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1.
  • Abdalrahim, Maysoon S, 1962, et al. (författare)
  • Documentation of Postoperative pain by Nurses in Surgical Wards
  • 2008
  • Ingår i: Acute Pain. - : Elsevier BV. - 1366-0071. ; 10:2, s. 73-81
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose To describe nursing documentation of pain assessment and management in the first 72h postoperatively in surgical wards. Methods A retrospective approach was used to collect data on nurses’ documentation from patients’ records. A total sample size of 322 records at six hospitals in Jordan were audited using three audit instruments; Pain and Anxiety Audit Tool, the North American Nursing Diagnosis Association (NANDA) form for characteristics of acute pain, and comprehensiveness assessment tool. Results There was no evidence of pain assessment documentation on the first day of surgery in 113 (35%) of patient's records. Pain location was the most recorded information for pain assessment in 197 (61%) notes, and only 14 (4.3%) nurses used a pain scale. More than 53% of the records lacked information about medication for pain management. There was a significant difference (p<0.05) in all the categories of pain documentation between the first day and the subsequent days. Nurses documented patients’ self-report of pain [297 (92.3%)], and patients’ crying [200 (62.1%)]. More than 80% (273) of the records were ranked below the minimum score for a satisfactory documentation. Conclusion The results indicate the need to improve postoperative pain assessment and documentation, and the establishment of acute pain service.
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2.
  • Abdalrahim, Maysoon S, 1962, et al. (författare)
  • Jordanian surgical nurses' experiences in caring for patients with postoperative pain
  • 2010
  • Ingår i: APPLIED NURSING RESEARCH. - 0897-1897. ; 23:3, s. 164-170
  • Tidskriftsartikel (refereegranskat)abstract
    • This qualitative study aimed to describe surgical nurses' experiences in caring for patients with postoperative pain. Twelve expert Jordanian surgical nurses participated to provide data for this study. Texts were analyzed using Kvale's guidelines for analyzing qualitative data. Five themes emerged from the texts: being faced with patients' suffering, being caught between ideals and work conditions, facing neglect and misconceptions, being confronted with families' concerns and hostility, and facing the feelings of the necessity to change. Results suggested that health care organizations need to understand and empower nurses so that effective quality care can be delivered to patients.
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3.
  • Abdalrahim, Maysoon S, 1962, et al. (författare)
  • The effect of postoperative pain management program on improving nurses’ knowledge and attitudes toward pain
  • 2011
  • Ingår i: Nurse Education in Practice. - : Elsevier BV. - 1471-5953. ; 11:4, s. 250-255
  • Tidskriftsartikel (refereegranskat)abstract
    • Effective postoperative pain treatment is an essential component to good quality of care. The purpose of this study was to explore nurses’ knowledge of and attitudes toward pain in surgical wards before and after implementation of a postoperative management program at a university hospital in Jordan. The program consisted of an education program for nurses, and its effect was evaluated by using a pre- and post-intervention design. Sixty five registered nurses were asked to respond to a 21 items questionnaire, and a total of 240 patients’ records were audited. After implementation of the program, the mean scores for all the questionnaire items were found to increase to 75%, with an average of 16/21 for the correct answers. There was a statistically significant difference (p < 0.05) between the number of correct answers between nurses’ responses in the pre-intervention phase and their responses in the post-intervention phase for most of the questionnaire items. Also, there was a statistically significant improvement in the documentation of patients’ care in 85% of the audited patients’ records. It was recommended to introduce an acute pain services (APS) using a well established and safe pain management routines to increase the quality of care.
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4.
  • Adriansson, Camilla, 1962, et al. (författare)
  • The use of topical anaesthesia at children´s minor lacerations: an experimental study
  • 2004
  • Ingår i: Accident and Emergency Nursing. - 0965-2302. ; 12:2, s. 78-84
  • Tidskriftsartikel (refereegranskat)abstract
    • In a great many situations within health care and treatment, children are subjected to unnecessary pain and suffering. When local anaesthetics is to be administered the child can experience this as incomprehensible especially when the nursing staff assures the child that no pain would be felt, only to discover soon after, that it actually did hurt at the moment of anaesthetic infiltration. The soothing of pain during the suturing of wounds in emergency wards can be reduced. In order to prevent this (subjection to unnecessary pain), and by improving accepted practice, it was interesting to investigate whether children felt pain at the time of infiltration anaesthesia following the initial topical anaesthesia. The aim of the present study was to investigate the effects of introductory topical anaesthesia using Xylocain solution dropped in the wound prior to a definitive infiltration-anaesthesia. An experimental prospective design was used where children were included in either an experimental (10) or control (10) group. The experimental group was given a Xylocain solution while eth control group received physiological Sodium solution. Pain was estimated by using VAS and by interviews. The study shows that a certain alleviation of pain does occur when using Xylocain, but not statistically significant difference exists between the two groups. Irrespective of whether the children received an introductory topical anaesthesia with Xylocain or Sodium solution at the time of infiltration anaesthesia, they expressed pain in connection with infiltration. Many children expressed fear and anxiety. Current research highlights the difficulties involved in offering children a really satisfactory form of pain relief in connection with infiltration anaesthesia and suturing of wounds. It is urgent to throw more light on children´s pain both from a nursing and from a medical point of view. No statistically significant differences was found in children´s reported pain, after treatment with Xylocain but the solution can have a positive effect at the time of the infiltration jab, but a larger study needs to be done in order to establish this firmly.
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5.
