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  • 1.
    Andersson, Elin
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Bohlin, Linda
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Herlitz, Johan
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Fekete, Zoltán
    Andersson Hagiwara, Magnus
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Prehospital Identification of Patients with a Final Hospital Diagnosis of Stroke.2018In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Introduction the early phase of stroke, minutes are critical. Since the majority of patients with stroke are transported by the Emergency Medical Service (EMS), the early handling and decision making by the EMS clinician is important. Problem The study aim was to evaluate the frequency of a documented suspicion of stroke by the EMS nurse, and to investigate differences in the clinical signs of stroke and clinical assessment in the prehospital setting among patients with regard to if there was a documented suspicion of stroke on EMS arrival or not, in patients with a final hospital diagnosis of stroke.

    METHODS: The study had a retrospective observational design. Data were collected from reports on patients who were transported by the EMS and had a final diagnosis of stroke at a single hospital in western Sweden (630 beds) in 2015. The data sources were hospital and prehospital medical journals.

    RESULTS: In total, 454 patients were included. Among them, the EMS clinician suspected stroke in 52%. The findings and documentation on patients with a suspected stroke differed from the remaining patients as follows: a) More frequently documented symptoms from the face, legs/arms, and speech; b) More frequently assessments of neurology, face, arms/legs, speech, and eyes; c) More frequently addressed the major complaint with regard to time and place of onset, duration, localization, and radiation; d) Less frequently documented symptoms of headache, vertigo, and nausea; and e) More frequently had an electrocardiogram (ECG) recorded and plasma glucose sampled. In addition to the 52% of patients who had a documented initial suspicion of stroke, seven percent of the patients had an initial suspicion of transitory ischemic attack (TIA) by the EMS clinician, and a neurologist was approached in another 10%.

    CONCLUSION: Among 454 patients with a final diagnosis of stroke who were transported by the EMS, an initial suspicion of stroke was not documented in one-half of the cases. These patients differed from those in whom a suspicion of stroke was documented in terms of limited clinical signs of stroke, a less extensive clinical assessment, and fewer clinical investigations. Andersson E , Bohlin L , Herlitz J , Sundler AJ , Fekete Z , Andersson Hagiwara M . Prehospital identification of patients with a final hospital diagnosis of stroke.

  • 2.
    Arkkukangas, M
    et al.
    Mälardalens högskola.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Söderlund, A
    Mälardalens Högskola.
    Eriksson, S
    Umeå University.
    Johansson, A-C
    Mälardalens högskola.
    Older persons’ experiences of home-based exercise with behaviour change support2017In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 12, p. 905-913Article in journal (Refereed)
    Abstract [en]

    Background: It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons.

    Purpose: This descriptive study used a qualitative inductive approach to describe older persons’ experiences of a fall-preventive, home-based exercise program with support for behavioral change. Methods: Semi-structured interviews were conducted with 12 elderly persons aged 75 years or older, and a qualitative content analysis was performed.

    Results: Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise.

    Conclusion: With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age. 

  • 3.
    Berglund, Mia
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Westin, Lars
    Högskolan i Skövde, Institutionen för vård och natur.
    Svanström, Rune
    Högskolan i Skövde, Institutionen för vård och natur.
    Johansson Sundler, Annelie
    Högskolan i Skövde, Institutionen för vård och natur.
    Suffering caused by care - Patients' experiences from hospital settings2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, p. Article number 18688-Article in journal (Refereed)
    Abstract [en]

    Suffering and well-being are significant aspects of human existence; in particular, suffering and well-being are important aspects of patients’ experiences following diseases. Increased knowledge about existential dimensions of illness and healthcare experiences may be needed in order to improve care and reduce unnecessary suffering. Therefore, the aim of this paper is to illuminate the phenomenon of suffering experienced in relation to healthcare needs among patients in hospital settings in Sweden. In this study, we used a reflective lifeworld approach. The data were analysed with a focus on meanings. The results describe the essential meaning of the phenomenon of suffering in relation to healthcare needs. The patients were suffering during care-giving when they felt distrusted or mistreated and when their perspective on illness and health was overlooked. Suffering was found to arise due to healthcare actions that neglected a holistic and patient-centred approach to care. Unfortunately, healthcare experiences that cause patients to suffer seem to be something one needs to endure without being critical. The phenomenon can be described as having four constituents: to be mistreated; to struggle for one’s healthcare needs and autonomy; to feel powerless; and to feel fragmented and objectified. The study concludes that there are problems associated with patients experiencing suffering at the hands of healthcare providers, even if this suffering may not have been caused deliberately to the patient. Consequently, conscious improvements are needed to lessen the suffering caused by care-giving, as are strategies that promote more patient-centred care and patient participation.

  • 4.
    Berglund, Mia
    et al.
    University of Skövde, School of Life Sciences.
    Westin, Lars
    University of Skövde, School of Life Sciences.
    Svanström, Rune
    University of Skövde, School of Life Sciences.
    Johansson Sundler, Annelie
    University of Skövde, School of Life Sciences.
    Suffering caused by care - Patients' experiences from hospital settings2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, article id 18688Article in journal (Refereed)
    Abstract [en]

    Suffering and well-being are significant aspects of human existence; in particular, suffering and well-being are important aspects of patients’ experiences following diseases. Increased knowledge about existential dimensions of illness and healthcare experiences may be needed in order to improve care and reduce unnecessary suffering. Therefore, the aim of this paper is to illuminate the phenomenon of suffering experienced in relation to healthcare needs among patients in hospital settings in Sweden. In this study, we used a reflective lifeworld approach. The data were analysed with a focus on meanings. The results describe the essential meaning of the phenomenon of suffering in relation to healthcare needs. The patients were suffering during care-giving when they felt distrusted or mistreated and when their perspective on illness and health was overlooked. Suffering was found to arise due to healthcare actions that neglected a holistic and patient-centred approach to care. Unfortunately, healthcare experiences that cause patients to suffer seem to be something one needs to endure without being critical. The phenomenon can be described as having four constituents: to be mistreated; to struggle for one’s healthcare needs and autonomy; to feel powerless; and to feel fragmented and objectified. The study concludes that there are problems associated with patients experiencing suffering at the hands of healthcare providers, even if this suffering may not have been caused deliberately to the patient. Consequently, conscious improvements are needed to lessen the suffering caused by care-giving, as are strategies that promote more patient-centred care and patient participation.

  • 5.
    Berglund, Mia
    et al.
    University of Skövde.
    Westin, Lars
    University of Skövde.
    Svanström, Rune
    University of Skövde.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Suffering caused by care--patients' experiences from hospital settings.2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, no 1Article in journal (Refereed)
    Abstract [en]

    Suffering and well-being are significant aspects of human existence; in particular, suffering and well-being are important aspects of patients' experiences following diseases. Increased knowledge about existential dimensions of illness and healthcare experiences may be needed in order to improve care and reduce unnecessary suffering. Therefore, the aim of this paper is to illuminate the phenomenon of suffering experienced in relation to healthcare needs among patients in hospital settings in Sweden. In this study, we used a reflective lifeworld approach. The data were analysed with a focus on meanings. The results describe the essential meaning of the phenomenon of suffering in relation to healthcare needs. The patients were suffering during care-giving when they felt distrusted or mistreated and when their perspective on illness and health was overlooked. Suffering was found to arise due to healthcare actions that neglected a holistic and patient-centred approach to care. Unfortunately, healthcare experiences that cause patients to suffer seem to be something one needs to endure without being critical. The phenomenon can be described as having four constituents: to be mistreated; to struggle for one's healthcare needs and autonomy; to feel powerless; and to feel fragmented and objectified. The study concludes that there are problems associated with patients experiencing suffering at the hands of healthcare providers, even if this suffering may not have been caused deliberately to the patient. Consequently, conscious improvements are needed to lessen the suffering caused by care-giving, as are strategies that promote more patient-centred care and patient participation.

