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  • 1.
    Arenhall, Eva
    et al.
    Örebro universitet.
    Kristofferzon, Marja-Leena
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap. Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala.
    Fridlund, Bengt
    Hälsohögskolan Jönköping.
    Nilsson, Ulrica
    Örebro universitet.
    The female partners' experiences of intimate relationship after a first myocardial infarction2011Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, nr 11-12, s. 1677-1684Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim.

    This study aimed to explore and describe women’s experience of intimate relationships in connection to and after their partner’s first myocardial infarction.

     

    Background.

    Support from partners is important for recovery, but little is known about partners’ experience of intimate relationships after myocardial infarction.

     

    Design.

    The study used an explorative, qualitative design.

     

    Methods.

    The first author interviewed 20 women having a partner who had suffered a first myocardial infarction during the preceding year. Qualitative content analysis was used to analyse the data.

     

    Findings.

    Three themes emerged: ‘limited life space’, ‘sense of life lost’ and ‘another dimension of life’. The women described how their self-assumed responsibility led to a more stifling and limited life. Their sense of life lost was described in terms of deficits and feeling the loss. The women also described experiencing another dimension of life characterised by three subthemes: ‘uncertainty of life’, ‘certain of relationship’ and ‘share life more’.

     

    Conclusions.

    The partners’ myocardial infarction had an impact on the interviewees’ intimate relationships; they suffered a major loss and missed their ‘former’ partner, both emotionally and sexually. They struggled with the new asymmetry in their intimate relationship and felt compelled to adapt to their partners’ lack of sexual desire or function. Also, their partner controlled them, which lead towards a stifling, more limited life space.

     

    Relevance to clinical practice.

    Caregivers in hospital and primary care settings could apply the findings in their efforts to help couples recover or maintain intimate relationships following myocardial infarction.

  • 2.
    Björn, Catrine
    et al.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden .
    Lindberg, Magnus
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Rissén, Dag
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden.
    Significant factors for work attractiveness and how these differ from the current work situation among operating department nurses2016Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, nr 1-2, s. 109-116Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim was to examine significant factors for work attractiveness and how these differ from the current work situation among operating department nurses. A second objective was to examine the associations between age, gender, length of employment, work engagement, work ability, self-rated health indicators and attractiveness of the current work situation.

    BACKGROUND: The attractiveness of work is rarely taken into account in research on nurse retention. To expand this knowledge, it is relevant to examine factors that make work attractive and their associations with related concepts.

    DESIGN: Correlational, cross-sectional survey using a convenience sample.

    METHODS: Questionnaires were answered by 147 nurses in four operating departments in Sweden. Correlation and regression analyses were conducted.

    RESULTS: The nurses rated the significance of all factors of work attractiveness higher than they rated those factors in their current work situation; salary, organisation and physical work environment had the largest differences. The most significant attractive factors were relationships, leadership and status. A statistically significant positive correlation between work engagement and attractive work was found. In the multiple regression model, the independent variables work engagement and older age significantly predicted work attractiveness.

    CONCLUSIONS: Several factors should be considered in the effort to increase work attractiveness in operating departments and thereby to encourage nurse retention. Positive aspects of work seem to unite work engagement and attractive work, while work ability and self-rated health indicators are other important dimensions in nurse retention.

    RELEVANCE TO CLINICAL PRACTICE: The great discrepancies between the significance of attractive factors and the current work situation in salary, organisation and physical work environment suggest ways in which work attractiveness may be increased. To discover exactly what needs to be improved may require a deeper look into the construct of the examined factors.

  • 3.
    Häggström, Elisabeth
    et al.
    Högskolan i Gävle, Institutionen för vårdvetenskap och sociologi, Ämnesavdelningen för vårdvetenskap.
    Engström, Maria
    Högskolan i Gävle, Institutionen för vårdvetenskap och sociologi, Ämnesavdelningen för vårdvetenskap.
    Wadensten, Barbro
    Högskolan i Gävle, Institutionen för vårdvetenskap och sociologi, Ämnesavdelningen för vårdvetenskap. Uppsala universitet.
    A nine-month intervention programme focusing on empowerment; caregivers' descriptions of changed behaviour and increased room for acting2009Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, nr 6, s. 866-873Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe public nursing home Enrolled Nurses' and Nurses Aides' view of their work and their perceptions of themselves in their professional role while they were receiving a serious of role awareness sessions focusing on empowerment for nine months. BACKGROUND: According to several studies, it is typical that women may experience problems and injustices at work. The main focus of the intervention was to help enrolled nurses' and nurses aides' in developing their self-image and professional role. DESIGN: This study was descriptive and qualitative in design. METHODS: The present study comprises semi-structured interviews conducted with enrolled nurses and nurses aides (n = 14) from public nursing homes at start of the intervention and again nine months following the intervention. The text from the interviews was analysed using latent content analysis. RESULTS: The main findings primarily show an improved professional role for the caregivers, as described in the following themes: the move from passivity to activity, the move from complaining to understanding, the move from expectations to frustration and the move from being silent to speaking loud. CONCLUSIONS: For caregivers working with older people within public nursing home care, it seems to be a good form of clinical supervision to implement a serious of role awareness sessions in order to improve their professional role. RELEVANCE TO CLINICAL PRACTICE: The findings showed that an intervention providing opportunities with focus on empowerment improved the enrolled nurses' and nurses aides' professional role in working with older people. This can be useful information for managers and educators and they may want to adapt it when working in a public nursing home.

