| 1. |
- Dahl, Oili, et al.
(författare)
-
Adapting to life after burn injury : reflections on care
- 2012
-
Ingår i: Journal of Burn Care & Research. - 1559-047X .- 1559-0488. ; 33:5, s. 595-605
-
Tidskriftsartikel (refereegranskat)abstract
- A burn injury is an unforeseen event that means physical and psychological trauma for the person afflicted. The trauma experienced by different individuals varies greatly, as do perceived problems during care, rehabilitation, and throughout the remainder of life. The purpose of this study was to explore burn patients' experiences of adapting to life after burn injury to acquire a deeper understanding of the most important issues for patients when providing care during and after a burn injury. A qualitative approach was applied, and interviews were conducted with 12 adult burn patients (8 men and 4 women) 6 to 12 months postburn. The interviews were analyzed using Kvales' method for structuring analysis and comprised a close reading and interpretation of the texts. Analysis focused on the personal experiences of burn patients living after burn injury and treatment. Struggling with the consequences of burn injury and how patients perceived life today after treatment are important issues for adapting to life after burn injury. New experiences of a fragile body, coping with daily life, and reflections of burn care were also prominent themes. Patients with burn injuries need adequate repeated information about the plan for their care, about the physiological changes, and more support to handle the trauma event. The patients would also like to be more involved in their care. A program of support and preparatory work to help the patient to cope with the new bodily sensations and new body image is necessary and should begin during hospital care. A multidisciplinary team approach for pain treatment needs to be prioritized. In addition, multidisciplinary follow-up after burns need to include patients with minor burns. (J Burn Care Res 2012;33:595-605)
|
|
| 2. |
- Dahl, Oili
(författare)
-
Memories of pain, adaptation to life and early identification of stressors in patients with burns
- 2013
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Burn injury is an unforeseen event causing physical and psychological trauma for the person afflicted. Patients treated for burns commonly experience high levels of pain and anxiety related to burn treatment during burn care. During the first year after burn injury patients may still be coping with intrusive memories and struggle with daily problems related to physical limitations and body image dissatisfaction. Despite the trauma, most burn patients adapt well to life after injury but some are unable to readjust, resulting in persisting psychological symptoms. The overall aim of this thesis was to investigate the patient’s experience during burn care and at follow-up with focus on pain, body image, posttraumatic stress and coping and explore adaptation to life after burn injury. Methods: Studies I and II were qualitative and interviews were conducted with 12 adult burn patients, 6-12 months post-burn, and explored burn patients’ experiences of pain, coping and adjustment. Study III, focused on to culturally adapt and validate the Satisfaction With Appearance Scale (SWAP) into Swedish to be to be used in the context of burn care. Pre-testing of the questionnaire was conducted with 13 former burn patients and psychometric properties were tested in 90 respondents. In study IV, 52 burn patients were followed at the three months after discharge and 32 patients completed the six month follow up. A standardised clinical protocol was used for systematic assessment of posttraumatic stress disorder (PTSD), body image dissatisfaction and coping strategies. The follow-up included an intervention with a burn nurse to complement the existing program. Results: Patients provide a multifaceted description of burn pain and many aspects of daily burn care are painful. In general, coping during hospitalization was characterised by efforts to “endure" the pain experience itself. Patients depict post-injury life as a struggle to live with the sequelae of a burn injury. This struggle involves various ways of dealing with a fragile body, with limitations to activities of daily living and emotional processing of the trauma. The Swedish version of the Satisfaction with Appearance Scale (SWAP-Swe) proved to be a reliable and valid instrument for assessing body image dissatisfaction. Higher body image dissatisfaction was found for female gender, for participants with moderate burns and longer hospital stay and participants who undergo surgery during burn care. Approximately half of the patients had a risk of developing PTSD three months after discharge from hospital, and body image dissatisfaction was found to potentially predict risk for PTSD during follow-up. Conclusions: There is a need for increased focus on and the development of pain treatment for burn injury, especially with burn wound procedures. Psychosocial support for patients should be implemented in the future to support coping and to increase the patients’ ability to adapt to burn injury. Body image dissatisfaction is a stressor after burn injury, and particular attention should be directed towards the female patients’ and patients with more extensive burns. It is important to include patients with less extensive burns in early follow-up care since this group is at risk of developing PTSD.
|
|
| 3. |
- Dahl, Oili, et al.