  • 6.
    Bisholt, Birgitta
    et al.
    Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Ohlsson, Ulla
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Kullén Engström, Agneta
    School of Health, University of Borås, Borås, Sweden.
    Johansson Sundler, Annelie
    Högskolan i Skövde, Institutionen för vård och natur.
    Gustafsson, Margareta
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Nursing students' assessment of the learning environment in different clinical settings2014In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 14, no 3, p. 304-310Article in journal (Refereed)
    Abstract [en]

    Introduction: Nursing students perform their clinical practice in different types of clinical settings. The clinical learning environment is important for students to be able to achieve desired learning outcomes. Knowledge is lacking about the learning environment in different clinical settings. Aim: The aim was to compare the learning environment in different clinical settings from the perspective of the nursing students. Design: A cross-sectional study with comparative design was conducted. Method: Data was collected from 185 nursing students at three universities by means of a questionnaire involving the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) evaluation scale. An open-ended question was added in order to ascertain reasons for dissatisfaction with the clinical placement. Results: The nursing students' satisfaction with the placement did not differ between clinical settings. However, those with clinical placement in hospital departments agreed more strongly that sufficient meaningful learning situations occurred and that learning situations were multi-dimensional. Some students reported that the character of the clinical setting made it difficult to achieve the learning objectives. Conclusion: In the planning of the clinical placement, attention must be paid to whether the setting offers the student a meaningful learning situation where the appropriate learning outcome may be achieved. 

  • 7.
    Bisholt, Birgitta
    et al.
    Department of Health Sciences, Karlstad University, Sweden.
    Ohlsson, Ulla
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Kullén Engström, Agneta
    School of Health, University of Borås, Borås, Sweden.
    Johansson Sundler, Annelie
    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.
    Nursing students' assessment of the learning environment in different clinical settings2014In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 14, no 3, p. 304-310Article in journal (Refereed)
    Abstract [en]

    Introduction: Nursing students perform their clinical practice in different types of clinical settings. The clinical learning environment is important for students to be able to achieve desired learning outcomes. Knowledge is lacking about the learning environment in different clinical settings. Aim: The aim was to compare the learning environment in different clinical settings from the perspective of the nursing students. Design: A cross-sectional study with comparative design was conducted. Method: Data was collected from 185 nursing students at three universities by means of a questionnaire involving the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) evaluation scale. An open-ended question was added in order to ascertain reasons for dissatisfaction with the clinical placement. Results: The nursing students' satisfaction with the placement did not differ between clinical settings. However, those with clinical placement in hospital departments agreed more strongly that sufficient meaningful learning situations occurred and that learning situations were multi-dimensional. Some students reported that the character of the clinical setting made it difficult to achieve the learning objectives. Conclusion: In the planning of the clinical placement, attention must be paid to whether the setting offers the student a meaningful learning situation where the appropriate learning outcome may be achieved. © 2013 Elsevier Ltd. All rights reserved.

  • 8.
    Bisholt, Birgitta
    et al.
    University of Borås, School of Health Science.
    Ohlsson, Ulla
    University of Borås, School of Health Science.
    Kullén Engström, Agneta
    University of Borås, School of Health Science.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Gustafsson, Margareta
    University of Borås, School of Health Science.
    Nursing students' assessment of the learning environment in different clinical settings2014In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 14, no 3, p. 304-310Article in journal (Refereed)
    Abstract [en]

    Introduction Nursing students perform their clinical practice in different types of clinical settings. The clinical learning environment is important for students to be able to achieve desired learning outcomes. Knowledge is lacking about the learning environment in different clinical settings. Aim The aim was to compare the learning environment in different clinical settings from the perspective of the nursing students. Design A cross-sectional study with comparative design was conducted. Method Data was collected from 185 nursing students at three universities by means of a questionnaire involving the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) evaluation scale. An open-ended question was added in order to ascertain reasons for dissatisfaction with the clinical placement. Results The nursing students' satisfaction with the placement did not differ between clinical settings. However, those with clinical placement in hospital departments agreed more strongly that sufficient meaningful learning situations occurred and that learning situations were multi-dimensional. Some students reported that the character of the clinical setting made it difficult to achieve the learning objectives. Conclusion In the planning of the clinical placement, attention must be paid to whether the setting offers the student a meaningful learning situation where the appropriate learning outcome may be achieved.

  • 9.
    Björk, Maria
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Johansson Sundler, Annelie
    Högskolan i Skövde, Institutionen för vård och natur.
    Hammarlund, Kina
    Högskolan i Skövde, Institutionen för vård och natur.
    Hallström, Inger
    Lund University, Department of Health Sciences, Lund, Sweden.
    Living an everyday life shaded with traces from the cancer trajectory – families' lived experiences in a six year follow up2012In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 59, no 6, p. 1130-1130Article in journal (Refereed)
  • 10.
    Björk, Maria
    et al.
    University of Skövde, School of Life Sciences.
    Johansson Sundler, Annelie
    University of Skövde, School of Life Sciences.
    Hammarlund, Kina
    University of Skövde, School of Life Sciences.
    Hallström, Inger
    Lund University, Department of Health Sciences, Lund, Sweden.
    Living an everyday life shaded with traces from the cancer trajectory – families' lived experiences in a six year follow up2012In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 59, no 6, p. 1130-1130Article in journal (Refereed)
  • 11.
    Björk, Maria
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. CHILD Research Group, Department of Nursing Science, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Sundler, Annelie J.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
    Hallström, Inger
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Hammarlund, Kina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Like being covered in a wet and dark blanket: Parents' lived experiences of losing a child to cancer2016In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 25, p. 40-45Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to illuminate parents' lived experiences of losing a child to cancer. Method: Interviews and a narrative about parents' experiences of losing a child to cancer were gathered from six parents of children whom had participated in a longitudinal study across the child's illness trajectory. The analysis of the data was inspired by van Manen's hermeneutic phenomenological approach. Results: One essential theme emerged: Like being covered in a wet and dark blanket, as well as six related themes: Feeling conflicting emotions, Preparing for the moment of death, Continuing parenting after death, Recollecting and sharing memories, Working through the sorrow and New perspectives in life. Conclusion: There is a need for good palliative care. If not, there is a risk that the parent will perseverate and blame themselves for not being a good parent during the suffering child's last time in life. Meetings with the parents six months and two years after the child's death might facilitate healing through the grief process. 

  • 12.
    Björk, Maria
    et al.
    Jönköping University.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hallstöm, Inger
    Lund university.
    Hammarlund, Kina
    Högskolan i Skövde.
    Like being covered in a wet and dark blanket - Parents' lived experiences of losing a child to cancer2016In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 25, p. 40-45Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to illuminate parents' lived experiences of losing a child to cancer. Method: Interviews and a narrative about parents' experiences of losing a child to cancer were gathered from six parents of children whom had participated in a longitudinal study across the child's illness trajectory. The analysis of the data was inspired by van Manen's hermeneutic phenomenological approach. Results: One essential theme emerged: Like being covered in a wet and dark blanket, as well as six related themes: Feeling conflicting emotions, Preparing for the moment of death, Continuing parenting after death, Recollecting and sharing memories, Working through the sorrow and New perspectives in life. Conclusion: There is a need for good palliative care. If not, there is a risk that the parent will perseverate and blame themselves for not being a good parent during the suffering child's last time in life. Meetings with the parents six months and two years after the child's death might facilitate healing through the grief process.

  • 13.
    Blom, Helen
    et al.
    Department of Intensive Care Unit, Skaraborg Hospital, Skövde, Sweden.
    Gustavsson, Christina
    Department of Intensive Care Unit, Skaraborg Hospital, Skövde, Sweden.
    Johansson Sundler, Annelie
    University of Skövde, School of Life Sciences.
    Participation and support in intensive care as experienced by close relatives of patients: A phenomenological study2013In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 29, no 1, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to explore participation and support as experienced by close relatives of patients at an intensive care unit (ICU).

    Method: This study used the phenomenological approach as developed by Dahlberg et al. (2008) as a method for reflective lifeworld research. Seven close relatives of critically ill patients cared for at an ICU were interviewed. The data were analysed with a focus on meanings.

    Results: Being allowed to participate in the care of critically ill patients at an ICU is impor-tant for close relatives to the patients. Their experiences can be described as having four constituents: participation in the care of and being close to the patient; confidence in the care the patient receives; support needed for involvement in caregiving; and vulnerability.

    Conclusion: Participation with and support from health-care professionals are important for the relatives’ well-being and their ability to contribute to the patients’ care. Health-care profes-sionals, especially critical care nurses, need to create an atmosphere that invites relatives to participate in the care provided at an ICU.

  • 14. Blom, Helen
    et al.
    Gustavsson, Christina
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Participation and support in intensive care as experienced by close relatives of patients: a phenomenological study.2013In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 29, no 1, p. 1-8Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to explore participation and support as experienced by close relatives of patients at an intensive care unit (ICU).

