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- Cederwall, Carl-Johan, et al.
(författare)
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Critical care nurses management of prolonged weaning: an interview study
- 2014
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Ingår i: Nursing in Critical Care. - : Wiley. - 1362-1017. ; 19:5, s. 236-242
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Tidskriftsartikel (refereegranskat)abstract
- Background: For most critically ill patients requiring mechanical ventilation in the intensive care unit (ICU) weaning is uncomplicated. For the remainder, weaning is a challenge and may result in further complications and increased risk of mortality. Critical care nurses (CCNs) require substantial knowledge and experience to manage patients experiencing prolonged weaning. Aim: The aim of this study was to explore CCNs approach for management of patients experiencing prolonged weaning in the ICU. Methods: Semi-structured interviews with 19 experienced CCNs were conducted. Data were analysed using content analysis. Results: Participants used various strategies for weaning that were grouped into four categories: individualized planning for the weaning process, assessing patient's capacity, managing the process and team interaction. The overall theme that emerged was: CCNs drive the weaning process using both a patient centred and targeted approach. Conclusion: CCNs in these ICUs performed weaning using a patient centred approach to plan, initiate, assess and establish a holistic weaning process. Team collaboration among all health care practitioners was important. CCNs have a key role in prioritizing weaning and driving the process forward. Relevance to clinical practice: Closeness to the patient and a key role in management of the mechanical ventilated patient in ICU gives the CCN unique potential to develop and create models and tools for prolonged weaning. These tools, specially designed for patients undergoing prolonged weaning, would give focus on continuous planning, collaborating, managing and evaluation in the process of liberating patients from mechanical ventilation.
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| 2. |
- Cederwall, Carl-Johan, et al.
(författare)
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Liberate from mechanical ventilation
- 2013
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Ingår i: EfCCNA Conference in Belgrade, Serbia, Oral paper.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 3. |
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| 4. |
- Nielsen, Susanne, 1969, et al.
(författare)
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Authentic Situations Motivate Medical Students for Dealing with Medical Insurance Issues
- 2012
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Ingår i: Creative Education. - : Scientific Research Publishing, Inc.. - 2151-4755 .- 2151-4771. ; 3:1, s. 120-125
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Tidskriftsartikel (refereegranskat)abstract
- In this study, e-learning based on authentic situations was used as a pedagogic method to stimulate medi-cal students to reflect over their own learning styles and to prepare them for dealing with medical insur-ance issues in their future profession. The aim was to explore the learning styles used by the students in a Social medicine course when e-learning, based on authentic situations was used as a pedagogical ap-proach. A learning style questionnaire by Kember, Biggs and Leung, and a course evaluation question-naire designed by the authors were used. Seventy-seven students answered the questionnaires and the questionnaires were analysed by Mann-Whitney U-test, and Fisher’s test was used as a pair comparison. One hundred forty comments made by the students were analysed using content analysis. The results showed that: 69% of the students regarded e-learning as a very good/good pedagogical method to study medical insurance. Men had a significantly higher rate of surface learning than women. A majority of the students thought that it was positive to take part of peer students’ assignments but they highlighted the risk of plagiarism and cheating. The students made use of the flexibility in this type of learning which suited their lifestyle.
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| 5. |
- Ringdal, Mona, 1955, et al.
(författare)
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Memories and health related quaity of life after intensive care - a follw-up study
- 2010
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Ingår i: Critical Care Medicine. - 0090-3493. ; 38:1, s. 38-44
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The overall aim was to describe changes in health related quality of life (HRQoL), anxiety, depression and return to work (RTW) from 0.5-1.5 to 4.5-5.5 years after trauma in patients with and without delusional memories (DM) during their ICU stay. A secondary aim was to explore factors that were related to HRQoL and to compare patients´ HRQoL 4.5-5.5 years after trauma with a reference sample. Design and methods: A follow-up study was conducted with 153 consenting adults. Each patient answered a postal questionnaire twice, 0.5-1.5 years and 4.5-5.5 years after the trauma. HRQoL was assessed in a previous study and used in this study as possible factors of poor HRQoL. Results: 75% were males and mean ISS was 10.7+7.1. When comparing HRQoL over time, there was significant improvement in 5 domains of HRQoL for patients with DM compared to four years ago. Significantly more patients with DM had anxiety and depression (HAD more than 8). Patients with DM were still significantly separated from the other patients in all HRQoL domains except for general health.75% of all patients had RTW. Despite a poorer HRQoL, patients with delusions had RTW to the same degree. Patients with trauma still scored signficantly lower in all domains 4.5-5.5 years after the trauma compared to the Swedish population in the reference group. Two factors, DM during ICU-stay and pre-existing disease prior to the trama, had the most influence on a poorer HRQoL.
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| 6. |
- Zetterlund, Per, et al.
(författare)
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Memories from intensive care unit persists for several years- A longitudinal prospective multi-centre study
- 2012
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier BV. - 0964-3397. ; 28:3, s. 159-167
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Tidskriftsartikel (refereegranskat)abstract
- Introduction:In connection with the care received in the intensive care unit (ICU), the patient can experience discomfort and frustration. Earlier studies have shown mechanical ventilation (MV) to be a factor that increases patients' delusional memories in the ICU. The patients who need MV after a physical trauma constitute a vulnerable group who so far has attracted little attention fram a long-term perspective. Aim: The aim for this study is to describe mechanically ventilated trauma patients over time regarding their memories, psychological recovery and health related quality of life (HRQoL). Methods: In a mulitcentre study, 41 patients who had received MV, answered a questionnaire with the SF-36, HAD and ICUM tool on two occasions about one and five years after the injury and care in the ICU. Results: The patients' memories were stable over time and significantly more patients remembered panic and anxiety. 37% remembered pain over one year after the trauma and 46% five years thereafter. The majority of the patients remembered the family's presence from their ICU stay. Half of the patients had thoughts regarding why they had so few recollections. One fourth of the patients experienced clear symptoms of anxiety and the same amount had symptoms of depression one year after the injury. In seven of the patients the symptoms of probable anxiety persisted after five years. In six of the patients the symptoms of probable depression persisted after five years. Two of eight dimensions in HRQoL, the physical and emotional role functions had improved significantly five years after the injury. Conclusions: Five years after the trauma, the memories from the ICU were still the same and the HRQoL improved in only two out of eight dimensions. A smaller group of patients had remaining symptoms of psychologicla ill-health. MV in connection with trauma may result in continued reduced health in the long term.
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