| 1. |
- Abelsson, Tobias, et al.
(författare)
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The dilemma of the split between theory and reality as experienced by primary healthcare professionals: a mixed methods study of evidence-based practice in a primary care context
- 2024
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Ingår i: BMC PRIMARY CARE. - 2731-4553. ; 25:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrimary care depends upon a good information flow across professional and structural boundaries to provide the best care for patients. Previous research has mainly focused on Evidence-Based Practice (EBP) within specific professions. Mapping of pan-professional experiences of and attitudes to EBP in publicly funded clinical practice is necessary to deepen the understanding of EBP and its implementation. Thus, this study aimed to investigate healthcare professionals' experiences of and attitudes towards working in accordance with EBP in primary care.MethodsThe study used a convergent mixed methods design divided into two strands: a quantitative enquiry tool (Evidence-Based Practice Attitude Scale, EBPAS) and a set of qualitative interviews analysed by means of qualitative content analysis. Both strands included all primary care employees with patient interaction in the studied county (n = 625), including doctors, nurses, physiotherapists, psychologists and assistant nurses. Out of the original 625 healthcare professionals, 191 finished the first strand and 8 volunteered for the second strand (2 nurses, 2 physiotherapists, 1 psychiatrist and 3 doctors).ResultsThe EBPAS value of 2.8 (max 4) indicated a generally positive attitude towards EBP amongst the population, which was also evident in the interviews. However, there were additional experiences of not having the ability or resources to engage in EBP. This was illustrated by the theme that emerged from the qualitative content analysis: "The dilemma of the split between theory and reality". Due to the organisational and managerial focus on efficiency rather than quality of care, there were few or no incentives for promoting individual educational or research development.ConclusionsAlthough the general attitude towards EBP is positive, experiences of practising it differ. There is a need to increase knowledge of EBP concepts, requirements and implementation in the clinical setting. The absence of opportunities to do research and collegial debate about new ways of finding and implementing research-based evidence results might influence the quality of care.
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| 2. |
- Abelsson, Tobias, et al.
(författare)
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A Feeling of Ambiguity: A Qualitative Content Analysis of Managers’ Experiences of Evidence-Based Practice in Swedish Primary Care
- 2022
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Ingår i: Journal of Healthcare Leadership. - 1179-3201. ; 14, s. 143-153
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Primary care manager plays a vital role in promoting a research culture in the healthcare center. The position involves both the implementation of organizational directives and patient care. The research culture and use of evidence influence each individual healthcare professional and ultimately the quality of patient care. Purpose: To describe primary healthcare managers’ understanding of evidence-based practice in the Swedish primary healthcare context and their ability to influence its implementation. Methodology: Qualitative content analysis of data collected in individual interviews. Results: In general, managers expressed a positive view toward the use of evidence in daily practice. However, they were sometimes hesitant about fully implementing evidence-based results. This was mostly attributed to the struggle of balancing finances and allocating sufficient time for staff to keep up with and engage in evidence-based practice. Conclusion: The organizational culture impacts the mind-set of all co-workers including managers. Those managers influenced by traditions and norms may fall into the trap of devaluing the benefit of research and evidence. The inherent feeling of being alone and without guidance in some matters related to evidence-based practice inevitably leads to inconsistency and ambiguity. The use of clinical pathways that constitute one form of evidence has become a substitute for proper, careful, individual investigation, implementation, and evaluation of each patient case. This means that managers experience moral and physical stress when trying to meet organizational, staff, and patient demands. Practice Implication: Awareness of managers’ influence and experience of working according to evidence-based practice is valuable to gain an insight into how Swedish primary healthcare functions at local level. Illuminating and discussing evidence-based practice is an assurance of quality that contributes to many aspects of the overall safety of care. © 2022 Abelsson et al.
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| 3. |
- Abelsson, Tobias, et al.
(författare)
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Quality and availability of information in primary healthcare: the patient perspective
- 2020
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 38:1, s. 33-41
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore lived experiences of patients communicating with and receiving information from primary health care. Design: Qualitative study analysing transcribed interviews by descriptive content analysis. Setting: Recruitment and interviews took place in southern Sweden in three primary care centres where privacy and undisturbed interview environments was ensured. Subjects: 17 primary care patient informants, 9 men and 8 women aged 31 - 84 years with varying educational levels from primary school to post graduates. Main outcome measures: Thematic categories and subcategories reporting the lived experience of the patients. Results: The analysis yielded three categories and identified as a main theme a feeling of unpredictability based on the emotional aspects of feeling lost and vulnerable when trying to access primary care. The category" Need for easy access" illustrated emotional aspects of importance to patients when contacting primary health care." Need for individual adaptation" described the need to individually adapt health related information." Information exchange" comprised experiences of information evaluation and understanding new information. Conclusions: Patients generally trusted the information received, but experienced a lack of communication, which evoked feelings of unpredictability and abandonment. Experiences of limited access to primary health care and the need for varying degrees of adaptation on the part of the individual were factors of concern for how patients experienced the care.
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| 4. |
- Adman, Per, et al.
(författare)
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171 forskare: ”Vi vuxna bör också klimatprotestera”
- 2019
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Ingår i: Dagens nyheter (DN debatt). - Stockholm. - 1101-2447.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- DN DEBATT 26/9. Vuxna bör följa uppmaningen från ungdomarna i Fridays for future-rörelsen och protestera eftersom det politiska ledarskapet är otillräckligt. Omfattande och långvariga påtryckningar från hela samhället behövs för att få de politiskt ansvariga att utöva det ledarskap som klimatkrisen kräver, skriver 171 forskare i samhällsvetenskap och humaniora.
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| 5. |
- Karlsson, Ann-Kristin, 1953, et al.
