| 1. |
- Hjalmarsson, Anna, 1976-
(författare)
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Being provided with a safe haven : Care-dependent older persons' participation in prehospital emergency care
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Participation in care is a key concept in many welfare societies and serves to guide clinical practice and adapt care to personal preferences and needs in order to promote well-being and quality of life. Previous research has shown that practicing participation in care is complex due to the concept not being clearly defined. A significant risk is, therefore, that participation in care is practiced based on the professional caregivers' own definitions, which might be inconsistent with the cared-for persons' perceptions of what participation is.Older persons can continue to live in their own homes with the support of municipal home care services that meet everyday care needs. Care-dependent older persons are known to have increased emergency care needs, which in Sweden require inter-organizational and inter-professional collaboration involving a care transfer between welfare levels. This thesis aimed to deepen the understanding of care-dependent older persons' participation in prehospital emergency care from lifeworld and welfare perspectives. The inductive design was based on a lifeworld approach and included triangulation of the phenomenon of participation in care using descriptive, interpretative, and comparative methods.From the perspective of care-dependent older persons, participation in prehospital emergency care means a forced transfer of life responsibility to professional caregivers when being existentially unsafe and incapacitated due to acute illness. Through authorized representation, the professional caregivers act for the older person, with the power to bring about change and create opportunities for existence. Care-dependent older persons' participation in prehospital emergency care involves a deepened dependence that necessitates coexistence and being provided with a 'safe haven' through the entire emergency care chain. A 'safe haven' can be understood as an unconditional, calm, and sheltered interpersonal space for emotional rest that is provided to the older person during an existentially challenging situation. From the perspective of care-dependent older persons, the emergency care chain transcends organizational boundaries and includes mobile safety alarm services and emergency department attendance.The involved professionals must be supported in practicing participation in care based on a comprehensive understanding of the concept, and emergency care options must be aligned with the care-dependent older persons' need for coordinated and continuous care. Collaborative challenges related to unstructured collaboration and professional hierarchy need to be addressed to support well-functioning collaboration in situations involving acutely ill older persons. The involved organizations need to recognize care-dependent older persons' deepened dependence when acutely ill, as well as their extended view of the prehospital emergency care chain.
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| 2. |
- Aryuwat, Pimwalunn, et al.
(författare)
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An integrative review of resilience among nursing students in the context of nursing education
- 2022
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Ingår i: Nursing Open. - : Wiley. - 2054-1058.
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Tidskriftsartikel (refereegranskat)abstract
- This integrative review aimed to examine empirical research on resilience among nursing students in the context of nursing education. Resilience helps nursing students handle challenges, such as changing learning styles and experiencing their first clinical practice.DesignAn integrative review.MethodsThe search terms focused on resilience and health in nursing students and nursing education. The database used in this review were CINAHL Plus, PubMed and MEDLINE. The Mixed Methods Appraisal Tool appraised the studies' quality.ResultsThis study explored 52 records and revealed three current research focuses related to nursing students' resilience: (1) the concept and description of resilience, (2) the characteristics affecting resilience and (3) the mediating role of resilience in maintaining holistic health. Recommendations include adding a resilience topic to the nursing curriculum, providing resilience enhancement programs, examining the relationship between resilience and holistic health and exploring the influence of resilience about global health crises.Public Contribution Resilience among nursing students plays a vital role in helping them to overcome adversities during their nursing education. Additionally, after graduation, nursing students can continue contributing to society as resilient Registered Nurses in the future.
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| 3. |
- Aryuwat, Pimwalunn, et al.
