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Mamhidir, Anna-Greta
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Publications (10 of 35) Show all publications
Hedman, M., Häggström, E., Mamhidir, A.-G. & Pöder, U. (2019). Caring in nursing homes to promote autonomy and participation. Nursing Ethics, 26(1), 280-292, Article ID 969733017703698.
Open this publication in new window or tab >>Caring in nursing homes to promote autonomy and participation
2019 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 26, no 1, p. 280-292, article id 969733017703698Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Autonomy and participation are threatened within the group of older people living in nursing homes. Evidence suggests that healthcare personnel act on behalf of older people but are still excluding them from decision-making in everyday care.

OBJECTIVE: The purpose was to describe registered nurses' experience of caring for older people in nursing homes to promote autonomy and participation.

RESEARCH DESIGN: A descriptive design with a phenomenological approach was used. Data were collected by semi-structured individual interviews. Analysis was inspired by Giorgi's method. Participants and research context: A total of 13 registered nurses from 10 nursing homes participated. Ethical considerations: Ethical approval was obtained from the Regional Research Ethics Committee. Informed consent was achieved and confidentiality guaranteed.

FINDINGS: The essence of caring for older people in nursing homes to promote autonomy and participation consisted of registered nurses' awareness of older people's frailty and the impact of illness to support health and well-being, and awareness of acknowledgement in everyday life and trusting relationships. Paying attention to older people by being open to the persons' wishes were aspects that relied on registered nurses' trusting relationships with older people, their relatives and surrounding healthcare personnel. The awareness reflected challenges in caring to promote older people's right to autonomy and participation in nursing homes. Registered nurses' strategies, hopes for and/or concerns about development of everyday life in nursing homes were revealed and mirrored their engagement in caring for older people.

DISCUSSION AND CONCLUSION: Awareness of older people's frailty in nursing homes and the importance of maintained health and well-being were described as the main source for promoting autonomy and participation. Everyday life and care in nursing homes needs to be addressed from both older people's and healthcare personnel's perspectives, to promote autonomy and participation for residents in nursing homes.

Keywords
Autonomy, nursing home, older people, participation, phenomenology, registered nurse
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:hig:diva-23918 (URN)10.1177/0969733017703698 (DOI)000458874900027 ()28425315 (PubMedID)2-s2.0-85041591391 (Scopus ID)
Projects
Äldres autonomi och delaktighet
Available from: 2017-04-26 Created: 2017-04-26 Last updated: 2019-08-12Bibliographically approved
Sving, E., Frediksson, L., Gunningberg, L. & Mamhidir, A.-G. (2017). Getting evidence-based pressure ulcer prevention into practice: a process evaluation of a multi-faceted intervention in a hospital setting. Journal of Clinical Nursing, 26(19-20), 3200-3211
Open this publication in new window or tab >>Getting evidence-based pressure ulcer prevention into practice: a process evaluation of a multi-faceted intervention in a hospital setting
2017 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 19-20, p. 3200-3211Article in journal (Refereed) Published
Abstract [en]

AIM:

The aim of the present study was to describe registered nurses', assistant nurses' and first-line managers' experiences and perceptions of a multi-faceted hospital setting intervention focused on implementing evidence-based pressure ulcer prevention.

BACKGROUND:

Pressure ulcer prevention is deficient. Different models exist to support implementation of evidence-based care. Little is known about implementation processes.

DESIGN:

A descriptive qualitative approach.

METHOD:

Five focus-group nurse interviews and five individual first-line manager interviews were conducted at five Swedish hospital units. Qualitative content analysis was used.

RESULT:

The findings support that the intervention and the implementation process changed the understanding and way of working with pressure ulcer prevention: from treating to preventing. This became possible as 'Changed understanding enables changed actions - through one's own performance and reflection on pressure ulcer prevention'. Having a common outlook on pressure ulcer prevention, easy access to pressure-reducing equipment, and external and internal facilitator support were described as important factors for changed practices. Bedside support, feedback and discussions on current results increased the awareness of needed improvements.

CONCLUSION:

The multi-faceted intervention approach and the participants' positive attitudes seemed to be crucial for changing understanding and working more preventatively. The strategies used and the skills of the facilitators need to be tailored to the problems surrounding the context. Feed-back discussions among the staff regarding the results of the care provided also appear to be vital.

