| 1. |
- Johansson, Lotta, 1965, et al.
(författare)
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Evaluation of a sound environment intervention in an ICU : A feasibility study
- 2018
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Ingår i: Australian Critical Care. - Amsterdam : Elsevier. - 1036-7314 .- 1878-1721. ; 31:2, s. 59-70
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Tidskriftsartikel (refereegranskat)abstract
- Background: Currently, it is well known that the sound environment in intensive care units (ICU) is substandard. Therefore, there is a need of interventions investigating possible improvements. Unfortunately, there are many challenges to consider in the design and performance of clinical intervention studies including sound measurements and clinical outcomes.Objectives: (1) explore whether it is possible to implement a full-scale intervention study in the ICU concerning sound levels and their impact on the development of ICU delirium; (2) discuss methodological challenges and solutions for the forthcoming study; (3) conduct an analysis of the presence of ICU delirium in the study group; and (4) describe the sound pattern in the intervention rooms.Methods: A quasi-randomized clinical trial design was chosen. The intervention consisted of a refurbished two-bed ICU patient room (experimental) with a new suspended wall-to-wall ceiling and a low frequency absorber. An identical two-bed room (control) remained unchanged.Inclusion criteria: Patients >18 years old with ICU lengths of stay (LoS) >48. h. The final study group consisted of 31 patients: six from the rebuilt experimental room and 25 from the control room. Methodological problems and possible solutions were continuously identified and documented.Results: Undertaking a full-scale intervention study with continuous measurements of acoustic data in an ICU is possible. However, this feasibility study demonstrated some aspects to consider before start. The randomization process and the sound measurement procedure must be developed. Furthermore, proper education and training are needed for determining ICU delirium.Conclusion: This study raises a number of points that may be helpful for future complex interventions in an ICU. For a full-scale study to be completed a continuously updated cost calculation is necessary. Furthermore, representatives from the clinic need to be involved in all stages during the project.
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| 2. |
- Lindahl, Berit, 1955, et al.
(författare)
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A meta-synthesis describing the relationships between patients, informal caregivers and health professionals in home-care settings
- 2011
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 20:3/4, s. 454-463
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Tidskriftsartikel (refereegranskat)abstract
- The present study describes, through a meta-synthesis, the relationship between patients, informal caregivers and health professionals involved in home care. Today, many people receive help from health care professionals in their homes with the consequence that, for many health care professionals, their working place is the patients' homes. Research that addresses the dynamics in the caring relationship in home care seems to be rare. A meta-synthesis is an integrated interpretation of qualitative research findings, which is more substantive than the results from each individual investigation. We performed a systematic literature search regarding studies published during the period 1992-2005, using the search terms home nursing, professional and home health care. The included studies described relations in a home care context, between health professionals and patients or relations between health professionals, patients and their informal caregivers published in the same study. The fi ; ndings showed that when professionals entered people's home, the private area changed. The study presents an interpretation of the changed meanings of home as the place and space for professional care. We described the meanings of the relationship in two main themes with subthemes. The main themes are 'being there' and 'home care as a co-creation'. The understanding of relationships in home care is seen as the development of a professional friendship. This concept is reflected on through the writings of Aristotle and Alberoni. To address these concerns, it is important that home care providers, recipients and their family members develop friendships. These friendships should be a part of any professional relationship. When health professionals enter patients' homes, they have to be aware of the risk of transgressing borders of privacy. In addition, devaluing patients' or their informal caregivers' knowledge and their opinions about the care is interpreted as an exercise of institutiona ; l power.
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| 3. |
- Andersson, Morgan, et al.
(författare)
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Is it possible to feel at home in a patient room in an intensive care unit? Reflections on environmental aspects in technology dense environments : Is it possible to feel at home in a patient room in an intensive care unit?
- 2019
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Ingår i: Nursing Inquiry. - London : Wiley-Blackwell Publishing Inc.. - 1320-7881 .- 1440-1800.
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Tidskriftsartikel (refereegranskat)abstract
- This paper focuses on the patient’s perspective and the philosophical underpinnings that support what might be considered optimal for the future design of the Intensive Care Unit (ICU) patient room. It also addresses the question of whether the aspects that support at-homeness are applicable to ICU patient rooms. The concept of ‘at-homeness’ in ICUs is strongly related to privacy and control of space and territory. This study investigates whether the sense of at-homeness can be created in an ICU, when one or more patients share a room. From an interdisciplinary perspective, we critically reflect on various aspects associated with conflicts surrounding the use of ICU patient rooms. Thus, from an architectural and a caring perspective, the significance of space and personal territory in ICU patient rooms is emphasized. Recommendations for further research are suggested. In conclusion, privacy and control are deemed to be essential factors in the stimulation of recovery processes and the promotion of wellbeing in situations involving severe illness or life-threatening conditions.
