| 1. |
- Fläckman, Birgitta, et al.
(författare)
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Consequences of working in elder care during changes and cutbacks in the organisation while education and clinical supervision was provided : A mixed methods study
- 2015
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Ingår i: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; 5:9, s. 813-827
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reorganization and downsizing can disrupt a competent staff and conflicts can arise between what the employee is being asked to do and their knowledge and competences. Reduced job satisfaction among nursing home staff with increased workload and strain can occur. Aim and Objectives: The aim was to investigate the organizational climate and prevalence of burnout symptoms among caregivers over time in three Swedish nursing homes (NH I-III) undergoing organizational changes, while education and clinical supervision were provided. Design: The study design combines qualitative and quantitative methods in a longitudinal two-year follow-up project in NH I-III. Methods: Support through education and clinical supervision was provided for caregivers only at NH I and NH II. At NH I-III caregiver self-assessments and interviews were completed and analysed three different times. Results: NH I revealed improvement and increased innovation over time, while NH II showed a decline with no ability to implement new knowledge. NH III retained a more status quo. Conclusions: Organizational changes and cutbacks, occurring at different times, appeared to cause major stress and frustration among the three personnel groups. They felt guilty about not meeting their perceived obligations, seemed to have lost pride in their work but kept struggling. The changes seemed to over-shadow attempts to improve working conditions through education and clinical supervision initially. Implications for practice: It will be important to learn from reorganizations and the consequences they will have for the staff and quality of care. Important topics for future research are to study financial cutbacks and changes in organizational processes in care of older people to be able to develop a more person centered care for older people.
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| 2. |
- Holmberg, Mats, 1976-, et al.
(författare)
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Ambulance clinicians' experiences of relationships with patients and significant others
- 2016
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Ingår i: Nursing in Critical Care. - Hoboken, NJ : Wiley-Blackwell Publishing Inc.. - 1362-1017 .- 1478-5153. ; 21:4, s. e16-e23
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Tidskriftsartikel (refereegranskat)abstract
- Background: Ambulance clinicians (ACs) have to provide advanced care and treatment to patients in a challenging and emotionally demanding environment, therefore they establish interpersonal relationships embracing both patients and significant others. Relationships in emergency care were earlier found to be short-lived and lacking a holistic understanding of the patient. In their relationship with the ambulance clinicians, it is for patients to surrender and become dependent, which may be interpreted as both a negative and a positive experience.Aim: The aim of this study was to elucidate ambulance clinicians' experiences of relationships with patients and significant others.Methods: Data were collected from four focus group conversations, with a total of 18 participating ambulance clinicians. An inductive qualitative content analysis method was chosen.Findings: The analysis resulted in one main category: 'To be personal in a professional role' and three generic categories: 'To be there for the affected person', 'To be personally involved' and 'To have a professional mission'. There were subsequently nine sub-categories. The main category was described as intertwining the experience of being both personal and professional. The ambulance clinicians adapt to a situation while having the affected person in focus. They involve themselves as persons but at the same time use the power of their professional role.Conclusion: The relationship with patients and significant others from the ambulance clinicians' perspective can be understood as embracing both personal and professional aspects.Relevance to critical practice: This study provides an understanding of the ambulance clinicians' professional role as embracing a personal perspective, which is important when developing an emergency ambulance service focusing on care that involves more than just emergency medical treatment.
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| 3. |
- Holmberg, Mats, 1976-, et al.
(författare)
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The knowledge desired by emergency medical service managers of their ambulance clinicians - A modified Delphi study
- 2017
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Ingår i: International Emergency Nursing. - : Elsevier BV. - 1755-599X .- 1878-013X. ; 34, s. 23-28
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of the study was to identify the types of knowledge that Swedish Emergency Medical Service (EMS) managers considered desirable in their Ambulance Clinicians.BACKGROUND: Emergency medical service managers are responsible for organisational tasking and in this are dependent on the knowledge possessed by their ambulance clinicians. It would therefore be of value to explore EMS managers' approach to this knowledge.DESIGN: A modified Delphi method in three rounds.METHODS: In total thirty-six EMS managers participated, and twenty-four finished all three rounds. They were encouraged to rate each sub-category, and the ten with the highest mean were interdependently ranked in the final round.RESULTS: Five categories and twenty-six sub-categories emerged in the first round, covering knowledge related to; contextual aspects, medical and holistic assessments, formal education and organisational issues. Eventually, the sub-category 'Knowledge to assess the patient's situation from a holistic perspective' was the highest ranked, followed by 'Medical knowledge to assess and care for different diseases' and 'Knowledge to be able to care for critically ill patients'.CONCLUSIONS: Taken together the knowledge areas address essentially medical care, contextual aspects and nursing. The boundaries between these can sometimes be seen as elusive, calling for ambulance clinicians to balance these areas of knowledge.
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| 4. |
- Holmberg, Mats, 1976-, et al.
