| 1. |
- Dychawy-Rosner, I, et al.
(författare)
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Direct care staff's need for support in their perceived work role in day activities units
- 2000
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 8:1, s. 39-48
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: This study sets out to investigate direct care staff's views of their need for support, supervision, and training in their practice in day care settings when supporting daily occupations among developmentally disabled persons. BACKGROUND: The first line staff are considered as having a prominent role in the successful delivery of service. METHODS: Three municipalities, one urban and two rural areas in southern Sweden, were chosen for the study. The studied population n = 81 consisted of 94.1% of all staff employed in day activities units supporting the clients' daily occupations or community-integrated, sheltered work employment. The data were collected by means of a questionnaire. FINDINGS: This material identified the staff's perceived work role, and their needs for support, supervision, and training in the areas of communication, environment adaptation, individual activation and training methods, with regard to learning disabilities and special needs. CONCLUSIONS: Care managers should focus upon preparation of staff support programmes to improve the quality and efficiency in this area of care.
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| 2. |
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| 3. |
- Ivarsson, Bodil, et al.
(författare)
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Patient reactions to cancelled or postponed heart operations.
- 2002
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 10:2, s. 75-81
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim was to survey the rate and cause of cancellations of planned cardiac operations at a Swedish clinic during 1999, and to study how the patients were affected. Design Questionnaires were distributed to 74 patients who had their operations cancelled. Their mood after discharge was measured with The Hospital Anxiety and Depression scale. Ninety-three patients, who were operated on without postponement, served as controls. Results Sixty-one percent of the patients in the cancellation group reacted negatively, especially if the reason for cancellation was organizational (P = 0.03). The women in the cancellation group had a significantly higher degree of depression than men (P = 0.01) and both women (P = 0.02) and men (P = 0.003) in the control group. Most of the patients, however, were satisfied with the nursing staff's reception and information. Conclusions The patients reacted negatively to the cancellation, especially if it had organizational reasons. Women subjected to cancellation had a significantly higher degree of depression than other patients. To be avoided, organizational and medical problems must be identified in time. One way to do this is to introduce a preadmission nurse clinic.
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| 4. |
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| 5. |
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| 6. |
- Levenstam, Anna-Karin, et al.
(författare)
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Changes in patients' need of nursing care reflected in the Zebra system.
- 2002
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 10:4, s. 191-199
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Tidskriftsartikel (refereegranskat)abstract
- During 1995-97, many head nurses stated that they had perceived an increase in patients' need of nursing care. A questionnaire was designed to determine the reasons for this. The purpose of the investigation was to answer two questions, 'What were the reasons for head nurses perception of an increase in patients need of nursing care from 1995 to May 1997?' and, 'Does patient classification in the Zebra system reflect the underlying changes in patients' need of nursing care? The results show that there are several reasons behind changes in the patients need of nursing care. The main reasons are a decreased general level of health among patients and that treatments are more time-consuming. After comparing statistics concerning patient classification with the answers received from the questionnaire, a good level of agreement could be seen in these.
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| 7. |
- Arvidsson, Barbro, 1945-, et al.
(författare)
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Psychiatric nurses' conceptions of how a group supervision programme in nursing care influences their professional competence : a 4-year follow-up study
- 2001
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Ingår i: Journal of Nursing Management. - Chichester, United Kingdom : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 9:3, s. 161-171
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of the study was to describe, after 4 years, psychiatric nurses' conceptions of how a 2-year group supervision programme within nursing care had influenced their professional competence.BACKGROUND: The intention of group supervision in nursing care is to understand nurses' experiences within real care settings and to structure these in a professional and personal context.METHODS: Ten psychiatric nurses participated in a 2-year group supervision programme. They were interviewed 4 years after the group supervision was ended. Data were analysed according to the phenomenographic method.FINDINGS: Six description categories emerged: a feeling of job satisfaction; gaining knowledge and competence; gaining a sense of security in nursing situations; a feeling of personal development; realizing the value of supervision; and a sense of professional solidarity.CONCLUSIONS: The findings of the 4-year follow-up showed that a group supervision programme in nursing care had lasting influences on the psychiatric nurses' professional competence in the form of a pronounced professional identity and an integrated nursing care perspective. Group supervision contributes to maintaining the strength and energy needed to carry on working, which makes continuing supervision necessary.IMPLICATIONS: An important research implication could be to investigate the type of knowledge that ought to be developed within group supervision in nursing care.© 2001 Blackwell Science Ltd.
