| 1. |
- Hägglund, Patricia, et al.
(author)
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Study protocol for the SOFIA project : Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial
- 2017
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In: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 17
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Journal article (peer-reviewed)abstract
- Background: Extensive studies have shown that older people are negatively impacted by impaired eating and nutrition. The abilities to eat, enjoy food, and participate in social activities associated with meals are important aspects of health-related quality of life (HRQoL) and recovery after illness. This project aims to (i) describe and analyze relationships between oral health and oral HRQoL, swallowing ability, eating ability, and nutritional risk among older individuals admitted to short-term care; (ii) compare the perceptions that older individuals and staff report on care quality related to oral hygiene and eating; and (iii) study the feasibility and effects of a training program for people with impaired swallowing (i.e., dysphagia). Methods/Design: This project consists of two parts, which will be performed in five Swedish counties. It will include approximately 400 older individuals and 200 healthcare professionals. Part 1 is a cross-sectional, descriptive study of older people admitted to short-term care. Subjects will be assessed by trained professionals regarding oral health status, oral HRQoL, eating and nutritional risk, and swallowing ability. Swallowing ability will be measured with a teaspoon test and a swallowing capacity test (SCT). Furthermore, subjects and staff will complete a questionnaire regarding their perceptions of care quality. Part 2 is a cluster randomized intervention trial with controls. Older participants with dysphagia (i.e., SCT < 10 ml/s, measured in part 1) will be recruited consecutively to either the intervention or control group, depending on where they were admitted for short-term care. At baseline, all subjects will be assessed for oral health status, oral HRQoL, eating and nutritional risk, swallowing ability, and swallowing-related QoL. Then, the intervention group will receive 5 weeks of training with an oral screen for neuromuscular training focused on orofacial and pharyngeal muscles. After completing the intervention, and at six months post-intervention, all assessments will be repeated in both study groups. Discussion: The results will make important contributions to rehabilitation knowledge, including approaches for improving swallowing function, oral health, and food intake and for improving the quality of oral care for older people.
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| 2. |
- Abrahamsen Grøndahl, Vigdis, 1964-, et al.
(author)
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The use of life stories and its influence on persons with dementia, their relatives and staff : A systematic mixed studies review
- 2017
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In: BMC Nursing. - : BioMed Central. - 1472-6955. ; 16:28
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Journal article (peer-reviewed)abstract
- BACKGROUND: Dementia is an important predictor of nursing home admissions. Due to progressive dementia symptoms, over time it becomes difficult for persons with dementia to communicate their wishes and participate in decisions concerning their everyday lives. Their well-being, sense of dignity, integrity and personhood are at risk. The persons' life stories have been highlighted as particularly important in dementia care and are referred to as seeing the person beyond the dementia. The aim of this study was to explore and describe the use of life stories and its influence on persons with dementia living in nursing homes, their relatives and staff.METHODS: A systematic mixed studies review was conducted. The literature searches were performed in the following databases: CINAHL, PubMed and PsycINFO and the Cochrane library, as well as by hand searching references in the studies included. An updated search was performed eight months after the first search. Data was synthesised inspired by integrative analysis.RESULTS: Three studies using quantitative design and two studies (presented in three papers) using qualitative design representing research from 2006 to 2015 were included in the review. Life stories generally had a positive influence on the persons with dementia, their relatives, and staff. The use of life stories might contribute to 'Maintenance of the person with dementia as a whole person rather than a demented patient'. On the other hand, enabling persons with dementia to tell their own story could be a challenge. For the staff it could be challenging when sensitive information emerged uninvited. Involving relatives could also be difficult as to whose story were uncovered.CONCLUSIONS: The use of person's life story might be of significance, but there is not enough evidence to make any statement about its importance as the research is scarce. Studies, including randomised controlled trials, are needed to measure the impact of life story work on the physiological and psychological aspects of persons with dementia, and also how it influences their relatives and staff.
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| 3. |
- Andersson, Maria, 1969-, et al.
(author)
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Good in Providing Oral Care, but we Could be Better-Nursing Staff Identification of Improvement Areas in Oral Care
- 2021
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In: Sage Open Nursing. - : Sage Publications. - 2377-9608. ; 7
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Journal article (peer-reviewed)abstract
- Introduction: Oral care to older people in short-term care units is a complex and challenging everyday practice for nursing staff. Oral care research and knowledge about prerequisites and obstacles is extensive. However, there is a lack of knowledge about how nursing staff in short-term care units describe their satisfaction about provided oral care in order to maintain older people's oral health. Objective: The purpose of this study was to describe how nursing staff perceive their satisfaction of oral care provided for older people in short-term care units and to identify oral care improvements. Methods: This study reports on the results of two open-ended questions that were part of a larger study. Informants (n = 54) were nursing staff working in the involved short-term care units in municipalities from both densely and sparsely populated regions in central and northern Sweden. The answers to the open-ended questions were analyzed using content analysis. Results: The analysis yielded one main category; "Working together to improve satisfaction with older people's oral care" and four subcategories: "Older people's oral health," " Consideration and respect for the older person's autonomy," "Having access to adequate products," and "Working together in the same direction." Conclusion: Identification of older people's oral health problems together with adequate nursing intervention will increase older people's health outcomes and quality of life. However, regardless of work role, the nursing staff might have difficulty changing their behavior or transforming intentions into actions. Oral care is a complicated and proactive practice that requires nursing staff's attention as well as both educational and organizational initiatives. Working in a supportive and collaborative relationship provides prerequisites for optimal oral care in short-term care units.
