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  • 301.
    Tengroth, Erica
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Krall, Tina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Men vem styr egentligen? Det gör ju jag!: Patienters uppfattning och hantering av sin sjukdom2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background The district nurse has a key role in caring and supporting patients with different kinds of health problems. A personcentered approach in the patient education facilitates for the patient to participate in self-care and management of the illness. Aim The aim of the study was to examine patients’ illness perceptions and management of their illness. Method Nine patients who has either hypertention, type 2 diabetes or chronic obstructive pulmonary disease were interviewed. The interviews were analyzed by qualitative content analysis with an inductive and deductive approach. Results The results were presented from Leventhal´s five dimensions in The Common Sense Model of Self-Regulation: identity, time-line, consequence, cause and control. The Participants´ describings were formulated into ten categories: the illness is present, mental image, cognitive coping, illness duration, daily impact, behavioral coping, thoughts about cause, coping strategy, meaning of the treatment and coping - seeking social support. Conclusion This study showed that there are different coping strategies to manage illness: The participants used distancing, accepting responsibility, planful problem solving, positive reappraisal and/or seeking social support

  • 302.
    Ternell, Hanna
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Steinhof, Martin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Omvårdnadspersonals strategier för att förebygga återfall i beroende inom rättspsykiatrisk vård2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Relapse in drug dependence is a common problem among patients within forensic psychiatric care. Dependence complicates the patient's ability to rehabilitate, it causes physical and mental harm and increases the risk of returning into crime. The knowledge among health care professionals, and their strategies to prevent relapses in dependence among patients in forensic psychiatric care, is very limited.

    The aim of this study is to describe strategies used by the nursing staff to prevent relapses in drug dependence. The authors have conducted interviews with eight professionals working in four different wards. The interviews have been analysed using qualitative content analysis.

    The results show the importance of the patient's own ability and desires should be the basis of nursing care. Specific routines and well known consequences must be used in case of relapse. The re-adaptation to society is of great importance to prevent relapse in dependence.

    Most respondents however, asked for more specific strategies for dealing with dependency problems, especially regarding methods for dialogue and motivation.

  • 303.
    Tveter, Helena
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Visit or visitation?: parent's experiences of receiving a home visit by a district nurse after the birth of their first child.2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In Sweden, the first contact between parents and child health care is normally in the form of a home visit by a district nurse from a child health care clinic. This study aims to describe first-time parents' experiences of a home visit by a district nurse after the birth of their first child. A qualitative research design was used to acquire an understanding of the parents' experiences. Collected data was analyzed using qualitative content analysis and resulted in the category Visit or visitation, and two subcategories, being overwhelmed and being relieved by the home visit by the district nurse and represent the feelings experienced by the participants. Many participants were negative to the purpose and necessity of the home visit, but conversely positive to the actions and behavior of the district nurse. By the district nurse being positive and supportive, she made the home visit a positive experience after all.

  • 304.
    Uvnäs-Moberg, Kerstin
    et al.
    University of Agriculture (SLU), Uppsala, Sweden.
    Ekström-Bergström, Anette
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Skövde, School of Health and Education, Skövde, Sweden.
    Berg, Marie
    University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden.
    Buckley, Sarah
    The University of Queensland, School of Public Health, Brisbane, Australia..
    Pajalic, Zada
    Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences Oslo, Norway.
    Hadjigeorgiou, Eleni
    University of Technology, Faculty of Health Sciences, Cyprus, Limassol, Cyprus.
    Kotłowska, Alicja
    Medical University of Gdańsk, Faculty of Health Sciences with Subfaculty of Nursing and Institute of Maritime and Tropical Medicine, Gdańsk, Poland.
    Lengler, Luise
    Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany.
    Kielbratowska, Bogumila
    Medical University of Gdańsk, Faculty of Medical Sciences, Gdańsk, Poland.
    Leon-Larios, Fatima
    University of Seville, Faculty of Nursing, Physiotherapy and Podiatry, Seville, Spain.
    Magistretti, Claudia Meier
    Lucerne University of Applied Sciences and Arts, Department of Social Work Center for Health Promotion and Social Participation, Luzern, Switzerland.
    Downe, Soo
    University of Central Lancashire, Research in Childbirth and Health (ReaCH) group, Preston, UK.
    Lindström, Bengt
    Norwegian University of Science and Technology, Trondheim, Norway.
    Dencker, Anna
    University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden .
    Maternal plasma levels of oxytocin during physiological childbirth: a systematic review with implications for uterine contractions and central actions of oxytocin2019In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 19, no 1, article id 285Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Oxytocin is a key hormone in childbirth, and synthetic oxytocin is widely administered to induce or speed labour. Due to lack of synthetized knowledge, we conducted a systematic review of maternal plasma levels of oxytocin during physiological childbirth, and in response to infusions of synthetic oxytocin, if reported in the included studies.

