| 1. |
- Johansson, Lotta, 1965, et al.
(author)
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Evaluation of a sound environment intervention in an ICU : A feasibility study
- 2018
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In: Australian Critical Care. - Amsterdam : Elsevier. - 1036-7314 .- 1878-1721. ; 31:2, s. 59-70
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Journal article (peer-reviewed)abstract
- Background: Currently, it is well known that the sound environment in intensive care units (ICU) is substandard. Therefore, there is a need of interventions investigating possible improvements. Unfortunately, there are many challenges to consider in the design and performance of clinical intervention studies including sound measurements and clinical outcomes.Objectives: (1) explore whether it is possible to implement a full-scale intervention study in the ICU concerning sound levels and their impact on the development of ICU delirium; (2) discuss methodological challenges and solutions for the forthcoming study; (3) conduct an analysis of the presence of ICU delirium in the study group; and (4) describe the sound pattern in the intervention rooms.Methods: A quasi-randomized clinical trial design was chosen. The intervention consisted of a refurbished two-bed ICU patient room (experimental) with a new suspended wall-to-wall ceiling and a low frequency absorber. An identical two-bed room (control) remained unchanged.Inclusion criteria: Patients >18 years old with ICU lengths of stay (LoS) >48. h. The final study group consisted of 31 patients: six from the rebuilt experimental room and 25 from the control room. Methodological problems and possible solutions were continuously identified and documented.Results: Undertaking a full-scale intervention study with continuous measurements of acoustic data in an ICU is possible. However, this feasibility study demonstrated some aspects to consider before start. The randomization process and the sound measurement procedure must be developed. Furthermore, proper education and training are needed for determining ICU delirium.Conclusion: This study raises a number of points that may be helpful for future complex interventions in an ICU. For a full-scale study to be completed a continuously updated cost calculation is necessary. Furthermore, representatives from the clinic need to be involved in all stages during the project.
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| 2. |
- Lindahl, Berit, 1955, et al.
(author)
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A meta-synthesis describing the relationships between patients, informal caregivers and health professionals in home-care settings
- 2011
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 20:3/4, s. 454-463
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Journal article (peer-reviewed)abstract
- The present study describes, through a meta-synthesis, the relationship between patients, informal caregivers and health professionals involved in home care. Today, many people receive help from health care professionals in their homes with the consequence that, for many health care professionals, their working place is the patients' homes. Research that addresses the dynamics in the caring relationship in home care seems to be rare. A meta-synthesis is an integrated interpretation of qualitative research findings, which is more substantive than the results from each individual investigation. We performed a systematic literature search regarding studies published during the period 1992-2005, using the search terms home nursing, professional and home health care. The included studies described relations in a home care context, between health professionals and patients or relations between health professionals, patients and their informal caregivers published in the same study. The fi ; ndings showed that when professionals entered people's home, the private area changed. The study presents an interpretation of the changed meanings of home as the place and space for professional care. We described the meanings of the relationship in two main themes with subthemes. The main themes are 'being there' and 'home care as a co-creation'. The understanding of relationships in home care is seen as the development of a professional friendship. This concept is reflected on through the writings of Aristotle and Alberoni. To address these concerns, it is important that home care providers, recipients and their family members develop friendships. These friendships should be a part of any professional relationship. When health professionals enter patients' homes, they have to be aware of the risk of transgressing borders of privacy. In addition, devaluing patients' or their informal caregivers' knowledge and their opinions about the care is interpreted as an exercise of institutiona ; l power.
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| 3. |
- Andersson, Morgan, et al.
(author)
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Is it possible to feel at home in a patient room in an intensive care unit? Reflections on environmental aspects in technology dense environments : Is it possible to feel at home in a patient room in an intensive care unit?
- 2019
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In: Nursing Inquiry. - London : Wiley-Blackwell Publishing Inc.. - 1320-7881 .- 1440-1800.
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Journal article (peer-reviewed)abstract
- This paper focuses on the patient’s perspective and the philosophical underpinnings that support what might be considered optimal for the future design of the Intensive Care Unit (ICU) patient room. It also addresses the question of whether the aspects that support at-homeness are applicable to ICU patient rooms. The concept of ‘at-homeness’ in ICUs is strongly related to privacy and control of space and territory. This study investigates whether the sense of at-homeness can be created in an ICU, when one or more patients share a room. From an interdisciplinary perspective, we critically reflect on various aspects associated with conflicts surrounding the use of ICU patient rooms. Thus, from an architectural and a caring perspective, the significance of space and personal territory in ICU patient rooms is emphasized. Recommendations for further research are suggested. In conclusion, privacy and control are deemed to be essential factors in the stimulation of recovery processes and the promotion of wellbeing in situations involving severe illness or life-threatening conditions.
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| 4. |
- Björk, Kristofer, 1985-, et al.
(author)
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Family members’ experiences of waiting in intensive care: a concept analysis
- 2019
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In: Scandinavian Journal of Caring Sciences. - London : Wiley. - 0283-9318 .- 1471-6712. ; , s. 1-18
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Journal article (peer-reviewed)abstract
- AIM:The aim of this study was to explore the meaning of family members' experience of waiting in an intensive care context using Rodgers' evolutionary method of concept analysis.METHOD:Systematic searches in CINAHL and PubMed retrieved 38 articles which illustrated the waiting experienced by family members in an intensive care context. Rodgers' evolutionary method of concept analysis was applied to the data.FINDINGS:In total, five elements of the concept were identified in the analysis. These were as follows: living in limbo; feeling helpless and powerless; hoping; enduring; and fearing the worst. Family members' vigilance regarding their relative proved to be a related concept, but vigilance does not share the same set of attributes. The consequences of waiting were often negative for the relatives and caused them suffering. The references show that the concept was manifested in different situations and in intensive care units (ICUs) with various types of specialties.CONCLUSIONS:The application of concept analysis has brought a deeper understanding and meaning to the experience of waiting among family members in an intensive care context. This may provide professionals with an awareness of how to take care of family members in this situation. The waiting is inevitable, but improved communication between the ICU staff and family members is necessary to reduce stress and alleviate the suffering of family members. It is important to acknowledge that waiting cannot be eliminated but family-centred care, including a friendly and welcoming hospital environment, can ease the burden of family members with a loved one in an ICU.