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| 4. |
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| 5. |
- Andersson, Maria, 1969-, et al.
(author)
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Intensive care nurses fail to translate knowledge and skills into practice : A mixed-methods study on perceptions of oral care
- 2019
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In: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 52, s. 51-60
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Journal article (peer-reviewed)abstract
- Objectives: To identify intensive care nurses’ perceptions of oral care according to Coker et al.'s (2013) conceptual framework and to contribute to the knowledge base of oral care in intensive care. Design/methods: This was a concurrent embedded mixed-methods design, with more weight given to the quantitative part. Participants responded to the Nursing Care related to Oral Health questionnaire, including perceptions of oral care antecedents (18 items), defining attributes (17 items), and consequences (6 items) and two open-ended questions. The data were analysed with descriptive and correlation statistics and qualitative content analysis. Setting: Intensive care nurses (n = 88) in six general intensive care units. Results: Intensive care nurses perceived that an important part of nursing care was oral care, especially to intubated patients. They perceived that the nursing staff was competent in oral care skills and had access to different kinds of equipment and supplies to provide oral care. The oral cavity was inspected on a daily basis, mostly without the use of any assessment instruments. Oral care seemed to be task-oriented, and documentation of the patients’ experiences of the oral care process was rare. Conclusions: The antecedents, knowledge and skills are available to provide quality oral care, but intensive care nurses seem to have difficulties translating these components into practice. Thus they might have to shift their task-oriented approach towards oral care to a more person-centred approach in order to be able to meet patients’ needs. © 2018 Elsevier Ltd
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| 6. |
- Andersson, Maria, 1969-, et al.
(author)
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Older people's perceptions of the quality of oral care in short-term care units : A cross-sectional study
- 2018
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In: International Journal of Older People Nursing. - : John Wiley & Sons. - 1748-3735 .- 1748-3743. ; 13:2, s. 1-14
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Journal article (peer-reviewed)abstract
- Background: There is a lack of knowledge about oral care among older people living in short-term care (STC) units and how the quality of oral care provided by nursing staff is perceived by the older people. Aim: To (i) describe person-related conditions among older people in STC, (ii) describe and compare perceptions of the quality of oral care (including perceptions of care received and the subjective importance of such care), within and between older people who have the ability to perform oral self-care and those who are dependent on help with oral care and (iii) examine the relationship between person-related conditions and the quality of oral care. Methods: A cross-sectional study was conducted with 391 older people in STC units in Sweden based on self-reported questionnaire and clinical assessments. Results: The older people were assessed as having normal oral health (2%), moderate oral health problems (78%) or severe oral health problems (20%). When comparing older people's perceptions of quality of oral care in terms of perceived reality and subjective importance, significant differences appeared within and between groups. Psychological well-being had a significant relationship with perception of the quality of oral care (both perceived reality and subjective importance), and gender and oral health status had a significant relationship with subjective importance. Conclusions: Older people's perceptions of areas for improvement regarding quality of oral care is a new and important knowledge for nursing staff in STC units. Older people want personalised information regarding oral health and oral care. Registered Nurses who take the responsibility in nursing care for older people's oral health may avoid unnecessary suffering by older people caused by oral health problems. Implications for practice: Older people's perspective is an important component for quality work and might lead to improvements in the quality of oral care in STC. © 2018 John Wiley & Sons Ltd.
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| 7. |
- Andersson, Maria, 1969-, et al.
(author)
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Oral care : identifying quality improvement areas
- 2019
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In: International Journal of Health Care Quality Assurance. - : Emerald Group Publishing Limited. - 0952-6862 .- 1758-6542. ; 32:1, s. 45-58
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Journal article (peer-reviewed)abstract
- Purpose: To describe and compare nurses' and healthcare assistants' oral care qualityperceptions, including perceived reality and subjective importance, to identify improvementareas in intensive care and short-term care, and to explore potential nursing satisfactionpredictors regarding oral care.Design/methodology/approach: Swedish staff, 154 within intensive care and 278 withinshort-term care responded to a modified Quality of Care from a Patient Perspectivequestionnaire. Descriptive and analytical statistics were used.Findings: Staff scored oral care quality both high and low in relation to perceived reality andsubjective importance. Improvement areas were identified, despite high satisfaction valuesregarding oral care. Setting, subjective importance, and perceived reality explained 51.5% ofthe variance in staff satisfaction regarding oral care quality.Practical implications: Quality improvements could guide oral care development.Originality/value: This study describes oral care by comparing nurse perceptions of howimportant they perceive different oral care aspects and to what extent these oral care aspectsare performed.