  • Alpers, Lise-Merete, et al. (författare)
  • Experiences of inner strength in critically ill patients - a heremenutical approach
  • 2012
  • Ingår i: Intensive & Critical Care Nursing. - : Elsevier BV. - 0964-3397. ; 28:3, s. 150-158
  • Tidskriftsartikel (refereegranskat)abstract
    • Becoming critically ill and in need of ventilator treatment is a considerable burden. Fear and anciety are natural reactions and it is not uncommon for patients to experience hopelessness, withdrawal and depression. In situations like these the possession of inner strength can be of vital importance. Objectives: To gain knowledge on what factors contribute to inner strength in critically ill patients cared for in an intensive care unit. The depth interviews were conducted with six former ventilator-treated patients aged 60-72 years. Setting: The informants were recruited through the ICU at an urban hospital in Norway. Research methodlogy/design: The study has an exploratory an d descriptive design. A hermeneutic approach was used to interpret the data, in which Kvale's self-perception, critical common sense and theoretical levels were applied. Results: The study clearly demonstrates that there are certain factors that promote the inner strength of patients undergoing ventilator treatment. These are: "To have the support of next of kin", The wish to go on living", "To be seen" and "Signs of progress". Amongst these patients it appears that the presence of one's next of kin has prime significance in promoting inner strength.
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6.
  • Bazzi, May, 1979, et al. (författare)
  • Collaboration in the Hybrid Operating Room: A Focus Group Study From the Perspective of the Nursing Staff
  • 2021
  • Ingår i: Journal of Radiology Nursing. - : Elsevier BV. - 1546-0843 .- 1555-9912. ; 40:3, s. 259-267
  • Tidskriftsartikel (refereegranskat)abstract
    • Technical advancements in the operating room setting continue, and the concept of the hybrid operating room is promoted and accepted worldwide. The hybrid setting means inclusion of radiology in the already complex environment of a traditional operating room. Collaboration in this type of environment becomes essential and investigating how the nursing staff experiences this collaboration in the hybrid operating room is needed. The aim of the study was to investigate how the nursing staff from the specialties of surgery, anesthesiology, and radiology experienced collaborating in a hybrid operating room. Explorative qualitative design was used. Five focus groups consisting of operating room nurses, operating room assistant nurses, nurse anesthetists, assistant nurse anesthetists, and radiographers were included in the study. Interviews using semistructured questions were conducted. Directive content analysis was used for the data analysis. The following categories revealed: (1) different patient safety perspectives; (2) responsibilities being shared and divided; (3) collaboration becoming better over time; (4) uneven division of labor in a strained work situation and different terms of employment; (5) lack of education and joint meetings; and (6) environmental constraints for satisfying collaboration. The nursing staff in the hybrid operating room highlighted they worked toward a common goal but prioritized their own specific tasks rather than the procedure as a whole. This, together with the uneven task distribution and unclear responsibilities, could create tension between the different staff categories, impacting procedures negatively. The results revealed the importance of proper preparation of the staff to work in the hybrid operating room. Having team building activities, common meetings, relevant training to meet educational needs, and adjusting the team composition could improve hybrid operating room collaboration and improve patient safety and outcomes. © 2021 Association for Radiologic & Imaging Nursing
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7.
  • Bazzi, May, 1979, et al. (författare)
  • Patients' lived experiences of waiting for and undergoing endovascular aortic repair in a hybrid operating room: A qualitative study
  • 2020
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 29:5-6, s. 810-820
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives The overall aim of the study was to illuminate the patients' lived experiences of waiting for and undergoing an endovascular aortic repair (EVAR) in a hybrid operating room (OR). Background The hybrid OR is an example of the technological advancements within hospitals. The environmental impact on humans is well recognised but is rarely taken into account when hospitals are designed or rebuilt. The patient's experience of a hybrid OR is not earlier described. Design A qualitative design based on hermeneutic phenomenology was implemented. Methods Interviews were conducted with 18 patients. A thematic interpretation based on van Manen's approach was then used to analyse the findings. The consolidated criteria for reporting qualitative studies (COREQ) were used (Data S1). Results The following three themes emerged from the interviews: (a) being scheduled for surgery induced both anxiety and hopefulness; (b) feeling watched over and surrendering to others in the technology intense environment and (c) feeling relief but unexpected exhaustion after surgery. In the discussion, the results were additionally reflected upon out from the four lifeworld existentials: lived body, lived space, lived time and lived others. Conclusions The hybrid OR technology did not frighten the patients, but it was also not an environment that promoted or was conductive to having a dialogue with the staff. The disease and surgery brought feelings of anxiety, which was largely associated with the uncertainty of the situation. We suggest that continuity in contact with staff and patient-centred information could be solutions to further calm the patients. Relevance to clinical practice The hybrid OR environment itself did not seem to frighten the patient, but the way the high-tech environment increased the distance between the patient and the multiple staff members needs further investigation.
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8.
  • Bazzi, May, 1979, et al. (författare)
  • Team composition and staff roles in a hybrid operating room: A prospective study using video observations
  • 2019
  • Ingår i: Nursing Open. - : Wiley. - 2054-1058. ; 6:3, s. 1245-1253
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim The aim of the study was to evaluate team composition and staff roles in a hybrid operating room during endovascular aortic repairs. Design Quantitative descriptive design. Methods Nine endovascular aortic repairs procedures were video-recorded between December 2014 and September 2015. The data analysis involved examining the work process, number of people in the room and categories of staff and their involvement in the procedure. Results The procedures were divided into four phases. The hybrid operating room was most crowded in phase 3 when the skin wound was open. Some staff categories were in the room for the entire procedure even if they were not actively involved. The largest number of people simultaneously in the room was 14.
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9.