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| 4. |
- Björk, Kristofer, 1985-, et al.
(författare)
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Family members’ experiences of waiting in intensive care: a concept analysis
- 2019
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Ingår i: Scandinavian Journal of Caring Sciences. - London : Wiley. - 0283-9318 .- 1471-6712. ; , s. 1-18
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Tidskriftsartikel (refereegranskat)abstract
- AIM:The aim of this study was to explore the meaning of family members' experience of waiting in an intensive care context using Rodgers' evolutionary method of concept analysis.METHOD:Systematic searches in CINAHL and PubMed retrieved 38 articles which illustrated the waiting experienced by family members in an intensive care context. Rodgers' evolutionary method of concept analysis was applied to the data.FINDINGS:In total, five elements of the concept were identified in the analysis. These were as follows: living in limbo; feeling helpless and powerless; hoping; enduring; and fearing the worst. Family members' vigilance regarding their relative proved to be a related concept, but vigilance does not share the same set of attributes. The consequences of waiting were often negative for the relatives and caused them suffering. The references show that the concept was manifested in different situations and in intensive care units (ICUs) with various types of specialties.CONCLUSIONS:The application of concept analysis has brought a deeper understanding and meaning to the experience of waiting among family members in an intensive care context. This may provide professionals with an awareness of how to take care of family members in this situation. The waiting is inevitable, but improved communication between the ICU staff and family members is necessary to reduce stress and alleviate the suffering of family members. It is important to acknowledge that waiting cannot be eliminated but family-centred care, including a friendly and welcoming hospital environment, can ease the burden of family members with a loved one in an ICU.
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| 5. |
- Dahlborg Lyckhage, Elisabeth, 1974-, et al.
(författare)
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A Theoretical Framework for Emancipatory Nursing With a Focus on Environment and Persons’ Own and Shared Lifeworld : A Theoretical Framework for Emancipatory Nursing
- 2018
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Ingår i: Advances in Nursing Science. - 0161-9268 .- 1550-5014. ; 41:4, s. 340-350
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Tidskriftsartikel (refereegranskat)abstract
- By giving a brief overview of the meta concepts in nursing, with a focus on environment, we sketch a theoretical framework for an emancipatory perspective in nursing care practice. To meet the requirements of equality in care and treatment, we have in our theoretical framework added a critical lifeworld perspective to the anti oppressive practice, to meet requirements of equity in health care encounter. The proposed model of emancipatory nursing goes from overall ideological structures to ontological aspects of the everyday world. Based on the model, nurses could identify what kind of theoretical critical knowledge and thinking they require to conduct equal care and encounter the person behind the patient role.
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| 6. |
- Egerod, I., et al.
(författare)
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The patient experience of intensive care: A meta-synthesis of Nordic studies
- 2015
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 52:8, s. 1354-1361
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sedation practices in the intensive care unit have evolved from deep sedation and paralysis toward lighter sedation and better pain management. The new paradigm of sedation has enabled early mobilization and optimized mechanical ventilator weaning. Intensive care units in the Nordic countries have been particularly close to goals of lighter or no sedation and a more humane approach to intensive care. Objectives: The aim of our study was to systematically review and reinterpret newer Nordic studies of the patient experience of intensive care to obtain a contemporary description of human suffering during life-threatening illness. Design: We conducted a meta-synthesis in which we collected, assessed, and analyzed published qualitative studies with the goal of synthesizing these findings into a new whole. Analysis was based on the scientific approach of Gadamerian hermeneutics. Methods: We performed a literature search of qualitative studies of the patient experience of intensive care based on Nordic publications in 2000-2013. We searched the following databases: PubMed, CINAHL, Scopus, and PsycINFO. Each original paper was assessed by all authors using the Critical Appraisal Skills Program instrument for qualitative research. We included 22 studies, all of which provided direct patient quotes. Results: The overarching theme was identified as: The patient experience when existence itself is at stake. We constructed an organizing framework for analysis using the main perspectives represented in the included studies: body, mind, relationships, and ICU-environment. Final analysis and interpretation resulted in the unfolding of four themes: existing in liminality, existing in unboundedness, existing in mystery, and existing on the threshold. Conclusions: Our main finding was that human suffering during intensive care is still evident although sedation is lighter and the environment is more humane. Our interpretation suggested that patients with life-threatening illness descend into a liminal state, where they face the choice of life or death. Caring nurses and family members play an important role in assisting the patient to transition back to life. (C) 2015 Elsevier Ltd. All rights reserved.
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| 7. |
- Egerod, I., et al.
