| 1. |
- Höglund, Anna, 1960-, et al.
(författare)
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From denial to awareness : a conceptual model for obtaining equity in healthcare.
- 2018
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Ingår i: International Journal for Equity in Health. - Springer : Springer Science and Business Media LLC. - 1475-9276. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although Swedish legislation prescribes equity in healthcare, studies have reported inequalities, both in face-to-face encounters and in telephone nursing. Research has suggested that telephone nursing has the capability to increase equity in healthcare, as it is open to all and not limited by long distances. However, this requires an increased awareness of equity in healthcare among telephone nurses. The aim of this study was to explore and describe perceptions of equity in healthcare among Swedish telephone nurses who had participated in an educational intervention on equity in health, including which of the power constructs gender, ethnicity and age they commented upon most frequently. Further, the aim was to develop a conceptual model for obtaining equity in healthcare, based on the results of the empirical investigation.METHOD: A qualitative method was used. Free text comments from questionnaires filled out by 133 telephone nurses before and after an educational intervention on equity in health, as well as individual interviews with five participants, were analyzed qualitatively. The number of comments related to inequity based on gender, ethnicity or age in the free text comments was counted descriptively.RESULTS: Gender was the factor commented upon the least and ethnicity the most. Four concepts were found through the qualitative analysis: Denial, Defense, Openness, and Awareness. Some informants denied inequity in healthcare in general, and in telephone nursing in particular. Others acknowledged it, but argued that they had workplace routines that protected against it. There were also examples of an openness to the fact that inequity existed and a willingness to learn and prevent it, as well as an already high awareness of inequity in healthcare.CONCLUSION: A conceptual model was developed in which the four concepts were divided into two qualitatively different blocks, with Denial and Defense on one side of a continuum and Openness and Awareness on the other. In order to reach equity in healthcare, action is also needed, and that concept was therefore added to the model. The result can be used as a starting point when developing educational interventions for healthcare personnel.
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| 2. |
- Ahlstedt, Carina, 1969-, et al.
(författare)
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What makes registered nurses remain in work? : An ethnographic study
- 2019
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Ingår i: International Journal of Nursing Studies. - : Elsevier Ltd. - 0020-7489 .- 1873-491X. ; 89, s. 32-38
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Tidskriftsartikel (refereegranskat)abstract
- Background: Registered nurses’ work-related stress, dissatisfaction and burnout are some of the problems in the healthcare and that negatively affect healthcare quality and patient care. A prerequisite for sustained high quality at work is that the registered nurses are motivated. High motivation has been proved to lead to better working results. The theory of inner work life describes the dynamic interplay between a person's perceptions, emotions and motivation and the three key factors for a good working life: nourishment, progress and catalysts. Objectives: The aim of the study was to explore registered nurses’ workday events in relation to inner work life theory, to better understand what influences registered nurses to remain in work. Design: A qualitative explorative study with an ethnographic approach. Methods: Participant observation over four months; in total 56 h with 479 events and 58 informal interviews during observation; all registered nurses employed at the unit (n = 10) were included. In addition, individual interviews were conducted after the observation period (n = 9). The dataset was analysed using thematic analysis and in the final step of the analysis the categories were reflected in relation to the three key factors in theory of inner work life. Results: Nourishment in a registered nurse context describes the work motivation created by the interpersonal support between colleagues. It was important to registered nurses that physicians and colleagues respected and trusted their knowledge in the daily work, and that they felt comfortable asking questions and supporting each other. Progress in the context of registered nurses’ work motivation was the feeling of moving forward with a mix of small wins and the perception of solving more complex challenges in daily work. It was also fundamental to the registered nurses’ development through new knowledge and learning during daily work. Catalysts, actions that directly facilitate the work, were highlighted as the possibility to work independently along with the opportunity to work together with other registered nurses. Conclusion: This study has a number of implications for future work and research on creating an attractive workplace for registered nurses. Working independently, with colleagues from the same profession, integrated with learning, visible progress, and receiving feedback from the work itself, contribute to work motivation.
