| 1. |
- Andersson, Susanne, et al.
(författare)
-
Attitudes Regarding Participation in a Diabetes Screening Test among an Assyrian Immigrant Population in Sweden
- 2016
-
Ingår i: Nursing Research and Practice. - : Hindawi Limited. - 2090-1429 .- 2090-1437.
-
Tidskriftsartikel (refereegranskat)abstract
- Immigrants from the Middle East have higher prevalence and incidence of type 2 diabetes (T2D) compared with native Swedes. The aim of the study was to describe and understand health beliefs in relation to T2D as well as attitudes regarding participation in a screening process in a local group of Assyrian immigrants living in Sweden. A qualitative and quantitative method was chosen in which 43 individuals participated in a health check-up and 13 agreed to be interviewed. Interviews were conducted, anthropometric measurements and blood tests were collected, and an oral glucose tolerance test was performed. In total, 13 of the 43 participants were diagnosed with impaired glucose metabolism, 4 of these 13 had TD2. The interviewed participants perceived that screening was an opportunity to discover more about their health and to care for themselves and their families. Nevertheless, they were not necessarily committed to taking action as a consequence of the screening. Instead, they professed that their health was not solely in their own hands and that they felt safe that God would provide for them. Assyrians' background and religion affect their health beliefs and willingness to participate in screening for TD2.
|
|
| 2. |
- Bergbom, Ingegerd, 1947, et al.
(författare)
-
Developing and evaluating an instrument to measure Recovery After INtensive care : the RAIN instrument
- 2018
-
Ingår i: BMC Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 17:1
-
Tidskriftsartikel (refereegranskat)abstract
- Measuring and evaluating patients' recovery, following intensive care, is essential for assessing their recovery process. By using a questionnaire, which includes spiritual and existential aspects, possibilities for identifying appropriate nursing care activities may be facilitated. The study describes the development and evaluation of a recovery questionnaire and its validity and reliability.
|
|
| 3. |
- Bernson, Elin, 1987, et al.
(författare)
-
Identification of Tissue-Resident Natural Killer and T Lymphocytes with Anti-Tumor Properties in Ascites of Ovarian Cancer Patients
- 2023
-
Ingår i: Cancers. - 2072-6694. ; 15:13
-
Tidskriftsartikel (refereegranskat)abstract
- Simple Summary Ovarian cancer is the deadliest among gynecological cancers, and there is a huge demand for new treatments for these patients. Immunotherapy holds great potential in cancer treatment, but has not yet proven successful for the majority of ovarian cancer patients. To better understand the immunological landscape of the disease, we have characterized lymphocytes in patients with high-grade serous ovarian cancer. Natural killer cells and T cells are present in both primary tumors and in the metastasizing environment of ascites, a fluid in the abdominal cavity that is developed in many patients with ovarian cancer. Our data reveal that a large fraction of these natural killer cells and T cells express tissue-resident markers and the inhibitory receptor, NKG2A, and are able to kill ovarian cancer cells. In summary, we report a functional subset of lymphocytes that may be targeted in future immunotherapeutic approaches. Women with ovarian cancer have limited therapy options, with immunotherapy being unsatisfactory for a large group of patients. Tumor cells spread from the ovary or the fallopian tube into the abdominal cavity, which is commonly accompanied with massive ascites production. The ascites represents a unique peritoneal liquid tumor microenvironment with the presence of both tumor and immune cells, including cytotoxic lymphocytes. We characterized lymphocytes in ascites from patients with high-grade serous ovarian cancer. Our data reveal the presence of NK and CD8(+) T lymphocytes expressing CD103 and CD49a, which are markers of tissue residency. Moreover, these cells express high levels of the inhibitory NKG2A receptor, with the highest expression level detected on tissue-resident NK cells. Lymphocytes with these features were also present at the primary tumor site. Functional assays showed that tissue-resident NK cells in ascites are highly responsive towards ovarian tumor cells. Similar results were observed in an in vivo mouse model, in which tissue-resident NK and CD8(+) T cells were detected in the peritoneal fluid upon tumor growth. Together, our data reveal the presence of highly functional lymphocyte populations that may be targeted to improve immunotherapy for patients with ovarian cancer.
|
|
| 4. |
- Holm, Anna, et al.