(författare)
-
The cultural adaptation and validation of a Swedish version of the Satisfaction With Appearance Scale (SWAP-Swe)
- 2014
-
Ingår i: Burns. - : Elsevier BV. - 0305-4179 .- 1879-1409. ; 40:4, s. 598-605
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Body image dissatisfaction is a source of stress after burns and it is important to attempt to objectively measure this aspect. Unfortunately, there are no Swedish questionnaires to assess satisfaction of appearance after burns,. Aim: The aim of this study was to translate, culturally adapt and validate the Satisfaction With Appearance Scale (SWAP) into Swedish from American English to be used in the context of burn care. Method: The SWAP was translated and cross-cultural adapted inspired by the guidelines by Guillemin. Pre-testing with 13 burn patients was conducted and 90 patients tested the questionnaire in order to determine its psychometric properties. Results: Cronbach's alpha was 0.89 indicating a high level of internal consistency of Swedish SWAP. Test for construct validity showed that length of hospital stay, more severe burns and female gender generated significantly higher scores in SWAP-Swe. The principal-components analysis found similar subscales according to the original SWAP that together accounted for 68% of the total variance. Conclusions: SWAP-Swe is a reliable and valid instrument for use in a Swedish speaking population. The questionnaire was perceived to be relevant for usage in the context of burn care and is well understood by the patients. (C) 2013 Elsevier Ltd and ISBI. All rights reserved.
|
|
| 4. |
- Escher, Cecilia, et al.
(författare)
-
Fear of making a mistake : a prominent cause of stress for COVID-19 ICU staff-a mixed-methods study
- 2023
-
Ingår i: BMJ Open Quality. - : BMJ. - 2399-6641. ; 12:1
-
Tidskriftsartikel (refereegranskat)abstract
- IntroductionThe COVID-19 pandemic has had a profound effect on many domains of healthcare. Even in high-income countries such as Sweden, the number of patients has vastly outnumbered the resources in affected areas, in particular during the first wave. Staff caring for patients with COVID-19 in intensive care units (ICUs) faced a very challenging situation that continued for months. This study aimed to describe burnout, safety climate and causes of stress among staff working in COVID-19 ICUs.MethodA survey was distributed to all staff working in ICUs treating patients with COVID-19 in five Swedish hospitals during 2020 and 2021. The numbers of respondents were 104 and 603, respectively. Prepandemic data including 172 respondents from 2018 served as baseline.ResultsStaff exhaustion increased during the pandemic, but disengagement decreased compared with prepandemic levels (p<0.001). Background factors such as profession and work experience had no significant impact, but women scored higher in exhaustion. Total workload and working during both the first and second waves correlated positively to exhaustion, as did being regular ICU staff compared with temporary staff. Teamwork and safety climate remained unchanged compared with prepandemic levels.Respondents reported 'making a mistake' as the most stressful of the predefined stressors. Qualitative analysis of open-ended questions identified 'lack of knowledge and large responsibility', 'workload and work environment', 'uncertainty', 'ethical stress' and 'organization and teamwork' as major causes of stress.ConclusionDespite large workloads, disengagement at work was low in our sample, even compared with prepandemic levels. High levels of exhaustion were reported by the ICU staff who carried the largest workload. Multiple significant causes of stress were identified, with fear of making a mistake the most significant stressor.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
- Karlsson, Emelie, et al.