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| 8. |
- Andersson, Maria, 1969-, et al.
(author)
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Oral care quality - do humanity aspects matter? : Nursing staff and older people's perspectives
- 2020
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In: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 7:3, s. 857-868
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Journal article (peer-reviewed)abstract
- Aim (a) To describe and compare perceptions of humanity aspects of oral care quality in relation to nursing staff in short-term care units and intensive care units and older people in short-term care units and their person-related conditions; and (b) to compare humanity aspects of oral care quality perceptions between nursing staff and older people in short-term care units. Design Cross-sectional study. Self-reported questionnaire and clinical assessments. Methods Nursing staff (N = 417) and older people (N = 74) completed the modified Quality of Care from a Patient Perspective instrument and person-related items. Older people's oral health status was clinically assessed using the Revised Oral Assessment Guide. Data were analysed using descriptive and analytic statistics. The data were collected from 2013-2016. Results Nursing staff's perceptions of humanity aspects of oral care quality were related to gender, work role and care environment. Older people's perceptions of humanity aspects of oral care quality were related to self-reported physical health. Nursing staff in short-term care units perceived the subjective importance of humanity aspects of oral care quality higher compared with older people in short-term care units.
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| 9. |
- Andersson, Maria, 1969-
(author)
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Oral care quality in intensive care units and short-term care units : Nursing staff and older people's perspectives
- 2019
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Doctoral thesis (other academic/artistic)abstract
- The overall aim of this thesis was to investigate oral care and its quality through the perspectives of nursing staff in intensive care units and short-term care units and from the perspectives of older people in short-term care units. Methods: The mix-method study (I) had a concurrent embedded design and was cross-sectional. Eighty-eight intensive care nurses (response rate (RR) 40%) responded to the Nursing Care related to Oral Health questionnaire, and the data were analysed with analytic statistics and qualitative content analysis. The quantitative studies (II-IV), which were also cross-sectional, included 432 nursing staff in intensive care and short-term care (RR 51–52%) and 391 older people (RR 77%) in short-term care units. Participants responded to the modified version of the Quality from Patients’ Perspective instrument and provided information about person-related conditions. Descriptive and analytical statistics were used. Main results: Intensive care nurses perceived having the antecedents, knowledge, and skills to provide optimal oral care quality, but the result indicated that they were having difficulties putting these into practice (I). Areas for improvement in oral care quality were identified in both care environments (II). Older people preferred personalised information about oral health and oral care (III). Nursing staff as well as older people’s perceptions of oral care quality and its humanity aspects, seemed to be related to person-related conditions and differed between the two care environments. In short-term care, nursing staff’s preferences for the humanity aspects of oral care quality were higher compared to older people’s preferences (IV). Conclusion: Oral care is complicated and proactive and requires registered nurses’ and other nursing staff’s attention as well as educational and organisational initiatives. Many older people were assessed to have oral health problems. With early identification and optimal oral care, unnecessary suffering might be prevented. The identified quality improvement areas might guide RNs, nurse managers, and other nursing staff to further oral care quality development.
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| 10. |
- Andersson, Maria, 1969-, et al.
(author)
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Patient photographs-A landmark for the ICU staff : A descriptive study.
- 2013
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In: Intensive & Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 29:4, s. 193-201
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The purpose of this study was to investigate ICU staff's perceptions of photographs displayed at the bedsides of unconscious patients and whether profession, years in ICU and work status had any influence on these perceptions.RESEARCH METHODOLOGY: A cross-sectional study was used comprising a questionnaire with statements and one open-ended question. All registered nurses, enrolled nurses and anaesthetists working in one ICU in Sweden were included. A total of 85 participants returned a questionnaire (response rate=77%).RESULTS: The findings of the study revealed that a photograph of the patient helped the ICU staff to relate to the patient as a person. Profession, years in ICU and work status had influence on the ICU staff's perceptions. From the content analysis two categories emerged: "getting closer and see the person" and "a landmark bringing hope".CONCLUSION: The ICU staff need to consider how close to the patient they want to be and why the patient's recovery is worth striving for. Keeping a professional approach is one of the challenges of working in ICU. A photograph can be an inexpensive and easy way of preventing the loss of identity of the patient as an individual within the technocratic environments of the ICU.
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| 11. |
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| 12. |
- Ballangrud, Randi, 1959-, et al.
(author)
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Intensive care nurses' perceptions of simulation-based team training for building pation safety in intensive care: A descriptive qualittaive study
- 2014
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In: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 30:4, s. 179-187
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Journal article (peer-reviewed)abstract
- Objectives: To describe intensive care nurses' perceptions of simulation-based team training for building patient safety in intensive care. Background: Failures in team processes are found to be contributory factors to incidents in an intensive care environment. Simulation-based training is recommended as a method to make health-care personnel aware of the importance of team working and to improve their competencies. Design: The study uses a qualitative descriptive design. Methods: Individual qualitative interviews were conducted with 18 intensive care nurses from May to December 2009, all of which had attended a simulation-based team training programme. The interviews were analysed by qualitative content analysis. Results: One main category emerged to illuminate the intensive care nurse perception: "training increases awareness of clinical practice and acknowledges the importance of structured work in teams". Three generic categories were found: "realistic training contributes to safe care", "reflection and openness motivates learning" and "finding a common understanding of team performance". Conclusions: Simulation-based team training makes intensive care nurses more prepared to care for severely ill patients. Team training creates a common understanding of how to work in teams with regard to patient safety.
