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Lindberg, Maria
Publications (10 of 12) Show all publications
Lindberg, M., Carlsson, M., Engström, M., Kristofferzon, M.-L. & Skytt, B. (2019). Nursing student's expectations for their future profession and motivating factors - a longitudinal descriptive study from Sweden. Nurse Education Today
Open this publication in new window or tab >>Nursing student's expectations for their future profession and motivating factors - a longitudinal descriptive study from Sweden
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2019 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793Article in journal (Refereed) Accepted
Place, publisher, year, edition, pages
Elsevier, 2019
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-30703 (URN)
Available from: 2019-09-27 Created: 2019-09-27 Last updated: 2019-09-30Bibliographically approved
Wijk, K., Åberg Jönsson, F. & Lindberg, M. (2019). Perceived enabling factors and barriers for the implementation of improvements in health care in order to achieve patient-centred care: A case report from Sweden. Paper presented at 2019/09/05. Journal of Evaluation In Clinical Practice
Open this publication in new window or tab >>Perceived enabling factors and barriers for the implementation of improvements in health care in order to achieve patient-centred care: A case report from Sweden
2019 (English)In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753Article in journal (Refereed) Epub ahead of print
Abstract [en]

Abstract Rationale, aim, and objectives More knowledge is needed regarding the complex factors and perceptions that enable the implementation of change in health care. The study aimed to examine the enabling factors and barriers encountered in the implementation of improvements in health care in order to achieve patient-centred care (PCC) and to study if there was a correlation in the extent the improvements were perceived to be implemented and the preconditions that were considered to affect them. Methods Using a mixed method design, data were gathered via a questionnaire and individual interviews with health care personnel, clinic managers, and first-line managers. The data collection and analyses were based on the framework for Promoting Action on Research Implementation in Health Services (PARiHS). Correlations between PCC improvements and preconditions for improvements were performed. Results A high level of involvement, knowledge, and adequate resources were considered important to achieve an implementation of PCC with joint responsibility. Leadership and management need to be explicit and promote continuous follow-up and feedback. Preconditions for improvement had a linear correlation with the perceived level of implementation. Knowledge-related preconditions had greatest impact on implementation. Conclusions The PARiHS framework was appropriate to use since the three components of evidence, context, and facilitation present different important preconditions in the implementation process. Evidence was the highest rated contributor since evidence-based practices in health care are necessary. It is vital that the important role of the context and facilitators is acknowledged in the implementation process to enable a successful implementation of change. There is a need to incorporate a clear strategy involving all levels in the organization. Furthermore, leaders play an important role in the implementation by facilitating communication and support and by having trust in facilitators and health care personnel. The results are applicable to other interventions implementing change in health care.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
health care, implementation, improvements, PARiHS, patient-centred care
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-30629 (URN)10.1111/jep.13272 (DOI)31475435 (PubMedID)2-s2.0-85071485440 (Scopus ID)
Conference
2019/09/05
Note

Funding: Region Gävleborg

Available from: 2019-09-05 Created: 2019-09-05 Last updated: 2019-10-04Bibliographically approved
Wijk, K., Åberg Jönsson, F. & Lindberg, M. (2019). Perceived enabling factors and barriers for the implementation of improvements in health care in order to achieve patient‐centred care: A case report from Sweden. Journal of Evaluation In Clinical Practice
Open this publication in new window or tab >>Perceived enabling factors and barriers for the implementation of improvements in health care in order to achieve patient‐centred care: A case report from Sweden
2019 (English)In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753Article in journal (Refereed) Epub ahead of print
Abstract [en]

Rationale, aim, and objectives

More knowledge is needed regarding the complex factors and perceptions that enable the implementation of change in health care. The study aimed to examine the enabling factors and barriers encountered in the implementation of improvements in health care in order to achieve patient‐centred care (PCC) and to study if there was a correlation in the extent the improvements were perceived to be implemented and the preconditions that were considered to affect them.

Methods

Using a mixed method design, data were gathered via a questionnaire and individual interviews with health care personnel, clinic managers, and first‐line managers. The data collection and analyses were based on the framework for Promoting Action on Research Implementation in Health Services (PARiHS). Correlations between PCC improvements and preconditions for improvements were performed.