  • Bazzi, May, 1979, et al. (författare)
  • The drama in the hybrid OR: Video observations of work processes and staff collaboration during endovascular aortic repair
  • 2019
  • Ingår i: Journal of Multidisciplinary Healthcare. - 1178-2390. ; 12, s. 453-464
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: A hybrid operating room (OR) is a surgical OR with integrated imaging equipment and the possibility to serve both open surgery and image-guided interventions. Aim: This study aimed to investigate the work processes and types of collaboration in a hybrid OR during endovascular aortic repair (EVAR). Methods: Data consisted of video recordings from nine procedures, with a total recording time of 48 hrs 39 mins. The procedures were divided into four episodes (Acts). A qualitative cross-case analysis was conducted, resulting in a typical case. The type of collaboration during specific tasks was discussed and determined based on Thylefors' team typology. Results: An extensive amount of safety activities occurred in the preparation phase (Acts 1 and 2), involving a number of staff categories. After the skin incision (Act 3), the main activities were performed by fewer staff categories, while some persons had a standby position and there were persons who were not at all involved in the procedure. Discussion: The different specialist staff in the hybrid OR worked through different types of collaboration: multi-, inter-and transprofessional. The level of needed collaboration depended on the activity performed, but it was largely multiprofessional and took place largely in separate groups of specialties: anesthesiology, surgery and radiology. Waiting time and overlapping tasks indicate that the procedures could be more efficient and safe for the patient. Conclusion: This study highlights that the three expertise specialties were required for safe treatment in the hybrid OR, but the extent of interprofessional activities was limited. Our results provide a basis for the development of more effective procedures with closer and more efficient interprofessional collaboration and reduction of overlapping roles. Considerable waiting times, traffic flow and presence of people who were not involved in the patient care are areas of further investigation. © 2019 Bazzi et al.
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10.
  • Berg, Katarina, 1959- (författare)
  • Patients’ perspectives on recovery from day surgery
  • 2012
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • A large number of elective surgical patients in Sweden and elsewhere have their surgical procedure performed in a day surgery context. The surgical care event, with its postoperative surveillance, is brief at the surgery unit and patients are discharged home with the intention that they should manage postoperative recovery mainly themselves. However, several patients attest to being in an exposed situation when assuming responsibility for recovery at home. The overall aim of this thesis was to attain comprehensive knowledge of postoperative recovery following day surgery from a patient perspective.A questionnaire, the Post-discharge Surgical Recovery scale, was translated into Swedish and evaluated regarding its psychometric properties in a Swedish context. A sample of 607 day surgery patients who had undergone orthopaedic, general or gynaecological surgery self-rated their recovery at postoperative Days 1, 7 and 14 using the Post-discharge Surgical Recovery scale and the Quality of Recovery-23. Health-related quality of life was assessed before and 30 days after the surgical procedure, using the EQ-5D. In a second sample, 31 patients were interviewed in their homes regarding their recovery after day surgery. The interviews were conducted on postoperative Days 11-37, and focused on the meaning of recovery, self-care and perceptions of recovery. Data were explored by means of a phenomenographic analysis.The Post-discharge Surgical Recovery scale showed satisfactory psychometric properties when used among Swedish day surgery patients. Following discharge, recovery included both physical and emotional perspectives. Recovery varied, and influencing factors were found to be type of surgery, age, perceived health and emotional status on the first postoperative day. Orthopaedic patients had a more protracted recovery process compared to general surgery and gynaecological patients, along with more postoperative pain and lower health-related quality of life. Patients perceived that postoperative recovery comprised different internal and external factors and a large amount of responsibility regarding their recovery and surgical outcome. To be prepared for recovery at home, patients wanted knowledge and understanding about the normal range of recovery following their specific surgical procedure, and needed support from different sources in their surroundings.This thesis provides insight into day surgery patients’ postoperative situation. Based on the studies, individualized and well thought-out support appears favourable in order to have confident and well prepared patients at home. In contrast to smooth and easy patient care at the surgery unit, the postoperative phase seems to be a weak link in the day surgical continuity of patient care. Postoperative care needs to be further improved to increase quality and patients’ overall satisfaction with the day surgical experience. Attention should be paid to patients’ physical and emotional resources and needs.
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11.
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12.
  • Bergbom, Ingegerd, 1947 (författare)
  • Caring for health in a globalized world
  • 2011
  • Ingår i: Scandinavian Journal of Caring Sciences. ; 25:1
  • Annan publikation (övrigt vetenskapligt/konstnärligt)
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13.
  • 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.
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14.
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15.
  • Bergbom, Ingegerd, 1947, et al. (författare)
  • First-time pregnant women’s experiences of their body in early pregnancy
  • 2017
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 31:3, s. 579-586
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The body of first-time pregnant women is affected in many ways, and the women may not know what to expect. Conversations between women and healthcare personnel about women’s bodily experience in early pregnancy can contribute to increased body knowledge, which may have a positive impact in later stages of their pregnancy and in relation to delivery. The aim of the study was to describe first-time pregnant women’s experiences of their body in early pregnancy (pregnancy weeks 10–14). Method: Twelve women were asked to draw pictures and answer questions freely about their experiences of their first pregnant body. Hermeneutical text interpretation was used to obtain an overall view of the experiences. Findings: A main theme emerged: ‘the body is connected to the cycle of life’. This theme comprised five subthemes: ‘bodily longing and a sense of ambivalence’, ‘being 'doubtful’, ‘welcoming changes in body and mind’, ‘feeling inner strength and struggle to find strength’ and ‘accepting a different body and mind’. This main theme and the subthemes were further interpreted and were understood as an experience of ‘me and my body’. Conclusions: The body reminded the women to take care of it and gave rise to positive thoughts. When the body exhibited uncomfortable reactions and sensations, these were taken as evidence of pregnancy, which was also seen positive but it also triggered a sense of dissatisfaction with the body and a feeling of it becoming alien.
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16.
  • Bergbom, Ingegerd, 1947, et al. (författare)
  • Göteborgs universitet
  • 2014
  • Ingår i: När omvårdnad blev vetenskap. - Stockholm : Liber. - 9789147114047 ; , s. 199-125
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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17.
  • Bergbom, Ingegerd, 1947 (författare)
  • Hermeneutiska observationer
  • 2008
  • Ingår i: Gryning 3.
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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18.
