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1.
  • Abelsson, Anna, 1971-, et al. (författare)
  • Nurse students learning acute care by simulation : Focus on observation and debriefing
  • 2017
  • Ingår i: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 24, s. 6-13
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Simulation creates the possibility to experience acute situations during nursing education which cannot easily be achieved in clinical settings. Aim: To describe how nursing students learn acute care of patients through simulation exercises, based on observation and debriefing. Design: The study was designed as an observational study inspired by an ethnographic approach.MethodData was collected through observations and interviews. Data was analyzed using an interpretive qualitative content analysis.Results: Nursing students created space for reflection when needed. There was a positive learning situation when suitable patient scenarios were presented. Observations and discussions with peers gave the students opportunities to identify their own need for knowledge, while also identifying existing knowledge. Reflections could confirm or reject their preparedness for clinical practice. The importance of working in a structured manner in acute care situations became apparent. However, negative feedback to peers was avoided, which led to a loss of learning opportunity.Conclusion: High fidelity simulation training as a method plays an important part in the nursing students' learning. The teacher also plays a key role by asking difficult questions and guiding students towards accurate knowledge. This makes it possible for the students to close knowledge gaps, leading to improved patient safety.
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2.
  • Allvin, Renée, 1956-, et al. (författare)
  • Self-assessed competence and need for further training among registered nurses in somatic hospital wards in Sweden : a cross-sectional survey
  • 2020
  • Ingår i: BMC Nursing. - : BMC. - 1472-6955. ; 19:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Professional competence and continuous professional development is essential for ensuring high quality and safe nursing care, and it might be important for motivating nurses to stay in the profession. Thus, there is a need to identify the developmental process of nursing competency. Assessment of competence and need for further training helps to identify areas for quality improvement, and to design interventions in order to facilitate continuous competence development in different work contexts. The current study aimed to 1) describe registered nurses' self-assessment of clinical competence as well as the need for further training, and 2) explore possible differences between registered nurses with varying lengths of professional experience as a nurse (<= 0,5 year, > 0,5-5 years, and >= 6 years). Methods A cross-sectional survey design was applied, using the Professional Nurse Self-Assessment Scale of clinical core competencies II. Registered nurses (n = 266) working in medical and surgical contexts in hospitals in Sweden responded (response rate 51%). Independent student t-test and analysis of variance were carried out. Results Registered nurses assessed their competence highest in statements related to cooperation with other health professionals; taking full responsibility for own activities; and acting ethically when caring for patients. They assessed their need for further training most for statements related to assessing patients' health needs by telephone; giving health promotion advice and recommendations to patients by telephone; as well as improving a creative learning environment for staff at the workplace. For self-assessed competence and need for further training, differences between the groups for 35 and 46 items respectively, out of 50 were statistically significant. Conclusions Although the registered nurses assessed their competence high for important competence components expected of professionals such as cooperation with other healthcare professionals, it is problematic that knowledge of interactions and side-effects of different types of medication were reported as having the highest need of training. Longitudinal follow up of newly graduated nurses regarding their continuous development of competence as well as further training is needed.
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3.
  • Bisholt, Birgitta, 1963-, et al. (författare)
  • Nursing students' assessment of the learning environment in different clinical settings
  • 2014
  • Ingår i: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 14:3, s. 304-310
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Nursing students perform their clinical practice in different types of clinical settings. The clinical learning environment is important for students to be able to achieve desired learning outcomes. Knowledge is lacking about the learning environment in different clinical settings.AIM: The aim was to compare the learning environment in different clinical settings from the perspective of the nursing students.DESIGN: A cross-sectional study with comparative design was conducted.METHOD: Data was collected from 185 nursing students at three universities by means of a questionnaire involving the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) evaluation scale. An open-ended question was added in order to ascertain reasons for dissatisfaction with the clinical placement.RESULTS: The nursing students' satisfaction with the placement did not differ between clinical settings. However, those with clinical placement in hospital departments agreed more strongly that sufficient meaningful learning situations occurred and that learning situations were multi-dimensional. Some students reported that the character of the clinical setting made it difficult to achieve the learning objectives.CONCLUSION: In the planning of the clinical placement, attention must be paid to whether the setting offers the student a meaningful learning situation where the appropriate learning outcome may be achieved.
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4.
  • Bisholt, Birgitta, 1963 (författare)
  • Nyutexaminerade sjuksköterskor yrkessocialisation - Erfarenheter av ett introduktionsprogram
  • 2009
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • ABSTRACT Through the ”VÅRD 77” amendment and the higher education reform from 1993, nursing education has been changed from vocational to academic. Theoretical aspects of nursing have been emphasised above clinical ones, and since 1993 clinical training has been reduced in such a way that the traditional professional and clinical skills of newly graduated nurses have changed. An increased theoretical focus and decreased clinical training have resulted in sharp criticism from health care institutions against the content of the nursing education programme, specifically regarding the fact that newly graduated nurses fail to meet demands and expectations on the professional skills and competence of a nurse. As a consequence of this criticism, employers offer newly graduated nurses introduction programmes after they have completed their nursing education. This study focuses on the newly graduated nurses´ experience of an introduction programme as they are about to enter the labour market. The aim is to analyse and describe the learning process of newly graduated nurses in professional situations and how they are socialised into the profession and seek meaning in their encounter with that environment. The theoretical framework is symbolic interactionism, used to understand how the newly graduated nurse interacts with other members of the staff as well as the environment in which interaction takes place. The research method is ethnographic, and the empirical material is based upon data from participant observations, interviews and field notes. The result shows that all eight workplaces use the master-apprentice system as a model for supervising newly graduated nurses during the introduction programme. In this model, the novices learn how to imitate and seek knowledge through the experienced nurses. The fact that workplaces are free to choose among supervision models may explain why the traditional model is used in the introduction programme. This model primarily offers the novices an opportunity to practice practical and technical tasks and learn how to act like the master. The result also shows that the novices have theoretical knowledge and know what action to take, but that they may have trouble assessing which part of their knowledge to use, which shows that they do not have the readiness to act or the competence required in the profession. The introduction programme must therefore give newly graduated nurses the opportunity to practice professional skills in different patient situations and allow them to perform tasks independently to a higher degree. Results also show that the staff questions and strongly doubts the professional skills of the novices, which means that they must constantly prove their professional ability in order to attain member status. Through various sanctions and master suppression techniques employed by the staff, the novice is formed into a nurse oriented towards medicine/science. The novices end up as outsiders if they deviate from the norms and expectations associated with the professional role. This explains why several of the novices in this study become outsiders. Novices must therefore adapt in order to avoid becoming outsiders. The result further shows that there is tension between the academic environment of the nursing college and the professional environment. Within nurse education the ideology of nursing and the development of critical thinking have been prominent, but within the profession the emphasis is on good vocational skills. This means that novices end up posited between two cultures, something which can be described as being in a marginal situation. One conclusion that can be drawn from the result of this study is that the introduction programme, as it is structured today, posits an obstacle in the professional development of the novices.