(författare)
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The relationship with the ambulance clinicians as experienced by significant others
- 2016
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Ingår i: Nursing in Critical Care. - Hoboken, USA : Wiley-Blackwell Publishing Inc.. - 1362-1017 .- 1478-5153. ; 21:4, s. e1-e8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Interpersonal relationships between clinicians and patients are important aspects of the ambulance care, requiring a balance between objectified acute medical treatment and a holistic care. Being a significant other (SO) in the ambulance care setting is described as being caught between hope and dread. Little research has focused on SOs' experiences of the relationship with the ambulance clinicians.Aim: To elucidate meanings of the relationship with the clinicians in the ambulance care setting as experienced by the patients' SOs.Design: Qualitative lifeworld design.Methods: Data was collected using open-ended interviews with nine SOs. The verbatim transcribed interviews were analysed with a phenomenological hermeneutic method.Findings: The structural analysis resulted in one main theme: 'Being lonely together'. The main theme comprises three themes: 'Being in a shared struggle', 'To hand over the affected person in trust' and 'Being the second person in focus' and six subthemes. The main theme is for the SOs to share the struggles of the affected person with the ambulance clinicians and to be comforted while handing over the responsibility for the affected person. Hence the SO is excluded and lonely and on his/her own, while not the primary focus of the ambulance clinicians.Conclusions: The relationship with the ambulance clinicians from the perspective of the SOs can be understood as complex, involving both being lonely and together at the same time. The findings support a holistic approach towards the ambulance care involving SOs.Relevance for clinical practice: This study outlines the importance of an emergency ambulance care involving SOs as affected persons and supports a balance between emergency medical treatment to the patient and a holistic care, involving the SOs' suffering.
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| 5. |
- Karlstedt, Michaela, et al.
(författare)
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Is the competence of Swedish Registered Nurses working in municipal care of older people merely a question of age and postgraduate education?
- 2015
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 29:2, s. 307-316
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Previous studies suggest that not only education but also personal aspects such as experience of working as a registered nurse (RN) and age can influence competence. The objective was to explore the educational and self-rated competence of RNs and their duties within the care of older people.METHODS: A cross-sectional descriptive design was used. All RNs in two counties in Sweden were asked to complete a written questionnaire: a study specific questionnaire with educational and work related questions using the Nurse Competence Scale. The response rate was 61% (n 344).RESULTS: Higher self-rated satisfaction with own professional competence was related to older age, more years after nursing education and possessing at least one postgraduate education in specialist nursing. Educational needs were related to younger age and fewer years since nursing graduation. Education within elder care, including education about drugs was rated the most urgently needed area of education. The most frequently reported tasks were found in the domain helping role, whereas ensuring quality was less present in their daily work.CONCLUSIONS:Educational level, age and years of experience had an impact on RNs' self-perceived competence, which is in accordance with previous descriptions of the concept competence. It seems imperative that RNs working in care of the old and with the demands placed on them are given the opportunity to take a postgraduate specialist education in order to gain a competence level in their desired area of work. It is also important that RNs working in care of the old get tailored education in line with the requirements the organisation places on them.
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| 6. |
- Kneck, Åsa, 1973-, et al.
(författare)
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Encumbered by vulnerability and temporality : the meanings of trigger situations when learning to live with diabetes
- 2016
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 25:19-20, s. 2874-2883
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: The aim of the study was to illuminate the meanings of trigger situations experienced in everyday life when learning to live with diabetes.BACKGROUND: Adults become active learners when faced with situations they do not know how to manage, triggering a need to understand something in a different way than before. Knowing more about experiential learning for persons living with diabetes is important for understanding how learning can be supported by health care.DESIGN: A life-world approach with a phenomenological hermeneutical method, inspired by the philosophy of Paul Ricoeur.METHODS: This method was used for interpreting transcriptions of interviews and consists of three stages: naïve understanding, structural analysis and a comprehensive understanding. Participants (n = 13), with either type I or type II diabetes, were interviewed on three different occasions over a three-year period after being diagnosed with diabetes.RESULTS: When learning to live with diabetes, the meanings of trigger situations were described as 'the unpredictable body heightens insecurity with awareness of one's own dependability', 'losing control in unsustainable situations' and 'encumbered by vulnerability and temporality in earlier familiar situations'.CONCLUSION:The meanings of trigger situations were to lose the smooth, unreflected way of managing an everyday life situation, interlaced with feelings of lost control of how to live with new insights of being vulnerable. Trigger situations meant an opportunity for learning, as well as being demanding, unplanned and with limited freedom of choice. Trigger situations presented life and body as unpredictable.RELEVANCE TO CLINICAL PRACTICE: If healthcare professionals can identify the worries and questions raised in trigger situations, knowledge gaps can be identified and reflected on to stimulate learning.
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| 7. |
- Prahl, Charlotte, et al.
