, questions about workplace and clinical group supervision. One hundred and thirteen nurses who had recently graduated from three Swedish universities were included in the study.

    Results: The stress was high among the newly graduated nurses but it differed significantly between workplaces, surgical departments generating the most stress. Nurses who had received clinical group supervision reported significantly less stress. The stress between workplaces remained significant also when participation in clinical group supervision was taken into account.

    Conclusions: Newly graduated nurses experience great stress and need support, especially those in surgical departments. Nurses participating in clinical group supervision reported significantly less stress.

    Implications for nursing management: It is important to develop strategies that help to adapt the work situation so as to give nurses the necessary support. Clinical group supervision should be considered as an option for reducing stress.

  • 36.
    Blomberg, Karin
    et al.
    Örebro universitet, Sweden.
    Isaksson, Ann-Kristin
    Örebro universitet, Sweden.
    Allvin, Renée
    Örebro universitet, Sweden.
    Bisholt, Birgitta
    Karlstads universitet, Sweden.
    Ewertsson, Mona
    Örebro universitet, Sweden.
    Kullén Engström, Agneta
    Högskolan Borås, Sweden.
    Ohlsson, Ulla
    Örebro universitet, Sweden.
    Sundler Johansson, Annelie
    Högskolan Skövde, Sweden.
    Gustafsson, Margareta
    Örebro universitet, Sweden.
    Work stress among newly graduated nurses in relation to workplace and clinical group supervision2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 1, p. 80-87Article in journal (Refereed)
    Abstract [en]

    AIM: The aim was to investigate occupational stress among newly graduated nurses in relation to the workplace and clinical group supervision.

    BACKGROUND: Being a newly graduated nurse is particularly stressful. What remains unclear is whether the workplace and clinical group supervision affect the stress.

    METHOD: A cross-sectional comparative study was performed in 2012. Data were collected by means of a numerical scale measuring occupational stress, questions about workplace and clinical group supervision. One hundred and thirteen nurses who had recently graduated from three Swedish universities were included in the study.

    RESULTS: The stress was high among the newly graduated nurses but it differed significantly between workplaces, surgical departments generating the most stress. Nurses who had received clinical group supervision reported significantly less stress. The stress between workplaces remained significant also when participation in clinical group supervision was taken into account.

    CONCLUSIONS: Newly graduated nurses experience great stress and need support, especially those in surgical departments. Nurses participating in clinical group supervision reported significantly less stress.

    IMPLICATIONS FOR NURSING MANAGEMENT: It is important to develop strategies that help to adapt the work situation so as to give nurses the necessary support. Clinical group supervision should be considered as an option for reducing stress.

  • 37.
    Bondas, Terese
    University of Borås, School of Health Science.
    Paths to Nursing Leadership2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 13, no 5, p. 1-8Article in journal (Refereed)
  • 38. Boström, B
    et al.
    Hinic, H
    Lundberg, D
    Fridlund, Bengt
    Högskolan i Halmstad.
    Pain and health-related quality of life among cancer patients in final stage of life: a comparison between two palliative care teams2003In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 11, no 3, p. 189-196Article in journal (Refereed)
  • 39. Boström, B
    et al.
    Ramberg, T
    Davies, BD
    Fridlund, Bengt
    Högskolan i Halmstad.
    Survey of post-operative patients' pain management1997In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 5, no 6, p. 341-349Article in journal (Refereed)
  • 40.
    Boström, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Hinic, Hansi
    Halmstad University, School of Social and Health Sciences (HOS).
    Lundberg, Dag
    Dept. of Anaesthiol./Intensive Care, Lund University, Lund, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Pain and health-related quality of life among cancer patients in final stage of life: a comparison between two palliative care teams2003In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 11, no 3, p. 189-196Article in journal (Refereed)
    Abstract [en]

    A two-centred descriptive study was performed in order to describe and compare pain and health-related quality of life (HRQOL) among cancer patients, in their final stage of life. The patients were cared for by either a nurse-led palliative care team I (PCT I) or a physician-led palliative care team II (PCT II). Forty-six consecutive, stratified patients (PCT I, n = 21 and PCT II, n = 25) participated. The medical outcomes study short form 36 (SF-36) was used for evaluating HRQOL and the Pain-O-Meter for assessing pain. Patients' pain intensity, pain quality and HRQOL showed no significant difference between the two groups PCT I and PCT II. The patients from PCT I had significantly longer survival time (P = 0.017) than those from PCT II. The different composition of the teams being led by nurses or physicians is worth further research; both from the patient's and staff's viewpoint, there may also be cost-benefits worth examining.