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| 8. |
- Arvidsson, Barbro, 1945-, et al.
(författare)
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Psychiatric nurses' conceptions of how group supervision in nursing care influences their professional competence
- 2000
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Ingår i: Journal of Nursing Management. - Oxford : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 8:3, s. 175-185
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of the study was to describe, after 1 and 2 years respectively, psychiatric nurses' conceptions of how group supervision within nursing care influenced their professional competence.BACKGROUND: The intention of group supervision in nursing care is to understand nurses' experiences within real care settings and to structure these in a professional and personal context.THE STUDY: Ten psychiatric nurses participated in the group supervision. They were interviewed on two occasions: after 1 and 2 years, respectively.FINDINGS: The data analysis was influenced by the phenomenographic approach and provided four description categories: a feeling of job satisfaction; acquiring knowledge and competence; gaining a sense of security in nursing situations; and a feeling of personal development.CONCLUSIONS: In supervision, practice and theory are integrated, resulting in enhanced nursing competence among the participants. Supervision should be an integrated part of nursing work and regarded as a means of quality assurance. A long-term follow-up could give valuable proof that group supervision in nursing care has a lasting effect on nurses' professional competence.
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| 9. |
- Bégat, Ingrid, 1942-, et al.
(författare)
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Australian nurse supervisors' styles and their perceptions of ethical dilemmas within health care
- 2003
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 11:1, s. 6-14
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To examine clinical nurse supervisors' styles, in terms of models, organization, focus on supervision and theories used in supervision, as well as their perceptions of ethical dilemmas within health care. BACKGROUND: The importance of clinical supervision in clinical practice has been reported. However, literature dealing with its implementation is rare. METHODS: This study is a descriptive-correlational study. Data were collected by means of a questionnaire from two groups of nurse supervisors randomly selected from a university (n = 55) and a hospital (n = 31). Data were analysed using descriptive and inferential statistics. RESULTS: The models most frequently used were 'case-oriented' and 'decision-making oriented'. The nurse supervision was reported as being organized on a one-to-one basis. The focus of supervision was on 'patient problems' and 'cooperation in team'. The theory most commonly used was the theory of reflection. The supervisors' perceptions of moral dilemmas were related to 'decision making' and actions impacting on quality of care resulting from their supervisor styles. CONCLUSION: By correlating the supervisors' styles and their perceptions of ethical dilemmas, we conclude that it is important to contribute to further research on supervisors' styles in order to ensure successful supervision.
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| 10. |
- Berg, Agneta, et al.
(författare)
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Dementia care nurses experiences of systematic clinical group supervision and supervised individually planned nursing care
- 2000
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Ingår i: Journal of Nursing Management. - 0966-0429 .- 1365-2834. ; 8:6, s. 357-368
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Tidskriftsartikel (refereegranskat)abstract
- AimTo reveal 13 nurses' experiences of systematic clinical group supervision and supervised individually planned nursing care, while working with people suffering from severe dementia.BackgroundClinical supervision is a major issue in nursing, however empirical knowledge of the subject is limited. Nurse's narrations about their experiences may extend the knowledge available and serve as a basis for creating models of support systems for nurses in their care provision.MethodsOpen-ended interviews were performed and the text was analysed through content analysis. A questionnaire was used to evaluate the views of the effects of clinical supervision.FindingsTwo main themes were found. Confirmed uniqueness included two sub-themes: confirming the nurses as a person and as a professional and confirming the patient as a unique human being. Consolidated sense of community included three sub-themes: closer relationship between the nurses, changed organization of nursing care and improved individualizing in routines of nursing care. The questionnaire result showed improvements in co-operation and in providing professional nursing care and personal development.ConclusionInterventions to improve working conditions for the nurses and care quality for the patients may well focus the core process, i.e. feedback and support for the nurse–patient interaction and person-orientated nursing care, taking into account the constellation and conditions of the group.
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| 11. |
- Boström, Barbro, et al.
