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- Wallin, Kim, 1978-, et al.
(author)
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Enablers and barriers in ambulance clinical placements – a mentor perspective
- 2019
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In: Presented at Ambulans2019PreHospen: Ambulanssjukvårdens roll i morgondagens akutsjukvård, Stockholm, Sweden, April 2-3, 2019.
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Conference paper (peer-reviewed)abstract
- Background: The importance of clinical placements for nursing students to be able to integrate theory and practice and develop clinical competence are described in literature. Recent research in the Swedish prehospital context has shown that there possibly are differences in the preparations among ambulance nursing students before entering their clinical placements in accordance with studies in other countries. Studies have also highlighted difficulties in creating a good learning environment in the context of prehospital emergency care. The role of the mentor in supporting these students during clinical placements via an individualized mentorship model has proven to be of most importance. At the same time the role of the mentor is described as demanding, undefined and lacking support from both universities and ambulance services. In the Swedish educational system, the voice of the mentor is missing in research in order to develop and enhance the learning environment during clinical placements.Purpose: To describe mentors ‘experiences of enablers and barriers for supervision during ambulance clinical placements.Methods: Individual interviews were conducted with 20 mentors from 10 ambulance districts from all parts of Sweden. The interviews were analysed according to qualitative content analysis.Results/Conclusions: Preliminary findings indicates that the mentors need specific competence, further education and improved support from universities and ambulances services to feel competent and safe. They are forced to adjust their learning strategies to the unique context of prehospital emergency care and are constantly drawn between responsibilities towards the patient and the student. The role and the assignment are unclear and they are in need of support and structure. The competence and attitudes of the team colleague are of high importance for the mentors’ perceived support.
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| 3. |
- Blomberg, Karin, 1970-, et al.
(author)
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Translating the Patient Dignity Inventory
- 2019
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In: International Journal of Palliative Nursing. - : Pensord Press Ltd.. - 1357-6321 .- 2052-286X. ; 25:7, s. 334-343
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Journal article (peer-reviewed)abstract
- BACKGROUND: The Patient Dignity Inventory (PDI) is based on an empirically-driven dignity model that has been developed and used for clinically assessing the various sources of dignity-related distress. In a recent review, it received the highest score as a useful instrument in both practice and research in palliative care. The PDI has been adapted to and validated for use in various countries, but not yet Sweden.AIMS: To translate the PDI into Swedish, including cultural adaptation for clinical use.METHODS: A multi-step process of translation, negotiated consensus, expert group discussion (n=7: four invited experts and three researchers) and cognitive interviewing (n=7: persons with palliative care needs).FINDINGS: Discussion, by the expert reviewers, of both linguistic and cultural issues regarding the content and readability of the translated Swedish version resulted in revisions of items and response alternatives, focusing mainly on semantic, conceptual, and experiential equivalence. A pilot version for cognitive interviews was produced. The analysis of data showed that most of the items were judged to be relevant by the persons with palliative care needs.CONCLUSION: The process of translation and adaptation added clarity and consistency. The Swedish version of the PDI can be used in assessing dignity-related distress. The next step will be to test this Swedish version for psychometric properties in a larger group of patients with palliative care needs before use in research.
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| 5. |
- Bylund-Grenklo, Tove, et al.
(author)
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Dignity in life and care : The perspectives of Swedish patients in a palliative care context
- 2019
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In: International Journal of Palliative Nursing. - : MA Healthcare Ltd. - 1357-6321 .- 2052-286X. ; 25:4, s. 193-201
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Journal article (peer-reviewed)abstract
- Background: How patients preserve their sense of dignity in life is an important area of palliative care that remains to be explored. Aims: To describe patients' perspectives of what constitutes a dignified life within a palliative care context. Methods: Twelve palliative care patients were interviewed about their views on living with dignity. Data were analysed using qualitative content analysis. Results: What constitutes a dignified life during end-of-life care was captured by the theme 'I may be ill but I am still a human being' and presented under the categories 'preserving my everyday life and personhood', 'having my human value maintained by others through 'coherence' and 'being supported by society at large'. Conclusion: Patients' sense of dignity can be preserved by their own attitudes and behaviours, by others and through public support. Health professionals need to adopt a dignity-conserving approach, for which awareness of their own attitudes and behaviours is crucial.