(författare)
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Experiences of Nursing Students Regarding Challenges and Support for Resilience during Clinical Education : A Qualitative Study
- 2024
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Ingår i: Nursing Reports. - 2039-4403. ; , s. 1604-1620
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Tidskriftsartikel (refereegranskat)abstract
- Nursing students require resilience to navigate the complexities of clinical practice. This characteristic is essential for managing demanding workloads, unpredictable patient situations, and emotional stressors while maintaining performance and well-being. Fostering resilience helps students develop the capacity to adapt to adversity, overcome setbacks, and remain committed to providing high-quality patient care. This qualitative study explores the challenges and supports influencing nursing students’ resilience during clinical education. Interviews with 28 Thai nursing students revealed two key themes: the “experience of vulnerability” and the “experience of meaningfulness”. The sub-themes of vulnerability included “navigating uncertainty”, “transcending professional struggles”, and “being exposed to diverse encounters”. The sub-themes of meaningfulness focused on restoring strength through social interactions and engaging in positive transformation. This study highlights the need for comprehensive support systems that address personal and professional vulnerabilities. Integrating caring theory principles could further enhance resilience by emphasizing compassionate care and fostering student empathy. This suggests that instructors and stakeholders can significantly impact student well-being by creating supportive environments built on collaboration, empathy, and mentorship, all of which are aligned with caring theory.
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| 4. |
- Aryuwat, Pimwalunn, et al.
(författare)
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Factors Associated with Resilience among Thai Nursing Students in the Context of Clinical Education : A Cross-sectional Study
- 2024
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Ingår i: Education Sciences. - 2227-7102. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Resilience aids nursing students in dealing with adversities during their nursing education. This study examined the relationship between nursing students’ resilience and relevant variables in the context of clinical education. Methods: A cross-sectional study was conducted to collect data from 319 undergraduate nursing students in Northeast Thailand. The Connor–Davidson Resilience Scale, the Multidimensional Scale of Perceived Social Support, the Learning Experience Scale or the Personal Responsibility Orientation to Self-Direction in Learning Scale, and the Stressors in Nursing Students scale were administered. A multiple regression analysis was performed for factors presumed to be associated with resilience. Results reported that Thai nursing students’ average resilience score was 71.79 ± 16.33. Multiple regression analysis indicated factors associated with resilience, in which social support (β = 0.354, p < 0.001, 95%CI: 0.240 to 0.469) and self-directed learning (β = 0.787, p < 0.001, 95%CI: 0.606 to 0.968) showed a positive association, while stress (β = −0.083, p = 0.025, 95%CI: −0.083 to −0.006) had a negative association. The final model accounted for 43.4% of the variance in the resilience score. In conclusion, self-directed learning, social support, and perceived stress among nursing students during clinical education are associated with their resilience.
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| 5. |
- Asp, Margareta, 1958-
(författare)
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Vila och lärande om vila. En studie på livsvärldsfenomenologisk grund
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Avhandlingsarbetets syfte var att utifrån människors levda erfarenheter av vila, utveckla en tentativ teori om vila och om lärande avseende vila. Den kunskapen har utgjort grund för att beskriva hur förutsättningar för lärande avseende vila kan skapas. En modell för lärande avseede vila har utvecklats, i vilken en ömsesidighet mellan innehåll, lärande och förutsättningar för lärande beaktas. Studien genomfördes med en livsvärldsfenomenologisk ansats och med intervju som datainsamlingsmetod. Analysen genomfördes enligt en beskivande fenomenlogisk metodologi, i syfte att beskriva fenomenets generella struktur En generell struktur av fenomenet vila, implicerar en dualitet mellan vila och icke-vila. Essensen i vila utgörs av en harmoni i vilja, känsla och handling Vilan gestaltas i och med att en inre verklighet avseende behov och längtan överensstämmer med den yttre verklighetens beskaffenhet. Till vilans essens relateras innebördselementen: vilorytm i livet, stämningar av skönhet och trevnad, bejakad utan bedömning, frihet från bekymmer och tvång, samvaro med gemensamt intresse, att dröja, lustfylld stimulans och lustfylld utmaning. Essensen i icke- vila är disharmoni i vilja, känsla och handling. Upplevelsen av disharmoni tär på krafterna och blir allt påtagligare ju längre icke-vilan pågår. Att lära sig vila innebär att bli medveten om sitt behov av att ha en livsrytm som ger utrymme för vila, att tillåta sig att leva i en sådan rytm och att finna eller skapa källor där kraft kan hämtas. Modellen för lärande avseende vila består av tre dimensioner: lärande om vila, lärande i vila och lärande genom vila. Lärande om vila kan relateras till idëer om livsvärld, levd kropp, tid och rum, cirkularitet och intentionalitet. Lärande genom vila kan relateras till hälsa och lärande i vila kan relateras till etiska och estetiska aspekter.