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| 5. |
- Dahlborg Lyckhage, Elisabeth, 1974-, et al.
(author)
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A Theoretical Framework for Emancipatory Nursing With a Focus on Environment and Persons’ Own and Shared Lifeworld : A Theoretical Framework for Emancipatory Nursing
- 2018
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In: Advances in Nursing Science. - 0161-9268 .- 1550-5014. ; 41:4, s. 340-350
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Journal article (peer-reviewed)abstract
- By giving a brief overview of the meta concepts in nursing, with a focus on environment, we sketch a theoretical framework for an emancipatory perspective in nursing care practice. To meet the requirements of equality in care and treatment, we have in our theoretical framework added a critical lifeworld perspective to the anti oppressive practice, to meet requirements of equity in health care encounter. The proposed model of emancipatory nursing goes from overall ideological structures to ontological aspects of the everyday world. Based on the model, nurses could identify what kind of theoretical critical knowledge and thinking they require to conduct equal care and encounter the person behind the patient role.
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| 6. |
- Egerod, I., et al.
(author)
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The patient experience of intensive care: A meta-synthesis of Nordic studies
- 2015
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In: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 52:8, s. 1354-1361
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Journal article (peer-reviewed)abstract
- Background: Sedation practices in the intensive care unit have evolved from deep sedation and paralysis toward lighter sedation and better pain management. The new paradigm of sedation has enabled early mobilization and optimized mechanical ventilator weaning. Intensive care units in the Nordic countries have been particularly close to goals of lighter or no sedation and a more humane approach to intensive care. Objectives: The aim of our study was to systematically review and reinterpret newer Nordic studies of the patient experience of intensive care to obtain a contemporary description of human suffering during life-threatening illness. Design: We conducted a meta-synthesis in which we collected, assessed, and analyzed published qualitative studies with the goal of synthesizing these findings into a new whole. Analysis was based on the scientific approach of Gadamerian hermeneutics. Methods: We performed a literature search of qualitative studies of the patient experience of intensive care based on Nordic publications in 2000-2013. We searched the following databases: PubMed, CINAHL, Scopus, and PsycINFO. Each original paper was assessed by all authors using the Critical Appraisal Skills Program instrument for qualitative research. We included 22 studies, all of which provided direct patient quotes. Results: The overarching theme was identified as: The patient experience when existence itself is at stake. We constructed an organizing framework for analysis using the main perspectives represented in the included studies: body, mind, relationships, and ICU-environment. Final analysis and interpretation resulted in the unfolding of four themes: existing in liminality, existing in unboundedness, existing in mystery, and existing on the threshold. Conclusions: Our main finding was that human suffering during intensive care is still evident although sedation is lighter and the environment is more humane. Our interpretation suggested that patients with life-threatening illness descend into a liminal state, where they face the choice of life or death. Caring nurses and family members play an important role in assisting the patient to transition back to life. (C) 2015 Elsevier Ltd. All rights reserved.
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| 7. |
- Egerod, I., et al.
(author)
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Trends and recommendations for critical care nursing research in the Nordic countries: Triangulation of review and survey data
- 2020
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In: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397. ; 56
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Journal article (peer-reviewed)abstract
- Background: Priorities for critical care nursing research have evolved with societal trends and values. In the 1980s priorities were the nursing workforce, in 1990s technical nursing, in 2000s evidence-based nursing and in 2010s symptom management and family-centred care. Objectives: To identify current trends and future recommendations for critical care nursing research in the Nordic countries. Methods: We triangulated the results of a literature review and a survey. A review of two selected critical care nursing journals (2016-2017) was conducted using content analysis to identify contemporary published research. A self-administered computerised cross-sectional survey of Nordic critical care nursing researchers (2017) reported current and future areas of research. Results: A review of 156 papers identified research related to the patient (13%), family (12%), nurse (31%), and therapies (44%). Current trends in the survey (n = 76, response rate 65%) included patient and family involvement, nurse performance and education, and evidence-based protocols. The datasets showed similar trends, but aftercare was only present in the survey. Future trends included symptom management, transitions, rehabilitation, and new nursing roles. Conclusion: Critical care nursing research is trending toward increased collaboration with patient and family, delineating a shift toward user values. Recommendations include long-term outcomes and impact of nursing. (C) 2019 Elsevier Ltd. All rights reserved.
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| 8. |
- Engwall, Marie, et al.
(author)
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Patients' Self-Reported Recovery After an Environmental Intervention Aimed to Support Patient's Circadian Rhythm in Intensive Care
- 2021
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In: Herd-Health Environments Research & Design Journal. - : SAGE Publications. - 1937-5867 .- 2167-5112. ; 14:4, s. 194-210
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Journal article (peer-reviewed)abstract
- Background: Patients in intensive care units (ICUs) are among the most vulnerable, and they require support to start their recovery. The design of the patient area in the ICU can play a prominent role in both the quality of care and patients' recovery. The lighting environment has the opportunity to restore and strengthen the natural human circadian rhythm and health. Aim: To evaluate patients' self-reported recovery after being cared for in an ICU room rebuilt according to evidence-based design principles that promote recovery. Method: An intervention was set up in a two-bed patient room including a cycled lighting system. Self-reported recovery was reported at 6 and 12 months after discharge. Data were analyzed using a 2(mechanically ventilated, nonmechanically ventilated) x 2(intervention room, ordinary room) analysis of covariance (ANCOVA) and 2(male, women) x 2(intervention room, ordinary room) ANCOVA. Results: Data from the different rooms showed no significant main effects for recovery after 6 months, p = .21; however, after 12 months, it become significant, p. < .05. This indicated that patient recovery was positively influenced for patients cared for in the intervention room (M = 8.88, SD = 4.07) compared to the ordinary room (M = 10.90, SD = 4.26). There were no interaction effects for gender or if the patients had been mechanically ventilated either at 6 or 12 months' postdischarge. Conclusions: A cycled lighting system may improve patient self-reported recovery after ICU care; however, more research on the topic is needed.
