| 1. |
- Björling, Gunilla, Docent
(författare)
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Long-Term Tracheostomy : Outcome, Cannula care, and Material Wear
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Do people with long-term tracheostomy need hospital care? Which cleaning method is most appropriate for decontamination of inner cannulae? Are tracheostomy tubes changed for rational reasons? There is clearly a lack of evidence based research in this field and the clinical guidelines available are often based on local practice. A tracheostomy is a created opening in trachea to facilitate breathing. It is a direct entry to the deeper airways, e.g. for micro-organisms causing a potential risk for lung infections. Indications for long-term tracheostomy can be, e.g. upper airway obstruction, malformations, or chronic hypoventilation, when ventilation via nasal mask is not possible. The research of the present thesis was conducted at the National Respiratory Centre (NRC) at Danderyd Hospital in Stockholm, Sweden. This unit opened in 1982, with the expressed goal of supporting outpatients with long-term tracheostomy. The overall aims of the thesis were to evaluate the outcome of patients with long-term tracheostomy and to conduct evidence based studies concerning their care.A comparison was made for the number of days in hospital care during the 2-year periods before and after the tracheostomy was established. The life expectancy of the general population and the observed life span of a cohort of tracheostomized patients from the start of NRC in 1982 were also compared. Interestingly enough, the need for hospital care was unchanged despite of the tracheostomy. The patients’ observed life spans were remarkably high and for many patients not lower than the life expectancy of Swedish people in general.To find a practical and safe decontamination method for inner cannulae we compared two different cleaning methods; detergent followed by chlorhexidine-alcohol, or detergent alone. Samples for bacterial culture were taken before and after cleaning and the numbers of bacteria colonies were counted. The effectiveness of both cleaning methods was greater than expected and the results showed a nearly total elimination of organisms. Thus, the methods investigated were equivalent in achieving decontamination.The duration of use in our unit for polymeric tracheostomy tubes, i.e. silicone (Si), polyvinyl chloride (PVC), and polyurethane (PU) was determined and compared. We found, that Si tubes were used for longer periods (three months) than tubes made of PU or PVC (both two months).Whether or not surface changes could be observed on the tracheostomy tubes after 30 days’, three and six months’ exposure in the trachea were investigated in collaboration with the Royal Institute of Technology and Sophiahemmet University College in Stockholm, Sweden. The analyzing methods were Scanning Electron Microscopy, Attenuated Total Reflectance Fourier Transform Infrared Spectroscopy, and Differential Scanning Calorimetry. All tubes, except one, showed changes in the surface after 30 days’ exposure. The surface changes had progressed significantly after three and six months' exposure, compared to the changes detected after 30 days. The SF-36 questionnaire and a study specific questionnaire were used to describe the patients’ health-related quality of life and experiences of long-term tracheostomy. The results show that all patients were satisfied with their tracheostomy and demonstrated a numerically mean mental health status score above that of the general population.In summary, long-term tracheostomy does not increase the need for hospital care nor does it reduce a patient’s life span. Cleaning the tracheostomy inner cannula with detergent and water is sufficient to achieve decontamination. Si tracheostomy tubes are used longer compared to those made of PVC or PU. The polymeric material investigated suffered evident surface changes after 30 days’ use. Clinical use of polymeric tracheostomy tubes beyond three months cannot be recommended, as we found extensive surface changes and degradation of the polymeric chains. All patients were, in general content, with their tracheostomy. The findings from the present thesis contribute to making the care of long-term tracheostomized patients’ evidence based.
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| 2. |
- Gripewall, E., et al.