Keywords
hospital, implementation, pressure ulcer prevention, qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-22762 (URN)10.1111/jocn.13668 (DOI)000410546400035 ()27875015 (PubMedID)2-s2.0-85016508327 (Scopus ID)
Note

Funding agencies:

Centre for Research & Development, Uppsala University/Country Council of GävleborgUppsala-Örebro Regional Research Council in Sweden 

Available from: 2016-11-15 Created: 2016-11-15 Last updated: 2018-03-13Bibliographically approved
Sjölund, B.-M., Mamhidir, A.-G. & Engström, M. (2017). Pain prevalence among residents living in nursing homes and factors associated with quality of life and well-being.
Open this publication in new window or tab >>Pain prevalence among residents living in nursing homes and factors associated with quality of life and well-being
2017 (English)In: Article in journal (Other academic) Submitted
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-25928 (URN)
Projects
Smärta hos äldre med eller utan kognitiv nedsättning - en interventionsstudie där äldres och vårdares perspektiv efterfrågas
Available from: 2018-01-04 Created: 2018-01-04 Last updated: 2018-03-13Bibliographically approved
Mamhidir, A.-G., Sjölund, B.-M., Fläckman, B., Wimo, A., Sköldunger, A. & Engström, M. (2017). Systematic pain assessment in nursing homes: a cluster-randomized trial using mixed-methods approach. BMC Geriatrics, 17, Article ID 61.
Open this publication in new window or tab >>Systematic pain assessment in nursing homes: a cluster-randomized trial using mixed-methods approach
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2017 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, article id 61Article in journal (Refereed) Published
Abstract [en]

Background

Chronic pain affects nursing home residents’ daily life. Pain assessment is central to adequate pain management. The overall aim was to investigate effects of a pain management intervention on nursing homes residents and to describe staffs’ experiences of the intervention.

Methods

A cluster-randomized trial and a mixed-methods approach. Randomized nursing home assignment to intervention or comparison group. The intervention group after theoretical and practical training sessions, performed systematic pain assessments using predominately observational scales with external and internal facilitators supporting the implementation. No measures were taken in the comparison group; pain management continued as before, but after the study corresponding training was provided. Resident data were collected baseline and at two follow-ups using validated scales and record reviews. Nurse group interviews were carried out twice. Primary outcome measures were wellbeing and proxy-measured pain. Secondary outcome measures were ADL-dependency and pain documentation.

Results

Using both non-parametric statistics on residential level and generalized estimating equation (GEE) models to take clustering effects into account, the results revealed non-significant interaction effects for the primary outcome measures, while for ADL-dependency using Katz-ADL there was a significant interaction effect. Comparison group (n = 66 residents) Katz-ADL values showed increased dependency over time, while the intervention group demonstrated no significant change over time (n = 98). In the intervention group, 13/44 residents showed decreased pain scores over the period, 14/44 had no pain score changes ≥ 30% in either direction measured with Doloplus-2. Furthermore, 17/44 residents showed increased pain scores ≥ 30% over time, indicating pain/risk for pain; 8 identified at the first assessment and 9 were new, i.e. developed pain over time. No significant changes in the use of drugs was found in any of the groups. Nursing pain related documentation was sparse. In general, nurses from the outset were positive regarding pain assessments. Persisting positive attitudes seemed strengthened by continued assessment experiences and perceptions of improved pain management.

Conclusion

The implementation of a systematic work approach to pain issues in nursing homes indicates that an increased awareness, collaboration across and shared understanding among the team members of the pain assessment results can improve pain management and lead to decreased physical deterioration or the maintenance of physical and functional abilities among NH residents. However, pain (proxy-measured) and wellbeing level did not reveal any interaction effects between the groups over time.

Trial registration

The study was registered in ISRCTN71142240 in September 2012, retrospectively registered.

