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  • 1.
    Andersson, Inger
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Hofsten, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Medical science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Case seminars open new doors to understanding – students’ experiences of learning2013Conference paper (Refereed)
  • 2.
    Björklund, Ove
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Åbo Akademi University, Vaasa, Finland.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Åbo Akademi University, Vaasa, Finland.
    Nyström, Lisbet
    Åbo Akademi University, Vaasa, Finland.
    Young Finnish Unemployed Men's Experiences of Having Participated in a Specific Active Labor Market Program2017In: American Journal of Men's Health, ISSN 1557-9883, E-ISSN 1557-9891, Vol. 11, no 5, p. 1426-1435Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was to describe young Finnish unemployed men's experiences of having participated in a specific active labor market program, intended to fight unemployment and offered at a resource center. Fifteen young unemployed Finnish men in the age range 18 to 27 years were interviewed face-to-face. Purposive sampling was used to increase the variation among informants. The interview texts were analyzed using both manifest and latent qualitative content analysis. The present results reported that the young men felt that they, thanks to the program at the resource center, had acquired daily routines and could ultimately believe in the future. The young men described how they now had a structure, economic support, and that they could return to their daily life. The informants also described how they could see new possibilities and believe in oneself. There is a lack of empirical studies assessing the possible impact of active labor market programs on the unemployed based on participants' own experiences. Further research is needed to describe and elucidate in more detail the effects of targeted support measures and the needs of unemployed men of different ages and living in different contexts.

  • 3.
    Björklund, Ove
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Åbo Akademi.
    Söderlund, Maud
    Åbo Akademi.
    Nyström, Lisbet
    Åbo Akademi.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Åbo Akademi.
    Unemployment and Health: Experiences Narrated by Young Finnish Men2015In: American Journal of Men's Health, ISSN 1557-9883, E-ISSN 1557-9891, Vol. 9, no 1, p. 76-85Article in journal (Refereed)
    Abstract [en]

    Studies have shown that the experiences and consequences of unemployment can affect people differently depending on, for example, age and gender. The purpose of the present study was to describe young Finnish men's experiences of being unemployed as well as how their experiences of health emerged. Fifteen young unemployed Finnish men in the age range 18 to 27 years were interviewed face to face. Purposive sampling was used to increase the variation among informants. The interview texts were analyzed using both manifest and latent qualitative content analysis. The present results showed that the young men were strongly negatively affected by being unemployed. They described how they had slowly lost their foothold. They also described feelings of shame and guilt as well as a flight from reality. The present results show that even young men who have only experienced shorter periods of unemployment, in this study periods between 2 and 6 months, are negatively affected, for example, with regard to their identity and emotional life. Further research is needed to describe and elucidate in more detail the effects of unemployment on men of different ages and living in different contexts.

  • 4.
    Engström, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Wadensten, Barbro
    Department of Public Health and Caring Sciences, Uppsala universitet.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Caregivers' job satisfaction and empowerment before and after an intervention focused on caregiver empowerment2010In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 18, no 1, p. 14-23Article in journal (Refereed)
    Abstract [en]

    Aims: To evaluate a training programme aimed at strengthening caregivers' self-esteem and empowering them, and also to study correlations between psychological empowerment and job satisfaction.

    Background: Structural and psychological empowerment have received increased attention in nursing management, yet few intervention studies on this topic, based on theoretical assumptions, have been conducted in elderly care.

    Method: Data on self-assessed psychological empowerment and job satisfaction were collected in an intervention (n = 14) and a comparison group (n = 32), before and after the intervention.

    Results: When compared over time in the respective groups, there were significant improvements in the intervention group regarding the factor criticism (job satisfaction scale). There were no statistically significant differences in the comparison group. Total empowerment and all factors of empowerment correlated positively with total job satisfaction. Six out of eight factors of job satisfaction correlated positively with total empowerment.

    Conclusions: Caregivers' perception of criticism can improve through an intervention aimed at strengthening their self-esteem and empowering them.

    Implications for nursing management: Intervention focused on psychological empowerment and especially caregivers' communication skills seems to be beneficial for caregivers. Recommendations are to increase the programme's length and scope and to include all staff at the unit. However, these recommendations need to be studied further.

  • 5.
    Fläckman, Birgitta
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Fagerberg, Ingegerd
    Department of Caring and Public Health Sciences, Mälardalen University, Västerås; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Häggström, Elisabeth
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Kihlgren, Annica
    Department of Health Sciences, Örebro University, Örebro, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Kihlgren, Mona
    Centre of Nursing Science, Örebro University Hospital, Örebro, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Despite shattered expectations a willingness to care for elders remains with education and clinical supervision2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 3, p. 379-389Article in journal (Refereed)
    Abstract [en]

    Despite shattered expectations a willingness to care for elders remains with  education and clinical supervision The aim was to describe nursing home (NH) caregivers’ work experiences while receiving education and clinical supervision for 2 years. Working in elder care seems to be losing its attraction especially with organizational changes, cutbacks and changes in work place conditions. Clinical supervision has been reported to increase job satisfaction and creativity. Semi-structured interviews from caregivers working at an NH in Sweden were conducted, at the start and again at 12 and 24 months. At about 12 months the caregivers were informed of planned cutbacks. Content analysis was the method used to analyse the interviews from seven caregivers who participated throughout the entire period. Findings show that the value of a caring milieu was one category generated by the subcategories: experiences related to work activities and changes, and experiences related to relationships. The value of knowledge was the other category that was influenced by the experiences related to the different backgrounds and the experiences related to increased knowledge gained from the support through education and clinical supervision. The categories contained positive as well as negative influences on care. The initial focus on practical duties associated with the opening of the NH shifted towards caregiver activities with the elders they spoke warmly about. After 2 years the caregivers’ willingness to care continued despite their disappointment in the worsened working conditions. The main theme that resulted was: Despite shattered expectations a willingness to care for elders remained. Continued education and clinical supervision seems to be one factor behind the retained willingness. These findings demonstrate that support and caregiver involvement in educational programmes are important during times of change and when disappointments arise in the workplace.