  • 4.
    Häggström, Elisabeth
    et al.
    Högskolan i Gävle, Institutionen för vårdvetenskap och sociologi, Ämnesavdelningen för vårdvetenskap. Neurotec-Department, Karolinska Institutet, Stockholm, Sweden.
    Kihlgren, Annica
    Neurotec-Department, Karolinska Institutet, Stockholm, Sweden; Centre of Nursing Science, University Hospital, Örebro, Sweden.
    Mona, Kihlgren
    Neurotec-Department, Karolinska Institutet, Stockholm, Sweden; Centre of Nursing Science, University Hospital, Örebro, Sweden.
    Sörlie, Venke
    Centre of Nursing Science, University Hospital, Örebro, Sweden; Institute of Nursing and Health Sciences, University of Oslo, Oslo, Norway.
    Relatives' struggle for an improved and more just care for older people in community care2007Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, nr 9, s. 1749-1757Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims and objectives. The aim of the present study was to describe the relatives' experience concerning older family members living in special housing facilities. Background. During the 21st century, the relatives of older people and their efforts related to the care and nursing of older people have been observed. The interest in these relatives is because of factors such as demographic changes, where the number of older people has increased and the increasing gap between the resources that are available for geriatric care and the care needed for older people. Design. The present study has a descriptive design and is part of a project including 24 specific residences, called special housing facilities. Method. The study focused on the narratives supplied by the relatives that were analysed using qualitative latent content analysis, an interpretative process where the researcher considers the content of the text. Results. The relatives' experience of having an older person in a special housing facility that emerged from the study, was expressed in one main theme: The relatives' struggle for an improved and just care for older people and four sub-themes: (i)'To trust in caregivers'; (ii) 'To be confirmed'; (iii) 'To trust in care'; (iv) 'To receive the kind of care that one considers one has the right to receive'. Conclusions. The study shows that the relatives need more support and more opportunities, so that they can participate in the care. The study shows the relatives engagement in working for a just society's obligation towards the protection of older peoples rights and the staff's working conditions. Relevance to clinical practice. It is important that caregivers and management working with older people realize that they, together with them and their relatives, are a part of society and that all individuals are influenced by the discourse of that society.

  • 5.
    Häggström, Elisabeth
    et al.
    Högskolan i Gävle, Institutionen för vårdvetenskap och sociologi, Ämnesavdelningen för vårdvetenskap.
    Skovdahl, Kirsti
    Fläckman, Birgitta
    Högskolan i Gävle, Institutionen för vårdvetenskap och sociologi, Ämnesavdelningen för vårdvetenskap.
    Kihlgren, Annica
    Kihlgren, Mona
    Work satisfaction and dissatisfaction: caregivers’ experiences after a two-year intervention in a newly opened nursing home2005Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 14, nr 1, s. 9-19Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Work satisfaction and dissatisfaction – caregivers’ experiences after a two-year intervention in a newly opened nursing home Aims and objectives. The aim of the study was to investigate, from the narratives of nine enrolled nurses and one nurses’ aide directly involved in patient care, the deeper meaning of work satisfaction and dissatisfaction when working with the older people.

    Background. Both nationally and internationally, there is little research documented regarding the working situation of the enrolled nurses and nurses’ aides who make upthe majority of care for older people today. With this in mind, it is important to focus on how these occupational groups experience their work with the older residents in municipal care, following a two-year intervention.

    Design. The study is part of a larger longitudinal study, with a quasi-experimental design within the municipal system of care for older people in Sweden. The investigation was carried out following a two-year intervention, which included: education, support and clinical supervision.

    Method. The interviews were performed 12 and 24 months after start of the intervention and were analysed with a phenomenological–hermeneutic method inspired by Ricoeur’s philosophy.

    Results. The findings from these narratives illustrated a change compared with the findings from the first interviews, when the nursing home had just opened. There was a 2005 Blackwell Publishing Ltd 9 shift from a dominance of dissatisfaction with work, to a dominance of work satisfaction and this was expressed in the following themes: experience of a changed perspective, experience of open doors, and experience of closed doors. Each theme emerged from several different subthemes and each subtheme that had been expressed in the caregivers’ narratives was interpreted.

    Conclusions. The study shows that the caregivers’ experience of work satisfaction in the workplace exceeded their experience of dissatisfaction and that the intervention, consisting of: education, support, and supervision might have facilitated this positive development where the older residents were prioritized. It also shows that communication and understanding between management and staff had increased as the nursing home had opened.

    Relevance to clinical practice. The findings can be used to help to prevent work dissatisfaction, and thereby increase work satisfaction for caregivers working in nursing homes.