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5.
  • Bisholt, Birgitta, 1963- (författare)
  • The learning process of recently graduated nurses in professional situations : Experiences of an introduction program
  • 2012
  • Ingår i: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 32:3, s. 289-293
  • Tidskriftsartikel (refereegranskat)abstract
    • An increased theoretical focus and decreased clinical training have resulted in sharp criticism from health care institutions of the content of the nursing education program. As a consequence of this criticism, employers offer introduction programs to recently graduated nurses after they have completed their nursing education. This study is part one of a larger research study. The aim of the present study was to analyze and describe how recently graduated nurses learn at the place of work and how they seek a meaning in their encounter with that environment. The research method was ethnographic, and the empirical material was based upon data from participant observations, interviews and field notes. The results disclosed that workplaces using the master–apprentice system as a model for supervising recently graduated nurses during the introduction program. The results also showed that the novices have acquired theoretical knowledge and know what action to take, but may have trouble assessing which part of their knowledge to use. The introduction program constitutes an obstacle in the professional development of the novices.
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6.
  • Bisholt, Birgitta, 1963- (författare)
  • The professional socialization of recently graduated nurses : Experiences of an introduction program
  • 2012
  • Ingår i: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 32:3, s. 278-282
  • Tidskriftsartikel (refereegranskat)abstract
    • Nursing education entails a three-year program leading up to a Bachelor's degree. Recently graduated nurses lack theoretical as well as clinical skills, thus experiencing difficulties in taking on the professional role. Health care institutions have previously expressed great concern about the increase of theoretical focus at the cost of decreased clinical training and consequently employers presently offer introduction programs after the completion of the nursing education. The present study is part two of a larger study. The aim of the present study was to describe and analyze how recently graduated nurses are socialized into the profession. The research was conducted using an ethnographic approach and the empirical data was acquired by means of participant observations, interviews and field notes. The findings revealed that the staff questions the novices' nursing knowledge and strongly doubts their professional skills. In order for novices to attain member status at the clinical facility, they must constantly prove their professional ability. The findings showed furthermore that deviation by the novices from the norms and expectations associated with the professional role results in their becoming outsiders. Within nursing education the ideology of nursing is prominent, but within the profession the emphasis is on good occupational skills.
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8.
  • Blomberg, Ann-Catrin, 1956- (författare)
  • Att vårda patienten inom operationssjukvård : en fenomenografisk studie
  • 2014
  • Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Syfte: Det övergripande syftet med avhandlingen var att beskriva uppfattningar av operationssjuksköterskans vårdande inom operationssjukvård och perioperativ vårdMetod: En kvalitativ beskrivande design med en fenomenografisk metod valdes i båda studierna (I och II). I studie I samlades data in genom intervjuer med 16 strategiskt utvalda legitimerade sjuksköterskor och studenter i sista terminen av grundutbildningen till sjuksköterska. I studie II samlades data in genom intervjuer med 15 kliniskt verksamma operationssjuksköterskor. Båda studierna analyserades enligt fenomenografisk metod.Resultat: Resultatet av studie I visade att operationssjuksköterskans yrkesfunktion uppfattades som osjälvständig men ändå med ansvar för patientens vård utifrån specifika kunskaper i hygien och operationsmetodik. Omvårdnaden i yrkesfunktionen var otydlig och uppfattades som fragmentarisk eftersom operationssjuksköterskor enbart var delaktiga i en del av patientens vårdprocess och hade få möjligheter att skapa en vårdrelation med patienten. Resultatet i studie II visade att operationssjuksköterskor ville följa patienten hela vägen. Det innebar att lära känna patienten både före och efter operationen och därigenom bli ansvariga för att säkerställa patientens kontinuitet och säkerhet i vården. Genom att hålla ett vakande öga skyddade de patientens kropp och bevarade patientens värdighet.Konklusioner: Operationssjuksköterskans yrkesfunktion ansågs som fragmenterad och uppfattades vara medicinskt och tekniskt inriktad. Det framkom att vårdandet inom operationssjukvård och perioperativ vård var otydlig. Det fanns en vilja att bli mer delaktig i patientens vård och att vårdandet blev tydligare för andra yrkeskategorier inom vård.
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9.
