| 1. |
- Öresland, Stina, et al.
(författare)
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Nurses as guests or professionals in home health care
- 2008
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 15:3, s. 371-383
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore and interpret the diverse subject of positions, or roles, that nurses construct when caring for patients in their own home. Ten interviews were analysed and interpreted using discourse analysis. The findings show that these nurses working in home care constructed two positions: 'guest' and 'professional'. They had to make a choice between these positions because it was impossible to be both at the same time. An ethics of care and an ethics of justice were present in these positions, both of which create diverse ethical appeals, that is, implicit demands to perform according to a guest or to a professional norm.
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| 2. |
- Wijk, Helle, 1958, et al.
(författare)
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Verksamhetsförlagd utbildning på avancerad nivå : ny utmaning för specialistutbildningar för sjuksköterskor
- 2009
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Ingår i: Vård i Norden. - København : Sjuksköterskornas samarbete i Norden. - 0107-4083 .- 1890-4238. ; 29:94, s. 41-43
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this article is to discuss challenges in the development of Specialist Nursing Educations as a result of the 2007 Swedish Higher EducationReform: the implementation of the so-called Bologna process. Certain challenges follow this reform, particularly since the specialist nursingprogrammes will be part of the second cycle of the higher education system, and it will be possible to combine the professional degree witha masters degree (one year). Possible strategies in four areas related to the Specialist Nursing Education are discussed: integration of researchbasedknowledge, experienced-based knowledge, improvement knowledge, and strategies for collaboration between university institutions andclinics. Specific didactical issues are raised.
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| 3. |
- Strömsöe, Anneli, 1969, et al.
(författare)
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Education in cardiopulmonary resuscitation in Sweden and its clinical consequences.
- 2010
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Ingår i: Resuscitation. - : Elsevier BV. - 1873-1570 .- 0300-9572. ; 81:2, s. 211-6
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Tidskriftsartikel (refereegranskat)abstract
- To describe the use of cardiopulmonary resuscitation (CPR) training programmes in Sweden for 25 years and relate those to changes in the percentage of patients with out of hospital cardiac arrest (OHCA) who receive bystander CPR.
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| 4. |
- Thuresson, Marie, et al.
(författare)
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Factors that influence the use of ambulance in acute coronary syndrome.
- 2008
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Ingår i: American heart journal. - Amsterdam : Elsevier BV. - 1097-6744 .- 0002-8703. ; 156:1, s. 170-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: National guidelines recommend activation of the emergency medical service by patients who have symptoms of acute coronary syndrome (ACS). In spite of this, only 50% to 60% of persons with myocardial infarction initiate care by using the emergency medical service. The aim of this study was to define factors influencing the use of ambulance in ACS. METHODS: The method used in this study was a national survey comprising intensive cardiac care units at 11 hospitals in Sweden; 1,939 patients with diagnosed ACS and symptom onset outside the hospital completed a questionnaire a few days after admission. RESULTS: Half of the patients went to the hospital by ambulance. Factors associated with ambulance use were knowledge of the importance of quickly seeking medical care and calling for an ambulance when having chest pain (odds ratio [OR] 3.61, 95% CI 2.43-5.45), abrupt onset of pain reaching maximum intensity within minutes (OR 2.08, 1.62-2.69), nausea or cold sweat (OR 2.02, 1.54-2.65), vertigo or near syncope (OR 1.63, 1.21-2.20), ST-elevation ACS (OR 1.58, 1.21-2.06), increasing age (per year) (OR 1.03, 1.02-1.04), previous history of heart failure (OR 2.48, 1.47-4.26), and distance to the hospital of >5 km (OR 2.0, 1.55-2.59). Those who did not call for an ambulance thought self-transport would be faster or did not believe they were sick enough. CONCLUSIONS: Symptoms, patient characteristics, ACS characteristics, and perceptions and knowledge were all associated with ambulance use in ACS. The fact that knowledge increases ambulance use and the need for behavioral change pose a challenge for health-care professionals.