  • 6.
    Kristofferzon, Marja-Leena
    Högskolan i Gävle, Institutionen för vårdvetenskap och sociologi, Ämnesavdelningen för vårdvetenskap.
    Commentary on Kristofferzon M-L, Lofmark R & Carlsson M (2007) Striving for balance in daily life experiences of Swedish women and men shortly after a myocardial infarction. Journal of Clinical Nursing 16, 391-401 - Response2008Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, nr 8, s. 1106-1106Artikkel i tidsskrift (Fagfellevurdert)
  • 7.
    Kristofferzon, Marja-Leena
    et al.
    Högskolan i Gävle, Institutionen för vårdvetenskap och sociologi, Ämnesavdelningen för vårdvetenskap. Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Löfmark, Rurik
    Centre for Bioethics at Karolinska Institutet and Uppsala University, Solna, Sweden.
    Carlsson, Marianne
    Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Striving for balance in daily life: experiences of Swedish women and men shortly after myocardial infarction2007Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, nr 2, s. 391-401Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim is to describe experiences of daily life of women and men during the first four to six months after a myocardial infarction. The focus is on problems, managing problems and support from their network.

    Background: A cardiac event is traumatic and may influence well-being during a significant period of time. Few qualitative studies have investigated experiences of both women and men after a myocardial infarction and remarkably little research has been conducted on men’s experiences.

    Design: The study design was descriptive, retrospective and qualitative.

    Methods: Semi-structured interviews were conducted with 20 women and 19 men from January 2000 to November 2001. Data were analysed using qualitative content analysis.

    Results: Three themes were generated from the analysis; ‘Threatening ordinary life’, ‘Struggling for control’ and ‘The ambiguous network’. Physical symptoms and emotional distress were the most commonly described problems during the first months after a myocardial infarction. The informants manage the problems by negotiating with themselves, relying on their own capabilities, changing attitudes and behaviours and taking their own decisions and actions. The network was generally supportive but rather often the informants also experienced communication problems when they interacted with their network.

    Conclusions: Women and men strive for balance between problems and resources in daily life after a myocardial infarction. How well they succeeded depends on how secure they feel how well they communicate their needs to their network and how sensitive their network is to their spoken and unspoken needs.

    Relevance to clinical practice: The findings provide an insight into what kind of problems women and men may experience after myocardial infarction and how caregivers can aid them to increase security in their daily life. Some risk characteristics that may have increased their problems in daily life are suggested, for women and men respectively.

  • 8.
    Kvangarsnes, Marit
    et al.
    Aalesund University College, Aalesund, Norway.
    Torheim, Henny
    Aalesund University College, Aalesund, Norway.
    Hole, Torstein
    Medical Clinic, Helse Møre og Romsdal, Aalesund, Norway, og Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
    Öhlund, Lennart S
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Aalesund University College, Aalesund, Norway.
    Narratives of breathlessness in chronic obstructive pulmonary disease2013Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, nr 21-22, s. 3062-3070Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore patient perceptions of chronic obstructive pulmonary disease exacerbation and the patients' experiences of their relations with health personnel during care and treatment.

    BACKGROUND: Patients suffering from acute exacerbation of chronic obstructive pulmonary disease often experience life-threatening situations and undergo noninvasive positive-pressure ventilation via bi-level positive airway pressure in a hospital setting. Theory on trust, which often overlaps with the issue of power, can shed light on patient's experiences during an acute exacerbation.

    DESIGN: Narrative research design was chosen.

    METHODS: Ten in-depth qualitative interviews (n = 10) were conducted with patients who had been admitted to two intensive care units in Western Norway during the autumn of 2009 and the spring of 2010. Narrative analysis and theories on trust and power were used to analyse the interviews.

    RESULTS: Because of their breathlessness, the patients perceived that they were completely dependent on others during the acute phase. Some stated that they had experienced an altered perception of reality and had not understood how serious their situation was. Although the patients trusted the health personnel in helping them breathe, they also told stories about care deficiencies and situations in which they felt neglected.

    CONCLUSIONS: This study shows that patients with an acute exacerbation of chronic obstructive pulmonary disease often feel wholly dependent on health personnel during the exacerbation and, as a result, experience extreme vulnerability.

    RELEVANCE TO CLINICAL PRACTICE: The findings give nurses insight into building trust and a good relationship between patient and caregiver during an acute exacerbation of chronic obstructive lung disease.

  • 9.
    Lindberg, Magnus
    et al.
    Uppsala universitet.
    Wikström, Björn
    Uppsala universitet.
    Lindberg, Per
    Uppsala universitet.
    Subgroups of haemodialysis patients in relation to fluid intake restrictions: a cluster analytical approach.2010Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, nr 21-22, s. 2997-3005Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS: To determine whether definable subgroups exist in a sample of haemodialysis patients with regard to self-efficacy, attentional style and depressive symptomatology and to compare whether interdialytic weight gain varies between patients in groups with different cognitive profiles.

    BACKGROUND: Theory-based research suggests that cognitive factors (e.g. self-efficacy and attentional style) and depressive symptomatology undermine adherence to health protective regimens. Preventing negative outcomes of fluid overload is essential for haemodialysis patients but many patients cannot achieve fluid control, and nursing interventions aimed to help the patients reduce fluid intake are ineffective. Understanding the interaction between cognitive factors and how this is related to adherence outcomes might therefore lead to the development of helpful nursing interventions.

    DESIGN: Explorative cross-sectional multicentre survey.

