| 1. |
- Ericson-Lidman, Eva, et al.
(författare)
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Meanings of being a change agent in implementing a new organisational culture in home care services : a phenomenological hermeneutic study
- 2023
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Culture change is common in healthcare organisations worldwide today, and change agents are key persons in the process of change. It is therefore of vital importance to deepen the knowledge about change agents’ experiences. The aim of the study was to illuminate meanings of being a change agent to improve home care services. Ten change agents were interviewed individually using open-ended questions. The interviews were analysed with phenomenological hermeneutics. The design of the study followed the COREQ guidelines. Three themes were revealed in the analysis: ‘Being confirmed by the opportunity to make quality improvements’; ‘Pushing oneself to transfer the message’; and ‘Being strengthened by achievements but wishing for better conditions’. In order to prepare co-workers, change agents need training before their mission begins and during the change process.
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| 2. |
- Ericson-Lidman, Eva, et al.
(författare)
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Registered nurses' experiences of challenging situations in their psychosocial working environment in home care of patients with functional and/or intellectual disability : a qualitative study
- 2023
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:1
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Tidskriftsartikel (refereegranskat)abstract
- Around 15% of the world’s population lives with some form of functional and/or intellectual disability (FID). Nursing staff often face threats and violence in the care of patients with FID. This study aimed to illuminate registered nurses’ experiences of challenging situations in their psychosocial working environment in home care of patients with functional and/or intellectual disabilities. Nine registered nurses/district nurses working in municipal settings were interviewed using a qualitative approach. COREQ was used for explicit and comprehensive reporting of qualitative studies. Three categories were revealed: To face challenging behaviour, To face emotional burden and To face communication difficulties. Nurses need continuous training and support to cope with work-related stress to meet a person with FID in a calm and relaxed mood and to be prepared for critical situations in their psychosocial environment. Training and support may enable nurses to be in a state of harmony and to be present in order to build caring relationships.
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| 3. |
- Nazari, Shima, et al.
(författare)
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Perceptions and stress of conscience in relation to burnout among nursing staff in older people care settings : a cross sectional study
- 2023
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Ingår i: BMC Nursing. - : BioMed Central (BMC). - 1472-6955 .- 1472-6955. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Considering cultural influences, it is important to study the perceptions and stress of conscience in different contexts. This study aimed to investigate the association between perceptions of conscience, stress of conscience, and burnout among nursing staff working in older people care settings in Tehran.Methods: This was a descriptive, cross-sectional study. A total of 161 participants completed the Perceptions of Conscience Questionnaire, Stress of Conscience Questionnaire, and Oldenburg Burnout Inventory, 2019. All nursing staff working at the 20 contacted nursing homes agreed to participate in the study. The descriptive and inferential analysis was conducted through SPSS, using T-tests and one-way between-groups analysis of variance, Chi-square and t-tests, Cohen's d (d), Eta-squared (η2), and Phi coefficient (φ), Partial least squares regression (PLSR), jackknife approximate t-tests of the regression coefficients, and jackknife 95% confidence intervals of the regression coefficients.Results: The nursing staff perceived their conscience mainly as an authority, asset, and warning signal. Impact of workload on family life was the most common source of stress for the nursing staff. Dealing with incompatible demands, the impact of workload on family life, witnessing insulated patients, inability to meet one’s standards in providing care, and perception of conscience as a burden were strongly associated with the burnout.Conclusions: Perceiving conscience as a warning signal or authority may serve as a buffer against burnout among nursing staff. This study highlights the need for further exploration of perceptions of conscience in different cultural and social backgrounds.
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| 4. |
- Vikström, Nina, et al.
(författare)
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Registered nurses’ experiences of barriers in providing care for older patients with low mood in swedish municipal settings : a qualitative study
- 2023
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:1
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Tidskriftsartikel (refereegranskat)abstract
- Low mood and depression are common mental states among older people, and are difficult to diagnose and treat, causing suffering and declining functions. The aim of the study was to describe registered nurses’ experiences of barriers in providing care for older persons with low mood in Swedish municipal settings. Ten registered nurses working in municipal settings were interviewed using a qualitative approach. The analysis resulted in two main categories, ‘Professional barriers in the care of older persons with low mood’ and ‘Organisational barriers in the care of older persons with low mood’, and four subcategories. Improvements regarding increased knowledge about the use of assessments tools are suggested. Registered nurses should strive to listen to the older person's desires and needs. Furthermore, suggestions about improved collaboration within the organisation as well as with other caregivers in order to provide quality care to older persons with low mood, are made. COREQ was used as criteria to report qualitative data.
