| 11. |
- Carnesten, Hillewi, 1969-
(author)
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Nurses' caring struggle : Stress in caring within hospital emergency care during the COVID-19 pandemic
- 2024
-
Doctoral thesis (other academic/artistic)abstract
- Nurses took a frontline caregiving role during the COVID-19 pandemic in pervasively altered conditions in Swedish hospital emergency healthcare. Little is known about nurses’ experiences of the stress they were subjected to. In this thesis, findings from individual in-depth interviews with both newly graduated registered nurses (NGRNs) and experienced nurses (ERNs), as well as a web-based questionnaire, illuminate nurses’ lived experiences of stress in caring during the COVID-19 pandemic. Three studies employed qualitative methods (I, II, IV), and one a mixed methods approach (III). Study I aimed to describe NGRNs’ experiences of encountering stress in EDs during the COVID-19 pandemic. Findings illuminate how dedicated NGRNs struggle to develop into the nurse they want to be whilst battling extraordinary situations and conflicting emotions. Loss of control and experiences of shortcomings caused by work overload in combination with understaffing force NGRNs into an independent role at an early point in their career. Study II aimed to illuminate the meaning of NGRNs' experiences of caring for patients in EDs during the COVID-19 pandemic. Findings comprise caring being bestowed through spatial, emotional, and temporal barriers. NGRNs want to be present, relieve suffering yet describe caring during the pandemic as being a hidden activity, less acknowledged and left to the recognition of each nurse. Study III aimed to explore healthcare workers’ (HCWs’) experiences of the changed caring reality of the COVID-19 pandemic. Findings disclose traumatic experiences and having to sacrifice moral values and harbour dilemmas in isolation. Experiencing stress was significantly correlated to lower sense of coherence (SOC). Study IV aimed to explore nurses’ lived experiences of stress in the transformed caring reality during the COVID-19 pandemic. The interpreted meaning comprises the dilemma of enduring the unbearable, meaning having to silence one’s inner ethical, caring compass. In conclusion, stress in caring during the COVID-19 pandemic from a nurse perspective, can be understood as a caring struggle entailing bodily, knowledge, and ethical stress in a search for meaning that might be found in togetherness with patients, with colleagues, with dear ones and in nature.
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| 12. |
- Carnesten, Hillewi, 1969-, et al.
(author)
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Struggling in the dehumanized world of COVID-An exploratory mixed-methods study of frontline healthcare workers' experiences
- 2024
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In: Journal of Advanced Nursing. - : WILEY. - 0309-2402 .- 1365-2648.
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Journal article (peer-reviewed)abstract
- Aim: To explore healthcare workers' experiences of the changed caring reality during the COVID-19 pandemic in Sweden. Design: An online fully mixed-methods design. Methods: A web-based self-reported questionnaire with fixed and open-ended answers collected data from March to April 2021, analysed in three steps. First, free-text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta-inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting. Results: Meta-inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post-traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy. Conclusions: Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID-19 pandemic and to prevent mental health illness in future crisis. Patient or Public Contribution: No patient or public contribution. Summary: The pandemic outbreak exposed frontline healthcare workers to unparallelled stress shown as negative for their mental health in several meta-analyses and systematic reviews. In-depth understanding on experiences and how symptoms of post-traumatic stress disorder relate to coping mechanisms have been scarcely explored. This study contributes to understanding on healthcare workers' experiences and the relation between lower sense of coherence and increased risk of developing symptoms of post-traumatic stress disorder. Implications for Practice/Policy: This study might guide how to prepare for resilience in future emergencies.
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| 13. |
- Carnesten, Hillewi, 1969-, et al.
(author)
-
Struggling in the dehumanized world of COVID-An exploratory mixed-methods study of frontline healthcare workers' experiences.
- 2024
-
In: Journal of Advanced Nursing. - : WILEY. - 0309-2402 .- 1365-2648.
