| 1. |
- Jacobsson, Ann, 1964-, et al.
(författare)
-
Promoting and Hindering Health and Well-Being in Firefighter Discourse
- 2020
-
Ingår i: SAGE Open. - : Sage Publications. - 2158-2440. ; 10:4
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this critical discourse analysis is to identify and discuss dominant and recurrent themes in firefighter discourse that promote and hinder firefighters' health and well-being. Using critical discourse analysis, the focus is directed toward routine work culture at the station, as well as how firefighters deal with extraordinary events. The empirical material was collected from rescue services in Sweden representing different geographical areas. In total, 28 firefighters participated in focus group discussions or individual interviews. We identified dominant themes in the discourse that promoted firefighters' health and well-being. We also identified recurrent themes that may serve as hindrances to health and well-being. We note that themes in the latter category also relate to changes in the profession and work culture, expressing external pressures on the rescue service. One reason for resistance toward change might be the health benefits that the current order of firefighter discourse brings.
|
|
| 2. |
- Jonsson, Karin, 1970-, et al.
(författare)
-
Do team and task performance improve after training situation awareness? : A randomized controlled study of interprofessional intensive care teams
- 2021
-
Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : BioMed Central. - 1757-7241. ; 29:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: When working in complex environments with critically ill patients, team performance is influenced by situation awareness in teams. Moreover, improved situation awareness in the teams will probably improve team and task performance. The aim of this study is to evaluate an educational programme on situation awareness for interprofessional teams at the intensive care units using team and task performance as outcomes.Method: Twenty interprofessional teams from the northern part of Sweden participated in this randomized controlled intervention study conducted in situ in two intensive care units. The study was based on three cases (cases 0, 1 and 2) with patients in a critical situation. The intervention group (n = 11) participated in a two-hour educational programme in situation awareness, including theory, practice, and reflection, while the control group (n = 9) performed the training without education in situation awareness. The outcomes were team performance (TEAM instrument), task performance (ABCDE checklist) and situation awareness (Situation Awareness Global Assessment Technique (SAGAT)). Generalized estimating equation were used to analyse the changes from case 0 to case 2, and from case 1 to case 2.Results: Education in situation awareness in the intervention group improved TEAM leadership (p = 0.003), TEAM task management (p = 0.018) and TEAM total (p = 0.030) when comparing cases 1 and 2; these significant improvements were not found in the control group. No significant differences were observed in the SAGAT or the ABCDE checklist.Conclusions: This intervention study shows that a 2-h education in situation awareness improved parts of team performance in an acute care situation. Team leadership and task management improved in the intervention group, which may indicate that the one or several of the components in situation awareness (perception, comprehension and projection) were improved. However, in the present study this potential increase in situation awareness was not detected with SAGAT. Further research is needed to evaluate how educational programs can be used to increase situation awareness in interprofessional ICU teams and to establish which components that are essential in these programs.Trial registration: This randomized controlled trial was not registered as it does not report the results of health outcomes after a health care intervention on human participants.
|
|
| 3. |
- Jonsson, Karin, et al.
(författare)
-
Factors Influencing Team and Task Performance in Intensive Care Teams in a Simulated Scenario
- 2020
-
Ingår i: Simulation in Healthcare. - : Lippincott Williams & Wilkins. - 1559-2332 .- 1559-713X. ; 16:1, s. 29-36
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Healthcare teams and their performance in a complex environment such as that of intensive care units (ICUs) are influenced by several factors. This study investigates the relationship between team background characteristics and team as well as task performance.METHODS: This study included 105 professionals (26 teams), working at the ICUs of 2 hospitals in Northern Sweden. The team-based simulation training sessions were video recorded, and thereafter, team performance and task performance were analyzed based on ratings of the TEAM instrument and the ABCDE checklist.RESULTS: The final analyses showed that a higher age was significantly associated with better total team performance (β = 0.35, P = 0.04), teamwork (β = 0.04, P = 0.04), and task management (β = 0.04, P = 0.05) and with a higher overall rating for global team performance (β = 0.09, P = 0.02). The same pattern was found for the association between age and task performance (β = 0.02, P = 0.04). In addition, prior team training without video-facilitated reflection was significantly associated with better task performance (β = 0.35, P = 0.04). On the other hand, prior team training in communication was significantly associated with worse (β = -1.30, P = 0.02) leadership performance.CONCLUSIONS: This study reveals that a higher age is important for better team performance when caring for a severely ill patient in a simulation setting in the ICU. In addition, prior team training had a positive impact on task performance. Therefore, on a team level, this study indicates that age and, to some extent, prior team training without video-facilitated reflection have an impact on team performance in the care of critically ill patients.
