| 1. |
- Björk, Maria, et al.
(författare)
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Validation of two brief instruments (the SURE and CollaboRATE) to measure shared decision-making in patients with restless legs syndrome
- 2023
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Ingår i: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869.
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Tidskriftsartikel (refereegranskat)abstract
- Restless legs syndrome (RLS) is a common neurological disorder characterised by an urge to move arms and legs, usually associated with discomfort, pain, motor restlessness, and sleep disturbance. An individually adapted treatment is needed but difficult to optimise, which makes shared decision-making (SDM) important. However, brief validated instruments on how patients with RLS perceive their involvement in treatment decisions are lacking. Therefore, the aim was to validate two instruments, SURE (Sure of myself, Understand information, Risk-benefit ratio, Encouragement, i.e., to assess decisional conflict) and CollaboRATE (brief patient survey focused on SDM, i.e., to assess SDM), in patients with RLS. A cross-sectional design, including 788 participants with RLS (65% females, mean [SD] age 70.8 [11.4] years) from a national patient organisation for RLS, was used. A postal survey was sent out to collect data regarding weight, height, comorbidities, demographics, and RLS-related treatment data. The following instruments were included: the SURE, CollaboRATE, Restless Legs Syndrome-6 Scale, and eHealth Literacy Scale. Confirmatory factor analysis and Rasch models were used to assess the validity and reliability of the SURE and CollaboRATE. Measurement invariance, unidimensionality, and differential item functioning (DIF) across age, gender, and medication groups were assessed. The SURE and CollaboRATE were both identified as unidimensional instruments with satisfactory internal consistency. No DIF across age and gender was identified, while significant DIF was observed for both the SURE and CollaboRATE regarding medication use categories. However, both the SURE and CollaboRATE are potential instruments to be used in research, but also as reflection tools by healthcare professionals, patients, and students to explore and assess SDM, and support its development in clinical care.
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| 2. |
- Högberg, Anders, et al.
(författare)
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The Spread of Flint Axes and Daggers in Neolithic Scandinavia
- 2001
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Ingår i: Památky Archeologické. - 0031-0506. ; 92:2, s. 193-221
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Tidskriftsartikel (refereegranskat)abstract
- Flint has a limited distribution in the Scandinavian area, natural sources being largely confined to the southern regions. Here, the use of flint for making daggers and polished axes during the Neolithic is widespread and extensive. There is also evidence for mining of flint at Södra Sallerup in southern Sweden and on several sites in Denmark, but flint is available in till deposits as well. The goal of the article is to study the distribution of flint as a raw material in Neolithic contexts, concentrating on local and long-distance movement. We begin with a discussion of flint sources and their exploitation during the Neolithic. Thereafter we present three case studies illustrating how the use of flint varied over both time and space.
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| 3. |
- Koldestam, Maria, 1968-
(författare)
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MILO - A Conceptual Learning Model Grounded in a Hermeneutical and a Caritative Caring Perspective : Development and Evaluation
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim was to develop and evaluate a conceptual learning model grounded in a caritative caring perspective aimed to facilitate undergraduate nursing students’ learning during clinical practice.Methods: This thesis comprises four studies with a descriptive explorative design overall. In the inductively applied research, different designs using both qualitative and quantitative methods, were used. Studies I–III used qualitative methods; data for study I were collected using the Delphi method and analysed using qualitative data analysis. In study II, data were collected using focus group interviews and analysed using latent content analysis. In study III, data were collected using individual interviews and analysed using a phenomenographic approach. Study IV used quantitative methods and data were collected using a questionnaire and analysed using statistical methods.Results: Study I resulted in a conceptual learning model grounded in hermeneutics and a caritative caring perspective. The Model for Improvement in Learning Outcomes (MILO) encompasses eight concepts: four intrapersonal, i.e. the students’ own characteristics, reflecting understanding, and four contextual concepts, i.e. environmental concepts, reflecting structure. Study II showed that students’ learning is facilitated as a result of natural actions and elements that occur in daily life, integrating natural caring with professional caring. Studies III and IV showed that students’ learning was a gain in knowledge and understanding of supportive elements for learning and the perspective of the patients, and a gain in engagement and dedication. Study IV also showed that the intrapersonal concepts were valued more than the contextual concepts in the three different semesters studied. The use of the applications was valued more at the start of the students’ education. Some of the concepts and their applications had not been used in accordance with MILO’s implementation in the region involved.Conclusions: The fundamentals needed to become a professional caring nurse include having compassion and competence. Undergraduate nursing students’ learning during clinical practice needs to be facilitated by a theoretical foundation establishing an ethical bearing, by knowledge and understanding of one self and of the patient as a whole, and by challenged learning using a diversity of tools to achieve the intended outcome of better health and well-being for the patient.