(författare)
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Trends and recommendations for critical care nursing research in the Nordic countries: Triangulation of review and survey data
- 2020
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Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397. ; 56
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Tidskriftsartikel (refereegranskat)abstract
- Background: Priorities for critical care nursing research have evolved with societal trends and values. In the 1980s priorities were the nursing workforce, in 1990s technical nursing, in 2000s evidence-based nursing and in 2010s symptom management and family-centred care. Objectives: To identify current trends and future recommendations for critical care nursing research in the Nordic countries. Methods: We triangulated the results of a literature review and a survey. A review of two selected critical care nursing journals (2016-2017) was conducted using content analysis to identify contemporary published research. A self-administered computerised cross-sectional survey of Nordic critical care nursing researchers (2017) reported current and future areas of research. Results: A review of 156 papers identified research related to the patient (13%), family (12%), nurse (31%), and therapies (44%). Current trends in the survey (n = 76, response rate 65%) included patient and family involvement, nurse performance and education, and evidence-based protocols. The datasets showed similar trends, but aftercare was only present in the survey. Future trends included symptom management, transitions, rehabilitation, and new nursing roles. Conclusion: Critical care nursing research is trending toward increased collaboration with patient and family, delineating a shift toward user values. Recommendations include long-term outcomes and impact of nursing. (C) 2019 Elsevier Ltd. All rights reserved.
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| 8. |
- Engwall, Marie, et al.
(författare)
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Patients' Self-Reported Recovery After an Environmental Intervention Aimed to Support Patient's Circadian Rhythm in Intensive Care
- 2021
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Ingår i: Herd-Health Environments Research & Design Journal. - : SAGE Publications. - 1937-5867 .- 2167-5112. ; 14:4, s. 194-210
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients in intensive care units (ICUs) are among the most vulnerable, and they require support to start their recovery. The design of the patient area in the ICU can play a prominent role in both the quality of care and patients' recovery. The lighting environment has the opportunity to restore and strengthen the natural human circadian rhythm and health. Aim: To evaluate patients' self-reported recovery after being cared for in an ICU room rebuilt according to evidence-based design principles that promote recovery. Method: An intervention was set up in a two-bed patient room including a cycled lighting system. Self-reported recovery was reported at 6 and 12 months after discharge. Data were analyzed using a 2(mechanically ventilated, nonmechanically ventilated) x 2(intervention room, ordinary room) analysis of covariance (ANCOVA) and 2(male, women) x 2(intervention room, ordinary room) ANCOVA. Results: Data from the different rooms showed no significant main effects for recovery after 6 months, p = .21; however, after 12 months, it become significant, p. < .05. This indicated that patient recovery was positively influenced for patients cared for in the intervention room (M = 8.88, SD = 4.07) compared to the ordinary room (M = 10.90, SD = 4.26). There were no interaction effects for gender or if the patients had been mechanically ventilated either at 6 or 12 months' postdischarge. Conclusions: A cycled lighting system may improve patient self-reported recovery after ICU care; however, more research on the topic is needed.
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| 9. |
- Engwall, Marie, 1964, et al.
(författare)
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The effect of cycled lighting in the intensive care unit on sleep, activity and physiological parameters: A pilot study
- 2017
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Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 41, s. 26-32
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Tidskriftsartikel (refereegranskat)abstract
- Patients in intensive care suffer from severe illnesses or injuries and from symptoms related to care and treatments. Environmental factors, such as lighting at night, can disturb patients' circadian rhythms. The aim was to investigate whether patients displayed circadian rhythms and whether a cycled lighting intervention would impact it. In this pilot study (N=60), a cycled lighting intervention in a two -bed patient room was conducted. An ordinary hospital room functioned as the control. Patient activity, heart rate, mean arterial pressure and body temperature were recorded. All data were collected during the patients' final 24h in the intensive care unit. There was a significant difference between day and night patient activity within but not between conditions. Heart rates differed between day and night significantly for patients in the ordinary room but not in the intervention room or between conditions. Body temperature was lowest at night for all patients with no significant difference between conditions. Patients in both conditions had a natural circadian rhythm; and the cycled lighting intervention showed no significant impact. As the sample size was small, a larger repeated measures study should be conducted to determine if other types of lighting or environmental factors can impact patients' well-being. (C) 2017 Elsevier Ltd. All rights reserved.
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| 10. |
- Eriksson, Thomas, et al.
(författare)
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Hermeneutic observational studies: describing a method
- 2021
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Ingår i: Scandinavian Journal of Caring Sciences. - Nordic College of Caring Science : Wiley. - 0283-9318 .- 1471-6712. ; 35:1, s. 319-327
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Tidskriftsartikel (refereegranskat)abstract
- There is a need to develop and use research observations in the clinical field, primarily to gain insight
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