(författare)
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Intensive Care Nurses’ Experiences of Caring during the Organ Donor Process in Sweden : a Qualitative Study
- 2022
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Ingår i: International Journal of Caring Sciences. - Hellas : Athens Alexander Technological Educational Institu. - 1791-5201 .- 1792-037X. ; 15:2, s. 720-726
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Tidskriftsartikel (refereegranskat)abstract
- Background: The organ donor process is challenging, not at least for intensive care nurses. The situation changes radically, from intensively working to save the patient’s life to instead caring for the donor patient’s organs so that those, in turn, can save another patient’s life. The donation process challenges nurses’ view on what dignified caring at end-of-life entails. The inner core of caring comprises love, mercy and compassion. Dignified caring is related to treating the patient as a unique human being and respecting human value, rooted in the theory of caritative caring that is the framework for this study. Aim: The aim was to illuminate intensive care nurses’ experiences of caring during the organ donor process, from a caring science perspective.Methodology: A descriptive research design including inductive qualitative content analysis of interviews with twelve intensive care nurses in Sweden about their experiences of caring during the donor process.Results: The theme The complexity of caring during the organ donor process with two categories and five subcategories was generated. Intensive care nurses experienced caring during the donor process as being complex in relation to the potential donor patient and patient’s family as well as communication, teamwork and organization. Caring affects not only the patient and families, but also the nurses and receivers of the donated organs. Intensive care nurses perceive the other’s life situation as if it were their own and recognize the importance of shared humanity.
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| 3. |
- Hansson, Julia, et al.
(författare)
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The Healthcare Staffs’ Perception of Parents’ Participation in Critical Incidents at the PICU, a Qualitative Study
- 2021
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Ingår i: Nursing Reports. - : MDPI. - 2039-439X .- 2039-4403. ; 11:3, s. 680-689
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Tidskriftsartikel (refereegranskat)abstract
- Background: Internationally, there are very few guidelines regarding how near relations can be taken care of on a children’s intensive care unit. Despite knowledge about the positive effects of parental presence, staff frequently reject parents out of insecurity. This study aimed to investigate health professionals’ understanding of letting parents be present throughout critical situations. A qualitative method with semi-structured interviews was used to answer the aim of his study. Nine persons participated in the study, both physicians and nurses. The result showed that health professionals’ main view is that parents’ presence is positive. However, their presence often has lower priority than the medical focus of the child and the health professionals’ concern of failure. Conclusion: Health professionals have the power to decide if parents can be present in critical situations. Only when a parent demands to be present does that demand beat the decisions made by health professionals. Lack of resources within the team and fear of parents becoming a disturbance or a distraction are cited as the primary reasons not to let parents be present.
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| 4. |
- Manhica, Hélio, et al.
(författare)
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Promoting sustainable health and wellbeing for pregnant adolescents in Uganda – A qualitative case study among health workers
- 2021
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Ingår i: International Journal of Africa Nursing Sciences. - : Elsevier. - 2214-1391. ; 14, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Adolescent pregnancy is a global health problem. In Uganda, the rate of teenage pregnancies is approximately 25% and these are associated with both poor maternal- and perinatal health outcome.Objective: This qualitative case study aimed to examine health workers’ experiences of promoting sustainable health and well-being for pregnant adolescent girls in Uganda.Method: A qualitative study design was used. Data was collected through semi-structured interviews of four health workers working for a Non-Government Organization (NGO) based in Uganda. Data was inductively analyzed by content analysis.Result: Three categories emerged: social structure, organization’s work – rehabilitation and therapy, and outcome. Healthcare workers worked with health promotion using a person-centered approach, emphasizing therapies and empowerment strategies and an overall faith-based approach. Furthermore, the result showed that girls were abandoned by their families when entering the center, but with help from the NGO they increased their understanding of the girls situation, due to resettlement of plan and follow up made by the health workers.Conclusion: Health workers can promote health and well-being among pregnant adolescent by applying person-centered care, including therapies and empowerment strategies by a faith-based approach. Social structures and families should be encouraged to provide support to pregnant adolescent girls.
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| 5. |
- Mattsson, Janet, Docent, Ph.D, 1967-, et al.