-
Journal article (peer-reviewed)abstract
- AIM: To explore healthcare workers' experiences of the changed caring reality during the COVID-19 pandemic in Sweden.DESIGN: An online fully mixed-methods design.METHODS: A web-based self-reported questionnaire with fixed and open-ended answers collected data from March to April 2021, analysed in three steps. First, free-text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta-inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting.RESULTS: Meta-inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post-traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy.CONCLUSIONS: Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID-19 pandemic and to prevent mental health illness in future crisis.PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.SUMMARY: The pandemic outbreak exposed frontline healthcare workers to unparallelled stress shown as negative for their mental health in several meta-analyses and systematic reviews. In-depth understanding on experiences and how symptoms of post-traumatic stress disorder relate to coping mechanisms have been scarcely explored. This study contributes to understanding on healthcare workers' experiences and the relation between lower sense of coherence and increased risk of developing symptoms of post-traumatic stress disorder.IMPLICATIONS FOR PRACTICE/POLICY: This study might guide how to prepare for resilience in future emergencies.
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| 14. |
- Carnesten, Hillewi, 1969-, et al.
(author)
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Struggling with frightening experiences in a transformed reality : A mixed methods study of healthcare workers’ experiences during the pandemic.
- 2023
-
Conference paper (other academic/artistic)abstract
- Background: The COVID-19 pandemic continues to impact health care workers’ (HCWs’) mental health. Research show that psychological distress and hard challenges abide with strong commitment to contribute. Yet, in-depth understanding of HCWs’ experiences of the changed caring reality during the pandemic is missing. Mixed methods research (MMR) accommodates several features apart from employing either quantitative or qualitative methods. This presentation focuses on examples from the 13-step mixed method by Leech and Onwuegbuzie.Methods: 97 HCWs in one hard-hit region in Sweden answered a web-based questionnaire measuring symptoms of stress (using DSM-5 criteria for post-traumatic stress syndrome, PTSD) in relation to perceived sense of coherence (SOC-scale) and self-compassion (SCS) as well as HCWs’ experiences. First, qualitative data (experiences of the pandemic) was analyzed by qualitative content analysis, then quantitative data (associations between PTSD and SOC/SCS) were analyzed with linear regression adjusted for covariates. Thirdly, a synthesis, the meta-inference of qualitative and quantitative data, explained a new comprehensive understanding. Results: By analyzing the categories and subcategories from the qualitative analysis in relation to symtoms of stress and SOC/SCS, a synthesis emerged. This was undertaken by merging and comparing the findings and discussing the new comprehensive understanding. Finally, to fully outline the mixed methods approach, qualitative and quantitative data were synthesized into a new comprehensive whole, a meta inference. Conclusion: This study moves away from dichotomic traditions between qualitative or quantitative approaches. By broadening the methodological departure this study may provide a new comprehensive understanding and contribute to enhance quality in MMR.
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| 15. |
- Donner, Lucas, et al.
(author)
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Navigating between Compassion and Uncertainty – Psychiatric Nurses’ Lived Experiences of Communication with Patients Who Rarely Speak
- 2020
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In: Issues in Mental Health Nursing. - : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 42:4, s. 307-316
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Journal article (peer-reviewed)abstract
- Caring conversations are considered essential in psychiatric and mental health nursing. However, some patients are more or less silent and rarely express themselves verbally. This can be challenging for nurses who also need to find ways of communicating with these patients. Therefore, the aim of this study is to describe psychiatric nurses’ lived experiences of communication with patients who rarely speak. Five nurses were recruited from a psychiatric nursing home. Participants were encouraged in interviews to reflect on their experiences of caring for patients who are more or less silent. The transcribed interviews were subject to a phenomenological hermeneutic analysis. The findings are reflected in three main themes: (i) giving space for the unspoken narrative, (ii) remaining in uncertainty, and (iii) being in reflective vigilance. The themes were synthesised and reflected on in the light of Fredriksson’s theory of caring conversations. The comprehensive understanding reveals that nurses’ understanding of the patient’s unspoken narrative relies both on compassion and a willingness to engage, but also on a preparedness to remain in the uncertainty of not knowing. Balancing good intentions and the fear of one’s own shortcomings requires reflections not only in actions during encounters with the patient, but on actions. When nurses can apprehend and respond to what the patient expresses non-verbally, a joint narrative can emerge.
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| 16. |
- Eriksson, Anna-Lena, 1971, et al.