  • 6.
    Hagerman, Heidi
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    Wadensten, Barbro
    Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    Manliga första-linjenschefers upplevelser av sin arbetssituation i äldreomsorgen – med utgångspunkt i empowerment2018In: FALF KONFERENS 2018 Arbetet – problem eller potential för en hållbar livsmiljö?   10-12 juni 2018 Gävle: Program och Abstracts, 2018, p. 143-Conference paper (Other academic)
    Abstract [en]

    Bakgrund

    Den svenska äldreomsorgen blir allt mer ansträngande att arbeta inom. Stora organisa-toriska förändringar har lett till att arbetet upplevs som oroligt och stressfullt. Den administrativa rollen har ökat och första-linjens chefers möjligheter att delta i det dagliga arbetet har minskat. För att klara av de allt högre krav som ställs är det viktigt att cheferna känner att de har goda strukturella förutsättningar (empowerment), handlingsutrymme och känner att de har kontroll över sitt arbete.

    Syfte

    Att beskriva manliga första-linjens chefers upplevelser av sin arbetssituation i äldreomsorgen.

    Metod

    Semi-strukturerade intervjuer gjordes med fjorton manliga första-linjens chefer i äldreomsorgen i Sverige från hösten 2010 till våren 2011. Intervjuguiden var inspirerad av teorier om empowerment. Tolv chefer arbetade inom kommunal äldreomsorg och två chefer inom privat äldreomsorg. Deltagarna valdes utifrån ett ändamålsenligt urval med förhoppningen om att ge en variation i sina skildringar. De hade arbetat som chefer mellan 0.5-35 år. Intervjuerna varade mellan 1-2.5 timmar och materialet analyserades med kvalitativ innehållsanalys. Två teman och fem subteman skapades.

    Resultat

    Det första temat handlade om när organisatoriska krav var i balans med chefernas upplevda chefsansvar och strukturella förutsättningar. Där beskrevs upplevelserna av att vara ensam men inte utelämnad, att ha frihet inom givna ramar samt en känsla av tillfredsställelse och stimulans i arbetet. Det andra temat handlade om när organisatoriska krav var i obalans med chefernas upplevda chefsansvar och strukturella förutsättningar. Detta tema beskrev chefernas känsla av frustration och en känsla av uppgivenhet. Sammantaget upplevde de manliga första-linjens cheferna att arbetssituationen var både utmanande, komplex och föränderlig. Cheferna behövde bättre tillgång till strukturella förutsättningar, speciellt i form av resurser, stöd och information. Utmaningarna sågs dock som en ständig drivkraft för cheferna. De beskrev att deras arbete var ”mödan värt” även om de ibland upplevde arbetssituationen som negativ. Slutsatsen i studien var att cheferna upplevde sitt arbete som en positiv utmaning även om de beskrev brister i sitt stöd.

  • 7.
    Hagerman, Heidi
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Wadensten, Barbro
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Male first-line managers’ experiences of the work situation in elderly care: an empowerment perspective2015In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 23, no 6, p. 695-704Article in journal (Refereed)
    Abstract [en]

    Aim

    To describe male first-line managers' experiences of their work situation in elderly care.

    Background

    First-line managers' work is challenging. However, less attention has been paid to male managers' work situation in health care. Knowledge is needed to empower male managers.

    Method

    Fourteen male first-line managers were interviewed. The interview text was subjected to qualitative content analysis.

    Result

    Work situations were described as complex and challenging; challenges were the driving force. They talked about ‘Being on one's own but not feeling left alone’, ‘Having freedom within set boundaries’, ‘Feeling a sense of satisfaction and stimulation’, ‘Feeling a sense of frustration’ and ‘Having a feeling of dejection and resignation’.

    Conclusion

    Although the male managers report deficiencies in the support structure, they largely experience their work as a positive challenge.

    Implications for nursing management

    To meet increasing challenges, male first-line managers need better access to supportive structural conditions. Better access to resources is needed in particular, allowing managers to be more visible for staff and to work with development and quality issues instead of administrative tasks. Regarding organisational changes and the scrutiny of management and the media, they lack and thus need support and information from superiors.

  • 8.
    Hedman, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences, Caring Science. Uppsala University, Sweden.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences, Caring Science. Uppsala University, Sweden.
    Mamhidir, Anna-Greta
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences, Caring Science. Uppsala University, Sweden.
    Pöder, Ulrika
    Uppsala University, Sweden.
    Caring in nursing homes to promote autonomy and participation2019In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 26, no 1, p. 280-292, article id 969733017703698Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 9.
    Hedman, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Pöder, Ulrika
    Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Mamhidir, Anna-Greta
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Häggström, Elisabet
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Life memories and the ability to act: the meaning of autonomy and participation for older people when living with chronic illness2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 824-833Article in journal (Refereed)
    Abstract [en]

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

  • 10.
    Hofsten, Anna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Medical science.
    Andersson, Inger
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Case seminars open new doors to understanding: nursing students’ experiences of learning2012Conference paper (Refereed)
    Abstract [en]

    Background

    The Case Method is a teaching method in which cases from real life inspire students to actively seek knowledge that they discuss in seminars. During seminars, different solutions and ideas are written in a structured way on the white board. Hofsten (2010) described how case seminars in cardiology help nursing students share knowledge and identify possible ways of dealing with patients.

    Summary of work

    To deepen the understanding of learning in case seminars, we asked students in a very different educational context, psychiatric care, about their experiences. Written narratives from 44 nursing students were analyzed using a content analysis.

    Summary of results

    The students described the importance of different perspectives and of seeing a context and of learning in a climate that promotes discussions; they felt that the overview on the white board encouraged students to participate. Different categories and the preliminary themes To reflect on thoughts, To give and take, and To see what is said are shown in Figure 1. When we presented these results to the students, most reported recognizing our description of learning situation to a great or very great degree; see Figure 2.