(författare)
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Pain and health-related quality of life among cancer patients in final stage of life : a comparison between two palliative care teams
- 2003
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Ingår i: Journal of Nursing Management. - Chichester, West Sussex : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 11:3, s. 189-196
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Tidskriftsartikel (refereegranskat)abstract
- A two-centred descriptive study was performed in order to describe and compare pain and health-related quality of life (HRQOL) among cancer patients, in their final stage of life. The patients were cared for by either a nurse-led palliative care team I (PCT I) or a physician-led palliative care team II (PCT II). Forty-six consecutive, stratified patients (PCT I, n = 21 and PCT II, n = 25) participated. The medical outcomes study short form 36 (SF-36) was used for evaluating HRQOL and the Pain-O-Meter for assessing pain. Patients' pain intensity, pain quality and HRQOL showed no significant difference between the two groups PCT I and PCT II. The patients from PCT I had significantly longer survival time (P = 0.017) than those from PCT II. The different composition of the teams being led by nurses or physicians is worth further research; both from the patient's and staff's viewpoint, there may also be cost-benefits worth examining.
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| 12. |
- Kullén Engström, Agneta, et al.
(författare)
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Management vs symbolic leadership and hospitals in transition : a Swedish example
- 2000
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Ingår i: Journal of Nursing Management. - : Wiley-Blackwell Publishing Ltd.. - 0966-0429 .- 1365-2834. ; 8:3, s. 167-173
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Tidskriftsartikel (refereegranskat)abstract
- Aim To describe, analyse and interpret symbolic leadership in Swedish public hospitals. Background Swedish hospitals are undergoing major structural changes. Hospitals are amalgamated in order to increase productivity and accessibility and reduce health care costs. Method In-depth interviews have been performed with 54 politicians, senior civil servants, medical directors and trade union representatives at nine hospitals. The interviews have been analysed and interpreted following a grounded theory approach. Findings The results show that leadership is manifested in two dimensions—management and symbolic leadership. The management dimension comprises general leadership aspects like planning, regulation and control. In the symbolic leadership dimension, the leader acts as a guide, inspirer and visionary. Leaders consider they are acting in two large arenas: a public arena and a hospital arena. In the public arena their professional competence is thought to be most important and in the hospital arena their social competence. Conclusions Structural changes in Swedish hospitals have forced the actors to come out into the public arena, where they increasingly meet the media and have to defend budget cut-backs. This reduces their manoeuvring space in the hospital arena. When leaders work as a team, and make full use of their symbolic role, this helps to promote the process of transition. Symbolic leadership has a potential to increase the role repertory for not least the head nurse.
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| 13. |
- Olofsson, Brita, et al.
(författare)
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Absence of response : a study of nurses' experience of stress in the workplace
- 2003
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 11:5, s. 351-8
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Tidskriftsartikel (refereegranskat)abstract
- It has become clear that nursing is a high-risk occupation with regards to stress-related diseases. In this study, we were interested in nurses' experiences of stress and the emotions arising from stress at work. Results showed that nurses experienced negative stress which was apparently related to the social environment in which they worked. Four nurses were interviewed. The method used was grounded theory. Analysis of the interviews singled out absence of response as the core category. Recurring stressful situations obviously caused problems for the nurses in their daily work. Not only did they lack responses from their supervisors, they also experienced emotions of frustration, powerlessness, hopelessness and inadequacy, which increased the general stress experienced at work. Our conclusion is that the experience of absence of response leads to negative stress in nurses.
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| 14. |
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| 15. |
- Ziegert, Kristina, 1957-, et al.