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| 3. |
- Coyne, I., et al.
(författare)
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Centeredness in Healthcare : A Concept Synthesis of Family-centered Care, Person-centered Care and Child-centered Care
- 2018
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Ingår i: Journal of Pediatric Nursing. - : W.B. Saunders. - 0882-5963 .- 1532-8449. ; 42, s. 45-56
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Tidskriftsartikel (refereegranskat)abstract
- Background: Increasingly within healthcare, different kind of ‘centeredness’ are used to denote the focus of care which can create confusion for practitioners. Methods: A concept analysis was undertaken to identify the antecedents, attributes and relationship between family-, person-, and child-centered care. PubMed and CINAHL were searched from 2012 to 2017 and thirty-five papers were reviewed. Results: Both person- and child-centered care are focused on individuals, a symmetric relationship and the tailoring of care to individual needs while family- centered care is focused on the family as a unit of which the child is included. Person-centered care focuses on an adult person with autonomy, while the focus in child-centered care is the individual child as an own actor with rights but still close to a family. Conclusion: It appears at a conceptual level that the concepts of centeredness contain both similarities and differences. Finding ways to structure nursing and focus the care that respects a person's dignity and humanity is essential in healthcare and should be a major goal of health policy and health systems worldwide. Implications: The identification of the antecedents and attributes embedded in the concepts may help raise professionals’ awareness of the different foci and how this will influence one's practice. There is a need to recognize strengths and weaknesses of the centeredness in different settings and environments. Furthermore, it is important to know which approach to apply within different situations so that quality care is enabled for every person, child and family.
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| 4. |
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| 5. |
- Ernesäter, Annica, et al.
(författare)
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Telephone nurses' communication and response to callers' concern : a mixed methods study
- 2016
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Ingår i: Applied Nursing Research. - : Elsevier BV. - 0897-1897 .- 1532-8201. ; 29, s. 116-121
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Tidskriftsartikel (refereegranskat)abstract
- AimsTo describe telephone nurses’ and callers’ communication, investigate relationships within the dyad and explore telephone nurses’ direct response to callers’ expressions of concernBackgroundTelephone nurses assessing callers’ need of care is a rapidly growing service. Callers with expectations regarding level of care are challenging.MethodRIAS-and content analysis was performed on a criterion sampling of calls (n=25) made by callers who received a recommendation from telephone nurses of a lower level of care than expected.ResultsTelephone nurses mainly ask close-ended questions, whilst open-ended questions are sparsely used. Relationships between callers’ expressions of Concern and telephone nurses responding with Disapprovalwere found. Telephone nurses mainly responded to concern with close-ended medical questions whilst exploration of callers’ reason for concern was sparse.ConclusionTelephone nurses’ reluctance to use open-ended questions and to follow up on callers’ understanding might be a threat to concordance, and a potential threat to patient safety.
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| 6. |
- Hakimnia, Roya, et al.
(författare)
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Doing gender in the context of telenursing : Analyses of authentic calls to a telenursing site in Sweden
- 2015
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Ingår i: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 3:2, s. 24-30
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Aim: The aim of the present study was to analyze authentic health calls to a telenursing site in Sweden regardingreasons for calling and outcome of the calls with focus on a gender perspective. Background: Telephone advice nursing isan expanding service in many Western countries. In Sweden, all regions are now connected to a national telenursing service.Healthcare in Sweden is stipulated by law to be equitable. This includes the teleursing service, which is a new actor in Swedishhealthcare system, and which often is a citizen’s first contact with healthcare.Methods: The study had a descriptive and comparative design. 800 authentic calls to SHD were analysed regarding reasons forcalling, and outcome of the calls.Results: The results showed that men, and especially fathers, received more referrals to general practitioners than women. Themost common caller was a woman fluent in Swedish (64%), and the least likely caller was a man non-fluent in Swedish (3%).All in all, 70% of the callers were women. When the calls concerned children, 78% of the callers were female. In total, 9% ofthe calls were made by a man calling for another person. Callers were predominately young (mean age 29 years for women and33 for men).Conclusions: It is important that telenursing does not become a “feminine” activity, only suitable for young callers fluent inSwedish. Given the telenurses’ gatekeeping role, there is a risk that differences on this first level of health care can be reproducedthroughout the whole healthcare system. In striving for more equitable telenursing services, future research might investigate ifcampaigns encouraging men to call, and more frequent use of translators could enhance access to telenursing services.
