| 1. |
- Backlund, Maja, et al.
(författare)
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Nurses' Experiences as Care Providers for Refugees in Emergency and Critical Care in Jordan: A Qualitative Interview Study
- 2021
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Ingår i: Global Qualitative Nursing Research. - : SAGE Publications. - 2333-3936. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- During the global refugee crisis of the 2010s, hundreds of thousands of Syrians fled to Jordan. As displaced Palestinians have had refugee status for several decades in Jordan already, this study aimed to explore nurses' perceptions of caring for Palestinian and Syrian refugees within the context of critical and emergency care. The qualitative design was executed through twelve semi-structured interviews with nurses working in refugee camps and public hospitals. Three main themes were identified describing the nurses' empathetic understanding of the refugees' situation, various challenging factors, as well as different aspects of the opportunities that they perceived in critical care and emergency care. The experiences of publicly employed nurses generally differed from those working in the camps. In addition, the findings indicate the importance of further research conducted locally, as it suggests several elements that have a negative impact on the quality of advanced healthcare for refugees.
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| 2. |
- Cederwall, Carl-Johan, et al.
(författare)
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Care practices for patients requiring mechanical ventilation more than seven days in Swedish intensive care units: A national survey.
- 2023
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Ingår i: Intensive & critical care nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 74
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Tidskriftsartikel (refereegranskat)abstract
- To identify care practices in Swedish intensive care units specific to patients requiring mechanical ventilation for >7 days.We conducted a national cross-sectional survey inviting all adult Swedish ICUs (n = 79). Nurse managers were invited by email to complete a questionnaire by telephone. The questionnaire included seven domains: ventilator weaning, mobilisation, communication, nutrition, symptom assessment, psychosocial support and organisational characteristics.We received responses from 77 units (response rate, 97%). Weaning protocols were available in 42 (55%) units, 52 (68%) used individualised weaning strategies and 50 (65%) involved physicians and nurses in collaborative decision making. In 48 units (62%), early mobilisation was prioritised using bed cycling but only 26 (34%) units had mobilisation protocols. Most of the intensive care units (74, 96%) had nutrition protocols but only 2 (3%) had dedicated dieticians. Delirium screening tools were available in 49 (64%) ICUs, 3 (4%) assessed anxiety and none assessed dyspnoea. Nineteen (25%) units employed a primary nursing model and 11 (14%) indicated person-centred care policies. Regular case conferences, including family participation, were held by 39 (51%) units.We found that an individualised approach to ventilator weaning, decided by physicians and nurses in collaboration, was the predominant approach, although weaning protocols were available in some intensive care units. Most units prioritised early mobilisation, though few used protocols. Nutritional protocols were widely adopted, as few units had a dedicated dietician.
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| 3. |
- Cederwall, Carl-Johan, et al.
(författare)
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Person-centred care during prolonged weaning from mechanical ventilation, nurses' views: an interview study
- 2018
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Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397. ; 46, s. 32-37
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine: 1) if the three elements of person-centred care (initiating, working and safeguarding the partnership) were present, and 2) to identify evidence of barriers to person-centred care during prolonged weaning from mechanical ventilation. Research methodology: Secondary analysis of semi structured interviews with 19 critical care nurses using theoretical thematic analysis. Setting: This study was conducted in three Swedish intensive care units, one in a regional hospital and two in a university hospital. Findings: Three themes and nine subthemes related to person-centred care were identified. The three themes included: 1) 'finding a person behind the patient' related to the 'initiating the partnership' phase, 2) 'striving to restore patient's sense of control' related to 'working the partnership' phase and 3) 'impact of patient involvement' related to 'safeguarding the partnership' phase of person-centred care'. Additionally a further theme 'barriers to person-centred care' was identified. Conclusion: We found evidence of all three person-centred care routines. Barriers to person-centred care comprised of lack team collaboration and resources. Facilitating patients to actively participate in decision-making during the weaning process may optimise weaning outcomes and warrants further research. (C) 2017 Elsevier Ltd. All rights reserved.
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| 4. |
- Cederwall, Carl-Johan, et al.