|
|
| 4. |
- Jonsson, Karin, 1970-
(författare)
-
Knowing what’s going on : situation awareness and team performance in interprofessional teams
- 2021
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background Within critical care, it is necessary to have an awareness ofwhat is going on in order to be able to make the right decision at the right time.Situation awareness (SA) is a non-technical skill (NTS) that is important instressful, complex environments such as the intensive care unit (ICU).Deficiencies in NTS are well known to impact performance and thereby causeadverse events. More knowledge about how background factors are associatedto team performance and explore critical care team members experiencesteamwork are of importance to develop models for improving teamwork. Aneducational intervention aiming to improve SA during critical events might bevaluable to improve the performance of interprofessional teams. For this,instruments for assessment of SA and NTS are needed.Aim The aim of this thesis was to test different instruments for measuringSA, team performance and task performance for feasibility and reliability; to investigate the relationship between team background characteristics, teamperformance and task performance; to evaluate an educational programme inSA for intensive care teams; and to explore team members’ experience ofteamwork.Methods This thesis was based on data from 69 different video-recordedteam training sessions with a simulator as a patient (studies I–III) and ninefocus group interviews (Study IV). In Study I, the participants were 55 medicalstudents, and the sessions took place at a clinical training centre. Theparticipants in Study II (n=105) and III (n=75) were ICU staff members fromtwo different hospitals, and the sessions took place in situ at the respectiveICUs. In Study III, the participants were randomized into control orintervention group, where the intervention group received an educationalintervention comprising lectures and reflective discussions. The control grouponly performed team training without lectures and reflective discussions. Thetraining sessions were analysed with a focus on team and task performanceusing the TEAM instrument and the ABCDE checklist, respectively. Inaddition, a questionnaire (SAGAT) was used to assess individuals’ SA (StudyI and III). The data in Study I–III were quantitatively analysed. In Study IV,focus group interviews with staff members (n= 31) from the ICUs wereanalysed using qualitative content analysis.Results The findings in Study I showed that SAGAT was feasible to use andthat the inter-rater reliability for the ABCDE checklist and the TEAMinstrument indicated sufficient stability. In Study II, higher age wasassociated with several aspects of good team performance such as teamwork,task management, team overall and total team. Prior team training withoutvideo was associated with better task performance, while prior education incommunication was negatively associated with leadership. In Study III, theresults demonstrated that the educational intervention improved theperformance of the intervention group in the TEAM subscales of leadershipand task management, as well as in the total score. In Study IV, the mainfinding presented as a theme was balancing knowledge and behaviour inteamwork. The interviews revealed three categories of aspects that facilitatevor act as barriers to teamwork: (1) having potential for excellence while copingwith members who do not act as team players; (2) creating a safe atmospherewhile working in an unknown environment and struggling to maintain one’spositions; and (3) being in a workflow without becoming overwhelmed.Conclusions By implementing an educational programme focusing on SA,different parts of interprofessional team performance could be improved. Foroptimal interprofessional teamwork in the ICU, both knowledge andbehaviours were essential components. For the studies in this thesis, thedifferent instruments used were both feasible and reliable. High age wasrelated to good team and task performance, indicating that generic factors thatis associated with age might influence team and task performance.This thesis will probably contribute to a safer care of seriously ill patients at ICU.
|
|
| 5. |
- Nilsson, Karin, et al.