  • Blomberg, Ann-Catrin, 1956-, et al. (författare)
  • Making the invisible visible : Operating theatre nurses’ perceptions of caring in perioperative practice
  • 2015
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 29:2, s. 361-368
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to describe operating theatre nurses' (OTNs') perceptions of caring in perioperative practice. A qualitative descriptive design was performed. Data were collected with interviews were carried out with fifteen strategically selected operating theatre nurses from different operating theatres in the middle of Sweden. A phenomenographic analysis was used to analyse the interviews. The findings show that operating theatre nurses' perceptions of caring in perioperative practice can be summarised in one main category: To follow the patient all the way. Two descriptive categories emerged: To ensure continuity of patient care and keeping a watchful eye. The operating theatre nurses got to know the patient and as a result became responsible for the patient. They protected the patient's body and preserved patient dignity in perioperative practice. The findings show different aspects of caring in perioperative practice. OTNs wanted to be more involved in patient care and follow the patient throughout the perioperative nursing process. Although OTNs have the ambition to make the care in perioperative practice visible, there is today a medical technical approach which promotes OTNs continuing to offer care in secret.
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10.
  • Blomberg, Ann-Catrin, PhD stud, 1956-, et al. (författare)
  • Operating theatre nurses' self-reported clinical competence in perioperative practice : A mixed method study
  • 2019
  • Ingår i: Nursing Open. - Hoboken : Wiley. - 2054-1058. ; 6:4, s. 1510-1516
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: During many years the operating theatre nurse's clinical competence has been describing in relation to patient safety, but the nursing care of the patient remains unclear. Therefore, we want in this study to investigate the relationship between background factors of operating theatre nurses self-rated clinical competence and describe factors of importance for development of clinical competence in perioperative nursing.Methods: A cross-sectional study with a mixed method approach was chosen. The instrument Professional Nurse Self-Assessment Scale of Clinical Core Competence was used for self-rating operating theatre nurses' clinical competence in perioperative nursing, and an open-ended question was added to describe factors of importance for development of clinical competence. In total, 1057 operating theatre nurses in Sweden were asked to participate, and 303 responded (28 %). They had different educational backgrounds and professional experiences, and were employed in universities or central/regional and district hospitals.Results: Academic degree, professional experience and place of employment were significant for the development of the operating theatre nurses' clinical competence. Academic degree appeared to affect operating theatre nurse leadership and cooperation, as well as how consultations took place with other professions about patient care. Being employed at a university hospital had a positive effect on professional development and critical thinking.Conclusions:  An academic degree influenced the operating theatre nurses' ability to act in complex situations, and along with professional experience strengthened the nurses' ability to use different problem-solving strategies and face the consequences of decisions made. Scientific knowledge and interprofessional learning and competence development in medical technologies should supplement nursing care for the development of clinical competence.
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11.
  • Blomberg, Ann-Catrin, PhD stud, 1956-, et al. (författare)
  • Operating theatre nurses' with managerial responsibility : Self-reported clinical competence and need of competence development in perioperative nursing
  • 2022
  • Ingår i: Nursing Open. - : Wiley-Blackwell. - 2054-1058. ; 9:1, s. 692-704
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: The aim of this study was to investigate operating theatre nurses (OTNs) with managerial responsibility, and their self-rated clinical competence and need for competence development in perioperative nursing. Design: A cross-sectional study was applied using a modified version of Professional Nurse Self-Assessment Scale of Clinical Core Competence I. Method: Data were collected from 303 OTNs in Sweden, 80 of whom indicated that they had managerial responsibility. Statistics analysis was used to identify the relationships between background variables to compare OTNs with and without managerial responsibility and their need for competence development. Results: OTNs with an academic degree and managerial responsibility self-rated their clinical competence higher compared with OTNs without an academic degree. It also turned out that OTNs with RN education and 1-year advanced nursing in theatre care, and master's 60 credits had a lower need for competence development in cooperation and consultation, professional development and critical thinking.
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12.
  • Blomberg, Ann-Catrin, PhD stud, 1956- (författare)
  • Operationssjuksköterskans vårdande och kompetens inom perioperativ vård
  • 2019
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall aim was to describe and deepen the understanding of what operating theatre nurses experience as caring and responsibility as well as ethical problems in perioperative practice. The aim was also to investigate how operating theatre nurses perceive clinical competence in perioperative nursing.Methods: This research has a hermeneutic design. Qualitative, quantitative and mixed method was used. In the study (I), data were collected through interviews and analysed with phenomenographic method. In studies (II-III) the interview texts from the study (I) was reused. Secondary analysis were performed with hermeneutic text interpretation. In the study (IV), data were collected through a modified questionnaire PROFFSNurse SAS I, which was supplemented with an open question. These data were analysed using statistics and qualitative conventional content analysis.Results: Operating theatre nurses have the will to meet the patient, be involved and created continuity in the perioperative nursing process (I). Operating theatre nurses experience that they have a formal responsibility to ensure that patients are not at risk and maintain patient integrity and dignity based on personal ethical values (II). Ethical problems and value conflicts can occur if routines and habits prevent operating theatre nurses from caring and when their clinical competence are not utilized in perioperative practice (III). The operating theatre nurses’ self-assessment of clinical competence showed that academic degree, professional experience and interprofessional learning were important for the development of clinical competence. On the other hand, existing routines and habits, as well as inadequate resources, were an obstacle (IV).Conclusion: Perioperative nursing care includes a nursing process and the operating theatre nurses have responsibility based on ethical values. When the operating theatre nurses are prevented from being a caregiver or that their clinical competence is not utilized, stress of conscience can be caused. Important for the development of clinical competence is an academic degree, professional experience and interprofessional learning.
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13.