(author)
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Association between the low activity genotype of catechol-O-methyltransferase and myocardial infarction in a hypertensive population
- 2004
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In: Eur Heart J. ; 25:5, s. 386-91
-
Journal article (peer-reviewed)abstract
- AIM: Estrogens regulate several biological processes involved in the pathogenesis of myocardial infarction. Catechol-O-methyltransferase (COMT) is a key enzyme in the degradation of estrogens. There is a functional polymorphism in the COMT gene (Val158Met), affecting the activity of the enzyme. We investigated if the low activity genotype of COMT is associated with an altered risk of myocardial infarction. METHODS AND RESULTS: In a prospectively followed hypertensive cohort we identified 174 patients who suffered a myocardial infarction during the study and compared them to 348 controls from the same cohort. The COMT polymorphism and serum levels of sex hormones were analysed. Patients homozygous for the low activity COMT genotype had a decreased risk of myocardial infarction compared to those with the high activity genotype, odds ratio 0.65 (95% CI 0.44-0.97, p=0.033 ). The protective effect of the low activity genotype was most evident among older patients (> 58 years of age), odds ratio 0.43 (95% CI 0.23-0.79, p=0.006 ). Serum levels of estradiol were increased ( p=0.006 ) in males with the low activity genotype. CONCLUSIONS: Our findings suggest that the low activity COMT genotype is protective against myocardial infarction. One may speculate that the altered estrogen status could be involved in this effect.
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| 17. |
- Eriksson, Nadya Travina, et al.
(author)
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Blessed Alienation : The Christian Monastery as a Caring and Restorative Environment
- 2014
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In: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 24:2, s. 172-182
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Journal article (peer-reviewed)abstract
- Being mentally ill is often associated with experiencing alienation from society because sensations are not easily shared with others. Modern health care leads us to pose many questions. Some sufferers search and find their way to monasteries as they did centuries ago. We interviewed six persons staying in a monastery to understand the meaning of health and care in a monastic environment in contemporary Sweden. We analyzed the transcripts by means of a hermeneutic approach and discovered that the helping effect of the monastery was based on its contradictory/paradoxical structure that corresponded to the lifeworld of a person suffering from mental illness. The monastery was a place where one could be different but equal, and simultaneously provided freedom within boundaries, calmness and intensity, privacy and relations, demands and confirmation. This facilitated experiences of health and wholeness, necessary to manage the challenges of recovery.
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| 18. |
- Eriksson, Nadya Travina, et al.
(author)
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Hermeneutic Inquiry : Researching Lived Experience of Mental Health and Recovery in a Christian Monastery in Contemporary Sweden
- 2018
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In: SAGE Research Methods Cases Part 1. - 1 Oliver's Yard, 55 City Road, London EC1Y 1SP United Kingdom : Sage Publications. - 9781526440341
-
Book chapter (peer-reviewed)abstract
- In this case study, we, the student Nadya and her supervisor Lena, will describe the processand challenges associated with conducting an empirical study for a master’s degree in caringscience in psychiatric nursing. We will describe how the idea for the thesis evolved, theoreticaland practical preparations, as well as methodological procedures in relation to data collectionand analysis. We will also share some reflections we made in relation to challengesencountered during this study. Many of these reflections were directed toward methodologicalaspects of the study. However, along the way, it also became clear that experiences fromconducting the study also yielded important knowledge and understanding about mental healthcare. The reflections about what happened in the encounter between Nadya and theparticipants added depth not only to our understanding of the subject for this study, that is,how mental health, care, and recovery are experienced by people in a Christian monastery incontemporary Sweden, but also shed light on important aspects of mental health nursing inrelation to modern psychiatry.
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| 19. |
- Fredriksson, Lennart, et al.
(author)
-
Vårdande kommunikation
- 2022. - 3
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In: Vårdvetenskapliga begrepp i teori och praktik. - Lund : Studentlitteratur AB. - 9789144161372 ; , s. 415-428
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Book chapter (other academic/artistic)
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| 20. |
- Gabrielsson, Sebastian, 1975-, et al.
(author)
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Positioning Psychiatric and Mental Health Nursing as a Transformative Force in Health Care
- 2020
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In: Issues in Mental Health Nursing. - London : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 11:1, s. 976-984
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Journal article (peer-reviewed)abstract
- From the perspective of psychiatric and mental health nurses in Sweden, this discussion paper aims to position psychiatric and mental health nursing as a transformative force contributing to enforcing person-centered values and practices in health care. We argue the potential impact of psychiatric and mental health nursing on service user health and recovery, nursing student education and values, and the organization and management of health care. Psychiatric and mental health nursing is discussed as a caring, reflective, and therapeutic practice that promotes recovery and health. Implications for nursing education, research, management, and practice are outlined.
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