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- Almerud, Sofia, et al.
(författare)
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Beleaguered by technology : care in technologically intense environments.
- 2008
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Ingår i: Nursing Philosophy. - : Wiley-Blackwell Publishing Ltd.. - 1466-7681 .- 1466-769X. ; 9:1, s. 55-61
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Tidskriftsartikel (refereegranskat)abstract
- Modern technology has enabled the use of new forms of information in the care of critically ill patients. In intensive care units (ICUs), technology can simultaneously reduce the lived experience of illness and magnify the objective dimensions of patient care. The aim of this study, based upon two empirical studies, is to find from a philosophical point of view a more comprehensive understanding for the dominance of technology within intensive care. Along with caring for critically ill patients, technology is part of the ICU staff's everyday life. Both technology and caring relationships are of indispensable value. Tools are useful, but technology can never replace the closeness and empathy of the human touch. It is a question of harmonizing the demands of subjectivity with objective signs. The challenge for caregivers in ICU is to know when to heighten the importance of the objective and measurable dimensions provided by technology and when to magnify the patients' lived experiences, and to live and deal with the ambiguity of the technical dimension of care and the human side of nursing.
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| 3. |
- Almerud, S, et al.
(författare)
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Caught in an Artificial Split : A Phenomenological Study of Being a Caregiver in the Technologically Intense Environment
- 2007
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Ingår i: Intensive & Critical Care Nursing. - : Churchill Livingstone. - 0964-3397 .- 1532-4036. ; 24:2, s. 130-136
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Tidskriftsartikel (refereegranskat)abstract
- A symbiotic relationship exists between technology and caring, however, technologically advanced environments challenge caregivers. The aim of this study is to uncover the meaning of being a caregiver in the technologically intense environment. Ten open-ended interviews with intensive care personnel comprise the data. A phenomenological analysis shows that ambiguity abounds in the setting. The act of responsibly reading and regulating instruments easily melds the patient and the machinery into one clinical picture. The fusion skews the balance between objective distance and interpersonal closeness. The exciting captivating lure of technological gadgets seduces the caregivers and lulls them into a fictive sense of security and safety. It is mind-boggling and heart-rending to juggle ‘moments’ of slavish mastery and security menaced by insecurity in the act of monitoring a machine while caring for a patient. Whenever the beleaguered caregiver splits technique from human touch, ambiguity decays into ambivalence. Caring and technology become polarized. Everyone loses. Caregiver competence wanes; patients suffer. The intensive care unit should be technologically sophisticated, but also build-in a disclosive space where solace, trust, and reassurance naturally happen. Caring professionals need to balance state-of-the-art technology with integrated and comprehensive care and harmonize the demands of subjectivity with objective signs.
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| 7. |
- Almerud, Sofia, 1969-
(författare)
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Vigilance & Invisibility : Care in technologically intense environments
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis focuses on the relationship between technology and caring in technologically intense environments. The overall aim was to uncover the meaning of care in those environments as experienced by patients and caregivers. Moreover, the study aimed at finding a deeper understanding for the almost total dominance of technology in care in intensive care. The thesis includes three empirical studies and one theoretical, philosophical study. The research was guided by a phenomenological and lifeworld theoretical approach. Research data consist of quantitative parameters and qualitative interviews with caregivers and patients. Data was analysed and synthesised with aim of seeking meaning through openness, sensitivity and a reflective attitude. The goal was to reach the general structure of the phenomenon and its meaning constituents. The result shows that an intensive care unit is a cognitive and emotionally complex environment where caregivers are juggling a precarious handful of cards. Despite being constantly monitored and observed, intensive care patients express that they feel invisible. The patient and the apparatus easily meld into a unit, one item to be regulated and read. From the patients’ perspective, caregivers demonstrate keen vigilance over technological devices and measured parameters, but pay scant attention to their stories and experiences. Technology, with its exciting captive lure and challenging character, seduces the caregivers and lulls them into a fictive sense of security and safety. Technical tasks take precedence or have more urgency than caring behaviour. A malaise settles on caregivers as they strive for garnering the security that technology promises. Yet simultaneously, insecurity creeps in as they read the patient’s biological data. Technical tasks take precedence over and seemingly are more urgent than showing care. Listening, inspiring trust, and promoting confidence no longer have high priority. Trying to communicate ‘through’ technology is so complex, that it is a difficult challenge to keep in perspective what or who is the focus; ‘seeing’ or caring. Technology should be like a catalyst; do its ‘thing’ and withdraw ‘unnoticed’. This thesis has contributed in gaining deeper knowledge about care in technologically intense environments and the impact of technology. The main contribution is that caregivers need to be aware that the roar of technology silences the subtle attempts of the critically ill or injured person to give voice to his or her needs. In conclusion, the challenges for caregivers are to distinguish when to heighten the importance of the objective and measurable dimensions provided by technology and when to reduce their importance. In order to magnify the patients’ lived experiences. It is a question of balancing state-of-the-art technology with integrative and comprehensive care, of harmonizing the demands of subjectivity with objective signs.