  • Bergbom, Ingegerd, 1947, et al. (författare)
  • Katie Erikson's caring theories. Part 2. The theory of caritative caring ethics and the theory of evidence
  • 2022
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 36:4, s. 1251-1258
  • Tidskriftsartikel (refereegranskat)abstract
    • In this article, Katie Eriksson's theory of caritative caring ethics and the theory of evidence, are described. Both theories are anchored in caritas, that is love, mercy and compassion. The theory of caritative caring ethics was first described by Eriksson in 1995, where seven assumptions or basic categories were elaborated. These were: the human being's dignity, the care relationship, invitation, responsibility, virtue, obligation or duty, and good and evil. Eriksson's theoretical contribution is that she makes a distinction between caring and nursing ethics, between inner and external ethics, and between natural and clinical ethics. Concerning the theory of evidence, Eriksson claims that a multidimensional scientific view of evidence in caring that focuses on the patient's world is necessary and vital. To see, realise, know, attest and revise constitute the ontological definitions of the concepts of evidence and evident. The theories are united by the core concepts of testimony and witnessing the human being's suffering. Eriksson points out that it is in the ethical acts that deeds are formed, based on ethos. The anchorage in an ethos means to have firm value-loaded judgements of an inner motive. Moreover, the anchorage in ethos presupposes a personal and natural ethic. The good deeds are realised in the relationship between the patient and the carer, but the caring ethics is not a professional or external ethics. Caring ethics is an ontological inner ethics meaning fellowship and the right to exist, but it is the patient's world and reality that decides the foundation and starting point for caritative caring ethics in clinical practice. The ultimate purpose and goal of caring are to guarantee the patient's dignity and absolute value as a human being.
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19.
  • Bergbom, Ingegerd, 1947 (författare)
  • Konsensusbegrepp som epistemologiska begrepp
  • 2012
  • Ingår i: Vårdvetenskapliga begrepp i teori och praktik / redaktörer: Lena Wiklund Gustin, Ingegerd Bergbom. - 9789144071046 ; , s. 47-63
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Teoretiska kunskaper är en bas för makt och vetenskapliga discipliners autonomi, men indirekt också för yrkesutövares autonomi. Därför är en begrepps- och teoriutveckling viktig, eftersom teorier och teoretiska resonemang bygger på ett begreppsliggörande av den verklighet som vårdandet är. Kommunikation och intradisciplinära diskussioner och debatter är viktiga för att ständigt utveckla disciplinens "eget språk". Det behöver inte betyda att det språk eller begrepp som används inte kan förstås av andra utanför disciplinen. Innehållet i något artikuleras genom begrepp, vilket betyder att om vårdandet skall kunna beskrivas måste begreppen innehålla det som vårdandet består av.
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20.
  • Bergbom, Ingegerd, 1947 (författare)
  • News, coming events and new steps
  • 2012
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318. ; 26:1, s. 1-2
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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23.
  • Bergbom, Ingegerd, 1947, et al. (författare)
  • Understanding the Meaning of Doubt, Despair, and Belief in Caring Sciences
  • 2021
  • Ingår i: International Journal for Human Caring. - 1091-5710. ; 25:2, s. 89-99
  • Tidskriftsartikel (refereegranskat)abstract
    • Healthcare professionals encounter patients' and relatives' expressions of doubt, despair, and hope in relation to illness and suffering. These feelings and experiences are often challenging for patients, relatives, and carers to face. The article's purpose is to describe and discuss how the meaning of doubt, despair, dread, and belief can be understood through Kierkegaard's and Spinoza's philosophical thoughts, thus contributing to a deeper understanding of caring and knowledge in caring science. Dread, doubt, and despair have their roots in grief and powerlessness but are also connected to belief and faith, which create an inner strength that can alleviate suffering. © Copyright 2021 International Association for Human Caring.
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24.
  • Bergbom, Ingegerd, 1947, et al. (författare)
  • Visual arts and drawings to communicate and explore authentic life situations, a data collection method in caring science - a hermeneutic perspective
  • 2022
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 36:3, s. 625-634
  • Tidskriftsartikel (refereegranskat)abstract
    • This methodological article aims to describe three methodological strategies for using drawings as a part of qualitative data collection methods in caring research based on hermeneutics. In some research interview situations, participants may have difficulties to express their experiences and feelings in words. The consequences may be that the descriptions in research reports will become superficial and not authentic, meaning, "telling it as it is". Drawn pictures may facilitate and support reflection related to the deepening of experiences and thoughts, and communicate and express more than words can do. It may also reveal thoughts and feelings the person drawing the picture was not aware of. Three methodological strategies are described: (1) Drawing a picture as an introduction or starting point for an interview, (2) During an ongoing interview, encouraging the participant to draw a picture when further explanation or description is needed for deepening the communication and (3) Drawing something in a pre-existing picture. The theoretical foundation of Gadamer's hermeneutic philosophy is discussed in relation to what a drawing is representing and presents. The interpretation of the drawn picture depends primarily on the creator of the picture, but at the same time the interpretation and understanding is a movement between the interviewer's and the participant's horizons, and thus is open for preunderstanding and new understanding. In contrast to an ordinary interview between two parties, an interview involving a drawing adds something specific to the conversation as it becomes a "trialogue" and not only a dialog. The drawn picture stands on its own. Using the participant's drawing can, therefore, be understood as an ongoing process with three parties involved: (1) the participant, (2) the researcher and (3) the drawing.
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25.
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27.
  • Bergbom, Ingegerd, 1947 (författare)
  • Vårdande vårdmiljöer
  • 2014
  • Ingår i: Vårdmiljöns betydelse. (Red.) Helle Wijk. - Lund : Studentlitteratur. - 9789144078113 ; , s. 17-42
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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28.
  • Bergbom, Ingegerd, 1947, et al. (författare)
  • Vårdvetenskap
  • 2015
  • Ingår i: Personliga tillbakablickar över ämnesområden vid Göteborgs universitet. - Göteborg : University of Gothenburg. - 9789198142822 ; , s. 62-67
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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29.