  • Blomberg, Ann-Catrin, PhD stud, 1956-, et al. (författare)
  • Responsibility for patient care in perioperative practice
  • 2018
  • Ingår i: Nursing Open. - Hoboken : John Wiley & Sons. - 2054-1058. ; 5:3, s. 414-421
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To obtain an understanding of operating theatre nurses' experiences of responsibility for patient care and safety in perioperative practice. Design: A hermeneutic design were used. Method: Data were collected during 2012 from 15 operating theatre nurses who participated in individual interviews. The text was analyzed by hermeneutical text interpretation. Findings: The texts revealed two main themes: A formal external responsibility and personal ethical value. Responsibility that the patient was not exposed to risks, protecting the patient's body, systematically planning and organizing work in the surgical team. The personal ethical value meant confirming the patient as a person, caring for the patient and preserving the patient's dignity. A new understanding emerged that the operating theatre nurse always have the patient in mind.
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14.
  • Blomberg, Ann-Catrin, PhD stud, 1956-, et al. (författare)
  • Value conflicts in perioperative practice
  • 2019
  • Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 26:7-8, s. 2213-2224
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND:: The foundation of all nursing practice is respect for human rights, ethical value and human dignity. In perioperative practice, challenging situations appear quickly and operating theatre nurses must be able to make different ethical judgements. Sometimes they must choose against their own professional principles, and this creates ethical conflicts in themselves.OBJECTIVES:: This study describes operating theatre nurses' experiences of ethical value conflicts in perioperative practice.RESEARCH DESIGN:: Qualitative design, narratives from 15 operating theatre nurses and hermeneutic text interpretation.ETHICAL CONSIDERATION:: The study followed ethical principles in accordance with the Helsinki Declaration and approval was granted by the local university ethics committee.FINDINGS:: The result showed that value conflicts arose in perioperative practice when operating theatre nurses were prevented from being present in the perioperative nursing process, because of current habits in perioperative practice. The patient's care became uncaring when health professionals did not see and listen to each other and when collaboration in the surgical team was not available for the patient's best. This occurred when operating theatre nurses' competence was not taken seriously and was ignored in patient care.CONCLUSION:: Value conflicts arose when operating theatre nurses experienced that continuity of patient care was lacking. They experienced compassion with the patient but still had the will and ability to be there and take responsibility for the patient. This led to feelings of despair, powerlessness and of having a bad conscience which could lead to dissatisfaction, and even resignations.
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15.
  • Blomberg, Karin, 1970-, et al. (författare)
  • Clinical group supervision for integrating ethical reasoning : Views from students and supervisors
  • 2016
  • Ingår i: Nursing Ethics. - London, United Kingdom : Sage Publications. - 0969-7330 .- 1477-0989. ; 23:7, s. 761-769
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Clinical group supervision has existed for over 20 years in nursing. However, there is a lack of studies about the role of supervision in nursing students' education and especially the focus on ethical reasoning.Aim: The aim of this study was to explore and describe nursing students' ethical reasoning and their supervisors' experiences related to participation in clinical group supervision.Research design: The study is a qualitative interview study with interpretative description as an analysis approach.Participants and research context: A total of 17 interviews were conducted with nursing students (n = 12) who had participated in clinical group supervision in their first year of nursing education, and with their supervisors (n = 5).Ethical conciderations: The study was based on the ethical principles outlined in the Declaration of Helsinki, and permission was obtained from the Regional Ethical Review Board in Sweden.Findings: The analysis revealed that both the form and content of clinical group supervision stimulated reflection and discussion of handling of situations with ethical aspects. Unethical situations were identified, and the process uncovered underlying caring actions.Disscusion and conclusion: Clinical group supervision is a model that can be used in nursing education to train ethical reflection and to develop an ethical competence among nursing students. Outcomes from the model could also improve nursing education itself, as well as healthcare organizations, in terms of reducing moral blindness and unethical nursing practice.
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18.
  • Blomberg, Karin, 1970-, et al. (författare)
  • Swedish nursing students' experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education
  • 2014
  • Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Ltd.. - 0962-1067 .- 1365-2702. ; 23:15-16, s. 2264-2271
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS AND OBJECTIVES: To describe nursing students' experience of stress during clinical practice and evaluate the risk of stress in relation to the clinical setting characteristics and the organisation of the clinical education. BACKGROUND: Stress during clinical practice is well documented, but there is a lack of knowledge concerning whether the clinical setting characteristics and the organisation of the education make a difference. DESIGN: A cross-sectional study with evaluative design. METHODS: Data were collected by means of a numerical rating scale for the assessment of stress and questions about the clinical setting characteristics and the organisation of the education. One hundred and eighty-four students who had completed their final year on the nursing programme at three universities in Sweden were included. RESULTS: Nearly half of the students (43%) experienced high level of stress during clinical practice. Measured by decision in the tree analysis, the absolute risk of stress was 57% in students with placements in hospital departments, as compared to 13% in students with placements in other clinical settings. The risk of stress increased to 71% if the students with placement in a hospital took the national clinical final examination. Performance of practice in a hospital department overcrowded with patients was also associated with increased risk of stress. The organisation of supervision and number of students at the clinical placement had an effect on the experience of stress, but did not prove to be risk factors in the analysis. CONCLUSIONS: The risk of stress in nursing students during their clinical practice differs depending on clinical setting characteristics. The taking of the national clinical final examination could be a source of stress, but this requires further investigation. RELEVANCE TO CLINICAL PRACTICE: It is important that supervisors are aware that students in hospital departments overcrowded with patients are at risk of stress and may have increased need of support.
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19.