  • 41.
    Boström, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Ramberg, T.
    Pain Clinic, Varberg Hospital, Varberg, Sweden.
    Davies, B.D.
    Dean of Nursing Studies, School of Nursing Studies, University of Wales, Cardi , UK.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Survey of post-operative patients' pain management1997In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 5, no 6, p. 341-349Article in journal (Refereed)
    Abstract [en]

    Although effective pain treatment is available for both cancer-related pain and acute post-operative pain, many patients suffer unnecessarily. The aim of this study was to evaluate post-operative patients' pain management. A descriptive survey study was conducted in a 460-bed acute hospital in the southwestern part of Sweden. One hundred post-operative inpatients, on their second post-operative day, took part in the study. They were consecutively selected from six surgical wards. Data were collected using an interview questionnaire designed by the American Pain Society and analysed by descriptive and inferential statistics. At the time of the interview, 29 of the patients reported moderate to severe pain. Regarding the patients' worst pain experienced during the last 24 h, 79 of them reported moderate to very severe pain. Significant correlations were found between reported poor pain relief after pain medication and high intensity of pain both within the last 24 h and at the time of the interview. Eighty-three patients were satisfied with the way nurses treated their pain, while 64 patients were satisfied with the way physicians treated their pain. However, the higher the pain intensity experienced by the patients the less satisfied they were. The fact that patients do not know what kinds of relief are available may be one reason for the patients expressing satisfaction despite being in pain, another that the patients judge the kindness of the staff rather than their way of treating the pain. The field of pain management is rapidly changing requiring professional knowledge and experience in order to ensure pain management of good quality.

  • 42.
    Bystedt, Maria
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Eriksson, Maria
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Delegation within municipal healthcare2011In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 19, no 4, p. 534-541Article in journal (Refereed)
    Abstract [en]

    Aim To describe how registered nurses (RNs) perceive delegation to unlicensed personnel (UP) in a municipal healthcare context in Sweden. Background Within municipal health care RNs often delegate tasks to UP. The latter have practical training, but lack formal competence. Method Twelve RNs were interviewed and the material was analysed using a phenomenographic approach. Results Owing to a shortage of RNs, delegation is seen as a prerequisite for a functioning organization. This necessity also involves a number of perceived contradictions in three areas: (1) the work situation of RNs - facilitation and relief vs. lack of control, powerlessness, vagueness regarding responsibility, and resignation; (2) the relationship with unlicensed personnel - stimulation, possibility for mentoring, use of UP competence and the creation of fairness vs. questioning UP competence; and (3) The patients - increase in continuity, quicker treatment, and increased security vs. insecurity (with respect to, for example, the handling of medicine). Conclusion Registered nurses perceptions of delegation within municipal healthcare involve their own work situation, the UP and the patients. Implications for nursing management Registered nurses who delegate to UP must be given time for mentoring such that the nursing care is safe care of high quality.

  • 43.
    Bégat, Ingrid
    et al.
    University West, Department of Nursing.
    Berggren, Ingela
    University West, Department of Nursing.
    Ellefsen, Bodil
    University of Oslo, Ullevål Hospital, Institute of Nursing Science.
    Severinsson, Elisabeth
    Hedmark College, Department of Nursing Education.
    Australian nurse supervisors' styles and their perceptions of ethical dilemmas within health care2003In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 11, no 1, p. 6-14Article in journal (Refereed)
    Abstract [en]

    AIM: To examine clinical nurse supervisors' styles, in terms of models, organization, focus on supervision and theories used in supervision, as well as their perceptions of ethical dilemmas within health care. BACKGROUND: The importance of clinical supervision in clinical practice has been reported. However, literature dealing with its implementation is rare. METHODS: This study is a descriptive-correlational study. Data were collected by means of a questionnaire from two groups of nurse supervisors randomly selected from a university (n = 55) and a hospital (n = 31). Data were analysed using descriptive and inferential statistics. RESULTS: The models most frequently used were 'case-oriented' and 'decision-making oriented'. The nurse supervision was reported as being organized on a one-to-one basis. The focus of supervision was on 'patient problems' and 'cooperation in team'. The theory most commonly used was the theory of reflection. The supervisors' perceptions of moral dilemmas were related to 'decision making' and actions impacting on quality of care resulting from their supervisor styles. CONCLUSION: By correlating the supervisors' styles and their perceptions of ethical dilemmas, we conclude that it is important to contribute to further research on supervisors' styles in order to ensure successful supervision.

