| 1. |
- Andersson, Henrik, et al.
(författare)
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Ethics education to support ethical competence learning in healthcare : an integrative systematic review
- 2022
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Ingår i: BMC Medical Ethics. - : BioMed Central. - 1472-6939. ; 23
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Forskningsöversikt (refereegranskat)abstract
- Background: Ethical problems in everyday healthcare work emerge for many reasons and constitute threats to ethi- cal values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.Methods: In this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 arti- cles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.Results: The review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previ- ously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.Conclusions: The review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations.
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| 2. |
- Bremer, Anders, Docent, 1957-, et al.
(författare)
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Ethical conflicts in patient relationships : experiences of ambulance nursing students
- 2020
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 27:4, s. 946-959
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Tidskriftsartikel (refereegranskat)abstract
- Background: Working as an ambulance nurse involves facing ethically problematic situations with multi-dimensional suffering, requiring the ability to create a trustful relationship. This entails a need to be clinically trained in order to identify ethical conflicts.Aim: To describe ethical conflicts in patient relationships as experienced by ambulance nursing students during clinical studies.Research design: An exploratory and interpretative design was used to inductively analyse textual data from examinations in clinical placement courses.Participants: The 69 participants attended a 1-year educational programme for ambulance nurses at a Swedish university.Ethical consideration: The research was conducted in accordance with the Declaration of Helsinki. Participants gave voluntary informed consent for this study.Findings: The students encountered ethical conflicts in patient relationships when they had inadequate access to the patient’s narrative. Doubts regarding patient autonomy were due to uncertainty regarding the patient’s decision-making ability, which forced students to handle patient autonomy. Conflicting assessments of the patient’s best interest added to the conflicts and also meant a disruption in patient focus. The absence of trustful relationships reinforced the ethical conflicts, together with an inadequacy in meeting different needs, which limited the possibility of providing proper care.Discussion: Contextual circumstances add complexity to ethical conflicts regarding patient autonomy, dependency and the patient’s best interest. Students felt they were fluctuating between paternalism and letting the patient choose, and were challenged by considerations regarding the patient’s communication and decision-making ability, the views of third parties, and the need for prioritisation.Conclusion: The essence of the patient relationship is a struggle to preserve autonomy while focusing on the patient’s best interest. Hence, there is a need for education and training that promotes ethical knowledge and ethical reflection focusing on the core nursing and caring values of trust and autonomy, particularly in situations that affect the patient’s decision-making ability.
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| 3. |
- Ekebergh, Margaretha, et al.
(författare)
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Patient-nurse anesthetist interaction during regional anesthesia and surgery based on video recordings
- 2013
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Ingår i: Journal of Perianesthesia Nursing. - : W.B. Saunders Co.. - 1089-9472 .- 1532-8473. ; 28:5, s. 260-270
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The purpose of this study was to interpret and describe the patient-nurse anesthetist (NA) interaction during regional anesthesia. Design Video recordings conducted during orthopedic surgery at a surgical clinic in Sweden formed the basis for the study, in which three patients and three NAs participated. Methods A hermeneutic analysis was conducted on the data. Finding The findings of the analysis demonstrated that the NA was in either “present” presence or “absent” presence in the awake patient's visual field during surgery. The NA's professional actions at times dominated the patient's existential being in the intraoperative situation. The findings conveyed insights about the patient-NA interaction that open up possibilities for nurses to understand and reflect upon their own practice in an expanded way. Conclusions Using video recordings for reflections enables development of professional skills that positively influence the care quality for patients during regional anesthesia.
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| 4. |
- Hansson, Joacim, 1966-, et al.
