1. |
- Björklund, Margereth, 1950-, et al.
(författare)
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Cancer patients' experiences of nurses' behaviour and health promotion activities : a critical incident analysis
- 1999
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Ingår i: European Journal of Cancer Care. - Oxford : Blackwell Publishing. - 0961-5423 .- 1365-2354. ; 8:4, s. 204-212
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Tidskriftsartikel (refereegranskat)abstract
- Patients with head and neck cancer report several disease- and health-related problems before, during and a long time after completed treatment. Nurses have an important role in educating/supporting these patients about/through the disease and treatment so that they can attain well-being. This study describes the cancer patients' experiences of nurses' behaviour in terms of critical incidents after nurses had given them care to promote health. The study had a qualitative, descriptive design and the method used was the critical incident technique. Twenty-one informants from the Nordic countries diagnosed with head and neck cancer were strategically selected. It was explained to the informants what a critical incident implies before the interviews took place; this was defined as a major event of great importance, an incident, which the informants still remember, due to its great importance for the outcome of their health and well-being. The nurses' behaviour was examined, and critical incidents were involved in 208 cases-150 positive and 58 negative ones-the number of incidents varying between three and 20 per informant. The nurses' health promotion activities or lack of such activities based on the patients' disease, treatment and symptoms, consisted of informing and instructing the patients as well as enabling their participation. Personal consideration and the nurses' cognisance, knowledge, competence, solicitude, demeanour and statements of understanding were found to be important. Continuous health promotion nursing interventions were of considerable value for the majority of this group of cancer patients. Oncology nurses could reconfirm and update the care of head and neck cancer patients by including health promotion activities in individual care plans. By more frequent use of health promotion models, such as the empowerment model, the nurses could identify and focus on those individuals who needed to alter their life-style as well as tailor their approach towards these patient by setting goals for well-being and a healthy life-style.
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2. |
- Flemme, Inger, et al.
(författare)
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Life situation of patients with an implantable cardioverter defibrillator : a descriptive longitudinal study
- 2001
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 10:4, s. 563-572
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Tidskriftsartikel (refereegranskat)abstract
- • The aim of this study was to describe changes in the life situation of patients with an implantable cardioverter defibrillator over a period of 1 year. A sample of 56 consecutive patients took part in the study.• Life situation was measured through uncertainty in illness, satisfaction, and fear of the life situation. Descriptive statistics were used to present results, and analytical statistics were used to map out changes over time.• Overall uncertainty showed a decrease over time. A statistically significant difference was found within the domain uncertainty related to information (P < 0.001).• Satisfaction increased within the domains health-functioning, socio-economic, psychological–spiritual, and family.• The ability to act within the domain health-functioning showed a statistical significance (P < 0.05).• The domain life changes within fear in the life situation decreased and showed a statistical significance (P < 0.05).• The overall life situation showed increased satisfaction as well as lower uncertainty and fear in the life situation.• The research indicates that patients need more information about changes in the life situation after the implantable cardioverter defibrillator-implantation. The study encourages more humanistic, holistic research about patients’ life situations as well as more education in teaching skills for health care personnel.
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3. |
- Fridlund, Bengt, et al.
(författare)
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Essentials of Nursing Care in Randomized Controlled Trials of Nurse-Led Interventions in Somatic Care : A Systematic Review
- 2014
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Ingår i: Open Journal of Nursing. - Irvine : Scientific Research Publishing. - 2162-5336 .- 2162-5344. ; 4:3, s. 181-197
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Forskningsöversikt (refereegranskat)abstract
- Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP). How far this EBP has progressed in different health aspects is usually established by systematic reviews of RCTs. Nurse-led RCTs exist but no study has addressed the essentials of nursing care. Aim: The aim was therefore to determine the essentials of nurses’ interventions by means of nurse-led RCTs in somatic care focusing on the stated context, goals, content, strategies as well as the nurse’s role related to effectiveness. Methods: A systematic review was realized according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data extraction process (n = 55) from PubMed and CINAHL. Results: Of the RCTs in somatic care, 71% showed a positive effectiveness of nurse-led interventions, of which the nurse had a significant role with regard to being the main responsible in 67% of the studies. Also, 47% of the RCTs presented a theoretical standpoint related to the nurse-led interventions and most prominent were international evidence-based guidelines. Goals were found to have either a patient-centered or a professional-centered ambition. Strategies were based on patient-directed initiatives, nurse-patient-directed initiatives or nurse-directed initiatives, while contents were built upon either a patient-nurse interaction or a nursing management plan. Conclusions: This review underlines the necessity of a holistic view of a person, as nurse-led RCTs comprising a patient-centered ambition, patient-directed initiative and patient-nurse interaction plan showed beneficial nursing care effectiveness, particularly if theory-based. In a nurse-led RCT, a basic theoretical perspective is advantageous as well as to elucidate the role of the nurse in relation to the estimated effects.
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4. |
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5. |
- Haraldsson, Katarina, et al.
(författare)
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Adolescent Girls' Experiences of Underlying Social Processes Triggering Stress in Their Everyday Life : A grounded theory study
- 2011
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Ingår i: Stress and Health. - Chichester : John Wiley & Sons. - 1532-3005 .- 1532-2998. ; 27:2, s. E61-E70
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to generate a theoretical model of underlying social processes that trigger stress in adolescent girls’ everyday life. In-depth interviews regarding the experiences of stress at home, school and during leisure time were conducted with 14 17-year-old schoolgirls. Data were analysed by means of the grounded theory method. Stress was triggered in the interaction between responsibility and the way in which the girls were encountered. Triggered emotional reactions took the form of four dimensions of stress included ambivalence, frustration, despair and downheartedness. These reactions were dependent on whether the girls voluntary assumed responsibility for various situations or whether they were forced, or felt they were being forced, to assume responsibility in interaction with an encounter characterized by closeness or distance. These forms of stress reactions could appear in one dimension and subsequently shift to another. From the public health perspective, the generated stress model can be used in the planning and implementation of future actions to prevent stress and promote well-being related to stress in adolescent girls.
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6. |
- Lantz, Emelie, et al.
(författare)
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Serving the community while balancing multiple responsibilities : experiences of working as a paid part-time firefighter
- 2023
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Ingår i: International Journal of Emergency Services. - : Emerald Group Publishing Limited. - 2047-0894 .- 2047-0908. ; :1, s. 17-38
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe purpose of this study was to describe experiences of working as a paid part-time firefighter (PTF) in Swedish rural areas.Design/methodology/approachAn inductive explorative design was used, based on interviews with 18 paid PTFs in Sweden. Data were analyzed using qualitative latent content analysis.FindingsThree themes emerged from the interviews and describe paid PTFs’ experiences. The findings provide insights into how firefighters share a strong commitment, how support plays a crucial role, and how training and call-outs contribute to their experiences. Paid PTFs’ experiences are nuanced, ranging from personal limitations and challenges to satisfaction and the contrast with ordinary life.Practical implicationsThe implications for fire and rescue service organizations are that they can encourage firefighters’ commitment and pride, as well as the commitment and support of their families and main employers. Further, highlighting the importance of support and facilitating flexibility when on call is crucial. Finally, acknowledging and promoting personal development and facilitating an inclusive culture are important factors for both motivation and satisfaction.Originality/valuePaid PTFs are under-represented in the literature, despite the reliance on them in Sweden, and this study begins to address the knowledge gap. To improve retention, it is vital to understand paid PTFs work situation: what motivates them, what barriers they face, and how those challenges influence their experiences.
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7. |
- Lantz, Emelie, et al.