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| 9. |
- Engwall, Marie, 1964, et al.
(author)
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The effect of cycled lighting in the intensive care unit on sleep, activity and physiological parameters: A pilot study
- 2017
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In: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 41, s. 26-32
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Journal article (peer-reviewed)abstract
- Patients in intensive care suffer from severe illnesses or injuries and from symptoms related to care and treatments. Environmental factors, such as lighting at night, can disturb patients' circadian rhythms. The aim was to investigate whether patients displayed circadian rhythms and whether a cycled lighting intervention would impact it. In this pilot study (N=60), a cycled lighting intervention in a two -bed patient room was conducted. An ordinary hospital room functioned as the control. Patient activity, heart rate, mean arterial pressure and body temperature were recorded. All data were collected during the patients' final 24h in the intensive care unit. There was a significant difference between day and night patient activity within but not between conditions. Heart rates differed between day and night significantly for patients in the ordinary room but not in the intervention room or between conditions. Body temperature was lowest at night for all patients with no significant difference between conditions. Patients in both conditions had a natural circadian rhythm; and the cycled lighting intervention showed no significant impact. As the sample size was small, a larger repeated measures study should be conducted to determine if other types of lighting or environmental factors can impact patients' well-being. (C) 2017 Elsevier Ltd. All rights reserved.
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| 10. |
- Eriksson, Thomas, et al.
(author)
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Hermeneutic observational studies: describing a method
- 2021
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In: Scandinavian Journal of Caring Sciences. - Nordic College of Caring Science : Wiley. - 0283-9318 .- 1471-6712. ; 35:1, s. 319-327
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Journal article (peer-reviewed)abstract
- There is a need to develop and use research observations in the clinical field, primarily to gain insight
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| 11. |
- Eriksson, Thomas, 1959-, et al.
(author)
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The experiences of patients and their families of visiting whilst in an intensive care unit - a hermeneutic interview study
- 2011
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In: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 27:2, s. 60-66
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Journal article (peer-reviewed)abstract
- Aim The aim of this study was to interpret and understand the meanings of the lived experiences of visiting of patients in an ICU and their families. Method The research design was hermeneutic, based on interviews. This study includes 12 interviews with seven patients and five relatives who had been in an ICU. The interview text was interpreted in a Gadamerian manner as different plays with actors and plots. Findings Patients’ narratives could be divided into two parts; recall of real life and unreal life experiences, the unreal being more common. Relatives’ narratives are described as being on stage and being backstage, i.e. in the room with the patient and outside it. Conclusion The final interpretation elucidated the experience of visiting as the sudden shift between being present in real life vs. being present in the real life of unreality. It was a process whereby the patient and the family build a new understanding of life that creates a new form of interplay within the family. The pre-critical illness life is no longer there – a new life has begun. To support patients and their families in this process of change a family-centred care perspective is necessary.
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| 12. |
- Halvorsen, K., et al.
(author)
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Patients' experiences of well-being when being cared for in the intensive care unit—An integrative review
- 2022
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 31:1-2, s. 3-19
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Journal article (peer-reviewed)abstract
- Objective: The aim of this integrative review was to identify facilitators and barriers to patients’ well-being when being cared for in an ICU setting, from the perspective of the patients. Background: To become critically ill and hospitalised in an ICU is a stressful, chaotic event due to the life-threatening condition itself, as well as therapeutic treatments and the environment. A growing body of evidence has revealed that patients often suffer from physical, psychological and cognitive problems after an ICU stay. Several strategies, such as sedation and pain management, are used to reduce stress and increase well-being during ICU hospitalisation, but the ICU experience nevertheless affects the body and mind. Design; Methods: Since research exploring patients’ sense of well-being in an ICU setting is limited, an integrative review approach was selected. Searches were performed in CINAHL, Medline, Psych Info, Eric and EMBASE. After reviewing 66 studies, 12 studies were included in the integrative review. Thematic analysis was used to analyse the studies. The PRISMA checklist for systematic reviews was used. Results: The results are presented under one main theme, ‘Well-being as a multidimensional experience—interwoven in barriers and facilitators’ and six sub-themes representing barriers to and facilitators of well-being in an ICU. Barriers identified were physical stressors, emotional stressors, environmental disturbances and insecurity relating to time and space. Facilitators were meeting physical needs and activities that included dimensions of a caring and relational environment. Conclusion: Our main findings were that experiences of well-being were multidimensional and included physical, emotional, relational and environmental aspects, and they were more often described through barriers than facilitators of well-being. Relevance for clinical practice: This integrative review has shown that it is necessary to adopt an individual focus on patient well-being in an ICU setting since physical, emotional, relational and environmental stressors might impact each patient differently. © 2021 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.
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| 13. |
- Israelsson-Skogsberg, Åsa, 1968-, et al.