Results

A high level of involvement, knowledge, and adequate resources were considered important to achieve an implementation of PCC with joint responsibility. Leadership and management need to be explicit and promote continuous follow‐up and feedback. Preconditions for improvement had a linear correlation with the perceived level of implementation. Knowledge‐related preconditions had greatest impact on implementation.

Conclusions

The PARiHS framework was appropriate to use since the three components of evidence, context, and facilitation present different important preconditions in the implementation process. Evidence was the highest rated contributor since evidence‐based practices in health care are necessary. It is vital that the important role of the context and facilitators is acknowledged in the implementation process to enable a successful implementation of change. There is a need to incorporate a clear strategy involving all levels in the organization. Furthermore, leaders play an important role in the implementation by facilitating communication and support and by having trust in facilitators and health care personnel. The results are applicable to other interventions implementing change in health care.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-30762 (URN)10.1111/jep.13272 (DOI)000484718900001 ()
Note

Funding: Region Gävleborg

Available from: 2019-10-09 Created: 2019-10-09 Last updated: 2019-10-09Bibliographically approved
Lindberg, M., Skytt, B., Wågström, B.-M., Arvidsson, L. & Lindberg, M. (2018). Risk behaviours for organism transmission in daily care activities: a longitudinal observational case study. Journal of Hospital Infection, 100(3), e146-e150
Open this publication in new window or tab >>Risk behaviours for organism transmission in daily care activities: a longitudinal observational case study
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2018 (English)In: Journal of Hospital Infection, ISSN 0195-6701, E-ISSN 1532-2939, Vol. 100, no 3, p. e146-e150Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: To understand healthcare personnel's infection prevention behaviour has long been viewed as a key factor in preventing healthcare-associated infections. Suboptimal hand hygiene compliance and handling of materials, equipment and surfaces present the main risks for potential organism transmission. Further exploration is needed regarding the role of context-specific conditions and the infection prevention behaviours of healthcare personnel. Such knowledge could enable the development of new intervention strategies for modifying behaviour.

AIM: To describe risk behaviours for organism transmission in daily care activities over time.

METHODS: Unstructured observations of healthcare personnel carrying out patient related activities were performed on 12 occasions over a period of 18 months.

FINDINGS: Risk behaviours for organism transmission occur frequently in daily care activities and the results shows that the occurrence is somewhat stable over time. Interruptions in care activities contribute to an increased risk for organism transmission that could lead to subsequent healthcare-associated infection.

CONCLUSION: Interventions aimed at reducing the risks of healthcare-associated infections need to focus on strategies that address: hand hygiene compliance; the handling of materials, equipment, work clothes and surfaces; as well as the effects of interruptions in care activities if they are to alter healthcare personnel's infection prevention behaviour sufficiently.

Keywords
Hand hygiene, Healthcare-associated infections, Hygiene, Infection control, Interruptions, Observation of practice
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:hig:diva-27851 (URN)10.1016/j.jhin.2018.07.041 (DOI)000448006000024 ()30081148 (PubMedID)2-s2.0-85054148028 (Scopus ID)
Available from: 2018-09-05 Created: 2018-09-05 Last updated: 2019-10-11Bibliographically approved
Lindberg, M., Carlsson, M. & Skytt, B. (2014). MRSA-colonized persons’ and healthcare personnel's experiences of patient-professional interactions in and responsibilities for infection prevention in Sweden. Journal of Infection and Public Health, 7(5), 427-435
Open this publication in new window or tab >>MRSA-colonized persons’ and healthcare personnel's experiences of patient-professional interactions in and responsibilities for infection prevention in Sweden
2014 (English)In: Journal of Infection and Public Health, ISSN 1876-0341, Vol. 7, no 5, p. 427-435Article in journal (Refereed) Published
Abstract [en]