    METHODS: The sample consisted of 133 haemodialysis patients. Data were collected using structured questionnaires. A brief self-report form and data on interdialytic weight gain was also used. Two-step cluster analysis was used to identify subgroups. One-way analysis of variance (anova) or Pearson's chi-square test was used for comparing subgroups.

    RESULTS: Three distinct subgroups were found and subsequently labelled: (1) low self-efficacy, (2) distraction and depressive symptoms and (3) high self-efficacy. The subgroups differed in fluid intake, but not in age, dialysis vintage, gender, residual urine output or in receiving any fluid intake advice.

    CONCLUSIONS: Clinically relevant subgroups of haemodialysis patients could be defined by their profiles regarding self-efficacy, attentional style and depressive symptoms.

    RELEVANCE TO CLINICAL PRACTICE: Based on this study, we would encourage clinical practitioners to take into account cognitive profiles while performing their work. This is especially important when a targeted nursing intervention, which aims to encourage and maintain the patient's fluid control, is introduced.

  • 10.
    Lindberg, Maria
    et al.
    Centre for Research and Development, Uppsala University/Country Council of Gävleborg.
    Skytt, Bernice
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap.
    Högman, Marieann
    Centre for Research and Development, Uppsala University/Country Council of Gävleborg.
    Carlsson, Marianne
    Department of Public Health and Caring Sciencies, Uppsla University.
    The Multidrug-Resistant Bacteria Attitude Questionnaire: validity and understanding of responsibility for infection control in Swedish registered district, haematology and infection nurses2012Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, nr 3-4, s. 424-436Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 11.
    Ludvigsen S, Mette
    et al.
    Department of Renal Medicine, Aarhus University Hospital.
    Hermansen M, Hanne
    Department of Renal Medicine, Aarhus University Hospital.
    Lindberg, Magnus
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala universitet; Gävle sjukhus.
    The quality of nursing care during intradialytic fluid removal in haemodialysis: time to change practice?2015Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, nr 11/12, s. 1733-1736Artikkel i tidsskrift (Fagfellevurdert)
  • 12.
    Mamhidir, Anna-Greta
    et al.
    Neurotec Department, Division of Gerontological Caring Science, Karolinska Institutet, Stockholm, Sweden.
    Karlsson, Ingvar
    Göteborg University, Institute of Neuroscienses, Section of Psychiatry, Mölndal Hospital, Mölndal, Sweden.
    Norberg, Astrid
    Department of Nursing, Umeå University, Umeå , Sweden.
    Kihlgren, Mona
    Neurotec Department, Division of Gerontological Caring Science, Karolinska Institutet, Stockholm, Sweden; Centre for Nursing Science, Örebro University Hospital, Örebro, Sweden.
    Weight increase in patients with dementia, and alteration in meal routines and meal environment after integrity promoting care2007Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, nr 5, s. 987-996Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS: To follow weight changes in patients with moderate and severe dementia and analyse how these changes related to biological and psychological parameters after staff education and support in integrity promoting care. A further aim was to describe meal environment and routines relative to the intervention. BACKGROUND: Weight loss in patients with dementia and in particular Alzheimer’s disease (AD) is common. The etiology appears multifactorial with the meal environment and a decreased independence while eating among the factors. METHOD: Over a three-month intervention period, an integrity-promoting care training program was conducted with the staff of a long-term ward. AD patients, 18 from an intervention ward and 15 from a control ward were included and possible effects were evaluated. Weighing was conducted at the start and after completion of the intervention. Weight changes were analyzed in relation to psychological and biochemical parameters. In addition, the staff wrote diaries about e.g. changes made in the environment and in their work.

    RESULTS: The most prominent difference observed was weight increases in 13 of 18 patients compared to two of 15 patients in the control ward. No weight changes were related to the type of dementia. The individual weight changes correlated significant to changes in the intellectual functions. Relationships between weight change, increased motor function and increased appetite were non-significant. There was no significant relationship between weight changes and changes in biochemical parameters. According to the staff, increased contact with the patients and a more pleasant atmosphere resulted when the meal environment and routines were changed. RELEVANCE TO CLINICAL PRACTICE: Weight gain in patients with moderate and severe dementia was achieved by adjusting the meal environment to the individual’s needs. Staff education was profitable, as increased competence seemed to promote individually adapted feeding situations. Ensuring good meal situations need to be given high priority.