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| 4. |
- Koldestam, Maria, 1968-, et al.
(författare)
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Model for Improvements in Learning Outcomes (MILO) : Development of a conceptual model grounded in caritative caring aimed to facilitate undergraduate nursing students’ learning during clinical practice (Part 1)
- 2021
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Ingår i: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 55
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim was to describe the development of a caritative caring conceptual model aimed to facilitate undergraduate nursing students’ learning during clinical practice. Design: An explorative design was used.Methods: The Delphi method with a panel of 12 experts together with a literature search with a systematic approach were used and data were analysed according to content analysis.Results: The Model for Improvements in Learning Outcomes (MILO) consists of eight core concepts divided into four intrapersonal concepts (nursing, a reflective approach, a critical approach, quality and safety) and four contextual concepts (peer learning, co-clinical teachers, student-centred and student-active supervision, a good learning environment). MILO is grounded in the theory of caritative caring with a hermeneutic approach and the understanding of caring and learning as parallel processes. Tools such as reflection, structure and guiding pm are used to intertwine caring, nursing, pathophysiology and medicine.Conclusions: MILO intertwines didactics with concepts important for nursing students’ learning with a foundation in caritative caring and may facilitate undergraduate nursing students’ learning in clinical practice.
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| 5. |
- Koldestam, Maria, 1968-, et al.
(författare)
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Supervisors’ experiences of undergraduate nursing students’ learning in clinical practice when applying caring and learning as parallel processes in a caritative caring conceptual learning model (Part 2)
- 2021
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Ingår i: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 52
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Tidskriftsartikel (refereegranskat)abstract
- The Model for Improvements in Learning Outcomes (MILO) is theoretically grounded and designed to intertwine didactics, pathophysiology and medicine with specific concepts important for learning. The aim was to describe supervisors' experiences of undergraduate nursing students' learning during clinical practice when using MILO. A qualitative and explorative design was used. Seventeen supervisors, thirteen women and four men from different departments at three hospitals in southern Sweden participated. After using the model, data were collected through four focus group interviews with open unstructured interview questions and analysed using inductive latent content analysis. Twelve subcategories, four generic subcategories and one main category emerged. The students developed a questioning approach and were more reflective, open and compliant. Twosomes enhanced learning. Specific documents generated structure and feelings of participation. The supervisors felt that taking the students' pre-understanding into account and a caring approach in the learning environment were valuable for enhanced learning. The students established a caring relationship with the patients and the patients’ perspective became emphasized. Using MILO, intertwining between the natural and the professional became possible; enhanced learning in nursing skills together with a more caritative caring approach towards the patient was revealed. The need of compassion is discussed.
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| 6. |
- Koldestam, Maria, 1968-, et al.
(författare)
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Undergraduate nursing student's attitudes to learning during clinical practice in different semesters when using a conceptual learning model grounded in a caritative caring perspective – A cross-sectional study
- 2023
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712.