(författare)
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Serving the community while balancing multiple responsibilities – experiences of working as a paid part-time firefighter
- 2023
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Ingår i: International Journal of Emergency Services. - 2047-0894. ; 12:1, s. 17-28
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this study was to describe experiences of working as a paid part-time firefighter (PTF) in Swedish rural areas. Design/methodology/approach: An inductive explorative design was used, based on interviews with 18 paid PTFs in Sweden. Data were analyzed using qualitative latent content analysis. Findings: Three themes emerged from the interviews and describe paid PTFs’ experiences. The findings provide insights into how firefighters share a strong commitment, how support plays a crucial role, and how training and call-outs contribute to their experiences. Paid PTFs’ experiences are nuanced, ranging from personal limitations and challenges to satisfaction and the contrast with ordinary life. Practical implications: The implications for fire and rescue service organizations are that they can encourage firefighters’ commitment and pride, as well as the commitment and support of their families and main employers. Further, highlighting the importance of support and facilitating flexibility when on call is crucial. Finally, acknowledging and promoting personal development and facilitating an inclusive culture are important factors for both motivation and satisfaction. Originality/value: Paid PTFs are under-represented in the literature, despite the reliance on them in Sweden, and this study begins to address the knowledge gap. To improve retention, it is vital to understand paid PTFs work situation: what motivates them, what barriers they face, and how those challenges influence their experiences.
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8. |
- Samarasinghe, Kerstin, 1950-, et al.
(författare)
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Primary health care nurses' conceptions of involuntarily migrated families' health
- 2006
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Ingår i: International Nursing Review. - : Blackwell Publishing. - 0020-8132 .- 1466-7657. ; 53:4, s. 301-307
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Tidskriftsartikel (refereegranskat)abstract
- Background: Involuntary migration and adaptation to a new cultural environment is known to be a factor of psychological stress. Primary Health Care Nurses (PHCNs) frequently interact with refugee families as migrant health needs are mainly managed within Primary Health Care. Aim: To describe the health of the involuntary migrated family in transition as conceptualized by Swedish PHCNs. Method: Thirty-four PHCNs from two municipalities in Sweden were interviewed and phenomenographical contextual analysis was used in analysing the data. Findings: Four family profiles were created, each epitomizing the health characteristics of a migrated family in transition: (1) a mentally distressed family wedged in the asylum-seeking process, (2) an insecure family with immigrant status, (3) a family with internal instability and segregated from society, and (4) a stable and wellfunctioning family integrated in society. Contextual socio-environmental stressors such as living in uncertainty awaiting asylum, having unprocessed traumas, change of family roles, attitudes of the host country and social segregation within society were found to be detrimental to the well-being of the family. Conclusion: Acceptance and a clear place in society as well as clearly defined family roles are crucial in facilitating a healthy transition for refugee families. Primary Health Care Nursing can facilitate this by adopting a family system perspective in strengthening the identity of the families and reducing the effects of socio-environmental stressors.
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9. |
- Samarasinghe, Kerstin, 1950-, et al.
(författare)
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Primary health care nurses' promotion of involuntary migrant families' health
- 2010
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Ingår i: International Nursing Review. - Chichester : Wiley-Blackwell. - 0020-8132 .- 1466-7657. ; 57:2, s. 224-231
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Tidskriftsartikel (refereegranskat)abstract
- Background: Involuntary migrant families in cultural transition face a number of challenges to their health and to family cohesion. Primary health care nurses (PHCNs) therefore play a vital role in the assessment and promotion of their health. Aim: The aim of this study was to describe the promotion of health in involuntary migrant families in cultural transition as conceptualized by Swedish PHCNs. Method: Interviews were conducted with 34 strategically chosen PHCNs covering the entire range of the primary health care sector in two municipalities of Southern Sweden. A contextual approach with reference to phenomenography was used in interpreting the data. Findings: There are three qualitatively different descriptive categories epitomizing the characteristics of the PHCNs' promotion of health: (1) an ethnocentric approach promoting physical health of the individual, (2) an empathic approach promoting mental health of the individual in a family context, and (3) a holistic approach empowering the family to function well in everyday life. Conclusions: For nurses to promote involuntary migrant families'health in cultural transition, they need to adopt a holistic approach. Such an approach demands that nurses cooperate with other health care professionals and community authorities, and practise family-focused nursing; it also demands skills in intercultural communication paired with cultural self-awareness in interacting with these families. Adequate knowledge regarding these skills should therefore be included in the education of nurses, both at under- and at post-graduate level.
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10. |
- Abrahamsen Grøndahl, Vigdis, 1964-
(författare)
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Patients’ perceptions of actual care conditions and patient satisfaction with care quality in hospital
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There are theoretical and methodological difficulties in measuring the concepts of quality of care and patient satisfaction, and the conditions associated with these concepts. A theoretical framework of patient satisfaction and a theoretical model of quality of care have been used as the theoretical basis in this thesis. Aim. The overall aim was to describe and explore relationships between person-related conditions, external objective care conditions, patients’ perceptions of quality of care, and patient satisfaction with care in hospital. Methods. Quantitative and qualitative methods were used. In the quantitative study (I-III), 528 patients (83.7%) from eight medical, three surgical and one mixed medical/surgical ward in five hospitals in Norway agreed to participate (10% of total discharges). Data collection was conducted using a questionnaire comprising four instruments: Quality from Patients’ Perspective (QPP); Sense of Coherence scale (SOC); Big Five personality traits – the Single-Item Measures of Personality (SIMP); and Emotional Stress Reaction Questionnaire (ESRQ). In addition, questions regarding socio-demographic data and health conditions were asked, and data from ward statistics were included. Multivariate statistical analysis was carried out (I-III). In the qualitative study 22 informants were interviewed (IV). The interviews were analysed by conventional content analysis. Main findings. Patients’ perceptions of quality of care and patient satisfaction ranged from lower to higher depending on whether all patients or groups of patients were studied. The combination of person-related and external objective care conditions explained 55% of patients’ perceptions of quality of care (I). 54.7% of the variance in patient satisfaction was explained, and the person-related conditions had the strongest impact, explaining 51.7% (II). Three clusters of patients were identified regarding their scores on patient satisfaction and patients’ perceptions of quality of care (III). One group consisted of patients who were most satisfied and had the best perceptions of quality of care, a second group of patients who were less satisfied and had better perceptions, and a third group of patients who were less satisfied and had the worst perceptions. The qualitative study revealed four categories of importance for patients’ satisfaction: desire to regain health, need to be met in a professional way as a unique person, perspective on life, and need to have balance between privacy and companionship (IV). Conclusions. Patients’ perceptions of quality of care and patient satisfaction are two different concepts. The person-related conditions seem to be the strongest predictors of patients’ perceptions of quality of care and patient satisfaction. Registered nurses need to be aware of this when planning and conducting nursing care. There is a need of guidelines for handling over‑occupancy, and of procedures for emergency admissions on the wards. The number of registered nurses on the wards needs to be considered. Healthcare personnel must do their utmost to provide the patients with person‑centred care.
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11. |
- Al-Azawy, Mawahib, et al.
(författare)
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Premedication and preoperative information reduces pain intensity and increases satisfaction in patients undergoing ablation for atrial fibrillation : A randomised controlled study
- 2015
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Ingår i: Applied Nursing Research. - : Elsevier. - 0897-1897 .- 1532-8201. ; 28:4, s. 268-273
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPain and discomfort are common during radiofrequency ablation (RFA) for atrial fibrillation.AimsTo compare and evaluate the effect of premedication, standardised preoperative information and preoperative anxiety on pain intensity, drug consumption and patients’ satisfaction.MethodsPreoperative anxiety at baseline, pain intensity during RFA, and patient satisfaction after the procedure were measured in 3 random groups. Group A (n = 20) received standard pain management, group B (n = 20) received premedication and group C (n = 20) received premedication and standardised preoperative information.ResultsPatients in groups B and C experienced less pain intensity (p < 0.001) and needed fewer anxiolytics (p = 0.023) and analgesics (p = 0.031) compared to group A. Patient satisfaction was higher in group C (p = 0.005) compared to group A. Increased preoperative anxiety is related to elevated drug demand (p < 0.05).ConclusionPremedication alone or combined with preoperative information reduces and higher preoperative anxiety increases pain intensity and drug consumption during RFA. Preoperative information improves patient satisfaction.