(författare)
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Profession, utbildning, forskning : biblioteks- och informationsvetenskap för en stärkt bibliotekarieprofession
- 2018
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Rapport (populärvet., debatt m.m.)abstract
- Sekretariatet för nationell biblioteksstrategi vid Kungliga Biblioteket har givit de fem biblioteks- och informationsvetenskapliga utbildningarna vid Högskolan i Borås, Linnéuniversitetet, Lunds univeritet, Umeå universitet och Uppsala universitet uppdraget att utreda och formulera förslag kring utbildning och forskning för en stärkt bibliotekarieprofession. Syftet med föreliggande rapport är, att visa situationen för svensk biblioteks- och informationsvetenskap, tydliggöra relationen till bibliotekarieprofessionen och lämna strategiska förslag på hur ämnet kan förstärkas till förmån för en stärkt professionsutvecklig. En omvärldsanalys med riktning mot bibliotekssektorn görs samt en beskrivning av nuläget för biblioteks- och informationsvetenskaplig utbildning och forskning. Biblioteks- och informationsvetenskapens centrala betydelse för bibliotekarieprofessionen lyfts fram. Utbildingsprogrammen i ämnet attraherar gott om studenter och som svar på bibliotekens konstaterade behov av biblioteks- och informationsvetenskapligt utbildad personal argumenterar rapportförfattarna för möjligheten att expandera utbildningarna på kandidat- och masternivå vid samtliga fem lärosäten. Inom forskningen konstateras, att trots att ämnet idag i grunden fungerar väl finns ännu svårigheter att erhålla finansiering för professionsinriktad biblioteksforskning. Omvärldsanalysen visar upp ett behov av en tydligare struktur för kontinuerlig kompetensutveckling inom bibliotekarieprofessionen. Rapporten mynnar ut i fem strategiska förslag rörande grundutbildning, forskning och kontinuerlig kompetensutveckling:En ökning av antalet studieplatser på program på kandidat- och masternivå i biblioteks- och informationsvetenskap.Nationell forskarskola för biblioteksforskning.Inrättande av en externfinansierad professur med inriktning mot biblioteksforskning.Stärkt finansieringsstruktur för biblioteksforskning.Etablerande av en samlad nationell struktur för kontinuerlig kompetensutveckling.
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| 5. |
- Hessulf, Fredrik, 1986, et al.
(författare)
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Adherence to Guidelines is Associated With Improved Survival Following In-hospital Cardiac Arrest in Sweden
- 2020
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Ingår i: Resuscitation. - : Lippincott Williams & Wilkins. - 0300-9572 .- 1873-1570. ; 155, s. -21
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Tidskriftsartikel (refereegranskat)abstract
- Background: Most resuscitation guidelines have recommendations regarding maximum delay times from collapse to calling for the rescue team and initiation of treatment following cardiac arrest. The aim of the study was to investigate the association between adherence to guidelines for cardiopulmonary resuscitation (CPR) after in-hospital cardiac arrest (IHCA) and survival with a focus on delay to treatment.Methods: We used the Swedish Registry for CPR to study 3212 patients with a shockable rhythm and 9113 patients with non-shockable rhythm from January 1, 2008 to December 31, 2017. Adult patients older than or equal to 18 years with a witnessed IHCA where resuscitation was initiated were included. We assessed trends in adherence to guidelines and their associations with 30-day survival and neurological function. Adherence to guidelines was defined as follows: time from collapse to calling for the rescue team and CPR within 1 min for non-shockable rhythms. For shockable rhythms, adherence was defined as the time from collapse to calling for the rescue team and CPR within 1 min and defibrillation within 3 min.Results: In patients with a shockable rhythm, the 30-day survival for those treated according to guidelines was 66.1%, as compared to 46.5% among those not treated according to guidelines on one or more parameters, adjusted odds ratio 1.84 (95% CI 1.52-2.22). Among patients with a non-shockable rhythm the 30-day survival for those treated according to guidelines was 22.8%, as compared to 16.0% among those not treated according to guidelines on one or more parameters, adjusted odds ratio 1.43 (95% CI 1.24-1.65). Neurological function (cerebral performance category 1-2) among survivors was better among patients treated in accordance with guidelines for both shockable (95.7% vs 91.1%, <0.001) and non-shockable rhythms (91.0% vs 85.5%, p < 0.008). Adherence to the Swedish guidelines for CPR increased slightly 2008-2017.Conclusions: Adherence to guidelines was associated with increased probability of survival and improved neurological function in patients with a shockable and non-shockable rhythm, respectively. Increased adherence to guidelines could increase cardiac arrest survival.
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| 6. |
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| 7. |
- Israelsson, Johan, et al.