    Conclusions

    The Case Method seems to involve students in a way that deepens their understanding and this effect seems to be independent of subject or teacher

  • 11.
    Hofsten, Anna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Medical science.
    Gustafsson, Christina
    University of Gävle, Faculty of Education and Business Studies, Department of Culture Studies, Religious Studies and Educational Sciences, Curriculum studies.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Case seminars open doors to deeper understanding: Nursing students’ experiences of learning2010In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 30, no 6, p. 533-538Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The Case Method is a teaching method in which cases from real life inspire students to actively seek knowledge that they discuss in structured seminars. Case seminars in health education have been evaluated, compared and discussed, but descriptions that can help us understand how students learn in the seminars have not previously been published. In a Swedish nursing programme, where case seminars have been used for several years, students were asked to write about their experiences of learning in the seminars. The aim of the present study was to describe this learning process from the students' point of view.

    METHOD:

    Written data were analysed using content analysis.

    FINDINGS:

    A theme concerning how the Case Method opens doors to deeper understanding was identified as a thread running through different codes and categories. Students described the importance of new perspectives and their wish to participate in discussions with other students. The students indicated that the structure, which involved pre-prepared cases and writing on the white board, positioned their own knowledge in a wider context and that the learning atmosphere enabled everyone to participate.

    CONCLUSIONS:

    The Case Method seems to involve students in a way that deepens their understanding and critical thinking.

  • 12.
    Hofsten, Anna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Medical science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Alternating large group seminars using the white board with small group discussions helps students be active and reflective2014Conference paper (Refereed)
    Abstract [en]

    Background

    Discussion and reflection are important in university education, and in healthcare education patient cases are commonly used for this purpose. Learning in case seminars has recently been the topic of a systematic BEME review, which called for more qualitative research on how students learn and how much structure is required (1).

    Summary of work

    The number of students in healthcare education is increasing, and case seminars can involve as many as twenty students. How can we increase students’ opportunities for reflection? To address this question, we alternated large group with small group (three students) discussion approximately four times during a case. Large group discussion including white board notes was unaltered. To understand more about how students learn, we asked them to describe their learning in these kinds of seminars. Written data were collected in September 2013 from 68/80 students in a Swedish nursing program with case seminars. The narratives were analyzed using latent qualitative content analysis (2).

    Summary of results

    Three themes describing how students learn were identified in the analysis: Being active, Being part of a discussion and Seeing new problems and solutions. The analysis with examples of quotations will be presented at the conference.

    Conclusions

    In the small group, students were able to test ideas and build self-confidence, allowing them to act as problem-solvers in the large group discussion. Alternating large group seminars using the white board with small group discussions helps students be active and reflective and allows larger numbers of students per seminar.

  • 13.
    Hofsten, Anna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Medical science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Case seminars open doors to deeper understanding: Nursing students’ experiences of learning2010Conference paper (Refereed)
    Abstract [en]

    Introduction: Creation of new knowledge is mainly accomplished by students themselves, and the main task of teachers in higher education is thus to facilitate this learning process (Ramsden 2003). The Case Method is a teaching method in which cases from real life inspire students to actively seek knowledge to be discussed in structured seminars. In the seminars, the problem-solving process is important and the aim of the seminar discussion is to consider different solutions and identify possible ways of dealing with the situation. Case seminars in health education have been evaluated and discussed, but descriptions that can help us understand how students learn in the seminars have not previously been published. In a Swedish nursing programme, where case seminars have been used in teaching cardiovascular diseases for several years, students were asked to describe how the case seminars had helped them in their learning and what had been troublesome with the seminars, and 69/72 did. The aim of the present study was to describe this learning process from the students’ point of view.

    Methods: Written data were analyzed using content analysis, a process of organizing and integrating qualitative information into themes, categories and codes. All quotations were read and commented on by the three authors, but the analysis was made by two of the authors in collaboration.

    Results: A theme concerning how the Case Method opens doors to deeper understanding was identified as a thread running through different codes and categories. Students described the importance of new perspectives and their wish to participate in discussions with other students. The structure, which involved pre-prepared cases and writing on the white board, positioned the students’ own knowledge in a wider context and the learning atmosphere seemed to enable everyone to participate in the discussions (Hofsten et al 2009).

    Discussion: The interest in reflective discussions, other students’ points of view and solutions to the cases indicate a deep approach to learning (Ramsden 2003). Two years later the findings were presented to the students who participated in the study. All students agreed much or very much to the analysis presented.

    Conclusion: The Case Method seems to involve students in a way that deepens their understanding and critical thinking.

  • 14.
    Hofsten, Anna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Medical science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Case seminars open doors to deeper understanding: Nursing students’ experiences of learning2010Conference paper (Refereed)
    Abstract [en]

    Background

    Creation of new knowledge is mainly accomplished by students themselves, and the main task of teachers in higher education is thus to facilitate this learning process. The Case Method is a teaching method in which cases from real life inspire students to actively seek knowledge that they discuss in structured seminars. Case seminars in health education have been evaluated, compared and discussed, but descriptions that can help us understand how students learn in the seminars have not previously been published. In a Swedish nursing programme, where case seminars have been used in teaching cardiovascular diseases for several years, students were asked to freely write down answers to three open questions concerning how the case seminars had helped them in their learning,what had been troublesome with the seminars, and whether they had any other comments on the seminars. The aim of the present study was to describe this learning process from the students’ point of view.

    Methods

    Written data were analyzed using content analysis, which is a process of organizing and integrating qualitative information into themes, categories and codes.

