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Introducing the Attending Nurse Caring Model of Jean Watson into primary health care in Sweden. A feasibility study
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.ORCID iD: 0000-0001-7804-5266
(English)Manuscript (preprint) (Other academic)
National Category
Health Sciences
Research subject
Health-Promoting Work
Identifiers
URN: urn:nbn:se:hig:diva-35401OAI: oai:DiVA.org:hig-35401DiVA, id: diva2:1535257
Available from: 2021-03-08 Created: 2021-03-08 Last updated: 2021-03-08Bibliographically approved
In thesis
1. Aspects of Health Promotion Practice in Swedish primary healthcare: Perspectives from staff and patients related to working conditions of district nurses and lifestyle habit management in patients with risk factors for cardiovascular disease
Open this publication in new window or tab >>Aspects of Health Promotion Practice in Swedish primary healthcare: Perspectives from staff and patients related to working conditions of district nurses and lifestyle habit management in patients with risk factors for cardiovascular disease
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of present thesis was to generate knowledge about aspects of Health Promotion Practice (HPP) related to district nurses’ working conditions and their professional patient-related work. Further, the aim was to study lifestyle habit management and experiences of caring encounters in patients with risk factors of developing CVD. Various approaches of both a qualitative and quantitative nature were used. In Study I, data were collected by interviews to describe district nurses ׳ experiences of working with health promotion actions among patients with risk factors for cardiovascular disease (CVD). Study II was performed as a pilot using an intervention consisting of Motivational Interviewing (MI) and Physical Activity on Prescription (PAP), aiming to investigate exercise levels in patients. Study III was a feasibility study using an intervention of the “Attending Nurse Caring Model” (ANCM) among district nurses, to describe working life and working health. In Study IV, interviews were performed to describe patients’ experiences of the caring encounter between district nurses and patients. From the district nurses’ perspective, HPP was viewed as the essence of their work but organizational structures in primary healthcare were regarded as obstacles that complicated the prioritization of HPP, and their reports of dissatisfaction and stress due to not being able to complete their HPP were also a distinguishing feature (Study I). MI and PAP were piloted and studied concerning the impact on patients suffering from risk factors for CVD. This resulted in improvements in various health variables, both physical and psychosocial, among the patients studied (Study II). The feasibility of the ANCM was studied concerning district nurses’ own experiences of stress, burnout, empathy, and self-care in connection with work. Improvements were observed in all variables and indicated increased awareness of their patterns of action in their work (Study III). Moreover, the ANCM feasibility study also showed a strengthening in the caring encounter between patients and district nurses (Study IV). A theory-guided nursing practice consisting of elements that strengthened reflection activities of self-care and self-awareness in the district nurses was regarded as a valuable addition to a health-promoting working life as well as beneficial to their patients.   

Abstract [sv]

Det övergripande syftet med avhandlingen var att generera kunskap om aspekter av hälsofrämjande arbete relaterade till distriktssköterskors arbetsförhållanden och deras patientrelaterade arbete. Syftet var vidare att studera hantering av livsstilsförändringar och erfarenheter av vårdmöten bland patienter med riskfaktorer för hjärt-kärlsjukdom. Olika metoder av både kvalitativ och kvantitativ karaktär användes. I studie I samlades data in genom intervjuer för att beskriva distriktssköterskors erfarenheter av att arbeta med hälsofrämjande åtgärder bland patienter med riskfaktorer för hjärt-kärlsjukdom. Studie II utfördes som en pilotstudie med en intervention bestående av Motiverande samtal (MI) och Fysisk aktivitet på Recept (FaR), i syfte att undersöka aktivitetsnivåer hos patienter. Studie III undersökte genomförbarheten av en relationsscentrerad vårdmodell ”Attending Nurse Caring Model” (ANCM) (bestående av komponenter för reflektion och egenvård) bland distriktssjuksköterskor för att beskriva deras arbetsliv och arbetshälsa. I Studie IV genomfördes intervjuer för att beskriva patienters upplevelser av vårdmötet mellan distriktssköterskor och patienter efter genomförandet av ANCM-interventionen. Ur distriktssköterskans perspektiv betraktades det hälsofrämjande arbetet som kärnan i deras arbete men struktur och kultur inom primärvårdsorganisationen utgjorde hinder som komplicerade prioriteringen av det hälsofrämjande arbetet. Att inte kunna genomföra sitt arbete på ett tillfredsställande vis skapade missnöje och stress (Studie I). Tillämpningen av MI och FaR resulterade i förbättringar i flera hälsovariabler, både fysiska och psykosociala, bland de studerade patienterna (Studie II). Interventionen av ANCM bland distriktssköterskor visade förbättringar i stress, utbrändhetssymtom, empati och egenvård. Erfarenheter visade också en ökad självmedvetenhet och en medvetenhet kring egna handlingsmönster i arbetet vilket på sikt kan förbättra arbetslivet och arbetshälsan (Studie III). Intervjuer med patienter gav en god beskrivning om vårdmötet mellan patient och distriktssköterska och antydde att ANCM haft positiv inverkan på patienternas livsstilsförändringar kopplade till kardiovaskulär risk (Studie IV). En teoridriven vårdverksamhet bestående av komponenter som stärker reflektionsaktiviteter för egenvård och självmedvetenhet hos personalen ansågs vara ett värdefullt tillskott till ett hälsofrämjande arbetsliv, men också värdefullt för dess klienter – patienterna.  

Place, publisher, year, edition, pages
Gävle: Gävle University Press, 2021. p. 59
Series
Doctoral thesis ; 20
Keywords
Cardiovascular disease, District nurse, Health Promotion, Intervention, Primary healthcare, The Theory of Human Caring, Distriktssköterska, Hjärt-kärlsjukdom, Hälsofrämjande, Intervention, Primärvård, The Theory of Human Caring
National Category
Health Sciences
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-35402 (URN)978-91-88145-65-9 (ISBN)978-91-88145-66-6 (ISBN)
Public defence
2021-05-07, Lilla Jadwigasalen (https://hig-se.zoom.us/j/61300450243), Kungsbäcksvägen 47, Gävle, 10:30 (Swedish)
Opponent
Supervisors
Available from: 2021-04-15 Created: 2021-03-08 Last updated: 2024-08-29Bibliographically approved

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Lundberg, Kristina

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