    METHODS: An a priori protocol was designed and a systematic search was conducted in PubMed, CINAHL, and PsycINFO in October 2015. Search hits were screened on title and abstract after duplicates were removed (n = 4039), 69 articles were examined in full-text and 20 papers met inclusion criteria. As the articles differed in design and methodology used for analysis of oxytocin levels, a narrative synthesis was created and the material was categorised according to effects.

    RESULTS: Basal levels of oxytocin increased 3-4-fold during pregnancy. Pulses of oxytocin occurred with increasing frequency, duration, and amplitude, from late pregnancy through labour, reaching a maximum of 3 pulses/10 min towards the end of labour. There was a maximal 3- to 4-fold rise in oxytocin at birth. Oxytocin pulses also occurred in the third stage of labour associated with placental expulsion. Oxytocin peaks during labour did not correlate in time with individual uterine contractions, suggesting additional mechanisms in the control of contractions. Oxytocin levels were also raised in the cerebrospinal fluid during labour, indicating that oxytocin is released into the brain, as well as into the circulation. Oxytocin released into the brain induces beneficial adaptive effects during birth and postpartum. Oxytocin levels following infusion of synthetic oxytocin up to 10 mU/min were similar to oxytocin levels in physiological labour. Oxytocin levels doubled in response to doubling of the rate of infusion of synthetic oxytocin.

    CONCLUSIONS: Plasma oxytocin levels increase gradually during pregnancy, and during the first and second stages of labour, with increasing size and frequency of pulses of oxytocin. A large pulse of oxytocin occurs with birth. Oxytocin in the circulation stimulates uterine contractions and oxytocin released within the brain influences maternal physiology and behaviour during birth. Oxytocin given as an infusion does not cross into the mother's brain because of the blood brain barrier and does not influence brain function in the same way as oxytocin during normal labour does.

  • 305.
    Van Bulck, Lisbet
    et al.
    KU Leuven – University of Leuven, Department of Public Health and Primary Care, Belgium.
    Luyckx, Koen
    KU Leuven – University of Leuven, School Psychology and Development in Context, Belgium; UNIBS, University of the Free State, South Africa.
    Goossens, Eva
    KU Leuven – University of Leuven, Department of Public Health and Primary Care,Belgium; Research Foundation Flanders (FWO), Belgium; Division of Congenital and Structural Cardiology, University Hospitals Leuven, Belgium .
    Apers, Silke
    KU Leuven – University of Leuven, Department of Public Health and Primary Care, Belgium.
    Kovacs, Adrienne. H.
    University of Toronto, Peter Munk Cardiac Centre, Canada; Oregon Health & Science University, Knight Cardiovascular Institute, USA .
    Thomet, Corina
    Center for Congenital Heart Disease, Bern University Hospital, Switzerland.
    Budts, Werner
    Division of Congenital and Structural Cardiology, University Hospitals Leuven, Belgium ; KU Leuven – University of Leuven, Department of Cardiovascular Sciences,Belgium .
    Sluman, Maayke A.
    Department of Cardiology, Academic Medical Center, The Netherlands; Department of Cardiology, Jeroen Bosch Hospital, The Netherlands; Coronel Institute for Occupational Health, Academic Medical Centre, The Netherlands.
    Eriksen, Katrine
    Department of Cardiology, Oslo University Hospital – Rikshospitalet, Norway.
    Dellborg, Mikael
    University of Gothenburg, Centre for Person-Centred Care (GPCC), Sweden; Adult Congenital Heart Unit, Sahlgrenska University Hospital, Sweden; Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Centre for Person-Centred Care (GPCC), Sweden.
    Johansson, Bengt
    Umeå University, Department of Public Health and Clinical Medicine, Sweden.
    Caruana, Mayanne
    Department of Cardiology, Mater Dei Hospital, Malta.
    Soufi, Alexandra
    Department of Congenital Heart Disease, Louis Pradel Hospital, France.
    Callus, Edward
    Clinical Psychology Service, IRCCS Policlinico San Donato, Italy; Università degli Studi di Milano, Department of Biomedical Sciences for Health, Italy .
    Moons, Philip
    KU Leuven – University of Leuven, Department of Public Health and Primary Care, Belgium; University of Gothenburg, Institute of Health and Care Sciences, Sweden; Department of Paediatrics and Child Health, University of Cape Town, South Africa .
    Patient-reported outcomes of adults with congenital heart disease from eight European countries: scrutinising the association with healthcare system performance2019In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 6, p. 465-473Article in journal (Refereed)
    Abstract [en]

