| 1. |
- Carnesten, Hillewi, et al.
(author)
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Battling extraordinary situations and conflicting emotions : A qualitative study of being a newly graduated Registered Nurse in the emergency department during the COVID-19 pandemic
- 2022
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In: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 9:5, s. 2370-2380
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Journal article (peer-reviewed)abstract
- Aim: To describe newly graduated registered nurses' (NGRNs') experiences of encountering stress in emergency departments (EDs) during the COVID-19 pandemic. Design: A qualitative descriptive study. Methods: Data from 14 in-depth interviews with NGRNs working in an ED for 3-36 months after graduation was analysed by the means of qualitative content analysis as described by Graneheim and Lundman. Interviews were conducted from March to November 2020 covering the first two waves of the pandemic. Results: Data revealed three categories and nine subcategories comprised in the theme Battling extraordinary situations and conflicting emotions. Empowered by acknowledging themselves as important caregivers during the pandemic NGRNs struggle against limitations and exert themselves beyond their known limit. External stressors due to work overload in combination with understaffing force NGRNs into the role of the experienced nurse prematurely and internal stressors derives from part taking in less qualitative care.
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| 2. |
- Carnesten, Hillewi, et al.
(author)
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Caring through barriers—Newly graduated registered nurses' lived experiences in emergency departments during the COVID-19 pandemic
- 2023
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In: Journal of Advanced Nursing. - : John Wiley and Sons Inc. - 0309-2402 .- 1365-2648. ; 79:6, s. 2269-2279
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Journal article (peer-reviewed)abstract
- Aim: To illuminate the meaning of newly graduated registered nurses' experiences of caring for patients in emergency departments during the COVID-19 pandemic. Design: A phenomenological hermeneutical study guided by Lindseth and Norberg. Methods: In-depth one-on-one interviews with 14 nurses from five hospitals were conducted from March to November 2020 and analysed using thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) were used as the reporting guideline. Results: The findings comprise one main theme Caring through barriers and three themes with sub-themes. In the first theme, having intention to care, participants revealed their dedication to care for patients during the pandemic despite extensive stress, little experience and skills. The second theme, with tied hands in human suffering, illuminates experiences of being disconnected from the patient, overwhelmed by responsibility and unable to relieve suffering. The third theme, feeling inadequate, reveals experiences of lack of support and doubts meaning less space to develop into the nurse one wants to be. Conclusion: Findings reveal a new understanding of new nurses' experiences during times of crisis. The essence of caring in the emergency department during the pandemic can be explained as mediated through spatial, temporal and emotional barriers preventing new nurses from providing holistic care. Impact: The results may be used as anticipatory guidance for new nurses and inform targeted support interventions to support new nurses entering the profession in crisis conditions. Public Contribution: This study involved new nurses in semi-structured interviews.
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| 3. |
- Carnesten, Hillewi, 1969-
(author)
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Nurses' caring struggle : Stress in caring within hospital emergency care during the COVID-19 pandemic
- 2024
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Doctoral thesis (other academic/artistic)abstract
- Nurses took a frontline caregiving role during the COVID-19 pandemic in pervasively altered conditions in Swedish hospital emergency healthcare. Little is known about nurses’ experiences of the stress they were subjected to. In this thesis, findings from individual in-depth interviews with both newly graduated registered nurses (NGRNs) and experienced nurses (ERNs), as well as a web-based questionnaire, illuminate nurses’ lived experiences of stress in caring during the COVID-19 pandemic. Three studies employed qualitative methods (I, II, IV), and one a mixed methods approach (III). Study I aimed to describe NGRNs’ experiences of encountering stress in EDs during the COVID-19 pandemic. Findings illuminate how dedicated NGRNs struggle to develop into the nurse they want to be whilst battling extraordinary situations and conflicting emotions. Loss of control and experiences of shortcomings caused by work overload in combination with understaffing force NGRNs into an independent role at an early point in their career. Study II aimed to illuminate the meaning of NGRNs' experiences of caring for patients in EDs during the COVID-19 pandemic. Findings comprise caring being bestowed through spatial, emotional, and temporal barriers. NGRNs want to be present, relieve suffering yet describe caring during the pandemic as being a hidden activity, less acknowledged and left to the recognition of each nurse. Study III aimed to explore healthcare workers’ (HCWs’) experiences of the changed caring reality of the COVID-19 pandemic. Findings disclose traumatic experiences and having to sacrifice moral values and harbour dilemmas in isolation. Experiencing stress was significantly correlated to lower sense of coherence (SOC). Study IV aimed to explore nurses’ lived experiences of stress in the transformed caring reality during the COVID-19 pandemic. The interpreted meaning comprises the dilemma of enduring the unbearable, meaning having to silence one’s inner ethical, caring compass. In conclusion, stress in caring during the COVID-19 pandemic from a nurse perspective, can be understood as a caring struggle entailing bodily, knowledge, and ethical stress in a search for meaning that might be found in togetherness with patients, with colleagues, with dear ones and in nature.
