| 1. |
- Cederwall, Carl-Johan, et al.
(författare)
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Care practices for patients requiring mechanical ventilation more than seven days in Swedish intensive care units: A national survey.
- 2023
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Ingår i: Intensive & critical care nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 74
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Tidskriftsartikel (refereegranskat)abstract
- To identify care practices in Swedish intensive care units specific to patients requiring mechanical ventilation for >7days.We conducted a national cross-sectional survey inviting all adult Swedish ICUs (n=79). Nurse managers were invited by email to complete a questionnaire by telephone. The questionnaire included seven domains: ventilator weaning, mobilisation, communication, nutrition, symptom assessment, psychosocial support and organisational characteristics.We received responses from 77 units (response rate, 97%). Weaning protocols were available in 42 (55%) units, 52 (68%) used individualised weaning strategies and 50 (65%) involved physicians and nurses in collaborative decision making. In 48 units (62%), early mobilisation was prioritised using bed cycling but only 26 (34%) units had mobilisation protocols. Most of the intensive care units (74, 96%) had nutrition protocols but only 2 (3%) had dedicated dieticians. Delirium screening tools were available in 49 (64%) ICUs, 3 (4%) assessed anxiety and none assessed dyspnoea. Nineteen (25%) units employed a primary nursing model and 11 (14%) indicated person-centred care policies. Regular case conferences, including family participation, were held by 39 (51%) units.We found that an individualised approach to ventilator weaning, decided by physicians and nurses in collaboration, was the predominant approach, although weaning protocols were available in some intensive care units. Most units prioritised early mobilisation, though few used protocols. Nutritional protocols were widely adopted, as few units had a dedicated dietician.
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| 2. |
- Collet, M. O., et al.
(författare)
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Functional and cognitive rehabilitation interventions during intensive care admission: A protocol for a systematic integrative review
- 2023
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 67:5, s. 670-4
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundLong-term cognitive impairment occurs in up to 60% of intensive care unit (ICU) survivors. Early use of functional and cognitive rehabilitation interventions, while patients are still in ICU, may reduce cognitive decline. We aim to describe the functional and cognitive interventions used during the ICU stay, the healthcare professionals providing interventions, and the potential impact on functional and cognitive rehabilitation. MethodIn this integrative systematic review, we will include empirical qualitative, quantitative, mixed- and multiple-methods studies assessing the use of functional and cognitive rehabilitation provided in ICU. We will identify studies in relevant electronic databases from 2012 to 2022, which will be screened for eligibility by at least two reviewers. Literature reported as narrative reviews and editorials will be excluded. We will assess the impact of interventions evaluating a cognitive and functional function, quality of life, and all-cause mortality at 6-12 months after ICU discharge. The Revised Cochrane risk-of-bias Tool will be used for assessing risk of bias in clinical trials. For observational studies, we will use the National Institutes of Health Quality Assessment tool for Observational Cohort and Cross-Sectional Studies. Furthermore, we will use the critical appraisal skills programme for qualitative studies and the mixed methods appraisal tool for mixed methods studies. We will construct four matrices, including results describing which ICU patients and healthcare professionals were engaged in rehabilitation, which interventions were included in early rehabilitation in ICU, the potential impact on patient outcomes of rehabilitation interventions provided in ICU and a narrative synthesis of themes. A summary of the main results will be reported using modified GRADE methodology. ImpactThis integrative review will inform the feasibility randomised clinical trial testing the development of a complex intervention targeting functional and cognitive rehabilitation for patients in ICU.
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| 3. |
- Hamdan Alshehri, Hanan, et al.
(författare)
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Attitudes towards death and dying among intensive care professionals: A cross-sectional design evaluating culture-related differential item functioning of the frommelt attitudes toward care of the dying instrument.
- 2023
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Ingår i: Heliyon. - 2405-8440. ; 9:8
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Tidskriftsartikel (refereegranskat)abstract
- The objective is to examine whether one of the most used instruments for measuring attitudes towards caring for dying patients, the Frommelt Attitude Toward Care of the Dying (FATCOD-B) instrument, has the same meaning across different societal contexts, as exemplified by Swedish and Saudi Arabian intensive care professionals.A cross-sectional design used the 30-item FATCOD-B questionnaire. It was distributed to intensive care professionals from Sweden and Saudi Arabia, generating a total sample of 227 participants. Ordinal logistic regression models were used to examine the differential item functioning (DIF) for each item.Up to 12 of the 30 items were found to have significant DIF values related to: (a) Swedish and Saudi Arabian intensive care professionals, (b) Swedish and Saudi Arabian registered nurses (RNs), (c) RNs' levels of experience and (d) RNs and other intensive care professionals in Saudi Arabia.The results indicate that FATCOD should be used cautiously when comparing attitudes towards death and dying across different societal and healthcare contexts.
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| 4. |
- Nolbeck, Kajsa, 1982, et al.
(författare)
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Be prepared and do the best you can: a focus group study with staff on the care environment at Swedish secure youth homes
- 2023
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- This study focuses on the care environment of secure youth homes run by the Swedish National Board of Institutional Care, where youths up to 21 years old are placed according to law due to extensive care needs or sentences. Purpose This study examined staff members' experiences of the institutional care environment within secure youth homes. Methods Data were collected through three focus group discussions with 17 staff members at two secure youth homes. Subsequently, a thematic analysis was conducted. Results The analysis indicated two main themes: risk management and damage control in a restricted environment and compensating and reconstructing ordinariness-trying to make the best of it; each theme had three subthemes. The care environment seems to be experienced by staff as characterized by conflicting demands, thus constituting a gap between needs and what is possible to achieve-a balancing act that constitutes a constant struggle. Conclusions The staff members' constant struggle could be interpreted as conflicting moral and instrumental demands; they know what the youths need, but the environment of the secure youth homes demands the decorous behaviour of sociomaterial control practices-rather than care practices.
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