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| 7. |
- Holmström, Inger K., 1960-, et al.
(författare)
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Frequent callers in primary health care : a qualitative study with a nursing perspective
- 2017
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 73:3, s. 622-632
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To: (a) describe how telephone nurses define a frequent caller; and (b) describe their experiences with calls from frequent callers to primary healthcare centres.BACKGROUND: Telephone nursing has been noted to be a cost-effective method to enhance access to and use of health care. Some patients use these services extensively and are called 'frequent callers'. Little is known about this group of callers, the reasons behind these calls and telephone nurses' experiences and strategies to manage the calls.DESIGN: Descriptive design with a qualitative inductive approach.METHODS: Interviews were conducted with ten telephone nurses in Sweden in 2015. Qualitative content analysis was conducted.RESULTS: A main theme was established, called 'Balancing between the experienced and assessed needs', which described the telephone nurses' experiences with calls made by frequent callers to primary healthcare centres and was further described in five categories with 15 subcategories. The categories described telephone nurses' definitions of frequent callers, telephone nurses' views of the underlying reasons for the calls, challenges related to frequent callers, experiences with an increased work load and strategies used to manage and help frequent callers.CONCLUSION: Frequent callers were commonly encountered by telephone nurses' in this study. Their calls were experienced as complex and demanding to manage. The findings point to needs for guidelines and routines to improve the care of frequent callers. In addition, support and training in communication skills to encounter this group of callers in an optimal and safe way may be required.
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| 8. |
- Håkansson Eklund, Jakob, 1971-, et al.
(författare)
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Empathy levels among nursing students : A comparative cross-sectional study.
- 2019
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Ingår i: Nursing open. - : Wiley. - 2054-1058. ; 6:3, s. 983-989
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Empathy is a crucial component of the nurse-patient relationship, but knowledge is lacking as to when empathy develops during nursing education. The aim of the present study was to compare empathy levels at different stages of undergraduate nursing education and different master's nursing programmes.Design: The design was a comparative cross-sectional study.Methods: A total of 329 participants in Sweden, comprised of nursing students in their second and sixth semesters in an undergraduate nursing programme as well as master's nursing students, rated their own empathy using the Jefferson Scale of Physician Empathy.Results: Students in their sixth semester in an undergraduate nursing programme expressed more empathy than did students in their second semester and master's nursing students. Among the five master's programmes, public-health nursing students expressed the most empathy and intensive-care nursing students the least.
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| 9. |
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| 10. |
- Håkansson Eklund, Jakob, 1971-, et al.
(författare)
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Same same or different? A review of reviews of person-centred and patient-centred care.
- 2019
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; :1, s. 3-11
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo provide a synthesis of already synthesized literature on person-centered care and patient-centered care in order to identify similarities and differences between the two concepts.MethodsA synthesis of reviews was conducted to locate synthesized literature published between January 2000 and March 2017. A total of 21 articles deemed relevant to this overview were synthesized using a thematic analysis.ResultsThe analysis resulted in nine themes present in person-centered as well as in patient-centered care: (1) empathy, (2), respect (3), engagement, (4), relationship, (5) communication, (6) shared decision-making, (7) holistic focus, (8), individualized focus, and (9) coordinated care. The analysis also revealed that the goal of person-centered care is a meaningful life while the goal of patient-centered care is a functional life.ConclusionsWhile there are a number of similarities between the two concepts, the goals for person-centered and patient-centered care differ. The similarities are at the surface and there are important differences when the concepts are regarded in light of their different goals.Practice implicationsClarification of the concepts may assist practitioners to develop the relevant aspects of care. Person-centered care broadens and extends the perspective of patient-centered care by considering the whole life of the patient.
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