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Tidskriftsartikel (refereegranskat)abstract
- Aim:To describe undergraduate nursing students' attitudes to learning during clinical practice in different semesters when using the conceptual learning model, Model for Improvements in Learning Outcomes (MILO) grounded in a caritative caring perspective.Background: With the intention to support interlinking between theory and praxis and offer understanding and structure to facilitate learning, MILO, theoretically grounded in hermeneutics and a caritative caring perspective based on ethical values, was implemented. MILO consists of four contextual concepts (peer learning, co-clinical teachers, student-centred and student-active supervision) and four intrapersonal concepts (nursing, a reflective approach, a critical approach, quality and safety).Methods: A descriptive comparative quantitative study design was applied at a Swedish university, 3 hospitals and 13 municipalities in one county. Cross-sectional data collected via a questionnaire developed to assess attitudes to learning related to MILO's contextual and intrapersonal concepts and their applications were used.Results: 209 students in semester 3, 4 and 6 participated in 6 different clinical practice courses. In comparison, intrapersonal concepts, that is, the student's own characteristics and abilities were viewed to be of greater value for learning than contextual, that is, organisational-related concepts in all semesters. Understanding the needs of others and reflective learning were rated to be of major importance. Students in semester 3 valued the use of the applications the highest. To be supervised in pairs was rated the lowest in semester 6. Some of the concepts and their applications were to great extent not applied.Conclusions: In all semesters, fundamentals in caritative caring and characteristics and abilities related to the individual student were rated to be of greater importance for learning than environmental support. Providing students opportunities to develop independency seems essential. Use of a learning model such as MILO is dependent on a bearing of a caritative caring culture and a shared understanding between all involved in student learning during clinical practice.
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| 7. |
- Mårtensson, Sophie, et al.
(författare)
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Caring Behavior Coding Scheme based on Swanson’s Theory of Caring – development and testing among undergraduate nursing students
- 2021
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 35:4, s. 1123-1133
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Tidskriftsartikel (refereegranskat)abstract
- Rationale: To maintain patients’ dignity and well-being and alleviate suffering, it is essential that healthcare providers engage in caring behaviours. Yet, every year patient boards receive an increasing number of complaints from patients and significant others regarding healthcare providers’ non-caring behaviours. Defining and measuring both verbal and nonverbal caring and non-caring behaviour in healthcare delivery is vital to address such complaints. However, no studies were found that incorporated a comprehensive theory of caring to code encounters between healthcare providers and patients.Aim: The aim was to develop and test a Caring Behavior Coding Scheme based on Swanson’s Theory of Caring.Method: An instrument development process was used for behavioural coding including observational data from thirty-eight video recordings collected in an undergraduate nursing course at a Swedish University. The observational data involved interactions between undergraduate nursing students and a standardised patient.Result: The Caring Behavior Coding Scheme (the CBCS), contains seventeen verbal and eight nonverbal behavioural codes, categorised as caring and non-caring in accordance with Swanson’s Theory of Caring. Content and face validity were assessed. Timed-event sequential continuous coding was performed in INTERACT software. The coder achieved excellent agreement with the developed gold standard (k = 0.87) and excellent mean inter-rater reliability (k = 0.82). All domains in Swanson’s Theory of Caring were observed and coded in the interaction.Discussion/Conclusion: The CBCS is a theory-based instrument that contributes to research on healthcare providers’ behavioural encounters. It uses verbal and nonverbal caring and non-caring behavioural codes to assess the alignment of both the theory and practice of caring. The CBCS can contribute to both development and measurement of interventions focused on improving healthcare providers’ caring behaviour with the intended outcome of patient well-being.
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| 8. |
- Mårtensson, Sophie, et al.