    Background: Inter-country variation in patient-reported outcomes of adults with congenital heart disease has been observed. Country-specific characteristics may play a role. A previous study found an association between healthcare system performance and patient-reported outcomes. However, it remains unknown which specific components of the countries' healthcare system performance are of importance for patient-reported outcomes.

    Aims: The aim of this study was to investigate the relationship between components of healthcare system performance and patient-reported outcomes in a large sample of adults with congenital heart disease.

    Methods: A total of 1591 adults with congenital heart disease (median age 34 years; 51% men; 32% simple, 48% moderate and 20% complex defects) from eight European countries were included in this cross-sectional study. The following patient-reported outcomes were measured: perceived physical and mental health, psychological distress, health behaviours and quality of life. The Euro Health Consumer Index 2015 and the Euro Heart Index 2016 were used as measures of healthcare system performance. General linear mixed models were conducted, adjusting for patient-specific variables and unmeasured country differences.

    Results: Health risk behaviours were associated with the Euro Health Consumer Index subdomains about patient rights and information, health outcomes and financing and access to pharmaceuticals. Perceived physical health was associated with the Euro Health Consumer Index subdomain about prevention of chronic diseases. Subscales of the Euro Heart Index were not associated with patient-reported outcomes.

    Conclusion: Several features of healthcare system performance are associated with perceived physical health and health risk behaviour in adults with congenital heart disease. Before recommendations for policy-makers and clinicians can be conducted, future research ought to investigate the impact of the healthcare system performance on outcomes further.

  • 306.
    Venckiene, Ina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjuksköterskors upplevelser av personer med samsjuklighet inom kommunal hälso- och sjukvård2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: People with mental illness and substance abuse are in great need of care and treatment. To increase the chances of recovery, both diagnoses need to be identified. Mental illness and substance abuse are perceived as deviant in society and among caregivers, with the result that the person is not seeking care and likely to deteriorate in their health. The nurse is obliged to use his/hers understanding in a fair and unprejudiced way, and deal with the person with respect and understanding regardless of the disease. For nurses in the municipal health care responsibilities for people with comorbidity leads to a higher workload and stress. Previous research shows that nurses lack skills in psychiatric nursing, causing uncertainty in health care meeting. Aim: The purpose of the study is to describe nurses' experiences of people with mental illness and substance abuse in municipal health care.Method: A qualitative method with individual interviews were used. The sample consisted of seven nurses, three psychiatric nurses, a district nurse and three general nurses. Participants were six women and one man, between twenty-five and fifty-two years old. The collected material was analyzed by qualitative content analysis. Result: Three categories are presented in the outcome - Patient needs that are difficult to master, Conditions for a good care relationship and Organizational shortcomings create role confusion. These categories created a theme: Comorbidity - multifaceted and difficult to master. Conclusion: We need greater knowledge of psychiatry in the municipal health service. For this to happen, we need understanding from the top of the organization regarding the illuminated phenomenon and understanding of psychiatric nurses' skills. Further research on how the organization can be improved could contribute to greater understanding and thereby improve patient situation.

