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- Karlberg-Traav, Malin, 1962-
(författare)
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Evidence-based nursing : reflections from different perspectives
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to describe the use of evidence-based nursing (EBN) with respect to the four cornerstones of EBN: research, nursing theory, the patient’s perspective and clinical competence. Study I explored registered nurses (RNs) self-reported research utilization (RU) in relation to their work climate. A quantitative approach was used; further analyze led to a cluster solution of the measured variables, and low reported RU were compared with higher reported RU. The result showed that an academic degree underpinned the instrumental research utilization (IRU), also women reported higher use of conceptual research utilization (CRU). An association between low RU and dynamism/liveliness was seen, and younger RNs and RNs with shorter working experience reported higher scores for playfulness/humor and conflicts. Study II described how nurses conceived working in a ward where a nursing philosophy had been implemented. A phenomenographic method was used. The philosophy supported the clinical work and underpinned reflection and shared values. A prerequisite was a dedicated leader. The RNs described the care being of high quality. First line nurse managers (FLNMs) role and their experience of opportunities and obstacles to support EBN, was explored in study III. Data was collected using focus groups and analysed using phenomenography. The result showed that the FLNMs need to make an entity of vision and reality to be supportive according of EBN. The last study was an integrative literature review and the perspective of the patient in articles reporting on interventions designed to improve nursing was in focus. The result in study IV showed that the perspective of the patient represents five aspects, and that reporting clinical implications is important. In conclusion; the different perspectives all relates to EBN. Registered nurses need to be encouraged to develop their academic training, to be able to work according to EBN. A nursing philosophy provides time for reflection and a feeling of performing care of high quality. FLNMs need to take their role to support the RNs in order to work evidence-based. Conscious and communicated aspects supported the perspective of the patient.
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| 2. |
- Ewertzon, Mats, 1956-
(författare)
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Familjemedlem till person med psykossjukdom : bemötande och utanförskap i psykiatrisk vård
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis focused on the situation of family members of persons with psychotic illness, particular on their experience of the approach of the healthcare professionals and of their feelings of alienation regarding the professional care of their family member. A further aim was to explore how siblings who have participated in a support group for siblings experienced their situation.A questionnaire was developed that enabled the aims of this thesis to be investigated (I). Seventy family members from various parts of Sweden participated, and data were collected via the questionnaire developed in study I (II-III). Thirteen siblings who previously had participated in a support group participated in follow-up focus groups interviews (IV).The questionnaire developed was shown to be reliable and valid in these studies (I). In many cases, the participants had experienced an approach from professionals that indicated that they did not experience openness, confirmation and cooperation, and that they felt powerless and socially isolated in relation to the care. There was also found to be a certain degree of association between how the participants experienced the approach and whether they felt alienation (II). The majority of the participants considered openness, confirmation, and cooperation to be important aspects of professional’s approach. The result also identified a low level of agreement between the participants’ experience and what they considered to be significant in the professional’s approach (III). The findings revealed the complexity of being a sibling of an individual with psychotic illness. Participating in a support group for siblings can be of importance in gaining knowledge and minimizing feelings of being alone (IV).Although the psychiatric care services in Sweden have been aware of the importance of cooperating with family members, the results indicated that there is a need for further research in this area.
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| 3. |
- Söderlund, Mona, 1957-
(författare)
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Förhållningssätt och kommunikation i mötet med personer med demenssjukdom : utvärdering av ett träningsprogram med validationsmetoden
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Communication difficulties among residents with dementia disease living in nursing homes may complicate care situations. These residents can have difficulties describing how they experience their everyday lives, which can lead to withdrawal, social isolation, or feelings of homelessness. Research indicates that nurses involved in dementia care experience communication as difficult and challenging. The validation method developed by Feil is held to facilitate communication through emphatic and confirmatory approaches. Scientific reviews show insufficient evidence for recommending the use of the method, in spite of this the method is used in dementia care. Evaluations of the validation method have primarily focused on the residents’ perspective, and reports on nurses’ experiences of the validation method are sparse. The overall aim for this thesis was to evaluate Feils’ validation method by describing nurses’ experiences and skills in communication observed during implementation of a training programme. Twelve nurses participated in the validation method training programme that included 10 days of theoretical training with supervision about once a month, and practical training integrated in everyday work. During practical training nurses had conversation with 3 residents each 2-3 times a week, and videotaped one conversation per month. Methods: The design is based on naturalistic scientific approach. Data were collected with interviews (I, II) and a questionnaire (II) before and after the programme, and videotaped conversations during the programme (III, IV). An interview was conducted as a comparison with nurses from another nursing home, who had long experiences of using the validation method (I). The result showed that nurses improved their communication and had closer relationships with residents with dementia disease after validation method training, in accordance with nurses with long experiences (I). The training strengthened the nurses, but also posed an extra strain on them. Even though the nurses described an extra strain on the entire nursing staff, this was not reflected in the results from the questionnaire about the work climate (II). Videotaped one-to-one conversations between nurses and residents showed that the nurses developed their approaches and communication skills, although to different degrees. An overall pattern revealed nurses’ movements within and between various paths when improving their communication skills (III). The findings were in congruence with the nurses described experiences (I). In videotaped conversations from the end of the programme, the residents had the possibilities to use their remaining communication abilities and to communicate what was currently on their mind (IV). This may be related to the development of the nurses’ communication skills during the programme. Conclusions of this thesis were that the nurses developed their skills in caring approach and communication when communicating with residents with dementia disease, which gave these residents possibilities to communicate according to their abilities. In order to integrate new knowledge about communication the results showed that it was necessary to combine theoretical and practical training with supervision and reflection. To provide nursing staff with this type of training could be seen as an investment for nursing homes, an opportunity to increase job satisfaction for nurses and to increase social community for residents.
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