| 1. |
- Blomberg, Karin, 1970-, et al.
(författare)
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Swedish nursing students' experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education
- 2014
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Ltd.. - 0962-1067 .- 1365-2702. ; 23:15-16, s. 2264-2271
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To describe nursing students' experience of stress during clinical practice and evaluate the risk of stress in relation to the clinical setting characteristics and the organisation of the clinical education. BACKGROUND: Stress during clinical practice is well documented, but there is a lack of knowledge concerning whether the clinical setting characteristics and the organisation of the education make a difference. DESIGN: A cross-sectional study with evaluative design. METHODS: Data were collected by means of a numerical rating scale for the assessment of stress and questions about the clinical setting characteristics and the organisation of the education. One hundred and eighty-four students who had completed their final year on the nursing programme at three universities in Sweden were included. RESULTS: Nearly half of the students (43%) experienced high level of stress during clinical practice. Measured by decision in the tree analysis, the absolute risk of stress was 57% in students with placements in hospital departments, as compared to 13% in students with placements in other clinical settings. The risk of stress increased to 71% if the students with placement in a hospital took the national clinical final examination. Performance of practice in a hospital department overcrowded with patients was also associated with increased risk of stress. The organisation of supervision and number of students at the clinical placement had an effect on the experience of stress, but did not prove to be risk factors in the analysis. CONCLUSIONS: The risk of stress in nursing students during their clinical practice differs depending on clinical setting characteristics. The taking of the national clinical final examination could be a source of stress, but this requires further investigation. RELEVANCE TO CLINICAL PRACTICE: It is important that supervisors are aware that students in hospital departments overcrowded with patients are at risk of stress and may have increased need of support.
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| 2. |
- Hafskjold, Linda, et al.
(författare)
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A cross-sectional study on person-centred communication in the care of older people : the COMHOME study protocol.
- 2015
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 5:4
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of the COMHOME study is to generate knowledge on person-centred communication with older people (>65 years) in home healthcare services, radiographic and optometric practice.METHODS AND ANALYSIS: This study will explore the communication between care providers and older persons in home care services. Home healthcare visits will be audiorecorded (n=500) in Norway, the Netherlands and Sweden. Analyses will be performed with the Verona Coding Definitions for Emotional Sequences (VR-CoDES), the Roter Interaction Analysis System (RIAS) and qualitative methods. The content of the communication, communicative challenging situations as well as empathy, power distance, decision-making, preservation of dignity and respect will be explored. In Norway, an additional 100 encounters, 50 in optometric practice (video recorded) and 50 in radiographic practice (audiorecorded), will be analysed. Furthermore, healthcare providers' self-reported communication skills, empathy, mindfulness and emotional intelligence in relation to observed person-centred communication skills will be assessed using well-established standardised instruments.ETHICS AND DISSEMINATION: Depending on national legislation, approval of either the central ethical committees (eg, nation or university), the national data protection officials or the local ethical committees (eg, units of home healthcare) was obtained. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The research findings will add knowledge to improve services provided to this vulnerable group of patients. Additionally, the findings will underpin a training programme for healthcare students and care providers focusing on communication with older people.
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| 3. |
- Holmström, Inger, et al.
(författare)
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Frequent callers in primary healthcare – a nursing perspective
- 2017
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 3:3, s. 622-632
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Tidskriftsartikel (refereegranskat)abstract
- AIM:To: (a) describe how telephone nurses define a frequent caller; and (b) describe their experiences with calls from frequent callers to primary healthcare centres.BACKGROUND:Telephone nursing has been noted to be a cost-effective method to enhance access to and use of health care. Some patients use these services extensively and are called 'frequent callers'. Little is known about this group of callers, the reasons behind these calls and telephone nurses' experiences and strategies to manage the calls.DESIGN:Descriptive design with a qualitative inductive approach.METHODS:Interviews were conducted with ten telephone nurses in Sweden in 2015. Qualitative content analysis was conducted.RESULTS:A main theme was established, called 'Balancing between the experienced and assessed needs', which described the telephone nurses' experiences with calls made by frequent callers to primary healthcare centres and was further described in five categories with 15 subcategories. The categories described telephone nurses' definitions of frequent callers, telephone nurses' views of the underlying reasons for the calls, challenges related to frequent callers, experiences with an increased work load and strategies used to manage and help frequent callers.CONCLUSION:Frequent callers were commonly encountered by telephone nurses' in this study. Their calls were experienced as complex and demanding to manage. The findings point to needs for guidelines and routines to improve the care of frequent callers. In addition, support and training in communication skills to encounter this group of callers in an optimal and safe way may be required.