  • 307.
    Vidaurrazaga Aras, Valentina
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Larsson, Thomas
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjuksköterskors erfarenheter av vårdrelationer inom öppenvården med personer som har psykossjukdom2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background The care relationship is central for psychiatric nursing. People with a psychosis diagnosis encounter symptoms that result in difficulties for the interpersonal communication. Stigma and previous experiences of compulsory care are obstacles that hinder or complicate the patient's participation in their care. A person-centered caring relationship increases adherence and the patient's possibility to be a part of their recovery. Therefore it is important for the psychiatric nurse to gain a deeper understanding of what specific strategies and practices the nurse uses to enhance the potential of the care relationship and provide a person-centered care.

    Aim The aim of the study is to describe the nurse´s experience of the care relationship with people who have a psychosis diagnosis.

    Method The study was conducted at two outpatient facilitations in Sweden. Eight nurses were asked about their experiences of the care relationship during individual semi-structured interviews. The data was analyzed by using a qualitative content analysis.

    Results The result was presented in three categories; Trust - essential for a supportive care relationship, Careful perception of the person's boundaries and conditions and Structural possibilities and limitations. The three categories consisted of six subcategories that emphasized the importance of the nurse creating trust and an equal meeting. The care relationship was related to getting to know the person’s history by using the nurse’s personal characteristics and how the nurse handled challenging conditions. Difficulties in creating such a relationship could be demands from the organization or the power dynamics within the health care facilitation.

    Conclusion By creating trust and an equal meeting the nurse is able to get to know the person’s history and thereby provide a person-centered care for people with psychosis diagnosis.

  • 308.
    Wachsmann, Solbrith
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Spirometri och konditionstests påverkan på livskvalitet hos personer som röker: En randomiserad kontrollerad studie2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: People who smoke risks lower lung capacity and consequently inferior physical fitness. Awareness regarding their own physical fitness and lung capacity could affect the motivation for change. The aim of this study was to investigate whether lung-capacity test (spirometry) and a fitness test ("Hälsospår") can affect the quality of life for people who smoke.

    Method: A randomized and controlled study was conducted. Participants were recruited from an ongoing cross-sectional study in southwestern Sweden where recruitment was done through the Swedish person and address database. Inclusion criteria's were daily smoking and age between 18 to 65 years. The 60 participants were randomly assigned to two parallel groups: intervention group (n=30) who did spirometry and "Hälsospår "or control group (n=30). Intervention was made by the same asthma-nurse respective health coach. The 36-item Short Form Health Survey (SF-36) was administered before and after one year intervention.

    Results: At the one year follow-up, regarding the subscale role emotional, the intervention group (n=18) had improved significantly more (median:0.0 [interquartile range (IQR):0.0 to 42]) vs (median:0.0 [IQR:0.0 to 0.0]); p <0.05) compared to the controls (n=22).

    Conclusion: Health care could advantageously offer people who smoke both spirometry and "Hälsospår" in nursing to increase people's quality of life. The result generate further research to influence the quality of life and life suffering of people who smoke.

  • 309.
    Wallin, Carl
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Dahlberg, Jessica
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Upplevelser av att leva med självskadebeteende: En bloggstudie2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Self-injurious behavior is an increasing problem among adolescents and young adults.

    The aim of this study was to explore the experiences of adolescents and young adults' living with self-injurious behavior.

    Method: The material consists of 15 blogs on the internet. These blogs have been analyzed using qualitative content analysis.

    The result emerged in one theme: An inner struggle, with the following four categories: Difficulties in everyday life, Concealment, The behavior gets ascendancy, Relationships and limitations, Treatment. The result shows a lack of understanding about self-injurious behavior in health care and in society. The treatment they face in health care, in relationships and in the society show a lack of understanding and of acceptance, which means they hide their mood and their self-injurious behavior. The people suffer an endless struggle with feelings they do not understand or can express, and with a vapor, which they can handle only by, for example cutting themselves, due to lack of other coping strategies.