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| 6. |
- Hjalmarsson, Anna, 1976-, et al.
(författare)
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A matter of participation? : A critical incident study of municipal care personnel in situations involving care-dependent older persons and emergency medical services
- 2022
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis Group. - 1748-2623 .- 1748-2631. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study aimed at describing municipal care personnel’s experiences of and actions in situations when older persons need emergency medical services (EMS) at home. METHODS: An inductive descriptive design adhering to critical incident technique (CIT) was used. Data were collected through interviews and free text written questionnaires, analysed in accordance with CIT procedure. RESULTS: Experiences related to the main areas of Lifesaving competence and Collaborative care. Lifesaving competence involved having sufficient knowledge to guide older persons in emergencies without organizational support. The lack of care alternatives carries dependence on inter-organizational collaboration, as well as having to accept the collaborative conditions provided by the EMS. Actions meant Adjusting to situational needs and EMS authority, which involved safeguarding the person while being directed by the EMS. CONCLUSIONS: Lack of organizational support, care alternatives, and structured collaboration jeopardize care-dependent older persons’ health, and ability to influence care when emergency situations occur at home. Municipal care personnel’s actions as the older person’s representative support human agency, allowing older persons to become active participants in care despite acute suffering. This study underlines the importance of further developing welfare policies that facilitate and regulate inter-organizational responsibilities of health and social care to favour older people.
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| 7. |
- Hjalmarsson, Anna, 1976-, et al.
(författare)
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Balancing power : Ambulance personnel's lived experience of older persons' participation in care in the presence of municipal care personnel
- 2023
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 37:3, s. 766-776
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patient participation is considered to promote well- being and is, there-fore, central in care contexts. Care- dependent older persons living at home constitute a vulnerable population with increased ambulance care needs. Care transfers risk challenging participation in care, a challenge that can be accentuated in situations involving acute illness.Aim: To illuminate meanings of older persons' participation in ambulance care in the presence of municipal care personnel from the perspective of ambulance personnel.Method: A phenomenological hermeneutical method was used to analyse tran-scripts of narrative interviews with 11 ambulance personnel.Results: The ambulance personnel's lived experience of older persons' participa-tion includes passive and active dimensions and involves a balancing act between an exercise of power that impedes participation and equalisation of power that em-powers participation. The main theme ‘Balancing dignity in relation to manipulat-ing the body’ included the themes Providing a safe haven and Complying with bodily expressions, which means shouldering responsibility for existential well- being and being guided by reactions. The main theme ‘Balancing influence in relation to per-ceived health risks’ included the themes Agreeing on a common perspective, Directing decision- making mandate, and Sharing responsibility for well- being, which means shouldering responsibility for health focusing on risks. Influence is conditional and includes performance requirements for both the older person and municipal care personnel.Conclusion: Care- dependent older persons' participation in care from the per-spective of ambulance personnel means recognising passive and active dimensions involving human dignity, the ability to influence care, and optimising care efforts through collaboration. This study provides a deepened understanding of the balanc-ing of power involved in ambulance care determining participation, where power is equalised or exercised depending on personal engagement, health risks, and available care options. The knowledge provided holds the potential to improve am-bulance care to benefit older persons in critical life situations.
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| 8. |
- Hjalmarsson, Anna, 1976-, et al.