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12. |
- Algurén, Beatrix, et al.
(författare)
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A Multidisciplinary Cross-Cultural Measurement of Functioning After Stroke : Rasch Analysis of the Brief ICF Core Set for Stroke
- 2011
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 18:6, s. 573-586
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the possibility of constructing a multiprofessional cross-cultural measure of functioning after stroke across categories of the International Classification of Functioning, Disability and Health (ICF). Method: Data on 757 stroke survivors from China, Germany, Italy, and Sweden, including ratings of 15 categories from the Brief ICF Core Set for stroke, were analyzed using the Rasch model. Unidimensionality, reliability, fit of the ICF categories to the model, ordering of response options of the ICF qualifier, and presence of differential item functioning (DIF) were studied. Results: Of the 15 ICF categories, response options for 7 categories were collapsed, 5 categories were deleted due to misfit, and 4 ICF categories showed DIF for country and were accordingly split into country-specific categories. The proposed final clinical measure consists of 20 ICF categories (6 categories were country-common) with an overall fit statistic of χ2180 = 184.87, P = .386, and a person separation index of r = 0.72, which indicates good reliability. Based on an individual's functioning after stroke, the ratings across the different ICF categories can be summed on an interval scale ranging from 0 to 100. Conclusion: A construction of a cross-cultural clinical measure after stroke based on ICF categories across body functions, structures, and activities and participation was possible. With this kind of clinical measure, stroke survivors' functional levels can be compared even across countries. Despite the promising results, further studies are necessary to develop definitive measures based on ICF categories.
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13. |
- Algurén, Beatrix, et al.
(författare)
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A scoping review and mapping exercise comparing the content of patient-reported outcome measures (PROMs) across heart disease-specific scales
- 2020
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Ingår i: Journal of Patient-Reported Outcomes. - : Springer. - 2509-8020. ; 4:1
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Over the past decade, the importance of person-centered care has led to increased interest in patient-reported outcome measures (PROMs). In cardiovascular care, selecting an appropriate PROM for clinical use or research is challenging because multimorbidity is often common in patients. The aim was therefore to provide an overview of heart-disease specific PROMs and to compare the content of those outcomes using a bio-psycho-social framework of health.METHODS: A scoping review of heart disease-specific PROMs, including arrhythmia/atrial fibrillation, congenital heart disease, heart failure, ischemic heart disease, and valve diseases was conducted in PubMed (January 2018). All items contained in the disease-specific PROMs were mapped to WHO's International Classification of Functioning, Disability and Health (ICF) according to standardized linking rules.RESULTS: A total of 34 PROMs (heart diseases in general n = 5; cardiac arrhythmia n = 6; heart failure n = 14; ischemic heart disease n = 9) and 147 ICF categories were identified. ICF categories covered Body functions (n = 61), Activities & Participation (n = 69), and Environmental factors (n = 17). Most items were about experienced problems of Body functions and less often about patients' daily activities, and most PROMs were specifically developed for heart failure and no PROM were identified for valve disease or congenital heart disease.CONCLUSIONS: Our results motivate and provide information to develop comprehensive PROMs that consider activity and participation by patients with various types of heart disease.
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14. |
- Algurén, Beatrix, et al.
(författare)
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Factors Associated With Health-Related Quality of Life After Stroke: A 1-Year Prospective Cohort Study.
- 2012
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Ingår i: Neurorehabilitation and neural repair. - : SAGE Publications. - 1552-6844 .- 1545-9683. ; 26:3, s. 266-274
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In line with patient-centered health care, it is necessary to understand patients' perceptions of health. How stroke survivors perceive their health at different time points after stroke and which factors are associated with these feelings provide important information about relevant rehabilitation targets. OBJECTIVE: This study aimed to identify the independent factors of health-related quality of life (HRQoL) from a biopsychosocial perspective using the methods of multivariate regression at 3 different time points poststroke. METHODS: Included in the study were 99 patients from stroke units with diagnosed first-ever stroke. At admission and at 6 weeks, 3 months, and 1 year poststroke, HRQoL was assessed using the EuroQoL-5D Visual Analogue Scale (EQ-5D VAS). Consequences in Body Functions and Activities and Participation, and Environmental Factors were documented using 155 categories of the International Classification of Functioning, Disability and Health (ICF) Core Set for Stroke. RESULTS: For a period of 1 year, problems with recreation and leisure, personality functions, energy and drive functions, and gait pattern functions were repeatedly associated with worse HRQoL. Whereas Body Functions and Activities and Participation explained more than three-fourths of the variances of HRQoL at 6 weeks and 3 months (R (2) = 0.80-0.93), the variation at 1 year was best explained by either Body Functions or Environmental Factors (R (2) = 0.51). CONCLUSIONS: The results indicate the importance of Body Functions and Activities and Participation (mainly personality functions and recreation and leisure) on HRQoL within 3 months poststroke, but increased impact of Environmental Factors on HRQoL at 1 year.
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15. |
- Alm, Carin, et al.
(författare)
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Knowing your risk factors for coronary heart disease improves adherence to advice on lifestyle changes and medication
- 2006
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Ingår i: The Journal of Cardiovascular Nursing. - 1550-5049. ; 21:5, s. 24-31
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Tidskriftsartikel (refereegranskat)abstract
- Implementation of guidelines for coronary heart disease prevention is less optimal in clinical practice. The aim of this study was to investigate if specific knowledge (patients' knowledge about their own coronary heart disease risk factors) would correlate to their adherence as measured by self-reported lifestyle changes, reaching defined treatment goals and adhering to treatment with prescribed drugs. The consecutive medical records of 509 men and women younger than 71 years, hospitalized for a cardiac event, were screened. Of these, 392 patients came for an interview and were subjected to a clinical examination. All patients received a questionnaire regarding their specific knowledge of risk factors and their adherence to lifestyle changes, which was completed by 347 patients. In addition, data were collected and analyzed on how their treatment goals were attained in 8 domains and their adherence to drug treatment. There were significant correlations between specific knowledge and self-reported lifestyle changes, the ability to reach treatment goals in all 8 domains, and adherence to prescribed drugs. Patients with coronary heart disease will benefit from increased specific knowledge of risk factors to adhere with lifestyle changes and prescribed medication after a cardiac event.
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16. |
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17. |
- Almerud, Sofia, et al.
(författare)
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Acute coronary syndrome : social support and coping ability on admittance
- 2008
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Ingår i: British Journal of Nursing. - London : Mark Allen. - 0966-0461 .- 2052-2819. ; 17:8, s. 527-531
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To compare social support and coping ability in acute coronary syndrome patients at the time of the cardiac event with a healthy community-based sample, with regard to age, sex, education and marital status.Method: The study comprised 241 patients and 316 healthy controls. The participants answered a self-administered questionnaire that included three well-established scales. Multiple logistic regression was used in the analysis to compare the health situation between the patients and controls.Results: Persons suffering from acute coronary syndrome rated emotional support significantly lower than the healthy controls. However, there were no differences between the two groups in terms of socio-demographic variables.Conclusion: This study indicates that social support may be a predictor of acute coronary syndrome.
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18. |
- Almerud, Sofia, et al.
(författare)
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Beleaguered by technology : care in technologically intense environments.