  • Billhult, Annika, et al. (författare)
  • Massage relieves nausea in women with breast cancer who are undergoing chemotherapy.
  • 2007
  • Ingår i: Journal of alternative and complementary medicine (New York, N.Y.). - : Mary Ann Liebert Inc. - 1075-5535 .- 1557-7708. ; 13:1, s. 53-7
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The aim of the present study was to examine the effect of massage on nausea, anxiety, and depression in patients with breast cancer undergoing chemotherapy. DESIGN: This work was a single-center, prospective, randomized, controlled trial. SETTINGS/LOCATION: This study was conducted in an oncology clinic, in a hospital in southwestern Sweden. SUBJECTS: Thirty-nine (39) women (mean age = 51.8) with breast cancer undergoing chemotherapy were enrolled. INTERVENTIONS: The patients were randomly assigned to a massage therapy group (20 minutes of massage on five occasions) or a control group (five 20-minute visits). OUTCOME MEASURES: All patients recorded nausea and anxiety on the Visual Analogue Scale before and after each intervention. They also completed the Hospital Anxiety and Depression Scale. RESULTS: Massage treatment significantly reduced nausea compared with control treatment (p = 0.025) when improvement was measured as a percentage of the five treatment periods. Differences in anxiety and depression between the two treatment regimes could not be statistically demonstrated. CONCLUSIONS: This study complements previous studies on the effect of massage and supports the conclusion that massage reduces nausea in these patients.
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30.
  • Billhult, Annika, et al. (författare)
  • The experience of massage during chemotherapy treatment in breast cancer patients.
  • 2007
  • Ingår i: Clinical nursing research. - : SAGE Publications. - 1054-7738 .- 1552-3799. ; 16:2
  • Tidskriftsartikel (refereegranskat)abstract
    • This study aimed to describe the experience of massage for breast cancer patients during chemotherapy treatment. Ten patients received massage at five occasions. They were interviewed and analysis was conducted using Giorgi's ideas of phenomenological research. The essential meaning of getting massage during chemotherapy was described as a retreat from the feeling of uneasiness toward chemotherapy. Results revealed five themes: the patients experienced distraction from the frightening experience, a turn from negative to positive, a sense of relaxation, a confirmation of caring, and finally they just felt good. In conclusion, the findings of this study show that massage offered a retreat from uneasy, unwanted, negative feelings connected with chemotherapy treatment. It is a treatment that can be added to the arsenal of treatment choices available to the oncological staff.
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31.
  • Bjurling-Sjöberg, Petronella, 1968- (författare)
  • Clinical Pathway Implementation and Teamwork in Swedish Intensive Care : Challenges in Evidence-Based Practice and Interprofessional Collaboration
  • 2018
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Suboptimal quality of care is an evident issue in current healthcare services. Clinical pathways (CPs) have the potential to facilitate evidence-based practice and interprofessional teamwork, and thereby improve patient safety and quality of care.The overall aim of the thesis was to develop comprehensive empirical knowledge and understanding of CP implementation and teamwork in Swedish intensive care units (ICUs). Four studies were included (I-IV).Study I was a survey including all Swedish ICUs (N84) and a document analysis of CP examples (n12). In total, 17 (20%) ICUs used CPs and many had implementation plans. The quality, extent and content of the CPs (n56) varied greatly, with sometimes insufficient interprofessionalism, evidence base and renewal.Study II was a mixed method including ICUs using CPs. The implementation processes were retrospectively explored through questionnaire data (n15) and qualitative content analysis of interviews with key informants (n10). The CP implementation was revealed as a process directed at realizing the usefulness and creating new habits, which requires enthusiasm, support and time.Studies III and IV were grounded theory studies in an action research project in an ICU. Study III explored everyday teamwork through focus group interviews with registered nurses, assistant nurses and anesthesiologists, as well as an individual interview with a physiotherapist (n38). Teamwork was revealed as an act of ‘balancing intertwined responsibilities.’ The type of teamwork fluctuated as the team processes were affected by circumstantial factors and involved individuals. Study IV prospectively explored the implementation process of a CP during a five-year period through repeated focus groups and individual interviews, questionnaires and logbooks/field notes, including the interprofessional project group, staff and managers (n71), and retrospective screening of health records (n136). ‘Struggling for a feasible tool’ was revealed as a central phenomenon. The implementation process included contextual and processual circumstances that enforced negotiations to achieve progress, which made the process tentative and prolonged and had consequences on the process output.In conclusion, CP implementation processes are affected by multiple interplaying factors. Although progress has been achieved in evidence-based practice and interprofessional collaboration there is still potential for substantial improvements, emphasizing a need for further facilitation.
  •  
32.
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33.
  • Carin, Modh, et al. (författare)
  • First time pregnant women's experiences in early pregnancy
  • 2011
  • Ingår i: International journal of qualitative studies on health and well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 6:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: There are few studies focusing on women’s experiences of early pregnancy. Medical and psychological approaches have dominated the research. Taking women’s experiences seriously during early pregnancy may prevent future suffering during childbirth. Aim: To describe and understand women’s first time experiences of early pregnancy. Method: Qualitative study using a phenomenological hermeneutic approach. Data were collected via tape-recorded interviews in two antenatal care units in Sweden. Twelve first time pregnant women in week 10-14, aged between 17 and 37 years participated. Results: To be in early pregnancy means for the women a life opening both in terms of life affirming and suffering. The central themes are: living in the present and thinking ahead, being in a change of new perspectives and values and being in change to becoming a mother. Conclusions: The results have implications for the midwife’s encounter with the women during pregnancy. Questions of more existential nature, instead of only focusing the physical aspects of the pregnancy, may lead to an improvement in health condition and a positive experience for the pregnant woman.