    METHOD: This study used the phenomenological approach as developed by Dahlberg et al. (2008) as a method for reflective lifeworld research. Seven close relatives of critically ill patients cared for at an ICU were interviewed. The data were analysed with a focus on meanings.

    RESULTS: Being allowed to participate in the care of critically ill patients at an ICU is important for close relatives to the patients. Their experiences can be described as having four constituents: participation in the care of and being close to the patient; confidence in the care the patient receives; support needed for involvement in caregiving; and vulnerability.

    CONCLUSION: Participation with and support from health-care professionals are important for the relatives' well-being and their ability to contribute to the patients' care. Health-care professionals, especially critical care nurses, need to create an atmosphere that invites relatives to participate in the care provided at an ICU.

  • 15.
    Blom, Helene
    et al.
    Skaraborg Hospital.
    Gustavsson, Christina
    Skaraborg Hospital.
    Johansson Sundler, Annelie
    Högskolan i Skövde, Institutionen för vård och natur.
    Participation and support in intensive care as experienced by close relatives of patients: A phenomenological study2013In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 29, no 1, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to explore participation and support as experienced by close relatives of patients at an intensive care unit (ICU).

    Method: This study used the phenomenological approach as developed by Dahlberg et al. (2008) as a method for reflective lifeworld research. Seven close relatives of critically ill patients cared for at an ICU were interviewed. The data were analysed with a focus on meanings.

    Results: Being allowed to participate in the care of critically ill patients at an ICU is impor-tant for close relatives to the patients. Their experiences can be described as having four constituents: participation in the care of and being close to the patient; confidence in the care the patient receives; support needed for involvement in caregiving; and vulnerability.

    Conclusion: Participation with and support from health-care professionals are important for the relatives’ well-being and their ability to contribute to the patients’ care. Health-care profes-sionals, especially critical care nurses, need to create an atmosphere that invites relatives to participate in the care provided at an ICU.

  • 16.
    Blomberg, Karin
    et al.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Bisholt, Birgitta
    Department of Nursing, Karlstad University, Karlstad, Sweden.
    Kullén Engström, Agneta
    School of Health, University of Borås, Borås, Sweden.
    Ohlsson, Ulla
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Johansson Sundler, Annelie
    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.
    Swedish nursing students' experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 15-16, p. 2264-2271Article in journal (Refereed)
  • 17.
    Blomberg, Karin
    et al.
    Örebro universitet, Sweden.
    Bisholt, Birgitta
    Karlstads universitet, Sweden.
    Kullén Engström, Agneta
    Högskolan Borås, Sweden.
    Ohlsson, Ulla
    Örebro universitet, Sweden.
    Sundler Johansson, Annelie
    Högskolan Skövde, Sweden.
    Gustafsson, Margareta
    Örebro universitet, Sweden.
    Swedish nursing students' experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education.2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 15-16, p. 2264-2271Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe nursing students' experience of stress during clinical practice and evaluate the risk of stress in relation to the clinical setting characteristics and the organisation of the clinical education.

    BACKGROUND: Stress during clinical practice is well documented, but there is a lack of knowledge concerning whether the clinical setting characteristics and the organisation of the education make a difference.

    DESIGN: A cross-sectional study with evaluative design.

    METHODS: Data were collected by means of a numerical rating scale for the assessment of stress and questions about the clinical setting characteristics and the organisation of the education. One hundred and eighty-four students who had completed their final year on the nursing programme at three universities in Sweden were included.

    RESULTS: Nearly half of the students (43%) experienced high level of stress during clinical practice. Measured by decision in the tree analysis, the absolute risk of stress was 57% in students with placements in hospital departments, as compared to 13% in students with placements in other clinical settings. The risk of stress increased to 71% if the students with placement in a hospital took the national clinical final examination. Performance of practice in a hospital department overcrowded with patients was also associated with increased risk of stress. The organisation of supervision and number of students at the clinical placement had an effect on the experience of stress, but did not prove to be risk factors in the analysis.

    CONCLUSIONS: The risk of stress in nursing students during their clinical practice differs depending on clinical setting characteristics. The taking of the national clinical final examination could be a source of stress, but this requires further investigation.

    RELEVANCE TO CLINICAL PRACTICE: It is important that supervisors are aware that students in hospital departments overcrowded with patients are at risk of stress and may have increased need of support.

  • 18. Blomberg, Karin
    et al.
    Bisholt, Birgitta
    Kullén Engström, Agneta
    University of Borås, School of Health Science.
    Olsson, Ulla
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Gustafsson, Margareta
    Swedish nursing students' experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 15-16, p. 2264-2271Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe nursing students' experience of stress during clinical practice and evaluate the risk of stress in relation to the clinical setting characteristics and the organisation of the clinical education. BACKGROUND: Stress during clinical practice is well documented, but there is a lack of knowledge concerning whether the clinical setting characteristics and the organisation of the education make a difference. DESIGN: A cross-sectional study with evaluative design. METHODS: Data were collected by means of a numerical rating scale for the assessment of stress and questions about the clinical setting characteristics and the organisation of the education. One hundred and eighty-four students who had completed their final year on the nursing programme at three universities in Sweden were included. RESULTS: Nearly half of the students (43%) experienced high level of stress during clinical practice. Measured by decision in the tree analysis, the absolute risk of stress was 57% in students with placements in hospital departments, as compared to 13% in students with placements in other clinical settings. The risk of stress increased to 71% if the students with placement in a hospital took the national clinical final examination. Performance of practice in a hospital department overcrowded with patients was also associated with increased risk of stress. The organisation of supervision and number of students at the clinical placement had an effect on the experience of stress, but did not prove to be risk factors in the analysis. CONCLUSIONS: The risk of stress in nursing students during their clinical practice differs depending on clinical setting characteristics. The taking of the national clinical final examination could be a source of stress, but this requires further investigation. RELEVANCE TO CLINICAL PRACTICE: It is important that supervisors are aware that students in hospital departments overcrowded with patients are at risk of stress and may have increased need of support.

  • 19. 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.

  • 20.
    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)
  • 21.
    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.

  • 22.
    Eklund, Jakob Hakansson
    et al.
    Malardalen Univ, Sch Hlth Care & Social Welf, Postbox 883, SE-72123 Vasteras, Sweden.
    Holmström, Inger K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Malardalen Univ, Sch Hlth Care & Social Welf, Postbox 883, SE-72123 Vasteras, Sweden.
    Kumlin, Tomas
    Malardalen Univ, Sch Hlth Care & Social Welf, Postbox 883, SE-72123 Vasteras, Sweden.
    Kaminsky, Elenor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Skoglund, Karin
    Malardalen Univ, Sch Hlth Care & Social Welf, Postbox 883, SE-72123 Vasteras, Sweden.
    Hoglander, Jessica
    Malardalen Univ, Sch Hlth Care & Social Welf, Postbox 883, SE-72123 Vasteras, Sweden.
    Sundler, Annelie J.
    Univ Boras, Fac Caring Sci Work Life & Social Welf, SE-50190 Boras, Sweden.
    Conden, Emelie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Meranius, Martina Summer
    Malardalen Univ, Sch Hlth Care & Social Welf, Postbox 883, SE-72123 Vasteras, Sweden.
    "Same same or different?": A review of reviews of person-centered and patient-centered care2019In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 102, no 1, p. 3-11Article, review/survey (Refereed)
    Abstract [en]

    Objective: To provide a synthesis of already synthesized literature on person-centered care and patient-centered care in order to identify similarities and differences between the two concepts.

    Methods: A synthesis of reviews was conducted to locate synthesized literature published between January 2000 and March 2017. A total of 21 articles deemed relevant to this overview were synthesized using a thematic analysis.

    Results: The analysis resulted in nine themes present in person-centered as well as in patient-centered care: (1) empathy, (2), respect (3), engagement, (4), relationship, (5) communication, (6) shared decision-making, (7) holistic focus, (8), individualized focus, and (9) coordinated care. The analysis also revealed that the goal of person-centered care is a meaningful life while the goal of patient-centered care is a functional life.

    Conclusions: While there are a number of similarities between the two concepts, the goals for person-centered and patient-centered care differ. The similarities are at the surface and there are important differences when the concepts are regarded in light of their different goals.

    Practice implications: Clarification of the concepts may assist practitioners to develop the relevant aspects of care. Person-centered care broadens and extends the perspective of patient-centered care by considering the whole life of the patient.