- 2008
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Ingår i: Nursing Philosophy. - : Wiley-Blackwell Publishing Ltd.. - 1466-7681 .- 1466-769X. ; 9:1, s. 55-61
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Tidskriftsartikel (refereegranskat)abstract
- Modern technology has enabled the use of new forms of information in the care of critically ill patients. In intensive care units (ICUs), technology can simultaneously reduce the lived experience of illness and magnify the objective dimensions of patient care. The aim of this study, based upon two empirical studies, is to find from a philosophical point of view a more comprehensive understanding for the dominance of technology within intensive care. Along with caring for critically ill patients, technology is part of the ICU staff's everyday life. Both technology and caring relationships are of indispensable value. Tools are useful, but technology can never replace the closeness and empathy of the human touch. It is a question of harmonizing the demands of subjectivity with objective signs. The challenge for caregivers in ICU is to know when to heighten the importance of the objective and measurable dimensions provided by technology and when to magnify the patients' lived experiences, and to live and deal with the ambiguity of the technical dimension of care and the human side of nursing.
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20. |
- Almerud, S, et al.
(författare)
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Caught in an Artificial Split : A Phenomenological Study of Being a Caregiver in the Technologically Intense Environment
- 2007
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Ingår i: Intensive & Critical Care Nursing. - : Churchill Livingstone. - 0964-3397 .- 1532-4036. ; 24:2, s. 130-136
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Tidskriftsartikel (refereegranskat)abstract
- A symbiotic relationship exists between technology and caring, however, technologically advanced environments challenge caregivers. The aim of this study is to uncover the meaning of being a caregiver in the technologically intense environment. Ten open-ended interviews with intensive care personnel comprise the data. A phenomenological analysis shows that ambiguity abounds in the setting. The act of responsibly reading and regulating instruments easily melds the patient and the machinery into one clinical picture. The fusion skews the balance between objective distance and interpersonal closeness. The exciting captivating lure of technological gadgets seduces the caregivers and lulls them into a fictive sense of security and safety. It is mind-boggling and heart-rending to juggle ‘moments’ of slavish mastery and security menaced by insecurity in the act of monitoring a machine while caring for a patient. Whenever the beleaguered caregiver splits technique from human touch, ambiguity decays into ambivalence. Caring and technology become polarized. Everyone loses. Caregiver competence wanes; patients suffer. The intensive care unit should be technologically sophisticated, but also build-in a disclosive space where solace, trust, and reassurance naturally happen. Caring professionals need to balance state-of-the-art technology with integrated and comprehensive care and harmonize the demands of subjectivity with objective signs.
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21. |
- Almerud, S, et al.
(författare)
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Caught in an artificial split : a phenomenological study of being a caregiver in the technologically intense environment.
- 2008
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Ingår i: Intensive & Critical Care Nursing. - 0964-3397 .- 1532-4036. ; 24:2, s. 130-136
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Tidskriftsartikel (refereegranskat)abstract
- A symbiotic relationship exists between technology and caring, however, technologically advanced environments challenge caregivers. The aim of this study is to uncover the meaning of being a caregiver in the technologically intense environment. Ten open-ended interviews with intensive care personnel comprise the data. A phenomenological analysis shows that ambiguity abounds in the setting. The act of responsibly reading and regulating instruments easily melds the patient and the machinery into one clinical picture. The fusion skews the balance between objective distance and interpersonal closeness. The exciting captivating lure of technological gadgets seduces the caregivers and lulls them into a fictive sense of security and safety. It is mind-boggling and heart-rending to juggle 'moments' of slavish mastery and security menaced by insecurity in the act of monitoring a machine while caring for a patient. Whenever the beleaguered caregiver splits technique from human touch, ambiguity decays into ambivalence. Caring and technology become polarized. Everyone loses. Caregiver competence wanes; patients suffer. The intensive care unit should be technologically sophisticated, but also build-in a disclosive space where solace, trust, and reassurance naturally happen. Caring professionals need to balance state-of-the-art technology with integrated and comprehensive care and harmonize the demands of subjectivity with objective signs
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26. |
- Almerud, Sofia, 1969-
(författare)
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Vigilance & Invisibility : Care in technologically intense environments
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis focuses on the relationship between technology and caring in technologically intense environments. The overall aim was to uncover the meaning of care in those environments as experienced by patients and caregivers. Moreover, the study aimed at finding a deeper understanding for the almost total dominance of technology in care in intensive care. The thesis includes three empirical studies and one theoretical, philosophical study. The research was guided by a phenomenological and lifeworld theoretical approach. Research data consist of quantitative parameters and qualitative interviews with caregivers and patients. Data was analysed and synthesised with aim of seeking meaning through openness, sensitivity and a reflective attitude. The goal was to reach the general structure of the phenomenon and its meaning constituents. The result shows that an intensive care unit is a cognitive and emotionally complex environment where caregivers are juggling a precarious handful of cards. Despite being constantly monitored and observed, intensive care patients express that they feel invisible. The patient and the apparatus easily meld into a unit, one item to be regulated and read. From the patients’ perspective, caregivers demonstrate keen vigilance over technological devices and measured parameters, but pay scant attention to their stories and experiences. Technology, with its exciting captive lure and challenging character, seduces the caregivers and lulls them into a fictive sense of security and safety. Technical tasks take precedence or have more urgency than caring behaviour. A malaise settles on caregivers as they strive for garnering the security that technology promises. Yet simultaneously, insecurity creeps in as they read the patient’s biological data. Technical tasks take precedence over and seemingly are more urgent than showing care. Listening, inspiring trust, and promoting confidence no longer have high priority. Trying to communicate ‘through’ technology is so complex, that it is a difficult challenge to keep in perspective what or who is the focus; ‘seeing’ or caring. Technology should be like a catalyst; do its ‘thing’ and withdraw ‘unnoticed’. This thesis has contributed in gaining deeper knowledge about care in technologically intense environments and the impact of technology. The main contribution is that caregivers need to be aware that the roar of technology silences the subtle attempts of the critically ill or injured person to give voice to his or her needs. In conclusion, the challenges for caregivers are to distinguish when to heighten the importance of the objective and measurable dimensions provided by technology and when to reduce their importance. In order to magnify the patients’ lived experiences. It is a question of balancing state-of-the-art technology with integrative and comprehensive care, of harmonizing the demands of subjectivity with objective signs.
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27. |
- Almerud Österberg, S, et al.
(författare)
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Knowledge of heart disease risk in patients declining rehabilitation
- 2010
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Ingår i: British Journal of Nursing. ; 19:5, s. 288-293
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Tidskriftsartikel (refereegranskat)abstract
- Background: Participation in cardiac rehabilitation programmes (CRPs) allows patients to increase their knowledge of the importance of established risk factors to help them maintain healthy lifestyle changes after coronary heart disease (CHD).Aim: To explore perceived importance and knowledge of known risk factors for CHD among non-attendees in CRPs.Method: Consecutive non-attendees in CRPs (n=106) answered a questionnaire focusing on patients' attitudes towards risk factors and cardiac rehabilitation.Results: The non-attendees lacked knowledge of non-physical characteristics such as depression and social isolation. They also had poor knowledge about biological causes and hereditary factors. However, those who said they knew enough about CHD to prevent recurrent illness did have sufficient knowledge about the established risk factors.Conclusion: There is a lack of knowledge about social isolation and depression and their importance in the development of CHD among the non-attendees. They show greater knowledge about biological risk factors than the importance of companionship, joy and happiness. CHD and loneliness are intimately correlated, so creating a sense of belonging must not be underestimated as a measure to prevent CHD.
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28. |
- Amofah, H. A., et al.