Background: Patient-professional interactions and adherence to infection control measures are central to the quality of care and patient safety in healthcare. Persons colonized with methicillin-resistant Staphylococcus aureus (MRSA) describe insufficient support and unprofessional behavior among healthcare personnel. Methods: A descriptive qualitative study was conducted to investigate managers', physicians', registered nurses' and MRSA-colonized persons' experiences of patient-professional interactions in relation to and responsibilities for infection prevention in the care of colonized patients. Five persons with MRSA colonization and 20 healthcare personnel employed within infection, hematology, nephrology or primary healthcare settings participated. The data were collected using open-ended semi-structured individual interviews with the MRSA-colonized persons and semi-structured focus group interviews with the healthcare personnel. Results: The participants perceived MRSA as an indefinable threat and described that the responsibility for infection prevention is important, but such adherence was a neglected and negotiable issue. The described actions that were acknowledged as unprofessional and inappropriate adherence to infection prevention resulted in stigmatized patients. Conclusion: Colonized persons' and healthcare personnel's understanding of MRSA determines whether the personnel's behavior is perceived as proper or improper. Individual responsibility for patient-professional interactions in relation to MRSA colonization and adherence to infection control measures should be more stringent.

Keywords
Infection prevention, MRSA, Patient-professional interaction, Responsibility
National Category
Nursing Infectious Medicine
Identifiers
urn:nbn:se:hig:diva-18433 (URN)10.1016/j.jiph.2014.02.004 (DOI)000354964000009 ()24888790 (PubMedID)2-s2.0-84926247521 (Scopus ID)
Available from: 2014-12-10 Created: 2014-12-10 Last updated: 2018-03-13Bibliographically approved
Lindberg, M., Bäckström-Andersson, H., Lindström, R. & Lindberg, M. (2013). Dry weight from the haemodialysis patient perspective. Renal Society of Australasia Journal, 9(2), 68-73
Open this publication in new window or tab >>Dry weight from the haemodialysis patient perspective
2013 (English)In: Renal Society of Australasia Journal, ISSN 1832-3804, Vol. 9, no 2, p. 68-73Article, review/survey (Refereed) Published
Abstract [en]

Background:The concept of dry weight is central to fluid control in patients on haemodialysis (HD). Few studies have explored the concept from the patient perspective. Thus, the aim of the present study was to explore how patients on HD perceive the concept of dry weight and how they act in relation to it.

Methods:A purposive sample of 10 HD patients was interviewed once during a dialysis session in May–June 2009. The narratives were analysed using manifest qualitative content analysis.

Findings: The findings indicated that the concept was regarded as either an aid to securing treatment-related health, as indicating the fluid surplus volume or as a reminder of the daily fluid allotment. Some informants, however, did not report any specific perception. Plans for dealing with the perceptions were expressed in terms of using self-care strategies to control fluid balance, transferring responsibility to the HD team, and managing the physical consequences or social and psychological concerns.

Conclusion: Four ways in which HD patients perceived the dry weight concept were demonstrated. It is important that HD patients understand the significance of dry weight, both for their own wellbeing and for treatment adequacy. Prevalent misunderstandings about the dry weight concept have to be addressed by the dialysis team in order to prevent further suffering. By acknowledging the patient’s perspective of the dry weight concept, the dialysis team could help the patient to successfully develop self-care strategies for dealing with the consequences of chronic renal failure.

Keywords
Dry weight, haemodialysis, qualitative content analysis, renal nursing, water-electrolyte balance
National Category
Nursing Urology and Nephrology
Identifiers
urn:nbn:se:hig:diva-15891 (URN)2-s2.0-84901410410 (Scopus ID)
Available from: 2013-12-16 Created: 2013-12-16 Last updated: 2018-03-13Bibliographically approved
Lindberg, M. & Lindberg, M. (2012). Haemodialysis nurses knowledge about methicillin-resistant Staphylococcus aureus. Journal of renal care, 38(2), 82-85
Open this publication in new window or tab >>Haemodialysis nurses knowledge about methicillin-resistant Staphylococcus aureus
2012 (English)In: Journal of renal care, ISSN 1755-6686, Vol. 38, no 2, p. 82-85Article in journal (Refereed) Published
Abstract [en]

Healthcare workers may lack knowledge about antibiotic-resistant bacteria and thereby increase the spread of such organisms. The aim of the present study was to describe the relationship between self-rated knowledge and actual knowledge about methicillin-resistant Staphylococcus aureus (MRSA) among 326 Swedish haemodialysis nurses. Data were collected through a postal questionnaire. The findings suggest that ongoing education about MRSA should be provided to haemodialysis nurses, but also that standardised evaluation of adequate knowledge, skills and competencies' regarding safe practices is warranted. Future research should focus on effective mechanisms to ensure that haemodialysis nurses provide safe MRSA care.