(författare)
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Challenges in Nursing Care of Children With Substance Withdrawal Syndrome in the PICU
- 2022
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Ingår i: Sage Open Nursing. - : Sage Publications. - 2377-9608. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Substance withdrawal is one of the most common advert events in the Pediatric Intensive Care Unit (PICU), as the administration of potent opiates and sedative drugs is frequently performed several times each day.Objectives: The present study explored the challenges in nursing care of children with substance withdrawal syndrome inthe PICU.Method: The study has an explorative and descriptive semi-structured qualitative interview design, with a strategic selection of informants. It was conducted at one out of three pediatric intensive care units in Sweden.Results: Three different main themes were identified describing the different challenges regarding withdrawal symptoms: monitor the child’s interest, work with structured support, and understand the observation.Conclusions: There is a discrepancy between the medical perspective and the nursing care perspective regarding children in PICU suffering from withdrawal syndrome. The lack of joint guidelines, language, and nursing diagnoses may lead to subjective evaluations and increase suffering for these children.
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| 6. |
- Mattsson, Janet, Docent, Ph.D, 1967-, et al.
(författare)
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Delirium, How Do Nurses Cope In The PICU
- 2022
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Ingår i: Pediatric Critical Care Medicine. - : Lippincott Williams & Wilkins. - 1529-7535 .- 1947-3893. ; 23:Supplement 1 11S
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 7. |
- Mattsson, Janet, Docent, Ph.D, 1967-, et al.
(författare)
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Nurses’ Experiences of Caring for Patients With Suspected or Confirmed COVID-19 in the Initial Stage of the Pandemic
- 2022
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Ingår i: Sage Open Nursing. - : SAGE Publications. - 2377-9608. ; 8, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Nursing staff have faced various challenges during the global pandemic of COVID-19 such as nursing shortages. The great number of COVID-19 patients requiring hospitalization placed heavy demands on healthcare staff to maintain patient safety and to work according to constantly changing guidelines to prevent the spread of infection.Objective: The objective was to describe nurses’ experiences of caring for patients with suspected or confirmed COVID-19 in the initial phase of the pandemic.Methods: The study has a qualitative design. Semi-structured interviews were conducted with seven nurses in primary care and hospital care during the initial stage of the pandemic. Qualitative content analysis with an inductive approach was used.Results: The nurses expressed that the working routines changed very quickly at the onset of the pandemic. A triage system was implemented to care for patients with symptoms of COVID-19 to prevent transmission between patients. A major change was the constant use of personal protective equipment in patient care. The nurses also experienced a sense of inadequacy regarding the care of the patients and became emotionally affected and exhausted.Conclusion: The nurses experienced that many patients worsened clinically, leading to exhausting and difficult nursing care situations. They also experienced increasing responsibility since new protective equipment and procedures needed to be quickly implemented according to frequently changing recommendations, causing the nurses to feel uncertain about how to maintain patient safety. Support from colleagues was crucial to cope throughout the initial stage of the pandemic.
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| 8. |
- Mattsson, Janet, Docent, Ph.D, 1967-, et al.
(författare)
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Quality Of Life in Children With Home Mechanical Ventilation – A Scoping Review
- 2022
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Ingår i: Sage Open Nursing. - : Sage Publications. - 2377-9608. ; 8, s. 1-12
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Forskningsöversikt (refereegranskat)abstract
- Introduction: Home mechanical ventilation is an established method to support children suffering from chronic respiratory insufficiency, still more research is needed regarding mechanically ventilated children’s and adolescents’ quality of life (QoL). Therefore, the aim of this scoping review was to explore research regarding QoL and lived experience of children and adolescents with home mechanical ventilation. Methods: A scoping review with systematic searches for research studies published between year 2000–2020 was performed in Cinahl, Medline, and PubMed. Studies that met the inclusion criteria were quality assessed and a thematic analysis was performed.Results: In total, ten articles were quality assessed and included in the results. Four themes emerged: Children’s self-reported QoL, Parents’ perception and parent-proxy report, Differences between the child’s and parent’s perception, and challenges in daily life. Children with home mechanical ventilation reported a lower QoL than healthy children and children with other chronic diseases. Generally, parents rate their child’s QoL lower than the children themselves.Conclusion: This is the first literature review focusing on HMV in the paediatric population. It is clear that HMV does not only affect the treated child or adolescent but also the whole family. It is important to regularly measure and evaluate QoL in children and adolescents with
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| 9. |
- Alden-Joyce, Tara, et al.