  • 13.
    Olsen, Rose Mari
    et al.
    Faculty of Health and Science, Nord-Trøndelag University College, Namsos, Norway.
    Horntvedt Østnor, Bjørg
    Faculty of Nursing Education, Sør-Trøndelag University College, Trondheim.
    Enmarker, Ingela
    Faculty of Health and Science, Nord-Trøndelag University College, Namsos, Norway.
    Hellz�n, Per Ove
    Faculty of Health and Science, Nord-Trøndelag University College, Namsos, Norway.
    Barriers to information exchange during older patients' transfer: nurses' experiences2013Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, nr 19-20, s. 2964-2973Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Despite an increased focus on the need for cooperation between providers across health care organizations, researchers still report problems in the exchange of information between the hospitals and the health care systems in the municipalities. The aim of the present study was to investigate barriers that influence nurses' information exchange during elderly patients transfer across health care organizations, based on the experience of registered nurses within medical hospital unit and home health care. Methods and Materials: A qualitative approach was chosen in this study, and data were collected using focus group methodology. Three focus group interviews were conducted, interpreted and analysed through content analysis. Fourteen registered nurses, two men and twelve women, were recruited from two units at the general medical department at a hospital and the home health care agency affiliated with this hospital. Each focus group consisted of between three and six nurses who had direct experience in information management during elderly patient transfer. Results: Three preliminary main themes were formed to describe barriers that influence nurses' information exchange during elderly patients transfer between hospital and home health care. These themes were: organizational factors, interpersonal factors, and personal factors. These themes included several sub-themes. Conclusion: The findings in this study highlight the challenges nurses encounter in ensuring successful information exchange and continuity of care during the elderly patients' transfer through the health care system. Recognition of these barriers that affect nurses exchange of information is important to meet to ensure patient safety and successful transitions from hospital to home care. In order for nurses to conduct a successful exchange of information, it is critical that hospital and home health care facilitate this through adequate resources, clear mission and responsibilities, and understandable policies.

  • 14.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Using focused ethnography to explore and describe the process of nurses' shift reports in a psychiatric intensive care unit2018Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, nr 15-16, s. 3104-3114Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore and describe the cultural routine of shift reports among nursing staff in a psychiatric intensive care unit, and further to develop a taxonomic, thematic and theoretical understanding of the process.

    BACKGROUND: Lack of communication among healthcare staff is associated with risks for medical errors. Thus, handovers and shift reports are an essential and integral routine among nurses in order to pass on information about the patients' health status. Previous studies within the field have highlighted the benefits of structured reporting tools. However, shift reports as a cultural activity within the nursing tradition have been given less attention, not the least in psychiatric care.

    METHODS: Focused ethnography was used. The data comprised 20 observational sessions. The observations ranged over a time span of 5 months and were conducted in a psychiatric intensive care unit in Sweden.

    RESULTS: The process of shift reports encompassed the following three phases: 1) getting settled, 2) giving the report and 3) engaging in the aftermath. The results demonstrate that the phases entails different cultural activities, which take place in different areas of the ward and that the level of formality varied.

    CONCLUSIONS: Shift reports are not an isolated event with clear boundaries. The study enriches the understanding of shift reports as a 'fuzzy process'. The individual phases were found to be tied to cultural connotations, such as activities, places and roles with certain meanings for staff members.

    RELEVANCE TO CLINICAL PRACTICE: The new insights are useful for nurses in overcoming an uncritical adoption of the biomedical tradition regarding pace and tone during shift reports. The reporting nurse has the potential to transform shift reports from a monologue with a foreclosed style to a more dialogical interaction with colleagues that focuses on the patients' needs rather than the needs of staff.

  • 15.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Rydlo, Cecilia
    School of Health, Care and Social Welfare, University of Mälardalen, Västerås, Sweden.
    Wiklund Gustin, Lena
    School of Health, Care and Social Welfare, University of Mälardalen, Västerås, Sweden; Department of Health and Care Sciences, UiT/The Arctic University of Norway, Campus Narvik, Norway.
    Getting to know the person behind the illness: the significance of interacting with patients hospitalised in forensic psychiatric settings2016Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, nr 9-10, s. 1426-1434Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe what nurses want to accomplish in relationships with patients who are hospitalised in forensic psychiatric settings.

    BACKGROUND: Relationships between staff and patients in forensic psychiatric settings should be grounded in trust and confidence, and the patients need opportunities for emotional reconciliation. However, relationships can be challenging for nurses, who sometimes distance themselves from patients' expressions of suffering. The role of forensic mental health nurses is nebulous, as are the prescriptives and the implementation of nursing practices.

    DESIGN: Qualitative descriptive design.

    METHODS: In-depth interviews with five nurses who all work in forensic psychiatric settings.

    RESULTS: We present a descriptive analysis of what nurses want to accomplish in relationships with patients who are hospitalised in forensic psychiatric settings. The results are presented in two main categories: (1) getting to know the person behind the illness and (2) making a difference.

    CONCLUSION: Care in forensic psychiatry needs to shift towards a more long-term view of the role of nursing, focusing less on the traditional and stereotypical identity of the productive nurse and more on the care given when nurses slow down and take the time to see the patients as individuals. Establishing trusting relationships with patients in forensic psychiatric settings is viewed as a less oppressive way to control patients and guide them in directions that are preferable for the nurses and for the society.

    RELEVANCE TO CLINICAL PRACTICE: Nurses may use simple strategies in their daily practice such as sitting on the sofa with patients to establish trust. We stress that nurses should abandon policing roles and custodial activities in favour of guiding principles that promote individual recovery, treatment and health-promoting care.