(author)
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'I'm almost never sick': Everyday life experiences of children and young people with home mechanical ventilation
- 2018
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In: Journal of Child Health Care. - : SAGE Publications. - 1367-4935 .- 1741-2889. ; 22:1, s. 6-18
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Journal article (peer-reviewed)abstract
- Developments in medical technology and treatment have increased the survival rates of children with serious illnesses or injuries, including those receiving home mechanical ventilation, which is a small but growing group. The aim of this study was to explore everyday life experiences of children and young people living with home mechanical ventilation (HMV). Data were obtained through interviews with nine participants. The interviews were supported by photovoice methodology: photographs taken by the participants before or during the interviews were used to facilitate conversation. Interview data were analyzed using qualitative content analysis. The findings revealed that everyday life on a ventilator can be described as including power but simultaneously as characterized by vulnerability to the outside world, comparable to balancing on a tightrope. Various types of technology, both information and communication technology (ICT) and vital medical technology, enabled the participants to engage with the world around them. This study contributes knowledge about the experiences of children and young people with HMV, who depict their lives as good and valuable. The study also underscores, when designing plans and home support, it is necessary to take a sensible approach to personal experiences of what a good life is and what resources are needed to attain and maintain health.
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| 14. |
- Israelsson-Skogsberg, Åsa, et al.
(author)
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Personal care assistants' experiences of caring for people on home mechanical ventilation.
- 2016
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712.
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Journal article (peer-reviewed)abstract
- AIM: The aim of this study was to describe personal care assistants' (PCA) experiences of working with a ventilator-assisted person at home. METHODS: Data were collected from fifteen audiotaped semistructured interviews with PCAs supporting a child or adult using home mechanical ventilation (HMV). Thirteen women and two men participated; their working experience with HMV users ranged from one to 17 years (median 6 years). Data were subjected to qualitative content analysis in an inductive and interpretive manner. FINDINGS: Five categories emerged from the data: Being part of a complex work situation; Taking on a multidimensional responsibility; Caring carried out in someone's home; Creating boundaries in an environment with indistinct limits; and Being close to another's body and soul. CONCLUSIONS: The participants felt very close to the person they worked with, both physically and emotionally. They had a great responsibility and therefore a commensurate need for support, guidance and a well-functioning organisation around the HMV user. There is international consensus that advanced home care will continue to expand and personal care assistance is key in this development. We suggest that one way to move forward for PCAs working with HMV users is to create multiprofessional teams led by a key-person who coordinates the individual needs. More research is needed within this area from a broad perspective including the HMV-assisted persons, relatives, personal care assistants and management organisations.
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| 15. |
- Israelsson-Skogsberg, Åsa, et al.
(author)
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Young adults’ narratives about living with home mechanical ventilation – a phenomenological hermeneutical study
- 2023
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In: Disability and Rehabilitation. - 0963-8288 .- 1464-5165.
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Journal article (peer-reviewed)abstract
- PurposeAn increasing number of children and young adults with complex medical conditions and respiratory failure are treated with home mechanical ventilation (HMV). The current study aimed to describe how young adults using HMV experience their everyday life with the ventilator, their physical impairments and their opportunities for an educational and professional career.Materials and methodsData were collected via narrative interviews with nine young HMV users (3 females and 6 males, aged 18–31 years) in their homes. Two were ventilated invasively, six were ventilated non-invasively and one was treated with continuous positive airway pressure (CPAP) via facemask. Data were analysed using a phenomenological hermeneutical method.ResultA multi-professional team contributed to participants’ safety and ability to participate in society through higher education and professional work. A good and valuable life, mostly feeling healthy were experienced but also prejudice and stiffened social society structures.ConclusionThe findings of this study prove the importance of having long-standing access to a competent and supportive available multi-professional healthcare team when living with a long-term complex condition. These teams provided well-functioning human and technological support in everyday lives.Implications for Rehabilitation· An increasing number of children and young adults are treated with home mechanical ventilation due to respiratory failure.· The home mechanical ventilation treatment provided rest from breathing and improved sleep quality in such a way that work and higher studies could be managed.· Longstanding access to a supportive multi-professional healthcare team provided feelings of being safe, which in turn boosted self-confidence in life and preparedness to meet new challenges.
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| 16. |
- Johansson, K., et al.
(author)
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Moving between rooms - moving between life and death: nurses' experiences of caring for terminally ill patients in hospitals
- 2012
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 21:13-14, s. 2034-2043
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Journal article (peer-reviewed)abstract
- Aim. This study describes the meanings of generalist registered nurses experiences of caring for palliative care patients on general wards in hospitals. Background. Earlier research shows that work with patients in palliative care is demanding. More research concerning palliative care is undertaken in oncological care, in hospice and in home-care settings than in general wards. It is therefore important to examine the palliative care in the context of acute-care settings to discover more about this phenomenon, to understand the experiences of nurses in this situation and to develop patient care. Design. Qualitative, descriptive and interpretive study. Method. Eight registered nurses in two different hospitals in Sweden were interviewed. The patients on these wards suffered from surgical and medical conditions, i.e. both curative and palliative care were administered. The interviews were analysed using a phenomenological hermeneutical approach inspired by Ricoeurs philosophy. Results. The registered nurses experiences are presented as seven themes and a comprehensive, interpreted whole. This latter revealed the significance of contrasts, contradictions and movement between the material and psychological experiences of the room and nursing care in this care context. Conclusions. The registered nurses say that something momentous occurred during the care process and they showed a strong determination and commitment to being part of the ending of the patients life circle, despite the situation often being one of stress. Relevance to clinical practice. The findings highlight the need for various forms of support for the nurses to meet their need for new and updated knowledge and support in existential matters. This may promote a better quality of care and confirm the nurses in their caring practice. Moreover, there is a need to introduce the hospice philosophy into acute-care settings in hospitals.
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| 17. |
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| 18. |
- Johansson, Lotta, 1965, et al.
