| 1. |
- Backlund, Maja, et al.
(författare)
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Nurses' Experiences as Care Providers for Refugees in Emergency and Critical Care in Jordan: A Qualitative Interview Study
- 2021
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Ingår i: Global Qualitative Nursing Research. - : SAGE Publications. - 2333-3936. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- During the global refugee crisis of the 2010s, hundreds of thousands of Syrians fled to Jordan. As displaced Palestinians have had refugee status for several decades in Jordan already, this study aimed to explore nurses' perceptions of caring for Palestinian and Syrian refugees within the context of critical and emergency care. The qualitative design was executed through twelve semi-structured interviews with nurses working in refugee camps and public hospitals. Three main themes were identified describing the nurses' empathetic understanding of the refugees' situation, various challenging factors, as well as different aspects of the opportunities that they perceived in critical care and emergency care. The experiences of publicly employed nurses generally differed from those working in the camps. In addition, the findings indicate the importance of further research conducted locally, as it suggests several elements that have a negative impact on the quality of advanced healthcare for refugees.
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| 2. |
- Cederwall, Carl-Johan, et al.
(författare)
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Prevalence and Intensive Care Bed Use in Subjects on Prolonged Mechanical Ventilation in Swedish ICUs
- 2021
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Ingår i: Respiratory Care. - : Daedalus Enterprises. - 0020-1324 .- 1943-3654. ; 66:2, s. 300-306
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The number of patients requiring prolonged mechanical ventilation (PMV) is predicted to escalate due to an aging population. International studies on prevalence and resource utilization of this patient group exist, but data are lacking from Scandinavian ICUs, where there is a relatively low number of ICU beds in relation to population. The primary aim was to identify prevalence of admissions requiring mechanical ventilation >= 7-21 d and PMV > 21 d, and their use of ICU bed days in Sweden. Secondary aims were to describe patient characteristics and outcomes. METHODS: We obtained data from the Swedish Intensive Care Registry on admissions age >= 18 y mechanically ventilated >= 7 d and used open source registry data to calculate the prevalence and use of bed days of admissions ventilated >= 7-21 d and PMV > 21 d. RESULTS: Of the 39,510 ICU admissions to Swedish ICUs in 2017, those mechanically ventilated >= 7-21 d accounted for 1,643 (4%) admissions, and those with PMV > 21 d accounted for 307 (0.8%) admissions. Of the 109,457 ICU bed days, 22% were consumed by admissions ventilated >= 7-21 d and 10% by those with PMV > 21 d. The ICU mortality of both groups was 21%. Admissions with mechanical ventilation >= 7 d had a median age of 65 y and were predominantly male (64%). CONCLUSIONS: Admissions to Swedish ICUs who required mechanical ventilation >= 7-21 d and PMV > 21 d form a relatively small proportion of all ICU admissions, but consume a significant proportion of ICU beds days. Prevalence of admissions, ICU bed days, and ICU mortality were lower than reports from other countries, but the admissions were predominantly elderly and male, in accordance with other reports.
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| 3. |
- Hamdan Alshehri, Hanan, et al.
(författare)
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Managerial and organisational prerequisites for the integration of palliative care in the intensive care setting: A qualitative study.
- 2021
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 29:8, s. 2715-2723
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Tidskriftsartikel (refereegranskat)abstract
- To explore the association of organizational structures when integrating palliative care in intensive care units.Palliative care within intensive care settings has been widely recognized as an area requiring improvement when caring for patients and their families. Despite this, intensive care units continue to struggle to integrate palliative care.A qualitative descriptive methodology was used. Data were collected through research interviews with 15 managers and 36 health care professionals working in intensive care. The data were analysed adopting constant comparative analysis.This study provides insight into a diverse range of perspectives on organizational structure in the context of facilitation and the challenges posed. Three themes were identified: Do not resuscitate policy as a gateway to palliative care, facilitating family members to enable participation and support and barriers for palliative care in intensive care unit as a result of intensive care organization.In fostering a sustainable organizational culture and practice development in intensive care, the findings indicate the need for specific palliative care policies and implementation strategies tailored according to context.Management has a responsibility to facilitate dialogue within any multidisciplinary team regarding palliative care and, in particular, to focus on 'do not resuscitate' policies as a gateway into this conversation.
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| 4. |
- Nordenskjöld Syrous, Alma, 1979, et al.
(författare)
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Reasons for physician-related variability in end-of-life decision-making in intensive care
- 2021
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 65:8, s. 1102-1108
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Tidskriftsartikel (refereegranskat)abstract
- Background There is increasing evidence that the individual physician is the main factor influencing variability in end-of-life decision-making in intensive care units. End-of-life decisions are complex and should be adapted to each patient. Physician-related variability is problematic as it may result in unequal assessments that affect patient outcomes. The primary aim of this study was to investigate factors contributing to physician-related variability in end-of-life decision-making. Method This is a qualitative substudy of a previously conducted study. In-depth thematic analysis of semistructured interviews with 19 critical care specialists from five different Swedish intensive care units was performed. Interviews took place between 1 February 2017 and 31 May 2017. Results Factors influencing physician-related variability consisted of different assessment of patient preferences, as well as intensivists' personality and values. Personality was expressed mainly through pace and determination in the decision-making process. Personal prejudices appeared in decisions, but few respondents had personally witnessed this. Avoidance of criticism and conflicts as well as individual strategies for emotional coping were other factors that influenced physician-related variability. Many respondents feared criticism for making their assessments, and the challenging nature of end-of-life decision-making lead to avoidance as well as emotional stress. Conclusion Variability in end-of-life decision-making is an important topic that needs further investigation. It is imperative that such variability be acknowledged and addressed in a more formal and transparent manner. The ethical issues faced by intensivists have recently been compounded by the devastating impact of the COVID-19 pandemic, demonstrating in profound terms the importance of the topic.
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| 5. |
- Olausson, Sepideh, 1972, et al.
(författare)
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Patients’ experiences of place and space after a relocation to evidence-based designed forensic psychiatric hospitals
- 2021
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Ingår i: International Journal of Mental Health Nursing. - : Wiley. - 1447-0349 .- 1445-8330. ; 30:5, s. 1210-1220
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Tidskriftsartikel (refereegranskat)abstract
- Forensic hospitals provide care for incarcerated patients who have committed a crime under the influence of serious mental illness. The care and (re)habilitation of the target group require highly competent staff and treatment strategies as well as purpose-built facilities that promote successful recovery. The aim of this study was to examine patients’ experiences of place and space in new, purpose-built, evidence-based designed forensic psychiatric facilities in terms of supporting everydayness. A qualitative methodology was chosen. In total, 19 patients agreed to participate. Data were collected through photovoice (a combination of photographs and interviews) at three forensic hospitals, according to an evidence-based design and the concept of person-centred care in Sweden. The data were analysed through thematic content analysis. Four themes emerged from the data, revealing the patients’ experiences of the new buildings: (i) having a private place, (ii) upholding one’s sense of self, (iii) feelings of comfort and harmony, and (iv) remaining connected to one’s life. The findings reveal that purpose-built environments can support everyday living and well-being and can create comfort. This is considered highly therapeutic by the patients. In conclusion, the findings of this study are of imperative importance in the design of health-promoting forensic hospitals.
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