  • 16.
    Saunamäki, Nina
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap. Cty Council Gavleborg, Gavle, Sweden.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap. Uppsala University, Dept Publ Hlth & Caring Sci, Uppsala, Sweden.
    Registered Nurses' Reflections on Discussing Sexuality with Patients: Responsibilities, doubts and fears2014Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, s. 531-540Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims and objectives: To describe registered nurses' reflections on discussing sexuality with patients. Background: It is known that many diseases and treatments have a negative impact on sexual health. Despite these facts, registered nurses typically do not address sexual issues with patients. Design: A descriptive design and a qualitative approach were used. Methods: Interviews were conducted in 2010 with 10 registered nurses. The data were analysed using qualitative content analysis. Results: The themes 'Doing the right thing and doing good', 'Could've, would've, should've: a nurse's conflicting feelings' and 'I just don't talk about it: sexuality as a nontopic' confirmed the notion that discussing sexuality in nursing care is still challenging and difficult for nurses, but also revealed that nurses who do talk to patients about sexual issues do so based on their strong sense of wanting to help. They felt a responsibility because of their knowledge in the area, but the topic also brought out conflicting feelings such as fear and embarrassment. Lack of time, support and places to talk to patients in private as well as prejudice were contributing factors to their not addressing sexuality. Some nurses also felt that sexuality was someone else's responsibility and a taboo subject. Conclusions: Patients' sexuality is still surrounded by silence. But factors exist that can facilitate discussion of sexuality. Nurses have a key role in detecting ill-health. This study suggests that when nurses use their knowledge and go beyond their comfort zone and address sexuality, they can identify patients' sexual problems. Relevance to clinical practice: Nurses need to understand how their knowledge can help patients who are experiencing sexual problems; they also need support from the workplace and to have access to routines that reinforce the notion that sexuality is a topic worth discussing. © 2013 John Wiley & Sons Ltd.

  • 17.
    Silén, Marit
    et al.
    Högskolan i Jönköping, HHJ, Avd. för omvårdnad.
    Svantesson, Mia
    Universitetssjukhuset Örebro samt Karlskoga lasarett, Örebro läns landsting.
    Kjellström, Sofia
    Högskolan i Jönköping, HHJ, Institutet för gerontologi.
    Sidenvall, Birgitta
    Högskolan i Jönköping, Hälsohögskolan.
    Christensson, Lennart
    Högskolan i Jönköping, HHJ, Avd. för omvårdnad.
    Moral distress and ethical climate in a Swedish nursing context: perceptions and instrument usability2011Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, nr 23-24, s. 3483-3493Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. The aim was fivefold: to describe Swedish nurses' perceptions of moral distress and determine whether there were differences in perceptions depending on demographic characteristics and to describe the usability of the Moral Distress Scale in a Swedish context. Further, the aim was to describe Swedish nurses' perceptions of ethical climate and the relationship between moral distress and ethical climate.

    Background. Moral distress has been studied for more than two decades and the Moral Distress Scale is the most widely used instrument for measuring it. Moral distress has mainly been studied in relation to nurses' characteristics, but increasing attention has been paid to contextual aspects, such as ethical climate, that could be associated with moral distress.

    Design. Descriptive, with a quantitative approach.

    Methods. The study used two questionnaires: the Moral Distress Scale and the Hospital Ethical Climate Survey. The study was carried out at two hospitals in Sweden and included 249 nurses.

    Results. Both level and frequency of moral distress were low, however level of moral distress was high in situations when the patient was not given safe and proper care. Generally, the frequency of moral distress was lower than the level. Of the situations on the Moral Distress Scale, 13 of the 32 were considered irrelevant by 10-50% of the participants. The more positive the ethical climate was perceived to be, the less frequentely morally distressing situations were reported.

    Conclusions. Since a positive ethical climate was associated with less frequent occurencies of moral distress, it should be investigated what contributes to a positive ethical climate. To be used in a Swedish context, the Moral Distress Scale needs further revision.

    Relevance to clinical practice. Open dialouges at wards are encouraged regarding what practices contribute to a positive ethical climate.

  • 18.
    Silén, Marit
    et al.
    Högskolan i Jönköping, HHJ, Avd. för omvårdnad.
    Tang, Ping Fen
    Ahlström, Gerd
    Swedish and Chinese nurses' conceptions of ethical problems: a comparative study2009Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, nr 10, s. 1470-1479Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: To investigate Swedish and Chinese nurses' conceptions of ethical problems and workplace stress and ascertain whether there are differences between the nurses in the two countries and between types of clinics.

    BACKGROUND: Nursing can be regarded as an ethical practice and ethical problems are one type of problems nurses have to deal with.

    DESIGN: The research design was comparative and quantitative.

    METHODS: A questionnaire was used. The study was carried out at one hospital in China and two hospitals in Sweden. One hundred and thirty-six Chinese nurses and 137 Swedish nurses participated.

    RESULTS: There was a statistical difference between nurses working in the different countries regarding commonest stated ethical problem. The Swedish nurses indicated a greater number of ethical problems than the Chinese nurses. The latter felt irritated, dissatisfied or sad at work or after work more often than the Swedish nurses. Forty-one per cent of the nurses in both countries thought there was a modest or rather big difference between the current and the desired quality of nursing.

    CONCLUSIONS: The findings were partially the same in the two countries and this underlines the importance of looking at ethical problems from an organisational perspective.

    RELEVANCE TO CLINICAL PRACTICE: The findings also show the need for a reduction of nurses' workload as well as the importance of assuring that nurses have the knowledge they need to carry out their work. The communication between nurses and other members of the health-care team, patients and relatives also needs to be improved.