Keywords
pain assessment, pain intervention, nursing homes, cluster-randomized trial, mixed-methods
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-23724 (URN)10.1186/s12877-017-0454-z (DOI)000397457500001 ()28241785 (PubMedID)2-s2.0-85021856753 (Scopus ID)
Projects
Smärta hos äldre med eller utan kognitiv nedsättning
Funder
The Dementia Association - The National Association for the Rights of the Demented
Note

Funding agencies:

University of Gavle, Sweden  

Swedish Alzheimer's Foundation  

Available from: 2017-03-07 Created: 2017-03-07 Last updated: 2018-03-13Bibliographically approved
Skytt, B., Engström, M., Mårtensson, G. & Mamhidir, A.-G. (2016). A longitudinal qualitative study of health care personnel’s perceptions of simultaneous implementation of three risk assessment scales on falls, malnutrition and pressure ulcers. Journal of Clinical Nursing, 25(13/14), 1912-1922
Open this publication in new window or tab >>A longitudinal qualitative study of health care personnel’s perceptions of simultaneous implementation of three risk assessment scales on falls, malnutrition and pressure ulcers
2016 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 13/14, p. 1912-1922Article in journal (Refereed) Published
Abstract [en]

Aims and objectives

In this study, the aim was to understand health care personnel's expectations and experiences of participating in an intervention aimed at the implementation of three assessment scales for fall injuries, malnutrition and pressure ulcers, and the performance of preventive measures in these areas over the period of 18 months.

Background

Fall injuries, malnutrition and pressure ulcers among older people are challenging issues for caregivers at different levels in the health care system.

Design

A descriptive design with a qualitative approach was used to follow health care personnel before, during and after implementation of a care prevention intervention.

Methods

Twelve health care personnel with different professions at the hospital, primary care and municipal care levels participated in a preventive care introduction. Seminars were held at four occasions, with assignments to be completed between seminars. Lectures and group discussions were performed, and three risk assessment scales were introduced. The participants were interviewed before, during and after the introduction. Manifest and latent content analysis were used.

Results

The main results are presented in the theme ‘Patient needs are visualised through a gradually developed shared understanding’ and in five categories. The work approach of performing three risk assessments simultaneously was perceived as positive and central to ensuring quality of care; it was not, however, perceived as unproblematic.

Conclusion

The participants as well as health care team members showed a positive attitude towards and described the advantages of being given opportunities for shared understanding to improve patient safety and to provide structure for the provision of good care.

Relevance to clinical practice

The managerial approach of listening to and acting on issues stressed by health care personnel is important to ensure ongoing and future improvement initiatives.

Keywords
interview, older people, risk assessments
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-20912 (URN)10.1111/jocn.13207 (DOI)000377214300010 ()27075599 (PubMedID)2-s2.0-84963815368 (Scopus ID)
Available from: 2015-12-21 Created: 2015-12-21 Last updated: 2018-12-03Bibliographically approved
Sving, E., Högman, M., Mamhidir, A.-G. & Gunningberg, L. (2016). Getting evidence-based pressure ulcer prevention into practice: a multi-faceted unit-tailored intervention in a hospital setting. International Wound Journal, 13(5), 645-654
Open this publication in new window or tab >>Getting evidence-based pressure ulcer prevention into practice: a multi-faceted unit-tailored intervention in a hospital setting
2016 (English)In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 13, no 5, p. 645-654Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to evaluate whether a multi-faceted, unit-tailored intervention using evidenced-based pressure ulcer prevention affects (i) the performance of pressure ulcer prevention, (ii) the prevalence of pressure ulcers and (iii) knowledge and attitudes concerning pressure ulcer prevention among registered and assistant nurses. A quasi-experimental, clustered pre- and post-test design was used. Five units at a hospital setting were included. The intervention was based on the PARIHS framework and included a multi-professional team, training and repeated quality measurements. An established methodology was used to evaluate the prevalence and prevention of pressure ulcers. Nurses' knowledge and attitudes were evaluated using a validated questionnaire. A total of 506 patients were included, of whom 105 patients had a risk to develop pressure ulcer. More patients were provided pressure ulcer prevention care (P = 0·001) and more prevention care was given to each patient (P = 0·021) after the intervention. Corresponding results were shown in the group of patients assessed as being at risk for developing pressure ulcers. Nurses' knowledge about pressure ulcer prevention increased (P < 0·001). Positive attitudes towards pressure ulcer prevention remained high between pre- and post-test surveys. This multi-faceted unit-tailored intervention affected pressure ulcer prevention. Facilitation and repeated quality measurement together with constructed feedback of results seemed to be the most important factor for pressure ulcer prevention.