(författare)
-
Senior nursing students' reflections on deviations from guideline adherence regarding venous blood specimen collection practice : A qualitative study
- 2022
-
Ingår i: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 115
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Venous blood specimen collection is a common procedure within healthcare and both diagnoses as well as treatment evaluation, are often based on results from these analyses. However, studies among both students and staff have demonstrated suboptimal adherence to venous blood specimen collection practice guidelines which in turn might jeopardize patient safety.Objectives: This study aimed to describe final semester nursing students' experiences of deviations from venous blood specimen collection practice guidelines during clinical training.Methods: This study adopted a qualitative design. Twentysix final (6th) semester nursing students were recruited through purposive sampling at a Swedish university. Data were collected through semi-structured, face-to-face, focus group interviews in September 2015. The transcribed interviews were analyzed using qualitative content analysis.Results: The students' experiences generated two categories; 1) Striving to blend in (subcategories Feeling uncomfortable and Adapting to the prevailing practice culture) and 2) Diminished confidence (subcategories Being confused due to inconsistency and Being uncertain about guideline usefulness) forming the overall theme Being a copycat.Conclusion: The research concludes that nursing students adapt to the prevailing practice culture encountered during clinical training, often at the expense of guidelines adherence. Since the students are being assessed during clinical training, the eagerness to belong to the team and be well-liked might be stronger than the ambition to follow guidelines. As a consequence, nursing students in clinical training might become copycats by aligning themselves with the prevailing practice culture which in turn might jeopardize adherence with VBSC guideline practice and thereby patient safety. With the ambition to support nursing students' learning in clinical training, facilitators of learning to comprise both students and supervisors need to be further addressed. Tweetable abstract: Nursing students adapt to the prevailing venous blood sample collection practice culture and become copycats.
|
|
| 6. |
- Rönnberg, Linda, 1979-
(författare)
-
Tracheal Extubation of Patients Cared for in the Anesthesia Setting : Experiences Described by Registered Nurse Anesthetists and Anesthesiologists
- 2020
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background In Sweden, extubation is an interdisciplinary process involving teamwork between Registered Nurse Anesthetists (RNA) and Anesthesiologists, and comprehensive demands are placed on the professionals providing anesthesia. The extubation of the endotracheal tube after General Anesthesia (GA) is a critical moment for the patient. In that moment, the patient is in a vulnerable state and at risk of suffering severe complications, such as hypoxia, laryngospasm, aspiration, and hypertension. Anesthesia deals with identifying options, making risk assessments and reconsiderations. Clinical decision-making in anesthesia includes making decisions quickly and sometimes re-evaluating these just as quickly. In the often brief meeting prior to anesthesia, a relationship with the patient emerges and an unspoken demand arises: to care for the life that is placed in the hands of the anesthetists.Aim The overall aim was to gain an understanding of the Registered Nurse Anesthetists’ and Anesthesiologists’ experiences of their decision-making practices in the process of extubation of the endotracheal tube in the anesthesia setting with patients undergoing general anesthesia.Method This licentiate thesis consists of two studies (I, II), both conducted with a qualitative design using focus-group interviews (I) and Individual interviews (II) to collect data. A total of 20 RNAs from two hospitals and 17 Anesthesiologists from three hospitals were included, using a consecutive sampling strategy. Both studies were analyzed with qualitative content analysis and adopted an inductive approach to seek a deeper understanding of the phenomena, using manifest content analysis. In order to explore how the RNAs and Anesthesiologists experience the process of extubation and to identify nuances between them, the two studies were merged together in this licentiate thesis.Results When merging these studies (I, II) together by combining subcategories from both, six themes emerged. The theme, Assembling unique decisions, deals with the how the RNAs (I) and Anesthesiologists (II) assess, prepare, prevent and reconsider when planning for the extubation. Acting upon sensibilities consists of them recognizing patterns, leaning on their experience, and being receptive to different inputs from the patient and other professionals. The third theme, Being guided by intuition, included how the RNAs and Anesthesiologists relied on their feelings and were guided by emotions when deciding when to extubate. Safeguarding the patient deals with them protecting and acting as an advocate for the patient and how they focus on and are humble in the process of extubation. In the fifth theme, Being in a vulnerable position, the RNAs (I) felt they were on their own when making the decision on when to extubate, while the Anesthesiologists (II) felt as if they were one of the team. Using their own receptivity included how they established a connection with the patient and sensed the atmosphere.Discussion In their first encounter with the patient, or when obtaining knowledge about the patient, the RNAs and Anesthesiologists had already started to tailor a mental plan of the extubation unique to each patient. The plan consisted of small pieces of information being gathered and assembled together during the anesthesia, and this information is then combined with their experience of similar situations and with their intuition with the aim of safeguarding the patient. RNAs and Anesthesiologists act upon sensibilities when deciding on when to extubate. These strategies align with the concept of phronesis, a form of knowledge understood as practical wisdom that facilitates good clinical judgement in being rational, which is based on pre-understanding, experience, and interpersonal relationships and which is difficult to teach to someone else.