National Category
Nursing Infectious Medicine
Identifiers
urn:nbn:se:hig:diva-12634 (URN)10.1111/j.1755-6686.2011.00215.x (DOI)22085397 (PubMedID)
Available from: 2012-08-21 Created: 2012-08-21 Last updated: 2018-03-13Bibliographically approved
Lindberg, M. (2012). Methicillin-resistant Staphylococcus aureus (MRSA) an Unclear and Untoward Issue: Patient-Professional Interactions, Experiences, Attitudes and Responsibility. (Doctoral dissertation). Uppsala: Acta Universitatis Upsaliensis
Open this publication in new window or tab >>Methicillin-resistant Staphylococcus aureus (MRSA) an Unclear and Untoward Issue: Patient-Professional Interactions, Experiences, Attitudes and Responsibility
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of the present thesis was to investigate experiences of living with multidrug-resistant bacteria (MDRB), using methicillin-resistant Staphylococcus aureus (MRSA) colonization as an illustration, and to develop and validate a tool to describe healthcare personnel’s attitudes towards patients with MDRB. A further objective was to study MRSA-colonized persons’ and healthcare personnel’s experiences of patient-professional interactions and responsibilities for infection prevention.

Four empirical studies were conducted. A total of 18 MRSA-colonized persons and 20 healthcare personnel were interviewed regarding their experiences, and a total of 726 RNs responded the MDRB Attitude Questionnaire.

The findings revealed the difficulties associated with living with MRSA colonization, which was described as something uncertain, and as an indefinable threat that has to be managed in both everyday life and in contacts with healthcare. Interactions with healthcare personnel were described as unprofessional owing to personnel’s inappropriate behaviour and insufficient information provision. According to the personnel, achieving adequate patient-professional interactions required having knowledge and experiences of MRSA. They also experienced difficulties in providing tailored information to patients. The MRSA-colonized persons described their unwanted responsibility to inform healthcare personnel about the colonization, but also felt responsible for limiting the spread of infection to others. Furthermore, responsibility for infection control was regarded as shared between healthcare personnel and patients. The personnel described such responsibility as a natural part of their daily work, although it was not always easy to adhere to hygiene precautions. The MRSA-colonized persons felt that healthcare personnel have insufficient knowledge of the bacteria and of hygiene precautions. The MDRB Attitude Questionnaire showed that registered nurses do have knowledge deficiencies. The MDRB Attitude Questionnaire has adequate psychometric properties.

In conclusion, MRSA colonization constitutes a psychological strain for carriers, and interactions with healthcare personnel resulted in feelings of stigmatization. The present thesis indicates that there is a need to improve healthcare personnel’s knowledge, behaviour and emotional response in relation to patients with MDRB, in order to ensure patient safety and address patients’ needs. The heads of department is responsible for such improvements, and the MDRB Attitude Questionnaire is useful in identifying areas in need for improvement.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. p. 74
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 741
Keywords
Attitudes of health personnel, colonization, hygiene, infection control, mixed-methods approach, MRSA, nursing care, patient-professional interaction, quality of healthcare, responsibility, The MDRB Attitude Questionnaire
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-18925 (URN)978-91-554-8273-2 (ISBN)
Public defence
2012-03-27, Universitetshuset, sal IX, Biskopsgatan 3, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2015-02-05 Created: 2015-02-04 Last updated: 2018-03-13Bibliographically approved
Lindberg, M., Skytt, B., Högman, M. & Carlsson, M. (2012). The Multidrug-Resistant Bacteria Attitude Questionnaire: validity and understanding of responsibility for infection control in Swedish registered district, haematology and infection nurses. Journal of Clinical Nursing, 21(3-4), 424-436
Open this publication in new window or tab >>The Multidrug-Resistant Bacteria Attitude Questionnaire: validity and understanding of responsibility for infection control in Swedish registered district, haematology and infection nurses
2012 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 3-4, p. 424-436Article in journal (Refereed) Published
Abstract [en]