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| 13. |
- Ballangrud, Randi, 1959-, et al.
(author)
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Intensive care unit nurses' evaluation of simulation used for team training
- 2014
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In: Nursing in Critical Care. - : Wiley. - 1362-1017 .- 1478-5153. ; 19:4, s. 175-184
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Journal article (peer-reviewed)abstract
- AimTo implement a simulation-based team training programme and to investigate intensive care nurses' evaluations of simulation used for team training.BackgroundSimulation-based training is recommended to make health care professionals aware of and understand the importance of teamwork related to patient safety.DesignThe study was based on a questionnaire evaluation design.MethodsA total of 63 registered nurses were recruited: 53 from seven intensive care units in four hospitals in one hospital trust and 10 from an intensive care postgraduate education programme. After conducting a simulation-based team training programme with two scenarios related to emergency situations in the intensive care, the participants evaluated each simulation activity with regard to: (i) outcome of satisfaction and self-confidence in learning, (ii) implementation of educational practice and (iii) simulation design/development.ResultIntensive care nurses were highly satisfied with their simulation-based learning, and they were mostly in agreement with the statements about self-confidence in learning. They were generally positive in their evaluation of the implementation of the educational practice and the simulation design/development. Significant differences were found with regard to scenario roles, prior simulation experience and area of intensive care practice.ConclusionThe study indicates a positive reception of a simulation-based programme with regard to team training in emergency situations in an intensive care unit.Relevance to clinical practiceThe findings may motivate and facilitate the use of simulation for team training to promote patient safety in intensive care and provide educators with support to develop and improve simulation-based training programmes.
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| 14. |
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| 15. |
- Bjuresäter, Kaisa, 1970-, et al.
(author)
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Omvårdnad i samband med nutrition
- 2012
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In: Omvårdnad vid kirurgiska sjukdomar. - Lund. - 9789144060606 ; , s. 251-262
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Book chapter (pop. science, debate, etc.)
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| 16. |
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| 17. |
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| 18. |
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| 19. |
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| 20. |
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| 21. |
- Fredholm, Angelica, et al.
(author)
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Learning in intensive care during the COVID-19 pandemic - postgraduate critical care nursing students’ experiences
- 2022
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In: International Journal of Medical Education. - : NLM (Medline). - 2042-6372. ; 13, s. 335-344
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Journal article (peer-reviewed)abstract
- Objectives: This study explored postgraduate critical care nursing students' experiences of learning in the ICU during the COVID-19 pandemic and to understand these experiences in relation to self-directed learning and professional development. Methods: An explorative qualitative design was used. Eight postgraduate critical care nursing students from two different universities were interviewed. Questions focused on learning, supervision, ethically difficult situations, issues regarding communication, as well as the impact of the pandemic on students' health. Interviews thematically analyzed, and further analyzed using a theoretical framework focusing self-directed learning and professional development containing the concepts of autonomy, authenticity, and attachment. Results: The result consists of three themes: 1) Attachment with subthemes Attachment to the patient, Attachment to family and friends, Attachment to the ICU-context, and Attachment to the clinical supervisor. 2) Authenticity with subthemes Experiencing a varying degree of authenticity, Clinical reasoning about how to prioritize care. 3) Autonomy with subthemes Being just a student - with limited responsibility, taking responsibility, and having worries regarding one's professional development. Conclusion: Findings show the need for participation in the ICU community of practice without the demands and responsibility of full participation. Students need to be given the opportunity to form a relationship with practice. For attachment, participation, and consequently professional development to take place, there is need for inviting students to be a part of the team even during such straining circumstances as an ongoing pandemic. These findings can advance the understanding of how to organize clinical education during future crisis such as a new pandemic.
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| 22. |
- Nordin, Anna, 1972-, et al.
(author)
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Measuring moral distress in Swedish intensive care: Psychometric and descriptive results
- 2023
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In: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 76
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Journal article (peer-reviewed)abstract
- Objectives: To investigate the construct validity and psychometric properties of the Swedish version of the Moral Distress Scale–Revised and to describe moral distress in an intensive care context.Research Methodology/Design: The Italian Moral Distress Scale–Revised was translated and semantically adjusted to the Swedish intensive care context. A web survey with 14 moral distress items, as well as three additional and eight background questions was answered by critical care nurses (N = 71) working in intensive care units during the second year of the coronavirus disease pandemic. Inferential and descriptive statistics were used to investigate the Italian four-factor model and to examine critical care nurses’ moral distress.Results: The result shows a factor model of four components differing from the previous model. Critical care nurses demonstrated significant differences in moral distress regarding priorities compared to before the pandemic, type of household; experience as critical care nurses and whether they had supervised students during the pandemic.Conclusion: The component structure might have originated from the specific situation critical care nurses perceived during the pandemic. The health care organisations’ role in preventing and healing the effects of moral distress is important for managers to understand.Implications for clinical practice: Moral distress is common in intensive care and it is necessary to use valid instrument when measuring it. A psychometrical investigation of the Swedish version of the Moral Distress Scale–Revised, adapted for intensive care shows need for further semantic and cultural adaptation. Perceived priorities during the pandemic, household type, supervising during the pandemic and working experience were related to critical care nurses’ experience of moral distress and managers need to be aware of conditions that may trigger such a response.