(author)
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Noise in the ICU patient room : Staff knowledge and clinical improvements
- 2016
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In: Intensive & Critical Care Nursing. - Amsterdam : Elsevier. - 0964-3397 .- 1532-4036. ; 35, s. 1-9
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Journal article (peer-reviewed)abstract
- Introduction: The acoustic environment in the intensive care unit patient room, with high sound levels and unpredictable sounds, is known to be poor and stressful. Therefore, the present study had two aims: to investigate staff knowledge concerning noise in the intensive care unit and: to identify staff suggestions for improving the sound environment in the intensive care unit patient room.Method: A web-based knowledge questionnaire including 10 questions was distributed to 1047 staff members at nine intensive care unit. Moreover, 20 physicians, nurses and enrolled nurses were interviewed and asked to give suggestions for improvement.Results: None of the respondents answered the whole questionnaire correctly; mean value was four correct answers. In the interview part, three categories emerged: improving staff's own care actions and behaviour; improving strategies requiring staff interaction; and improving physical space and technical design.Conclusion: The results from the questionnaire showed that the staff had low theoretical knowledge concerning sound and noise in the intensive care unit. However, the staff suggested many improvement measures, but also described difficulties and barriers. The results from this study can be used in the design of future interventions to reduce noise in the intensive care unit as well as in other settings.
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| 19. |
- Karlsson, Jonas, et al.
(author)
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Critical care nurses' lived experiences of interhospital intensive care unit-to-unit transfers : A phenomenological hermeneutical study
- 2020
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In: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 61, s. 1-7
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Journal article (peer-reviewed)abstract
- Objective: To explore critical care nurses' lived experiences of transferring intensive care patients between hospitals. Methods: A phenomenological hermeneutic approach using data generated through individual inter-views with 11 critical care registered nurses. Setting: Two general intensive care units in Sweden. Findings: Five themes were identified: it depends on me; your care makes a difference; being exposed; depending on interprofessional relationships; and sensing professional growth. These themes were synthesised into a comprehensive understanding showing how transferring intensive care patients between hospitals meant being on an ambivalent journey together with the patient but also on a journey within yourself in your own development and growth, where you, as a nurse, constantly are torn between contradictory feelings and experiences. Conclusion: Interhospital intensive care unit-to-unit transfers can be a challenging task for critical care nurses but also an important opportunity for professional growth. During the transfer, nurses become responsible for the patient, their colleagues and the entire transfer process. In a time of an increasing number of interhospital intensive care unit-to-unit transfers, this study illuminates the risk for missed nursing care, showing that the critical care nurse has an important role in protecting the patient from harm and safeguarding dignified care. (C) 2020 Elsevier Ltd. All rights reserved.
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| 20. |
- Karlsson, Jonas, 1972-, et al.
(author)
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Family members' lived experiences when a loved one undergoes an interhospital intensive care unit‐to‐unit transfer: A phenomenological hermeneutical study
- 2020
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702.
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Journal article (peer-reviewed)abstract
- Aims and objectivesTo reveal meanings of family members' lived experiences when a loved one undergoes an interhospital intensive care unit‐to‐unit transfer.BackgroundInterhospital intensive care unit‐to‐unit transfers take place between different hospitals and their respective intensive care units (ICUs). These types of transfers are an increasing phenomenon but are sparsely studied from the family members' perspective. Indeed, the patient's critical illness and care can have a major impact on family members. During the transfer process, there is a demand for the involved intensive care health personnel to make family members feel safe and cared for.DesignA qualitative design based on phenomenological hermeneutics.MethodsThe study was conducted at two Swedish general ICUs. Data were generated through individual in‐depth interviews with seven family members and analysed using a phenomenological hermeneutical approach. The Criteria for Reporting Qualitative Research principles were applied in the conduct and reporting of this study.ResultsFour themes that reveal meanings of family members' lived experiences were developed: losing your safe haven, dealing with uncertainty, carrying your own and others' burdens and a wish to be close.ConclusionsThe study reveals that an interhospital intensive care unit‐to‐unit transfer affects the whole family and is characterised by family members experiencing many negative feelings. The findings also illustrate that being a family member when a loved one is transferred means being exposed to the core existential elements of being human, such as loneliness and searching for meaning.Relevance to clinical practiceThe study highlights the importance of maintaining a family‐centred approach during the transfer process. Our findings can provide deeper knowledge for intensive care health personnel, better preparing them for the delicate task of providing family‐centred care during the interhospital intensive care unit‐to‐unit transfer process.
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| 21. |
- Karlsson, Jonas, 1972-, et al.
(author)
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The Patient’s Situation During Interhospital Intensive Care Unit-to-Unit Transfers: A Hermeneutical Observational Study
- 2019
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In: Qualitative Health Research. - : Sage Publications. - 1049-7323 .- 1552-7557. ; , s. 1-12
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Journal article (peer-reviewed)abstract
- Interhospital intensive care unit-to-unit transfers are an increasing phenomenon, earlier mainly studied from a patient safety perspective. Using data from video recordings and participant observations, the aim was to explore and interpret the observed nature of the patient’s situation during interhospital intensive care unit-to-unit transfers. Data collection from eight transfers resulted in over 7 hours of video material and field notes. Using a hermeneutical approach, three themes emerged: being visible and invisible; being in a constantly changing space; and being a fettered body in constant motion. The patient’s situation can be viewed as an involuntary journey, one where the patient exists in a constantly changing space drifting in and out of the health personnel’s attention and where movements from the journey become part of the patient’s body. Interhospital transfers of vulnerable patients emerge as a complex task, challenging the health personnel’s ability to maintain a caring atmosphere around these patients.
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| 22. |
- Karlsson, Veronika, 1972, et al.