(författare)
-
Older patients' attitudes towards, and perceptions of, preoperative physical activity and exercise prior to colorectal cancer surgery : a gap between awareness and action
- 2020
-
Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 28:8, s. 3945-3953
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Time for preoperative optimisation prior to colorectal cancer surgery is limited and older people tend to decline exercise interventions. This study sought to describe attitudes towards, and perceptions of, preoperative physical activity and exercise in older people prior to colorectal cancer surgery.METHODS: This is a qualitative interview study, analysed with inductive content analysis. Seventeen participants scheduled for colorectal surgery were recruited as a purposeful sample from two hospitals in Stockholm, Sweden. Individual semi-structured interviews were conducted, face-to-face (n = 8) or by telephone (n = 9).RESULTS: Nine participants were male, median age was 75 years (range 70-91). The theme, 'a gap between awareness and action', was identified based on two main categories: 'Attitudes towards preoperative physical exercise have a multifactorial base' and 'Preoperative physical exercise is possible with a push in the right direction'. The material described a gap between awareness of the benefits of physical activity and reports of performing physical activity. The reasons for the gap between thoughts and action in this respect seem to be multifactorial. Support from others emerged as an important possibility for overcoming the gap.CONCLUSIONS: A gap between the patients' awareness and action appeared in our material. Understanding this can guide healthcare professionals (HCPs) as to the support needed preoperatively. Advice on physical exercise before surgery should be specific, and individually tailored support for action should be offered. This support should also consider the individual's current physical activity and preoperative attitude towards physical exercise.
|
|
| 10. |
- Melander, Sara, et al.
(författare)
-
Critical incidents and post-traumatic stress symptoms among experienced registered nurses during the COVID-19 pandemic : a cross-sectional study
- 2024
-
Ingår i: International Journal of Nursing Studies Advances. - : Elsevier. - 2666-142X. ; 6
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Registered nurses working on the frontline during the COVID-19 pandemic encountered significant challenges, including exposure to critical incidents. Critical incidents refer to sudden unexpected clinical events that surpass an individual's ability to cope, leading to considerable psychological distress, which could potentially result in the development of post-traumatic stress disorder symptoms. Research has shown a high prevalence of post-traumatic stress disorder symptoms among healthcare workers, particularly those in close contact with COVID-19 patients.Objective: To assess the levels of post-traumatic stress symptoms among registered nurses in relation to exposure to working conditions during the COVID-19 pandemic, such as how much their work was affected by the pandemic, re-deployment, working hours hindering sufficient recovery between shifts and critical incidents.Design: Cross sectional study.Setting(s): The registered nurses working in multiple health care services covering all 21 geographic regions in Sweden.Participants: A total of 1,923 registered nurses, who are part of a Swedish national cohort and have been followed since their nursing education, were invited to participate in a survey in late September 2021 (15 to 19 years post graduation).Methods: The data were analyzed using descriptive statistics, unpaired t-tests, and one-way analysis of variance. Cohen's d was employed to quantify differences in mean levels between subgroups.Results: The response rate were 56.5 %. Over 50 % of experienced registered nurses reported significant disruptions to their work environments. In total, 85 % of registered nurses were exposed to at least one critical incident in their work during the pandemic, with 60 % facing organisational changes and nearly 50 % experiencing emotionally distressing situations. The exposure to work situations involving critical incidents consistently demonstrated strong associations with higher levels of post-traumatic stress disorder symptoms compared to those not exposed, with effect sizes ranging from moderate to high.Conclusions: This study underscores the profound impact that working conditions, such as redeployment and exposure to critical incidents, have on the mental health of registered nurses. We offer valuable insights into registered nurses’ pandemic-related challenges, highlighting the need for support and interventions to prevent and manage critical incidents, ultimately promoting their well-being. We also highlight the significance of thorough workforce readiness planning for future pandemics and other challenging health care scenarios, such as staff shortage.
|
|