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| 23. |
- Olai, Lena, 1958-, et al.
(author)
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Aspects of eating and quality of care among elderly in short-term accommodations - before and after an intervention
- 2013
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Conference paper (peer-reviewed)abstract
- Background: Lately, oral health-related quality of life (OHRQoL) and the mealtime situation for elderly people living in special accommodations have been placed in focus. In addition, it has been shown that the prevalence of dysphagia, an important aspect of the eating process, is high among frail elderly people. However, the knowledge on how frail elderly people in general perceive oral health and the mealtime situation is scarce. To our knowledge, there is no research on which eating and oral health related experience, older people regard as important factors in short-term accommodations. A simple and innovative training method for people with dysphagia has been successfully tested among people with stroke. In the present study the aims are (1) to describe OHRQoL, the prevalence of dysphagia and eating difficulties among elderly people in short-term accommodations, as well as their perceptions of care quality related to oral health and eating, (2) to compare elderly peoples’ and nursing staffs’ perceptions of quality, and (3) to evaluate a training program for dysphagia.Methods and materials: In this prospective study 400 older people will be examined with validated instruments measuring OHRQoL, perception of care quality, swallowing capacity and eating ability (OHIP14, QPP, SCT, MEONF-II). Patients with dysphagia will be included in an intervention program and tested before and after the training period.Results: Preliminary results will be presented.Conclusion: Eating and oral health is a multidisciplinary responsibility and key factors of importance for this process will be identified.
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| 24. |
- Persenius, Mona, 1958-, et al.
(author)
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Clinical nursing leaders’ perceptions of nutritionquality in Swedish stroke wards : a national survey
- 2015
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In: Journal of Nursing Management. - : Wiley-Blackwell. - 0966-0429 .- 1365-2834. ; 23:6, s. 705-715
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Journal article (peer-reviewed)abstract
- AimTo describe nursing leaders' perceptions of nutrition quality in Swedish stroke wards.BackgroundA high risk of undernutrition places great demand on nutritional care in stroke wards. Evidence-based guidelines exist, but healthcare professionals have reported low interest in nutritional care. The Donabedian framework of structure, process and outcome is recommended to monitor and improve nutrition quality.MethodUsing a descriptive cross-sectional design, a web-based questionnaire regarding nutritional care quality was delivered to eligible participants.ResultMost clinical nursing leaders reported structure indicators, e.g. access to dieticians. Among process indicators, regular assessment of patients' swallowing was most frequently reported in comprehensive stroke wards compared with other stroke wards. Use of outcomes to monitor nutrition quality was not routine. Wards using standard care plans showed significantly better results.ConclusionUsing the structure, process and outcome framework to examine nutrition quality, quality-improvement needs became visible. To provide high-quality nutrition, all three structure, process and outcome components must be addressed.Implications for nursing managementThe use of care pathways, standard care plans, the Senior Alert registry, as well as systematic use of outcome measures could improve nutrition quality. To assist clinical nursing leaders in managing all aspects of quality, structure, process and outcome can be a valuable framework.
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| 25. |
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| 26. |
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| 27. |
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| 28. |
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| 29. |
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| 30. |
- Persenius, Mona, 1958-, et al.
(author)
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Quality of life and sense of coherence in young people and adults with uncomplicated epilepsy : a longitudinal study
- 2015
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In: Epilepsy & Behavior. - : Elsevier. - 1525-5050 .- 1525-5069. ; 47, s. 127-131
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The aim of the study was, in a ten-year follow-up, to describe and explore potential changes in quality of life and sense of coherence in relation to gender differences among persons with epilepsy in the transition from adolescence to adulthood. MATERIALS AND METHODS: A longitudinal study of sense of coherence (SOC) and quality of life with repeated measurement design (1999, 2004, and 2009) was conducted in a population of persons (n=69) who were aged 13-22years in 1999 and 23-33years in 2009. The Quality-of-Life Index (QLI) and the Sense of Coherence (SOC) scale were used. RESULTS:There was a significant decrease (p≤0.001) in seizures compared with the 2004 results, mainly among the women (p=0.003). When comparing the total QLI scores, no significant differences were found between the three data collections and there were no differences in total scores between men and women. There was a decrease in the SOC total score over the 10-year period study. Total SOC was significantly higher among those being 30-33years old compared to those being 23-29years old (p=0.014) and among those having a driving license (p=0.029) compared to those not having a driving license.CONCLUSIONS:Both quality of life and sense of coherence are important for maintaining health and well-being. Promoting health and well-being requires effective high-quality multidisciplinary person-centered care.