(författare)
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Development of caring behaviour in undergraduate nursing students participating in a caring behaviour course
- 2024
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 38:1, s. 47-56
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Tidskriftsartikel (refereegranskat)abstract
- Background: In today's complex healthcare organisations there is an increasing recognition of the need to enhance care quality and patient safety. Nurses' competence in demonstrating caring behaviour during patient encounters affects how patients experience and participate in their care. Nurse educators are faced with the challenge of balancing the demand for increasingly complex knowledge and skills with facilitating students' abilities essential to becoming compassionate and caring nurses. Aim: The aim was to describe undergraduate nursing students' development of caring behaviour while participating in a caring behaviour course. Method: This pilot study used a quantitative observational design. At a university in Sweden, video-recorded observational data from twenty-five students were collected in the first and last weeks of a full-time five-week Caring Behaviour Course (the CBC). In total, 56-min video-recorded simulation interactions between a student and a standardised patient were coded by a credentialed coder using a timed-event sequential continuous coding method based on the Caring Behaviour Coding Scheme (the CBCS). The CBCS maps the five conceptual domains described in Swanson's Theory of Caring with related sub-domains that align with Swanson's qualities of the Compassionate Healer and the Competent Practitioner. The CBCS contains seventeen verbal and eight non-verbal behavioural codes, categorised as caring or non-caring. Results: Between the two simulations, most verbal caring behaviours increased, and most non-verbal caring behaviours decreased. Statistically significant differences between the simulations occurred in the sub-domains Avoiding assumptions and Performing competently/skilfully in the quality of the Competent Practitioner. Most observed caring behaviours aligned with the Compassionate Healer. Conclusion: Generally, the students' development of caring behaviours increased while participating in the CBC. Using a structured observational behavioural coding scheme can assist educators in assessing caring behaviour both in education and in practice, supporting caring as the universal foundation of nursing and a key to patient safety.
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| 9. |
- Mårtensson, Sophie, et al.
(författare)
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Undergraduate Nursing Students' Experiences of Learning Caring Using a Variety of Learning Didactics
- 2022
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Ingår i: International journal for human caring. - : Springer Publishing Company. - 1091-5710. ; 26:3, s. 145-158
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Tidskriftsartikel (refereegranskat)abstract
- This study examines undergraduate nursing students' experiences of participating in a Caring Behavior Course using various learning didactics. Twenty-five students participated in one of five focus group interviews with data analyzed according to qualitative content analysis. The main theme to emerge, an insightful and sudden awakening that caring is not only theoretical words, was further explained with three themes and nine subthemes. The Caring Behavior Course demonstrates effective learning didactics to develop awareness of values that influence caring behaviors and can contribute to patient well-being, particularly relevant for the care challenges in the time of COVID-19 and beyond.
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| 10. |
- Mårtensson, Sophie, et al.
(författare)
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Undergraduate nursing students' experiences of practicing caring behaviours with standardised patients
- 2023
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 37:1, s. 271-281
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Tidskriftsartikel (refereegranskat)abstract
- Rationale Undergraduate nursing students' learning opportunities to practice caring behaviours to assure compassionate and competent nursing practice with standardised patients are few. Earlier studies primarily focused on practicing communication skills in relation to mental health or developing psychomotor skills while caring for a patient with a specific diagnosis. Aim The study aim was to describe undergraduate nursing students' experiences of practicing caring behaviours with a standardised patient. Method A sample of forty-eight undergraduate nursing students in semester four at a school of nursing in southern Sweden, enrolled in a full-time, 5-week, on-campus elective caring behaviour course, were at the first and last week individually video-recorded during two caring behaviour simulations encountering a standardised patient. After observing each of their video-recordings, students completed written reflections focusing on their own compassionate and competent verbal and nonverbal caring behaviour. In total, 96 individual written reflections were analysed using qualitative content analysis to describe the experience. Results One main theme emerged: The challenge of being mindfully present in patient encounters. Four themes further described the experience: A challenging but realistic learning experience, learning the impact of nonverbal behaviour, recognising the complexity of verbal behaviour, and learning to be with the patient instead of only doing for the patient. Conclusion When caring is intertwined with visible and realistic nursing practice in simulations using standardised patients it facilitates undergraduate nursing students learning compassionate and competent caring behaviour. The learning experience opened the students' eyes to the impact of practicing caring, recognising that being with is not the same as doing for the patient, and thus, how challenging it is to be mindfully present in patient encounters. Designing caring behaviour simulations with standardised patients is a feasible and efficacious educational learning didactic to facilitate students' learning caring behaviour and enhancing patients' experiences.
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