(författare)
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Prevalence and Intensive Care Bed Use in Subjects on Prolonged Mechanical Ventilation in Swedish ICUs
- 2021
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Ingår i: Respiratory Care. - : Daedalus Enterprises. - 0020-1324 .- 1943-3654. ; 66:2, s. 300-306
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The number of patients requiring prolonged mechanical ventilation (PMV) is predicted to escalate due to an aging population. International studies on prevalence and resource utilization of this patient group exist, but data are lacking from Scandinavian ICUs, where there is a relatively low number of ICU beds in relation to population. The primary aim was to identify prevalence of admissions requiring mechanical ventilation >= 7-21 d and PMV > 21 d, and their use of ICU bed days in Sweden. Secondary aims were to describe patient characteristics and outcomes. METHODS: We obtained data from the Swedish Intensive Care Registry on admissions age >= 18 y mechanically ventilated >= 7 d and used open source registry data to calculate the prevalence and use of bed days of admissions ventilated >= 7-21 d and PMV > 21 d. RESULTS: Of the 39,510 ICU admissions to Swedish ICUs in 2017, those mechanically ventilated >= 7-21 d accounted for 1,643 (4%) admissions, and those with PMV > 21 d accounted for 307 (0.8%) admissions. Of the 109,457 ICU bed days, 22% were consumed by admissions ventilated >= 7-21 d and 10% by those with PMV > 21 d. The ICU mortality of both groups was 21%. Admissions with mechanical ventilation >= 7 d had a median age of 65 y and were predominantly male (64%). CONCLUSIONS: Admissions to Swedish ICUs who required mechanical ventilation >= 7-21 d and PMV > 21 d form a relatively small proportion of all ICU admissions, but consume a significant proportion of ICU beds days. Prevalence of admissions, ICU bed days, and ICU mortality were lower than reports from other countries, but the admissions were predominantly elderly and male, in accordance with other reports.
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| 5. |
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| 6. |
- Collet, M. O., et al.
(författare)
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Functional and cognitive rehabilitation interventions during intensive care admission: A protocol for a systematic integrative review
- 2023
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 67:5, s. 670-4
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundLong-term cognitive impairment occurs in up to 60% of intensive care unit (ICU) survivors. Early use of functional and cognitive rehabilitation interventions, while patients are still in ICU, may reduce cognitive decline. We aim to describe the functional and cognitive interventions used during the ICU stay, the healthcare professionals providing interventions, and the potential impact on functional and cognitive rehabilitation. MethodIn this integrative systematic review, we will include empirical qualitative, quantitative, mixed- and multiple-methods studies assessing the use of functional and cognitive rehabilitation provided in ICU. We will identify studies in relevant electronic databases from 2012 to 2022, which will be screened for eligibility by at least two reviewers. Literature reported as narrative reviews and editorials will be excluded. We will assess the impact of interventions evaluating a cognitive and functional function, quality of life, and all-cause mortality at 6-12 months after ICU discharge. The Revised Cochrane risk-of-bias Tool will be used for assessing risk of bias in clinical trials. For observational studies, we will use the National Institutes of Health Quality Assessment tool for Observational Cohort and Cross-Sectional Studies. Furthermore, we will use the critical appraisal skills programme for qualitative studies and the mixed methods appraisal tool for mixed methods studies. We will construct four matrices, including results describing which ICU patients and healthcare professionals were engaged in rehabilitation, which interventions were included in early rehabilitation in ICU, the potential impact on patient outcomes of rehabilitation interventions provided in ICU and a narrative synthesis of themes. A summary of the main results will be reported using modified GRADE methodology. ImpactThis integrative review will inform the feasibility randomised clinical trial testing the development of a complex intervention targeting functional and cognitive rehabilitation for patients in ICU.
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| 7. |
- Egerod, I., et al.
(författare)
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Trends and recommendations for critical care nursing research in the Nordic countries: Triangulation of review and survey data
- 2020
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Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397. ; 56
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Tidskriftsartikel (refereegranskat)abstract
- Background: Priorities for critical care nursing research have evolved with societal trends and values. In the 1980s priorities were the nursing workforce, in 1990s technical nursing, in 2000s evidence-based nursing and in 2010s symptom management and family-centred care. Objectives: To identify current trends and future recommendations for critical care nursing research in the Nordic countries. Methods: We triangulated the results of a literature review and a survey. A review of two selected critical care nursing journals (2016-2017) was conducted using content analysis to identify contemporary published research. A self-administered computerised cross-sectional survey of Nordic critical care nursing researchers (2017) reported current and future areas of research. Results: A review of 156 papers identified research related to the patient (13%), family (12%), nurse (31%), and therapies (44%). Current trends in the survey (n = 76, response rate 65%) included patient and family involvement, nurse performance and education, and evidence-based protocols. The datasets showed similar trends, but aftercare was only present in the survey. Future trends included symptom management, transitions, rehabilitation, and new nursing roles. Conclusion: Critical care nursing research is trending toward increased collaboration with patient and family, delineating a shift toward user values. Recommendations include long-term outcomes and impact of nursing. (C) 2019 Elsevier Ltd. All rights reserved.