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| 5. |
- Wolmesjö, Maria
(författare)
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Ledningsfunktion i omvandling : Om förändringar av yrkesrollen för första linjens chefer inom den kommunala äldre- och handikappomsorgen
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- During the 1990s many of the local authorities have been forced to reduce expenditure on the care of the elderly and people with disabilities, and many organisational changes have been carried out. New problems and their solutions are often related to leadership and management. This dissertation deals with three trends in the development of the organisation: The first trend is a market orientation, one example of which is the attempt to increase effectiveness and efficiency by utilising a purchaser/provider model in the organisation. Here the needs assessment model is studied. The second trend is the response to the pressed situation due to heavy workloads that staff members and their managers express, exemplified by self-managing work teams and a year-based working hour system. Here called flexible work organisations. The third trend focused in this dissertation is the decentralisation of social services. It is connected to increased demands on involvement in, and participation from those who use the services, i.e. the elderly and people with disabilities. The aim of this dissertation is to shed light on how politicians and managers view, experience and describe management and leadership in three types of local authority organisations. The focus is on the demands on managers and how the working conditions for managers are described in the different organisations. The material includes three different empirical methods. The first is a questionnaire to politicians and local authority officials, mainly managers at different levels in the care of the elderly and persons with disabilities. The second method consists of qualitative interviews with politicians and managers. The third method involved a document study of local authority documents, e.g. official guidelines, plans and evaluations. The method of analysis, a ?qualified content analysis? is inspired by discourse analysis and focuses on a comparison between the different local authorities, between politicians and managers and between women and men. This dissertation shows that the organisational changes brought about unexpected consequenses for management and that the demands differ between politicians and managers and between different organisations. Politicians and higher-level management expect the managers to manage the organisation, and employees expect them to lead. The solution seems to be a high level of competence, but which competence is needed? There are two different ideals for leadership. One is associated with focus on effectiveness and efficiency and the other associated with focus on communication. The dissertation highlights the conditions of a management, which is currently being pushed further down in the organisation. The dilemma of leadership ? being a manager or a leader will not disappear. Somewhere in the organisation the perspective of effectiveness and efficiency and the perspective of communication have to meet. It might be seen as a dilemma that will not go away ? only be placed in different levels in the organisation.
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| 6. |
- Gellerstedt, Martin, 1966-, et al.
(författare)
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Could a computer-based system including a prevalence function support emergency medical systems and improve the allocation of life support level?
- 2006
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Ingår i: Eur J Emerg Med. - London, UK : Lippincott Williams & Wilkins, Ltd.. - 0969-9546 .- 1473-5695. ; 13:5, s. 290-4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate whether a computer-based decision support system could be useful for the emergency medical system when identifying patients with acute myocardial infarction (AMI) or life-threatening conditions and thereby improve the allocation of life support level. METHODS: Patients in the Municipality of Goteborg who dialled the dispatch centre due to chest pain during a period of 3 months. To analyse the relationship between patient characteristics (according to a case record form used during an interview) and the response variables (AMI or life-threatening condition), multivariate logistic regression was used. For each patient, the probability of AMI/life-threatening condition was estimated by the model. We used these probabilities retrospectively to allocate advanced life support or basic life support. This model allocation was then compared with the true allocation made by the dispatchers. RESULTS: The sensitivity, that is, the percentage of AMI patients allocated to advanced life support, was 85.7% in relation to the true allocation made by the dispatchers. The corresponding sensitivity regarding allocation made by the model was 92.4% (P=0.17). The specificity was also slightly higher for the model allocation than the dispatcher allocation. Among the 15 patients with AMI who were allocated to basic life support by the dispatchers, nine died (eight during and one after hospitalization). Among the eight patients with AMI allocated to basic life support by the model, only one patient died (in hospital) (P=0.02). CONCLUSION: A computer-based decision support system including a prevalence function could be a valuable tool for allocating the level of life support. The case record form, however, used for the interview can be refined and a model based on a larger sample and confirmed in a prospective study is recommended.
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| 7. |
- Nilsson, Christina, et al.