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34.
  • Cronqvist, Agneta, 1953- (författare)
  • The moral enterprise in intensive care nursing
  • 2004
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aims of this thesis were to explore nurses' experiences of stress in the ICU (I), to analyze experiences of moral concerns in intensive care nursing from the perspective of relational ethics (II), to describe the synthesis of the concept of moral stress and to identify preconditions for moral stress (III) and to analyse and describe lived experiences of support in situations characterized by critical care situations and moral stress in intensive care (IV).The design was exploratory and descriptive. Material in studies I, II and IV consisted of interviews with intensive care nurses (10 head nurses and 26 staff nurses) employed in general, thoracic and neonatal intensive care units in five hospitals located in different parts of Sweden. The material in study III data from two studies of professional issues in nursing were used for the analysis: one concerned psychiatric nursing and the other was the previously referred study I.In study I qualitative content analysis and descriptive interpretation was used in the analysis. The main theme 'stress induced by dissonant imperatives' formulated in the analysis. Dissonant imperatives are composed of the four sub-themes: 1) controlled by the working situation - needing to be in control, 2) constrained by prioritisation - wanting to do more, 3) lacking authority to act - knowing that something should be done, and 4) professional distance - interpersonal involvement. In study II qualitative content analysis and descriptive interpretation were used in the analysis. A main theme was formulated, 'caring about-caring for: tensions between moral obligations and work responsibilities in intensive care nursing'. Five sub-themes were formulated 1) believing in a good death, 2) knowing the course of events, 3) feelings of distress, 4) reasoning about the physicians and 5) expressing moral awareness. In the study III a hypothetical-deductive method was used. The findings indicate that moral stress is independent of context-given specific pre-conditions: 1) nurses are morally sensitive to the patient's vulnerability, 2) nurses experience external factors preventing them from doing the best for the patient, and 3) nurses feel that they have no control over the situation. In the study IV an interpretive method was used. The first level of analysis of data identified contextual factors, such as type and purpose of support and working conditions. Thereafter five tentative interpretations were revealed: 1) receiving organised support is a matter of self-determination, 2) whether to participate or to be off duty is experienced mutually as exclusive, 3) dealing with moral stress is experienced as a private matter, 4) colleagues managing moral stress serve as models in stress support, and 5) not being able to deal with moral stress urges one to seek outside support. A comparison of these interpretations identified three major themes: availability, accessibility and receptivity of support. The main interpretation of data was: "lived experience of moral stress support involves an interconnectedness between structural and existential factors".A comprehensive understanding was formulated using the four studies (I, II, III and IV). Moral stress was found to be influential on the caring competence. Conflicts between different competences were found leading to a shift in focus away from the patients leading to a possible decrease in the caring competence. Moreover, the subtle resistance among nurses toward participation in organized moral stress support may obstruct the development of nurses' caring competence. Accordingly, imbalance, due to moral stress, between different competences hinders the development of collectively shared caring competence.
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35.
  • Egerod, I., et al. (författare)
  • The patient experience of intensive care: A meta-synthesis of Nordic studies
  • 2015
  • Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 52:8, s. 1354-1361
  • 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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36.
  • Ekman, Inger, 1952, et al. (författare)
  • Maintaining normality and support are central issues when receiving chemotherapy for ovarian cancer.
  • 2004
  • Ingår i: Cancer nursing. - 0162-220X. ; 27:3, s. 177-82
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to enrich the understanding of patients' perspective of being diagnosed and treated for ovarian cancer. A qualitative approach was used to obtain knowledge and insight into patients' experiences and thoughts. Ten Swedish women, diagnosed with ovarian cancer, participated in a total of 23 interviews on 3 occasions: at the time of diagnosis, during chemotherapy, and after completion of chemotherapy. The results of the interpretation of the interviews were formulated in the form of 3 themes: (1) feeling the same despite radical castrating surgery, (2) accepting chemotherapy, and (3) maintaining normality and support. Suggestions of caring implications from our interpretation of the interview data underscore the need to support these women in learning to cope with their feelings of weakness and anxiety. The findings further indicate the potential in narrative methods to identify important issues in comprehensive cancer care.
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37.
  • Engwall, Marie, et al. (författare)
  • Let there be light and darkness : findings from a prestudy concerning cycled light in the intensive care unit environment.
  • 2014
  • Ingår i: Critical Care Nursing Quarterly. - : Wolters Kluwer Health Lippincott Williams & Wilkins. - 0887-9303 .- 1550-5111. ; 37:3, s. 273-298
  • Tidskriftsartikel (refereegranskat)abstract
    • The present study reports findings concerning light in an intensive care unit setting presented from 3 aspects, giving a wide view. The first part is a systematic review of intervention studies concerning cycled light compared with dim light/noncycled light. The findings showed that cycled light may be beneficial to preterm infant health. Second, a lighting intervention in the intensive care unit is presented, comparing and assessing experience of this lighting environment with that of an ordinary room. Significant differences were shown in hedonic tone, favoring the intervention environment. In the third part, measured illuminance, luminance, and irradiance values achieved in the lighting intervention room and ordinary room lighting are reported.
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38.
  • Engwall, Marie, et al. (författare)
  • Lighting, sleep and circadian rhythm: An intervention study in the intensive care unit
  • 2015
  • Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 31:6, s. 325-335
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients in an intensive care unit (ICU) may risk disruption of their circadian rhythm. In an intervention research project a cycled lighting system was set up in an ICU room to support patients' circadian rhythm. Part I aimed to compare experiences of the lighting environment in two rooms with different lighting environments by lighting experiences questionnaire. The results indicated differences in advantage for the patients in the intervention room (n=48), in perception of daytime brightness (p =0.004). In nighttime, greater lighting variation (p =0.005) was found in the ordinary room (n = 52). Part II aimed to describe experiences of lighting in the room equipped with the cycled lighting environment. Patients (n=19) were interviewed and the results were presented in categories: "A dynamic lighting environment", "Impact of lighting on patients' steep", The impact of lighting/lights on circadian rhythm" and The Lighting calms". Most had experiences from sleep disorders and half had nightmares/sights and circadian rhythm disruption. Nearly all were pleased with the cycled lighting environment, which together with daylight supported their circadian rhythm. In night's actual lighting levels helped patients and staff to connect which engendered feelings of calm. (C) 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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39.