(författare)
-
Nurses' communication with mechanically ventilated patients in the intensive care unit : Umbrella review
- 2020
-
Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 76:11, s. 2909-2920
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: To conduct a review summarizing evidence concerning communication with mechanically ventilated patients in the intensive care unit (ICU).BACKGROUND: ICU patients undergoing mechanical ventilation are unable to communicate verbally, causing many negative emotions. Due to changes in sedation practice, a growing number of patients are conscious and experience communication difficulties.DESIGN: The umbrella review method guided by the Joanna Briggs Institute was applied.DATA SOURCES: A systematic search was done in the Cochrane Library, the Joanna Briggs Institute database, Cinahl, Pubmed, PsycINFO and Scopus between January -April 2019. Search terms were 'nurse-patient communication', 'mechanical ventilation', 'intensive care', and 'reviews as publication type'. Literature from 2009-2019 was included.REVIEW METHODS: Following recommendations by the Joanna Briggs Institute, a quality appraisal, data extraction, and synthesis were done.RESULTS: Seven research syntheses were included. There were two main themes and six subthemes: (1) Characterization of the nurse-patient communication: (a) Patients' communication; (b) Nurses' communication; (2) Nursing interventions that facilitate communication: (a) Communication assessment and documentation; (b) Communication methods and approaches; (c) Education and training of nurses; and (d) Augmentative and alternative communication.CONCLUSION: Nurse-patient communication was characterized by an unequal power relationship with a common experience - frustration. Four key interventions were identified and an integration of these may be key to designing and implementing future ICU communication packages.IMPACT: Nurse-patient communication is characterized by an unequal power relationship with one joint experience - frustration. Four key interventions should be integrated when designing and implementing communication packages in the ICU. Findings are transferable to ICU practices where patients are conscious and experience communication difficulties.
|
|
| 5. |
- Holm, Anna, et al.
(författare)
-
Nurses’ experiences of serving as a communication guide and supporting the implementation of a communication intervention in the intensive care unit
- 2021
-
Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis Group. - 1748-2623 .- 1748-2631. ; 16:1
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore the experience of serving as a nurse communication guide, supporting the bottom-up implementation of a multi-component communication intervention prototype in the intensive care unit.Methods: The overall frame was Complex Interventions, and the study was conducted within the phenomenological-hermeneutic tradition. Semi-structured telephone interviews were conducted with eight nurse communication guides. Data were analysed using a Ricoeur-inspired interpretation method.Results: Two main themes emerged: 1) “The communication intervention components provided overview, a conceptual framework, awareness and room for reflection” and 2) “Being a communication guide illuminated the barriers and challenges of implementation”. Furthermore, a comprehensive understanding was established that illuminated experiences throughout the analysis: “An ICU communication intervention has to be adaptable to the specific situation and the double need for individualization but also provide overall guidance”.Conclusion: Findings showed that as communication is inherent to all human beings, it can be difficult to change the communication behaviour of nurses. Therefore, a communication intervention in the intensive care unit must be sensitive to the nurse communication guides’ individual communication style. Furthermore, a communication intervention should provide nurse communication guides with overall guidance while at the same time remaining adaptable to the needs of each specific situation.
|
|
| 6. |
- Holm, Anna, et al.