    Conclusion: Adolescents and young adults with self-injurious behavior are living with an inner struggle. They are struggling with anxiety without relevant tools to handle the situation. Unworthy treatment and lack of understanding fill their everyday life. Therefore, they keep their problems as a secret, which limit their lives and causes them a lot of suffering.

  • 310.
    Wennerblom, Eva
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Möten i livet: En analys av självbiografier skrivna av personer med schizofreni2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Schizophrenia is a psychiatric disorder. Schizophrenia belongs to the group of psychotic disorders which means that the patient loses touch of reality. Schizophrenia is existing all over the world in the same degree. The aim with this study was to illuminate how persons with schizophrenia, experience meetings with other people. The method for reaching the aim in this study was to study, listen and read books written by persons with Schizophrenia and to analyze these books. It felt natural to use autobiographies of schizophrenic persons. The result showed that there were two themes and seven sub themes. The two themes were positive experiences and negative experiences. A positive experience was when they felt some happiness and joy, confirmation, safety and calmness from the person they met. Negative experience was feeling violated, not being confirmed and self- contempt. Conclusions of this study is that giving persons with the diagnosis schizophrenia confirmation and show respect is crucial for a positive experience of meeting with others.

  • 311.
    Wernerliv, Anna
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Palmhagen, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Patienters sökning efter hälsoinformation via internet inför mötet med distriktssköterskan2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: When we as health care nurses meets patients at day care centers, they often have questions regarding health information that they have found on the internet. These questions can be supportive and a guidance in the process of finding appropriate treatment and diagnosis. But the questions can also take important time when the patient interpreted the health information that they found and demand for unnecessary investigations. The aim of this study was to investigate patients search for health information online prior to contact of a Health care nurse. Method: To find participants that used internet for health search we found Facebook as the best place to share a questionnaire. The result of the study was interpreted by both quantitative and qualitative method. The authors used a content analysis to analyse the open questions in the study. The result formed these kategories; trust, participation, empowerment. Conclusion: The result showed that it is important that we as district nurses has knowledge from where patients get their information and that patients are aware the district nurses has the knowledge. Patient needs guidance from the nurses, but the result also shows that patients find it important to be able to discuss the health information they have found. Keywords: district nurse, empowerment, health information, internet, patient

  • 312.
    Wikström, Ann-Charlott
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing. University West, Department of Health Sciences, Section for nursing - graduate level.
    Knowing in practice: a tool in the production of intensive care2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim with the the present thesisi was to find out how intensive care is produced by focusing on the ICU staffs interaction with each other and the technological tools they use. Theoretical perspective draws on socio cultural theory and the concepts accounting practices, moralöity in discourse and workplace research. The method used is ethnography and the data has been collected through participant observations and interviews in an intensive care unit in Swedish health care. The result... mer

    is presented through four papers. The first paper shows that intensive care to a great extent is produced through rutines. The division of labour is marked and taken for granted by the ICU staffs. Verbal reports, visual displays and activities make the information avaliable and shared understanding seems to make words redundant when the everyday practices are carried out. Further technology seems to be embedded in the caring for the patients. In the second paper the findings also show that technology intervenes in the division of labour and both challenges the ICU staffs' practical knowing and refurmulates practice. The awareness of routine problems is connected to the ability to "see" and to the ICU staffs cultural/contextual knowing. Knowing in practice transforms when new technology is introduced in the ICU. Problems are solved in concert often in a hierarchical way. The third paper in turn illuminates that the meaning of technology seems to be connected to the ICU staffs' accounting practices, i.e. their experiences of intensive care, thaier education, how long they have worked in the ICU and their positions in the network. Accounting practices is also socially shaped by the interaction among the ICU staff.It is the knowing that has been developed over time and it is the knowing that new ICU staff members have to learn to be competent actors in the ICU environment. Furthermore it is found in the fourth paper that moral values are negotiated in assessments of patients, medical decisions, other professionals (in)competence and othe institutions' activities. Thus it seems that moral values embedded and intertwined in the ICU staffs' everyday practices. It is concluded that the ICU staffs competence i.e. knowing in situated activities could be seen as a tool in the production of intensive care. And this knowing seems to be distributed between the humans and between humans and the technological tools to make everyday practices more flexible. The ICU staff does not solve problems solely through individual cognitive work rather staff members "borrow" knowing from each other and solve problems in concert. Intensive care is produced here and now at the same time as the past is present in the everyday pracitices. The meaning is shaped in context and moral values are embedded in the intensive care discourse. In this sense intensive care could be described as a technically, cognitively and morally intense environment.