    Findings

    A theme concerning how the Case Method opens doors to deeper understanding was identified as a thread running through different codes and categories. Students described the importance of new perspectives and their wish to participate in discussions with other students. The structure, which involved pre-prepared cases and writing on the white board, seemed to position the students’ own knowledge in a wider context.This interest in reflective discussions andother students’ different opinions indicate a deep approach to learning. To see if the findings reflected the participants ́ voice, the analysis with quotations, codes, categories and a theme was presented two years later to 62/69 students participating in the study. In a questionnaire after the presentation all agreed much or very much with the findings presented. To conclude the Case Method seems to involve students in a way that deepens their understanding and critical thinking.

  • 15.
    Hofsten, Anna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Medical science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Case-seminarier – ett sätt att med patientfall engagera studenter till djupinlärning2010In: FOU-dagen: aktuell forskning och utveckling för alla intresserade i landstinget / [ed] Centrum för forskning och utveckling / Uppsala universitet, Landstinget Gävleborg, 2010, p. 23-23Conference paper (Other (popular science, discussion, etc.))
  • 16.
    Hofsten, Anna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Medical science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Caseseminarier öppnar dörrar till djupare förståelse2012Conference paper (Refereed)
    Abstract [sv]

    Ny kunskap skapas av studenten själv och lärarens uppgift i högskolan är därför huvudsakligen att underlätta denna lärprocess. I sjuksköterskeutbildningen i Gävle har vi i mer än tio år arbetat med studentaktiva undervisningsformer och under de senaste fem åren bedrivit forskning om studenters lärande. Av dessa olika forskningsprojekt väljer jag att här presentera och diskutera två projekt om studenters lärande vid caseseminarier. Casemetoden utvecklades ursprungligen för jurist- och ekonomistudenter och använder äkta fall som ska inspirerar studenter att aktivt söka kunskap (1,2,3). I vårdundervisning utgår vi från patientfall där sjukdomar och olika lösningar på problem diskuteras i strukturerade lärarledda seminarier (3,4). Casemetoden har på olika sätt utvärderats och diskuteras men beskrivande studier av hur studenter lär vid caseseminarier har tidigare saknats varför våra studier tillför ny kunskap som också publicerats (5).

    Casemetoden i undervisning av sjuksköterskor

    För att öka förståelsen för hur studenter lär bad vi alla andraårsstudenter i en kurs om hjärtsjukdomar berätta om sitt lärande i caseseminarier. Syftet med studien var att belysa lärandet från studenternas perspektiv. 69 studenter från sjuksköterskeprogrammet deltog och deras skrivna berättelser analyserades med hjälp av en innehållsanalys (6). Studenterna beskrev på olika sätt kreativa seminarier som gav nya perspektiv i diskussionerna tillsammans med andra studenter, men också problem med att göra sig hörda och vikten av bekräftelse. Upplägget, med egna förberedelser av patientfall och hur tavlan användes under seminarierna, gav enligt studenterna ökad förståelse för sambanden mellan sjukdomars symtom, diagnos och vård och den tillåtande atmosfären gav en lust att ställa frågor och diskutera. Intresse för reflektion och nya lösningar var tydligt och ett tema om djupare förståelse kunde ses som en röd tråd i berättelserna (5). Efter avslutad analys valde vi att presenterade resultaten för de deltagande studenterna. Av 62/69 närvarande studenterna ansåg alla att vår analys stämde väl eller mycket väl med deras erfarenheter av lärande i caseseminarier.

    För att undersöka våra resultat oberoende av kurs, studenter och lärare återupprepade vi våra frågeställningar i en ny studie år 2011. Nu i en helt annan context, med sjuksköterskestudenter i psykiatrisk omvårdnad och med två kliniska adjunkter som lärare. I denna lite mindre kurs deltog 34 studenter med berättelser om sitt lärande. Analysen gav åtta kategorier samlade i tre teman Att reflektera tankar, Att ge och ta och Att se vad som sägs. Även dessa resultat presenterades för               

    Vår slutsats är att Casemetoden öppnar dörrar till djupare förståelse oberoende av lärare och kurs i sjuksköterskeprogrammet. Slutligen, vilka styrkor och svagheter har de här studierna och är resultaten något ni känner igen från er egen undervisning med studentaktiva undervisningsformer?

    1. Barnes, L.B., Christensen, C.R., Hansen, A.J., 1994. Teaching and the Case Method. Harvard Business School Press. Boston, Massachusetts.
    2. Erskine J.A., Leenders M.R., Mauffette-Leenders L.A., 2003. Teaching with Cases. IveyPublishing, Richard Ivey School of Business, The University of Western Ontario, London,Ontario, Canada.
    3. Nordquist J., Sundberg K., Johansson L., 2011. Case – verktyg för professionslärande. Liber AB, Stockholm.
    4. Stjernquist M., Crang-Svalenius E., 2007. Problem based learning and the case method - medical students change preferences during clerkship. Medical Teacher 29, 814-820.
    5. Hofsten A., Gustafsson C, Häggström E., 2010. Case seminars open doors to deeper understanding - Nursing students’ experiences of learning. Nurse Educ Today 30, 533–538.
    6. Graneheim, U.H., Lundman B., 2004. Qualitative content analysis in nursing research:concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 24,105-112.

     

  • 17.
    Hofsten, Anna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Education in reverse: student activity first, lecture last2016In: Education in reverse: student activity first, lecture last, 2016Conference paper (Refereed)
    Abstract [en]

    3 key points

    • In this way of flipped classroom students valued first seeking the knowledge before the expert came to present and discuss the subject.

    • Our analysis revealed that students learn when they overcome difficulties, when they seek facts themselves and discuss in seminars and when their own knowledge is challenged.

    • In planning their courses, teachers must give students opportunities to be active learners instead of passive listeners and knowledge consumers.

    When students come to university for advanced studies, there must be challenges. The academic environment should provide opportunities for students to develop important metacompetencies such as problem-solving abilities for tackling unfamiliar problems, training in oral and written communication, and self-regulated planning of their work and studies (Lizzio 2002). The question is if we, the teachers who plan the courses, use the short time allotted to teaching and learning in the best way possible?