(författare)
-
Strengthening and supporting nurses’ communication with mechanically ventilated patients in the intensive care unit : Development of a communication intervention
- 2021
-
Ingår i: International Journal of Nursing Studies Advances. - : Elsevier. - 2666-142X. ; 3
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Nurse-patient communication in intensive care units is challenged by the fact that patients are voiceless due to intubation and mechanical ventilation. Difficult communication affects nurses negatively, and it requires knowledge and expertise to facilitate communication in this complex and technologically tense setting. Augmentative and alternative communication has been suggested as a way of optimising communication; several approaches can be combined in a multi-component intervention. Also, a communication algorithm has been proposed as a way of providing structure in patient communication. To enhance transparency and avoid poorly reported interventions, this paper describes the process, rationale and reflections behind developing a communication intervention called the ICU-COM.Objectives: To present the development process of a communication intervention prototype that aims to support and strengthen nurses’ communication with mechanically ventilated patients in an intensive care unit.Design: The Medical Research Council's framework for developing complex interventions in health was applied. The approach was target-population centred.Settings: The intervention was developed and tailored to four intensive care unit departments at Aarhus University Hospital in Denmark.Participants: Intensive care nurses and various experts, namely, speech-language pathologists, graphic designers, a software company, the local Centre for E-learning and nurse specialists were involved in its development.Results: An intervention consisting of: 1) a multi-component communication bundle, 2) delivery of the bundle via a teaching session and 3) initial implementation via nurse communication guides was developed. The communication bundle contained: 1) a communication strategy with a BASIS framework and algorithm, 2) a nurse education programme and 3) low-tech and high-tech communication tools.Conclusions: A systematic approach was applied in the development process. However, the acceptability and feasibility of the intervention is at present unknown.
|
|
| 7. |
- Karlsson, Veronika, 1972
(författare)
-
Att vårdas vaken med respirator : patienters och närståendes upplevelser från en intensivvårdsavdelning
- 2012
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In recent years, light or no sedation has become a common approach in patients who require mechanical ventilation (MV) when cared for in an intensive care unit (ICU). This new approach has resulted in medical advantages as well as a shorter time on MV and in the ICU. Aim: The overall objective of the thesis was to describe, illuminate and interpret patients' and relatives' experiences of caring and communication in connection with MV while the patient is conscious. Methods: The data collection methods were inductive and included interviews and observations, both audiotaped and video-recorded. The study group consisted of patients and relatives; fourteen patients in paper I, twelve in paper II and nineteen in paper III as well as ten relatives in paper IV. In paper I, the video-recorded interviews were analysed using content analysis and hermeneutics. The text in paper II was analysed using the phenomenological-hermeneutic method inspired by Ricoeur. The observations in paper III were analysed by means of a hermeneutic approach based on Gadamer's philosophy. In paper IV, relatives were interviewed on two occasions. The text from these interviews was also analysed using a hermeneutic method inspired by Gadamer. Results: The patients experienced an overall sense of being breathless. While conscious, they were aware of the mechanical ventilator as a life saver. Besides being breathless, being voiceless was considered the worst aspect. Communication was difficult and awkward as it demanded all their will power. Patients' communication patterns varied but there were commonalities; they also developed an individual style of communication. Being subjected to someone else's will and direction meant being painfully aware of one's dependency. Despite this, the patients struggled for independence in various ways as part of the recovery process. Being conscious while receiving MV demands caring communication, which in turn requires proximity, presence and constant attention by a nurse who is "standing by" and prepared to take care of the patient whatever happens. The patients' non-verbal communication through their gaze and facial expression was interpreted as sadness and sorrow, understood as expressions of unuttered suffering. The overall struggle and primary existential aim of relatives in the ICU is to be in contact with the patient, a need which overshadows everything else. Conclusion: Being conscious during MV means being painfully aware of one's dependency while voiceless and helpless. It is possible to endure this situation when the caregivers are "standing by", attentive to the patients' expressions, prepared to act to make sure that the patients are feeling better and do not leave them unattended. Caring for a conscious patient on MV presupposes nurses' ability to understand and be able to "standing by". If this approach is not possible, consciousness might be too painful and sedation should be considered.