(author)
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Patients' statements and experiences concerning receiving mechanical ventilation: a prospective video-recorded study
- 2012
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In: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 19:3, s. 247-258
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Journal article (peer-reviewed)abstract
- KARLSSON V, LINDAHL B and BERGBOM I. Nursing Inquiry 2012; 19: 247258 ?Patients statements and experiences concerning receiving mechanical ventilation: a prospective video-recorded study Prospective studies using video-recordings of patients during mechanical ventilator treatment (MVT) while conscious have not previously been published. The aim was to describe patients statements, communication and facial expressions during a video-recorded interview while undergoing MVT. Content analysis and hermeneutics inspired by the philosophy of Gadamer were used. The patients experienced almost constant difficulties in breathing and lost their voice. The most common types of communication techniques patients used were nodding or shaking the head. Their expressions were interpreted as stiffened facial expression, tense body position and feelings of sadness and sorrow. Nursing care for patients conscious during MVT is challenging as it creates new demands regarding the content of the care provided. In caring for patients undergoing MVT while conscious, establishing a caring relationship, making patients feel safe and helping them to communicate seem to be most important for alleviating discomfort and instilling hope.
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| 23. |
- Lindahl, Berit, 1955, et al.
(author)
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A student-centered clinical educational unit – a description of a model. Nursing Education in Practice.
- 2009
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In: Nurse Education in Practice. - : Elsevier BV. - 1471-5953. ; 9:1, s. 5-12
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Journal article (peer-reviewed)abstract
- This article describes a model of a student-centered Clinical Education Unit (CEU) within an undergraduate nursing education programme. The model comprises three various levels of learning in the nursing education programme at School of Health Sciences, University College of Borås, Sweden. The three levels of learning correspond to the first, second and third programme years of the nursing education. Each level of learning is represented by clinical training in three different hospital care settings. The educational model was developed through a co-operation between hospital representatives and nurse educators at the university college. The model is built on a human caring science perspective and knowledge that focuses on patients’ lived experience of their care and illness. The model emphasises collaboration in communion between students, hospital and faculty members as an alternative to bridge the gap between theory and practice in nursing. Reflection and critical thinking are the vital components in a clinical learning environment. Keywords: Reflective practice; Education clinical; Student-centered; Learning environment; Education; Nursing; Students; Reflection; Student placement
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| 24. |
- Lindahl, Berit, 1955, et al.
(author)
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Being the Parent of a Ventilator-Assisted Child: Perceptions of the Family-Health Care Provider Relationship When Care Is Offered in the Family Home
- 2013
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In: Journal of Family Nursing. - : SAGE Publications. - 1074-8407 .- 1552-549X. ; 19:4, s. 489-508
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Journal article (peer-reviewed)abstract
- The number of medically fragile children cared for at home is increasing; however, there are few studies about the professional support these families receive in their homes. The aim of the study was to understand the meanings that parents had about the support they received from health care professionals who offered care for their ventilator-assisted child in the family home. A phenomenological-hermeneutic method was used. Data included the narratives of five mother-father couples living in Sweden who were receiving professional support for their ventilator-assisted child. The findings indicate that receiving professional support meant being at risk of and/or exposed to the exercise of control over family privacy. The professional support system in the families' homes worked more by chance than by competent and sensible planning. In good cases, caring encounters were characterized by a mutual relationship where various occupational groups were embraced as a part of family life. The findings are discussed in light of compassionate care, exercise of power, and the importance of holistic educational programs. © The Author(s) 2013.
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| 25. |
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| 26. |
- Lindahl, Berit, 1955-, et al.
(author)
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Can an ICU-patient roompromote wellbeing and improve healthcare quality?
- 2019
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Conference paper (peer-reviewed)abstract
- To present novel reflections on environment regarding the design of the patient room in intensive care units(ICUs).Introduction: An ICU and the patient room in particular, is a protected and closed area in that other hospital staff and visitors have no immediate access to such environment. The ICU environment often appears frightening to patients and their loved ones due to presence of technology and advanced treatments. There is evidence that sounds, light, sleep deprivation and ICU delirium impact on patients’ health and recovery. Research has described negative effects of ICU environment to staff concerning noise, high work-load, heavy responsibilities and a complex psychological proximity to patients and their loved ones. A health care environment and patient room should be safe and attractive to staff so that they continue to contribute to caring processes. However, research about ICU’s physical environment and ICU-patient room design are sparse and thus evidence about how to design such areas is weak. Recommendations: Recommendations based on evaluation of a research program concerning evidence-based design in ICU-patient rooms will be shared. Components like light, sound environment, shape, colours, decoration and view to nature will be presented, pros and con with single rooms and the concepts privacy and control will be articulated. The research program was performed within a caring science perspective and so far it has generated three PhD theses with a forth on its way. Directions for further research such as interdisciplinary collaboration, the need for development of the meta-paradigm concept environment will be suggested. The latter needs to be theorized, problematized and practically explored. ICU-nurses, nursing researchers and former patients should collaborate with architects, building planners and economists in planning of new ICUs. Concepts like enriching and healing environments should be a part of ICU-nurses education curricula.
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| 27. |
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| 28. |
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| 29. |
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| 30. |
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| 31. |
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| 32. |
- Lindahl, Berit, 1955-
(author)
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Editorial SJCS September 2022
- 2022
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In: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712.
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Journal article (other academic/artistic)abstract
- In late April, the Nordic College of Caring Science (NCCS) held their fourth international scientific conference. The theme for the conference was ‘Caring in a changing world’. The conference began 26th April with a pre-conference designed for PhD students within the academic field of caring sciences. The NCCS annual board meeting was also held on that date. The venue for the conference was Mälardalen University, situated in a new but also renovated and integrated environment in the central city of Eskilstuna, Sweden. The seats of learning received the Swedish Government'srights and status as a university in 2022. The university offered a fantastic environment for knowledge exchange and socialisation with research colleagues and friends. During the annual meeting with the NCCS board discussed the work and development of the journal. Additionally, the new board was elected, and Associate Professor Mats Holmberg became NCCS's new chairperson.