(författare)
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Understanding the role of an educational model in developing knowledge of caring for older persons with dementia
- 2016
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Ingår i: Nurse Education in Practice. - : Elsevier BV. - 1471-5953 .- 1873-5223. ; 17:2, s. 97-101
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Statistics show that the number of older people in need of care is increasing worldwide, especially those with dementia. This implies demands on knowledge and competence among health care staff to care for them. In Sweden, Silviahemmet offers dementia care units the opportunity to become certified according to a special certification educational model. Silviahemmet provides educational programs for staff in dementia care and day care for person with dementia. All staff undergoes a systematic training course in dementia care. The aim of the study was to gain an understanding of how an educational model developed the perceived knowledge of staff caring for older persons with dementia in a nursing home.METHOD: A phenomenographical approach was used and qualitative interviews were carried out with 13 staff members in a nursing home.FINDINGS: The main results show that staff perceives the importance of knowledge, working together and creating a sense of fellowship. The care of persons with dementia requires a special approach and adherence. Participating in the educational program made the staff realize and acknowledge their tacit knowledge and the importance of reflection-in-action together in the team.CONCLUSION: The results indicate the need for a common theoretical knowledge base and value system to achieve coherence in daily work.
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| 8. |
- Swall, Anna, et al.
(författare)
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'Bringing respite in the burden of illness' : Dog handlers experience of visiting older persons with dementia together with a therapy dog
- 2016
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 25:15-16, s. 2223-2231
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To illuminate meanings of the lived experiences of dog handlers' when visiting older persons with dementia with their therapy dog.BACKGROUND: Studies indicate that care of persons with dementia should focus on a person-centred approach with the person's interests in the centre. Animal-assisted therapy using a therapy dog in the care of persons with dementia has been shown to increase well-being and decrease problematic behaviours associated with the illness.DESIGN: A qualitative lifeworld approach was adopted for this study.METHODS: Data were collected from open-ended interviews with nine dog handlers, and the analysis conducted using the phenomenological hermeneutical method.RESULTS: The structural analysis resulted in one theme, 'Respite from the burden of illness for persons with dementia'.CONCLUSIONS: Visiting a person with dementia can be seen as an act of caring, providing temporary respite from their illness, and creating a special relationship between handler and patient. A therapydog visit can represent a moment of communion between the handler and the person with dementia.IMPLICATION FOR CLINICAL PRACTICE: Dog handlers use their skills and knowledge to promote a situation that reduces symptoms of illness and encourages healthier behaviour. The results of this study may be of interest to researchers, clinical practitioners, caregivers and dog handlers who care for persons with dementia using therapy dog teams on prescription as an alternative method to minimise behavioural and psychological symptoms of dementia.
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| 9. |
- Swall, Anna, et al.
(författare)
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Can therapy dogs evoke awareness of one's past and present life in persons with Alzheimer's disease?
- 2015
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Ingår i: International Journal of Older People Nursing. - : Blackwell Publishing. - 1748-3735 .- 1748-3743. ; 10:2, s. 84-93
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Persons with Alzheimer's disease (AD) sometimes express themselves through behaviours that are difficult to manage for themselves and their caregivers, and to minimise these symptoms alternative methods are recommended. For some time now, animals have been introduced in different ways into the environment of persons with dementia. Animal-Assisted Therapy (AAT) includes prescribed therapy dogs visiting the person with dementia for a specific purpose.AIM: This study aims to illuminate the meaning of the lived experience of encounters with a therapy dog for persons with Alzheimer's disease.METHOD: Video recorded sessions were conducted for each visit of the dog and its handler to a person with AD (10 times/person). The observations have a life-world approach and were transcribed and analysed using a phenomenological hermeneutical approach.RESULTS: The result shows a main theme 'Being aware of one's past and present existence', meaning to connect with one's senses and memories and to reflect upon these with the dog. The time spent with the dog shows the person recounting memories and feelings, and enables an opportunity to reach the person on a cognitive level.CONCLUSIONS: The present study may contribute to health care research and provide knowledge about the use of trained therapy dogs in the care of older persons with AD in a way that might increase quality of life and well-being in persons with dementia.IMPLICATIONS FOR PRACTICE: The study might be useful for caregivers and dog handlers in the care of older persons with dementia.
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| 10. |
- Swall, Anna, et al.
(författare)
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Stepping out of the shadows of Alzheimer's disease : a phenomenological hermeneutic study of older people with Alzheimer's disease caring for a therapy dog
- 2017
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Living with Alzheimer's disease (AD) can involve a person being unable to recall and convey information in daily life. There are several ways to provide person-centred care to older people with AD, e.g. by empowering them in a situation. The use of animal-assisted therapy (AAT) with a therapy dog in the care of people with dementia is increasing, with the presence of a therapy dog being described as improving, among other things, the well-being and socialization of the person. The aim of this study was to illuminate meanings of care for people with AD in their encounters with a therapy dog.METHOD: The study used video-recorded observations of the person with AD and the dog. Data were transcribed and analysed using a phenomenological hermeneutic method.RESULTS: The main theme was "Using one's own resources and abilities as a human being", which meant being the person one can be and distancing oneself from the symptoms of AD during the time with the dog.CONCLUSIONS: The feelings evoked in the people with AD included empathy and altruism, which allowed for a sense of joy and tenderness, which may induce a sense of self-worth, of being needed, and of being meaningful.
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