  • 19.
    Sjöberg, Fredric
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap.
    Schönning, Emil
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Nurses' experiences of performing cardiopulmonary resuscitation in intensive care units: a qualitative study2015Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, nr 17-18, s. 2522-2528Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims and objectives: To describe the nurses' experiences of performing cardiopulmonary resuscitation in intensive care units.

    Background: Research in the area of resuscitation is primarily concentrated on medical and biophysical aspects. The subjective experiences of those who perform cardiopulmonary resuscitation and their emotions are more seldom addressed. Design: Qualitative descriptive design.

    Methods: Qualitative semi-structured interviews were used (n = 8). Data were analysed with content analysis.

    Results: Three categories describe the experiences of nurses: training and precardiopulmonary resuscitation; chaos and order during cardiopulmonary resuscitation; and debriefing postcardiopulmonary resuscitation. The study results indicate that the health care staff find it necessary to practice cardiopulmonary resuscitation, as it provides them with a basic feeling of security when applying it in actual situations.

    Conclusion: We argue that postcardiopulmonary resuscitation debriefing must be viewed in the light of its eigenvalue with a specific focus on the staff's experiences and emotions, and not only on the intention of identifying errors.

    Relevance to clinical practice: Debriefing is of the utmost importance for the nurses. Clinical leaders may make use of the findings of this study to introduce debriefing forums as a possible standard clinical procedure. 

  • 20.
    Skytt, Bernice
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Mårtensson, Gunilla
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Mamhidir, Anna-Greta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    A longitudinal qualitative study of health care personnel’s perceptions of simultaneous implementation of three risk assessment scales on falls, malnutrition and pressure ulcers2016Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, nr 13/14, s. 1912-1922Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 21.
    Stake-Nilsson, Kerstin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicinvetenskap.
    Hultcrantz, Rolf
    Karolinska University Hospital, Stockholm, Sweden.
    Unge, Peter
    Novartis, Basel, Switzerland.
    Wengström, Yvonne
    Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Complementary and alternative medicine used by persons with functional gastrointestinal disorders to alleviate symptom distress2012Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, nr 5-6, s. 800-808Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim.  The aim of this study was to describe the complementary and alternative medicine methods most commonly used to alleviate symptom distress in persons with functional gastrointestinal disorders. Background.  People with functional gastrointestinal disorders face many challenges in their everyday lives, and each individual has his/her own way of dealing with this illness. The experience of illness often leads persons with functional gastrointestinal disorders to complementary and alternative medicine as a viable healthcare choice. Design.  Quantitative and describing design. Method.  A study-specific complementary and alternative medicine questionnaire was used, including questions about complementary and alternative medicine methods used and the perceived effects of each method. Efficacy assessments for each method were preventive effect, partial symptom relief, total symptom relief or no effect. Results.  A total of 137 persons with functional gastrointestinal disorders answered the questionnaire, 62% (n = 85) women and 38% (n = 52) men. A total of 28 different complementary and alternative medicine methods were identified and grouped into four categories: nutritional, drug/biological, psychological activity and physical activity. All persons had tried at least one method, and most methods provided partial symptom relief. Conclusion.  Persons with functional gastrointestinal disorders commonly use complementary and alternative medicine methods to alleviate symptoms. Nurses have a unique opportunity to expand their roles in this group of patients. Relevance to clinical practice.  Increased knowledge of complementary and alternative medicine practices would enable a more comprehensive patient assessment and a better plan for meaningful interventions that meet the needs of individual patients.

  • 22.
    Sving, Eva
    et al.
    Clinical Training Centre, Region Gävleborg, Sweden; Centre for Research & Development, Uppsala University/Region Gävleborg; Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Sweden.
    Frediksson, Lennart
    Centre for Research & Development, Uppsala University/Region Gävleborg.
    Gunningberg, Lena
    Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Sweden.
    Mamhidir, Anna-Greta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Sweden.
    Getting evidence-based pressure ulcer prevention into practice: a process evaluation of a multi-faceted intervention in a hospital setting2017Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, nr 19-20, s. 3200-3211Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 23.
    Swing, Eva
    et al.
    Uppsala Universitet, Institutionen för folkhälso- och vårdvetenskap.
    Gunningberg, Lena
    Uppsala Universitet, Institutionen för folkhälso- och vårdvetenskap .
    Högman, Marieann
    Mamhidir, Anna-Greta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap.
    Registered nurses’ attention to and perceptions of pressure ulcer prevention in hospital settings2012Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, nr 9/10, s. 1293-1303Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. To describe how registered nurses perform, document and reflect on pressure ulcer prevention in a specific nurse-patient care situation, as well as generally, on hospital wards. Background. Registered nurses should provide safe and qualified pressure ulcer prevention, but pressure ulcers remain a problem. Compliance with evidence-based guidelines impedes pressure ulcer formation. Design. A descriptive design with a multimethods approach. Method. Nine registered nurses at three wards and hospitals participated. The registered nurses were observed in a specific nurse-patient care situation with patients at risk for pressure ulcers. Interviews followed and patients' records were reviewed. Quantitative and qualitative data analysis methods were used. Results. Pressure ulcer prevention performed by the registered nurses was dependent on the cultural care, which ranged from planned to unplanned prevention. Diversity was found in compliance with evidence-based guidelines across the wards. Although all patients involved were at risk and the nurses described pressure ulcer prevention as basic care, the nurses' attention to prevention was lacking. Few prevention activities and no structured risk assessments using risk assessment tools were observed, and few care plans were identified. The lack of attention was explained by registered nurses' trust in assistant nurses' knowledge, and prevention was seen as an assistant nurse task. Conclusion. Registered nurses paid little attention to pressure ulcer prevention among patients at risk. The planned and unplanned care structures affected the prevention. The nurses trusted and largely delegated their responsibility to the assistant nurses. Relevance to clinical practice. Evidence-based pressure ulcer prevention is fundamental to patient safety. Care quality is created in situations where patients and care providers meet. How registered nurses work with pressure ulcer prevention, their role and communication, particularly with assistant nurses, should be of major concern to them as well as to healthcare managers.