  • Engwall, Marie, et al. (författare)
  • Patients' Self-Reported Recovery After an Environmental Intervention Aimed to Support Patient's Circadian Rhythm in Intensive Care
  • 2021
  • Ingår i: Herd-Health Environments Research & Design Journal. - : SAGE Publications. - 1937-5867 .- 2167-5112. ; 14:4, s. 194-210
  • 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.
  •  
40.
  • Engwall, Marie, 1964, et al. (författare)
  • The effect of cycled lighting in the intensive care unit on sleep, activity and physiological parameters: A pilot study
  • 2017
  • Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 41, s. 26-32
  • 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.
  •  
41.
  • Eriksson, Thomas, et al. (författare)
  • Hermeneutic observational studies: describing a method
  • 2021
  • Ingår i: Scandinavian Journal of Caring Sciences. - Nordic College of Caring Science : Wiley. - 0283-9318 .- 1471-6712. ; 35:1, s. 319-327
  • Tidskriftsartikel (refereegranskat)abstract
    • There is a need to develop and use research observations in the clinical field, primarily to gain insight
  •  
42.
  • Eriksson, Thomas, et al. (författare)
  • Hermeneutiska observationsstudier : från ett metodologiskt perspektiv.
  • 2013
  • Konferensbidrag (refereegranskat)abstract
    • Sedan några år har det varit en pågående diskussion om hur observationer kan användas i den vårdvetenskapliga forskningen, när det gäller att samla in kvalitativa forskningsdata och att tolka dessa data med hjälp av hermeneutik. Syftet med denna artikel var att reflektera, argumentera och bidra med ett innehåll i en pågående diskurs som rör utveckling av hermeneutisk tolkning av observationer som vetenskaplig metod via ett exempel genomfört inom intensivvård. I den hermeneutiska observationsstudie som används för att belysa metoden ligger forskningens fokus på att fånga det vårdande i besöken av patienter som vårdas på intensivvårdsavdelning. Den främsta anledningen till varför det finns ett behov av att utveckla och använda observation som datainsamling i det kliniska fältet är behovet av att få insikt i och synliggöra vad vårdandets innersta kärna kan innebära. Men det innefattar även kunskapsbildning om det som innebär att kunna se och vittna om vad som händer.
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43.
  • Eriksson, Thomas, 1959-, et al. (författare)
  • The experiences of patients and their families of visiting whilst in an intensive care unit - a hermeneutic interview study
  • 2011
  • Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 27:2, s. 60-66
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim The aim of this study was to interpret and understand the meanings of the lived experiences of visiting of patients in an ICU and their families. Method The research design was hermeneutic, based on interviews. This study includes 12 interviews with seven patients and five relatives who had been in an ICU. The interview text was interpreted in a Gadamerian manner as different plays with actors and plots. Findings Patients’ narratives could be divided into two parts; recall of real life and unreal life experiences, the unreal being more common. Relatives’ narratives are described as being on stage and being backstage, i.e. in the room with the patient and outside it. Conclusion The final interpretation elucidated the experience of visiting as the sudden shift between being present in real life vs. being present in the real life of unreality. It was a process whereby the patient and the family build a new understanding of life that creates a new form of interplay within the family. The pre-critical illness life is no longer there – a new life has begun. To support patients and their families in this process of change a family-centred care perspective is necessary.
  •  
44.
  • Eriksson, Thomas, et al. (författare)
  • The visiting situation in an ICU : an observational hermeneutic study –oral presentation
  • 2011
  • Konferensbidrag (refereegranskat)abstract
    • Aim: The aim was to interpret the interplay between critically ill patients and their next of kin in an ICU to understand the visiting situation. Method: A hermeneutic research design with non-participant observation was chosen as the data collection method. Ten observations of 10 patients and 24 loved ones over a 20 hour period were conducted. The text describing the observations of the interplay was interpreted in accordance with Gadamer. Data were analysed by considering the text as a play with scenes, actors and plots. Results: The interpretation of the scenes revealed two themes describing the patient’s interplay and six themes describing the next of kin’s interplay. The understanding of the plot concerns people who had entered a situation where normal everyday life was disconnected. The path from health to illness was a totally unfamiliar environment and perception of life, where the body constituted a new and unknown world. As a result of the fact that the patients were unable to use their bodies in the usual way, which sends different signals to their loved ones, who in turn have difficulty deciding how to respond. Both parties become trapped or locked out by their own bodies. Conclusion: A hindrance to the interplay could be the room, which was designed for medical and technical use and thus did not promote healing. The professionals were crucial for interpreting the signals from both patients and next of kin, as well as for finding caring strategies, such as physical contact, that promote interplay, which in turn create a caring and healing atmosphere.
  •  
45.
  • Eriksson, Thomas, et al. (författare)
  • Visits in an intensive care unit : an observational hermeneutic study
  • 2010
  • Ingår i: Intensive & Critical Care Nursing. - : Churchill Livingstone. - 0964-3397 .- 1532-4036. ; 26:1, s. 51-57
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim The aim was to interpret the interplay between critically ill patients and their next of kin in an ICU and to disclose a deeper understanding of the visiting situation. Method A hermeneutic research design with non-participant observation was chosen as the data collection method. Ten observations of 10 patients and 24 loved ones over a 20-h period were conducted. The text describing the observations of the interplay was interpreted in accordance with Gadamer's thoughts. Data were analysed by considering the text as a play with scenes, actors and plots. Findings Due to their medical condition the patients were unable to use their bodies in the usual way, which sends different signals to their loved ones, who in turn have difficulty deciding how to respond. Both parties become, in a manner of speaking, trapped or locked out by their own bodies. Conclusion The physical environment became a hindrance to the interplay as it was designed for medical and technical use and thus did not promote healing. The professionals are important for interpreting the signals from both patients and next of kin, as well as for finding caring strategies, such as physical contact that promote interplay, which in turn strengthens connectedness.