(författare)
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Factors affecting in-hospital sleep-wake pattern in octogenarians during the early postoperative phase after transcutaneous aortic valve replacement
- 2017
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 16:Suppl. 1, s. S53-S53
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Tidskriftsartikel (refereegranskat)abstract
- Background: Octogenarian patients are an increasing group admitted for advanced cardiac treatment. Little is known about factors disturbing their sleep-wake pattern in the early postoperative phase after transcutaneous aortic valve replacement (TAVI), as current knowledge is based upon studies on younger age groups treated for surgical aortic valve replacement.Aim: To determine factors affecting the in-hospital sleep wake pattern in octogenarian patients after TAVI.Methods: This is a prospective cohort study in a tertiary university hospital. Inclusion criteria were age > 80 years with severe aortic stenosis accepted for TAVI. Actigraphy was used to identify sleep-wake pattern (sleep time night and sleep time day), and the Minimal Insomnia Symptom Scale (MISS) to measure self-reported insomnia daily during the first five postoperative days. Charlson`s comorbidity index was used as a measure of comorbidities and the Visual Analog Scale (VAS) to rate pain severity. Information regarding duration of anesthesia, blood transfusion and parenteral administration of morphine equivalents were derived from the patients’ medical journals. Multiple regression analysis was used to test associations between variables.Results: In all, 65 patients (41 women) were included. Mean age was 85 years (SD 2.8). No significant associations were found between age, comorbidities, blood transfusion and morphine equivalents and sleep. Gender was significantly associated with sleep time night and sleep efficiency as men had shortest duration of sleep from the third to the fifth postoperative night (p < .001, and adjusted R2=.230 to .283). Duration of anesthesia had a significant association with sleep time night and sleep efficiency from the third to the fifth postoperative night (p=.013 to p < .001, and adjusted R2=.230 to .283), where longer duration gave less total sleep and lower sleep efficiency. VAS score correlated with wake time night the third night, where a higher VAS score gave more wake time (p=.006 and adjusted R2 .236).Conclusion: Male gender, longer duration of perioperative anesthesia and postoperative pain were associated with disturbances in the postoperative sleep-wake pattern in octogenarian patients in the early postoperative phase after TAVI. This knowledge is important and relevant and should have implications in improving patient care.
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29. |
- Amofah, H. A., et al.
(författare)
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Factors associated with disturbances in sleep-wake pattern in octogenarian patients in the early postoperative phase after surgical aortic valve replacement
- 2017
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 16:Suppl. 1, s. S63-S64
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Tidskriftsartikel (refereegranskat)abstract
- Background: Disturbances of the sleep-wake pattern are known phenomenon in the postoperative phase after aortic valve replacement (SAVR) that have negative impact on the morbidity, quality of life and mortality. Octogenarian patients are an increasing group admitted for cardiac surgery, however knowledge is based on younger patients.Aims: To determine factors associated with disturbances in postoperative sleep-wake pattern in octogenarian patients after SAVR.Methods: A prospective cohort study of octogenarian patients in a single center university hospital. Inclusion criteria were age > 80 years, severe aortic stenosis, accepted for SAVR. Actigraphy was used to identify the sleep-wake pattern (sleep-time, sleep efficiency and wake time night and sleep- and wake-time day) for the five first postoperative days, and the sleep questionnaires Minimal Insomnia Symptom scale (MISS) to measure the selfreported insomnia at baseline and daily for the five first postoperative days. Charlsons comorbidity index was used to score comorbidities and the Visual Analog Scale (VAS), was used to rate pain severity. The patients’ medical journals were used to record duration of anesthesia, duration of cardiopulmonary by-pass, blood transfusions and parenteral administration of morphine equivalents. Multiple regression analysis was used to test associations between variables.Results: In all, 78 patients were included (40 women). Mean age was 82 years (SD 2.0). For the sleep-wake pattern first to fifth postoperative night, mean sleep-time night was 330-370 minutes (SD 32-124). Mean sleep efficiency was 68-77% (SD 21-26). Mean sleep-time day was 545-712 minutes (SD 146-169). Mean insomnia score was 1,8-5,3 (SD 2,6-3,8). On the first postoperative night the pain VAS score correlated with wake time night, where a higher VAS indicated more wake time (p=.014, adjusted R2=.213). No other variable; age, gender, duration of anesthesia, duration of cardiopulmonary by-pass, blood transfusion or morphine equivalents showed significant association with the sleep-wake pattern or insomnia.Conclusion: Postoperative pain was associated with disturbances in sleep-wake pattern in octogenarian patients in the early postoperative phase after SAVR. This indicates that pain management may be inadequate for patients after SAVR. More research on this issue is needed to establish data needed to improve treatment and care.
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30. |
- Amofah, H. A., et al.
(författare)
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Octogenarian patients experiences with hypnotics in relation to sleep disturbances and delirium after aortic valve therapy
- 2018
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 17, s. 104-105
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sleep disturbance and delirium are complications after surgical aortic valve replacement (SAVR) and transcutaneous aortic valve replacement (TAVI), especially in octogenarian patients. Sedatives and z-hypnotics are medications distributed to promote sleep. However, a knowledge-gap exists on patient experiences with these medications, and sleep and delirium after the cardiac treatment.Aim: To explore and describe how octogenarians suffering from delirium after SAVR/TAVI experience their sleep situation related to sedatives and z-hypnotics, in a long-term perspective.Methods An explorative and descriptive design with a longitudinal qualitative approach was applied. Inclusion criteria; age 80+, treated with SAVR or TAVI and had experienced delirium. Information about administration of sedatives and z-hypnotics was collected from the patients journals. The Confusion Assessment Method (CAM) was used to assess delirium, the Sleep Sufficient Index (SSI) and Minimal Insomnia Symptom Scale (MISS) were used to document self-reported sleep and insomnia. All measures were performed at baseline and daily the five first postoperative days. Ten patients were interviewed 6-12 months after treatment with focus on delirium. Five of these patients were re-interviewed four years later, focusing on their sleep situation.Findings: For the initial interview, five men and five woman, four after TAVI and six after SAVR, mean age 83 were included. One overarching theme revealed; hours in bed represented an emotional chaos. Three sub-themes described the patients experiences with sleep and delirium, a cascade of distressful experiences, the struggle between sleep and activity and elements influencing sleep. In the category physical sleep distractions, sleep medications emerged as a sleep disturbing element but also to evoke delirium. Patients described to be offered sedatives and z-hypnotics in hospital. However, they did not have a positive experience with this as the medication did not make them sleep better. Moreover, they associated the nightmares by the sedatives Four years after the cardiac treatment, the octogenarian patients described that medication did not have a sleep promoting effect, and they did not want it.Conclusion: Octogenarian patients are vulnerable to complications like sleep disturbances and delirium. In preventing and treating these conditions, health-care professionals should be aware of the effect and side-effect of sedatives and z-hypnotics in the octogenarian patients. Our findings show that medications should be cautiously used within this group of patients.
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31. |
- Amofah, Hege Andersen, et al.
(författare)
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Octogenarian patients' sleep and delirium experiences in hospital and four years after aortic valve replacement : a qualitative interview study
- 2021
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesSleep disturbances and delirium are frequently observed complications after surgical aortic valve replacement (SAVR) and transcutaneous aortic valve implantation (TAVI), especially in octogenarian patients. However, a knowledge gap exists on patient experiences of sleep and delirium. In particular, patients' long-term sleep and delirium experiences are unknown. This article explores and describes how octogenarian patients suffering from delirium after aortic valve replacement experience their sleep and delirium situation.DesignAn explorative and descriptive design with a longitudinal qualitative approach was applied. Qualitative content analysis following the recommended steps of Graneheim and Lundman was performed.SettingPatients were included at a tertiary university hospital with 1400 beds. Delirium and insomnia screening was performed at baseline and five postoperative days after aortic valve treatment. For qualitative data, 10 patients were interviewed 6-12 months after treatment with focus on delirium. Five of these patients were reinterviewed 4 years after treatment, with focus on their sleep situation.ParticipantsInclusion criteria; age 80+, treated with SAVR or TAVI and had experienced delirium after treatment.ResultsFor the initial interview, we included five men and five women, four following TAVI and six following SAVR, mean age 83. One overarching theme revealed from the content analyses; Hours in bed represented emotional chaos. Whereas three subthemes described the patients' experiences with sleep and delirium, a cascade of distressful experiences disturbing sleep, the struggle between sleep and activity and elements influencing sleep. Four years after the treatment, sleep disturbances persisted, and patients still remembered strongly the delirium incidences.ConclusionsFor octogenarian patients, sleep disturbances and delirium are long-term burdens and need a greater attention in order to improve patient care.
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32. |
- Amofah, Hege A., et al.
(författare)
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Sleep in octogenarians during the postoperative phase after transcatheter or surgical aortic valve replacement
- 2016
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 15:2, s. 168-177
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Tidskriftsartikel (refereegranskat)abstract
- Background: Octogenarians with aortic stenosis are an increasing population of patients admitted for surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). Although adequate sleep is important after illness and surgery, it has scarcely been studied in the immediate postoperative phase.Aims: To determine and compare the nature of self-reported sleep and insomnia, and recorded sleep–wake patterns in octogenarians during the in-hospital postoperative phase after SAVR or TAVI.Methods: A prospective cohort design was used that included octogenarian patients undergoing SAVR or TAVI at a regional university hospital. Self-reports were used to document sleep and insomnia, and actigraphy was used to record sleep–wake patterns. Data were collected at baseline preoperatively, and then daily for the first five postoperative days.Results: SAVR patients experienced the most insomnia on postoperative nights later in recovery, while TAVI patients experienced the most insomnia on postoperative nights early in recovery. The median total sleep time, as measured by actigraphy, was 6.4 h, and the median sleep efficiency was 79% for the five postoperative nights, but no differences were found between SAVR and TAVI patients on this parameter. All patients slept more during daytime than at night, with SAVR patients having significantly more total sleep hours for all five days than TAVI patients (p < 0.01).Conclusion: Octogenarians with aortic stenosis had disturbed self-reported sleep, increased insomnia, and disturbed sleep–wake patterns postoperatively, resulting in more daytime sleep and inactivity. In patients undergoing SAVR or TAVI, sleep evolves differently during the in-hospital postoperative phase.
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33. |
- Andersson, Bodil T., et al.
(författare)
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Development and psychometric evaluation of the radiographers’ competence scale
- 2012
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Ingår i: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; 2:2, s. 85-96
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Tidskriftsartikel (refereegranskat)abstract
- Assessing the competence of registered radiographers’ clinical work is of great importance because of the recent change in nursing focus and rapid technological development. Self-assessment assists radiographers to validate and improve clinical practice by identifying their strengths as well as areas that may need to be developed. The aim of the study was to develop and psychometrically test a specially designed instrument, the Radiographers Competence Scale (RCS). A cross sectional survey was conducted comprising 406 randomly selected radiographers all over Sweden. The study consisted of two phases; the development of the instrument and evaluation of its psychometric properties. The first phase included three steps: 1) construction of the RCS; 2) pilot testing of face and content validity; and 3) creation of a web-based 54-item questionnaire for testing the instrument. The second phase comprised psychometric evaluation of construct validity, internal consistency reliability and item reduction. The analysis reduced the initial 54 items of the RCS to 28 items. A logical two-factor solution was identified explaining 53.8% of the total variance. The first factor labelled “Nurse initiated care” explained 31.7% of the total variance. Factor 2 labelled “Technical and radiographic processes” explained 22.1% of the total variance. The scale had good internal consistency reliability, with a Cronbach’s alpha of 0.87. The RCS is a short, easy to administer scale for capturing radiographers’ competence levels and the frequency of using their competence. The scale was found to be valid and reliable. The self-assessment RCS can be used in management, patient safety and quality improvement to enhance the radiographic process.
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34. |
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35. |
- Andersson, Bodil T., et al.
(författare)
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Radiographers' areas of professional competence related to good nursing care
- 2008
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Ingår i: Scandinavian Journal of Caring Sciences. - : Blackwell Munksgaard. - 0283-9318 .- 1471-6712. ; 22:3, s. 401-409
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Tidskriftsartikel (refereegranskat)abstract
- Background: Radiographers’ ability and competence is a matter of vital importance for patients. Nursing care is an integral part of the radiographer’s work. The demand for high competence in clinical activities has increased in diagnostic radiology and has had an impact on the development of the profession.Aim: The aim was to describe the radiographer’s areas of professional competence in relation to good nursing care based on critical incidents that occur in the course of radiological examinations and interventions.Method: A descriptive design with a qualitative approach, using the Critical Incident Technique was employed. Interviews were conducted with a strategic sample of registered radiographers (n = 14), based at different hospitals in Sweden.Ethical issues: The appropriate ethical principles were followed. All the participants provided informed consent, and formal approval for conducting the research was obtained according to national and local directives.Results: The data analysis resulted in two main areas; direct and indirect patient-related areas of competence, which describe the radiographers’ skills that either facilitate or hinder good nursing care. In the direct patient-related area of competence, four categories emerged, which illustrate good nursing care in the patient’s immediate surroundings. In the indirect patient-related area of competence, four categories illuminated good nursing care that is provided without direct contact with the patient.Conclusions: The study highlights the different areas of the radiographer’s unique professional competence. The findings provide insight into the radiographer’s profession, on one hand as a carer and on the other as a medical technologist as well as highlighting the importance of each role. The radiographer’s work encompasses a variety of components – from caring for the patient to handling and checking the technical equipment.
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36. |
- Andersson, Bodil T., et al.
(författare)
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Radiographers' areas of professional competence related to good nursing care
- 2008
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 22:3, s. 401-409
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Radiographers' ability and competence is a matter of vital importance for patients. Nursing care is an integral part of the radiographer's work. The demand for high competence in clinical activities has increased in diagnostic radiology and has had an impact on the development of the profession.AIM: The aim was to describe the radiographer's areas of professional competence in relation to good nursing care based on critical incidents that occur in the course of radiological examinations and interventions.METHOD: A descriptive design with a qualitative approach, using the Critical Incident Technique was employed. Interviews were conducted with a strategic sample of registered radiographers (n = 14), based at different hospitals in Sweden.ETHICAL ISSUES: The appropriate ethical principles were followed. All the participants provided informed consent, and formal approval for conducting the research was obtained according to national and local directives.RESULTS: The data analysis resulted in two main areas; direct and indirect patient-related areas of competence, which describe the radiographers' skills that either facilitate or hinder good nursing care. In the direct patient-related area of competence, four categories emerged, which illustrate good nursing care in the patient's immediate surroundings. In the indirect patient-related area of competence, four categories illuminated good nursing care that is provided without direct contact with the patient.CONCLUSIONS: The study highlights the different areas of the radiographer's unique professional competence. The findings provide insight into the radiographer's profession, on one hand as a carer and on the other as a medical technologist as well as highlighting the importance of each role. The radiographer's work encompasses a variety of components--from caring for the patient to handling and checking the technical equipment.
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37. |
- Andersson, Bodil T.
(författare)
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Radiographers’ Professional Competence : Development of a context-specific instrument
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims: The overall aim of this thesis was to explore and describe radiographers‟ professional competence based on patients‟ and radiographers‟ experiences and to develop a context-specific instrument to assess the level and frequency of use of radiographers‟ professional competence.Methods: The design was inductive and deductive. Both qualitative and quantitative methods were used. The data collection methods comprised interviews (Studies I-II) and questionnaires (Studies III-IV). The subjects were patients in study I and radiographers in studies II-IV. In study I, 17 patients were interviewed about their experiences of the encounter during radiographic examinations and treatment. The interviews were analysed using qualitative content analysis. In study II, 14 radiographers were interviewed to identify radiographers‟ areas of competence. The critical incident technique was chosen to analyse the interviews. Studies III and IV were based on a national cross-sectional survey of 406 randomly selected radiographers. Study III consisted of two phases; designing the Radiographer Competence Scale (RCS) and evaluation of its psychometric properties. A 42-item questionnaire was developed and validated by a pilot test (n=16) resulting in the addition of 12 items. Thus the final RCS comprised a 54-item questionnaire, which after psychometric tests was reduced to 28 items. In study IV, the 28-item questionnaire served as data. The level of competencies was rated on a 10-point scale, while their use was rated on a six-point scale.Results: In study I, the female patients‟ comprehensive understanding was expressed as feelings of vulnerability. The encounters were described as empowering, empathetic, mechanical and neglectful, depending on the radiographers‟ skills and attitudes. Study II revealed two main areas of professional competence, direct patient-related and indirect patient-related. The first focused on competencies in the care provided in close proximity to the patient and the second on competencies used in the activities of the surrounding environment. Each of the two main areas was divided into four categories and 31 sub-categories that either facilitated or hindered good nursing care. In study III the analysis condensed the 54-item questionnaire in two steps, firstly by removing 12 items and secondly a further 14 items, resulting in the final 28-item RCS questionnaire. Several factor analyses were performed and a two factor-solution emerged, labelled; “Nurse initiated care” and “Technical and radiographic processes”. The psychometric tests had good construct validity and homogeneity. The result of study IV demonstrated that most competencies in the RCS received high ratings both in terms of level and frequency of use. Competencies e.g. „Adequately informing the patient‟, „Adapting the examination to the patient‟s prerequisites and needs‟ and „Producing accurate and correct images‟ were rated the highest while „Identifying and encountering the patient in a state of shock‟ and „Participating in quality improvement regarding patient safety and care‟ received the lowest ratings. The total score of each of the two dimensions had a low but significant correlation with age and years in present position. The competence level correlated with age and years in present position in both dimensions but not with the use of competencies in the “Nurse initiated care” dimension.Conclusion: This thesis has shown that professional competence is important in the encounter between patient and radiographer. It has also demonstrated that radiographers‟ self-rated professional competence is based on nursing, technological and radiographic knowledge. From a radiographer‟s perspective, „Nurse initiated care‟ and „Technical and Radiographic processes‟ are two core dimensions of Radiographer Competence Scale. The 28-item questionnaire regarding level and frequency of use of competence is feasible to use to measure radiographers‟ professional competence.
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38. |
- Andersson, Bodil T., et al.
(författare)
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Radiographers' self-assessed level and use of competencies : a national survey
- 2012
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Ingår i: Insights into Imaging. - : Springer Science and Business Media LLC. - 1869-4101. ; 3:6, s. 635-645
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To describe radiographers' self-assessed level and use of competencies as well as how sociodemographic and situational factors are associated with these competencies, particularly related to work experience.METHODS: A cross-sectional design was employed. Radiographers (n = 406) completed the self-administered 28-item questionnaire encompassing two dimensions: 'Nurse-initiated care' and 'Technical and radiographic processes'. The level of competencies was rated on a 10-point scale and the frequency of use on a 6-point scale.RESULTS: Most competencies received high ratings both in terms of level and frequency of use. In 'Nurse-initiated care' the competency 'Adequately informing the patient' was rated the highest, while 'Identifying and encountering the patient in a state of shock' and 'Participating in quality improvement regarding patient safety and care' received the lowest ratings. In 'Technical and radiographic processes' the highest rated competencies were 'Adapting the examination to the patient's prerequisites and needs' and 'Producing accurate and correct images'. The lowest frequency of use was 'Preliminary assessment of images'.CONCLUSION: The main findings underline the radiographers' high competency in both 'Nurse-initiated care' and 'Technical and radiographic processes'. The lower rated competencies emphasise the importance of continuous professional education and quality improvement.MAIN MESSAGES :• Assessing radiographers' clinical competencies is fundamental for ensuring professional standards.• Most competencies received high ratings both in the nursing and in the radiographic dimensions.• The highest rated competencies focussed on information and adaptability to the patients needs.• The lowest rated competencies focussed on encountering the patient in shock and image assessments.• Age, years in present position and work place only explained a relatively small part of competency.
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39. |
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40. |
- Andersson, S., et al.
(författare)
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The aphasic person's views of the encounter with other people : a grounded theory analysis
- 2002
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - Oxford : Blackwell. - 1351-0126 .- 1365-2850. ; 9:3, s. 285-292
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Tidskriftsartikel (refereegranskat)abstract
- Notes that being affected by aphasia influences the total life experience. The aim of this study was to generate a theoretical model, from a nursing perspective, of what 12 aphasic persons (aged 28-92 yrs old) experience in encounters with other people. Data were collected through interviews which adopted a biophysical, socio-cultural and psychological approach and then analyzed using grounded theory method. Two main categories emerged, namely: interaction and support. Encountered experiences led to (1) a feeling of having ability, (2) a feeling of being an outsider, and (3) a feeling of dejection or uncertainty. The feeling state was dependent on whether the interaction was obstructed or secure and on whether the support resulted in strengthened or impaired self-esteem. Therefore, nurses need to give support that enhances patients self-esteem and which results in them gaining a positive and realistic view of their aphasia, as well as involving those around them in this perspective. This then will give the possibility for the patient to turn the interaction process from an obstructed into a secure one.
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41. |
- Arenhall, Eva, 1974-, et al.
(författare)
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Decreased sexual function in partners after patients’ first-time myocardial infarction
- 2018
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 17:6, s. 521-526
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Tidskriftsartikel (refereegranskat)abstract
- Background: A myocardial infarction event affects not only patients but also partners, although how it affects the partners’ sexual function is not studied.Aim: The purpose of this study was to describe and compare how partners experienced their sexual function one year before with one year after first-time myocardial infarction of their partner.Methods: A longitudinal and comparative design was used. Self-reported data on Watts Sexual Function Questionnaire was collected retrospectively at two occasions from 123 partners (87 women and 36 men), measuring the year prior to the first-time myocardial infarction and the year after. Data were analysed using descriptive and inferential statistics.Results: The total score for Watts Sexual Function Questionnaire showed a significant decrease over time. In all four subscales a decrease was found, which were statistically significant in three out of the four subscales (sexual desire, 19.39 vs 18.61; p<0.001, orgasm, 14.11 vs 13.64; p=0.027 and satisfaction, 12.61 vs 12.31; p=0.042). Twenty-six partners reported that their intercourse frequencies decreased over time, while six partners reported an increased intercourse frequency.Conclusions: Partners’ sexual function decreased after patients’ first-time myocardial infarction. It is important for health personnel to offer information and discussion about sexual function and concerns with both patients and partners after a first-time myocardial infarction.
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42. |
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43. |
- Arenhall, Eva, et al.
(författare)
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The female partners' experiences of intimate relationship after a first myocardial infarction
- 2011
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 20:11-12, s. 1677-1684
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Tidskriftsartikel (refereegranskat)abstract
- Aim.This study aimed to explore and describe women’s experience of intimate relationships in connection to and after their partner’s first myocardial infarction. Background.Support from partners is important for recovery, but little is known about partners’ experience of intimate relationships after myocardial infarction. Design. The study used an explorative, qualitative design. Methods. The first author interviewed 20 women having a partner who had suffered a first myocardial infarction during the preceding year. Qualitative content analysis was used to analyse the data. Findings. Three themes emerged: ‘limited life space’, ‘sense of life lost’ and ‘another dimension of life’. The women described how their self-assumed responsibility led to a more stifling and limited life. Their sense of life lost was described in terms of deficits and feeling the loss. The women also described experiencing another dimension of life characterised by three subthemes: ‘uncertainty of life’, ‘certain of relationship’ and ‘share life more’. Conclusions.The partners’ myocardial infarction had an impact on the interviewees’ intimate relationships; they suffered a major loss and missed their ‘former’ partner, both emotionally and sexually. They struggled with the new asymmetry in their intimate relationship and felt compelled to adapt to their partners’ lack of sexual desire or function. Also, their partner controlled them, which lead towards a stifling, more limited life space. Relevance to clinical practice. Caregivers in hospital and primary care settings could apply the findings in their efforts to help couples recover or maintain intimate relationships following myocardial infarction.
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44. |
- Arenhall, Eva, 1974-, et al.
(författare)
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The male partners' experiences of the intimate relationships after a first myocardial infarction
- 2011
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 10:2, s. 108-114
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stress in the intimate relationship is found to worsen the prognosis in women suffering from myocardial infarction (MI). Little is known about how male spouses experience the intimate relationship.Aim: This study aimed to explore and describe the experience of men's intimate relationships in connection to and after their female partner's first MI.Methods: An explorative and qualitative design was used. Interviews were conducted with 16 men having a partner who the year before had suffered a first MI. The data were analysed with qualitative content analysis. Results: Three themes emerged: masculine image challenged; life takes another direction; and life remains unchanged. The men were forced to deal with an altered image of themselves as men, and as sexual beings. They were hesitant to approach their spouse in the same way as before the MI because they viewed her to be more fragile. The event also caused them to consider their own lifestyle, changing towards healthier dietary and exercise habits.Conclusions: After their spouse's MI, men experienced a challenge to their masculine image. They viewed their spouse as being more fragile, which led the men to be gentler in sexual intimacy and more hesitant to invite sexual activity. This knowledge about how male spouses experience the intimate relationship could be helpful for health personnel in hospitals and primary care when they interact with couples where the woman suffers from cardiac disease or other chronic disorders. (C) 2010 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
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45. |
- Arvidsson, Barbro, 1945-, et al.
(författare)
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A nurse-led rheumatology clinic’s impact on empowering patients with rheumatoid arthritis : A qualitative study
- 2006
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Ingår i: Nursing and Health Sciences. - Richmond, Australia : Wiley-Blackwell. - 1441-0745 .- 1442-2018. ; 8:133-9
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe a nurse-led rheumatology clinic’s impact on empowering patients with rheumatoid arthritis (RA). Rheumatoid arthritis is a chronic, inflammatory disease that attacks many joints, causing considerable functional restrictions for patients. Consequently, these patients are dependent on a wide variety of health-care services. A descriptive, qualitative design inspired by phenomenography was chosen. The conceptions were collected through interviews with 16 strategically selected patients with RA. Three descriptive categories comprising eight conceptions emerged: teaching (gaining insight and receiving information), regular review (receiving security, realizing regularity, and achieving accessibility), and attention (getting a holistic assessment, receiving coordinated care, and getting sufficient time). A nurse-led rheumatology clinic can be a source for empowering patients with RA to adopt new stances to alternative actions and achieve a higher level of faith in their own abilities.
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46. |
- Arvidsson, Barbro, et al.
(författare)
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Effects of process-oriented group supervision as reported by nursing students : a pilot study
- 2008
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Ingår i: Vård i Norden. - Köpenhamn : SSN [Sjuksköterskornas samarbete i Norden]. - 0107-4083 .- 1890-4238. ; 28:1, s. 26-29
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Tidskriftsartikel (refereegranskat)abstract
- One method to ensure that nursing students are better prepared for their future professional role can be to offer them process-oriented group supervision. The aim of this prospective, longitudinal pilot study was to evaluate the effects of a process-oriented group supervision programme (PGSP) comprising educational, supportive and developmental areas based on reports by nursing students undergoing a 3-year nursing education. The students (N=61) evaluated their experiences of the PGSP by means of a questionnaire, which they filled in after each study year. An independent t-test was conducted to compare the educational, supportive, and developmental areas after the first (2002), second (2003) and third year (2004) as well as over the whole 3-year study period. The result showed no significant difference in scores in the educational area. However, there was a significant increase in the supportive area (p=.03) over the 3-year period, which was especially noticeable during the first year (p=.013). There was also an increase in the developmental area over the 3-year period (p=.021) as well as during the first year (p=.024). Thus, PGSP seems to develop nursing students in their professional identity and personal growth. However, as this was a pilot study, a research implication is to perform a large-scale study over a longer period of time.
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47. |
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48. |
- Arvidsson, Barbro, et al.
(författare)
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Factors influencing nurse supervisor competence : a critical incident analysis study
- 2005
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Ingår i: Journal of Nursing Management. - Oxford : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 13:3, s. 231-7
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to identify factors related to critical incidents that influence the competence of nurse supervisors. Nurse supervisors require considerable competence in order to help supervisees to reflect on their clinical work and to interpret the needs of the patient. A qualitative approach involving the critical incident technique was used. Critical incidents were collected by means of self-reports from 25 nurse supervisors. Two main areas emerged: a professional and a personal stance. The professional stance described the nurse supervisors’ awareness of the importance of creating a secure learning environment and facilitating reflection. The supervisors structured the material and created awareness of fundamental nursing values. The second main area, personal stance, described the nurse supervisors’ behaviour when they gave the participating nurses the opportunity to work through the experiences gained in the daily provision of nursing care. Although they experienced lack of self-assurance during the supervision session, they also expressed security regarding their own performance as nurse supervisors. Nurse supervisors need to include more nursing theory and focus on the nursing process as well as being aware of their own shortcomings and resources. One way for the supervisior to scrutinize his/her actions is to discuss and examine them with a more experienced nurse supervisor colleague.
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49. |
- Arvidsson, Barbro, et al.
(författare)
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Process-oriented group supervision implemented during nursing education : nurses’ conceptions 1 year after their nursing degree
- 2008
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Ingår i: Journal of Nursing Management. - Oxford : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 16:7, s. 868-875
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe the variation in how nurses conceive process-oriented group supervision, implemented during nursing education, 1 year after their nursing degree. BACKGROUND: Process-oriented group supervision can be an effective support system for helping nursing students and nurses to reflect on their activities. METHODS: A descriptive qualitative design was chosen for the study. Conceptions were collected through interviews with 18 strategically selected Swedish nurses in 2005. RESULTS: Three descriptive categories comprising seven conceptions were emerged. Supportive actions comprised: a sense of security, belonging and encouragement. Learning actions involved: sharing and reflecting while developmental actions described: enabling professional identity and facilitating personal development. CONCLUSIONS: Process-oriented group supervision has a lasting influence on nurses' development. The possibility to reflect over new stances during nursing education was a prerequisite for the provision of high-quality care. Process-oriented group supervision can make an important contribution to nursing education. IMPLICATIONS: for Nursing Management Process-oriented group supervision provides nurses with the strength to achieve resilience to stress in their work. It may lead to autonomy as well as clarity in the nurse's professional function. This indicates the need for nurse managers to organize reflective group supervision as an integral part of the nurse's work.
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50. |
- Arvidsson, Barbro, 1945-, et al.
(författare)
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Psychiatric nurses' conceptions of how a group supervision programme in nursing care influences their professional competence : a 4-year follow-up study
- 2001
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Ingår i: Journal of Nursing Management. - Chichester, United Kingdom : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 9:3, s. 161-171
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of the study was to describe, after 4 years, psychiatric nurses' conceptions of how a 2-year group supervision programme within nursing care had influenced their professional competence.BACKGROUND: The intention of group supervision in nursing care is to understand nurses' experiences within real care settings and to structure these in a professional and personal context.METHODS: Ten psychiatric nurses participated in a 2-year group supervision programme. They were interviewed 4 years after the group supervision was ended. Data were analysed according to the phenomenographic method.FINDINGS: Six description categories emerged: a feeling of job satisfaction; gaining knowledge and competence; gaining a sense of security in nursing situations; a feeling of personal development; realizing the value of supervision; and a sense of professional solidarity.CONCLUSIONS: The findings of the 4-year follow-up showed that a group supervision programme in nursing care had lasting influences on the psychiatric nurses' professional competence in the form of a pronounced professional identity and an integrated nursing care perspective. Group supervision contributes to maintaining the strength and energy needed to carry on working, which makes continuing supervision necessary.IMPLICATIONS: An important research implication could be to investigate the type of knowledge that ought to be developed within group supervision in nursing care.© 2001 Blackwell Science Ltd.
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