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| 31. |
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| 32. |
- Persenius Wentzel, Mona, 1958-, et al.
(author)
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Nutrition
- 2016
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In: Omvårdnad och kirurgi. - Lund : Studentlitteratur AB. - 9789144088860 ; , s. 123-131
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Book chapter (other academic/artistic)
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| 33. |
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| 34. |
- Wentzel Persenius, Mona, 1958-, et al.
(author)
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Assessment and documentation of patients' nutritional status : perceptions of registered nurses and their chief nurses
- 2008
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 17:16, s. 2125-2136
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Journal article (peer-reviewed)abstract
- To study, within municipal care and county council care, (1) chief nurses' and registered nurses' perceptions of patient nutritional status assessment and nutritional assessment/screening tools, (2) registered nurses' perceptions of documentation in relation to nutrition and advantages and disadvantages with a documentation model.BACKGROUND:Chief nurses and registered nurses have a responsibility to identify malnourished patients and those at risk of malnutrition.DESIGN AND METHODS:In this descriptive study, 15 chief nurses in municipal care and 27 chief nurses in county council care were interviewed by telephone via a semi-structured interview guide. One hundred and thirty-one registered nurses (response rate 72%) from 14 municipalities and 28 hospital wards responded to the questionnaire, all in one county.RESULTS:According to the majority of chief nurses and registered nurses, only certain patients were assessed, on admission and/or during the stay. Nutritional assessment/screening tools and nutritional guidelines were seldom used. Most of the registered nurses documented nausea/vomiting, ability to eat and drink, diarrhoea and difficulties in chewing and swallowing, while energy intake and body mass index were rarely documented. However, the majority documented their judgement about the patient's nutritional condition. The registered nurses perceived the VIPS model (Swedish nursing documentation model) as a guideline as well as a model obstructing the information exchange. Differences were found between nurses (chief nurses/registered nurses) in municipal care and county council care, but not between registered nurses and their chief nurses.CONCLUSIONS:All patients are not nutritionally assessed and important nutritional parameters are not documented. Nutritionally compromised patients may remain unidentified and not properly cared for.RELEVANCE TO CLINICAL PRACTICE:Assessment and documentation of the patients' nutritional status should be routinely performed in a more structured way in both municipal care and county council care. There is a need for increased nutritional nursing knowledge.
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| 35. |
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| 36. |
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| 37. |
- Wentzel Persenius, Mona, 1958-, et al.
(author)
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Grasping the nutritional situation : A grounded theory study of patients' experiences in intensive care
- 2009
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In: Nursing in Critical Care. - : Wiley. - 1362-1017 .- 1478-5153. ; 14:4, s. 166-174
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Journal article (peer-reviewed)abstract
- Aim and objectives: The aim of this study was to provide a theoretical understanding of nutritional experiences for patients with enteral nutrition (EN) during their stay in the intensive care unit (ICU). Background: It is well known that EN can result in underfeeding for patients in ICUs. How the patients experience their nutritional care during their stay in the ICU remains somewhat unclear. Design and methods: In this study, a grounded theory approach was chosen to conduct and analyse 14 interviews with patients and 21 observations of nutritional care during the patients’ stay in an ICU. Findings: The core category ‘grasping nutrition during the recovery process’ was reflected in, and related to, the categories ‘facing nutritional changes’, ‘making sense of the nutritional situation’ and ‘being involved with nutritional care’. While grasping the nutrition, the patients were emotionally shifting between worry, fear and failure, and relief and hope. Turning points were having the appetite back, getting rid of the feeding tube and regaining a functioning gut. Conclusions: The patients’ views of nutritional care during their stay in the ICU may contribute to understanding of how patients make sense of their nutritional changes and how they are involved in their nutritional care. This study shows that grasping the nutrition can be a way to regain some control in a situation where the patients are highly dependent on professional care. Further research is needed to develop this substantive theory in other intensive care settings to support patients’ nutritional journey in intensive care. Relevance to clinical practice: Nurses can promote patients’ abilities to grasp their nutritional situation during their recovery process. There is a need to focus not only on the patients’ physical needs but also on their emotional and social needs.