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| 5. |
- Hadad, Ronza, 1984-, et al.
(författare)
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First National Genomic Epidemiological Study of Neisseria gonorrhoeae Strains Spreading Across Sweden in 2016
- 2022
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Ingår i: Frontiers in Microbiology. - : Frontiers Media S.A.. - 1664-302X. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- The increasing transmission and antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a global health concern with worrying trends of decreasing susceptibility to also the last-line extended-spectrum cephalosporin (ESC) ceftriaxone. A dramatic increase of reported gonorrhea cases has been observed in Sweden from 2016 and onward. The aim of the present study was to comprehensively investigate the genomic epidemiology of all cultured N. gonorrhoeae isolates in Sweden during 2016, in conjunction with phenotypic AMR and clinical and epidemiological data of patients. In total, 1279 isolates were examined. Etest and whole-genome sequencing (WGS) were performed, and epidemiological data obtained from the Public Health Agency of Sweden. Overall, 51.1%, 1.7%, and 1.3% resistance to ciprofloxacin, cefixime, and azithromycin, respectively, was found. No isolates were resistant to ceftriaxone, however, 9.3% of isolates showed a decreased susceptibility to ceftriaxone and 10.5% to cefixime. In total, 44 penA alleles were found of which six were mosaic (n = 92). Using the typing schemes of MLST, NG-MAST, and NG-STAR; 133, 422, and 280 sequence types, respectively, and 93 NG-STAR clonal complexes were found. The phylogenomic analysis revealed two main lineages (A and B) with lineage A divided into two main sublineages (A1 and A2). Resistance and decreased susceptibility to ESCs and azithromycin and associated AMR determinants, such as mosaic penA and mosaic mtrD, were predominantly found in sublineage A2. Resistance to cefixime and azithromycin was more prevalent among heterosexuals and MSM, respectively, and both were predominantly spread through domestic transmission. Continuous surveillance of the spread and evolution of N. gonorrhoeae, including phenotypic AMR testing and WGS, is essential for enhanced knowledge regarding the dynamic evolution of N. gonorrhoeae and gonorrhea epidemiology.
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| 6. |
- Åhlin, Johan, et al.
(författare)
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Assessments of stress of conscience, burnout and social support amongst care providers in home care and residential care for older people
- 2022
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 36:1, s. 131-141
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies points to that levels of stress of conscience and burnout among staff in healthcare contexts may seriously affect their health.Aim: To compare assessments and associations of stress of conscience, perceptions of conscience, social support and burnout amongst care providers working in home care respectively residential care for older people.Methods: This cross‐sectional descriptive comparative study was performed among all care providers working in home care (n = 227) and residential care of older people (n = 354) in a municipality in northern Sweden. Data was collected using four different questionnaires. Analysis were performed using partial least square regression, descriptive statistics, statistical tests and effect size measures.Results: Care providers in residential care of older people assessed higher levels of stress of conscience compared to those working in home care. Exhaustion was an important predictor for belonging to the group of care providers working in residential care of older people. The most important predictor for belonging to the group of care providers working in home care were social support from one's immediate superior and co‐workers. Women assessed significantly higher levels of stress of conscience and exhaustion compared to men.Conclusion: Further research seems needed to investigate what the high levels of stress of conscience is caused by. A combined intervention consisting of work‐directed measures against burnout and measures aiming at reducing stress of conscience is suggested.
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| 7. |
- Asplund, Sofia, et al.
(författare)
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Self-rated exhaustion disorder and associated health-related factors among municipal employees in rural areas of northern Sweden
- 2021
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer. - 0340-0131 .- 1432-1246. ; , s. 659-668
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aims of this study among municipal employees in rural areas of northern Sweden were to assess the prevalence of self-rated exhaustion disorder (s-ED), describe plausible between-group differences in self-reported health-related factors among employees with or without s-ED, and identify health-related factors associated with s-ED.METHODS: In a cross-sectional study, data were collected from 1093 municipal employees (76.1% women) in two rural areas using an instrument measuring s-ED and health variables drawn from the Modern Worklife Questionnaire (MWQ), the Perceived Stress Scale (PSS), and the National Board of Health and Welfare's questions about physical activity. Comparisons were made between an s-ED and a non-s-ED group. Health-related factors associated with s-ED were identified through a logistic regression.RESULTS: Self-rated exhaustion disorder was reported by 21.5% of the participants. Health-related factors associated with s-ED were cognitive problems, sleep problems, depressive symptoms, high stress, poor self-rated health, and stomach problems. There was no statistically significant difference in the prevalence of participants who met the criteria of physical activity among s-ED and non-s-ED group.CONCLUSION: Findings from this study suggest that s-ED is more common among municipal employees in rural areas than in other working populations in Sweden. Several health-related factors were associated with s-ED. Regular use of a self-rated instrument in evaluating the organizational and social work environment can identify people at risk of developing exhaustion disorder and requiring long-term sick leave.