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| 4. |
- Holmström, Inger K., 1960-, et al.
(författare)
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Frequent callers in primary health care : a qualitative study with a nursing perspective
- 2017
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 73:3, s. 622-632
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To: (a) describe how telephone nurses define a frequent caller; and (b) describe their experiences with calls from frequent callers to primary healthcare centres.BACKGROUND: Telephone nursing has been noted to be a cost-effective method to enhance access to and use of health care. Some patients use these services extensively and are called 'frequent callers'. Little is known about this group of callers, the reasons behind these calls and telephone nurses' experiences and strategies to manage the calls.DESIGN: Descriptive design with a qualitative inductive approach.METHODS: Interviews were conducted with ten telephone nurses in Sweden in 2015. Qualitative content analysis was conducted.RESULTS: A main theme was established, called 'Balancing between the experienced and assessed needs', which described the telephone nurses' experiences with calls made by frequent callers to primary healthcare centres and was further described in five categories with 15 subcategories. The categories described telephone nurses' definitions of frequent callers, telephone nurses' views of the underlying reasons for the calls, challenges related to frequent callers, experiences with an increased work load and strategies used to manage and help frequent callers.CONCLUSION: Frequent callers were commonly encountered by telephone nurses' in this study. Their calls were experienced as complex and demanding to manage. The findings point to needs for guidelines and routines to improve the care of frequent callers. In addition, support and training in communication skills to encounter this group of callers in an optimal and safe way may be required.
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| 5. |
- Holmström, Inger K., et al.
(författare)
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It is important that they care - older persons' experiences of telephone advice nursing.
- 2016
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 25:11-12, s. 1644-1653
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: The aim of the study was to explore older persons' experiences of telephone advice nursing at primary healthcare centres.BACKGROUND: Telephone advice nursing is expanding worldwide, and the older population is increasing. Little is known about older persons' experiences of telephone advice nursing provided by primary healthcare.DESIGN: This study has a descriptive design with a qualitative inductive approach.METHODS: Data were collected via interviews with a purposive sample of 10 older persons in 2014. The data were analysed using qualitative content analysis.RESULTS: The older persons' experiences were described in two themes: the patient-friendly aspects of telephone advice nursing and the patient-unfriendly aspects of telephone advice nursing. The themes can be understood as two sides of the same coin; the differences point to both the advantages and disadvantages of the service and are further illuminated through seven subthemes.CONCLUSIONS: This study contributes to increased awareness of the advantages and disadvantages of the telephone advice nursing system as experienced by older persons. To be the focus of attention during calls was highlighted as important; and clear communication was deemed crucial. When the communication between the nurse and the older persons was perceived as good and the perspective of the caller was the focus, an experience of safety and satisfaction was described. Older persons had great confidence in the telephone nurses' competence and perceived their ability to access the service as mostly good, even if it was sometimes difficult to use the service.RELEVANCE TO CLINICAL PRACTICE: The communicative competence of telephone nurses is essential when providing telephone advice nursing to older persons. In addition, a person-centred approach is important to provide optimal care in telephone advice nursing.