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| 6. |
- Söderman, Annika, 1980-, et al.
(author)
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En intervention för att bevara sköra äldre personers värdighet : utveckling och anpassning till en svensk kontext
- 2018
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In: Forskningen och utvecklingens dag, 2018. - Örebro.
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Conference paper (other academic/artistic)abstract
- Bakgrund: Utvärdering av palliativ vård i Sverige har visat att vården är ojämlik och att äldre personer får sämre palliativ vård. För att främja äldre personers livskvalitet den sista tiden i livet är bevarande av värdighet grundläggande. Förlust av värdighet kan innebära förtvivlan, en känsla av att vara en börda för andra och en önskan om att få dö, vanliga upplevelser hos sköra äldre personer. Konkreta arbetssätt behöver därför utvecklas för att bevara äldre personers värdighet, vilket idag saknas inom svensk palliativ vård. En värdighetsbevarande intervention (DCI) har utvecklats och prövats i Skottland och Irland. Interventionen består av ett formulär för kartläggning av värdighet, reflekterande frågor samt evidensbaserade vårdhandlingar.Syfte: Syftet var att utveckla och anpassa DCI till en svensk kontext.Metod: Utveckling och kulturanpassning skedde genom 1) översättning och anpassning av formuläret till svensk kontext via en expertpanel och via kognitiva intervjuer med äldre personer 2) identifiering av värdighetsbevarande vårdhandlingar relevanta för en svensk kontext, utifrån en litteraturgenomgång samt via intervjuer med äldre personer, deras närstående och vårdpersonal.Resultat: Mindre revideringar av formuläret genomfördes, men överlag accepterades det av de äldre personerna. Identifierade värdighetsbevarande vårdhandlingar speglade mestadels de redan angivna i originalversionen DCI. Dock framkom fler vårdhandlingar än i originalet vid några av kategorierna i den svenska DCI (DCI-SWE) som t.ex. ”socialt stöd”, medan det framkom färre vårdhandlingar än originalet vid t.ex. ”dödens följder för andra”. I DCI-SWE konkretiserades generella vårdhandlingar som t.ex. att lyssna och visa respekt, till skillnad från originalet.Konklusion: DCI-SWE har möjlighet att främja sköra äldre personers värdighet, och prövas nu av sjuksköterskor i en genomförbarhetsstudie inom hemsjukvården.
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| 7. |
- Söderman, Annika, 1980-, et al.
(author)
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Enhancing dignity in older persons in Sweden : adaptation of the Dignity Care Intervention
- 2018
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In: 24th Nordic Congress of Gerontology.
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Conference paper (other academic/artistic)abstract
- Background : In end of life, the older persons´ experiences of dignity can be affected due to serious illness and life changes, derived from physical, psychological, social and existential dimension. Loss of dignity impact the persons´ will to live. The Dignity Care Intervention (DCI) was developed and tested in Scotland and Ireland, to enhance dignity of older persons with palliative care needs, by nurses in municipality care. DCI consists a patient dignity inventory, reflective questions and examples of evidence-based care actions.The aim was to develop and adapt the DCI to a Swedish context.Methods: The patient dignity inventory was overall accepted by older persons in home care, however some changes in the wording were performed. The Swedish care actions reflected mostly earlier care actions described in the original version. However some more care actions derived in some of the categories in the Swedish DCI (DCI-SWE) e.g. “social support”, and some less care actions derived for example in the category “aftermath concerns”. In DCI-SWE general care actions like e.g. to show respect were concretized unlike the original DCI.Conclusions: The DCI-SWE has prospects to enhance older persons´ dignity, and is now tested in a feasibility study by twelve nurses in home care.