  • 23.
    Gustafsson, Margareta
    et al.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Kullén Engström, Agneta
    School of Health, University of 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. School of Health, Care and Social Welfare, Mälardalens University, Västerås, Sweden.
    Bisholt, Birgitta
    Department of Nursing, Karlstad University, Karlstad, Sweden.
    Nurse teacher models in clinical education from the perspective of student nurses: A mixed method study2015In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, no 12, p. 1289-1294Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    The aim was to describe and compare the clinical teacher's role in different models of clinical practice from the perspective of student nurses.

    DESIGN AND SETTINGS:

    The study took place in collaboration with two Swedish universities that applied different educational models in clinical practice. A mixed method approach was used. The quantitative part had a comparative design and the qualitative part had a descriptive design.

    PARTICIPANTS:

    The study group consisted of 114 student nurses (response rate 87%). Fifty-three of them had met clinical teachers employed at the university and not participating in the daily clinical work (University Nurse Teachers, UNTs), whilst 61 had met clinical teachers dividing their time between teaching and nursing (Clinical Nurse Teachers, CNTs). Eight students participated in the qualitative part of the study.

    METHODS:

    A questionnaire including the CLES+T scale was used to ascertain the students' perception of the clinical teacher's role, complemented by interviews directed towards an enrichment of this perception.

    RESULTS:

    Students meeting CNTs agreed more strongly than those meeting UNTs that the teacher had the ability to help them integrate theory and practice. Whilst spontaneous meetings between students and CNTs occurred, students mostly met UNTs in seminars. Students meeting UNTs felt alone but did appreciate having someone outside the clinical environment to provide support if they did not get along with their preceptor.

    CONCLUSIONS:

    In the case of UNTs, it is important that they keep their knowledge of clinical issues updated and visit the clinical placement not only for seminars but also to give students emotional support. In the case of CNTs, it is important that they are members of the faculty at the university, take part in the planning of the clinical courses and are able to explain the learning goals to the students.

  • 24.
    Gustafsson, Margareta
    et al.
    Örebro Universitet.
    Kullén Engström, Agneta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ohlsson, Ulla
    Örebro Universitet.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Bisholt, Birgitta
    Karlstad universitet.
    Nurse teacher models in clinical education from the perspective of student nurses - A mixed method study2015In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, no 12, p. 1289-1294Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim was to describe and compare the clinical teacher's role in different models of clinical practice from the perspective of student nurses.

    DESIGN AND SETTINGS: The study took place in collaboration with two Swedish universities that applied different educational models in clinical practice. A mixed method approach was used. The quantitative part had a comparative design and the qualitative part had a descriptive design.

    PARTICIPANTS: The study group consisted of 114 student nurses (response rate 87%). Fifty-three of them had met clinical teachers employed at the university and not participating in the daily clinical work (University Nurse Teachers, UNTs), whilst 61 had met clinical teachers dividing their time between teaching and nursing (Clinical Nurse Teachers, CNTs). Eight students participated in the qualitative part of the study.

    METHODS: A questionnaire including the CLES+T scale was used to ascertain the students' perception of the clinical teacher's role, complemented by interviews directed towards an enrichment of this perception.

    RESULTS: Students meeting CNTs agreed more strongly than those meeting UNTs that the teacher had the ability to help them integrate theory and practice. Whilst spontaneous meetings between students and CNTs occurred, students mostly met UNTs in seminars. Students meeting UNTs felt alone but did appreciate having someone outside the clinical environment to provide support if they did not get along with their preceptor.

    CONCLUSIONS: In the case of UNTs, it is important that they keep their knowledge of clinical issues updated and visit the clinical placement not only for seminars but also to give students emotional support. In the case of CNTs, it is important that they are members of the faculty at the university, take part in the planning of the clinical courses and are able to explain the learning goals to the students.

  • 25.
    Gustafsson, Margareta
    et al.
    Örebro universitet, Sweden.
    Kullén Engström, Agneta
    Högskolan Borås, Sweden.
    Ohlsson, Ulla
    Örebro universitet, Sweden.
    Sundler Johansson, Annelie
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Högskolan Skövde, Sweden.
    Bisholt, Birgitta
    Karlstads universitet, Sweden.
    Nurse teacher models in clinical education from the perspective of student nurses - A mixed method study.2015In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, no 12, p. 1286-1294Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim was to describe and compare the clinical teacher's role in different models of clinical practice from the perspective of student nurses.

    DESIGN AND SETTINGS: The study took place in collaboration with two Swedish universities that applied different educational models in clinical practice. A mixed method approach was used. The quantitative part had a comparative design and the qualitative part had a descriptive design.

    PARTICIPANTS: The study group consisted of 114 student nurses (response rate 87%). Fifty-three of them had met clinical teachers employed at the university and not participating in the daily clinical work (University Nurse Teachers, UNTs), whilst 61 had met clinical teachers dividing their time between teaching and nursing (Clinical Nurse Teachers, CNTs). Eight students participated in the qualitative part of the study.

    METHODS: A questionnaire including the CLES+T scale was used to ascertain the students' perception of the clinical teacher's role, complemented by interviews directed towards an enrichment of this perception.

    RESULTS: Students meeting CNTs agreed more strongly than those meeting UNTs that the teacher had the ability to help them integrate theory and practice. Whilst spontaneous meetings between students and CNTs occurred, students mostly met UNTs in seminars. Students meeting UNTs felt alone but did appreciate having someone outside the clinical environment to provide support if they did not get along with their preceptor.

    CONCLUSIONS: In the case of UNTs, it is important that they keep their knowledge of clinical issues updated and visit the clinical placement not only for seminars but also to give students emotional support. In the case of CNTs, it is important that they are members of the faculty at the university, take part in the planning of the clinical courses and are able to explain the learning goals to the students.

  • 26.
    Gustafsson, Tanja
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindberg, Elisabeth
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Maurin Söderholm, Hanna
    University of Borås, Faculty of Librarianship, Information, Education and IT.
    ACTION: A Person-centred Communication Intervention Targeting Nurse Assistants in Home Care for Older Persons2019Conference paper (Refereed)
    Abstract [en]

    Background: The aging population and the number of older persons living at home are increasing. Some have extensive needs for care, which leads to increased demands on professionals in home care settings. Professionals’ need to have sufficient competency to promote health and wellbeing among older persons. For sustainable care, there is a need for efficient educational efforts in the home care context. Person-centred communication may increase the quality of care and improve older persons independence.

    Aim: To develop, test and evaluate a web based educational intervention on person-centred communication targeting nurse assistants (NA) in home care setting.

    Method: A stepwise web based education, consisting of eight modules, was developed and tested. The education was evaluated using both quantitative and qualitative data.

    Results: In all, 23 NAs participated in the education. The majority of the NAs (n=21) participated in five or more modules. Overall, the education was experienced as feasible and accessible. Challenges emerged during the time of the intervention, such as time constrains, technical problems, and participants´ engagement.

    Conclusion: The web-based education was found to be a feasible way to offer education to home care staff, although successful implementation requires adaptations to the current context. Engagement from managers, especially considering the NAs motivation to complete the education is important for accomplishment by participants.

    Implications: This study can contribute to the knowledge regarding how to develop, test and evaluate an educational intervention, and considerations found to be important during the implementation process for success.

  • 27.
    Gustafsson, Tanja
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindberg, Elisabeth
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Maurin Söderholm, Hanna
    University of Borås, Faculty of Librarianship, Information, Education and IT.
    The Development and Process Evaluation of the ACTION Study. A Person-centred Communication Intervention Targeting Nursing Staff in Home Care for Older Persons2019Conference paper (Refereed)
    Abstract [en]

    Background: Person-centred communication is important to assure the quality of home care services and to promote older persons independence and influence over their lives. Previous research indicates challenges regarding communication between professionals and home care recipients, and how to deliver efficient educational efforts in the home care context. Hitherto, research on design and implementation of this type of intervention is scarce.

    Aims and objectives: To describe the development and process evaluation of an education intervention in person-centred communication for nursing staff (NS) in home care.

    Method: The web-based education consisted of eight modules, including short video based lectures and movies, one group supervision, and reflective assignments. The content was based on previous research of health care communication and person-centred care. Data was collected from multiple sources (web analytics, interviews, evaluation forms, and field notes), before, during and after the implementation, and analysed by a combination of quantitative and qualitative approaches.