(författare)
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Characteristic patterns of emergency ambulance assignments for older adults compared with adults requiring emergency care at home in Sweden : a total population study
- 2020
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Ingår i: BMC Emergency Medicine. - : BioMed Central. - 1471-227X. ; 20, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Since the vast majority of older adults in Sweden live in their private homes throughout life, the emergency medical services need to adapt accordingly. Hence, we aimed to describe characteristic patterns of dyadic staffed emergency ambulance assignments for older adults aged > 70 years compared with adults aged 18– 69 years requiring emergency care at home in Sweden.Methods: A descriptive retrospective study was performed using anonymized registry data from the emergency medical services in a region of Sweden during 2017–2018. One-sample χ2 test, one-way analysis of variance, and binary logistic regression models were used for investigating group differences. Variables for analysis were age, gender, clinical assessments, on-scene time, priority levels, result of response, and temporal patterns.Results: Of all included emergency ambulance assignments (n = 28,533), 59.9% involved older adults, of which 53.8% were women. The probability for older adults to receive the highest priority was decreased for both dispatch (p < 0.001, odds ratio [OR] 0.63, 95% confidence interval [CI] 0.59–0.66), and transport priorities (p < 0.001, OR 0.74, 95% CI 0.68–0.80). Older adults were more likely to receive dispatch priority levels 2 (p < 0.001, OR 1.48, 95% CI 1.40–1.56), and 3 (p < 0.001, OR 1.73, 95% CI 1.46–2.06). The older adults were similarly more likely to receive transport priority level 3 (p < 0.001, OR 1.40, 95% CI 1.28–1.52) compared with adults. Age had a small but additive effect in relation to on-scene time (p < 0.001, R2 = 0.01, F = 53.82). Distinguishing initial clinical assessments for older adults were circulatory, respiratory, trauma, infection, and nonspecific assessments. Emergency ambulance assignments for older adults were more frequently occurring on Mondays (p < 0.001, χ2 = 232.56), and in the 08:00– 11:59 interval (p < 0.001, χ2 = 1224.08).Conclusion: The issues of the lower priority level preponderance, and the decreased probability for receiving the highest priority warrant further attention in future research and clinical practice.
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| 9. |
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| 10. |
- Hjalmarsson, Anna, 1976-, et al.
(författare)
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Entrusting life to professionals : A phenomenological hermeneutical study of older persons' participation in prehospital emergency care involving municipal home care and ambulance services.
- 2024
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 38:2, s. 273-283
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Tidskriftsartikel (refereegranskat)abstract
- Background: Participation in care is considered to promote safe and qualitative care. Care-dependent older persons ageing in place have increased emergency care needs, which initiate inter-organisational collaboration involving municipal home care and ambulance services. Previous research concludes that uncertainties exist regarding what participation in care means in clinical practice, which necessitates the need to illuminate the phenomenon for older persons in critical life situations.Aim: This study aimed to illuminate meanings of participation in prehospital emergency care from the perspective of care-dependent older persons experiencing acute illness at home.Design: This study has a qualitative design with a lifeworld approach.Method: A phenomenological hermeneutical method was used to analyse transcribed telephone interviews with eleven care-dependent persons aged 70–93 years.Results: Care-dependent older persons' participation in prehospital emergency care means ‘Entrusting life to professional caregivers’ when being in helpless solitude and existentially unsafe, which emphasises a deepened interpersonal dependence. Meanings of participation in care from the perspective of older persons involve Being reassured in togetherness, Being pliant in trust of emergency expertise, Being enabled through the agency of professional caregivers, and Encountering readiness in the emergency care chain.Conclusion: Care-dependent older persons' participation in prehospital emergency care is existential and involves interpersonal dependence. Togetherness brings reassurance, safety and opportunity for emotional rest while accessing the professional caregivers' power, competence and abilities which provide opportunities for existence and movement towards well-being and continued living.Implications for practice: Prehospital emergency care from the perspective of care-dependent older persons transcends organisational boundaries and includes the municipal mobile safety alarm service. The involved municipal and regional organisations need to provide support by implementing lifeworld-led care models and care alternatives that enable professionals to recognise the existential dimension of participation in care.
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