Keywords
Implementation, Nursing care, PARIHS, Pressure ulcer, Prevention
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hig:diva-17335 (URN)10.1111/iwj.12337 (DOI)000387667600060 ()25060416 (PubMedID)2-s2.0-84904713902 (Scopus ID)
Note

Funding agencies: Centre for Research & Development, Uppsala/County Council of Gavleborg;  Uppsala-Orebro Regional Research Council in Sweden 

Available from: 2014-08-11 Created: 2014-08-11 Last updated: 2018-03-13Bibliographically approved
Mårtensson, G., Löfmark, A., Mamhidir, A.-G. & Skytt, B. (2016). Preceptors' reflections on their educational role before and after a preceptor preparation course: a prospective qualitative study. Nurse Education in Practice, 19, 1-6
Open this publication in new window or tab >>Preceptors' reflections on their educational role before and after a preceptor preparation course: a prospective qualitative study
2016 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 19, p. 1-6Article in journal (Refereed) Published
Abstract [en]

During clinical practice, preceptors play an important educational role in helping nursing students become secure and effective practitioners. For this educational role they need adequate preparation. The aim of the present prospective study was to describe preceptors' experiences of their educational role before and after attending a university preceptor preparation course. This 7.5-credit, Master's level course is offered on a part-time basis and covers one semester. The theoretical approach was self-directed and reflective learning. Twentyseven preceptors participated in group interviews before and after the course, and data were analyzed using qualitative content analysis. The findings revealed a shift in preceptors' perceptions. Their view of the educational role changed from being characterized by individual experiences and notions to being guided by personal and formal demands. Before the course, the lack of sufficient preconditions for preceptorship predominated, whereas after the course participants described ways of creating such preconditions. Before the course, the supervisory process was described as teaching, whereas after the course it was described as a learning process for students. Using reflective learning in a preceptor preparation course can develop and strengthen preceptors' view of their educational role and help them manage and create the preconditions for preceptorship.

Keywords
Preceptor, Educational role, Preceptor preparation course
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-21356 (URN)10.1016/j.nepr.2016.03.011 (DOI)000381650700001 ()27428684 (PubMedID)2-s2.0-84963706427 (Scopus ID)
Available from: 2016-03-29 Created: 2016-03-29 Last updated: 2018-03-13Bibliographically approved
Hedman, M., Pöder, U., Mamhidir, A.-G., Nilsson, A., Kristofferzon, M.-L. & Häggström, E. (2015). Life memories and the ability to act: the meaning of autonomy and participation for older people when living with chronic illness. Scandinavian Journal of Caring Sciences, 29(4), 824-833
Open this publication in new window or tab >>Life memories and the ability to act: the meaning of autonomy and participation for older people when living with chronic illness
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2015 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 824-833Article in journal (Refereed) Published
Abstract [en]

There is a lack of knowledge about how older people living with chronic illness describe the meaning of autonomy and participation, indicating a risk for reduced autonomy and participation in their everyday life. The purpose of this study was to describe the meaning of autonomy and participation among older people living with chronic illness in accordance with their lived experience. The design was descriptive with a phenomenological approach guided by Giorgi's descriptive phenomenological psychological method. Purposive sampling was used, and 16 older people living with chronic illness who lived in an ordinary home participated in individual interviews. The findings showed that the meaning of autonomy and participation among the older people emerged when it was challenged and evoked emotional considerations of the lived experience of having a chronic illness. It involved living a life apart, yet still being someone who is able, trustworthy and given responsibility – still being seen and acknowledged. The meaning of autonomy and participation was derived through life memories and used by the older people in everyday life for adjustment or adaption to the present life and the future. Our conclusion is that autonomy and participation were considered in relation to older people's life memories in the past, in their present situation and also their future wishes. Ability or disability is of less importance than the meaning of everyday life among older people. We suggest using fewer labels for limitations in everyday life when caring for older people and more use of the phrase ‘ability to act’ in different ways, based on older people's descriptions of the meaning of autonomy and participation.