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| 4. |
- Carnesten, Hillewi, 1969-, et al.
(author)
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Struggling in the dehumanized world of COVID-An exploratory mixed-methods study of frontline healthcare workers' experiences
- 2024
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In: Journal of Advanced Nursing. - : WILEY. - 0309-2402 .- 1365-2648.
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Journal article (peer-reviewed)abstract
- Aim: To explore healthcare workers' experiences of the changed caring reality during the COVID-19 pandemic in Sweden. Design: An online fully mixed-methods design. Methods: A web-based self-reported questionnaire with fixed and open-ended answers collected data from March to April 2021, analysed in three steps. First, free-text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta-inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting. Results: Meta-inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post-traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy. Conclusions: Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID-19 pandemic and to prevent mental health illness in future crisis. Patient or Public Contribution: No patient or public contribution. Summary: The pandemic outbreak exposed frontline healthcare workers to unparallelled stress shown as negative for their mental health in several meta-analyses and systematic reviews. In-depth understanding on experiences and how symptoms of post-traumatic stress disorder relate to coping mechanisms have been scarcely explored. This study contributes to understanding on healthcare workers' experiences and the relation between lower sense of coherence and increased risk of developing symptoms of post-traumatic stress disorder. Implications for Practice/Policy: This study might guide how to prepare for resilience in future emergencies.
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| 5. |
- Carnesten, Hillewi, 1969-, et al.
(author)
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Struggling with frightening experiences in a transformed reality : A mixed methods study of healthcare workers’ experiences during the pandemic.
- 2023
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Conference paper (other academic/artistic)abstract
- Background: The COVID-19 pandemic continues to impact health care workers’ (HCWs’) mental health. Research show that psychological distress and hard challenges abide with strong commitment to contribute. Yet, in-depth understanding of HCWs’ experiences of the changed caring reality during the pandemic is missing. Mixed methods research (MMR) accommodates several features apart from employing either quantitative or qualitative methods. This presentation focuses on examples from the 13-step mixed method by Leech and Onwuegbuzie.Methods: 97 HCWs in one hard-hit region in Sweden answered a web-based questionnaire measuring symptoms of stress (using DSM-5 criteria for post-traumatic stress syndrome, PTSD) in relation to perceived sense of coherence (SOC-scale) and self-compassion (SCS) as well as HCWs’ experiences. First, qualitative data (experiences of the pandemic) was analyzed by qualitative content analysis, then quantitative data (associations between PTSD and SOC/SCS) were analyzed with linear regression adjusted for covariates. Thirdly, a synthesis, the meta-inference of qualitative and quantitative data, explained a new comprehensive understanding. Results: By analyzing the categories and subcategories from the qualitative analysis in relation to symtoms of stress and SOC/SCS, a synthesis emerged. This was undertaken by merging and comparing the findings and discussing the new comprehensive understanding. Finally, to fully outline the mixed methods approach, qualitative and quantitative data were synthesized into a new comprehensive whole, a meta inference. Conclusion: This study moves away from dichotomic traditions between qualitative or quantitative approaches. By broadening the methodological departure this study may provide a new comprehensive understanding and contribute to enhance quality in MMR.
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| 6. |
- Cederbom, Sara, et al.
(author)
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Home Help Service Staffs' Descriptions of Their Role in Promoting Everyday Activities Among Older People in Sweden Who Are Dependent on Formal Care.
- 2017
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In: Journal of Applied Gerontology. - : SAGE Publications. - 0733-4648 .- 1552-4523. ; 36:8, s. 971-992
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Journal article (peer-reviewed)abstract
- The study aimed to explore how home help service staff described their role in improving the abilities of older people, in particular, older women with chronic pain who are dependent on formal care, to perform everyday activities. Three focus group interviews were conducted, and a qualitative inductive thematic content analysis was used. The analysis resulted in one theme: struggling to improve the care recipients' opportunities for independence but being inhibited by complex environmental factors. By encouraging the care recipients to perform everyday activities, the staff perceived themselves to both maintain and improve their care recipients' independence and quality of life. An important goal for society and health care professionals is to improve older people's abilities to "age in place" and to enable them to age independently while maintaining their quality of life. A key resource is home help service staff, and this resource should be utilized in the best possible way.
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| 7. |
- Dahlén, Micael, et al.
(author)
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Changes in Physical Activity Are Associated with Corresponding Changes in Psychological Well-Being : A Pandemic Case Study
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 20, s. 1-9
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Journal article (peer-reviewed)abstract
- Societal crises and personal challenges are often followed by substantial changes in physicalactivity. Is there a link between such changes and psychological well-being? Seeking to answerthis question, we conducted a correlational study on a representative sample in Sweden during thefirst year of the COVID-19 pandemic (N = 1035). About 49% of the sample had decreased theirphysical activity compared to their self-reported activity level prior to the pandemic, whereas 32%had increased it. The results showed a positive and robust association between changes in dailyactivity level and corresponding changes in psychological well-being. Specifically, individuals whohad reduced their physical activity over the last year reported lower life satisfaction than before, andindividuals who had increased their physical activity reported higher life satisfaction than before.The amount of complete physical inactivity (sitting) showed a similar pattern as the exercise data,meaning that individuals who reported increasing inactivity per day also reported a greater declinein life satisfaction. Additional analyses showed that the association between daily activity level andlife satisfaction was somewhat stronger for men than for women, but there was no difference whencomparing individual versus organized activities. The current study was based on a cross-sectionaldesign, measuring self-reported change over time. Recent work from other research teams have usedlongitudinal data and experience-sampling in different settings, finding similar results. We concludethat there is good reason to recommend physical exercise as a coping strategy in difficult times.