    Results: In all, 23 NS participated in the education. Initial analysis indicate that a majority of the participants completed six or more modules. Overall, the content was experienced as relevant and interesting. The flexibility and accessibility of the web-based format was appreciated, as well as the mix of lectures, short movies, reflective assignments and group supervision. Challenges included developing content relevant to work teams with diverse competence levels and individual differences (e.g. age, language, motivation). Furthermore, time constrains and structure of work emerged as barriers for implementing the education, in some cases adding stress and fragmentation to NS´ work.

    Conclusions: This type of intervention seems to be a feasible approach for flexible educations in person-centred communication for NS. Engagement and commitment from managers and team leaders may be key factors in succeeding, with impact on participants´ motivation to fulfil the education.

  • 28.
    Hafskjold, L.
    et al.
    Buskerud and Vestfold University College, Drammen, Norway.
    Sundler, Annelie
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holmström, Inger K.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sundling, V.
    Buskerud and Vestfold University College, Drammen, Norway.
    Van Dulmen, S.
    Buskerud and Vestfold University College, Drammen, Norway.
    Eide, H.
    Buskerud and Vestfold University College, Drammen, Norway.
    A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 4, article id e007864Article in journal (Refereed)
    Abstract [en]

    Introduction: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of the COMHOME study is to generate knowledge on person-centred communication with older people (>65 years) in home healthcare services, radiographic and optometric practice. Methods and analysis: This study will explore the communication between care providers and older persons in home care services. Home healthcare visits will be audiorecorded (n=500) in Norway, the Netherlands and Sweden. Analyses will be performed with the Verona Coding Definitions for Emotional Sequences (VR-CoDES), the Roter Interaction Analysis System (RIAS) and qualitative methods. The content of the communication, communicative challenging situations as well as empathy, power distance, decision-making, preservation of dignity and respect will be explored. In Norway, an additional 100 encounters, 50 in optometric practice (video recorded) and 50 in radiographic practice (audiorecorded), will be analysed. Furthermore, healthcare providers' self-reported communication skills, empathy, mindfulness and emotional intelligence in relation to observed person-centred communication skills will be assessed using well-established standardised instruments. Ethics and dissemination: Depending on national legislation, approval of either the central ethical committees (eg, nation or university), the national data protection officials or the local ethical committees (eg, units of home healthcare) was obtained. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The research findings will add knowledge to improve services provided to this vulnerable group of patients. Additionally, the findings will underpin a training programme for healthcare students and care providers focusing on communication with older people. 

  • 29.
    Hafskjold, Linda
    et al.
    Faculty of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway.
    Sundler, Annelie Johansson
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Holmström, Inger K.
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden / Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Sundling, Vibeke
    Faculty of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway.
    van Dulmen, Sandra
    Faculty of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway / NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands / Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
    Eide, Hilde
    Faculty of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway.
    A cross-sectional study on person-centred communication in the care of older people: The COMHOME study protocol2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 4, article id e007864Article in journal (Refereed)
    Abstract [en]

    Introduction: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of the COMHOME study is to generate knowledge on person-centred communication with older people (>65 years) in home healthcare services, radiographic and optometric practice. Methods and analysis: This study will explore the communication between care providers and older persons in home care services. Home healthcare visits will be audiorecorded (n=500) in Norway, the Netherlands and Sweden. Analyses will be performed with the Verona Coding Definitions for Emotional Sequences (VR-CoDES), the Roter Interaction Analysis System (RIAS) and qualitative methods. The content of the communication, communicative challenging situations as well as empathy, power distance, decision-making, preservation of dignity and respect will be explored. In Norway, an additional 100 encounters, 50 in optometric practice (video recorded) and 50 in radiographic practice (audiorecorded), will be analysed. Furthermore, healthcare providers' self-reported communication skills, empathy, mindfulness and emotional intelligence in relation to observed person-centred communication skills will be assessed using well-established standardised instruments. Ethics and dissemination: Depending on national legislation, approval of either the central ethical committees (eg, nation or university), the national data protection officials or the local ethical committees (eg, units of home healthcare) was obtained. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The research findings will add knowledge to improve services provided to this vulnerable group of patients. Additionally, the findings will underpin a training programme for healthcare students and care providers focusing on communication with older people. © 2015, BMJ Publishing Group. All rights reserved

  • 30. Hafskjold, Linda
    et al.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Holmström, Inger K
    Sundling, Vibeke
    van Dulmen, Sandra
    Eide, Hilde
    A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol.2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 4Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of the COMHOME study is to generate knowledge on person-centred communication with older people (>65 years) in home healthcare services, radiographic and optometric practice.

    METHODS AND ANALYSIS: This study will explore the communication between care providers and older persons in home care services. Home healthcare visits will be audiorecorded (n=500) in Norway, the Netherlands and Sweden. Analyses will be performed with the Verona Coding Definitions for Emotional Sequences (VR-CoDES), the Roter Interaction Analysis System (RIAS) and qualitative methods. The content of the communication, communicative challenging situations as well as empathy, power distance, decision-making, preservation of dignity and respect will be explored. In Norway, an additional 100 encounters, 50 in optometric practice (video recorded) and 50 in radiographic practice (audiorecorded), will be analysed. Furthermore, healthcare providers' self-reported communication skills, empathy, mindfulness and emotional intelligence in relation to observed person-centred communication skills will be assessed using well-established standardised instruments.

    ETHICS AND DISSEMINATION: Depending on national legislation, approval of either the central ethical committees (eg, nation or university), the national data protection officials or the local ethical committees (eg, units of home healthcare) was obtained. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The research findings will add knowledge to improve services provided to this vulnerable group of patients. Additionally, the findings will underpin a training programme for healthcare students and care providers focusing on communication with older people.

  • 31.
    Hammar, Lena Marmstål
    et al.
    Karolinska Institutet.
    Holmström, Inger K
    Mälardalens University.
    Skoglund, Karin
    Mälardalens University.
    Meranius, Martina Summer
    Mälardalens University.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    The care of and communication with older people from the perspective of student nurses. A mixed method study.2017In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 52, p. 1-6, article id S0260-6917(17)30025-4Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Undergraduate nurse education needs to prepare student nurses to meet the demands and to have the necessary communication skills for caring for an increasing older population. The challenges involve how best to support and empower student nurses to learn the communication skills needed to care for older people.

    OBJECTIVE: The aim of this study was to investigate student nurses' views on the care of and communication with older people.

    DESIGN: A descriptive study with a mixed-method approach was conducted.

    METHODS: Quantitative and qualitative data were collected from a questionnaire completed by third-year Swedish student nurses in 2015.

    RESULTS: The student nurses reported positive attitudes to the care of and communication with older people. The findings focus on the central aspects related to relationship building, techniques for communication and external prerequisites.

    CONCLUSIONS: Despite positive attitudes, student nurses had a limited view of communication with older people. Educators need to increase student nurses' capacity to communicate effectively with older people. Educational interventions to improve and evaluate the communication competency of nurses and student nurses are needed.

  • 32.
    Hammarlund, Kina
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Andersson, Emilie
    Home healthcare, Falköping Municipality, Falköping, Sweden.
    Tenenbaum, Hanna
    Primary healthcare, Vara, Sweden.
    Sundler, Annelie Johansson
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
    We are also interested in how fathers feel: a qualitative exploration of child health center nurses' recognition of postnatal depression in fathers2015In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 15, article id 290Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: To become a parent is an emotionally life-changing experience. Paternal depression during the postnatal period has been associated with emotional and behavioral problems in children. The condition has predominantly been related to mothers, and the recognition of paternal postnatal depression (PND) has been paid less attention to. PND in fathers may be difficult to detect. However, nurses in pediatric services meet a lot of fathers and are in a position to detect a father who is suffering from PND. Therefore, the aim of this study was (a) to explore Child Health Center nurses' experiences of observing depression in fathers during the postnatal period; and (b) to explore hindrances of observing these fathers.

    METHODS: A qualitative descriptive study was conducted. Ten nurses were interviewed in 2014. A thematic data analysis was performed and data were analyzed for meaning.

    RESULTS: Paternal PND was experienced as being vague and difficult to detect. Experiences of fathers with such problems were limited, and it was hard to grasp the health status of the fathers, something which was further complicated when routines were lacking or when gender attitudes influenced the daily work of the nurses.