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| 6. |
- Höglander, Jessica
(författare)
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Home care communication : moving beyond the surface
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Communication is an essential part of care and human interaction. While communication within care entails both task-focused and socio-emotional elements, nurses are sometimes perceived as too task-focused. When in need of care, older persons want to be perceived and treated as individuals – to feel involved. However, nurses might lack the prerequisites for establishing individualised home care, which is often based on daily tasks rather than on older persons’ needs and wishes. Despite the importance of communication in nurse-patient interactions, knowledge about daily communication within home care is scarce. Therefore, the overall aim of this thesis was to explore the naturally occurring communication between nursing staff and older persons during home care visits, with a focus on emotional distress and from a person-centred perspective.This thesis is an observational, cross-sectional study of the communication in 188 audio-recorded home care visits, and is part of the international COMHOME project. In Study I, older persons’ expressions of emotional distress were coded and analysed using the Verona Coding Definitions of Emotional Sequences [VR-CoDES]. The results showed that older persons often express emotional distress in the form of hints at emotional concerns, which were defined as cues. Explicit expressions of emotional distress, which were defined as concerns, were uncommon. The responses of nursing staff to older persons’ cues and concerns were coded and analysed in Study II using VR-CoDES. Nursing staff often responded by providing space rather than reducing it for further disclosure of older persons’ emotional distress. In Study III, the communication of emotional distress and participants’ characteristics were analysed using generalised linear mixed model [GLMM]. The results revealed that most cues and concerns were expressed by older females and to female nursing staff. Furthermore, elicitations of expressions of emotional distress were influenced by native language and profession, and responses that provided space were more often given to older females and to older persons aged 65-84 years. Home care communication between registered nurses and older persons was coded and analysed in Study IV using the Roter Interaction Analysis System [RIAS]. The results revealed a high degree of person-centred communication, especially during visits lasting 8-9 minutes, and that socio-emotional communication was more frequent than task-oriented communication.Home care communication contains important aspects of person-centred communication, with nursing staff providing space for the older person’s narrative; however, there are also challenges in the form of vague and implicit expressions of emotional distress. Keywords: communication; home care services; nursing staff; older persons; person-centred care; RIAS; VR-CoDES
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| 7. |
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| 8. |
- Sundler J, Annelie, 1973-, et al.
(författare)
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Communicative challenges in the home care of older persons - a qualitative exploration.
- 2016
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 72:10, s. 2435-2444
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To explore communicative challenges in encounters between nurse assistants and older persons during home care visits.BACKGROUND: The older population is increasing worldwide. Currently, there is a shift in care for older people from institutional care to home care. Providing home care in a person's home involves several challenges, including the complexity of communication.DESIGN: A descriptive observational design with a qualitative approach was used.METHODS: The data consisted of audio recordings of real-life encounters during home care visits between nurse assistants and older persons, collected in 2014. A hermeneutic phenomenological analysis was conducted.RESULTS: Communicative challenges were identified: (a) in situations where the older persons had a different view than the nurse assistants on the care task and its content; and (b) when unexpected actions or turns occurred in the communication. Challenges included older person's existential issues, fragility and worries and concerns, which often appeared to be only vaguely expressed and difficult to verbally detect and tackle. This engendered a risk of misinterpretation or ignorance of these challenges.CONCLUSION: The findings point to the importance of communication as the key to facilitate person-centred home care. Communication training should focus more on addressing needs and existential issues in older persons. Person-centred home care for older persons needs to be addressed at both an individual and an organizational level.
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| 9. |
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| 10. |
- Sundler J, Annelie, 1973-, et al.
(författare)
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Student nurses' experiences of the clinical learning environment in relation to the organization of supervision : A questionnaire survey
- 2014
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Ingår i: Nurse Education Today. - : Churchill Livingstone. - 0260-6917 .- 1532-2793. ; 34:4, s. 661-666
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Tidskriftsartikel (refereegranskat)abstract
- Aim The aim was to investigate student nurses' experiences of the clinical learning environment in relation to how the supervision was organized. Background The clinical environment plays an essential part in student nurses' learning. Even though different models for supervision have been previously set forth, it has been stressed that there is a need both of further empirical studies on the role of preceptorship in undergraduate nursing education and of studies comparing different models. Method A cross-sectional study with comparative design was carried out with a mixed method approach. Data were collected from student nurses in the final term of the nursing programme at three universities in Sweden by means of a questionnaire. Results In general the students had positive experiences of the clinical learning environment with respect to pedagogical atmosphere, leadership style of the ward manager, premises of nursing, supervisory relationship, and role of the nurse preceptor and nurse teacher. However, there were significant differences in their ratings of the supervisory relationship (p < 0.001) and the pedagogical atmosphere (p 0.025) depending on how the supervision was organized. Students who had the same preceptor all the time were more satisfied with the supervisory relationship than were those who had different preceptors each day. Students' comments on the supervision confirmed the significance of the preceptor and the supervisory relationship. Conclusion The organization of the supervision was of significance with regard to the pedagogical atmosphere and the students' relation to preceptors. Students with the same preceptor throughout were more positive concerning the supervisory relationship and the pedagogical atmosphere.
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