  • Blomberg, Karin, 1970-, et al. (författare)
  • Work stress among newly graduated nurses in relation to workplace and clinical group supervision
  • 2016
  • Ingår i: Journal of Nursing Management. - : Wiley-Blackwell Publishing Ltd.. - 0966-0429 .- 1365-2834. ; 24:1, s. 80-87
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim was to investigate occupational stress among newly graduated nurses in relation to the workplace and clinicla group supervision. Being a newly graduated nurse is particulary stressful. Whar remains unclear is wehter teh workplace and clinical group supervision affect the stress. A cross-sectional comperative study was performed. Data were collected by means of a numerical scale measuring occupational stress, questions about workplace and clinicla group supervision. One hundred and thirteen nusres were included in the study. Conclusions: Newly graduated nurses experience great strss and need support. Nusrse participating in clinical group supervision reported significantly less stress.
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20.
  • Granrud, Marie Dahlen (författare)
  • Mental health problems among adolescents : Public health nurses' work and interprofessional collaboration within the school health service
  • 2019
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aim with this thesis was to study adolescents with mental health problems, factors that are associated with mental health problems, visits to the public health nurse (PHN), and how PHNs and other professionals experience the collaboration in school and school health services related to mental health problems. Methods: Qualitative and quantitative methods were used. Study I included cross-sectional data from Ungdata, with 8052 adolescents. Descriptive statistics and hierarchical regression were used to analyse the data. Study II included individual interviews with 12 boys and qualitative content analysis was used. In study III, four focus group interviews were conducted and analysed with qualitative content analysis. In study IV, 18 PHNs were individually interviewed and a phenomenographic approach was used to analyse the interviews.Results: Gender differences were seen in the symptoms of depression, family conflicts and economics, lifestyle habits, school satisfaction and use of school health services with girls reporting in a higher proportion than boys. Boys described barriers such as finding the PHN inaccessible, difficulty talking about mental health problems and uncertainty about confidentiality when visiting the PHN. Interprofessional collaboration (IPC) is important for identifying adolescents with mental health problems. Accessibility, having different obligations, lack of criteria and goals and being dependent on others were described as affecting IPC.Conclusion: There are differences in boys and girls with girls reporting more mental health problems and visiting the school health service more often than boys. Boys described several barriers to visiting the PHN, but, when these barriers were crossed, the boys experienced the visit as positive. Several factors affected IPC in schools and the school health services. There were variations in the collaboration experienced, but when it worked it was experienced as positive.
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21.
  • Granrud, Marie Dahlen, et al. (författare)
  • Overcoming barriers to reach for a helping hand : Adolescent boys' experience of visiting the public health nurse for mental health problems
  • 2020
  • Ingår i: International Journal of Adolescence and Youth. - : Taylor & Francis. - 0267-3843 .- 2164-4527. ; 25:1, s. 649-660
  • Tidskriftsartikel (refereegranskat)abstract
    • Mental health problems among adolescents have become a public health issue in Norway. However, few adolescent boys seek help for their mental health problems. This study focus on adolescent boys' experiences related to visiting the public health nurse for mental health problems. Twelve adolescent boys were interviewed and qualitative content analysis was used to analyse the data. The theme identified from the data was: overcoming barriers to reach for a helping hand. The theme consisted of four categories: the public health nurse must be accessible; breaking the norm is a prerequisite for the adolescent boys to talk about mental health problems; ensuring that confidentiality is respected; and the public health nurse is a trustworthy person who can open up for new perspectives. The adolescent boys experienced barriers to visiting the public health nurse. When they had crossed these barriers, the visit was experienced as positive.
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23.
  • Granrud, M. D., et al. (författare)
  • Public health nurses' perceptions of interprofessional collaboration related to adolescents' mental health problems in secondary schools : A phenomenographic study
  • 2019
  • Ingår i: Journal of Clinical Nursing. - : Blackwell Publishing. - 0962-1067 .- 1365-2702. ; 28:15-16, s. 2899-2910
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives: To describe the variation in public health nurses' perceptions of interprofessional collaboration related to adolescents' mental health problems in secondary schools in Norway. Background: Mental health problems among adolescents account for a large portion of the global burden of disease and affect 10%–20% of adolescents worldwide. Public health nurses in school health services play an important role in disease prevention and promotion of physical and mental health. In order to serve adolescents with regard to mental health problems, public health nurses are dependent on collaboration with other professionals in schools. Design: Qualitative interviews were conducted with 18 public health nurses working in the school health services. Method: A phenomenographic approach was used for interviewing and for analysing the qualitative interviews. This study is presented in line with COREQ's checklist. Result: The analysis resulted in three descriptive categories based on eight identified conceptions. The categories are as follows: “The formal structure has an impact on interprofessional collaboration”; “The public health nurse is an important, but not always self-evident, partner in interprofessional collaboration”; and “The primary players are the teachers in collaboration.”. Conclusion: The public health nurses describe that they had limited impact on collaboration and were dependent on both the school principal and the teachers for achieving good collaboration. Teachers have the power to decide whether to collaborate with the public health nurse, and public health nurses regard teachers as the most important collaborative partners. The public health nurses need to make themselves and their competence visible. Relevance to clinical practice: The findings demonstrated that public health nurses are important collaborators, but are not always included in interprofessional collaboration. This knowledge is essential to strengthen public health nurses' roles and presence in schools, which could most certainly benefit adolescents with mental health problems in secondary school.
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25.