(författare)
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Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender
- 2017
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Ingår i: Resuscitation. - : Elsevier. - 0300-9572 .- 1873-1570. ; 114, s. 27-33
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe health status and psychological distress among in-hospital cardiac arrest (IHCA) survivors in relation to gender.METHODS: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS).RESULTS: Between 2013 and 2015, 594 IHCA survivors were included in the study. The median values for EQ-5D-5L index and EQ VAS among survivors were 0.78 (q1-q3=0.67-0.86) and 70 (q1-q3=50-80) respectively. The values were significantly lower (p<0.001) in women compared to men. In addition, women reported more problems than men in all dimensions of EQ-5D-5L, except self-care. A majority of the respondents reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (p<0.001) and symptoms of depression (p<0.001) compared to men. Gender was significantly associated with poorer health status and more psychological distress. No interaction effects for gender and age were found.CONCLUSIONS: Although the majority of survivors reported acceptable health status and no psychological distress, a substantial proportion reported severe problems. Women reported worse health status and more psychological distress compared to men. Therefore, a higher proportion of women may be in need of support. Health care professionals should make efforts to identify health problems among survivors and offer individualised support when needed.
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| 8. |
- Israelsson-Skogsberg, Åsa, 1968-, et al.
(författare)
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Children with home mechanical ventilation : parents' health-related quality of life, family functioning and sleep
- 2020
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Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 109:9, s. 1807-1814
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Tidskriftsartikel (refereegranskat)abstract
- AimChildren requiring home mechanical ventilation (HMV) have grown in number and complexity. Parents of children with HMV are often responsible for the advanced homecare. This study explored the health‐related quality of life (HRQoL), family functioning and sleep in parents of children with HMV. A secondary aim was to explore the impact on HRQoL, family functioning and sleep of selected potential determinants.MethodsQuestionnaires were completed by 45 mothers and 40 fathers, to 55 children receiving HMV. Parents were identified via respiratory clinics in the Swedish national quality register for oxygen and home respiratory treatment and invited to participate between December 2016 and December 2018.ResultsThere were no differences between mothers and fathers overall HRQoL or family functioning reports, although differences within the physical (P < .043) and cognitive (P < .009) functioning dimensions were found. One of four parents reported moderate or severe insomnia. The variability in HRQoL and family functioning was predicted by HMV mode and sleep quality to an extent of 45% and 21%, respectively.ConclusionSleep quality and the child's HMV mode predicted parental HRQoL and family functioning. The results underscore the importance of evaluating parents' sleep and of being aware that invasive ventilation influences parental HRQoL and family functioning.
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| 9. |
- Karlsson, Ann-Christin, et al.
(författare)
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An intraoperative caring model – the ’awake’ patient’s need for a genuine caring encounter
- 2013
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Ingår i: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 1:4, s. 23-35
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Tidskriftsartikel (refereegranskat)abstract
- Anaesthesia nursing care during regional anaesthesia is characterized by the encounter between the ‘awake’ patient’s own lifeworld and the nurse anaesthetist’s knowledge in theory and in practice. This study aims to present an intraoperative caring model from the patient’s perspective that will facilitate nurse anaesthetists’ (NA) practice to enhance and support the ‘awake’ patient’s intraoperative well-being during surgery under regional anaesthesia. The model is underpinned by a synthesis based on interviews with patients, a philosophical reflection using Merleau-Ponty’s philosophy, and video recordings from orthopaedic surgeries under regional anaesthesia. The model can be used as a tool to encounter awake patients’ existential needs in the intraoperative situation and to further enlighten NAs about the possible impact of their proximity, interaction and communication behaviour in the delivery of intraoperative nursing care. The model can help NAs to access, understand and learn through lived experiences, thereby deepening their professional caring skills. The model is a way to get research knowledge ready for use by NAs to reflect on what gaps need to be filled between what nurses know (research) and do (practice).
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| 10. |
- Karlsson, Ann-Christin, et al.
(författare)
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"Is that my leg?" patients' experiences of being awake during regional anesthesia and surgery
- 2012
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Ingår i: Journal of Perianesthesia Nursing. - : Elsevier B.V. - 1089-9472 .- 1532-8473. ; 27:3, s. 155-164
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Tidskriftsartikel (refereegranskat)abstract
- Most knee or hip replacement surgery is performed under regional anesthesia, when patients are awake. Previous research has primarily focused on patients' experiences during general anesthesia. The aim of this study was to uncover the meaning of being awake during regional anesthesia and surgery. Nine interviews with patients undergoing knee or hip replacement surgery comprise the data. The phenomenological analysis shows that being awake during surgery can be compared with walking a tightrope because of ambiguous feelings. Four interrelated constituents further elucidated the patients' experiences: balancing between proximity and distance in the operating theater, balancing between having control and being left out, my partly inaccessible body handled by others, and the significant role of the carer. Anesthesia providers and perioperative nurses need to understand the awake patients' intraoperative experiences to support and confirm them when they can no longer experience or have full access to their body.
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