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| 38. |
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| 39. |
- Wentzel Persenius, Mona, 1958-
(author)
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Nutritional Nursing Care : Nurses’ interactions with the patient, the team and the organization
- 2008
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Doctoral thesis (other academic/artistic)abstract
- The overall aim of the thesis was to gain a deeper understanding of nutritional nursing care in municipal care and county council care, with specific focus on enteral nutrition (EN) in intensive care. Quantitative and qualitative methods were used. Telephone interviews regarding assessment of the nutritional status of patients were carried out with special medical nurses (CNs) (n = 14) in municipalities in one county and first line managers (CNs) (n = 27) in one county council. Registered nurses (RNs) in municipalities (n = 74) and county councils (n = 57) answered a questionnaire about nutritional assessment and documentation (I). RNs (n = 44) at three different intensive care units answered a questionnaire about responsibility, knowledge, documentation and nursing interventions regarding EN. Observations (n = 40) on nursing care interventions for patients with EN were carried out (II). RNs (n = 8), enrolled nurses (n = 4) (III) and patients (n = 14) (IV) were interviewed and nutritional nursing care was observed (III-IV) at an intensive care unit. The results showed that assessment of nutritional status was not performed on all patients, according to RNs/CNs. Malnourished patients were estimated to occur to a varied extent. Sixty-six percent of RNs/CNs answered that there were no guidelines for nutritional care and 13% that they did not know if there were any. RNs saw the VIPS model as a guide in nursing care, but also as an obstacle to information exchange (I). A majority of RNs answered that there were guidelines for EN. There were differences between the RNs’ opinions about their responsibility, knowledge and documentation. Deviations from recommended nursing care interventions occurred (II). The developed substantive theory of nurses (RNs and enrolled nurses) concerns and strategies of nutritional nursing care for patients with EN, includes the core category ”to have and to hold nutritional control – balancing between individual care and routine care” and the categories ”knowing the patient”, ”facilitating the patients’ involvement”, ”being a nurse in the team”, ”having professional confidence” and ”having a supportive organization”. In order for RNs and enrolled nurses to have a sense of control over the patients’ care in relation to nutrition, a balance between routine care and individual care was required (III). The developed substantive theory regarding the patients’ experiences of nutritional care includes the core category ”grasping nutrition during the recovery process”. The core category is reflected in, and dependent on, the categories ”facing nutritional changes”, ”making sense of the nutritional situation” and ”being involved with nutritional care”. The patients alternated emotionally between worry, fear and failure, and relief and hope. The patients experienced a turning point and felt an improvement in their condition when their appetite returned, when the stomach and gut were functioning and when the feeding tube was removed (IV). The conclusion is that quality and safety in relation to nutritional nursing care is dependent on the interactions between the nurse and patient, between the nurse and the team, and the nurse and the organization.
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| 41. |
- Wentzel Persenius, Mona, 1958-, et al.
(author)
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To have and to hold nutritional control : Balancing between individual and routine care. A grounded theory study
- 2009
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In: Intensive & Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 25:3, s. 155-162
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Journal article (peer-reviewed)abstract
- OBJECTIVES:Gaining insight into nutritional processes can help nurses and other staff in their work. The aim was to provide a theoretical understanding of the concerns and strategies of nutritional nursing care for patients with enteral nutrition in intensive care units. DESIGN: A grounded theory approach was used. Observations of patient's nutritional care and twelve interviews with eight registered nurses and four enrolled nurses were conducted. SETTING: The study was carried out in one intensive care unit at a medium sized hospital in Sweden. RESULTS: The substantive theory developed included the core category "To have and to hold nutritional control - balancing between individual care and routine care". The core category was reflected in and related to the categories "knowing the patient", "facilitating the patient's involvement", "being a nurse in a team", "having professional confidence" and "having a supportive organisation". Finding a balance between individual care and routine care was a way of enhancing the patient's well-being, security and quality of care. CONCLUSION: To have and to hold nutritional control over the patient's nutrition was found to be a balancing act between individual care and routine care. Organisation and teamwork are both challenging and supporting the provision, maintenance and development of nutritional care.
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| 42. |
- Ängeby, Karin, 1966-, et al.
(author)
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Early labour experience questionnaire : Psychometric testing and women's experiences in a Swedish setting
- 2018
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In: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 64, s. 77-84
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Journal article (peer-reviewed)abstract
- Objective: (a) to psychometrically test the Early Labour Experience Questionnaire (ELEQ) among both primi- and multiparous women giving birth in a Swedish setting, and (b) to describe and compare their experiences during early labour in relation to background characteristics.Design: a cross-sectional study.Setting: a county in Sweden.Participants: primi- and multiparous women with a spontaneous onset of labour after gestational week 37 + 0. In total, n = 1193 women were invited, and n = 754 responded the questionnaire, with a final total of n = 344 primi and n = 410 multiparous women.Methods: the ELEQ was translated with cross-cultural adaptation. The validity was determined using exploratory factor analysis with principal axis factoring analyses. Reliability was estimated from the internal consistency using Cronbach's alpha. The relationship between the questionnaire and the demographic characteristics of the participating women were analysed using ANOVA and t-test.Findings: an explorative factor analysis showed a three-factor solution for primiparas women (SWE-ELEQ-PP) consist of 23 items and a stable factor structure that explained 49.2% of the total variance with sufficient reliability coefficients (0.81–0.86). A four-factor solution for multiparous women (SWE-ELEQ-MP) consist of 22 items, with 52.62% of the total variance explained and with adequate internal consistency reliability coefficients (0.77–0.86) for three factors and relatively low stability (0.62) for the fourth factor with two items. Primiparous women scored significantly higher on items about feeling confused, and significantly lower on some items measuring emotional wellbeing and perceptions of midwifery care compared to multiparous women. Primiparous women with longer early labour (>18 h), scored significantly lower on the perceptions of midwifery care. Primi- and multiparous women who were dissatisfied with their telephone conversation or with not being admitted during early labour, scored significantly lower on emotional wellbeing, higher regarding emotional distress, and significantly lower about perceptions of midwifery care.Key conclusions: the SWE-ELEQ-PP and SWE-ELEQ-MP are considered valid questionnaires for use in a Swedish setting. Differences exist between parity and the factor structure and experiences in early labour vary. Women less content with early labour management decisions rated perceived midwifery care lower regardless of parity.Implication for practice: the questionnaire can be used to evaluate early labour care in a Swedish setting. The result suggests that differences according to parity exist and should be addressed when managing early labour care and a more individualised approach requires considerations.