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| 8. |
- Hagerup, Anne, et al.
(författare)
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Toward a Future Orientation: A Supportive Mental Health Facility Environment
- 2024
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Ingår i: HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL. - 1937-5867 .- 2167-5112.
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Tidskriftsartikel (refereegranskat)abstract
- Background: The provision of supportive environments is essential in clinical and environmental psychology. Mental health disorders are a major issue, and the experience of being at a mental health facility is affected by numerous factors related to the building's design. Aim: The aim of this study is to explore the expectations of a mental health facility planning group regarding the potential impact of a supportive design on patients' mental health and staff's therapeutic practices when planning and designing a new mental health facility. Methods: The new mental health facility is a case study and data were collected through qualitative in-depth interviews with nine participants and analyzed using a thematic analysis. The participants came from a mental health facility planning group in a new mental health facility in Norway. Results: The overall expectation of the new building was related to a future orientation to support patients' mental health and therapeutic practices. Three main themes were identified: toward a future orientation, supportive building design, and work environment. Conclusions: Supportive environments are expected to influence patients' mental health and staff's therapeutic practices, including providing options for novel treatment needs in contrast to older and more outdated buildings that are perceived as hindering appropriate treatment conditions.
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| 9. |
- Halvorsen, K., et al.
(författare)
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Patients' experiences of well-being when being cared for in the intensive care unit—An integrative review
- 2022
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 31:1-2, s. 3-19
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this integrative review was to identify facilitators and barriers to patients’ well-being when being cared for in an ICU setting, from the perspective of the patients. Background: To become critically ill and hospitalised in an ICU is a stressful, chaotic event due to the life-threatening condition itself, as well as therapeutic treatments and the environment. A growing body of evidence has revealed that patients often suffer from physical, psychological and cognitive problems after an ICU stay. Several strategies, such as sedation and pain management, are used to reduce stress and increase well-being during ICU hospitalisation, but the ICU experience nevertheless affects the body and mind. Design; Methods: Since research exploring patients’ sense of well-being in an ICU setting is limited, an integrative review approach was selected. Searches were performed in CINAHL, Medline, Psych Info, Eric and EMBASE. After reviewing 66 studies, 12 studies were included in the integrative review. Thematic analysis was used to analyse the studies. The PRISMA checklist for systematic reviews was used. Results: The results are presented under one main theme, ‘Well-being as a multidimensional experience—interwoven in barriers and facilitators’ and six sub-themes representing barriers to and facilitators of well-being in an ICU. Barriers identified were physical stressors, emotional stressors, environmental disturbances and insecurity relating to time and space. Facilitators were meeting physical needs and activities that included dimensions of a caring and relational environment. Conclusion: Our main findings were that experiences of well-being were multidimensional and included physical, emotional, relational and environmental aspects, and they were more often described through barriers than facilitators of well-being. Relevance for clinical practice: This integrative review has shown that it is necessary to adopt an individual focus on patient well-being in an ICU setting since physical, emotional, relational and environmental stressors might impact each patient differently. © 2021 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.
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| 10. |
- Hamdan Alshehri, Hanan, et al.
(författare)
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Adaptation of a Palliative Care Approach in the Context of Intensive Care: A Systematic Literature Review
- 2019
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Ingår i: 16th Word Congress of the European Association for Palliative Care (EAPC). Berlin, May 23-25, Abstract P02-385. Palliative Medicine, vol. 33, issue 1. - : SAGE Publications.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background Palliative care is assumed to be an integral part of care in Intensive Care Units (ICU), yet, research still indicates lack knowledge about how to adapt, integrate and adopt palliative care in curative focused contexts such as in intensive care. Aim To identify factors influencing the integration of a palliative care approach in the context of ICU. Method A systematic review based on quantitative and qualitative studies using a thematic synthesis of the articles was performed. The following search term were used: Implementation, palliative care and ICU. In total 1843 articles were screened, and 25 articles were eligible for this review. Result: The findings show that the influencing factors for integrating a palliative care approach are multifaceted. Themes were identified; facilitators and barriers for implementation and adaptation on organizational level (facilitating policies and environmental support, care pathways, prognostication , multidisciplinary team, training and education) and interpersonal level (communication conflict, emotional and spiritual support, person-centred care and patient and family involvement). Conclusion To adopt a palliative care approach into the ICU setting, the integration process requires adaption of organizational support and personal beliefs and attitudes within the entire multi-professional team including the manager as well as patient and family.
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