    To become a specialized primary care nurse in Sweden, students have one year of primary care (with a Master´s paper) and two months of specialized pharmacology. One aim of the pharmacology course is for students to learn about nursing care for patients with common skin diseases, examine them and prescribe simple medications. For years, the traditional teaching approach in this course has been to invite a medical doctor to give a lecture and then to have seminar discussions and an exam. Inspired by the pedagogical discussion of “flipped classroom” (Gerstein 2011) we asked ourselves whether it would be more instructive for students to begin by searching for relevant information on skin disorders instead of by being passive listeners during a lecture?

    Aim/focus of the innovation

    To give students the opportunity to be more active in their own learning, we reversed the traditional order of learning methods.

    Implementation of the innovation                                                                                               

    The students first had to find information on how to examine skin disorders and nursing care for patients with common skin diseases, and then write a text that would be discussed in a seminar prior to meeting the lecturer. In this new arrangement, we hoped students would become more active, practice evaluating knowledge and prepare themselves before the lecture.

    Methods used to assess the innovation

    To understand more about how students learn in this reversed teaching order, we asked all students in the course to voluntarily write a paper about their learning experiences. All 23 students decided to participate in the study. Their mean age was 38 years and mean time working as a nurse, prior to the Master’s Programme in Primary Care, 7 years. In 2015, two researchers jointly conducted a content analysis of all written data, using Graneheim and Lundman’s (2004) approach.

    Key findings

    Our analysis revealed four categories concerning how students experienced learning in this reversed order. They described they learn when they seek facts themselves, when they overcome difficulties, when their own knowledge is challenged and when they are able to prepare and think before they meet an expert. The analysis and our findings will be presented in detail, including codes and quotations, at the conference. We will also offer a theoretical discussion of Kolb´s Learning Circle, applying the concepts Concrete Experience, Active Experimentation, Reflective Observation and Abstract Conceptualization to our findings (Kolb 1984).

    References

    Gerstein, J. (2011). The Flipped Classroom Model: A Full Picture. Retrieved January 15, 2015, from http://usergeneratededucation.wordpress.com/2016/01/21/the-flipped-classroom-model-a-full-picture.

    Graneheim, U.H. & Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, vol. 24, 105-112.

    Kolb, D.A. (1984). Experiential learning: experiences as the source of learning and development. New Jersey: Englewood Cliffs

    Lizzio, A., Wilson, K. & Simons, R. (2002). University students’ perceptions of the learning environment and academic outcomes: implications for theory and practice. Studies in Higher Education, vol. 27, no. 1, 27-52.

  • 18.
    Hofsten, Anna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Reversed order: student activity first and lecture last2015In: AMEE 2015 Abstract Book, Glasgow, 2015, p. 42-Conference paper (Refereed)
    Abstract [en]

    Abstract:

    Background When students return to university for continued education, there must be challenges. When becoming a specialized primary care nurse in Sweden, students learn to examine common skin diseases and prescribe pharmaceuticals to treat them. The traditional teaching approach is to first have a medical doctor give one or two lectures and to perhaps, later, have discussions in small groups before an exam.

    Summary of work To give students the opportunity to be more active, we reversed the above order of learning methods. The students first had to find facts about skin diseases themselves and write a text to be discussed in a seminar. In this new arrangement, the students had to seek knowledge themselves before meeting the expert in a lecture.

    Summary of results All 23 students in the course were asked to voluntarily write about their learning experience in the above reversed order. Their mean age was 38 years and mean time working as a nurse was 7 years. A content analysis was conducted by two researchers. Findings showed that students learn when they: seek knowledge themselves and write it down, practice trusting in their own conclusions and arguing for and against various claims, and are prepared with knowledge of their own when they meet the expert.

    Conclusions Students value seeking knowledge on their own, writing it down and discussing among themselves before meeting the expert.

    Take-home message Students learn better when they are active. Experiment with letting students engage in their own activity and learning before the experts come to tell their versions of truth.

     

     

  • 19.
    Häggström, Elisabeth
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Att stärka kvinnors yrkesroll inom äldreomsorgen2009Report (Other (popular science, discussion, etc.))
    Abstract [sv]

    Syftet med studien var att skapa möjligheter för undersköterskor och vårdbiträden vid ett äldreboende i Sandvikens kommun att delta i ett nio månaders träningsprogram med fokus på empowerment samt att beskriva deras syn på sin egen professionella roll i arbetet med de äldre vårdtagarna före och efter träningsprogrammets genomförande. Enligt flera studier är det vanligt att kvinnor tar på sig skulden för problem och orättvisor som de upplever i arbetslivet. Forskargruppens antagande var att ett sätt att förbättra arbetssituationen för vårdpersonal inom äldreomsorgen skulle vara att hjälpa dem att utveckla sin självkänsla och öka sin empowerment genom att erbjuda dem möjligheten att delta i ett träningsprogram med fokus på detta.

    Halvstrukturerade intervjuer genomfördes med 12 undersköterskor och två vårdbiträden vid äldreboendet i början och i slutet av träningsprogrammets genomförande. Materialet analyserades med hjälp av kvalitativ innehållsanalys. Huvudresultatet, som beskrivs genom följande teman, ’att gå från passivitet till aktivitet’, ’att gå från att klaga till att förstå’ och ’att gå från tystnad till att tala’ visar att vårdpersonalens självkänsla och empowerment stärktes. Slutsatsen av studien är att implementering av ett träningsprogram med fokus på empowerment tycks vara en bra form av handledning för undersköterskor och vårdbiträden inom äldreomsorgen. Enhetschefer, beslutsfattare och politiker inom äldreomsorgen bör ta tillvara dessa kunskaper och skapa förutsättningar för vårdpersonalen att delta i denna form av utbildning.