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| 43. |
- Ängeby, Karin, 1966-
(author)
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Prolonged latent phase of labour : Prevalence, labour outcomes, quality of care, women’s experiences and preferences, and psychometric properties of a questionnaire
- 2018
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Doctoral thesis (other academic/artistic)abstract
- The overall aim of this thesis was to investigate the prevalence and labour outcome of a prolonged latent phase of labour, quality of care, women’s experiences and preferences during labour, and to psychometrically test a questionnaire.Methods: Qualitative and quantitative methods. Sixteen primiparous women’s preferences for care during a prolonged latent phase of labour were studied with focus-group and individual interviews and analysed with content analysis (I). From a one-year cohort of 2660 women, 1554 women with a spontaneous onset of labour were invited to participate and 1389 women accepted invitation (II-IV). Data from 1343 women’s birth records were analysed with descriptive and analytic statistics (II). 758 women, (RR 64%), 343 primiparous and 415 multiparous, responded to the Intrapartal-specific Quality from Patients Perspective Questionnaire, QPP-I (III), the Early Labour Experience Questionnaire, ELEQ (IV) and additionally birth-related items. Data were analysed with descriptive, analytic, and psychometric statistics.Main findings: According to women’s self-reports, 23% of women with a spontaneous onset of labour had a prolonged latent phase (>18 hours), which was associated with more obstetrical interventions and instrumental births (II). These women preferred individualised care (I), rated the quality of their intrapartum care lower, were less content with the birth experience, and had more negative feelings during labour and birth than women with a shorter latent phase (III). The ELEQ was translated and adapted to Swedish and resulted in two questionnaires, one for primiparous women, SWE-ELEQ-PP, and one for multiparous women, SWE-ELEQ-MP. Both are valid and reliable and can be used to evaluate early labour care in Sweden (IV).Conclusions: A prolonged latent phase of labour can be regarded as a risk factor. It can result in more obstetrical interventions, more instrumental births, a lower perceived quality of care, and a more negative birth experience regardless of parity. Differences in parity must be considered when evaluating early labour care during the latent phase of labour, with special focus to primiparous women.
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| 44. |
- Ängeby, Karin, 1966-, et al.
(author)
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Women's labour experiences and quality of care in relation to a prolonged latent phase of labour
- 2019
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In: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 77, s. 155-164
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Journal article (peer-reviewed)abstract
- Aim: To describe primiparous and multiparous women's labour experiences and their perception of quality of intrapartum care, in relation to background characteristics and length of latent phase of labour prior to admittance to labour ward.Design: A cross-sectional study.Setting: A middle-sized hospital in a rural county in western part of Sweden.Participants: Primiparous and multiparous women, both low-risk and risk, with a spontaneous onset of labour after gestational week 37+0 were included. In total, n =1193 women were invited, and n = 757 responded the questionnaire, n = 342 primiparous and n = 415 multiparous women.Methods: The Intrapartal-specific Quality from Patient Perspective (QPP-I), with responses on perceived reality and subjective importance, was used for data collection. QPP-I covers ten factors of quality of care. Background characteristics, length of latent phase of labour, global items about labour experience and items regarding feelings during labour and birth were included. Data were analysed with descriptive and analytic statistics.Findings: All factors in QPP-I were rated higher for subjective importance than perceived reality, except for information about selfcare, for both primi- and multiparous women. Labour experience, perceived reality of quality of care, and feelings were related to length of the latent phase of labour. Primiparous women with a prolonged latent phase (>18 h) had significantly lower scores regarding six out of ten QPP-I factors (PR); Information procedures, Information self-care, Commitment (midwives), Commitment (enrolled nurses), Midwives present, and Partner/ significant others. They scored lower on Experience birth as normal and Safe during labour and birth. The felt less proud and felt more ignored by professionals. Multiparous women with a prolonged latent phase of labour scored significantly lower on one QPP-I factor, Commitment (midwives). They also scored lower on Control over the situation and felt less safe during labour and birth.Key Conclusion: Women's perception of quality of intrapartum care, the birth experience and feelings are related to length of the latent phase of labour. Women perceive quality of intrapartum care as being lower than its subjective importance.Implications for Practice: A prolonged latent phase of labour can be regarded as a risk factor for a more negative birthing experience.
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