    CONCLUSION: This study contributes to an increased awareness of hindrances to the recognition of PND in fathers. The importance to detect all signals of paternal health status in fathers suffering from PND needs to be acknowledged. Overall, more attention needs to be paid to PND in fathers where a part of the solution for this is that they are screened just like the mothers.

  • 33. Hammarlund, Kina
    et al.
    Andersson, Emilie
    Tenenbaum, Hanna
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    We are also interested in how fathers feel: a qualitative exploration of child health center nurses' recognition of postnatal depression in fathers2015In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 15Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: To become a parent is an emotionally life-changing experience. Paternal depression during the postnatal period has been associated with emotional and behavioral problems in children. The condition has predominantly been related to mothers, and the recognition of paternal postnatal depression (PND) has been paid less attention to. PND in fathers may be difficult to detect. However, nurses in pediatric services meet a lot of fathers and are in a position to detect a father who is suffering from PND. Therefore, the aim of this study was (a) to explore Child Health Center nurses' experiences of observing depression in fathers during the postnatal period; and (b) to explore hindrances of observing these fathers.

    METHODS: A qualitative descriptive study was conducted. Ten nurses were interviewed in 2014. A thematic data analysis was performed and data were analyzed for meaning.

    RESULTS: Paternal PND was experienced as being vague and difficult to detect. Experiences of fathers with such problems were limited, and it was hard to grasp the health status of the fathers, something which was further complicated when routines were lacking or when gender attitudes influenced the daily work of the nurses.

    CONCLUSION: This study contributes to an increased awareness of hindrances to the recognition of PND in fathers. The importance to detect all signals of paternal health status in fathers suffering from PND needs to be acknowledged. Overall, more attention needs to be paid to PND in fathers where a part of the solution for this is that they are screened just like the mothers.

  • 34.
    Henoch, Ingela
    et al.
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg.
    Browall, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Melin-Johansson, Christina
    Department of Health Sciences, Mid Sweden University, Östersund.
    Danielson, Ella
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg / Department of Health Sciences, Mid Sweden University, Östersund.
    Udo, Camilla
    Department of Health Sciences, Mid Sweden University, Östersund.
    Johansson Sundler, Annelie
    University of Skövde, School of Health and Education.
    Björk, Maria
    University of Skövde, School of Health and Education.
    Ek, Kristina
    University of Skövde, School of Health and Education.
    Hammarlund, Kina
    University of Skövde, School of Health and Education.
    Bergh, Ingrid
    University of Skövde, School of Health and Education.
    Strang, Susann
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg / Angered Local Hospital, Gothenburg, Sweden.
    The Swedish version of the Frommelt attitude toward care of the dying scale: Aspects of validity and factors influencing nurses' and nursing students' attitudes2014In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 37, no 1, p. E1-E11Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Nurses' attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language. OBJECTIVES: The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients. METHODS: A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used. RESULTS: The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach α's. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients. CONCLUSIONS: Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses' attitudes toward caring for dying patients. IMPLICATION FOR PRACTICE: Care culture might influence nurses' attitudes toward caring for dying patients; the benefits of education need to be explored.

  • 35.
    Henoch, Ingela
    et al.
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg.
    Browall, Maria
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Melin-Johansson, Christina
    Department of Health Sciences, Mid Sweden University, Östersund.
    Danielson, Ella
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg / Department of Health Sciences, Mid Sweden University, Östersund.
    Udo, Camilla
    Department of Health Sciences, Mid Sweden University, Östersund.
    Johansson Sundler, Annelie
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Björk, Maria
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Ek, Kristina
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Hammarlund, Kina
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Bergh, Ingrid
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Strang, Susann
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg / Angered Local Hospital, Gothenburg, Sweden.
    The Swedish version of the Frommelt attitude toward care of the dying scale: Aspects of validity and factors influencing nurses' and nursing students' attitudes2014In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 37, no 1, p. E1-E11Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Nurses' attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language.

    OBJECTIVES: The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients.

    METHODS: A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used.

    RESULTS: The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach α's. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients.

    CONCLUSIONS: Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses' attitudes toward caring for dying patients.

    IMPLICATION FOR PRACTICE: Care culture might influence nurses' attitudes toward caring for dying patients; the benefits of education need to be explored.

  • 36.
    Henoch, Ingela
    et al.
    Sahlgrenska Academy, University of Gothenburg .
    Browall, Maria
    Karolinska Institutet, Stockholm .
    Melin-Johansson, Christina
    Mid Sweden University.
    Danielson, Ella
    Sahlgrenska Academy, University of Gothenburg .
    Udo, Camilla
    Mid Sweden University.
    Johansson Sundler, Annelie
    University of Skövde.
    Björk, Maria
    University of Skövde.
    Ek, Kristina
    University of Skövde.
    Hammarlund, Kina
    University of Skövde.
    Bergh, Ingrid
    University of Skövde.
    Strang, Susann
    Angered Local Hospital.
    The Swedish version of the Frommelt Attitude Toward Care of the Dying Scale (FATCOD): Aspects of validity and factors influencing nurses' and nursing students' attitudes2014In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 37, no 1Article in journal (Refereed)
    Abstract [en]

    Background: Nurses' attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language.

    Objectives: The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients.

    Methods: A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used.

    Results: The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach [alpha]'s. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients.

    Conclusions: Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses' attitudes toward caring for dying patients.

    Implication for Practice: Care culture might influence nurses' attitudes toward caring for dying patients; the benefits of education need to be explored.

  • 37. Henoch, Ingela
    et al.
    Browall, Maria
    Melin-Johansson, Christina
    Danielson, Ella
    Udo, Camilla
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Björk, Maria
    Ek, Kristina
    Hammarlund, Kina
    Bergh, Ingrid
    Strang, Susann
    The Swedish version of the Frommelt Attitude Toward Care of the Dying scale: aspects of validity and factors influencing nurses' and nursing students' attitudes.2014In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 37, no 1, p. 1-11Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Nurses' attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language.

    OBJECTIVES: The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients.

    METHODS: A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used.

    RESULTS: The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach α's. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients.

    CONCLUSIONS: Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses' attitudes toward caring for dying patients.

    IMPLICATION FOR PRACTICE: Care culture might influence nurses' attitudes toward caring for dying patients; the benefits of education need to be explored.

  • 38.
    Holmström, Inger K.
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Krantz, Anna
    Ängens Vårdcent, Örebro, Sweden..
    Karacagil, Lena
    Västeras Sjukhus, Västerås, Sweden..
    Sundler, Annelie J.
    Univ Boras, Fac Caring Sci Work Life & Social Welf, Boras, Sweden..
    Frequent callers in primary health care - a qualitative study with a nursing perspective2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 3, p. 622-632Article in journal (Refereed)
    Abstract [en]

    Aim. To: (a) describe how telephone nurses define a frequent caller; and (b) describe their experiences with calls from frequent callers to primary healthcare centres. Background. Telephone nursing has been noted to be a cost-effective method to enhance access to and use of health care. Some patients use these services extensively and are called 'frequent callers'. Little is known about this group of callers, the reasons behind these calls and telephone nurses' experiences and strategies to manage the calls. Design. Descriptive design with a qualitative inductive approach. Methods. Interviews were conducted with ten telephone nurses in Sweden in 2015. Qualitative content analysis was conducted. Results. A main theme was established, called 'Balancing between the experienced and assessed needs', which described the telephone nurses' experiences with calls made by frequent callers to primary healthcare centres and was further described in five categories with 15 subcategories. The categories described telephone nurses' definitions of frequent callers, telephone nurses' views of the underlying reasons for the calls, challenges related to frequent callers, experiences with an increased work load and strategies used to manage and help frequent callers. Conclusion. Frequent callers were commonly encountered by telephone nurses' in this study. Their calls were experienced as complex and demanding to manage. The findings point to needs for guidelines and routines to improve the care of frequent callers. In addition, support and training in communication skills to encounter this group of callers in an optimal and safe way may be required.