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| 33. |
- Lindahl, Berit, 1955
(author)
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Experiences of exclusion when living on a ventilator: reflections based on the application of Julia Kristeva's philosophy to caring science
- 2011
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In: NURSING PHILOSOPHY. - : Wiley-Blackwell Publishing Ltd.. - 1466-7681 .- 1466-769X. ; 12:1, s. 12-21
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Journal article (peer-reviewed)abstract
- Abstract: The research presented in this work represents reflections in the light of Julia Kristeva's philosophy concerning empirical data drawn from research describing the everyday life of people dependent on ventilators. It also presents a qualitative and narrative methodological approach from a person-centred perspective. Most research on home ventilator treatment is biomedical. There are a few published studies describing the situation of people living at home on a ventilator but no previous publications have used the thoughts in Kristeva's philosophy applied to this topic from a caring science perspective. The paper also addresses what a life at home on a ventilator may be like and will hopefully add some new aspects to the discussion of philosophical issues in nursing and the very essence of care. Kristeva's philosophy embraces phenomena such as language, abjection, body, and love, allowing her writings to make a fruitful contribution to nursing philosophy in that they strengthen, expand, and deepen a caring perspective. Moreover, her writings about revolt having the power to create hope add an interesting aspect to the work of earlier philosophers and nursing theorists.
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| 34. |
- Lindahl, Berit, 1955, et al.
(author)
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Family Members' Experiences of Everyday Life When a Child Is Dependent on a Ventilator: A Metasynthesis Study
- 2011
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In: JOURNAL OF FAMILY NURSING. - : Sage Publications, Inc.. - 1074-8407 .- 1552-549X. ; 17:2, s. 241-269
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Journal article (peer-reviewed)abstract
- Children using mechanical ventilation for survival represent a small, but growing, vulnerable population in society. The aim of this study was to describe the existing qualitative research that examined family members’ experiences when a child is dependent on ventilator at home. A metasynthesis is an interpretative integration of qualitative research findings based on a systematic literature search. Twelve original research reports focusing on the life situation of ventilator- and technology-dependent children and their families published between 1998 and 2006 were selected as data. Themes from the metasynthesis included experiences of the ill child, siblings, and parents and the meaning of space and place. These findings provide an understanding of the family members’ experiences when a child is dependent on a ventilator for survival. Recommendations for future research with this population of families include a greater focus on professional support systems and family strengths and the use of longitudinal research methods using observation and interviews.
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| 35. |
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| 36. |
- Lindahl, Berit, 1955-
(author)
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“It’s all about stories” : on the use of narrative approaches in nursing research
- 2018
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Conference paper (peer-reviewed)abstract
- Nordic conference in Nursing ResearchTitle: It is all about stories – on the use of narrative approaches in nursing researchBackground: Nursing researchers often use the expression “to give voice to” in their publications. In collecting data in-depth interviews are often used where the research participants are asked to narrate their stories. From a constructionist/constructivist perspective narrations do not represent reality, i.e. are not absolute true stories. But represent what we are, how we see something and what this means to us. Consequently, when people tell a story about themselves it is the voice of their lived experience that is heard. This story is open for interpretation, and for the researcher to analyze and publish so the main findings can be shared by others.Objective: The aim is to present approaches used in nursing research from a caring and phenomenological- hermeneutic and narrative perspective. Method: A brief overview of various narrative approaches used in data collection processes, analyses and mediation of findings will be presented.Results: The presentation will focus on locating my research work within the narrative perspective through giving examples from my own research. Moreover, narrative interviewing and the act of reading, following, analyzing and presenting a story will be reflected on.Conclusion and implication for practice: Narrative approach is both an academic exercise but serves everyday practical issues in nursing and ordinary life. As nursing research often uses qualitative research methods narrative theory and praxis are important aspects in PhD-programmes and in nursing research.
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| 37. |
- Lindahl, Berit, 1955, et al.
(author)
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Kroppen, kroppslig vård och hygien
- 2009
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In: Omvårdnsdens grunder, Edberg, A-K. & Wijk, H. (red.). - Lund : Studentlitteratur. ; , s. 639-669, s. 646-676
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Book chapter (other academic/artistic)
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| 38. |
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| 39. |
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| 40. |
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| 41. |
- Lindahl, Berit, 1955-
(author)
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On text as technology
- 2023
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In: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 37:3, s. 609-610
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Journal article (other academic/artistic)
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| 42. |
- Lindahl, Berit, 1955
(author)
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Patients' suggestions about how to make life at home easier when dependent on ventilator treatment - a secondary analysis
- 2010
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In: SCANDINAVIAN JOURNAL OF CARING SCIENCES. - : Wiley-Blackwell Publishing Ltd.. - 0283-9318 .- 1471-6712. ; 24:4, s. 684-692
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Journal article (peer-reviewed)abstract
- Background: While quantitative research has provided valuable information, studies presenting patients’ experiences have been lacking in the field of knowledge of home mechanical ventilation. The aim of this study was, therefore, to present patient views and suggestions about how to improve home ventilator care and treatment. Method: Data in the present study comprise 35 qualitative research interviews collected for a primary project carried out in the years 2002–2005 and now analysed using qualitative content analysis, the most established method for secondary analysis. Results: The results are presented as six categories: the start-up process, to attach to oneself and the ventilator, to experience home as a shelter, to seek knowledge and understanding, to build up confidence in technology and the need to have people to relate to and depend on. The article presents a brief summary of patients’ ideas and requests to healthcare providers and manufacturers involved in home ventilator treatment. Conclusions: The patients’ perspectives and experiences include much useful knowledge of interest for nursing and medical professional practices. More attention needs to be given to these experiences in both home ventilator treatment and research. It is also of great importance for nurses and researchers to encourage manufacturers to develop beautiful and user-friendly design in their products, suitable for ‘home use’ and not just in hospitals.
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| 43. |
- Lindahl, Berit, 1955-
(author)
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Reflections on the publishing process
- 2022
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In: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712.