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| 8. |
- Dahlén, Micael, et al.
(author)
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The comeback effect : How happy are people who have recovered from a COVID-19 infection?
- 2022
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In: International Journal of Wellbeing. - : International Journal of Wellbeing. - 1179-8602. ; 12:2, s. 114-133
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Journal article (peer-reviewed)abstract
- There is already a large body of research on the dramatic negative effects of COVID-19 on peoples’ mental and physical health. Millions of people have died, and the pandemic has negatively influenced the lives of billions of people. Luckily however, the vast majority of people infected with the virus, recovers. The happiness and wellbeing of these people have not been extensively studied. In the current paper, we ask the question: Are people who have recovered from a COVID-19 infection happier than those who have not been infected at all? Building on previous research on hedonic adaptation and counterfactual thinking, we hypothesize, and find, that those who have had an infection appear slightly happier than others. The study relies on two surveys conducted in Sweden during the pandemic in 2020 (n=1029) and 2021 (n=1788).
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| 9. |
- Eklund, Caroline, 1983-, et al.
(author)
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The Meaning of Sedentary Behavior as Experienced by People in the Transition From Working Life to Retirement : An Empirical Phenomenological Study
- 2021
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In: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 101:8
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Journal article (peer-reviewed)abstract
- ObjectiveSedentary behavior (SB) is defined as a mean of >6 hours of daytime sitting or lying down. SB has been shown to increase with older age and is a risk factor for disease. During the transition from working life to retirement, changes in daily life activities occur, risking increased SB. The aim of the present study was to gain a deeper understanding of SB in relation to the transition from working life to retirement as experienced by persons in retirement.MethodsThe study was grounded in a phenomenological life-world perspective. Fourteen semi-structured interviews were conducted with participants aged 64–75. Data were analyzed using the empirical phenomenological psychological method.ResultsThe participants described that voluntary sedentary time was positively related to general health and well-being, while involuntary sedentary time was negatively related to health. Increased sedentary time was described as natural when aging. Retirement was expressed as a time for rest after hard work and the ability to choose a slower pace in life. Internal and external demands and daily routines interrupted SB, whereas loneliness was perceived to increase SB. Participants strived to find a balance between physical activity and sedentary time. The variations in the participants’ descriptions formed three typologies: in light of meaningful sedentary behavior, in the shadow of involuntary sedentary behavior, and a dual process – postponing sedentary behavior with physical activity.ConclusionsIncreased SB was perceived as natural when aging, but something that may be postponed by conscious choices. SB was perceived as associated with health, rest and recovery but also with the risk of deteriorating health.ImpactThis knowledge of the experienced meaning of SB could guide the design of health promotion interventions and may be helpful in targeting those in need of support and individualizing interventions to decrease SB in retirement.Lay SummaryThis study reveals how persons in retirement describe sedentary behavior as something healthy but also as unhealthy and that sedentary behavior is natural in aging and can be postponed by physical activity.
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| 10. |
- Elvén, Maria, 1973-, et al.
(author)
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Changes in Physical Activity and Sedentary Behavior before and during the COVID-19 Pandemic : A Swedish Population Study
- 2022
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:5
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Journal article (peer-reviewed)abstract
- Governments have enforced measures to limit the spread of COVID-19 with varying degrees of success, which could affect people’s physical activity (PA) and sedentary behavior. This study aimed to examine changes in PA levels, types of PA, and sedentary behavior in the Swedish population before and during the COVID-19 pandemic. Associations between changed PA levels and demographical and behavioral determinants were also investigated. In December 2020, 1035 individuals (18–79 years old) completed a survey about their PA and sedentary behavior before and during the pandemic. Factors influencing their PA were also explored. Fifty-one percent of the sample reported reduced total PA, 18% had no change, and 31% increased their PA. Overall, organized PA decreased the most and sedentary behavior increased. The youngest and oldest age groups reported the greatest reduction in PA, while middle-aged groups reported the most increased PA. Men reported a larger increase in sedentary behavior than women. Mental and physical capability was associated with change in PA. In conclusion, this study indicates that, during the COVID-19 pandemic, the majority of the Swedish population have decreased PA levels with a concurrent increase in sedentary behavior, which may have negative health consequences. Interventions are recommended to address both PA and sedentary behavior, specifically to strengthen people’s ability to perform PA and focusing on the youngest and oldest age groups.
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