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| 8. |
- Ericson-Lidman, Eva, et al.
(författare)
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Change agents’ experiences of implementing a new organizational culture in residential care for older people : a qualitative study
- 2021
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 41:3, s. 149-157
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Tidskriftsartikel (refereegranskat)abstract
- Culture change in organizations may affect employees and change agents are often a forgotten resource; their perspective is often overlooked in research. The aim of the study was to illuminate experiences of being a change agent in order to improve residential care of older people. Interviews were performed with 15 change agents who participated in a large culture transformation in residential care for older people. The study followed COREQ guidelines and content analysis was used to interpret the text. The analysis revealed that the change agents felt chosen when they accepted the challenge to become a change agent, but they also felt that transferring the message to co-workers was demanding. Conflicting demands about measuring care and aggravating circumstances to implement change were described. The results indicate that change agents benefit from preparation for the role itself as they have a great responsibility on their shoulders. In making the process more successful, all co-workers should be involved in the change process from the beginning.
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| 9. |
- Ericson-Lidman, Eva, et al.
(författare)
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Care providers' troubled conscience related to an implementation of a time management system in residential care for older people : a participatory action research study
- 2020
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 34:3, s. 745-753
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Tidskriftsartikel (refereegranskat)abstract
- Background: Care providers in residential care for older people often refer to time shortage, a problem that may generate troubled conscience.Aim: The aim of the study was to describe a PAR process to assist care providers in municipal residential care for older people to constructively deal with their troubled conscience related to an implemented time management system.Method: This intervention study was carried out with 14 care providers and their manager in residential care for older people with the support of participatory action research (PAR). The recorded PAR sessions were transcribed and compiled with inspiration from content analysis.Ethical considerations: The participants were given oral and written information and gave their written informed consent.Findings: The PAR process was found to empower the participants to form their own structure of the practical professional planning, adapted to the residents needs and to their daily work. In this process, participants used their troubled conscience as a driving force and as an asset.Conclusion: Instead of launching change without any deeper information, it is important to carefully prepare, involve and inform those who are going to execute the change. Meeting places should be arranged wherein care providers have the opportunity to share and reflect on challenging situations that can generate troubled conscience, especially when comprehensive changes in their work are going to be implemented.
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| 10. |
- Mazaheri, Monir, 1977-, et al.
(författare)
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Dealing with troubled conscience in care of older people with dementia
- 2020
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Ingår i: International Journal of Qualitative Methods. - : Sage Publications. - 1609-4069. ; 19, s. 40-41
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Tidskriftsartikel (refereegranskat)abstract
- A feature of healthcare system, particularly in the care of older people, is its cultural diversity in terms of having considerable numbers of both caregivers and care recipients with an immigrant background. Considering the influence of culture in ethical decision-making processes, the idea of conscience, and the adverse effects of a troubled conscience, it is important to study these issues in culturally diverse populations. There are no published studies regarding troubled conscience among immigrant populations that include enrolled nurses. The aim of the study was to illuminate the meanings of troubled conscience and how to deal with it among enrolled nurses with Iranian backgrounds working in Swedish residential care settings. The study conducted with a phenomenological hermeneutical design. Ten nurses were interviewed. Analysis included noting a naive understanding of text as a whole followed by a structural analysis. Five subthemes and two themes were identified. The meanings of having a troubled conscience include not being a good person, being an uncaring person, not acting according to one’s values, and living in a state of unease. Dealing with a troubled conscience involves trying to compensate for the harm one has caused and trying to prevent similar situations in the future. The nurses understood themselves as caring people and not only caregivers. They knew that they should hear their conscience and respond to it by trying to be a caring person and acting according to their values.
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