(författare)
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Depressed mood over time after open heart surgery impacts patient well-being: A combined study
- 2008
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Ingår i: European Journal of Cardiovascular Nursing. - Amsterdam : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 7:4, s. 277-283
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Tidskriftsartikel (refereegranskat)abstract
- Background: Depression is a common cause of decreased well-being after open heart surgery (OHS) and a risk factor for new cardiac events. Little is known about the long-term prevalence of depressive symptoms after OHS or their effect on well-being. The aim of this study was to explore the presence of depressed mood in patients during the recovery phase after open heart surgery as well as depressed mood and well-being 3 years later. Method: Eighty consecutively included patients completed a questionnaire about depressed mood at 5 weeks, 5 months and 3 years after OHS. A telephone interview took place after receipt of the third questionnaire to explore their well-being. Quantitative and qualitative data were analysed separately and thereafter together. Result: Depressed mood occurred in 52% of the patients during recovery or 3 years after OHS. The qualitative content analysis produced the theme of transition, which was based on three categories. Conclusion: Depressed mood was reported by the majority of patients during recovery after OHS and had a long-term effect on their well-being. OHS constituted a transition for all patients, but those with depressed mood had difficulty finishing the transition process and reorientating life.
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| 6. |
- Karlsson, Ann-Kristin, 1953
(författare)
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Open heart surgery and its consequences for well-being - the perspectives of patients, relatives and health care professionals
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Adjustment to open heart surgery (OHS) is complex and necessitates multidimensional explanations. The surgery does not always provide the desired outcome, which can contribute to reduced well-being among patients and their relatives. Health care professionals (HCPs) play an important role in detecting signs of reduced well-being. However, such signs in both patients and their relatives can be difficult to discover, as the patients? stay in hospital after surgery is short and the HCPs? workload high. Aim: The general aim of the thesis was to describe and explore OHS through patients? and relatives? experiences and HCPs? observations of its influence on well-being. Methods: Phenomenological interviews were performed with patients and relatives and analysed in accordance with Giorgi. HCPs involved with patients undergoing OHS participated in focus group discussions and the data were analysed by means of content analysis. Finally, patients who had been examined five weeks and five months after OHS participated in a follow-up study 3 years later, the data for which were collected by means of questionnaires and telephone interviews and evaluated using statistics in addition to content analysis. Quantitative and qualitative data were analysed both separately and together. Results: The essence of the patients? experience of OHS was ?fragility?, based on ?distance?, ?uncertainty?, ?vulnerability?, ?reliance? and ?gratitude?. The characteristic of their relatives was ?endurance? derived from the following constituents: ?unconditionality?, ?uncertainty?, ?mutuality? and ?sadness?. HCPs? sensitivity to signs of reduced well-being in patients and relatives after OHS formed the theme ?awareness of an exposed situation? based on the categories: ?signs of vulnerability? and ?signs of insecurity?. Depressed mood occurred in 52 % of the patients during recovery or three years after OHS. The theme ?transition?, which was based on three categories: ?adjusting oneself to conditional health?, ?positioning oneself in the surrounding world? and ?making an inner journey?, emerged from the qualitative content analysis. Conclusions: OHS was experienced as a great challenge, which changed the patients and made them fragile. Fragility remained in the life of all patients three years after OHS and was especially obvious in patients with depressed mood. This condition affected the majority of patients during recovery and also had an impact on their long-term well-being. OHS constituted a life transition for all patients, but those with depressed mood experienced disruptions while finishing their transitional process, which impeded reorientation. OHS had a major impact on the relatives, as it changed their lifeworld. The relatives? reaction was to show endurance, which involves the integrations of strength and vulnerability. HCPs recognised signs of reduced well-being in patients and their relatives after OHS. However, those most often recognised concerned the patients, while the relatives? well-being remained more or less unexplored.
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| 7. |
- Karlsson, Ann-Kristin, 1953, et al.
(författare)
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Well-being in patients and relatives after open-heart surgery from the perspective of health care professionals
- 2010
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Ingår i: Journal of Clinical Nursing. - Oxford : Wiley. - 1365-2702 .- 0962-1067. ; 19:5-6, s. 840-846
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to explore how health care professionals perceive the well-being of patients and relatives following open-heart surgery. BACKGROUND: Open-heart surgery is an extraordinary life event associated with hope and fear among both patients and relatives, thus they require attention from health care professionals. Patients' short stay in hospital after surgery and the workload of health care professionals increase the risk that reduced well-being will be overlooked. Health care professionals need to become familiar with the signs of reduced well-being. DESIGN: The study has an observational design and was performed using a qualitative method. METHOD: Health care professionals working with patients who have undergone open-heart surgery participated in focus group discussions. The data were analysed by means of content analysis. RESULTS: Two categories emerged: signs of vulnerability and signs of insecurity. The latent meaning of the study was interpreted as awareness of an exposed position. CONCLUSION: The health care professionals were aware of patients' and relatives' exposed position following open-heart surgery. Reduced well-being was communicated by bodily and emotional signs, which were captured using direct communication or intuition. RELEVANCE TO CLINICAL PRACTICE: Developing the ability to recognise signs of reduced well-being is important for minimising the negative influences associated with open-heart surgery for patients and relatives. Increased awareness that both anger and avoidance can mask depression is important. Patients and their relatives, particularly younger ones, should be observed to ensure early detection of a life crisis provoked by the heart disease. Furthermore, staff should invite patients and their partners to talk about sexuality. Changes aimed at increasing patients' and relatives' well-being would be facilitated by interdisciplinary teamwork, 'reflection groups' for a greater exchange of knowledge and the implementation of a patient/family perspective. The latter would lead to greater interest in the relatives' situation and position in cardiac care.
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