|
|
| 8. |
- Karlsson, Veronika, 1972-
(författare)
-
Att vårdas vaken med respirator : patienters och närståendes upplevelser från en intensivvårdsavdelning
- 2012
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In recent years, light or no sedation has become a common approach in patients who require mechanical ventilation (MV) when cared for in an intensive care unit (ICU). This new approach has resulted in medical advantages as well as a shorter time on MV and in the ICU. Aim: The overall objective of the thesis was to describe, illuminate and interpret patients' and relatives' experiences of caring and communication in connection with MV while the patient is conscious. Methods: The data collection methods were inductive and included interviews and observations, both audiotaped and video-recorded. The study group consisted of patients and relatives; fourteen patients in paper I, twelve in paper II and nineteen in paper III as well as ten relatives in paper IV. In paper I, the video-recorded interviews were analysed using content analysis and hermeneutics. The text in paper II was analysed using the phenomenological-hermeneutic method inspired by Ricoeur. The observations in paper III were analysed by means of a hermeneutic approach based on Gadamer's philosophy. In paper IV, relatives were interviewed on two occasions. The text from these interviews was also analysed using a hermeneutic method inspired by Gadamer. Results: The patients experienced an overall sense of being breathless. While conscious, they were aware of the mechanical ventilator as a life saver. Besides being breathless, being voiceless was considered the worst aspect. Communication was difficult and awkward as it demanded all their will power. Patients' communication patterns varied but there were commonalities; they also developed an individual style of communication. Being subjected to someone else's will and direction meant being painfully aware of one's dependency. Despite this, the patients struggled for independence in various ways as part of the recovery process. Being conscious while receiving MV demands caring communication, which in turn requires proximity, presence and constant attention by a nurse who is "standing by" and prepared to take care of the patient whatever happens. The patients' non-verbal communication through their gaze and facial expression was interpreted as sadness and sorrow, understood as expressions of unuttered suffering. The overall struggle and primary existential aim of relatives in the ICU is to be in contact with the patient, a need which overshadows everything else. Conclusion: Being conscious during MV means being painfully aware of one's dependency while voiceless and helpless. It is possible to endure this situation when the caregivers are "standing by", attentive to the patients' expressions, prepared to act to make sure that the patients are feeling better and do not leave them unattended. Caring for a conscious patient on MV presupposes nurses' ability to understand and be able to "standing by". If this approach is not possible, consciousness might be too painful and sedation should be considered.
|
|
| 9. |
- Karlsson, Veronika, 1972, et al.
(författare)
-
Communication when patients are conscious during respirator treatment : A hermeneutic observation study
- 2012
-
Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 28:4, s. 197-207
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to observe, interpret and describe nurses' communication with conscious patients receiving mechanical ventilation treatment (MVT) in an intensive care unit(ICU), and to examine if such communication could be interpreted as caring. Design: Hermeneutic observational study inspired by the philosophy of Gadamer. Method: Nineteen patients were observed on several occasions for a total of 66 hours, when conscious during MVT. Findings: A form of caring communication was identified and interpreted as comprising seven themes: being attentive and watchful, being inclusive and involving, being connected, remaining close, being reassuring and providing security, keeping company and using humour and using a friendly approach. Communication that mediated a non-caring approach was also identified and described under two thematic headings, i.e. being neglectful and being absent. Conclusions: Caring is communicated by the caring act of ''standing-by'' the patient. Caring or non-caring is communicated in non-verbal and verbal communication, in the words used, the tone of voice and behaviour, as well as in the performance of nursing care activities.
|
|
| 10. |
- Karlsson, Veronika, 1972, et al.
(författare)
-
Health is yearning--experiences of being conscious during ventilator treatment in a critical care unit.
- 2008
-
Ingår i: Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses. - Edinburgh : Elsevier BV. - 0964-3397 .- 1532-4036. ; 24:1, s. 41-50
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate experiences of being conscious during ventilator treatment in the ICU from a patient perspective. Hermeneutic, phenomenological methods were used. Eight patients who had received ventilator treatment were interviewed. The time on a ventilator varied from 1 day to several months. Some patients had been more heavily sedated during the acute phase while some were only lightly sedated and others had no sedation at all. The motor activity assessment scale was used to rate the sedation level. The patients had been sufficiently conscious to communicate with the help of the alphabet board, by means of facial expression or by nodding or shaking their head. The results show that the experience of care by patients who were conscious during ventilator treatment was described under the headings of: memories, mastering the situation and individual consequences. Health in the ICU is associated with yearning. The patient undergoes different stages of yearning as part of his or her recovery process. The patient who is conscious during ventilator treatment views him/herself and his/her worth on the basis of the attitude and behaviour of the caregivers, where the value of caring consists of the holistic confirmation of individual suffering.
|
|