  • Gustafsson, Margareta, 1952-, et al. (författare)
  • Nurse teacher models in clinical education from the perspective of student nurses : A mixed method study
  • 2015
  • Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 35:12, s. 1289-1294
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The aim was to describe and compare the clinical teacher's role in different models of clinical practice from the perspective of student nurses. Design and Settings: The study took place in collaboration with two Swedish universities that applied different educational models in clinical practice. A mixed method approach was used. The quantitative part had a comparative design and the qualitative part had a descriptive design. Participants: The study group consisted of 114 student nurses (response rate 87%). Fifty-three of them had met clinical teachers employed at the university and not participating in the daily clinical work (University Nurse Teachers, UNTs), whilst 61 had met clinical teachers dividing their time between teaching and nursing (Clinical Nurse Teachers, CNTs). Eight students participated in the qualitative part of the study. Methods: A questionnaire including the CLES + T scale was used to ascertain the students' perception of the clinical teacher's role, complemented by interviews directed towards an enrichment of this perception. Results: Students meeting CNTs agreed more strongly than those meeting UNTs that the teacher had the ability to help them integrate theory and practice. Whilst spontaneous meetings between students and CNTs occurred, students mostly met UNTs in seminars. Students meeting UNTs felt alone but did appreciate having someone outside the clinical environment to provide support if they did not get along with their preceptor. Conclusions: In the case of UNTs, it is important that they keep their knowledge of clinical issues updated and visit the clinical placement not only for seminars but also to give students emotional support. In the case of CNTs, it is important that they are members of the faculty at the university, take part in the planning of the clinical courses and are able to explain the learning goals to the students. (C) 2015 Elsevier Ltd. All rights reserved.
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26.
  • Johnsson, Anette (författare)
  • Creating and establishing a positive care relationship between nurses, patients and relatives : An ethnographic study of encounters at a department of medicine for older people
  • 2020
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background and aim: Numerous encounters take place in the healthcare sector every day. Although the encounters should be conducted in a safe and respectful manner, an increased number of complaints about communication and interaction have been reported to the Health and Social Care Inspectorate. When a nurse, patient and relative meet in a so-called triad encounter, the focus is on creating and establishing a care relationship with the facilitated by communication and interaction. Thus, if communication and interaction fail in these encounters there is a risk that the care relationship will be bad and the patient's needs not fulfilled, which can lead to poorly prepared patients with difficulties participating in their own care. The overall aim of this thesis was to explore and describe the care relationship, communication, content and social interaction in the triad encounter between nurses, patients and relatives at a department of medicine for older people.Methods: The four studies were designed using a qualitative, ethnographic approach guided by Vygotsky’s sociocultural and Goffman’s interactional perspective. Participatory observations (n=40) and informal field conversations (n=120) with patients, relatives and nurses were carried out (October 2015-September 2016) at the same time as field notes were written. Studies I, II and III were underpinned by an ethnographic analysis, while in study in IV, a thematic analysis with an abductive approach was conducted.Results: The result of study I, identified a process where patients, relatives and nurses used different strategies for navigating before, during and after a triad encounter. The process was based on the following categories: orienting in time and space, contributing to a care relationship and forming a new point of view. Study II, showed how nurses communicated, using four different voices which reinforced by body language, which formed patterns that constituted approaches that changed depending on the situation and orientation: a medical voice, a nursing voice, a pedagogical voice and a power voice. Study III, emphasized three categories of content of the communication exchanges: medical content focusing on the patient’s medical condition; personal content focusing on the patient’s life story; and explanatory content characterized by nurses attempting to increase the patient’s and relative’s knowledge about the patient’s health and nursing needs. Study IV showed that, to create social interaction, the nurses employed greetings, small talk and bodily expressions. Patients accepted the invitation with body language, while relatives employed various strategies to receive an invitation. Nurses led the conversation, patients followed and described their health problem through gestures, while relatives captured the moment to receive and give information. Nurses summarized using ritual language, patients expressed gratitude’s through verbal and non-verbal expressions and relatives verbally clarified the agreements. The synthesis of the four results showed a model with the four activities as puzzle pieces: navigating through different perspectives, being involved in the communication, being attentive to social interaction and explaining the relevant content. When the institutional environment is such that the asymmetry between the nurse, patient and relative is limited, and the norms and routines promote communication between them, it is more likely that the puzzle pieces fit together and an opportunity arises to create and establish a positive care relationship in the triad encounters.Conclusion: The nurses' role as a professional is crucial, as they start, lead and end the encounter. If nurses minimize the asymmetry and combine the medical, personal and pedagogical questions, an opportunity arises for creating and establishing a positive care relationship that enables the patients to become more active and relatives more visible. This can contribute to strengthening the patient’s position in the healthcare system and increasing patient safety.
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27.
  • Klarare, Anna, et al. (författare)
  • Methods and strategies to promote academic literacies in health professions : a scoping review
  • 2022
  • Ingår i: BMC Medical Education. - : BioMed Central. - 1472-6920. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Universities enroll students from diverse backgrounds every year, with 300 million students expected in higher education by 2025. However, with widening participation, increasing numbers of students enrolling in higher health education and future health professions will be underprepared to meet demands of academic literacies, i.e. ability to read, interpret and critically evaluate academic texts and communicating the understanding verbally or in writing. The aim of this scoping review was to describe and explore methods and strategies to promote development of academic literacies.RESULTS: Thirty-one relevant studies were included and analyzed according to scoping review guidelines. The results showed four strategies: (1) integrating learning activities to develop academic literacies in the regular curriculum, (2) changing the course design with new methods for teaching and learning, (3) establish collaborations amongst academics and librarian faculty, and (4) adding courses or foundation year focusing on development of academic literacies. The results are discussed in light of the United Nations Agenda 2030 Sustainable Development, Goal 4, Quality Education, and widening participation.CONCLUSIONS: Aspects of widening participation and inclusion in higher education have been debated, and increasing numbers of students from diverse backgrounds are expected to enter health studies in higher education. We encourage integration of teaching and learning activities targeting parallel learning of course materials and development of academic literacies, beyond study skills. Embracing epistemic complexity and diversity as well as choosing strategic work with academic literacies may provide a starting point toward realizing sustainable development goals and widening participation.
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28.