  • 313.
    Wikström, Ann-Charlott
    et al.
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing. University West, Department of Health Sciences, Section for nursing - graduate level.
    Cederborg, Ann-Christin
    Department of Behavioural Sciences, Linköping University.
    Johanson, Marita
    University West, Administration .
    The meaning of technology in an intensive care unit-an interview study2007In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 23, no 4, p. 187-195Article in journal (Refereed)
  • 314.
    Wikström, Ann-Charlott
    et al.
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing. University West, Department of Health Sciences, Section for nursing - graduate level.
    Johanson, Marita
    University West, Administration .
    Plos, Kathy
    Cederborg, Ann-Christin
    Morality in discourse in a intensive care unit: a field studtArticle in journal (Refereed)
  • 315.
    Wikström, Ann-Charlott
    et al.
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing. University West, Department of Health Sciences, Section for nursing - graduate level.
    Larsson, Ullabeth Sätterlund
    Sahlgrenska Academy at Göteborg University, Institute of Health Care Pedagogics.
    Technology -an actor in the ICU: a study in workplace research tradition.2004In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, no 5, p. 555-61Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The present study focuses on human-machine interaction in an intensive care unit in the West of Sweden. AIMS: The aim of the present study was to explore how technology intervenes and challenges the ICU staff's knowing in practice. THEORETICAL PERSPECTIVE: The study's theoretical starting point draws on workplace research tradition. Workplace studies encompass the interaction between the actors' situated activities and the technological tools that make their activities possible. METHOD: Fieldwork or in situ studies of everyday practice in an intensive care unit documented in written field notes constituted the data. RESULTS: The findings show first how technology intervenes in the division of labour when the taken-for-granted "old" everyday practice is disrupted when a new machine intervenes in the morning's work; secondly, it reveal how technology challenges practical knowing and thirdly, it shows how technology reformulates practice. Staff members' awareness of routine problems is often connected to the ability to see, which is always related to cultural/contextual competence. CONCLUSION: It is concluded that it is not talk alone that helps the caregivers to "(dis)solve" the problems. The ability to see the problems, the work environment and to find the relevant supporting tools for "(dis)solving" the routine problems is also crucial. But it is not possible to say that it is the skillful work of humans that solve problems, nor do we claim it is the tools that do so. Humans and tools are interwoven in the problem-solving process. Relevance to clinical practice. Routine problems in the intensive care unit are not "(dis)solved" through the cognitive work of individual staff members alone. Problems are also "(dis)solved" jointly with other staff members. Staff members "borrow" the knowing from each other and problems are re-represented through communication. The knowing has to be distributed among the intensive care unit staff to make the everyday work flexible.

  • 316.
    Wikström, Ann-Charlott
    et al.
    University West, Department of Nursing. University West, Department of Health Sciences, Section for nursing - graduate level.
    Sätterlund Larsson, Ullabeth
    Sahlgrenska Academy at Göteborg University, Institute of Health Care Pedagogics.
    Patient on display: a study of everyday practice in intensive care2003In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 43, no 4, p. 376-83Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: This study investigates the situated organization in a workplace producing intensive care, that is an intensive care unit (ICU). The workplace research tradition concerns work and interaction/communication in technology-intensive environments. Communication is seen as social action and cannot be separated from production or from the context in which the activities are situated. AIM: The aim of the present study was to explore how intensive care is produced by analysing a recurrent situated activity in the ICU, namely the delivery and reception of a patient coming from the operation unit. METHOD: In the fieldwork, participant observations was used to study everyday practice in an ICU, combined with written field notes. FINDINGS AND DISCUSSION: Intensive care is to a great extent produced through routine practices. The division of labour is marked and is taken for granted: everyone knows what to do. The actors' physical location in the room is connected to their functions and work with supportive tools. Verbal reports, visual displays and activities make the information transmission available to everyone in the patient room. Shared understanding of the situation seems to make words redundant when the activities of competent actors are co-ordinated. There is also coordination between the actors in the ICU and the technological equipment, which constantly produces new information that must be interpreted. Enrolled Nurses are physically closest to the patients, the physician is the one most physically distant from patients and Registered Nurses bridge the gap between them. These actors produce and re-produce intensive care through constant sense-making in the here and now at the same time as the past is present in their activities.