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Journal article (other academic/artistic)
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| 44. |
- Lindahl, Berit, 1955-
(author)
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The development and implementation of a complex clinical intervention project in an ICU
- 2017
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In: Working together – achieving more. - Exeter : European Academy of Nursing Science.
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Conference paper (peer-reviewed)abstract
- Aim: The poster presents an example of a complex intervention research in an intensive care unit (ICU).Design: The intervention comprised a refurbishment of one two-bed patient room in a general ICU. An identical room was kept as a control. The Medical Research Council’s (MRC) guideline directed the project. Principal concepts were: health geography, evidence-based design and healing environments, viewed from a caring science perspective.Results: Central aspects investigated were a cyclic light system, sound environment and changes in interior design. Light and sound measurements were carried out and instruments were used to identify light experiences. Interviews and data from patients’ records were also used. Some results from the initial evaluation process are reported.Conclusion: It is complicated to carry out intervention research in ICUs due to the patients’ and next of kin’s situation, staffing and environmental issues. Close contact with the clinical field are of vital importance.
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| 45. |
- Lindahl, Berit, 1955-, et al.
(author)
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The development and implementation of a complex clinical intervention project in an ICU
- 2015
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Conference paper (peer-reviewed)abstract
- Title (poster): The development and implementation of a complex clinical intervention project in an ICUAim: The poster presents an example of a complex intervention research in an intensive care unit (ICU).Design: The intervention comprised a refurbishment of one two-bed patient room in a general ICU. An identical room was kept as a control. The Medical Research Council’s (MRC) guideline directed the project. Principal concepts were: health geography, evidence-based design and healing environments, viewed from a caring science perspective.Results: Central aspects investigated were a cyclic light system, sound environment and changes in interior design. Light and sound measurements were carried out and instruments were used to identify light experiences. Interviews and data from patients’ records were also used. Some results from the initial evaluation process are reported.Conclusion: It is complicated to carry out intervention research in ICUs due to the patients’ and next of kin’s situation, staffing and environmental issues. Close contact with the clinical field are of vital importance.
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| 46. |
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| 47. |
- Lindahl, Berit, 1955-, et al.
(author)
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When technology enters the home – a systematic and integrative review examining the influence of technology on the meaning of home.
- 2018
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712.
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Journal article (peer-reviewed)abstract
- Aim: To analyse and synthesise the research that has investigated the experience of home in relation to home mechanical ventilation (HMV).Method: Systematic integrative review. Four electronic databases (CINAHL, PubMed, Scopus and ISI Web of Knowledge) were searched between January 2010 and April 2017 as well as reference lists of included studies. Quantitative and qualitative studies meeting the inclusion criteria were critically appraised. Study findings were inductively analysed and synthesised using the integrative approach.Results: Twenty-one studies were included in the review. Two main themes emerged: home and at home-ness and altered inter-personal relationships. The literature suggests that the technology alters the meaning of home through its structural and conceptual reconfiguration. Paradoxically the space is experienced as both a home and a workplace which creates tensions and ambiguities for HMV users/families and care workers. HMV users and their families attempt to recreate a sense of home and identity while gaining control over space and decision-making. Nevertheless, the home is seen as the preferred place to live and close bonds can develop between the different actors. Conclusions: The literature suggests that the transformation of the meaning of home by the presence of technology and workers poses challenges that are often under-recognised. Health care professionals and personal care assistants need preparation for the complexities of working in the home setting in addition to clinical aspects of caregiving. Home adaptations need to be carefully planned and include design principles that retain ‘at homeness’ while enabling the creation of a safe workplace.
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| 48. |
- Listerfeldt, Stephanie, et al.
(author)
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Facing the unfamiliar : Nurses' transcultural care in intensive care - A focus group study.
- 2019
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In: Intensive & Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036.
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Western Europe today is a culturally diverse society and expected to become more so in the future. When patients from unfamiliar cultures become critically ill and require intensive care, this places considerable demands on the cultural and linguistic competencies of the intensive care staff. Existing research regarding the transcultural aspects of intensive care is scarce and, in Sweden, non-existent.OBJECTIVE: To explore the experiences of critical care nurses and enrolled nurses in caring for culturally diverse patients in intensive care units.METHOD: Four focus group interviews were conducted with a total of 15 interviewees. The collected data were subjected to qualitative content analysis.FINDINGS: The findings mostly concerned the nursing staff's experiences of caring for relatives. Caring for the relatives of culturally diverse patients was described as challenging due to linguistic and cultural barriers.CONCLUSIONS: To overcome linguistic and cultural barriers, intensive care units should be reorganised and restructured to create a more welcoming environment for relatives. Alternative communication methods should be developed and traditional ways of using support from interpreters support must be re-evaluated. Education to ensure cultural competence and the promotion of an intercultural approach is key and the development of research programmes is recommended.
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| 49. |
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| 50. |
- Roxberg, Åsa, 1953-, et al.
(author)
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Space and place for health and care
- 2020
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In: International Journal of Qualitative Studies on Health and Well-being. - Abingdon : Taylor and Francis Ltd.. - 1748-2623 .- 1748-2631. ; 15:sup1
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Journal article (peer-reviewed)abstract
- Purpose: This discussion paper aims to contribute to a greater understanding of the state of the art of research engaged with conceptual matters of space and place for health and care. Method: The authors, who represent a variety of academic disciplines, discuss and demonstrate the conceptual recognition of space and place in research in health and caring sciences building upon own work and experience. Results: To explore the concepts of space and place for health and care is a research pursuit of utmost importance, and should be made through transdisciplinary research collaborations, whereby spatial theories from various disciplines could be communicated to cultivate truly novel and well-informed research. Furthermore, engaging with relational and topological perceptions of space and place poses methodological challenges to overcome in future research on health and care. Conclusions: We argue that there is a need for accelerating spatially informed research on health and care that is informed by current theories and perspectives on space and place, and transdisciplinary research collaborations are a means to achieving this. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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