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- Wåhlin, Ingrid, 1955-, et al.
(författare)
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Empowerment from the perspective of next of kin in intensive care
- 2009
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 18:18, s. 2580-2587
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. The aim of the study was to describe next of kin empowerment in an intensive care situation. Background. Next of kin is important in reducing intensive care patients’ fear and anxiety. However, admission to an intensive care unit is often recognised as an extremely stressful event, causing next of kin to experience shock, fear, anxiety and vulnerability. More knowledge is needed about how next of kin in intensive care can be strengthen and empowered. Design and methodology. The study was conducted using a phenomenological method and is based on ten interviews with intensive care patients’ next of kin. Findings. Perceptions of both a genuine will and a capacity to help and relieve were found to be essential for next of kin’s experiences of empowerment in an intensive care situation. All informants were strengthened and empowered by a caring atmosphere in which they received continuous, straightforward and honest information that left room for hope, and in which closeness to the patient was facilitated and medical care was experienced as the best possible. Some of the informants were also strengthened by support from other family members and/or by being involved in caring for the patient. Conclusions. The findings emphasise the essential entirety of what is done and how these acts are performed. A warm and positive atmosphere in which next of kin always feel welcome, are met with empathy in an unaffected way, are confirmed and receive support or advice when needed, are crucial to next of kin’s experiences of empowerment. Relevance to clinical practice. Knowledge of how to empower next of kin in an intensive care situation allows caring staff to support these persons in a more sensitive and appropriate way. Findings underline the importance of creating caring relations.
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| 2. |
- Wåhlin, Ingrid, 1955-, et al.
(författare)
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Staff empowerment in intensive care : nurses' and physicians' lived experiences
- 2010
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Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 26:5, s. 262-269
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Aim The purpose of the study was to describe empowerment from the perspective of intensive care staff. What makes intensive care staff experience inner strength and power? Background Intensive care staff are repeatedly exposed to traumatic situations and demanding events, which could result in stress and burnout symptoms. A higher level of psychological empowerment at the workplace is associated with increased work satisfaction and mental health, fewer burnout symptoms and a decreased number of sick leave days. Method Open-ended interviews were conducted with 12 intensive care unit (ICU) staff (four registered nurses, four enrolled nurses and four physicians) in southern Sweden. Data were analysed using a phenomenological method. Findings Intensive care staff were found to be empowered both by internal processes such as feelings of doing good, increased self-esteem/self-confidence and increased knowledge and skills, and by external processes such as nourishing meetings, well functioning teamwork and a good atmosphere. Conclusion Findings show that not only personal knowledge and skills, but also a supporting atmosphere and a good teamwork, has to be focused and encouraged by supervisors in order to increase staff's experiences of empowerment. Staff also need a chance to feel that they do something good for patients, next of kin and other staff members.
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| 3. |
- Wåhlin, Ingrid, 1955-
(författare)
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The circle of strength and power : Experiences of empowerment in intensive care
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Patients and next of kin in intensive care often experience powerlessness, anxiety and distress and intensive care staff are repeatedly exposed to traumatic situations and demanding events. Empowerment has been described as a process of overcoming a sense of powerlessness and a model through which people may develop a sense of inner strength through connections with others. The aim of this thesis was to describe empowerment as experienced by patients, next of kin and staff in intensive care and to compare patient's experiences with staff and next of kin beliefs. Empowerment is reflected in this thesis as experiences of inner strength and power and of participation/self-determination.The study was based on open-ended interviews with 11 patients, 12 next of kin and 12 staff members from two intensive care units in southern Sweden. A phenomenological perspective was applied in three studies, while a qualitative content analysis was used in the forth study.Findings showed that nourishing relationships were of crucial importance, and contributed to every participant's experiences of empowerment regardless of whether he/she was an intensive care patient, a next of kin or a staff member. Patients were found to be strengthened and empowered by a positive environment where their own inherent joy of life and will to fight was stimulated, where they felt safe and a sense of value and motivation were encouraged and where they were taken seriously and listened to. Next of kin were extremely important to patients' experiences of safety, value, human warmth and motivation, and patients were strengthened when their next of kin were acknowledge and welcomed by staff.Next of kin in intensive care were strengthened and empowered by a caring atmosphere in which they received continuous, straightforward and honest information that left room for some hope and in which closeness to the patient was facilitated and medical care was experienced as the best possible. Some informants were also empowered by family support and/or participation in caring for the patient. Intensive care staff were empowered by both internal processes such as feelings of doing good, increased self-esteem/self-confidence and increased knowledge and skills, and by external processes such as nourishing meetings, excitement and challenge, well functioning teamwork and good atmosphere.When comparing patient experiences with staff and next of kin beliefs, there was agreement regarding joy of life and will to fight being essential to patients' experiences of inner strength and power, but staff and next of kin seemed to see this as a more constant individual viewpoint or characteristic than the patient did. Next of kin, and especially staff, seemed to regard the patient as more unconscious and unable to participate in the communication and interaction process than the patient him/herself experienced. A mutual and friendly relationship was experienced by the patients as highly empowering, while a more professional relationship was emphasized by the staff. These findings could serve as a basis for reflection about patient, next of kin and staff experiences of strength and power and if empowerment is seen as a dimension in quality of care, the findings from this thesis ought to be taken into consideration to increase the quality of care in intensive care.
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| 4. |
- Ziegelasch, Michael, et al.
(författare)
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Anti-cyclic citrullinated peptide antibodies are associated with radiographic damage but not disease activity in early rheumatoid arthritis diagnosed in 2006-2011
- 2020
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Ingår i: Scandinavian Journal of Rheumatology. - : Taylor & Francis. - 0300-9742 .- 1502-7732. ; 49:6, s. 434-442
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The discovery of anti-citrullinated protein antibodies (ACPAs) and the introduction of new therapeutic options have had profound impacts on early rheumatoid arthritis (RA) care. Since ACPA status, most widely assessed as reactivity to cyclic citrullinated peptides (CCPs), influences treatment decisions in early RA, we aimed to determine whether anti-CCP remains a predictor of disease activity and radiographic joint damage in more recent 'real-world' early RA.Method: Two observational early RA cohorts from Sweden enrolled patients in 1996-1999 (TIRA-1, n = 239) and 2006-2009 (TIRA-2, n = 444). Clinical and radiographic data and ongoing treatment were prospectively collected up to 3 years. Two other cohorts served as confirmation cohorts (TRAM-1, with enrolment 1996-2000, n = 249; and TRAM-2, 2006-2011, n = 528). Baseline anti-CCP status was related to disease activity, pharmacotherapy, and radiographic joint damage according to Larsen score.Results: In the TIRA-1 cohort, anti-CCP-positive patients had significantly higher 28-joint Disease Activity Score, swollen joint count, C-reactive protein level, and erythrocyte sedimentation rate during follow-up compared with anti-CCP-negative patients. In TIRA-2, no such differences were found, but baseline anti-CCP positivity was associated with higher 3 year Larsen score (5.4 vs 3.5, p = 0.039). In TRAM-2, anti-CCP also predicted radiographic damage (8.9 vs 6.7, p = 0.027), with no significant differences in disease activity.Conclusion: In the early RA cohorts recruiting patients in 2006-2011, baseline anti-CCP positivity was not associated with disease activity over time, but was associated with increased radiographic damage at follow-up. Hence, close radiographic monitoring is warranted in early anti-CCP-positive RA regardless of disease activity.
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