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| 2. |
- Israelsson, Johan, et al.
(författare)
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Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender
- 2017
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Ingår i: Resuscitation. - : Elsevier. - 0300-9572 .- 1873-1570. ; 114, s. 27-33
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe health status and psychological distress among in-hospital cardiac arrest (IHCA) survivors in relation to gender.METHODS: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS).RESULTS: Between 2013 and 2015, 594 IHCA survivors were included in the study. The median values for EQ-5D-5L index and EQ VAS among survivors were 0.78 (q1-q3=0.67-0.86) and 70 (q1-q3=50-80) respectively. The values were significantly lower (p<0.001) in women compared to men. In addition, women reported more problems than men in all dimensions of EQ-5D-5L, except self-care. A majority of the respondents reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (p<0.001) and symptoms of depression (p<0.001) compared to men. Gender was significantly associated with poorer health status and more psychological distress. No interaction effects for gender and age were found.CONCLUSIONS: Although the majority of survivors reported acceptable health status and no psychological distress, a substantial proportion reported severe problems. Women reported worse health status and more psychological distress compared to men. Therefore, a higher proportion of women may be in need of support. Health care professionals should make efforts to identify health problems among survivors and offer individualised support when needed.
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| 4. |
- Malmqvist, Cecilia, 1965-, et al.
(författare)
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Differences in bud burst timing and bud freezing tolerance among interior and coastal seed sources of Douglas fir
- 2017
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Ingår i: Trees. - : Springer. - 0931-1890 .- 1432-2285. ; 31:6, s. 1987-1998
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Tidskriftsartikel (refereegranskat)abstract
- The need for species that will grow well through ongoing climate change has increased the interest in Douglas fir [Pseudotsuga menziesii (Mirb.) Franco] in Sweden. One of the most common problems seen in plantations of Douglas fir seedlings is damage caused by late spring frost, known to be highly correlated with the timing of bud burst. The objective of this study was to investigate spring-related bud development under Nordic conditions of seven Douglas fir provenances and to compare data with a local provenance of Norway spruce (Picea abies (L.) Karst). Results from a field trial and a greenhouse-based study were compared. The interior Douglas fir provenances exhibited an earlier bud burst than coastal provenances, both in the greenhouse and in the field trial. When comparing differences within the groups of interior and coastal Douglas fir provenances, no differences could be found. The local Norway spruce, only grown in the greenhouse, showed an intermediate bud development profile similar to the interior Douglas fir provenance Three Valley. We therefore suggest that Three Valley could be planted at the same locations as the investigated local provenance of Norway spruce in mid-Sweden. To avoid spring frost damage the Douglas fir seedlings need to be frozen stored and planted late in spring. Planting under shelterwood can also help protect the seedlings from spring frost damages. As similar results for bud development patterns of Douglas fir and Norway spruce provenances were obtained from the greenhouse and field trials, greenhouse tests could facilitate selection of provenances.
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- Wallin, Kim, Doktorand, 1978-
(författare)
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Balancing structure and flexibility in the ambulance service : the pursuit of professional judgement in caring and learning
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to describe the conditions for learning inthe ambulance service during clinical practice, and to develop an understanding of how to support the professional development of caring in this context.The findings of this thesis are based on four qualitative interview studies.The study group consisted of 28 specialist ambulance nursing students (I), 20 preceptors (II), 27 preceptors (III), and 16 specialist ambulance nursingstudents (IV), from all parts of Sweden. The data were collected by individual, dyadic, and focus group interviews. The study designs and analytical approach were guided by the critical incident technique, latent content analysis, reflexive thematic analysis, and a phenomenographic approach.The findings indicate that the contextual complexities of ambulance care contradict the students’ fundamental need to independently care for the patients in their development of all domains of knowledge. Caring and learning in the ambulance service requires a structured approach in medical, technical, and practical aspects to create a basic security for preceptors and students in dealing with the diversity in care situations, patient needs, and student needs. However, this structured approach may hinder an individualized and situationally adapted approach unless the preceptors and students develop a flexible and reflective questioning approach in the phronetic domains of knowledge. The support, educational strategies, and learning objectives needed for enhancing educational clarity and quality during clinical practice in ambulance care are presented at an organizational, environmental, situational, and interpersonal level.It is proposed in the conclusions that a reflective questioning approach and an embodied understanding of ambulance service work supported by critical reflections are fundamental to support professional development in this field. Higher education institutions and the ambulance departments should address the professional development as a mutual concern, where supporting the development of a caring competence should be viewed as a lifelong continuum of learning. The expanding scope of ambulance care requires professional judgement to manage the ethical complexities of clinical decision-making to safeguard the patient perspective in ambulance care.
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- Wallin, Kim, 1978-, et al.