  • 20.
    Häggström, Elisabeth
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Municipal care for older people: experiences narrated by caregivers and relatives2005Doctoral thesis, comprehensive summary (Other academic)
  • 21.
    Häggström, Elisabeth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Bruhn, Åsa
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Caregivers' attitude to education and supervision in work with the older people in a nursing home2009In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 29, no 8, p. 850-854Article in journal (Refereed)
    Abstract [en]

    Community-based care in Sweden has problems recruiting and keeping staff with formal competence and education. Both the caregiver’s well-being and the receiver’s care improve when the personnel receive support in the form of continuing supervision and education. Yet the caregivers in this study did not participate in a training and supervision programme during working hours. The aim of this study was to describe the attitudes towards education, support and supervision in the care of older people in municipal care in Sweden. The study used a qualitative approach with a descriptive design. Twelve caregivers, nine enrolled nurses and three nurses’ aides from four wards in a nursing home were interviewed. The interviews were analysed with qualitative content analysis. The main findings showed that all of the caregivers were positive towards the idea of participating in training and asked for education and supervision but felt that the management did not create conditions that made it possible to participate during working hours. According to the findings there is a need for developing new forms and methods for learning that can be integrated into working life.

  • 22.
    Häggström, Elisabeth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Engström, Maria
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Wadensten, Barbro
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Uppsala universitet.
    A nine-month intervention programme focusing on empowerment; caregivers' descriptions of changed behaviour and increased room for acting2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 6, p. 866-873Article in journal (Refereed)
    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.

  • 23.
    Häggström, Elisabeth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Hofsten, Anna
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för medicinsk vetenskap.
    Wadensten, Barbro
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Nurses’ opinions about a web-based distance course in a  specialist education programme for the care of older people: a questionnaire study2009In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 4, no 3, p. 177-184Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of the present study was to investigate students’ opinions about a web-based distance learning course that was part of a specialist education programme.

    Design.  Survey.

    Method. The study was a descriptive survey with both qualitative and quantitative questions.

    Results. The students found the web-based course very useful for their theoretical and professional development. New perspectives on ageing, increased knowledge about analysing and describing theories as well as practising interviews and qualitative analysis as methods were appreciated by the students.

    Conclusions. One way for RNs in Sweden to get a university specialist education in the care of older people is to have a distance web-based course, as it allows flexibility and improves the students’ theoretical and professional knowledge and communication skills.

    Relevance for clinical practice. Managers working in care for older people settings and educators will be interested in this study’s finding that distance learning is a useful strategy for providing education for RNs who work with older people.

  • 24.
    Häggström, Elisabeth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Kihlgren, Annica
    University of Örebro, Örebro, Sweden.
    Experiences of caregivers and relatives in public nursing homes2007In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 14, no 5, p. 691-701Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was, by means of discussion highlighting ethical questions and moral reasonings, to increase understanding of the situations of caregivers and relatives of older persons living in a public nursing home in Sweden. The findings show that these circumstances can be better understood by considering two different perspectives: an individual perspective, which focuses on the direct contact that occurs among older people, caregivers and relatives; and a societal perspective, which focuses on the norms, values, rules and laws that govern a society. Relatives and caregivers thought that the politicians were sending out mixed messages: they were praising caregivers and relatives for their efforts, but at the same time the public health care sector was subjected to significant cutbacks in resources. Both caregivers and relatives were dissatisfied and frustrated with the present situation regarding the care of older persons in public nursing homes.

  • 25.
    Häggström, Elisabeth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, 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 care2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 9, p. 1749-1757Article in journal (Refereed)
    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.

  • 26.
    Häggström, Elisabeth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Kihlgren, Mona
    Wadensten, Barbro
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Caregivers working with older people experience work dissatisfaction and low self-esteem orginating from power relations in municipal care organization2009In: Tidsskrift for Sygeplejeforskning, ISSN 0900-3002, Vol. 25, no 2, p. 27-33Article in journal (Refereed)
    Abstract [en]

    This study explores how a combined gender and power perspective might explain and help us understand caregivers´ expressions of low self-esteem and dissatisfaction in their work with older people. The aim of the study was to discover whether caregivers’ experiences in the nursing home can be understood on the basis of Ås´ framework of the Five Master Techniques. The study was conducted within the municipal gerontological care system in Sweden and has an explorative, qualitative design. Twenty caregivers were interviewed, and the interviews were analysed using a qualitative content approach. Based on Ås´ theory of Five Master Techniques, the caregivers’ experiences of being made to feel invisible, ridiculed, deprived of information, receiving double punishment and feelings of guilt and shame emerged from the analyses. The study shows that the caregivers’ experiences, listed above, were all obvious at the nursing home and that these experiences also affected their feelings of work dissatisfaction and low self-esteem. The findings show the importance of using a gender perspective in caring, so that power relations in the organization can be explored, understood and combated.

  • 27.
    Häggström, Elisabeth
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Mamhidir, Anna-Greta
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Kihlgren, Annica
    Health Academy, Örebro University, Örebro, Sweden.
    Caregivers' strong commitment to their relationship with older people2010In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 16, no 2, p. 99-105Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to describe caregivers' good as well as bad experiences of working with older people. The study was based on five focus group interviews. One theme emerged from a latent content analysis: strong commitment to the relationship. This theme functioned as a thread of underlying meaning throughout the entire interpretative process of 48 caregivers' experiences of work. A delicate relationship existed that could be vulnerable and could reveal itself in feelings of lack of knowledge, guilt and fear. The caregivers' committed relationship to the older adults created independency in the ways in which they protected the older people's needs. Further studies are needed that focus on caregivers' transition from dependency to independency. The findings highlight the importance of clinical supervision to personal development and identity, and to promoting caregivers' self-esteem and maintaining a committed relationship. Commitment is a deep human feeling, and it should be promoted in order to maintain and further develop quality care for older adults