(författare)
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Conceptions of life situation among next-of-kin of haemodialysis patients
- 2001
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Ingår i: Journal of Nursing Management. - Chichester, United Kingdom : Wiley-Blackwell. - 0966-0429 .- 1365-2834. ; 9:4, s. 231-239
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Tidskriftsartikel (refereegranskat)abstract
- The presence of renal disease in a family is a strain on both the patient and the next-of-kin, affecting their life situations. Surprisingly, few studies dealing with the ways that the next-of-kin experience their situation are available. The aim of this study was to describe how the next-of-kin of haemodialysis patients conceive their life situation. Data were collected by interviewing 12 people who live with someone with dialysis-treated renal disease and analysed according to a qualitative method inspired by the phenomenographic approach. Six description categories of how the subjects construed their life situation emerged: a feeling of confinement; a feeling of social isolation; a feeling that the way of life has changed; a feeling of security in life; a feeling of a threatening future; and promoting health. The next-of-kin generally expressed a large degree of commitment to and concern for the sick person. In spite of their life situation having been dramatically changed, the next-of-kin described an ability to adapt. With the help of society the feelings of confinement and social isolation can be dispersed, enabling the next-of-kin to promote the health of the sick person. A suggestion for further research is to study what adaptation strategies next-of-kin use in their life situation.
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| 20. |
- Idvall, Ewa, 1950-
(författare)
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Quality of care in postoperative pain management : What is realistic in clinical practice?
- 2004
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Ingår i: Journal of Nursing Management. - 0966-0429 .- 1365-2834. ; 12:3, s. 162-166
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents a study describing nurses' assessment of whether it was realistic to carry out good quality of care in postoperative pain management. Further, the study compared their assessment with the quality of care actually performed in clinical practice as assessed by both patients and nurses. Three questionnaires were used, one for patients (n = 198) and two for nurses (n = 63). Nurses and patients responded to similar questions, the patients assessed the quality of care they had received, and the nurses assessed the quality of care they had delivered. The nurses also responded to questions concerning whether the different aspects of good quality of care were realistic to carry out in practice. The results show that in several important aspects of postoperative pain management, both patients and nurses assessed the quality of care to be lower than the nurses' assessment of what was actually possible to effectuate in clinical practice, e.g. pain assessment and information. This finding highlights the problem of applying evidence-based care in actual clinical practice.
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| 21. |
- Magnusson, Annabella, et al.
(författare)
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The influence of clinical supervision on ethical issues in home care of people with mental illness in Sweden
- 2002
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Ingår i: Journal of Nursing Management. - 0966-0429 .- 1365-2834. ; 10:1, s. 37-45
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate in what ways clinical supervision can influence district nurses', psychiatric nurses' and mental health care workers' ethical decision-making in home care of people with mental illnesses. BACKGROUND: Nursing staff frequently have to make difficult ethical decisions when caring for mentally disturbed patients in the home. METHODS: This study is a descriptive, correlational study. Data was collected by a cross-sectional survey that focused on psychiatric nurses, district nurses and mental health care workers (n = 660). RESULTS: Health care professionals, who received supervision as support in their clinical nursing work, perceived that they felt more secure in decision-making, felt safer in their relationship with the patient and had gained a deeper insight into the meaning of security for the patient as well as for the carer. Furthermore, they regarded taking over responsibility for the patient, when necessary, as their moral right and that care and treatment in the patient's home could mean that the patient's integrity was violated. CONCLUSIONS: The results emphasize the need for clinical supervision as support for nursing staff, as it leads to their acquiring a greater sense of self-esteem. There is also a need to clarify the professional role of nurses through integration of theoretical and clinical knowledge. The importance of supervision is illustrated by means of previous studies.
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| 22. |
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| 23. |
- Lundgren, Solveig M, 1943, et al.
(författare)
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Nurses´ use of time in a medical-surgical ward with all-RN staffing
- 2001
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Ingår i: Journal of Nursing Management. - 0966-0429. ; :9, s. 13-20
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate allocation of nursing time, organisation of nursing activities and whether or not allocation and organisation have changed over time. Background: In a ward that changed to all-RN staffing, the nurses were encouraged to implement a patient-focused philosophy. The nurses perceived that they had difficulty in using the time available efficiently. Methods: Non-participant observations were conducted with 2-year intervals. Ten consecutive weekdays were covered on two occasions. The study was carried out at a university hospital in Sweden. Findings Between observations, a significant change in the organization of the direct care had occurred, and the same tendency was found in patient administration and general management. The organization of work changed from a partly fragmented to a more coherent one. The time used for direct care and administrative activities increased between the two observations, while indirect care, personal and service activities decreased. Conclusion: It can be suggested that the nurses used their time efficiently and, over time, they developed a more coherent way of organizing nursing activities.
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