  • 24.
    Wahlberg, Anna Carin
    et al.
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Björkman, Annica
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Expert in nursing care but sometimes disrespected-Telenurses' reflections on their work environment and nursing care2018Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, nr 21/22, s. 4203-4211Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe telenurses' reflections on their work environment and how it impacts on their nursing care.

    BACKGROUND: Telenursing is one of the largest healthcare settings in Sweden today; approximately 5.5 million care-seekers call the designated number-1177-each year. Telenursing is regarded as highly qualified nursing care, and providing care over the telephone is considered a complex form of nursing. Within other fields of nursing, the work environment has been shown to affect the outcome of care, patient safety, nurse job satisfaction and burnout.

    DESIGN: The study used a descriptive design and followed the COREQ checklist.

    METHODS: Twenty-four interviews were performed and analysed using qualitative content analysis.

    RESULTS: The main theme concerned "feeling like a nursing care expert but sometimes being disrespected." The telenurses reported that their work environment supported their work as nursing care experts via the telephone in some respects, but also hindered them. Appreciation and respect they received from the vast majority of callers positively impacted the work environment and contributed to work satisfaction. However, they also felt disrespected by both their employers and healthcare staff; they sometimes felt like a dumping ground. Receiving support from colleagues seemed invaluable in helping them feel like and be a nursing care expert.

    CONCLUSION: Work was perceived as cognitively demanding and sometimes exhausting, but appreciation from care-seekers and the feeling of being able to provide qualified nursing care made working as a telenurse worthwhile.

    RELEVANCE TO CLINICAL PRACTICE: If telenurses are to perform good nursing care over the telephone, managers must provide them with resources, for example, support, education and opportunities for recovery during shifts. It seems that the role of the 1177 service has not been properly implemented and accepted within the healthcare system, and politicians need to anchor its mission within the healthcare organisation.

  • 25.
    Wallin, Ewa
    et al.
    Inst. för kirurgiska vetenskaper, Uppsala universitet.
    Larsson, Ing-Marie
    Inst. för kirurgiska vetenskaper, Uppsala universitet.
    Rubertsson, Sten
    Inst. för kirurgiska vetenskaper, Uppsala universitet.
    Kristofferzon, Marja-Leena
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap.
    Relatives' experiences of everyday life six months after hypothermia treatment of a significant other's cardiac arrest2013Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, nr 11-12, s. 1639-1646Artikkel i tidsskrift (Fagfellevurdert)
  • 26.
    Östlund, Ann-Sofi
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala universitet.
    Wadensten, Barbro
    Department of Public Health and Caring Sciences, Uppsala universitet.
    Häggström, Elisabeth
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Kristofferzon, Marja-Leena
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    District nurses' and registered nurses' training in and use of motivational interviewing in primary care settings2014Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, nr 15-16, s. 2284-2294Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims and objectives

    To examine to what extent district nurses and registered nurses have training in motivational interviewing, to what extent they use it and what prerequisites they have for using it; to compare district nurses and registered nurses, as well as to compare users and nonusers of motivational interviewing; and to examine possible relationships between use of motivational interviewing and the variables training, supervision and feedback in motivational interviewing and prerequisites for use.

    Background

    Motivational interviewing is an effective method for motivating patients to change their lifestyle, used increasingly in primary care.

    Design

    A cross-sectional survey study.

    Methods

    A study-specific questionnaire was sent to all district nurses and registered nurses (n = 980) in primary care in three counties in Sweden, from September 2011–January 2012; 673 (69%) responded. Differences between groups as well as relationships between study variables were tested.

    Results

    According to self-reports, 59% of the respondents had training in motivational interviewing and 57% used it. Approximately 15% of those who reported using it had no specific training in the method. More district nurses than registered nurses had training in motivational interviewing and used it. The following factors were independently associated with the use of motivational interviewing: training in and knowledge of motivational interviewing, conditions for using it, time and absence of ‘other’ obstacles.

    Conclusions

    Having knowledge in motivational interviewing and personal as well as workplace prerequisites for using it may promote increased use of motivational interviewing.

    Relevance to clinical practice

    Having the prerequisites for using motivational interviewing at the workplace is of significance to the use of motivational interviewing. In the context of primary care, district nurses seem to have better prerequisites than registered nurses for using motivational interviewing.

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