  • 28.
    Häggström, Elisabeth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Mbusa, Ester
    Kilimanjaro Christian Medical College, Tanzania.
    Wadensten, Barbro
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Nurses' workplace distress and ethical dilemmas in Tanzanian health care2008In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 15, no 4, p. 478-491Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe Tanzanian nurses’ meaning of and experiences with ethical dilemmas and workplace distress in different care settings. An open question guide was used and the study focused on the answers the 29 registered nurses’ supplied. The written answers were analysed with a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur. From the findings the theme, ‘Tanzanian registered nurses’ invisible and visible expressions about existential conditions in care’, emerged from the interpretation of the following sub-themes, which appeared from the structural analysis: (1) ‘Suffering from workplace distress’; (2) ‘Suffering from ethical dilemmas’; (3) ‘Suffering from maintaining a good quality of nursing’; (4) ‘Suffering from the lack of respect, appreciation, and influence’; (5) ‘Suffering from a heavy workload does not prevent the registered nurses from struggling for better care for their patients’. In this study, the deep analysis of the Tanzanian nurses’ work situations shows that on a daily basis, they find themselves working on the edge of life and death, while they have few opportunities for doing anything about this situation. One of the conclusions is that the nurses need professional guidance so they can get insight into and also be able to reflect on the situations they are in, while also being made conscious of the fact that they do not have to overload themselves with ethical dilemmas and workplace distress.

  • 29.
    Häggström, Elisabeth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Skovdahl, Kirsti
    Fläckman, Birgitta
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Kihlgren, Annica
    Kihlgren, Mona
    To feel betrayed and to feel that you are betraying the older residents: caregivers' experiences at a newly opened nursing home2004In: Journal of clinical nursing, Vol. 13, no 6, p. 687-696Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    In Sweden and internationally, little research has focused on the working situation of Enrolled Nurses and Nurses' Aides who form the majority of workers in geriatric care today. With this in mind, it is important to focus on how these occupational groups experience their working situation with older residents in municipal care.

    AIMS AND OBJECTIVES:

    The aim of the study was to investigate the deeper meaning of work satisfaction and work dissatisfaction at a newly opened nursing home for older residents. The study focused on the narratives supplied by the caregivers at the nursing home. The participants included: one Registered Nurse, sixteen Enrolled Nurses, and three Nurses' Aides. All were directly involved in patient care.

    DESIGN:

    The present study is part of a larger longitudinal study within the municipal geriatric care system in Sweden, with a quasi-experimental design.

    METHOD:

    The interviews were analysed with a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur.

    RESULT:

    The caregivers experiences of work satisfaction and work dissatisfaction was expressed in four themes: (i) 'Experience of betrayal' describes how the staff felt let down in several ways; (ii) 'Experience of failing others' describes how the staff felt that they did not pay enough attention to older people, in several different ways; (iii) 'Experience of insufficiency' describes how the staff encountered overwhelming demands from several directions; (iv) 'Experience of work satisfaction' describes how the staff felt that they were given support in various ways. Each theme emerged from several subthemes that originated from the caregivers' narratives.

    CONCLUSIONS:

    The study shows that the caregivers' experience of work dissatisfaction overshadows their experience of work satisfaction. It also suggests that their feelings of failing the older residents are connected to their own experiences of feeling betrayed.

    RELEVANCE TO CLINICAL PRACTICE:

    The findings can be used when other nursing homes in municipal care are opened, as a means of preventing work dissatisfaction and increasing work satisfaction among future employees.

  • 30.
    Häggström, Elisabeth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Skovdahl, Kirsti
    Fläckman, Birgitta
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Kihlgren, Annica
    Kihlgren, Mona
    Work satisfaction and dissatisfaction: caregivers’ experiences after a two-year intervention in a newly opened nursing home2005In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 14, no 1, p. 9-19Article in journal (Refereed)
    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.

  • 31.
    Nilsson, Annika
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Häggström, Elisabeth
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
     The meaning of living with rheumatoid arthritis:  – a single case study based on one woman’s eight-year diary2009In: Tidsskrift for Sygeplejeforskning, ISSN 0900-3002, Vol. 25, no 3, p. 9-15Article in journal (Refereed)
    Abstract [en]

    Previous studies about experiences with rheumatoid arthritis (RA) often have a biomedical perspective. Few studies have discussed the meaning of living with the phenomenon RA from a single-case investigation. This was an important issue when deciding to analyse and interpret one woman’s diary, which covered eight years of living with RA. The aim of this study was to investigate the meaning of living with the phenomenon RA, using one woman’s personal diary spanning eight years. The present study is an in-depth case investigation with a phenomenological-hermeneutic design. One woman diagnosed with RA eight years ago and the meaning of living with RA, according to her. A personal periodically written diary was used for this study. The text was analysed using a phenomenological-hermeneutic method inspired by the philosopher Ricoeur. Results. The results are presented in two themes and five subthemes. The theme ‘To feel doubt, grief and lost identity’ mirror the big challenge it is to live with rheumatoid arthritis for body, soul, identity and social contacts in daily life. This theme emerged from the following subthemes: ‘Being sad about constant physical pain and the loss of bodily function’, ‘Being sad about feelings of constant tiredness’, ‘Losing identity creates a lack of confidence,’ and ‘Being sad and disappointed when meeting carers and colleagues face to face.’ The theme ‘To be good enough’ mirrors a long process in which an expression of more confidence becomes visible. This theme emerged from the subtheme ‘Enjoying the small things in life’. The meaning of living with RA for a number of years seems to have created feelings of not being good enough and also of losing one’s identity. The process of implementing a changed picture of oneself and also of implementing a good self-image seems to be a very long and difficult process for a person living with RA. This is an important issue for care staff working with RA patients to be aware of, since it has influence on the RA patient’s self-respect.

  • 32.
    Nyström, Anita
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Pålsson, Ylva
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Hofsten, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Medical science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Bachelor nursing students' experiences of being video-recorded during examination in a simulated emergency care situation2013Conference paper (Refereed)
  • 33.
    Nyström, Anita
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Pålsson, Ylva
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Hofsten, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet.
    Nursing students' experiences of being video-recorded during examination in a fictive emergency care situation2014In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 20, no 5, p. 540-548Article in journal (Refereed)
    Abstract [en]

    Background: Promoting bachelor nursing students’ learning in simulated care can be achieved through dynamic scenario-based training sessions that are documented using simple video equipment. One valuable aspect of this kind of training is the subsequent reflective dialogue that takes place between the teacher and the students during the examination.