Aim. To assess the discriminative and construct validity of the Multidrug-Resistant Bacteria Attitude Questionnaire and to study registered nurses knowledge of, behaviour toward and emotional responses to patients with multidrug-resistant bacteria in relation to how they understand their own, managers and politicians responsibility for adherence to preventive measures for infection control. Background. Multidrug-resistant organisms are a global problem and an essential topic in healthcare regarding patient safety improvement. Design. Descriptive and correlational cross-sectional survey. Method. Data were collected in a non-random sample consisting of 397 registered nurses; district, haematology or infection registered nurses. One-way analysis of variance and independent t-tests were used for comparisons and a principal component analysis was performed. Results. Discriminative and construct validity were supported, as the infection registered nurses generally had higher scores on knowledge, behaviour and emotional response, compared with district registered nurses and haematology registered nurses and the three-factor solution was confirmed. Registered nurses with higher scores on knowledge and emotional response attributed greater responsibility to themselves and to politicians. The Multidrug-Resistant Bacteria Attitude Questionnaire was translated using a forward-back translation process. Conclusion. The questionnaire has adequate psychometric properties. Insufficient knowledge of, behaviour toward and emotional response to patients with multidrug-resistant bacteria were described, but the registered nurses did estimate their own responsibility for adherence to preventive measures for infection control as being great or very great. Relevance to clinical practice. There is a considerable need to improve knowledge, behaviour and emotional response regarding infection prevention measures among healthcare workers. The hospital management are responsible for such improvements and the Multidrug-Resistant Bacteria Attitude Questionnaire is useful in identifying such needs, as it has adequate psychometric properties and is able to discriminate between groups. Evaluation among healthcare workers may indicate where to situate additional training, as this is of clinical significance for safe care.

National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-10038 (URN)10.1111/j.1365-2702.2011.03914.x (DOI)000298793400015 ()22150887 (PubMedID)2-s2.0-84855352106 (Scopus ID)
Available from: 2011-09-06 Created: 2011-09-06 Last updated: 2018-03-13Bibliographically approved
Lindberg, M., Lindberg, M., Skytt, B., Högman, M. & Carlsson, M. (2011). Attitudes toward patients with multidrug-resistant bacteria: scale development and psychometric evaluation. Journal of Infection Prevention, 12(5), 196-203
Open this publication in new window or tab >>Attitudes toward patients with multidrug-resistant bacteria: scale development and psychometric evaluation
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2011 (English)In: Journal of Infection Prevention, ISSN 1757-1782, Vol. 12, no 5, p. 196-203Article in journal (Refereed) Published
Abstract [en]

There is a need for validated assessment tools for measuring attitudes towards patients with multidrug- resistant bacteria. Such an assessment tool was developed and psychometrically evaluated in the present study. A literature review and discussions with experts and key informants were used to develop the questionnaire. To ensure item adequacy and interpretability, face validity and pre-tests were performed. Item validity, content validity and internal consistency reliability were evaluated in a non-random sample of 329 hemodialysis nurses. The psychometric properties were satisfactory, indicating good item validity. The content validity revealed three appropriate factors with good internal consistency reliability. The haemodialysis nurses’ knowledge about multidrug-resistant bacteria was not suf. cient, and their intentional behaviour was unsatisfactory with respect to infection control precautions. The multidrug-resistant bacteria Attitude Questionnaire would be a valuable tool, in nursing practice and nursing education, in promoting quality improvements in patient safety with regard to healthcare associated infections.

National Category
Nursing Infectious Medicine
Identifiers
urn:nbn:se:hig:diva-10037 (URN)10.1177/1757177411411122 (DOI)2-s2.0-80053104580 (Scopus ID)
Available from: 2011-09-06 Created: 2011-09-06 Last updated: 2018-03-13Bibliographically approved
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