Keywords
older people, chronic illness, autonomy, participation, independence, life memories, decision-making, ability to act, disability, phenomenology
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-18650 (URN)10.1111/scs.12215 (DOI)000368345900024 ()25856656 (PubMedID)2-s2.0-84958874374 (Scopus ID)
Projects
Äldres autonomi och delaktighet; Att leva med långvarig ohälsa (LVO-CopQoL)
Available from: 2014-12-29 Created: 2014-12-29 Last updated: 2018-06-05Bibliographically approved
Gunningberg, L., Mårtensson, G., Mamhidir, A.-G., Florin, J., Muntlin Athlin, Å. & Bååth, C. (2015). Pressure ulcer knowledge of registered nurses, assistant nurses and student nurses: a descriptive, comparative multicentre study in Sweden. International Wound Journal, 12(4), 462-468
Open this publication in new window or tab >>Pressure ulcer knowledge of registered nurses, assistant nurses and student nurses: a descriptive, comparative multicentre study in Sweden
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2015 (English)In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 12, no 4, p. 462-468Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to describe and compare the knowledge of registered nurses (RNs), assistant nurses (ANs) and student nurses (SNs) about preventing pressure ulcers (PUs). PU prevention behaviours in the clinical practice of RNs and ANs were also explored. A descriptive, comparative multicentre study was performed. Hospital wards and universities from four Swedish county councils participated. In total, 415 participants (RN, AN and SN) completed the Pressure Ulcer Knowledge Assessment Tool. The mean knowledge score for the sample was 58·9%. The highest scores were found in the themes ‘nutrition’ (83·1%) and ‘risk assessment’ (75·7%). The lowest scores were found in the themes ‘reduction in the amount of pressure and shear’ (47·5%) and ‘classification and observation’ (55·5%). RNs and SNs had higher scores than ANs on ‘aetiology and causes’. SNs had higher scores than RNs and ANs on 'nutrition'. It has been concluded that there is a knowledge deficit in PU prevention among nursing staff in Sweden. A major educational campaign needs to be undertaken both in hospital settings and in nursing education.

Keywords
Hospital, Knowledge, Nurse, Pressure ulcer, Student nurse
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-14991 (URN)10.1111/iwj.12138 (DOI)000357520400016 ()23919728 (PubMedID)2-s2.0-84942552056 (Scopus ID)
Projects
Pressure Ulcer Prevention (PUP)
Available from: 2013-08-12 Created: 2013-08-12 Last updated: 2018-03-13Bibliographically approved
diva2:689543
Open this publication in new window or tab >>Nursing preceptors' experiences of two clinical education models
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2014 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 14, no 4, p. 427-433Article in journal (Refereed) Published
Abstract [en]

Preceptors play an important role in the process of developing students' knowledge and skills. There is an ongoing search for the best learning and teaching models in clinical education. Little is known about preceptors' perspectives on different models. The aim of the study was to describe nursing preceptors' experiences of two clinical models of clinical education: peer learning and traditional supervision. A descriptive design and qualitative approach was used. Eighteen preceptors from surgical and medical departments at two hospitals were interviewed, ten representing peer learning (student work in pairs) and eight traditional supervision (one student follows a nurse during a shift). The findings showed that preceptors using peer learning created room for students to assume responsibility for their own learning, challenged students' knowledge by refraining from stepping in and encouraged critical thinking. Using traditional supervision, the preceptors' individual ambitions influenced the preceptorship and their own knowledge was empathized as being important to impart. They demonstrated, observed and gradually relinquished responsibility to the students. The choice of clinical education model is important. Peer learning seemed to create learning environments that integrate clinical and academic skills. Investigation of pedagogical models in clinical education should be of major concern to managers and preceptors.

Keywords
Clinical education, nurses, peer learning, traditional supervision
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-16119 (URN)10.1016/j.nepr.2014.01.010 (DOI)000349568200019 ()2-s2.0-84933044982 (Scopus ID)
Projects
VFU
Available from: 2014-01-21 Created: 2014-01-21 Last updated: 2018-03-13Bibliographically approved
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