    Aim: The aim of the present paper is to describe bachelor nursing students’ experiences of being video-recorded during an examination with a simulated patient in emergency care.

    Method: The study was descriptive in design and used a qualitative approach with written answers to open-ended questions; 44 bachelor nursing students participated.

    Results: A latent content analysis resulted in three themes: (1) Visualization may cause nervousness at first, (2) Visualization promotes dialogue and acknowledgement, and (3) Visualization promotes increased self-knowledge and professional growth.

    Conclusion: The conclusion is that video-recording is a good way for bachelor nursing students to develop skills in emergency care situations and to understand their own actions; it may also help them increase their self-knowledge.  

  • 34.
    Nyström, Anita
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Pålsson, Ylva
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Hofsten, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Medical science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Nursing students' experiences of being video-recorded during examination in a fictive emergency care situation2012Conference paper (Refereed)
    Abstract [en]

    Abstract

    Promoting bachelor nursing students’ learning in fictive care can be achieved through dynamic

    scenario-based training sessions that are documented using simple video equipment. One

    valuable aspect of this kind of training is the subsequent reflective dialogue that takes place

    between the teacher and the students.

    The aim of the present paper is to describe bachelor nursing students’ experiences of being videorecorded

    during an examination with a fictive patient in emergency care.

    The study was descriptive in design and used a qualitative approach with written answers to

    open-ended questions; 44 bachelor nursing students participated.

    A latent content analysis resulted in three themes: (1)

    Visualization may cause nervousness at

    first,

    (2) Visualization promotes dialogue and acknowledgement, and (3) Visualization promotes

    increased self-knowledge and professional growth.

    The conclusion is that video-recording is a good way for bachelor nursing students to develop

    skills in emergency care situations and to understand their own actions; it may also help them

    increase their self-knowledge

  • 35.
    Nyström, Anita
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Pålsson, Ylva
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Hofsten, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Medical science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Undergraduate nursing students experiences of beeing video-recorded during examination in a simulated emergency care situation2013Conference paper (Refereed)
  • 36.
    Wadensten, Barbro
    et al.
    Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Häggström, Elisabeth
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Public nursing home staff's experience of participating in an intervention aimed at enhancing their self-esteem2009In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 17, no 7, p. 833-842Article in journal (Refereed)
    Abstract [en]

    Aim The aim of the present study was to gain an understanding of how nursing staff experienced participating in a training programme aimed at strengthening their self-esteem and empowering them, to determine whether participation benefited them in any way, and to describe their opinions about possible benefits or disadvantages. Background Staff working in institutions such as nursing homes have a low status in society. A training programme was introduced to staff in a public nursing home. It focused on helping them understand factors in the work situation that influence them and on empowering them. Method The study was explorative and qualitative in design. Findings The participants in the programme were generally satisfied with it. Their opinions about the benefits they received from the programme can be described using three themes: 'improved communication skills', 'enhanced self-esteem' and 'sees work in a different light'. Conclusions The most important finding of the present study is that it was possible to strengthen and empower staff. Staff members were generally pleased and satisfied with the content/organization of the training programme. They felt the programme had been of value to them by improving their communication skills and increasing their self-esteem. Implications for nursing management The present result could be of value to managers and educators working in the area of nursing home care when planning education and development activities for staff. Learning to communicate better and understand the social structure at the workplace could improve staff members' self-esteem, thereby enhancing the work situation and atmosphere as well as empowering the individuals.

  • 37.
    Östlund, Ann-Sofi
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala universitet.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala universitet.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala universitet.
    Wadensten, Barbro
    Department of Public Health and Caring Sciences, Uppsala universitet.
    Primary care nurses' performance in motivational interviewing: a quantitative descriptive study2015In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 16, no 1, p. 89-100Article in journal (Refereed)
    Abstract [en]

    Background: Motivational interviewing is a collaborative conversational style intended to strengthen motivation to change. It has been shown to be effective in addressing many different lifestyle problems as well as in chronic disease management, and many disease prevention guidelines promote use of motivational interviewing. The aim of the present study was twofold: to assess to what extent the primary care nurses in the study perform motivational interviewing according to the Motivational Interviewing Treatment Integrity Code and to investigate how the participating primary care nurses rated their own performance in motivational interviewing.

    Method: The study was based on twelve primary care nurses’ audio-recorded motivational interviewing sessions with patients (total 32 sessions). After each session, the nurses completed a questionnaire regarding their experience of their own performance in motivational interviewing. The audio-recorded sessions were analyzed using Motivational Interviewing Integrity Code 3.1.1.

    Results: None of the nurses achieved beginning proficiency in all parts of any motivational interviewing sessions and two nurses did not achieve beginning proficiency in any parts or sessions. Making more complex than simple reflections was the specific verbal behavior/summary score that most nurses achieved. Beginning proficiency/competency in “percent open questions” was the summary score that fewest achieved.

    Conclusion: Primary care nurses did not achieve beginning proficiency/competency in all aspects of motivational interviewing in their recorded sessions with patients, where lifestyle change was discussed. This indicates a need for improvement and thus additional training, feedback and supervision in clinical practice with motivational interviewing.

  • 38.
    Östlund, Ann-Sofi
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala universitet.
    Wadensten, Barbro
    Department of Public Health and Caring Sciences, Uppsala universitet.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. 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 settings2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 15-16, p. 2284-2294Article in journal (Refereed)
    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.

  • 39.
    Östlund, Ann-Sofi
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    Wadensten, Barbro
    Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    Lindqvist, Helena
    Department of Clinical Neuroscience, MIC Lab, Karolinska Institutet, Stockholm, