| 1. |
- Anåker, Anna, et al.
(författare)
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The Professional Nurse Self-Assessment Scale II - Translation and cultural adaptation for Nordic countries
- 2024
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Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It is important to map the clinical competence of newly graduated nurses in Nordic countries. The use of a common Nordic instrument could provide insights into nurses' levels of self-assessed clinical competence and perceptions of their need for professional development.AIM: To translate and culturally adapt the original Norwegian version of the Professional Nurse Self-Assessment Scale II (PROFFNurse SAS II) into (1) Danish, (2) Finnish and (3) Icelandic versions.METHOD: The PROFFNurse SAS II was translated and cross-culturally adapted. This translation was inspired by the process used in the Guidelines for Cross-Cultural Adaptation.RESULT: The translation and cultural adaptation processes employed the required steps and provided specific details. In addition, practical issues encountered during the translation process while translating and adapting instruments that may influence future translations were revealed. This study found that having a professional bilingual/bicultural agency translator was partly problematic in the process of translation and found that it is important to adjust the translations to each country's specific words used in nursing.CONCLUSION: Translating the PROFFNurse SAS II instrument into all Nordic languages enables us to use the instrument from a Nordic perspective and across various countries. This is important when comparing self-awareness and reflecting on nurses' clinical competencies. Professional development is central to valuing and developing clinical competence and allowing for the discovery of gaps in clinical competence.
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| 2. |
- Baxter, Rebecca, 1989-
(författare)
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“Life is for living” : exploring thriving for older people living in nursing homes
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Demand for formal care in nursing homes has steadily increased in recent decades, prompting calls for exploration of health-promoting and salutogenic concepts that support people not only to survive in older age, but to thrive. The concept of thriving has been described as a holistic experience of place-related well-being resulting from interactions between the person and their lived-environment. However, detailed understandings of thriving among nursing home residents and staff are lacking, and little is known about the variables that influence thriving, how thriving is regarded outside of Scandinavia, or the extent to which thriving may change over time.Aim: The overall aim of this thesis was to explore meanings, expressions, measurements, and associations for thriving in nursing homes. Study I aimed to illuminate the meanings of thriving as narrated by persons living in an Australian nursing home. Study II aimed to explore how Australian nursing home staff recognise expressions of thriving among persons living in nursing homes. Study III aimed to further test and describe the psychometric properties and performance of the 32-item Thriving of Older People Assessment Scale (TOPAS) and to develop a short-form TOPAS. Study IV aimed to describe longitudinal changes in Swedish nursing home thriving over a five-year period and describe changes in associated factors. Methods: For studies I and II data were collected in the form of qualitative interviews with Australian nursing home residents (N=21; study I) and staff (N=14; study II). Qualitative data were analysed using phenomenological hermeneutical analysis and qualitative content analysis respectively. For studies III and IV cross-sectional baseline (i.e., 2013/2014) and follow-up (i.e., 2018/2019) data were collected from a nationally representative sample of Swedish nursing homes for the Swedish National Inventory of Care and Health in Residential Aged Care (SWENIS) study. The baseline SWENIS I sample consisted of 4,831 proxy-rated resident surveys from 35 municipalities (study III) and the follow-up SWENIS II sample consisted of 3,894 proxy-rated resident surveys from 43 municipalities (study IV). Quantitative data were analysed using descriptive statistics, validity testing, item response theory-based analysis, and simple linear regression.Results: The meanings of thriving for nursing home residents were understood as encompassing elements of acceptance, balance, and contentment in relation to the person’s living situation, as well as their social and physical environment (study I). These meanings were interpreted as having options and choices, and the agency to make decisions where possible, in relation to the care and living environment. Nursing home staff were found to recognise expressions of thriving through a combination of understanding, observing, and sensing (study II). Staff described recognising thriving through reflective assessment processes that involved comparing and contrasting their personal and professional interpretations of thriving with their overall sense of the resident. Psychometric testing of the 32-item and short-form versions of the TOPAS showed good validity and reliability to measure thriving among nursing home residents (study III). Population characteristics were relatively consistent between the SWENIS I baseline and SWENIS II follow-up samples (study IV). A sub-sample of nursing homes that participated in both baseline and follow-up data collections reported a statistically significant increase for thriving and a decrease in the prevalence of neuropsychiatric symptoms. Higher and lower thriving was associated with several neuropsychiatric symptoms.Conclusions: Thriving appeared to be a relevant and meaningful phenomenon with shared understandings among nursing home residents and staff, providing valuable support for the ongoing assessment and application of thriving in international and cross-cultural nursing home settings. The TOPAS appeared valid and reliable to facilitate proxy-rated measurement of thriving among nursing home residents, and the short-form TOPAS could have enhanced use for assessment of thriving in research and practice. Changes to the overall thriving scores between baseline and follow-up provides important information that may be used as a reference point for future measurements and comparisons of thriving and its associated variables over time. This thesis highlights the importance of considering the various experiences, perceptions, and interpretations of thriving if such a concept is to be effectively embedded in person-centred care, policy, and practice.
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| 3. |
- Bergman, Karin, et al.
(författare)
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Patients' satisfaction with the care offered by advanced practice nurses: a new role in Swedish primary care
- 2013
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Ingår i: International Journal of Nursing Practice. - : Wiley. - 1322-7114 .- 1440-172X. ; 19:3, s. 326-333
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to describe patients’ satisfaction with the new role of advanced practice nurses (APNs) in Swedish primary care. A questionnaire pertaining to patient satisfaction with the care offered by APNs was sent to respondents. Descriptive statistics, a chi-squared test and manifest qualitative content analysis were used during analysis. Although the results show an overall high level of patient satisfaction as regards APN-led care, those patients informed of the APN role prior to a consultation were significantly more satisfied. Respondents’ comments indicate that professional treatment and competence are characteristic of the care offered by APNs and also relate the concepts of increased availability of and continuity in health care to the APN role. In order to guarantee the positive development of the APN role in Sweden, continued research is needed from patient, organizational and interprofessional perspectives, including intervention studies of cost effectiveness and the quality of care.
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| 4. |
- Bliksvær, Trond, et al.
(författare)
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Health care services for older people in COVID-19 pandemic times – A Nordic comparison
- 2024
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Ingår i: Scandinavian Journal of Primary Health Care. - 0281-3432 .- 1502-7724. ; 42:1, s. 144-155
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to explore the Nordic municipal health and care services’ ability to promote principal goals within care for older people during the cOViD-19 pandemic.Design and setting: two surveys were conducted among managers of municipal health care services for older people in Denmark, Finland, Norway and sweden; the first around 6 months into the pandemic (survey 1), and the second around 12 months later (survey 2). Data were analysed through descriptive statistics, and multiple regression (Ols).Subjects: 1470 (survey 1, 2020) and 745 (survey 2, 2021) managers. 32% in home care, 51% in nursing homes, 17% combined.Results: in all countries the pandemic seems to have had more negative impact on eldercare services’ ability to promote an active and social life, than on the ability to promote or enhance older people’s mental and physical health. the regression analysis indicates that different factors influence the ability to promote these goals. Managers within nursing homes reported reduced ability to promote mental and physical health and an active social life to a significantly lower degree than managers of home care. the effect of three prevention strategies (lock down, testing, and/or organisational change), were explored. Organisational change (reorganize staff and practice, restrict use of substitutes) tended to impact the units’ ability to promote a social life in a positive direction, while lock down (areas, buffets etc) tended to impact both the ability to promote mental/physical health and a social life in a negative direction.Conclusion: Measures that can improve opportunities for an active and social life during a pandemic should have high priority, particularily within home care.KEY POINTS• it is important to learn from how the cOViD-19 outbreak in 2020 affected the municipal health and care services’ ability to achieve principal goals within care for older people.• the pandemic had a more negative impact on the services’ ability to promote an active and social life, than on their ability to promote or enhance mental and physical health.• Measures that can improve opportunities for an active and social life during a pandemic situation should have high priority, particularily within home-based care.
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| 5. |
- Christiansen, Mats, med. lic. 1972-, et al.
(författare)
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Reclaiming Sexual health : Unscripted sexual practices of men having sex with men after prostate cancer treatment as ways to comfort and wellbeing in everyday life
- 2022
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Ingår i: Caring in a changing world. ; , s. 34-34
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Konferensbidrag (refereegranskat)abstract
- Background: Prostate cancer is the most common form of cancer in men. Treatments affect the body and sexuality. Men having sex with men (MSM) report a more substantial influence on sexuality and quality of life.Aim: The purpose of the study was to describe the sexual health of MSM after prostate cancer treatment.Methods: Semi-structured interviews related to symptoms and issues and the help received. Interviews were analyzed using content analysis.Results: The following themes emerged during the analysis: Predominant heteronormative care, Unscripted sexualities, A window of peer support system emerged. The men described how their sexuality had been affected and hampered by their treatments with bodily changes and less pleasure. However, they also described the benefit of being MSM, accustomed to exploring new ways of expressing and exploring their sexualities due to a lack of sexual scripts. The treatment provided a new reason to explore new sexualities and sexual practices. In contacts with urology and oncology departments, they described a heteronormative environment. Albeit same-sex partners could be asked for in intake notes, no one reflected on what non-penovaginal sexuality could look like. Instead, their friends and ability to find alternative ways to valid information became important.Conclusion: The result shows that predominantly heteronormative care exists for MSM where they had to rely on their MSM peers and explore new sexual scripts.Caring in a changing world: MSM described well-meaning care but heteronormative. The men described being MSM as something that had made them explore unscripted sexual practices and had given them a broader sexual repertoire that was helpful for their sexual health. More information on sexual health is needed for healthcare personnel to care for MSM in different life situations.
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| 6. |
- Christiansen, Mats, et al.
(författare)
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Reclaiming Sexual health : unscripted sexual practices of men having sex with men after prostate cancer treatment as ways to comfort and wellbeing in everyday life
- 2022
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Ingår i: Caring in a changing world. ; , s. 34-34
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Konferensbidrag (refereegranskat)abstract
- Background: Prostate cancer is the most common form of cancer in men. Treatments affect the body and the sexuality. Men having sex with men (MSM) report stronger influence on sexuality and quality of life.Aim: The purpose of the study was to describe the sexual health of MSM after prostate cancer treatment.Methods: Semi-structured interviews related to symptoms and issues, and the help received. Interviews were analyzed using content analysis.Results: The following themes emerged during the analysis: A predominant heteronormative care, Unscripted sexualities, A window of peer support system emerged. The men described how their sexuality had been affected and hampered by the treatments they had received with bodily changes and less pleasure. However, they also described the benefit of being MSM, being accustomed to exploring new ways of expressing and exploring their sexualities due to a lack of sexual scripts. The treatment provided a new reason to explore new sexualities and sexual practices. In contacts with urology and oncology departments, they described a heteronormative environment. Albeit same-sex partners could be asked for in intake notes, no one reflected on what non-penovaginal sexuality could look like. Instead, their friends and ability to find alternative ways to valid information became important.Conclusion: The result shows that predominantly heteronormative care exists for MSM where they had to rely on their MSM peers, but also exploring new sexual scripts.Caring in a changing world: MSM describe care that was well-meaning but heteronormative. The men described being MSM as something that had made them explore unscripted sexual practices and had given them a broader sexual repertoire that was helpful for their sexual health. More information on sexual health is needed for healthcare personnel to care for MSM in different life situations.
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| 7. |
- Christiansen, Mats, med. lic. 1972-, et al.
(författare)
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Unscripted sexual practices : Sexual health of men having sex with men after prostate cancer treatment
- 2022
-
Konferensbidrag (refereegranskat)abstract
- Purpose: The purpose of the study was to describe the sexual health of men having sex with men after prostate cancer treatment.Methods: A snowball sampling was conducted via clinicians and gatekeepers to the community. After consenting to participate, a semi-structured interview was conducted based on a questionnaire related to symptoms and issues and the help asked for and received. The interviews were approximately one hour and took place via digital platforms. The interviews were transcribed verbatim and then analyzed using content analysis. The following themes emerged during the analysis: A predominant heteronormative care, A situation of suffering and possibilities, A window of peer support system emerged.Results: The men described how their sexuality had been severely affected by their treatments. Bodily changes with decreased penis size, difficulties maintaining an erection, and less pleasure from anal sex. However, they also described the benefit of being men who had sex with men. They described being accustomed to exploring new ways of expressing and exploring their sexualities due to a lack of sexual scripts. The prostate cancer treatment had given them a new reason to explore new sexualities and sexual practices. In contacts with urology and oncology departments, both physicians and nurses, the men described a heteronormative environment. Albeit same-sex partners could be asked for in intake notes, no one reflected on what non-penovaginal sexuality could look like. Therefore, getting the appropriate care for the men after prostate cancer treatment did not involve erectile dysfunction medications was challenging. Instead, their friends and ability to find alternative ways to valid information became important.Conclusion: The result shows that predominantly heteronormative care exists for men who have sex with men. The new insight of the treatment is regarded as a situation of suffering and new possibilities. To conclude, men who have sex with men describe care that was well-meaning but heteronormative. The men described being men having sex with men as something that had made them explore unscripted sexual practices and had given them a broader sexual repertoire that was helpful for their sexual health. Furthermore, the support they received emerged from a peer support system in their private life.
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| 8. |
- Dahlin Almevall, Albin, 1984-
(författare)
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Healthy Ageing and Well-Being in Old Age
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In the decades to come, Sweden will be facing an unprecedented increase in the proportion of inhabitants aged 80 years or older. This age group is characterised by large heterogeneity; however ageing also poses challenges for health and well-being. These challenges apply not only to the individual, but also to the health care systems. Care of this older age group employs much of the nursing resources, affecting society as a whole. Healthy ageing can and should, therefore, be promoted in the decades prior to reaching old age, and once having reached old age, well-being should be a continued focus of health care and society. In this way older adults can continue perceiving good health and well-being. The overall aim of this thesis was to explore and describe areas of importance to healthy ageing and well-being in old age. Predictors of healthy ageing were prospectively studied as part of the northern Sweden Silver-MONICA project, from baseline in 1999 (n=1595) to follow-up 20 years later (n=541). For the healthy ageing outcome, a composite outcome comprised of measures of cognition (MMSE), 2.4 metre walking speed, personal independence in everyday life (Katz P-ADL) and depression (GDS15) was constructed. To study perceptions of general well-being in old age, a subsample (n=52) age > 80 was analysed as a cross-section using mixed method with open-ended interviews and the PGCMS well-being measure. A similar approach was used (n=50) to investigate specific aspects of well-being in relation to home. To study the relationship between well-being and objectively measure everyday physical activity, an accelerometer was worn 24 hours per day for at least 5 consecutive days (n=77) and analysed for associations with the PGCMS and its subscales. The five top ranking predictors determined by the healthy ageing index, comprising the total baseline cohort including those who passed away before possible follow-up were smoking status, NT-proBNP, waist circumference, leisure time physical activity level and HbA1c. For those who participated in the Silver-MONICA follow-up, the top five ranking predictors as determined by the healthy ageing index were leisure time physical activity, HbA1c, BMI, waist circumference and high sensitivity Troponin I. In interviews of general well-being, six areas were described that related to social context, health, physical activity, home, engagement and freedom. In regression analysis independence in activities of everyday living along with age were significantly associated with well-being. Acceptance was key for handling consequences of ageing that impacted well-being. Home was perceived as a central aspect of well-being; however, participants described being in the margins of home. Morale was higher among persons living in single-dwelling housing compared to those living in apartments. In activity measures, well-being was associated with the number of steps, time spent stepping and time spent stepping at >75 steps/minute.In conclusion, the combination of qualitative, quantitative and mixed methodology utilised in this thesis to study healthy ageing allowed for the possibility to nuance conclusions and to describe the subject from different points of view. Based on the findings, this thesis suggests that physical ability in old age is the basis for being able to engage in and experience the important factors of well-being described above. However, support from others, often family, can compensate for the lack of physical ability. The support is positive to well-being as long as it does not create feelings of being a burden. As consequences of ageing affect the areas most crucial to well-being, it seems that the extent and way these changed conditions are accepted has an important role in the maintaining of well-being in old age.
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| 9. |
- de Groot, Gudrun Cathrine Lindgren, et al.
(författare)
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Older adults' motivating factors and barriers to exercise to prevent falls
- 2011
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa Healthcare. - 1103-8128 .- 1651-2014. ; 18:2, s. 153-160
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe motivating factors and barriers for older adults to adhere to group exercise in the local community aiming to prevent falls, and thereby gain knowledge about how health professionals can stimulate adherence. The motivation equation was used as a theoretical framework. Data were collected from individual semi-structured interviews (n = 10). The interviews were taped, transcribed, and thereafter analysed by using a descriptive content analysis consisting of four steps. The results showed that motivating factors to adhere to recommended exercise were perceived prospects of staying independent, maintaining current health status, and improving physical balance and the ability to walk. Barriers were reduced health status, lack of motivation, unpleasant experience during previous exercise group sessions, and environmental factors. All participants wanted information from health professionals on the benefit of exercise. Many considered individual variations in functional skills within each group as a disadvantage. The knowledge gained from this study suggests a greater involvement from all health professionals in motivating older adults to attend exercise groups. The results also suggest that physical therapists should be more aware of the importance of comparative levels of physical function when including participants in exercise groups.
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| 10. |
- Emma, Lindblad, et al.
(författare)
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Experiences of the new role of advanced practice nurses in Swedish primary health care--a qualitative study
- 2010
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Ingår i: International Journal of Nursing Practice. - 1322-7114. ; 2010:16, s. 69-74
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate and describe the experiences of the first advanced practice nurses (APNs), a new profession for Swedish health care, and of their supervising general practitioners (GPs), regarding the new role and scope of practice of APNs in primary health care. Individual interviews were conducted with the four first APNs and one focus group interview was conducted with five supervising physicians. The material was transcribed verbatim and analysed using latent content analysis. The respondents expressed confidence and trust in the new role of APNs. Some opposition to this new role from the GPs and other colleagues was observed, but was nonetheless overcome. The experiences of the APN role indicate that the new role is clearly demarcated from the role of physicians. The APNs were considered an extra resource for both the GPs and other nurses, which contributed to an increased availability of care for patients. The APN role requires an explicit definition and demarcation in relation to responsibility and roles among colleagues. Further development of the APN role presupposes the right to prescribe medication and order treatments, as well as an evaluation of patient, organizational and inter-professional perspectives on the matter.
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| 11. |
- Eriksson, Irene, 1965-, et al.
(författare)
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Do urinary tract infections affect morale among very old women?
- 2010
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Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 8, s. 73-
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Tidskriftsartikel (refereegranskat)abstract
- As UTI seems to be independently associated with low morale or poor subjective wellbeing, there needs to be more focus on prevention, diagnosis and treatment of UTI in old women.
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| 12. |
- Eriksson, Irene, et al.
(författare)
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Older women's experiences of suffering from urinary tract infections
- 2014
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. - 9789174591644 ; 23:9-10, s. 1385-1394
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To describe and explore older women's experiences of having had repeated urinary tract infections (UTIs). Background: UTIs are one of the most common bacterial infections among older women. Approximately one-third of very old women suffer from at least one UTI each year. Despite the high incidence of UTI, little is known about the impact of UTI on health and daily life in older women. Design: A qualitative descriptive design. Methods: A qualitative study using semi-structured interviews was conducted with 20 Swedish women aged 67-96 years who suffered from repeated UTIs the preceding year. The data were analysed using qualitative content analysis. Results: Two main themes were identified: being in a state of manageable suffering and depending on alleviation. Being in a state of manageable suffering was described in terms of experiencing physical and psychological health problems, struggling to deal with the illness and being restricted in daily life. Depending on alleviation was illustrated in terms of having access to relief but also receiving inadequate care. Conclusions: This study demonstrated that UTIs are a serious health problem among older women that not only affects both physical and mental health but also has serious social consequences. The women in this study described the physical and psychological health problems, struggling to deal with the illness, being restricted in daily life, depending on access to relief and receiving inadequate care. Relevance to clinical practice: It is important to improve the knowledge about how UTI affects the health of older women. This knowledge may help nurses develop strategies to support these women. One important part in the supportive strategies is that nurses can educate these women in self-care. © 2013 John Wiley & Sons Ltd.
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| 13. |
- Eriksson, Irene, 1965-, et al.
(författare)
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Prevalence and factors associated with urinary tract infections (UTIs) in very old women
- 2010
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 50:2, s. 132-135
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the prevalence of urinary tract infection (UTI) and associated factors among very old women. In a cross-sectional, population-based study in Sweden and Finland, 532 women were asked to participate and 395 (74.2%) were possible to evaluate for UTI. Data were collected from structured interviews and assessments made during home visits, from medical charts, caregivers and relatives. UTI diagnosis documented in medical records during the preceding 1 and 5 years was registered. About one-third (117/395, 29.6%) were diagnosed as having suffered from at least one UTI in the preceding year and 60% in the preceding 5 years. In a multivariate logistic regression model, UTI in the preceding year, was associated with vertebral fractures (odds ratio (OR) = 3.2; 95% confidence interval (95% CI) = 1.4-7.1), incontinence (OR = 2.8; 95% CI = 1.8-4.5), inflammatory rheumatic disease (OR = 2.8; 95% CI = 1.4-5.7) and multi-infarct dementia (OR = 2.4; 95% CI = 1.3-4.5). UTI is a major public health problem in very old women and were independently associated with vertebral fractures, urinary incontinence, inflammatory rheumatic disease and multi-infarct dementia which might indicate that UTI is not a harmless disease.
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| 14. |
- Eriksson, Irene, 1965-
(författare)
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Urinary tract infection : a serious health problem in old women
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Urinary tract infection (UTI) is a common bacterial infection in women of all ages but the incidence and prevalence increase with age. Despite the high incidence of UTI, little is known about its impact on morale or subjective wellbeing and daily life in old women. UTI in older people can be a complex problem in terms of approach to diagnosis, treatment and prevention because in these patients it frequently presents with a range of atypical symptoms such as delirium, gastrointestinal signs and falls. Even if UTI has been shown to be associated with delirium it has frequently been questioned whether UTI can cause delirium or if it is only accidentally detected when people with delirium are assessed. The main purpose of this thesis was to describe the prevalence of UTI, to identify factors associated with UTI among very old women and to illuminate the impact of a UTI on old women’s health and wellbeing. This thesis is based on two main studies, the GErontological Regional DAtabase (GERDA) a cross-sectional, population-based study carried out in the northern parts of Sweden and Finland during 2005-2007 and a qualitative interview study in western Sweden 2008-2009. Data were collected from structured interviews and assessments made during home visits, from medical records, care givers and relatives. UTI was diagnosed if the person had a documented symptomatic UTI, with either short- or long-term ongoing treatment with antibiotics, or symptoms and laboratory tests judged to indicate the presence of UTI by the responsible physician or the assessor. One hundred and seventeen out of 395 women (29.6%) were diagnosed as having suffered from at least one UTI during the preceding year and 233 of these 395 (60%) had had at least one diagnosed UTI during the preceding 5 years. These old women with UTI were more dependent in their activities of daily living, and had poorer cognition and nutrition. In these women, UTI during the preceding year was associated with vertebral fractures, urinary incontinence, inflammatory rheumatic disease and multi-infarct dementia. Eighty-seven of 504 women (17.3%), were diagnosed as having a UTI with or without ongoing treatment when they were assessed, and almost half (44.8%) were diagnosed as delirious or having had episodes of delirium during the past month. In all, 137 of the 504 women (27.2%) were delirious or had had episodes of delirium during the past month and 39 (28.5%) of them were diagnosed as having a UTI. Delirium was associated with Alzheimer’s disease, multi-infarct dementia, depression, heart failure and UTI. Forty-six out of 319 women (14.4%) were diagnosed as having had a UTI with or without ongoing treatment and these had a significantly lower score on the Philadelphia Geriatric Center Morale Scale (PGCMS), (10.4 vs 11.9, p=0.003) than those without UTI, indicating a significant impact on morale or subjective wellbeing among very old women. The medical diagnoses significantly and independently associated with low morale were depression, UTI and constipation. The experience of suffering from repeated UTI was described in interviews conducted with 20 old women. The interviews were analysed using qualitative content analysis. The participants described living with repeated UTI as being in a state of manageable suffering and being dependent on alleviation. Being in a state of manageable suffering was described in terms of experiencing physical and psychological inconveniences, struggling to deal with the illness and being restricted regarding daily life. Being dependent on alleviation was illustrated in terms of having access to relief but also experiencing receiving inadequate care. In conclusion, UTI is very common among old and very old women and is a serious health problem. UTI seems to be associated with delirium and to have a significant impact on the morale or subjective wellbeing of old women and those affected suffer both physically and psychologically and their social life is limited. UTI was also associated with vertebral fractures, urinary incontinence, inflammatory rheumatic disease and multi-infarct dementia which might raise the suspicion that UTI can have serious medical effects on health in old women.
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| 15. |
- Eriksson, Irene, 1965-, et al.
(författare)
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Urinary tract infection in very old women is associated with delirium
- 2011
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Ingår i: International psychogeriatrics. - : Cambridge University Press. - 1041-6102 .- 1741-203X. ; 23:3, s. 496-502
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of the study was to investigate whether urinary tract infection (UTI) in a representative sample of 85-, 90- and >/=95-year-old women is associated with delirium. Methods: In 504 out of 643 women (78.4%) it was possible to evaluate UTI and delirium. Assessments such as the Organic Brain Syndrome (OBS) Scale, the Geriatric Depression Scale-15 (GDS-15) and the Mini-mental State Examination (MMSE) were performed during home visits. Delirium, dementia and depression were diagnosed according to the DSM-IV criteria. A diagnosed, symptomatic UTI with or without ongoing treatment, documented in medical records or detected in association with the assessments, was registered. Results: Eighty-seven of 504 women (17.2%), were diagnosed as having a UTI with or without ongoing treatment when they were assessed, and almost half of them (44.8%) were diagnosed to be delirious or having had episodes of delirium during the past month. One hundred and thirty-seven of the 504 women (27.2%) were delirious or had had episodes of delirium during the past month and 39 (28.5%) of them were diagnosed to have a UTI. In a multivariate logistic regression model, delirium was significantly associated with Alzheimer's disease (OR = 5.8), multi-infarct dementia (OR = 5.4), depression (OR = 3.1), heart failure (OR = 2.3) and urinary tract infection (OR = 1.9).Conclusions: A large proportion of very old women with UTI suffered from delirium which might indicate that UTI is a common cause of delirium. There should be more focus on detecting, preventing and treating UTI to avoid unnecessary suffering among old women.
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| 16. |
- Eronen, Lotta, et al.
(författare)
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A qualitative document analysis of national guidelines in Nordic nursing education using the European Federation of Nurses Associations Competency Framework
- 2023
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Ingår i: Nordic journal of nursing research. - 2057-1585 .- 2057-1593. ; 43:2
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Tidskriftsartikel (refereegranskat)abstract
- Initial harmonization has been found within nursing education in the European Union member states, but with a need for the establishment of further, well-defined standards. The aim of this study was to describe and analyze the main content of nursing education expressed in national guidelines in the Nordic countries, seen as comparisons between the countries and to the European Federation of Nurses Associations (EFN) Competency Framework. A qualitative deductive research method and content analysis were applied to analyze 20 documents, using the EFN Competency Framework as a theoretical framework and analysis matrix. The study was performed in line with the Standards for Reporting Qualitative Research (SRQR) checklist. Variations in structure between the included countries was seen and evident uniformity was lacking. There were differences, e.g. the number of European Credit Transfer and Accumulation System (ECTS) credits needed for a degree that needs to be further explored in relation to the quality of education and the competence of newly qualified nurses. There is a question of whether the EU Framework corresponds to the need for nursing competencies for today and the future. Homogenization of guidelines and structures might facilitate further development and deeper collaboration between the Nordic countries, thereby leading to enhanced patient safety and care quality.
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| 17. |
- Fagerström, Lisbeth, et al.
(författare)
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An integrative research review of preventive home visits among older people : is an individual health resource perspective a vision or a reality?
- 2009
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 23:3, s. 558-568
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Tidskriftsartikel (refereegranskat)abstract
- This study has two aims: (i) to explore and evaluate the health-promoting effect of preventive home visit (PHV) by analysing the activities conducted during the PHV and the reported results, and (ii) to critically analyse if PHV is characterized by an individualized health resource perspective. The material was compiled through a systematic literature search in the databases Ebsco, CINAHL, Medline, Science Direct and CSA from the period 1984 to 2004. The result of the systematic database search was a total number of 49 scientific research articles, of which 18 are included in this study. The analysing method was a four-step integrating research review. The review describes the following content concerning (i) activities during home visits: screening, observation and evaluation, guidance, support, referral to care and other services, follow-up and individual aim; (ii) positive effects: reduced mortality, improved ability to function, improved life quality, improved subjective health, fewer admittances for care, older people's experiences of home visits and increased knowledge on health and (iii) unclear/negative effects: admittance to care, no effect on mortality, unaffected ability to function, unaffected general health and uninfluenced life quality. PHVs had been implemented based on an individual perspective in a total of 13 studies out of 18. The focus on sickness was surprisingly clear, and in 10 studies out of 18 a health resource perspective was lacking. The effects of PHVs have been questioned. Despite this, current research results imply that this method has a positive affect on older people's health and well-being. This form of care must still be developed to include extensive screenings and interventions, as well as a health resource perspective where the starting point during every home visit is the older person's individual needs and wishes.
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| 18. |
- Fagerström, Lisbeth, et al.
(författare)
-
An international study of Advanced Practice Nursing Students’ clinical competence by means of the PROFFNurse SAS : a professional nurse self-assessment scale of clinical core competencies
- 2014
-
Konferensbidrag (refereegranskat)abstract
- Background: Various educational programs in advanced practice nursing have been developed throughout the world during the last decades to raise registered nurses’ clinical competence, thereby improving nurses’ competence for independent nursing roles. The “Professional Nurse Self-Assessment Scale” instrument has been developed to determine the core competences of advanced practice nurses (APNs), in accordance with the ICN’s definition of advanced practice nursing. A central question is whether such educational programs develop the required core competencies.Aim: To describe APN students’ perception of competence and perception of need for further training/learning by means of the PROFFNurse SAS instrument.Methods: Approximately 50 APN students from Norway, Sweden, Finland, Iceland, the Netherlands and Great Britain will be asked to participate and answer the PROFFNurse SAS questionnaire (through Questback) from October 2013 to April 2014. Data will be collected during the last study year of the students’ study program. IBM SPSS Statistics 20 for Windows will be used for statistical analyses.Results: Descriptive statistics of the students’ self-assessment of clinical competence and need for more training/learning will be presented during the conference. Differences between countries and between NP and CNS programs will be analyzed.Conclusions: The results of the study will provide an overview of APN students’ self-assessed clinical competence and possible gaps in the APN education programs will be identified.Intended learning outcomes:Understand core APN competencies through the PROFFNurse SAS instrument;Discern whether differences in NP and CNS educational programs exist;Recognize the need for assessing education programs from students’ perspectives.
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| 19. |
- Fagerström, Lisbeth
(författare)
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Benchmarking by the RAFAELA Patient Classification System : a Descriptive Study of Optimal Nursing Intensity Levels
- 2009
-
Ingår i: Connecting Health and Humans. - : IOS Press. - 9781607500247 - 9781607504436 ; , s. 25-29
-
Konferensbidrag (refereegranskat)abstract
- The overall aim of the RAFAELA system is that the personnel resources should be in balance with the patients' caring needs, i.e. when the nursing intensity per nurse is on the optimal level of the unit. The RAFAELA system consists of three parts: the OPCq (Oulu Patient Classification Qualisan) instrument for measuring the nursing intensity, registration of the daily nursing resources and the PAONCIL (Professional Assessment of Optimal Nursing Care Intensity Level) method. The aim of this paper is (1) to describe the structure of benchmarking with the RAFAELA system and (2) to present comparisons of optimal nursing intensity levels in Finnish hospitals by using data from RAFAELA benchmarking reports in 2001. Totally 86 wards from 14 different hospitals in Finland took part in the study, the optimal nursing intensity had been decided for 53 wards. Data was analyzed using descriptive statistics. The avarage workload was on adult wards 25.2 NCI points per nurse. The optimal NCI was exceeded during 48% of the days and under during 22% of the days. An imbalance between nursing intensity and personnel resources clearly affects the care quality and the results. Benchmarking with the RAFAELA system provides nurse managers with many opportunities in their decision processes in human resource management.
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| 20. |
- Fagerström, Lisbeth
(författare)
-
Developing the scope of practice and education for advanced practice nurses in Finland
- 2009
-
Ingår i: International Nursing Review. - : Wiley-Blackwell. - 0020-8132 .- 1466-7657. ; 56:2, s. 269-272
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The reorganization of Finnish healthcare services has required a restructuring of the areas of responsibility between healthcare professionals.Aim: To describe the need for Advanced Practice Nurses in Finland and the development process of a Master's programme in Health Promotion, Advanced Clinical Care.Methods: The study consisted of a survey of nurse managers (24) and focus group interviews with clinical nurse specialists (46).Findings: The expanded role includes advanced clinical skills and responsibility for health prevention and promotion, education, supervision, leadership, research and development.Conclusions: The legislation, scope and models have to be supported and further developed to promote the full scope of advanced practice.
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| 21. |
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| 22. |
- Fagerström, Lisbeth
(författare)
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Evidence-based human resource management : a study of nurse leaders' resource allocation
- 2009
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Ingår i: Journal of Nursing Management. - : Wiley-Blackwell. - 0966-0429 .- 1365-2834. ; 17:4, s. 415-425
-
Tidskriftsartikel (refereegranskat)abstract
- Aims The aims were to illustrate how the RAFAELA system can be used to facilitate evidence-based human resource management.Background The theoretical framework of the RAFAELA system is based on a holistic view of humankind and a view of leadership founded on human resource management.Methods Nine wards from three central hospitals in Finland participated in the study. The data, stemming from 2006–2007, were taken from the critical indicators (ward-related and nursing intensity information) for national benchmarking used in the RAFAELA system. The data were analysed descriptively.Results The daily nursing resources per classified patient ratio is a more specific method of measurement than the nurse-to-patient ratio. For four wards, the nursing intensity per nurse surpassed the optimal level 34% to 62.2% of days. Resource allocation was clearly improved in that a better balance between patients' care needs and available nursing resources was maintained.Conclusions The RAFAELA system provides a rational, systematic and objective foundation for evidence-based human resource management.Implications for nursing management Data from a systematic use of the RAFAELA system offer objective facts and motives for evidence-based decision making in human resource management, and will therefore enhance the nurse leaders' evidence and scientific based way of working.
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| 23. |
- Fagerström, Lisbeth
(författare)
-
Kliniska expertsjukskötare
- 2008
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Ingår i: Epione. - : Sjuksköterskeföreningen i Finland. - 9529047517 ; , s. 21-31
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 24. |
- Fagerström, Lisbeth, et al.
(författare)
-
Leading change : a challenge for leaders in Nordic health care
- 2010
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Ingår i: Journal of Nursing Management. - : Blackwell Publishing Ltd.. - 1365-2834 .- 0966-0429. ; 18:5, s. 613-617
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of the present study was to describe personnel's attitudes to change processes between a regional hospital and the primary health care centre as well as investigate these results with regards to theories pertaining to change and leading change. Background: Leadership has three crucial dimensions: focusing on personnel, results/key processes and the ethical base of activities. Methods: A survey was conducted in 2003 using a comprehensive questionnaire. The total sample consisted of the personnel (n = 899) at the two organizations (answering rate was 68.8%). The data were analysed descriptively. Results: Approximately two-thirds of the respondents understood why the merger was occurring. Only one-third expressed that they had received sufficient information regarding the merger. In total 67% felt that the merger would create conflict while approximately one-fourth expressed uncertainty. Despite such negative responses, approximately two-thirds felt there were advantages to the merger. Significant differences were seen between the groups. Conclusions: In times of change personnel expect leaders to focus on dialogue with their personnel and to anchor the vision of the change process amongst the personnel. Implications for nursing management: By identifying the 'prison of thought' and creating an atmosphere where reflection and discussion are valued the nurse leader can help prevent resistance to change.
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| 25. |
- Fagerström, Lisbeth
(författare)
-
Positive life orientation - an inner health resource among older people
- 2010
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 24:2, s. 349-356
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Tidskriftsartikel (refereegranskat)abstract
- As pertains to life orientation, the study's conceptual framework demonstrates the importance of close relationships, meaning in life, and the strength of individuals to look forward and make plans for future. The aim of this study is to discover, in relation to background factors such as language, living situation, and culture, how people aged 65 and 75 experience life orientation. The study is a population-based cross-sectional survey with its material taken from 3,370 questionnaires which included the six-question Life Orientation scale. The SPSS static program, version 14.0, was used for all calcuations and the Chi-squared test was applied to determine if any significant differences between the groups existed. As seen in this study, most respondents aged 65 (85%) and 75 (73.2%) experienced a high degree of positive life orientation, clearly expressing a zest for life (93.5%), overall satisfaction with their lives (88.4%), and feelings of being needed (83.7%). Lower scores were given for never/seldom being depressed/sad (55.3%) and never/seldom feeling lonely (71.8%). Approximately every second respondent (51.9%) had plans for the future. A clear decreasing trend was seen in all questions for respondents aged 75 in comparison to those aged 65: only ``are you satisfied with life?'' showed no significant differences. Language/culture seems to clearly affect experiences of life orientation and well-being. Additionally, older people living alone reported significantly more negative response to all dimensions of life orientation. Positive life orientation is an important inner health resource for older. Accordingly, health promotion for older people should focus on facilitating the maintenance of important and close relationships and should include supporting older people's need to be needed.
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| 26. |
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| 27. |
- Fagerström, Lisbeth, et al.
(författare)
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Sense of security among people aged 65 and 75 : external and inner sources of security
- 2011
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Ingår i: Journal of Advanced Nursing. - : Blackwell Publishing Ltd. - 0309-2402 .- 1365-2648. ; 67:6, s. 1305-1316
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This paper is a report of a study exploring possible external and inner sources of the sense of security felt by older people aged 65 and 75. Background. The concept of ‘security’ has been parsimoniously defined and explored, especially as pertains to older people, and previous research has primarily focused on risks in relation to individuals’ declining health and functional ability. Methods. In 2005, population-based cross-sectional surveys were carried out in 15 municipalities in Västerbotten, Sweden and 18 municipalities in Ostrobothnia, Finland. A 15-page questionnaire (84 questions) was distributed, with the final total response rate reaching 68·4% (n = 3370): 1825 Swedish-speaking Swedes, 926 Swedish-speaking Finns and 621 Finnish-speaking Finns. The statistical analysis was three-stage, including nominal stepwise regressions. Results. Older people who indicate that they are ‘very secure’ are more likely to consider life meaningful and are able to master various life crises. Moreover, they possess confidence in economic institutions and are more likely to feel economically secure. Weak trust in family and friends or neighbours and decreased functional ability seem to indicate a subjective feeling of ‘insecurity’. Conclusion. Caregivers in health care should focus more on supporting older persons’ meaningfulness in life and how their feelings of security can be strengthened by trusting relationships and activities. In nursing, there should be more focus on developing knowledge of inner health resources, including positive life orientation and meaningfulness in life.
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| 28. |
- Fagerström, Lisbeth, et al.
(författare)
-
The use of Hegelian dialectics in nursing science
- 2010
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Ingår i: Nursing Science Quaterly. - 1552-7409. ; 23:1, s. 79-84
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this column is to describe dialectics as a philosophy and method which can be used by nurses to make a contribution to nursing science. Dialectics can be used in three ways: as a philosophical approach, as a method using the dialectic laws, and as a method of describing the dialectic process by focusing on the dynamic elements of the process. Dialectics can also be combined with hermeneutics.
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| 29. |
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| 30. |
- Finnbakk, Elisabeth, 1961-, et al.
(författare)
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Top-level managers' and politicians' worries about future care for older people with complex and acute illnesses : a Nordic study
- 2012
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Ingår i: International Journal of Older People Nursing. - West Sussex, United Kingdom : Wiley-Blackwell Publishing Inc.. - 1748-3735 .- 1748-3743. ; 7:2, s. 163-72
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Tidskriftsartikel (refereegranskat)abstract
- Background: The growing aging population, with its associated complex needs and illnesses, will in the future become an even more important challenge for the Nordic countries.Aim: The aim of the study was to describe and explore the perceptions and views of top-level managers and politicians in regard to an optimal future care for older people during the next decade.Design: The study has a qualitative, descriptive design.Methods: Top-level managers (n = 11) and politicians (n = 8) were interviewed in Sweden, Finland, Denmark and Norway in 2009. The data material was analysed through manifest and latent content analyses.Results: Future care should substantially focus on the individual needs and dignity of older people. The respondents also recommended a preventive perspective on future care. They anticipate that older people's needs will be complex, requiring nursing competence on an advanced level within home care and nursing homes, and point to the importance of leadership abilities and workplace image. Limited resources and the use of health technology will be dominant issues, entailing the need for open-mindedness to reorganise future care. The latent theme expressed was 'A creative willingness to act - but with an underlying worry about the future'.Conclusions: The findings reveal a multifaceted scenario of optimal future care; older people will have significant, acute and complex needs but resources will be limited. In the near future, medical treatment and nursing care for older people at advanced and specialised levels within primary health care will be needed.Implications for practice: To meet demands, a clear need exists for the advanced clinical competence of nurses. There is also a clear need to reorganise health care services for older people, develop the leadership abilities of nurse managers and make workplaces more attractive.
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| 31. |
- Frilund, Marianne, et al.
(författare)
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Assessment of ethical ideals and ethical manners in care of older people
- 2013
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Ingår i: Nursing Research and Practice. - : Hindawi Publishing Corporation. - 2090-1429 .- 2090-1437. ; , s. Article ID 374132-
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to establish structured clusters and well-defined ontological entities (nodes) describing ethical values as both ideal and opportunity for ethical manner as perceived by the caregiver. In this study, we use Bayesian Belief Networks (BBNs) to analyse ethical values (ethos) and ethical manners in daily work with older people. Material is based on questionnaire data collected by the instrument for the self-assessment of individual ethos in the care of older people (ISAEC) in spring 2007 in a municipality in Western Finland. This study is unique in its kind, both concerning the selected approach and methodological questions. BBNs have not been used significantly in nursing research, nor are there any studies that examine the ethical possibilities with focus on the probable effects upon changing conditions.
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| 32. |
- Frilund, Marianne, et al.
(författare)
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Managing the optimal workload by the PAONCIL method : a challange for nursing leadership in care of older people
- 2009
-
Ingår i: Journal of Nursing Management. - : Wiley-Blackwell. - 0966-0429 .- 1365-2834. ; 17:4, s. 426-434
-
Tidskriftsartikel (refereegranskat)abstract
- Aim The aim of the study was to test the ability of the professional assessment of optimal nursing care intensity level (PAONCIL)-method to establish the optimal nursing intensity (NI) per care giver within the care of older people by testing whether the method's prerequisites for hospital settings can be fulfilled within the care of older people as well.Background The PAONCIL method is included in the RAFAELA system as a method for calculating personnel resources based on NI.Method The PAONCIL assessments were collected through questionnaires (n = 3512). The data was analysed by simple linear regression analysis.Results It can be stated that the prerequisites for the PAONCIL method were fulfilled and that the optimal NI-level could be determined on seven participating units.Discussion It can be stated that the RAFAELA system is a useful system for measuring NI within the care of older people, but additional research is needed, especially within the home care setting.Conclusion Although an instrument never provides a complete overview of the patient's care needs and need satisfaction, it provides information about the daily situation as well as gives guidelines for long-term strategic planning.
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| 33. |
- Frilund, Marianne, et al.
(författare)
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Oulu Patient Classification Instrument within Primary Health Care
- 2009
-
Ingår i: Connecting Health and Humans. - : IOS Press. - 9781607500247 - 9781607504436 ; , s. 30-35
-
Konferensbidrag (refereegranskat)abstract
- As patients have become older their care needs have increased, and this has consequences for the work conditions within primary health care. Objectives: The aim of this study was to evaluate, whether the OPC instrument, which has been developed for hospital care, is valid and useful within primary healthcare for older people. Materials and Methods: Reliability and validity testing of the OPC instrument was carried out at a health care centre in Eastern Finland spring 2004. A total number of 92 questionnaires were handed out, and the response rate was 67% (n=61) in order to test the validity. The inter-rater reliability was tested through parallel classification. A total number of 860 patient's were classified; in total 1722 classifications were done. Cohens Kappa was chosen as the measurement for the consensus between the nurses' classification. Results: The consensus of the NI scores in total (OPC points) was 71%. The consensus measured with Kappa (k) showed a strong (0.65) consensus degree. Discussion: It can be said that the OPC instrument achieved a high enough reliability and validity in order to be seen as a reliable and useful instrument to measure the NCI within primary healthcare for the elderly. Conclusion: The OPC instrument can be seen as providing a fairly comprehensive view of the patient's caring needs, without claiming to be covering everything.
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| 34. |
- Frilund, Marianne, et al.
(författare)
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Validity and reliability testing of the Oulu patient classification : instrument within primary health care for the older people
- 2009
-
Ingår i: International Journal of Older People Nursing. - : Wiley-Blackwell Publishing Inc.. - 1748-3735 .- 1748-3743. ; 4:4, s. 280-287
-
Tidskriftsartikel (refereegranskat)abstract
- Aim. The aim of the study was to evaluate the reliability and validity of The Oulu Patient Classification (OPC) instrument to see whether the instrument that has been developed for hospital care is valid and useful within primary health care for older people.Background. Although different patient classification instruments have been under development since the 1960s, this is still a very important research area today.Method. Inter-rater reliability testing of the OPC instrument was undertaken. The inter-rater reliability was tested through parallel classification (n = 1722). Validity testing was conducted as an expert validation of the manual for the OPC instrument, using a questionnaire during June and July of 2005 (n = 61).Results. The inter-rater reliability testing achieved over 70% consensus, Cohen's Kappa showed a strong consensus for OPC classifications (0.65). The reliability measured with Cronbach's Alpha was also acceptable.Conclusion. The results show that the OPC instrument provides a good overview of the patient's care needs and is a reliable instrument within primary health care for older people.
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| 35. |
- Gabrielsson, Sebastian, 1975-, et al.
(författare)
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When the time is right: Men's experiences of recovery in self-harm
- 2024
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Ingår i: International Journal of Mental Health Nursing. - Hoboken : John Wiley & Sons. - 1445-8330 .- 1447-0349.
-
Tidskriftsartikel (refereegranskat)abstract
- Previous research has mainly focused on self-harm among women, defining what it is, what functions it has, how to manage and prevent self-harm, and how to recover from it. A recent review of the literature on self-harm among men concluded that research need to consider both clinical and personal aspects of recovery and pointed out the need to explore recovery from men's point of view. This study aimed to describe men's experiences of recovery in self-harm. Data were collected in Sweden in 2020 using semi-structured interviews. Eleven men who had recovered in self-harm were interviewed. Interviews were analysed using an abductive approach to qualitative content analysis. The analysis involved the application of an established framework for personal recovery in mental illness: connectedness, hope, identity, meaning, and empowerment (CHIME). The analysis identified one main theme: when the time is right, and five sub-themes: finding support in others; trusting that change is possible; getting to know yourself; reaching a new understanding; and developing new strategies to manage life. While the cessation of self-harm might both be a sign of and contribute to recovery, it is not the defining feature of recovery. Mental health professionals should be persistent in providing person-centred, recovery-oriented care for men who self-harm. The CHIME framework can be applied in the context of men's recovery in self-harm. This study is reported in accordance with the COREQ guidelines.
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| 36. |
- Glasberg, Ann-Louise, et al.
(författare)
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Erfarenheter av den nya yrkesrollen som klinisk expertsjukskötare : en kvalitativ studie
- 2009
-
Ingår i: Vård i Norden. - : Sykepleiernes Samarbeid i Norden (SSN). - 0107-4083 .- 1890-4238. ; 29:2, s. 33-37
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Tidskriftsartikel (refereegranskat)abstract
- Recommendations from national Finnish projects indicate the need for reorganization of future healthcare, raising the question of an advanced role for nurses. The first Advanced Practice Nurse (APN) course in Finland started in January 2005, at the University of Applied Sciences in Vaasa. The course concentrated on two main areas, assessment of acute care needs and care of patients with chronic diseases. Seventeen students completed their education in December 2006. The purpose of this study was to describe the consequences of the APN role from a personal and an organizational perspective.All 17 APNs who completed their education where interviewed. The interviews focused on the role of the APN, possible changes in working patterns, and attitudes towards the role. The interviews were analysed using qualitative content analysis.Results shows a great need for APNs in the clinics, however there are still much role confusion and attitudes are still pending. Some indicate that the content of their work has not changed at all. Others describe both increased responsibility and autonomy. However, everyone described that the education program had influenced them in their work: they describe an increased competence and capability; and altered notions of security and work satisfaction.
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| 37. |
- Gripewall, Emelie, et al.
(författare)
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Intensive Care Nurses’ Experiences of Caring during the Organ Donor Process in Sweden – a Qualitative Study
- 2022
-
Ingår i: International Journal of Caring Sciences. - 1791-5201 .- 1792-037X. ; 15:2, s. 720-726
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Tidskriftsartikel (refereegranskat)abstract
- Background: The organ donor process is challenging, not at least for intensive care nurses. The situation changesradically, from intensively working to save the patient’s life to instead caring for the donor patient’s organs so thatthose, in turn, can save another patient’s life. The donation process challenges nurses’ view on what dignifiedcaring at end-of-life entails. The inner core of caring comprises love, mercy and compassion. Dignified caring isrelated to treating the patient as a unique human being and respecting human value, rooted in the theory of caritativecaring that is the framework for this study.Aim: The aim was to illuminate intensive care nurses’ experiences of caring during the organ donor process, froma caring science perspective.Methodology: A descriptive research design including inductive qualitative content analysis of interviews withtwelve intensive care nurses in Sweden about their experiences of caring during the donor process.Results: The theme The complexity of caring during the organ donor process with two categories and fivesubcategories was generated. Intensive care nurses experienced caring during the donor process as being complexin relation to the potential donor patient and patient’s family as well as communication, teamwork andorganization. Caring affects not only the patient and families, but also the nurses and receivers of the donatedorgans. Intensive care nurses perceive the other’s life situation as if it were their own and recognize the importanceof shared humanity.Conclusion: The present study can increase knowledge from intensive care nurses and the caring team, in orderto provide better conditions such as the development of effective intervention strategies in the process of organdonor care as well as caring for the families and members of the team.
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| 38. |
- Jonsén, Elisabeth, et al.
(författare)
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Psychometric properties of the Swedish version of the Purpose in Life scale
- 2009
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Ingår i: Scandinavian Journal of Caring Sciences. - : Blackwell Publishing. - 0283-9318 .- 1471-6712. ; 24:1, s. 41-48
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to test the theoretical assumptions beyond the Purpose in Life (PIL) scale, and to elucidate the underlying structure of the Swedish version of the PIL. The PIL, originally created by Crumbaugh and Maholick, is a 20-item scale of the Lickert type with possible scores ranges from 20 to 140, the higher score, the stronger PIL. The analysis was based on 449 participants, 62% of whom were women, from five different samples, ranging from 19 to 103 years old. An exploratory factor analysis restricted to three factors was performed. The factors were labelled meaning in existence, freedom to create meaning in daily life, and will to find meaning in future challenges. These factors reflected the three dimensions described by Frankl. Cronbach's alpha coefficient for the total scale was 0.83 and varied between 0.54 and 0.83 in the three factors. We concluded that the Swedish version of the PIL scale seems to have construct validity and reliability. Our results give support to the fact that the PIL scale captures and confirms the theoretical assumptions of Frankl's existential theory. We consider the PIL scale to be both feasible and appropriate for use in nursing research.
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| 39. |
- Lindblad, Emma, et al.
(författare)
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Experiences of the new role of advanced practice nurses in Swedish primary health care - A qualitative study
- 2010
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Ingår i: International Journal of Nursing Practice. - : Blackwell Publishing Asia Pty Ltd. - 1322-7114 .- 1440-172X. ; 16:1, s. 69-74
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate and describe the experiences of the first advanced practice nurses (APNs), a new profession for Swedish health care, and of their supervising general practitioners (GPs), regarding the new role and scope of practice of APNs in primary health care. Individual interviews were conducted with the four first APNs and one focus group interview was conducted with five supervising physicians. The material was transcribed verbatim and analysed using latent content analysis. The respondents expressed confidence and trust in the new role of APNs. Some opposition to this new role from the GPs and other colleagues was observed, but was nonetheless overcome. The experiences of the APN role indicate that the new role is clearly demarcated from the role of physicians. The APNs were considered an extra resource for both the GPs and other nurses, which contributed to an increased availability of care for patients. The APN role requires an explicit definition and demarcation in relation to responsibility and roles among colleagues. Further development of the APN role presupposes the right to prescribe medication and order treatments, as well as an evaluation of patient, organizational and inter-professional perspectives on the matter. © 2010 Blackwell Publishing Asia Pty Ltd.
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| 40. |
- Norberg, Catharina, 1961-
(författare)
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Understanding spirituality and religiosity among very old people : measurements and experiences
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Spirituality is a multifaceted concept. In this thesis, spirituality is understood as an overarching term and a core of a person´s being. Religiosity is seen as one of many expressions of spirituality. Very old people are a vulnerable population, with an increased risk to be exposed to negative life events. Spirituality is suggested to have an impact on the possibility to adapt to life circumstances and manage age-related challenges.Aim: The overall aim of this thesis was to assess psychometric properties of instruments and to gain understanding about associations and experiences in relation to spirituality and religiosity among very old people.Method: The thesis has been conducted in the population based Umeå 85+/GERDA study. Half of those aged 85, all 90 year old, and all aged 95 and older in Umeå, Västerbotten, northern Sweden and in Ostrobothnia in Western Finland were invited to participate (cf. Näsman et al, 2017). Questionnaires used to measure religiosity versus spirituality were the Religious Orientations Scale (SROS) and the Self-Transcendence Scale (STS). None of these has previously been validated among very old people in a Swedish context. Factors associated and correlating with STS score are presented. How very old people express and perceive spirituality is also studied. Result: The participants in study I scored high on both subscales, indicating that they were religious in both an intrinsic and extrinsic manner. The SROS ability to distinguish between intrinsic and extrinsic items was tested. The cluster analysis revealed three clusters interpreted as intrinsic, extrinsic-personal, and extrinsic-social religious orientation, with no cross-loadings. The revised version of STS, (study II) with 10 items, had satisfactory psychometric properties (α .83). A factor analysis resulted in a two-factor solution (α .78 & .73). Test-retest reliability and concurrent criterion validity were supported. In study III STS showed a positive association with psychological well-being, self-rated health, having someone to talk with, and being able to go outdoors independently. A negative association was found between STS and diagnosis of depression, dementia disease, osteoporosis, living in a geriatric care institution, and feeling lonely. An accumulation of negative life events was associated with a larger decline of STS score over five years. Findings in study IV showed that spirituality was perceived as a connectedness to God, and other people. Telling about spiritual experiences was described as uncommon in conversation due to the private nature of the subject area and because of a fear of being considered as dubious. The findings also showed that experiences of spirituality were connected to a view of life where participants were transcending life’s circumstances, and experiencing mysteries. Conclusion: The results propose that the Swedish version of SROS and STS, aimed to measure religious orientation versus self-transcendence have satisfactory psychometric properties and are feasible to use among very old people. Furthermore, self-transcendence was positively and significantly, associated and correlated, to a number of factors known to enhance well-being. Spirituality was understood as including religiosity, a belief in God, connectedness to other people and conviction about a spiritual reality. The very old expressed a desire to share personal beliefs and experiences of spirituality, but they found it difficult due to a fear of not being taken serious. Hence spiritual needs can be unnoticed within the health care context, health care professionals need knowledge in order to recognize expressions of spirituality, and skills to support patients in a need of spiritual care.
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| 41. |
- Slåtten, Kari, et al.
(författare)
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Clinical competence in palliative care in Norway : the importance of good care routines
- 2010
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Ingår i: International Journal of Palliative Nursing. - : Mark Allen Group. - 1357-6321 .- 2052-286X. ; 16:2, s. 80-86
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This paper examines how clinical nurse specialists assessed their competences in relief of symptoms, and explores factors affecting good care routines in palliative care. Methods: A prospective survey among 235 former post-bachelor (response rate 50.6 %) students at two university colleges in Norway. Results: Correlations between the measured concepts showed a medium to high correlation between all the five competences. Use of care routines correlated with all the other factors. The ability to identify lack of care showed significant correlation with one concept: time available for nursing. The results from the regression analysis supported a model with good care routines as dependent variable (F=22.59, df=91, P<0.001). The independent variables in the model explained almost 57% of the variance in using care routines. Competences dealing with mouth problems, nausea, anxiety and the use of the Edmonton symptom assessment system (ESAS) had a positive effect on care routines. On the other hand, the ability to identify lack of care had a significant negative effect on the use of care routines. Conclusion: The importance of systematic assessment of the palliative patient's care needs and symptom management are emphasized, and use of the ESAS, and good care routines was affected by post-bachelor competences.
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| 42. |
- Thorsell, K. B. E., et al.
(författare)
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Time in Care for Older People Living in Nursing Homes
- 2010
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Ingår i: Nursing Research and Practice. - : Hindawi Publishing Corporation. - 2090-1429 .- 2090-1437. ; , s. Article ID 148435, 10 pages-
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Tidskriftsartikel (refereegranskat)abstract
- In order to measure actual care needs in relation to resources required to fulfill these needs, an instrument (Time in Care) with which to evaluate care needs and determine the time needed for various care activities has been developed with the aim of assessing nursing intensity in municipal care for older people. Interreliability (ICC=0.854) of time measurements (n = 10´546) of 32 nursing activities in relation to evaluated care levels in two nursing homes (staff n = 81) has been determined. Nursing intensity for both periods at the two nursing homes comprised on average a direct care time of 75 (45%) and 101 (42%) minutes, respectively. Work time was measured according to actual schedule (462 hours per nursing home during two weeks). Given that the need for care was high, one must further investigate if the quality of care the recipients received was sufficiently addressed.
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| 43. |
- Tofthagen, Randi, et al.
(författare)
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Clarifying self-harm through evolutionary concept analysis
- 2010
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 24:3, s. 610-619
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Tidskriftsartikel (refereegranskat)abstract
- Clarification of the concept self-harm is needed in order to enable research and theory development and facilitate the development and evaluation of medical interventions and nursing care for individuals who self-harm. This study presents such a conceptual analysis. Articles from 1997 to 2007 were sought from the Medline, PubMed, Cinahl, and PsychINFO search engines by entering the search words ‘self-harm’, ‘self-harming’, and ‘psychiatric care’. 25 medicine and 23 nursing science articles were chosen for inclusion and analysed. Rodgers’ evolutionary concept analysis process was used to delineate and clarify the concept’s context, surrogate terms, antecedents, attributes, and consequences, as well as to determine implications for further research. Attributes of self-harm may include repetitive injury of mouth or exterior body, that is to say the infliction of physical pain to alleviate mental pain, and time spent self-harming. Antecedents may be gender, mental pain, substance abuse and relational problems. Consequences often include the need for medication and help with altering coping behaviour. Some self-harm patients met with negative attitudes from nurses. Individualized care and treatment is recommended. Accordingly, inter-professional collaboration and postgraduate education is needed in order to provide better care and treatment for self-harm patients. Furthermore, better understanding is needed to help enable health care personnel understand why individuals self-harm. The conceptual analysis presented in this study may be helpful as regards theory development within this still rather unexplored field.
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| 44. |
- Tofthagen, Randi, et al.
(författare)
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Men who self-harm - A scoping review of a complex phenomenon
- 2022
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 78:5, s. 1187-1211
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Forskningsöversikt (refereegranskat)abstract
- Background: To understand and care for men who self-harm, it is important that healthcare professionals have understanding of how and why men self-harm, men's experiences of self-harm and what can be done to hinder or prevent self-harm.Aims: The aim of this study was to synthesize the existing knowledge on men who self-harm, with a special emphasis on background, self-harming methods, experiences and reported therapeutic interventions and/or care approaches.Design: Scoping review of internationally published and grey literature, based on a methodological framework by Arksey and O’Malley.Data sources: Systematic electronic database searches were conducted in CINAHL, MEDLINE (Ovid) and PsycINFO. From a total of 684 studies found, 24 studies met the inclusion criteria: full-text, published in English, peer-reviewed studies and grey literature including a focus on men who self-harm, men aged between 18 and 65 years, and published between 2010 and 2019.Results: Men's self-harm was understood as being related to mental disorders, a means of affect regulation, a loss of self-control, and a means of interpersonal communication. Self-harm can be a positive or negative experience, and there is a wide variety in the methods that men use to self-harm: sharp objects, injection, ingestion, without aids or riskful behaviour. Few studies reported on therapeutic interventions and/or care approaches for men who self-harm.Conclusion: Men's self-harm should be understood as a complex, socially and culturally conditioned phenomenon and studied from a multitude of perspectives.Impact: This scoping review concludes that self-harm among men should be understood as a complex, socially and culturally conditioned phenomenon. To empower men and support their recovery from self-harm, a person-centred approach should be incorporated into research on the subject and practice.
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| 45. |
- Tofthagen, Randi, et al.
(författare)
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Men who self-harm—A scoping review of a complex phenomenon
- 2022
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 78:5, s. 1187-1211
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Forskningsöversikt (refereegranskat)abstract
- Background: To understand and care for men who self-harm, it is important that healthcare professionals have understanding of how and why men self-harm, men's experiences of self-harm and what can be done to hinder or prevent self-harm.Aims: The aim of this study was to synthesize the existing knowledge on men who self-harm, with a special emphasis on background, self-harming methods, experiences and reported therapeutic interventions and/or care approaches.Design: Scoping review of internationally published and grey literature, based on a methodological framework by Arksey and O’Malley.Data sources: Systematic electronic database searches were conducted in CINAHL, MEDLINE (Ovid) and PsycINFO. From a total of 684 studies found, 24 studies met the inclusion criteria: full-text, published in English, peer-reviewed studies and grey literature including a focus on men who self-harm, men aged between 18 and 65 years, and published between 2010 and 2019.Results: Men's self-harm was understood as being related to mental disorders, a means of affect regulation, a loss of self-control, and a means of interpersonal communication. Self-harm can be a positive or negative experience, and there is a wide variety in the methods that men use to self-harm: sharp objects, injection, ingestion, without aids or riskful behaviour. Few studies reported on therapeutic interventions and/or care approaches for men who self-harm.Conclusion: Men's self-harm should be understood as a complex, socially and culturally conditioned phenomenon and studied from a multitude of perspectives.Impact: This scoping review concludes that self-harm among men should be understood as a complex, socially and culturally conditioned phenomenon. To empower men and support their recovery from self-harm, a person-centred approach should be incorporated into research on the subject and practice.
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| 46. |
- Wallin, Stina, et al.
(författare)
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Aging engineers' occupational self-efficacy : a mixed methods study
- 2023
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Ingår i: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Engineers' work has become more complex with increased demands in today's changing working life. Self-efficacy is essential to successfully adapt to work-related changes and to cope with adverse job demands. However, less is known about aging engineers' occupational self-efficacy. Therefore, this study explores facilitators and barriers to aging engineers' occupational self-efficacy beliefs to continue working until expected retirement age. An additional purpose is to explore if any of the aspects described by the engineers are more prominent.Methods: The study design was exploratory, using mixed methods with a qualitative to quantitative approach. A total of 125 engineers, aged between 45 and 65 years, answered two open-ended survey questions about what positively and negatively affect their occupational self-efficacy beliefs to continue working. First, data was analyzed using an inductive manifest qualitative content analysis. Next, descriptive statistics were performed based on the results of the qualitative study.Results: The analyses revealed that health and working conditions that affect health were crucial facilitators and barriers for the aging engineers' occupational self-efficacy to continue working until expected retirement age. Furthermore, the engineers emphasized competence, motivation from meaningful tasks, family and leisure, and private economy.Discussion: The aging engineers' own health seems to be prominent in their self-efficacy regarding a full working life; consequently, support still needs to address issues affecting health.
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| 47. |
- Wallin, Stina, et al.
(författare)
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Occupational self-efficacy and work engagement associated with work ability among an ageing work force : A cross-sectional study
- 2021
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Ingår i: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 70:2, s. 591-602
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Occupational self-efficacy (OSE) is an appropriate adaption capability to react to continuous changes in work life today. While self-efficacy is an important component in work context, there is less knowledge regarding older workers' OSE.OBJECTIVE: This study examined the relationship between work ability, OSE and work engagement among a middle-aged workforce, and whether there were any differences between age groups and between professionals in different work context.METHODS: Data were collected by questionnaire, which included Work Ability Index (WAI), Occupational Self-Efficacy Scale, and Utrecht Work Engagement Scale.RESULTS: A total of 359 home care workers and engineers (response rate 43%) participated. The average age was 54 (SD±5.3) years, 69%were women. The results of logistic regression analyses revealed an association between WAI, OSE (OR 0.66; 95%CI 0.52 to 0.86) and work engagement (OR 0.61; 95%CI 0.47 to 0.78). Higher OSE and work engagement were related to higher work ability. No difference in OSE (5.9; ±0.8) between professional groups was seen, but the home care workers scored considerably higher work engagement (5.1; ±0.9) than the engineers (4.5; ±1.3).CONCLUSIONS: Improving OSE could be worthwhile to support work ability among middle-aged workers, despite dissimilarities in work context and educational level.
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| 48. |
- Wallin, Stina, et al.
(författare)
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Work motivation and occupational self-efficacy belief to continue working among ageing home care nurses: a mixed methods study
- 2022
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Ingår i: BMC Nursing. - : Springer Nature. - 1472-6955. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is important to support ageing home care nurses (HCNs) to remain in work for longer, since the need for home care services is increasing. Personal resources such as self-efficacy belief contribute to work ability, as does work motivation. Few studies have targeted the ageing workers’ self-efficacy belief to manage their final working years. This study explores ageing HCNs’ work motivation, and occupational self-efficacy, i.e. belief in one’s capabilities, to continue working until expected retirement age.Methods: The design of the study is exploratory using a mixed method with a qualitative to quantitative approach. A total of 234 HCNs answered four open-ended questions from a cross-sectional survey, regarding their work motivation and self-efficacy beliefs. First, data was analysed using manifest qualitative content analysis. Next, a quantitative analysis was performed based on the results of the qualitative study, and the categories that emerged were quantitatively ranked.Results: The open-ended questions yielded 2339 utterances. The findings showed that several categories concurrently affected both work motivation and self-efficacy belief. When they were well-functioning, they positively affected both work motivation and self-efficacy belief, and when they were insufficient, they negatively affected either or both motivation and/or belief. Meaningfulness, job satisfaction, social support, and work environmental and organizational characteristics affected work motivation most. Perceived health highly affected the self-efficacy belief to continue working until expected retirement age, as well as meaningfulness of work, support from colleagues and home care managers, and work characteristics.Conclusions: Through highlighting the meaningfulness of work, and supporting the perceived health, the work community and leadership, both work motivation and self-efficacy belief to continue working might be facilitated among ageing HCNs. However, the still present draining workload must be handled.
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| 49. |
- Wangensteen, Sigrid, et al.
(författare)
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Postgraduate nurses' self-assessment of clinical competence and need for further training : A European cross-sectional survey
- 2018
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Ingår i: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 62, s. 101-106
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nursing practice requires application of knowledge, skills and values in various combinations and has undergone substantial changes the last decades. An increased focus on inter-professional collaboration and possible new and more independent roles for nurses are described. A variety of programs have been developed in order to educate registered nurses (RN) to meet the changes and demands in health and nursing care throughout the world.Aim: The aims were to 1) describe nurses' self-assessment of clinical competence and need for further training, and 2) explore possible differences between nurses in specialist vs master's programs.Methods: A cross-sectional survey design was applied. 97 nurses in postgraduate programs from five countries responded (response rate 45%). A revised version of the Professional Nurse Self-Assessment Scale of clinical core competencies (PROFFNurseSASII) was used for data collection. Independent student t-test and regression analyses were carried out.Results: The respondents rated their competence highest in taking full responsibility, cooperation with other health professionals and in acting ethically. Items where they considered themselves needing further training most were competence on medications, interaction and side effects and differential diagnoses. For all items, nurses in master's programs rated their competence higher than nurses in the specialist programs. Nurses in specialist programs rated their need for more training for all items higher than nurses in master's degree programs, and for 47 out of the 50 items these differences were statistically significant. Conclusion: Even though the nurses rated their competence high for important competence aspects such as taking responsibility and cooperation with other health professionals, it is worrying that their need for further training was highest for effects and interaction of various types of medications. Further studies are needed to conclude if and how master's education improves patient outcome.
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