  • Larsson, Margaretha, Lektor, et al. (författare)
  • The clinical learning environment during clinical practice in postgraduate district nursing students' education : a cross‐sectional study
  • 2023
  • Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 10:2, s. 879-888
  • Tidskriftsartikel (refereegranskat)abstract
    • AimTo describe and compare the clinical learning environment in community-based home care and primary health care in postgraduate district nursing students' education.DesignCross-sectional study design.MethodsA convenience sample of postgraduate district nursing students was derived from five Swedish universities in 2016 and 2017.ResultsThe postgraduate district nursing students were generally satisfied with the clinical learning environment in their clinical placement. In clinical placement, several factors affected the students' opportunities to learn, such as sufficiently meaningful learning situations with multidimensional content. A working environment that imposed psychosocial strain and high levels of stress among the staff negatively affected the students' learning. To further improve their learning from clinical practices, the students need preceptors who have the skills and competence required to support more advanced reflections and critical thinking on caring situations.
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29.
  • Sundler, Annelie Johansson, 1973-, et al. (författare)
  • Experiences of supervision during clinical education among specialised nursing students in Sweden : A cross-sectional study
  • 2019
  • Ingår i: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 79, s. 20-24
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The importance of the clinical learning environment in nurse education has gained increasing attention over the last decades. However, there is a lack of research on the learning environment, its significance and meaning in specialist nurse education. Objective: The objectives of the study were to investigate specialised nursing students' experiences of supervision during clinical practice and to compare students who were satisfied with the supervision with those who were dissatisfied with respect to a)organisation of supervision and number of preceptors, as well as time allocated by preceptors for b)supervision, c)reflection, d)discussion of intended learning outcomes, and e)assessments of students' performance by preceptors. Design: This study used a cross-sectional design. Sample and settings: A convenience sample of specialised nursing students was derived from five Swedish universities in the years 2016 and 2017. Methods: Data were collected using a questionnaire. Statistical analyses and a qualitative conventional content analysis were performed. Results: While almost all specialised nursing students reported that there had been time for discussion on their performance assessment, almost half of the students reported not getting time for supervision, or time for reflections and discussions on intended learning outcomes with the preceptor. Students reporting having time allocated for supervision by preceptors were found to be more satisfied with supervision. It was described as important that the preceptor(s)acknowledged the students previous work experiences. Even though being a registered nurse, reflections and feedback were described as valuable for the students learning. Several preceptors were described as positive allowing a broader picture and different views regarding working as a specialist nurse. Conclusions: This study indicates that supervision, in terms of discussions and reflections, of specialised nursing students is significant for learning experiences and satisfaction during clinical placement. © 2019 Elsevier Ltd
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30.
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31.
  • Sundler J, Annelie, 1973-, et al. (författare)
  • Student nurses' experiences of the clinical learning environment in relation to the organization of supervision : A questionnaire survey
  • 2014
  • Ingår i: Nurse Education Today. - : Churchill Livingstone. - 0260-6917 .- 1532-2793. ; 34:4, s. 661-666
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim The aim was to investigate student nurses' experiences of the clinical learning environment in relation to how the supervision was organized. Background The clinical environment plays an essential part in student nurses' learning. Even though different models for supervision have been previously set forth, it has been stressed that there is a need both of further empirical studies on the role of preceptorship in undergraduate nursing education and of studies comparing different models. Method A cross-sectional study with comparative design was carried out with a mixed method approach. Data were collected from student nurses in the final term of the nursing programme at three universities in Sweden by means of a questionnaire. Results In general the students had positive experiences of the clinical learning environment with respect to pedagogical atmosphere, leadership style of the ward manager, premises of nursing, supervisory relationship, and role of the nurse preceptor and nurse teacher. However, there were significant differences in their ratings of the supervisory relationship (p < 0.001) and the pedagogical atmosphere (p 0.025) depending on how the supervision was organized. Students who had the same preceptor all the time were more satisfied with the supervisory relationship than were those who had different preceptors each day. Students' comments on the supervision confirmed the significance of the preceptor and the supervisory relationship. Conclusion The organization of the supervision was of significance with regard to the pedagogical atmosphere and the students' relation to preceptors. Students with the same preceptor throughout were more positive concerning the supervisory relationship and the pedagogical atmosphere.
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32.
  • Terp, Ulrik, 1968-, et al. (författare)
  • A feasibility study of a cognitive behavioral based stress management intervention for nursing students : results, challenges, and implications for research and practice
  • 2022
  • Ingår i: BMC Nursing. - : BioMed Central. - 1472-6955. ; :1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Stress related psychological problems are growing in nursing education and constitute an essential challenge for educators. This makes research about strategies and interventions to meet these problems important. Stress management interventions need to be tested for feasibility and acceptability, before conducting large scale RCTs. The objective of our study was to assess the feasibility and acceptability of a newly developed cognitive behavioral stress management intervention for nursing students. Methods Data were collected using a combination of standardized measurements and newly created questionnaires in combination with qualitative data. Our data included recruitment capability, sample characteristics, intervention acceptability and preliminary evaluation of participant psychological changes. Results Findings suggested that the feasibility of conducting a full-scale evaluation was confirmed for intervention acceptability, data collection procedures, and adherence. However, difficulties relating to recruitment capability and homework were identified. All aspects taken together, the intervention was found feasible and acceptable to nursing students, and thus a potential stress management intervention for the nurse education context. Conclusions Overall, this study provides an insight into the challenges and complexities of developing and evaluating a new brief cognitive behavioral based stress management training intervention in a nurse education setting.
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33.