  • 39.
    Holmström, Inger K.
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Nokkoudenmaki, Mai-Britt
    Tunafors Primary Healthcare Ctr, Eskilstuna, Sweden..
    Zukancic, Selma
    Care and treatment, Torshälla, Sweden.
    Sundler, Annelie J.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    It is important that they care: older persons' experiences of telephone advice nursing2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 11-12, p. 1644-1653Article in journal (Refereed)
    Abstract [en]

    Aims and objectivesThe aim of the study was to explore older persons' experiences of telephone advice nursing at primary healthcare centres. BackgroundTelephone advice nursing is expanding worldwide, and the older population is increasing. Little is known about older persons' experiences of telephone advice nursing provided by primary healthcare. DesignThis study has a descriptive design with a qualitative inductive approach. MethodsData were collected via interviews with a purposive sample of 10 older persons in 2014. The data were analysed using qualitative content analysis. ResultsThe older persons' experiences were described in two themes: the patient-friendly aspects of telephone advice nursing and the patient-unfriendly aspects of telephone advice nursing. The themes can be understood as two sides of the same coin; the differences point to both the advantages and disadvantages of the service and are further illuminated through seven subthemes. ConclusionsThis study contributes to increased awareness of the advantages and disadvantages of the telephone advice nursing system as experienced by older persons. To be the focus of attention during calls was highlighted as important; and clear communication was deemed crucial. When the communication between the nurse and the older persons was perceived as good and the perspective of the caller was the focus, an experience of safety and satisfaction was described. Older persons had great confidence in the telephone nurses' competence and perceived their ability to access the service as mostly good, even if it was sometimes difficult to use the service. Relevance to clinical practiceThe communicative competence of telephone nurses is essential when providing telephone advice nursing to older persons. In addition, a person-centred approach is important to provide optimal care in telephone advice nursing.

  • 40. Holmström, Inger K
    et al.
    Nokkoudenmäki, Mai-Britt
    Zukancic, Selma
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    It is important that they care - older persons' experiences of telephone advice nursing.2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 11-12, p. 1644-1653Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim of the study was to explore older persons' experiences of telephone advice nursing at primary healthcare centres.

    BACKGROUND: Telephone advice nursing is expanding worldwide, and the older population is increasing. Little is known about older persons' experiences of telephone advice nursing provided by primary healthcare.

    DESIGN: This study has a descriptive design with a qualitative inductive approach.

    METHODS: Data were collected via interviews with a purposive sample of 10 older persons in 2014. The data were analysed using qualitative content analysis.

    RESULTS: The older persons' experiences were described in two themes: the patient-friendly aspects of telephone advice nursing and the patient-unfriendly aspects of telephone advice nursing. The themes can be understood as two sides of the same coin; the differences point to both the advantages and disadvantages of the service and are further illuminated through seven subthemes.

    CONCLUSIONS: This study contributes to increased awareness of the advantages and disadvantages of the telephone advice nursing system as experienced by older persons. To be the focus of attention during calls was highlighted as important; and clear communication was deemed crucial. When the communication between the nurse and the older persons was perceived as good and the perspective of the caller was the focus, an experience of safety and satisfaction was described. Older persons had great confidence in the telephone nurses' competence and perceived their ability to access the service as mostly good, even if it was sometimes difficult to use the service.

    RELEVANCE TO CLINICAL PRACTICE: The communicative competence of telephone nurses is essential when providing telephone advice nursing to older persons. In addition, a person-centred approach is important to provide optimal care in telephone advice nursing.

  • 41.
    Holmström, Inger
    et al.
    Mälardalens Högskola.
    Krantz, A
    Ängens vårdcentral, Örebro.
    Karagacil, L
    Hemsjukvården, Vård och omsorg Västerås stad.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Frequent callers in primary healthcare – a nursing perspective2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 3, no 3, p. 622-632Article in journal (Refereed)
    Abstract [en]

    AIM:

    To: (a) describe how telephone nurses define a frequent caller; and (b) describe their experiences with calls from frequent callers to primary healthcare centres.

    BACKGROUND:

    Telephone nursing has been noted to be a cost-effective method to enhance access to and use of health care. Some patients use these services extensively and are called 'frequent callers'. Little is known about this group of callers, the reasons behind these calls and telephone nurses' experiences and strategies to manage the calls.

    DESIGN:

    Descriptive design with a qualitative inductive approach.

    METHODS:

    Interviews were conducted with ten telephone nurses in Sweden in 2015. Qualitative content analysis was conducted.

    RESULTS:

    A main theme was established, called 'Balancing between the experienced and assessed needs', which described the telephone nurses' experiences with calls made by frequent callers to primary healthcare centres and was further described in five categories with 15 subcategories. The categories described telephone nurses' definitions of frequent callers, telephone nurses' views of the underlying reasons for the calls, challenges related to frequent callers, experiences with an increased work load and strategies used to manage and help frequent callers.

    CONCLUSION:

    Frequent callers were commonly encountered by telephone nurses' in this study. Their calls were experienced as complex and demanding to manage. The findings point to needs for guidelines and routines to improve the care of frequent callers. In addition, support and training in communication skills to encounter this group of callers in an optimal and safe way may be required.

  • 42.
    Håkansson Eklund, Jakob
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holmström, Inger K.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kumlin, Tomas
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kaminsky, Elenor
    Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden..
    Skoglund, Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Malardalen Univ, Sch Hlth Care & Social Welf, Postbox 883, SE-72123 Vasteras, Sweden..
    Höglander, Jessica
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sundler, Annelie J.
    Univ Boras, Fac Caring Sci Work Life & Social Welf, SE-50190 Boras, Sweden..
    Conden, Emelie
    Uppsala Univ, Vastmanland Hosp, Clin Res Ctr, Uppsala, Sweden..
    Summer Meranius, Martina
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    "Same same or different?" A review of reviews of person-centered and patient-centered care2019In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 102, no 1, p. 3-11Article, review/survey (Refereed)
    Abstract [en]

    Objective: To provide a synthesis of already synthesized literature on person-centered care and patient-centered care in order to identify similarities and differences between the two concepts. Methods: A synthesis of reviews was conducted to locate synthesized literature published between January 2000 and March 2017. A total of 21 articles deemed relevant to this overview were synthesized using a thematic analysis. Results: The analysis resulted in nine themes present in person-centered as well as in patient-centered care: (1) empathy, (2), respect (3), engagement, (4), relationship, (5) communication, (6) shared decision-making, (7) holistic focus, (8), individualized focus, and (9) coordinated care. The analysis also revealed that the goal of person-centered care is a meaningful life while the goal of patient-centered care is a functional life. Conclusions: While there are a number of similarities between the two concepts, the goals for person-centered and patient-centered care differ. The similarities are at the surface and there are important differences when the concepts are regarded in light of their different goals. Practice implications: Clarification of the concepts may assist practitioners to develop the relevant aspects of care. Person-centered care broadens and extends the perspective of patient-centered care by considering the whole life of the patient.

  • 43.
    Håkansson Eklund, Jakob
    et al.
    Mälardalen University.
    Holmström, Inger K
    Mälardalen University.
    Kumlin, Tomas
    Mälardalen University.
    Kaminsky, Elenor
    Uppsala University.
    Skoglund, Karin
    Mälardalen University.
    Höglander, Jessica
    Mälardalen University.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Condén, Emilie
    Uppsala University.
    Summer Merenius, Martina
    Mälardalen University.
    Same same or different? A review of reviews of person-centred and patient-centred care.2018In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134Article in journal (Refereed)
    Abstract [en]

    Objective

    To provide a synthesis of already synthesized literature on person-centered care and patient-centered care in order to identify similarities and differences between the two concepts.

    Methods

    A synthesis of reviews was conducted to locate synthesized literature published between January 2000 and March 2017. A total of 21 articles deemed relevant to this overview were synthesized using a thematic analysis.

    Results

    The analysis resulted in nine themes present in person-centered as well as in patient-centered care: (1) empathy, (2), respect (3), engagement, (4), relationship, (5) communication, (6) shared decision-making, (7) holistic focus, (8), individualized focus, and (9) coordinated care. The analysis also revealed that the goal of person-centered care is a meaningful life while the goal of patient-centered care is a functional life.

    Conclusions

    While there are a number of similarities between the two concepts, the goals for person-centered and patient-centered care differ. The similarities are at the surface and there are important differences when the concepts are regarded in light of their different goals.

    Practice implications

    Clarification of the concepts may assist practitioners to develop the relevant aspects of care. Person-centered care broadens and extends the perspective of patient-centered care by considering the whole life of the patient.