  • 44.
    Bégat, Ingrid
    et al.
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Ellefsen, Bodil
    Institute of Nursing and Health Sciences, University of Oslo, Norway.
    Severinsson, Elisabeth
    Department of Health Studies, Stavanger University of Stavanger, Norway.
    Nurses' satisfaction with their work environment and the outcomes of clinical nursing supervision on nurses' experiences of well-being -- a Norwegian study.2005In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 13, no 3, p. 221-30Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Various studies have demonstrated that nursing is stressful and that the incidence of occupational stress-related burnout in the profession is high. AIM: This descriptive-correlational study examined nurses' satisfaction with their psychosocial work environment, their moral sensitivity and differences in outcomes of clinical nursing supervision in relation to nurses' well-being by systematically comparing supervised and unsupervised nurses. METHODS: Nurses were selected from two hospitals (n = 71). Data collection was by means of questionnaires and analysed by descriptive and inferential statistics. RESULTS: The nurses' satisfaction with their psychosocial work environment was reflected in six factors: 'job stress and anxiety', 'relationship with colleagues', 'collaboration and good communication', 'job motivation', 'work demands' and 'professional development'. The nurses' perceptions of moral sensitivity comprised seven factors: 'grounds for actions', 'ethical conflicts', 'values in care', 'independence patient-oriented care', 'the desire to provide high-quality care' and 'the desire to provide high-quality care creates ethical dilemmas'. Nurses well-being were reflected in four factors 'physical symptom and anxiety', 'feelings of not being in control', 'engagement and motivation' and 'eye strain sleep disturbance'. The moral sensitivity 'ethical conflicts' were found to have mild negative correlations with psychosocial work environment 'job stress and anxiety professional development' and with 'total score' psychosocial work, moral sensitivity factor 'independence were correlated with psychosocial work factor 'relationships with colleagues' and 'total score', moral sensitivity were mildly correlated with 'collaboration and good communication and had a negative correlation to psychosocial work factor 'work demands'. In addition, significant correlations were found between the nurses' well-being profile and demographic variables, between 'engagement and motivation' and 'absence due to illness' and between 'time allocation for tasks', 'physical symptoms and anxiety' and 'age'. Mild significant differences were found between nurses attending and not attending group supervision and between 'physical symptoms and anxiety' and 'feelings of not being in control'. CONCLUSIONS: We conclude that ethical conflicts in nursing are a source of job-related stress and anxiety. The outcome of supporting nurses by clinical nursing supervision may have a positive influence on their perceptions of well-being. clinical nursing supervision have a positive effect on nurses physical symptoms and their feeling of anxiety as well as having a sense of being in control of the situation. We also conclude that psychosocial work have an influence on nurses experience of having or not having control and their engagement and motivation.

  • 45.
    Bégat, Ingrid.
    et al.
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Severinsson, Elisabet
    University of Stavanger, Faculty of Social Sciences, Department of Health Studies.
    Reflection on how clinical nursing supervision enhances nurses' experiences of well-being related to their psychosocial work environment2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 8, p. 610-616Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to make a synthesis of three studies that deal with the following research question: 'How does clinical nursing supervision enhance nurses' experiences of well-being in relation to their psychosocial work environment?' Background: Clinical nursing supervision is one way to support nurses in coping with their stressful work situation. Method: A hermeneutic approach was used to reflect and interpret nurses' experiences of well-being in relation to clinical nursing supervision and psychosocial work environment. Results: The findings suggest that clinical nursing supervision has an influence on nurses' experiences of well-being and in relation to their psychosocial work environment. Nurses attending clinical nursing supervision reported increased satisfaction with their psychosocial work environment. Conclusions: The significance of caring and nursing becomes evident when nurses realize and understand that clinical nursing supervision positively influences their existence and well-being. The value of work becomes clear when nurses reflect on themselves as professionals and as authentic human beings in clinical nursing supervision. This will lead to the emergence of self-recognition. © 2006 The Authors.

  • 46. Cronquist, A
    et al.
    Lützén, K
    Nyström, Maria
    University of Borås, School of Health Science.
    Nurses’ lived experiences of moral stress support in the intensive care context2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 5, p. 405-413Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to analyse and describe lived experiences of support in situations characterized by critical care situations and moral stress in intensive care nursing. An exploratory interpretative study was conducted. Data consisted of interviews with 36 nurses from different types of intensive care units. The first level of analysis of data identified contextual factors, such as type and purpose of support and working conditions. On the next level of analysis five tentative interpretations were identified: (1) receiving organized support is a matter of self-determination, (2) whether to participate in organized support or to be off duty are experienced as mutually exclusive, (3) dealing with moral stress is experienced as a private matter, (4) colleagues managing moral stress serve as models in stress support and (5) not being able to deal with moral stress urges one to seek outside support. A comparison of these interpretations identified three major themes: availability, accessibility and receptivity of support. The main interpretation and conclusion were: lived experience of moral stress support involves an interconnectedness between structural and existential factors. Thus, adequate moral stress support presupposes an allowable professional climate and access to caring supervision.