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| 9. |
- Söderman, Annika, 1980-, et al.
(author)
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The adaptation of the Dignity Care Intervention to a Swedish context
- 2018
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In: Nordic Conference in Nursing Research - Methods and Networks for the future, 2018.
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Conference paper (other academic/artistic)abstract
- Background: The Dignity Care Intervention (DCI) was developed in Scotland by Johnston and co-workers for nurses in municipality care, to enhance dignity in persons with palliative care needs. DCI includes a questionnaire, examples of reflective questions and suggests care actions. DCI has been tested in Ireland, and is now adapted to Swedish.Objective: To translate and adapt the DCI to a Swedish palliative context.Method: The questionnaire was translated and adapted into Swedish and reviewed by an expert group, before validated in cognitive interviews (N=7) with older persons. To update evidence concerning care actions from a Swedish context, a review of Swedish research literature and interviews with older persons, relatives and health care professionals were carried out. This gathered knowledge has been integrated into the Swedish DCI (DCI-SWE) and a feasibility study now takes place in one municipality in home care, Sweden. Included nurses got repeated information and participated in a shorter DCI-education, and will use the DCI in their everyday work for three months. Follow-up interviews will be conducted and analysed with qualitative content analysis.Results: The Swedish version of the questionnaire was experienced relevant for older persons, and both the Swedish review and the interviews gave culturally relevant proposals about dignity care actions. Further, a feasibility study will contribute to the ongoing development of the Swedish DCI-version.Conclusion and implication for practice: Implementing DCI in Sweden can enhance dignity in persons with palliative care needs and facilitate for a person-centered care.
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| 10. |
- Werkander Harstäde, Carina, et al.
(author)
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Adapting the Dignity Care Intervention to a Swedish Context
- 2015
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In: 978-0-9542022-3-1.
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Conference paper (peer-reviewed)abstract
- Abstract number: P1-212 Abstract type: Poster Adapting the Dignity Care Intervention to a Swedish Context WerkanderHarstäde C. 1 , Blomberg K. 2 , Söderman A. 2 ,ÖstlundU. 1 1 Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Kalmar, Sweden, 2 Örebro University, School of Health and Medical Sciences, Örebro, Sweden Presenting author email address: ulrika.ostlund@lnu.se Aims: The Dignity Care Intervention (DCI) was developed in Scotland to be used by community nurses caring for patients with palliative care needs, with an aim to conserve patients’sense of dignity. The DCI includesthe Patient Dignity Inventory (PDI) that is used to identify dignity related concerns. In a dialogue with the patient, the nurse discussidentified concerns and waysto addressthem by using reflective questions and evidence based care actions provided in the DCI. The DCI is now translated and adapted for implementation in Swedish palliative care. Design, method, and approach: DCI is based on Chochinovs model of dignity and the PDI is one key component. Two researchersindependently translated the model and the inventory from English to Swedish and the research group examined the translationstogether with the original versions. An expert review focusing on items and response alternatives was accomplished followed by cognitive interviews with patients answering the preliminary Swedish version of the PDI. Evidence based care actions were updated with Swedish publicationssuch astheses, clinical guidelines and governmental publications. Results: Swedish versions of the model of dignity and the PDI were produced, the process of translation and adaptation added clarity and consistency. From the review of Swedish publications, care actions were adapted and updated. Conclusions: The focus has been on achieving cultural relevance which might have affected equivalence to the original model of dignity and the PDI. To get local context evidence for care actions, focus group interviews will be conducted with nurses, physicians, patients and family members. After the process of adapting the DCI it will be implemented and evaluated in clinicalsettings. Two clinicalsettings have agreed to collaborate in this phase. Implementing the culturally adapted DCI will be a way for nursesto provide evidence based and person centred palliative care.
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