  • Terp, Ulrik, 1968- (författare)
  • Cognitive Behavioral Stress Management Training for Nursing Students
  • 2019
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall purpose of this thesis is to examine a stress management intervention developed for nursing students.The thesis comprises three studies (Study I-III) based on empirical data from a sample of nursing students. The specific aim in the first study (Paper I) was to investigate the feasibility and acceptability of the stress management intervention. The results in the first study suggested that the feasibility of conducting a full-scale evaluation was confirmed for recruitment, acceptability, data collection, and adherence to the intervention. However, difficulties relating to homework were also identified. In the second study (Paper II), the specific aim was to investigate the participants’ experiences of participating in the stress management intervention. Findings indicate that participants developed new adaptive coping strategies, which were attributed to the intervention. The participants expressed that they had increased their ability to reflect which led to increased insight and self-reflection. Findings emphasize the importance of both theoretical and structural aspects when planning a stress management training intervention. A group format delivery in combination with a multi-component cognitive behavioral intervention can be interrelated elements for positive stress-related changes. The third study (Paper III), aimed at investigating preliminary psychological effects regarding self-esteem, self-efficacy and stress management competence. In the third study, the results showed that perceived stress-management competency was improved and had withstanding effects one year later when compared with a control group. Self-esteem and self-efficacy, both psychological resources, increase over time after the intervention. In summary, this dissertation provides an insight into the challenges and the complexities of developing and implementing a stress management intervention in a nurse education context.
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34.
  • Terp, Ulrik, et al. (författare)
  • Effects of a Cognitive Behavioral-Based Stress Management Program on Stress Management Competency, Self-efficacy and Self-esteem Experienced by Nursing Students
  • 2019
  • Ingår i: Nurse Educator. - : Wolters Kluwer. - 0363-3624 .- 1538-9855. ; 44:1, s. E1-E5
  • Tidskriftsartikel (refereegranskat)abstract
    • Nursing students' exposure to stress negatively affects both academic and clinical performance and potentially their future as professional nurses. This pilot study measured the effects of a 10-week cognitive behavioral therapy-based stress management program, using a quasi-experimental design. Independent t tests showed positive effects of the training program compared with a control group. Students' perceived stress management competency, self-efficacy, and self-esteem were higher 1 year after the intervention.
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35.
  • Terp, Ulrik, 1968-, et al. (författare)
  • Not Just Tools to Handle It : A Qualitative Study of Nursing Students' Experiences From Participating in a Cognitive Behavioral Stress Management Intervention
  • 2019
  • Ingår i: Health Education & Behavior. - Thousand Oaks, CA, USA : Sage Publications. - 1090-1981 .- 1552-6127. ; 46:6, s. 922-929
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Stress-related problems are an increasing challenge within nurse education since it affects learning, professional development, and mental health negatively. Despite this, knowledge is scarce regarding nursing students' experiences of being in stress management interventions. Aim. This study aimed to describe how nursing students experienced a preventive cognitive behavioral therapy-based stress management intervention. Method. Data were collected through 14 semistructured interviews with nursing students who had participated in a stress management intervention, and analyzed using inductive qualitative content analysis. Results. The analysis yielded one theme, Turning points, which consisted of four categories: (1) more in touch with reality, (2) increased self-confidence, (3) improved communication skills, and (4) a new way of reflecting. Discussion. Findings emphasize the importance of both theoretical and structural aspects when planning a stress management training intervention. A group format delivery in combination with a multicomponent cognitive behavioral intervention can be interrelated elements for positive stress-related changes. Conclusion. Our findings indicate that participants developed new and more adaptive coping strategies, which were attributed to the intervention. The participants expressed that they had increased their ability to reflect, which led to increased insight and self-reflection. The intervention constitutes an example of a contribution to stress management research and provides information for stress management training initiatives in nurse education.
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36.
  • Österlind, Jane, 1959-, et al. (författare)
  • 6 S-modellen för personcentrerad palliativ vård : En undersökning av personalens uppfattningar på vård-och omsorgsboende och i hemtjänst
  • 2023
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Bakgrund: Palliativ vård innebär en holistisk vård av personer i alla åldrar. Syftet är att lindra lidande av fysisk, psykologisk, social eller existentiell/andlig natur. Döendet och döden är ofta omgärdade av tystnad, både i samhället i stort och bland vårdpersonal. Vårdpersonal kan känna sig obekväma vid tanken på döden. Djupare existentiella frågor undviks ofta genom att äldre personer inom hälso- och sjukvården avleds genom att prata om mer lättsamma samtalsämnen. Framtidens palliativa vård äger till stor del rum i hemmen och inom äldreomsorgen. Frågeställning: Studien är en del av en större interventionsstudie, EDUC-PC studien, och omfattar baslinjedata från 6S-enkäten med fokus på hur personal inom äldreomsorgen uppfattar att de arbetar enligt ett personcentrerat palliativt förhållningssätt.  Metod: En kvantitativ ansats antogs. Enkäten som innehåller nio frågor skickades till 266 anställda varav 136 svarade.  Resultaten redovisas som deskriptiv statistik i form av antal, procenttal, med median (md) som centralt mått. Resultat: Resultaten visar att den vård som ges uppfattas som bra eller mycket bra av personalen men att uppfattningarna varierar mellan olika yrkesgrupper. Innehållet i självbild, självbestämmande, sociala relationer och symtomlindring får alla höga poäng, medan de två existentiellt inriktade S:en; syntes och strategier, visar en större spridning mot lägre poäng.  Konklusion: Obalansen mellan de olika innehållen i 6S omvårdnadsmodellen visar att det finns brister i den palliativa omvårdnaden inom äldreomsorgen. Detta är tydligast när   de två S:en symtomlindring och strategier jämförs. Resultaten visar på ett behov av fortsatt fokus på äldre personers existentiella frågor inom äldreomsorgen.
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