  •  
46.
  • Eriksson, Thomas, et al. (författare)
  • Visits to intensive care unit patients : frequency, duration and impact on outocme
  • 2007
  • Ingår i: Nursing in Critical Care. - : Wiley-Blackwell Publishing Ltd.. - 1362-1017 .- 1478-5153. ; 12:1, s. 20-26
  • Tidskriftsartikel (refereegranskat)abstract
    • The issue of the presence of patients’ loved ones during their intensive care unit (ICU) stay is a frequently discussed topic among ICU staff. Today, ICU patients’ loved ones are seen as important for the care of the patient. There is a gap in knowledge and research concerning the frequency and duration of visits by loved ones and the effect of such visits on patient outcome. The aim of this study was to explore the frequency and duration of loved ones’ visits and whether or not such visits have an impact on patient outcome. A prospective, explorative observational study design was used. The sample included 198 ICU patients from a general ICU in Sweden. Twenty-five per cent of the patients had no visitors whatsoever. Forty-seven per cent of the patients who had visitors had visits of ≤0·5 h/day, 36% had visits of between 0·6 and 2 h/day and 17% had visits of >2 h/day. The most frequent visitors were spouses and children. Significant differences between the groups were that the patients who had no visitors were older, had a shorter ICU stay, lower nine equivalents of nursing manpower score and more often lived alone. There were no significant differences in mortality and length of hospital stay over time. We could not establish that patients who had no visitors had a poorer outcome. Most of the older patients had no visitors, which indicates that elderly people may have a poorer social network; thus, there may be a greater need for professional caring relationships and care planning.
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47.
  •  
48.
  • Fagerström, Lisbeth, et al. (författare)
  • The use of Hegelian dialectics in nursing science
  • 2010
  • Ingår i: Nursing Science Quaterly. - 1552-7409. ; 23:1, s. 79-84
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this column is to describe dialectics as a philosophy and method which can be used by nurses to make a contribution to nursing science. Dialectics can be used in three ways: as a philosophical approach, as a method using the dialectic laws, and as a method of describing the dialectic process by focusing on the dynamic elements of the process. Dialectics can also be combined with hermeneutics.
  •  
49.
  • Frid, Ingvar, 1945, et al. (författare)
  • Brain death: close relatives' use of imagery as a descriptor of experience.
  • 2007
  • Ingår i: Journal of advanced nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 58:1, s. 63-71
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: This paper is a report of a study to explore the use of imagery to describe the experience of confronting brain death in a close relative. BACKGROUND: The brain death of a loved one has been described as an extremely difficult experience for close relatives, evoking feelings of anger, emotional pain, disbelief, guilt and suffering. It can also be difficult for relatives to distinguish brain death from the state of coma and thus difficult to apprehend information about the diagnosis. METHODS: Narrative theory and a hermeneutic phenomenological method guided the interpretation of 17 narratives from close relatives of brain dead patients. All narratives were scrutinized for experiences of brain death. Data were primarily collected in 1999. The primary analysis related to close relatives' experience of brain death in a loved one. A secondary analysis of the imagery they used to describe their experience was carried out in 2003. FINDINGS: Six categories of imagery used to describe the experience of confronting a diagnosis of brain death in a loved one emerged: chaotic unreality; inner collapse; sense of forlornness; clinging to the hope of survival; reconciliation with the reality of death; receiving care which gives comfort. Participants also identified two pairs of dimensions to describe their feelings about the relationship between their brain dead relative's body and personhood: presence-absence and divisibility-indivisibility. Being confronted with brain death meant entering into the anteroom of death, facing a loved one who is 'living-dead', and experiencing a chaotic drama of suffering. CONCLUSION: It is very important for members of the intensive care unit team to recognize, face and respond to these relatives' chaotic experiences, which cause them to need affirmation, comfort and caring. Relatives' use of imagery could be the starting point for a caring conversation about their experiences, either in conversations at the time of the death or when relatives are contacted in a later follow-up.
  •  
50.
  • Frid, Ingvar, 1945, et al. (författare)
  • Brain death in ICUs and associated nursing care challenges concerning patients and families.
  • 1998
  • Ingår i: Intensive and Critical Care Nursing. ; :14, s. 21-29
  • Tidskriftsartikel (refereegranskat)abstract
    • In order to document the incidence and causes of brain death (BD) and the frequency of organ donation (OD) in a Swedish University Hospital, a retrospective review of deaths in a neurosurgical department and in the general intensive care units (ICUs), was carried out for the period 1988-1994. BD diagnosis was established in 197 (10.6%) of all deaths (n = 1843). The hospital records of all BD patients were examined in detail following a specific study plan. The majority of the BD patients (89%) were acute admissions to hospital, and among them 81 were transferred between hospitals often over a long distance. Among the BD patients the total number of OD was 65 (33%). The most common diagnosis leading to BD was spontaneous intracerebral bleeding and traumatic head injury. The BD diagnosis was established by neurological examination (60%) and by cerebral angiography (40%). Of the BD patients, 50% died within 48 hours in the ICU and the majority of requests for OD (67%) were made to the relatives of these patients. The findings are discussed with focus on the workload and psychological stress of ICU nurses when caring for BD patients and their families; a task which includes taking part in processes concerning BD diagnosis information and OD requests. PMID: 9652258 [PubMed - indexed for MEDLINE]
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