(författare)
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Tanzanian Nursing Students' Experiences of Student Exchange in Sweden : A Qualitative Case Study
- 2023
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Ingår i: Sage Open Nursing. - : Sage Publications. - 2377-9608. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionNeeds within healthcare are changing and nurses require new skills and knowledge in global nursing. Student exchange programs in global contexts provide an opportunity to develop the necessary skills. ObjectiveThe aim of this study was to describe Tanzanian nursing students' experiences of student exchange in Sweden. MethodsA qualitative design was used for this empirical study. Semistructured interviews were conducted with six Tanzanian nursing students who had participated in student exchange in Sweden. The participants were recruited by purposeful sampling. Inductive reasoning and qualitative content analysis were applied. ResultsFour main themes were formed; new roles, experience a new culture, establish new competencies, and global work ambitions. The findings revealed that the students experienced new approaches in Sweden, giving them new competencies and understanding. Furthermore, they increased their global perspectives on nursing and interest in working with global health issues, but they also experienced challenges in the new environment. ConclusionThe present study showed that Tanzanian nursing students benefitted from their student exchange, both personally, as well as for their future careers as nurses. More research is needed in examining nursing students from low-income countries participating in student exchange in high-income countries.
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| 10. |
- Anderberg, Peter, et al.
(författare)
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Analyzing nursing students’ relation to electronic health and technology as individuals and students and in their future career (the ENURSED study) : Protocol for a longitudinal study
- 2019
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Ingår i: Journal of Medical Internet Research. - : Journal of Medical Internet Research. - 1438-8871. ; 21:10
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Tidskriftsartikel (refereegranskat)abstract
- Background: The nursing profession has undergone several changes in the past decades, and new challenges are to come in the future; patients are now cared for in their home, hospitals are more specialized, and primary care will have a key role. Health informatics is essential in all core competencies in nursing. From an educational perspective, it is of great importance that students are prepared for the new demands and needs of the patients. From a societal point of view, the society, health care included, is facing several challenges related to technological developments and digitization. Preparation for the next decade of nursing education and practice must be done, without the advantage of certainty. A training for not-yet-existing technologies where educators should not be limited by present practice paradigms is desirable. This study presents the design, method, and protocol for a study that investigates undergraduate nursing students’ internet use, knowledge about electronic health (eHealth), and attitudes to technology and how experiences of eHealth are handled during the education in a multicenter study. Objective: The primary aim of this research project is to describe the design of a longitudinal study and a qualitative substudy consisting of the following aspects that explore students’ knowledge about and relation to technology and eHealth: (1) what pre-existing knowledge and interest of this area the nursing students have and (2) how (and if) is it present in their education, (3) how do the students perceive this knowledge in their future career role, and (4) to what extent is the education capable of managing this knowledge? Methods: The study consists of two parts: a longitudinal study and a qualitative substudy. Students from the BSc in Nursing program from the Blekinge Institute of Technology, Karlskrona, Sweden, and from the Swedish Red Cross University College, Stockholm/Huddinge, Sweden, were included in this study. Results: The study is ongoing. Data analysis is currently underway, and the first results are expected to be published in 2019. Conclusions: This study presents the design of a longitudinal study and a qualitative substudy. The eHealth in Nursing Education eNursEd study will answer several important questions about nursing students’ attitudes toward and use of information and communications technology in their private life, their education, and their emerging profession. Knowledge from this study will be used to compare different nursing programs and students’ knowledge about and relation to technology and eHealth. Results will also be communicated back to nursing educators to improve the teaching of eHealth, health informatics, and technology. ©Peter Anderberg, Gunilla Björling, Louise Stjernberg, Doris Bohman.
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