(författare)
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Previous birth experience in women with intense fear of childbirth
- 2010
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Ingår i: Journal of Obstetric, Gynecologic and Neonatal Nursing. - : Wiley-Blackwell. - 0884-2175 .- 1552-6909. ; 39:3, s. 298-309
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe the meaning of previous experiences of childbirth in pregnant women who have exhibited intense fear of childbirth such that it has an impact on their daily lives.Design: A descriptive phenomenological study. Setting: A maternity clinic for women with fear of childbirth in the western part of Sweden. Participants: Nine women with intense fear of childbirth who were pregnant with their second child and considered their previous birth experiences negative.Methods: Interviews that were transcribed verbatim and analyzed with a reflective life-world approach.Results: The essential meanings that emerged were a sense of not being present in the delivery room and an incomplete childbirth experience. The women felt as if they had no place there, that they were unable to take their place, and that even if the midwife was present, she did not provide support. The experience remained etched in the women’s minds and gave rise to feelings of fear, loneliness, and lack of faith in their ability to give birth and diminished trust in maternity care. These experiences contrasted with brief moments that made sense.Conclusions: Previous childbirth experiences for pregnant women with intense fear of childbirth have a deep influence and can be related to suffering and birth trauma. The implication is to provide maternity care where the nurse/ midwife is present and supports women during birth in a way that enables them to be present and take their place during birth.
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| 8. |
- Henriksson, Catrin, et al.
(författare)
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Knowledge and attitudes toward seeking medical care for AMI-symptoms
- 2011
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 147:2, s. 224-227
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Tidskriftsartikel (refereegranskat)abstract
- Background: Time is crucial when an acute myocardial infarction (AMI) occurs, but patients often wait before seeking medical care. Aim: To investigate and compare patients' and relatives' knowledge of AMI, attitudes toward seeking medical care, and intended behaviour if AMI-symptoms occur. Methods: The present study was a descriptive, multicentre study. Participants were AMI-patients <= 75 years (n = 364) and relatives to AMI-patients (n = 319). Questionnaires were used to explore the participants' knowledge of AMI and attitudes toward seeking medical care. Results: Both patients and relatives appeared to act more appropriate to someone else's chest pain than to their own. Patients did not have better knowledge of AMI-symptoms than relatives. Women would more often contact someone else before seeking medical care. A greater percentage of elderly (65-75 years), compared to younger individuals, reported that they would call for an ambulance if chest pain occurred. Conclusions: There were only minor differences between patients and relatives, regarding both knowledge and attitudes. It seems easier to act correctly as a bystander than as a patient. Therefore, in order to decrease patients' delay time it is important to educate relatives as well as patients on how to respond to symptoms of an AMI.
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| 9. |
- Herlitz, Johan, et al.
(författare)
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Factors of importance for patients' decision time in acute coronary syndrome
- 2010
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Ingår i: International Journal of Cardiology. - Amsterdam : Elsevier. - 0167-5273 .- 1874-1754. ; 141:3, s. 236-242
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Not much is known about the patients' decision time in acute coronary syndrome (ACS). The aim of the survey was therefore to describe patients' decision time and factors associated with this parameter in ACS. METHODS: We conducted a national survey comprising intensive cardiac care units at 11 hospitals in Sweden in which patients with ACS diagnosis and symptoms onset outside hospital participated. Main outcome measures were patients' decision time and factors associated with patients' decision time. RESULTS: In all, 1939 patients took part in the survey. The major factors associated with a shorter patient decision time were: 1) ST-elevation ACS, 2) associated symptoms such as vertigo or near syncope, 3) interpreting the symptoms as cardiac in origin, 4) pain appearing suddenly and reaching a maximum within minutes, 5) having knowledge of the importance of quickly seeking medical care and 6) experiencing the symptoms as frightening. The following aspects of the disease were associated with a longer decision time: 1) pain was localised in the back and 2) symptom onset at home when alone. CONCLUSION: A number of factors, including the type of ACS, the type and localisation of symptoms, the place where symptoms occurred, patients' interpretation of symptoms and knowledge were all associated with patients' decision time in connection with ACS.
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| 10. |
- Öresland, Stina, et al.
(författare)
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Patients as 'safeguard' and nurses as 'substitute' in home health care
- 2009
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 16:2, s. 219-230
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Tidskriftsartikel (refereegranskat)abstract
- One aim of this study was to explore the role, or subject position, patients take in the care they receive from nurses in their own home. Another was to examine the subject position that patients say the nurses take when giving care to them in their own home. Ten interviews were analysed and interpreted according to a discourse analytical method. The findings show that patients constructed their subject position as 'safeguard', and the nurses' subject position as 'substitute' for themselves. These subject positions provided the opportunities, and the obstacles, for the patients' possibilities to receive care in their home. The subject positions described have ethical repercussions and illuminate that the patients put great demands on tailored care.
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