  • 317.
    Åkerlund, Sofia  
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Lindgren, Jenny
    University West, Department of Health Sciences, Section for nursing - graduate level.
    "Försöka känna hopp samtidigt som jag försöker vara förberedd på det värsta": att vara närstående till en patient som vårdas på intensivvårdsavdelning.2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Relatives of a critically ill patient being cared for at an intensive care unit are in great need of support from the intensive care nurse. To be able to handle the stressful situation they need information, the opportunity to be involved and to be greeted in a positive manner.

    The purpose of this study was to describe relatives' psychiatric health at an intensive care unit.

    A cross-sectional study using a survey and qualitative content analysis was chosen as the design for this study.

    The result reveals that relatives feel great concern and have a hard time relaxing. A lot of them feel anxiety and depression as a result of the strains from the time at the intensive care unit. To oscillate between hope and despair meant that they lived with great uncertainty and made it difficult to keep their motivation up. They describe that their psychiatric health is affected by the promotion of relationships, as they're living with uncertainty, as they're being able to handle the situation and as they're experiencing a loss of control.

    The result of this study showed that relatives of a critically ill patient being cared for at an intensive care unit have a high occurrence of anxiety and depression. Resources need to be allocated to caring for relatives to prevent illness.

  • 318.
    Ólafsdóttir, Arndís Finna
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Users experience of Flash Glucose Monitoring2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: For individuals with diabetes it is important to be able to monitor their blood glucose in a safe and effective way. This has traditionally been done with Self-measurement of blood glucose. In the last decade Continuous Glucose Monitoring has become available and in 2014 a Flash Glucose monitor (FGM) came onto the market. To be able to help each individual find the best possible system for themselves the diabetes nurse has to be familiar with all systems.

    Aim: The aim of this study was to explore user's experience of a Flash Glucose Monitor.

    Method: This was a quantitative study done in 2 outpatient clinics in western Sweden during 2015. Individuals with type 1 diabetes answered a questionnaire (min0-max10) about their experience after using a Flash Glucose Monitor for 2 weeks.

    Results: Mean age was 47.5 years (SD 15.9) and 40% were women. The user experience was positive, with mean for the questions ranging from 8.08-9.79 (SD 0.6-2.5). There was a significant positive correlation to increasing age for 8 of the questions. Only statistical difference between genders was that women found the FGM disturbed more in their daily life.

    Conclusion: The FGM can be considered for individuals with type 1 diabetes and it is important to also include this when informing older individuals of the possible options for measurement of blood glucose.

  • 319.
    Östergren, Marina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjuksköterskors erfarenheter av möten med flyktingar i primärvården: En kvalitativ intervjustudie2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The migration into Sweden has been high during the last decade. Primary care nurses will encounter these migrants, on a regular basis, hence the primary care is the first step into the health care for the entire population. Nurses are obliged to keep a person centered care approach and to work with a health perspective. Aim: The aim with this study was to describe challenges nurses’ and district-nurses experienced from encounter with migrants in a primary care setting. Method: An interview study with a qualitative content analysis was conducted. Participants was recruited from primary care units in Western Sweden and from a closed group for nurses on Facebook. During the entire study ethical considerations were taken. Result: There are some challanges when it comes to migrants seeking care according to the nurses interviewed. Partly because of lack of common language but also because of differences in attitudes towards health and illness as well as cultural differences. According to the nurses it is a challenging and difficult task but also educative and rewarding. Nurses point out the importance of meeting every individual based on the individual’s unique point of view tough it is not always possible given the circumstances of the health care system. Conclusion: A lot of these difficulties and challenges could be decreased if the nurses adopt a more person centered and norm critical approach.

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