  • 47. Cronqvist, A.
    et al.
    Lützen, Kim
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Nyström, M.
    Nurses´ lived experience of moral stress support in the intensive care context2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 5, p. 405-413Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to analyse and describe lived experiences of support in situations characterized by critical care situations and moral stress in intensive care nursing. An exploratory interpretative study was conducted. Data consisted of interviews with 36 nurses from different types of intensive care units. The first level of analysis of data identified contextual factors, such as type and purpose of support and working conditions. On the next level of analysis five tentative interpretations were identified: (1) receiving organized support is a matter of self-determination, (2) whether to participate in organized support or to be off duty are experienced as mutually exclusive, (3) dealing with moral stress is experienced as a private matter, (4) colleagues managing moral stress serve as models in stress support and (5) not being able to deal with moral stress urges one to seek outside support. A comparison of these interpretations identified three major themes: availability, accessibility and receptivity of support. The main interpretation and conclusion were: lived experience of moral stress support involves an interconnectedness between structural and existential factors. Thus, adequate moral stress support presupposes an allowable professional climate and access to caring supervision.

  • 48. Cronqvist, A
    et al.
    Nyström, Maria
    University of Borås, School of Health Science.
    A theoretical argumentation on the consequences of moral stress2007In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 15, no 4, p. 458-465Article in journal (Refereed)
    Abstract [en]

    Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden. agneta.cronqvist@esh.se BACKGROUND: Intensive care units are characterized by heavy workloads, increasing work complexity and ethical concerns related to life-and-death decisions. In the present study, it is assumed that there is a relationship between moral stress, support and competence for nurses in intensive care units. AIM: To analyse and describe the theoretical relationship between moral stress and support on the one hand and competence on the other, in the context of intensive care. METHOD: A form of qualitative secondary analysis based on the findings from three original studies. In the analytic process a theory on professional competence was used. FINDINGS: The findings suggest that imbalance due to moral stress between different competences hinders the development of collectively shared caring competence. CONCLUSIONS: Moral stress cannot be totally eliminated in the intensive care unit. But moral stress is not only a problem. It can also become a driving force to stimulate competence.

  • 49.
    Cronqvist, Agneta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Lützén, Kim
    Nyström, Maria
    Nurses' lived experiences of moral stress support in the intensive care context.2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 5, p. 405-13Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to analyse and describe lived experiences of support in situations characterized by critical care situations and moral stress in intensive care nursing. An exploratory interpretative study was conducted. Data consisted of interviews with 36 nurses from different types of intensive care units. The first level of analysis of data identified contextual factors, such as type and purpose of support and working conditions. On the next level of analysis five tentative interpretations were identified: (1) receiving organized support is a matter of self-determination, (2) whether to participate in organized support or to be off duty are experienced as mutually exclusive, (3) dealing with moral stress is experienced as a private matter, (4) colleagues managing moral stress serve as models in stress support and (5) not being able to deal with moral stress urges one to seek outside support. A comparison of these interpretations identified three major themes: availability, accessibility and receptivity of support. The main interpretation and conclusion were: lived experience of moral stress support involves an interconnectedness between structural and existential factors. Thus, adequate moral stress support presupposes an allowable professional climate and access to caring supervision.

  • 50.
    Cronqvist, Agneta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Nyström, Maria
    A theoretical argumentation on the consequences of moral stress.2007In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 15, no 4, p. 458-65Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Intensive care units are characterized by heavy workloads, increasing work complexity and ethical concerns related to life-and-death decisions. In the present study, it is assumed that there is a relationship between moral stress, support and competence for nurses in intensive care units. AIM: To analyse and describe the theoretical relationship between moral stress and support on the one hand and competence on the other, in the context of intensive care. METHOD: A form of qualitative secondary analysis based on the findings from three original studies. In the analytic process a theory on professional competence was used. FINDINGS: The findings suggest that imbalance due to moral stress between different competences hinders the development of collectively shared caring competence. CONCLUSIONS: Moral stress cannot be totally eliminated in the intensive care unit. But moral stress is not only a problem. It can also become a driving force to stimulate competence.

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