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| 8. |
- Elmqvist, Carina, 1964-
(författare)
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Akut omhändertagande : i mötet mellan patienter, närstående och olika professioner på skadeplats och på akutmottagning
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To describe and develop understanding of the patient’s first encounter with the involved persons at the scene of an accident and at the emergency department; with a special focus on describing the meaning of emergency care of patients in these caring contexts. Method: The thesis uses a reflective lifeworld research (RLR) approach founded on phenomenological philosophy. The purpose with this approach is to describe the essential meaning and the variations of a phenomenon. Interviews with a lifeworld perspective were used for data collection and analyzed according to the RLR approach for searching for the essence of the phenomenon. The four essences in the studies (I-IV) establish a general structure for the phenomenon.Findings: Emergency care is characterized by an organisation, whose goal and resources are focused on life-saving, and that encounters a human being with needs of emergency care as well as existential support. The responsibility in emergency care means an intertwining of doing and being. The one who is in charge takes responsibility for performing or “doing” medical actions, and by “being” close and present in the situation the patient can at the same time feel an existential support. The responsibility for the injured or ill body is handed over to a chain of persons with more and more specialized competence and resources. This hand-over entails a relief for all involved but fails in one link in the chain, namely to explicitly hand back the responsibility to the patient. When the patient’s condition allows the distance to be larger the responsibility pales and the existential support decreases. A gap between doing and being arises where the patient is left to regain control and independence. The intertwining of doing and being, which appears as soon as the one in charge is close and present to the patient, facilitates the hand-over to the patient who in a natural way is able to receive the responsibility with possibilities to be able to conclude the encounter.Conclusions: A new understanding of emergency care appears which entails more than just life support measures. Emergency care includes different ways of communication in order to hand over the responsibility and complete the care chain back to the patient in a safe way. The results highlight the importance of empowering patients with a confirming, communicative contact throughout the whole caring process in order for them to retain their identity. There are also implications for educating students and personnel in inter-professional communication and work. In order to assist the intertwining between doing and being there are needs for the development of supportive structures for inter-professional reflection, which in turn would improve the interaction between patients and professionals in their encounter.
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| 9. |
- Elmqvist, Carina, et al.
(författare)
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Being first on the scene of an accident - experiences of 'doing' prehospital emergency care
- 2010
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 24:2, s. 266-273
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Tidskriftsartikel (refereegranskat)abstract
- Prehospital emergency care includes the care and treatment of patients prior to them reaching hospital. This is generally a field for the ambulance services, but in many cases firemen or police can be the ones to provide the first responses. The aim of this study was to describe and understand experiences of being the first responder on the scene of an accident, as described by policemen, firemen and ambulance staff. A lifeworld perspective was used in four different traumatic situations from southern Sweden. The data consisted of 13 unstructured interviews with first responders. The phenomenological analysis showed that experiences of being the first responder on the scene of an accident is expectations of doing a systematic course of action, dressed in the role of a hero, and at the same time being genuine in an interpersonal encounter. This entails a continuous movement between ‘being’ and ‘doing’. It is not a question of either – or, instead everything is to be understood in relation to each other at the same time. Five constituents further described the variations of the phenomenon; a feeling of security in the uncertainty, a distanced closeness to the injured person, one moment in an eternity, cross-border cooperation within distinct borders and a need to make the implicit explicit. This finding highlights the importance of using policemen and firemen in doing life support measures while waiting for the ambulance staff, and would in turn increase the importance of the relationship between the different professionals on the scene of an accident.
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| 10. |
- Elmqvist, C, et al.
(författare)
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More than medical treatment : the patient's first encounter with prehospital emergency care
- 2008
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Ingår i: Accident and Emergency Nursing. - : Elsevier Ltd. - 0965-2302 .- 1532-9267 .- 1755-599X .- 1878-013X. ; 16:3, s. 185-192
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Tidskriftsartikel (refereegranskat)abstract
- A common feature of emergency care services is the short, fragmented encounters with great demands for rapid treatment and efficiency. The aim of this study was to describe and understand the patient's first encounter with prehospital emergency care as experienced by the patient and the first responders. A lifeworld perspective was used in four different traumatic situations. The data consisted of 18 unstructured interviews with patients and first responders. The phenomenological analysis showed that the concept of lifesaving means more than just upholding vital functions. The patient needs to retain his/her identity by means of a communicative contact, to be confirmed in the lived encounter and to recapitulate the elapsed time of the unexpected event in order to regain a state of equilibrium. Five constituents further described the variations of the patients' first encounter; the encounter with the helpless injured body, the confirming existential encounter, the encounter while waiting, the lived encounter and the recapitulated encounter. This finding highlights the importance of a new understanding about empowering the patient with narratives throughout the whole caring process. There are also implications for educating personnel and students in emergency care about the first encounter with the patient in emergency care where the senses, the time and the narrative are essential elements that are unique for each person.
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