(författare)
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Enablers and barriers in ambulance clinical placements – a mentor perspective
- 2019
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Ingår i: Presented at Ambulans2019PreHospen: Ambulanssjukvårdens roll i morgondagens akutsjukvård, Stockholm, Sweden, April 2-3, 2019.
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Konferensbidrag (refereegranskat)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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- Wallin, Kim, 1978-, et al.
(författare)
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Necessary medical competence for police officers – a Delphi study
- 2021
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Ingår i: Presented at the 8th Nordic Police Research Conference, Police University College, Tampere, Finland, June 14-16, 2021.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Police patrol officers (PPO) are challenged by various encounters with sick and injured persons in their role as first responders. The study aim was to explore what is considered as necessary emergency medical competence for Swedish PPO. With an exploratory design, the data was collected with the Delphi technique from 43 experts covering all parts of Sweden; educators at police academies (n=10), instructors in the police department (n=11) and active PPO (n= 22). The results provides a detailed understanding of emergency medical competencies, relevant for PPOs. Basic assessment and basic life support measures (e.g. airway management, CPR and hemorrhage control) for traumatic injuries are among the most important competencies. Whereas, advanced assessments, psychiatric/medical complaints and care for persons with alcohol/drug use receives lower levels of agreement among the experts. These results can support educators at universities and the police department in preparing active PPO to perform relevant out-of-hospital care for acutely ill and injured persons.
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| 8. |
- Wallin, Kim, Doktorand, 1978-, et al.
(författare)
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Nurse preceptors' experience- based strategies for supporting learning in the ambulance service — A combined focus group and dyadic interview study
- 2022
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 78:6, s. 1704-1717
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Tidskriftsartikel (refereegranskat)abstract
- Ambulance service organizations worldwide report about an expanding professional role, responsibilities and scope of practice for ambulance clinicians, resulting in discussions concerning educational design and desired professional competencies. To face the contemporary demands in ambulance care, non-technical skills are advocated and clinical practice considered fundamental for the development of these abilities. However, there is very little research concerning educational strategies for supporting the desired competencies for novice registered nurses in the ambulance service.Aim: To describe and explore nurse preceptors' experience-based strategies for sup- porting registered nurses learning in the ambulance service.Design: The study had an inductive and data-driven approach, guided by phenomeno- logical epistemology.Methods: Twenty-seven Swedish nurse preceptors were interviewed in three focus groups and four dyadic interviews between October 2019 and April 2020. The data were analysed with reflexive thematic analysis.Findings: The nurse preceptors use several learning strategies, focusing on a socialization process and a clinical competence process, intertwined during clinical practice to support the development of a situated professional identity and a clinical decision-making competence. Supportive structures facilitate a progressive learning strategy when addressing desired skills and cognitive abilities in teamwork processes and clinical judgement.Conclusion: Supporting novice clinicians, prior to and during clinical practice in the ambulance service, should include medical assessment skills, situation awareness and processes for effective teamwork. Further, novice clinicians need to develop complex cognitive abilities to deal with the dynamic nature of decision-making in ambulance care.Impact: The study findings show contextual strategies, previously not described and desired competencies when supporting learning for registered nurses in the ambu- lance service. A theoretical grounding in episteme, techne, phronesis and situation awareness may guide educators at universities, managers in the ambulance service, preceptors and novice clinicians worldwide in the planning and performance of teaching and learning in the ambulance service.
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| 9. |
- Wallin, Kim, 1978-, et al.
(författare)
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Preceptors’ experiences of student supervision in the emergency medical services : a qualitative interview study
- 2020
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Ingår i: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 84, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundClinical placements play a central part in the education of future emergency medical services (EMS) staff and their development of clinical skills and competence. A key aspect of students' integration of theory and praxis and development into an independent clinician is a supportive mentorship with the preceptor. However, students report barriers for learning within the EMS, while the preceptors' experiences of their role have received scant attention in research.ObjectivesTo describe preceptors' experiences of student supervision in the EMS during clinical placements.DesignA descriptive qualitative design was used.Participants and settingTwenty specialist nurses were recruited among EMS staff from all parts of Sweden.MethodsData were collected using individual interviews and analyzed with latent qualitative content analysis.FindingsEMS preceptors develop a competence in combining caring and learning adapted to individual student needs when facing students with varying needs in an ever-changing healthcare setting. A trustful relationship between student and preceptor is fundamental when coping with a dual responsibility for student and patient needs. However, several aspects in the EMS setting hinders the preceptors' ability to support the development of the students' independence. Surrounding support structures are important if the preceptors are to feel safe and secure in their role as assessor, teacher and ambulance nurse.ConclusionsPreceptors need to develop a didactic flexibility through preceptor courses adapted to the complex premises found in the EMS. Ambulance services and universities should recognize the importance of preceptors´ colleagues, student continuity, university support and cooperation for improving quality and clarity in supervision during clinical placements.
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