  • 44.
    Håkansson Eklund, Jakob
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holmström, Inger K.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ollén Lindqvist, Anna
    Mälardalen University.
    Sundler, Annelie Johansson
    University of Borås, Borås, Sweden.
    Hochwälder, Jacek
    Mälardalen University, School of Business, Society and Engineering. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Marmstål Hammar, Lena
    Dalarna University, Falun, Sweden.
    Empathy levels among nursing students: A comparative cross-sectional study2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 3, p. 983-989Article in journal (Refereed)
    Abstract [en]

    Aim: Empathy is a crucial component of the nurse–patient relationship, but knowledge is lacking as to when empathy develops during nursing education. The aim of the present study was to compare empathy levels at different stages of undergraduate nursing education and different master's nursing programmes. Design: The design was a comparative cross-sectional study. Methods: A total of 329 participants in Sweden, comprised of nursing students in their second and sixth semesters in an undergraduate nursing programme as well as master's nursing students, rated their own empathy using the Jefferson Scale of Physician Empathy. Results: Students in their sixth semester in an undergraduate nursing programme expressed more empathy than did students in their second semester and master's nursing students. Among the five master's programmes, public-health nursing students expressed the most empathy and intensive-care nursing students the least. 

  • 45. Höglander, J
    et al.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Spreeuwenberg, P
    Holmström, I K
    Eide, H
    van Dulmen, S
    Håkansson Eklund, J
    Female gender explains emotional communication in home care2018Conference paper (Refereed)
  • 46.
    Höglander, Jessica
    et al.
    Mälardalen University.
    Eklund, Jakob Håkansson
    Mälardalen University.
    Eide, Hilde
    University College of Southeast Norway.
    Holmström, Inger K
    Uppsala University.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Registered Nurses' and nurse assistants' responses to older persons' expressions of emotional needs in home care.2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2923-2932Article in journal (Refereed)
    Abstract [en]

    AIM: This study aims to explore nurse assistants' and Registered Nurses' responses to older persons' expressions of emotional needs during home care visits.

    BACKGROUND: Communication is a central aspect of care. Older persons might express different emotions and needs during home care visits and such expressions can be challenging to respond to. Little is known about communication in home care or nursing staff responses to older persons' expressed emotional needs.

    DESIGN: Descriptive, cross-sectional design on nursing staff responses to older persons' negative emotions in home care.

    METHODS: Collected data consisted of audio recordings of home care visits between older persons and nursing staff. Data were collected between August 2014-November 2015. The nursing staff responses to older persons' negative emotions in the communication were analysed with the Verona Coding Definitions of Emotional Sequences (VR-CoDES).

    RESULTS: The nursing staff most often give non-explicit responses, providing space for further disclosure of older persons' expressed negative emotions. Such responses were more frequent if the nursing staff had elicited the older persons' expressions of a negative emotion than if such expressions were elicited by the older persons themselves. Most frequent types of responses were backchannel, active invitation or information advice.

    CONCLUSION: The nursing staff responses were mainly non-explicit responses providing space for older persons to tell more about their experiences. Such responses can be discussed in terms of person-centred communication and is important for the comfort of emotional concerns.

  • 47.
    Höglander, Jessica
    et al.
    Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden..
    Eklund, Jakob Håkansson
    Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden..
    Eide, Hilde
    Univ Coll Southeast Norway, Fac Hlth Sci, Drammen, Norway..
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden.
    Sundler, Annelie J.
    Univ Boras, Fac Caring Sci Work Life & Social Welf, Boras, Sweden..
    Registered Nurses' and nurse assistants' responses to older persons' expressions of emotional needs in home care2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2923-2932Article in journal (Refereed)
    Abstract [en]

    Aim: This study aims to explore nurse assistants' and Registered Nurses' responses to older persons' expressions of emotional needs during home care visits.

    Background: Communication is a central aspect of care. Older persons might express different emotions and needs during home care visits and such expressions can be challenging to respond to. Little is known about communication in home care or nursing staff responses to older persons' expressed emotional needs.

    Design: Descriptive, cross-sectional design on nursing staff responses to older persons' negative emotions in home care.

    Methods: Collected data consisted of audio recordings of home care visits between older persons and nursing staff. Data were collected between August 2014-November 2015. The nursing staff responses to older persons' negative emotions in the communication were analysed with the Verona Coding Definitions of Emotional Sequences (VR-CoDES).

    Results: The nursing staff most often give non-explicit responses, providing space for further disclosure of older persons' expressed negative emotions. Such responses were more frequent if the nursing staff had elicited the older persons' expressions of a negative emotion than if such expressions were elicited by the older persons themselves. Most frequent types of responses were backchannel, active invitation or information advice.

    Conclusion: The nursing staff responses were mainly non-explicit responses providing space for older persons to tell more about their experiences. Such responses can be discussed in terms of person-centred communication and is important for the comfort of emotional concerns.

  • 48.
    Höglander, Jessica
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Håkansson Eklund, Jakob
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Eide, Hilde
    Univ Coll Southeast Norway, Drammen, Norway..
    Holmström, Inger K.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sundler, Annelie J.
    Univ Borås, Borås, Sweden..
    Registered Nurses' and nurse assistants' responses to older persons' expressions of emotional needs in home care2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2923-2932Article in journal (Refereed)
    Abstract [en]

    Aim: This study aims to explore nurse assistants' and Registered Nurses' responses to older persons' expressions of emotional needs during home care visits. Background: Communication is a central aspect of care. Older persons might express different emotions and needs during home care visits and such expressions can be challenging to respond to. Little is known about communication in home care or nursing staff responses to older persons' expressed emotional needs. Design: Descriptive, cross-sectional design on nursing staff responses to older persons' negative emotions in home care. Methods: Collected data consisted of audio recordings of home care visits between older persons and nursing staff. Data were collected between August 2014-November 2015. The nursing staff responses to older persons' negative emotions in the communication were analysed with the Verona Coding Definitions of Emotional Sequences (VR-CoDES). Results: The nursing staff most often give non-explicit responses, providing space for further disclosure of older persons' expressed negative emotions. Such responses were more frequent if the nursing staff had elicited the older persons' expressions of a negative emotion than if such expressions were elicited by the older persons themselves. Most frequent types of responses were backchannel, active invitation or information advice. Conclusion: The nursing staff responses were mainly non-explicit responses providing space for older persons to tell more about their experiences. Such responses can be discussed in terms of person-centred communication and is important for the comfort of emotional concerns.

  • 49.
    Höglander, Jessica
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Håkansson Eklund, Jakob
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Spreeuwenberg, Peter
    NIVEL (Netherlands institute for health services research), Utrecht, The Netherlands.
    Eide, Hilde
    Johansson Sundler, Annelie
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Roter, Debra
    Holmström, Inger K.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    A positive tone and socio-emotional talk: Exploring person-centered aspects of home care communicationManuscript (preprint) (Other academic)
  • 50.
    Höglander, Jessica
    et al.
    Mälardalen Univ, Sch Hlth Care & Social Welf, Västeås, Sweden.
    Sundler, Annelie J.
    Univ Borås, Dept Caring Sci Work Life & Social Welf, Borås, Sweden.
    Spreeuwenberg, Peter
    Netherlands Inst Hlth Serv Res, Utrecht, Netherlands.
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Mälardalen Univ, Sch Hlth Care & Social Welf, Västerås, Sweden.
    Eide, Hilde
    Univ South Eastern Norway, Sci Ctr Hlth & Technol, Drammen, Norway.
    van Dulmen, Sandra
    Netherlands Inst Hlth Serv Res, Utrecht, Netherlands; Univ South Eastern Norway, Sci Ctr Hlth & Technol, Drammen, Norway; Radboud Inst Hlth Sci, Dept Primary & Community Care, Nijmegen, Netherlands.
    Eklund, Jakob H.
    Mälardalen Univ, Sch Hlth Care & Social Welf, Västerås, Sweden.
    Emotional communication with older people: A cross-sectional study of home care2019In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 21, no 3, p. 382-389Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore the influence of characteristics of nurses and older people on emotional communication in home care settings. A generalized, linear, mixed model was used to analyze 188 audio-recorded home care visits coded with Verona Coding Definitions of Emotional Sequences. The results showed that most emotional distress was expressed by older females or with female nurses. The elicitation of an expression of emotional distress was influenced by the nurses' native language and profession. Older women aged 65-84 years were given the most space for emotional expression. We found that emotional communication was primarily influenced by sex for nurses and older people, with an impact on the frequency of expressions of and responses to emotional distress. Expressions of emotional distress by older males were less common and could risk being missed in communication. The results have implications for students' and health professionals' education in increasing their knowledge of and attentiveness to the impacts of their and others' characteristics and stereotypes on emotional communication with older people.

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