|
|
| 7. |
- Shayesteh, Alexander, et al.
(författare)
-
'Excessive sweating is not a feminine thing' : a qualitative study of women's experiences suffering from primary hyperhidrosis
- 2021
-
Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 16:7
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Primary hyperhidrosis, excessive focal sweating is a common disease equally affecting men and women. Women tend to seek care more often and assess being more affected by hyperhidrosis in their daily life. The aim of this study was to explore experiences of living with primary hyperhidros in a sample of 15 women.Methods: Individual, semi-structured interviews with a purposive sample of 15 women diagnosed with primary hyperhidrosis and analysed by qualitative content analysis utilising an inductive approach.Results: The analysis resulted in a theme, constantly guarding the female image, based on three categories, misfitting the feminine norms, avoiding the attention of others and passing like any woman. Primary hyperhidrosis in women disrupted the ideal feminine appearance. Wearing clothes that concealed hyperhidrosis and distancing from social gatherings, in combination with negative remarks by others, created stress and anxiety and had a negative effect on self-esteem. Women felt poorly understood by others regarding the extent of their sweating and were misunderstood in intimate situations while trying to reduce the sweat production. Choices regarding education and career opportunities were affected, since being exposed and receiving attention due to primary hyperhidrosis was unwanted. Treatment with botulinum toxin liberated women from excessive sweating and removed a social handicap they described living with.Conclusion: Primary hyperhidrosis in women disrupts the feminine appearance, lowers self-esteem and hinders social interactions. Clinicians assessing primary hyperhidrosis need to be aware that women may report the impairments from primary hyperhidrosis as being more associated with body image and appearance than with functional reductions in daily life. Educating patients, providing accurate information regarding the disease via media and cooperating with patient groups are important for increasing awareness and achieving progress in care for women with primary hyperhidrosis.
|
|
| 8. |
- Shayesteh, Alexander, et al.
(författare)
-
Navigating in the fog : facing delays, rejection and ignorance when seeking help for primary hyperhidrosis
- 2021
-
Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 16:1
-
Tidskriftsartikel (refereegranskat)abstract
- Primary hyperhidrosis (PH) is a disease characterized by focal and excessive sweating.Purpose: The aim of this study was to describe the experiences of men and women with PH when seeking help for their condition.Method: A qualitative interview study with 30 men and women diagnosed with PH was conducted. Data was inductively analysed using manifest and latent content analysis.Results: The analysis resulted in a theme: Navigating in the fog, based on the categories doubtful encounters with health care professionals, helpful encounters with health care professionals, delays due to inadequate knowledge, and supported urge for help.Conclusions: Deficient knowledge and understanding about PH create a sense of resignation in individuals, resulting in delay of seeking treatment. Support from others, life-changing events, and finding information about PH were important motivating factors in seeking help and demanding access to treatment. A holistic approach towards patients with PH is important to reduce stigma and acknowledge the problems that are encountered in their daily lives. Educating health care professionals and students so that patients can be identified and assessed without delay and making information available about PH in schools and pharmacies could improve the general knowledge and facilitate obtaining treatment for individuals with PH.
|
|
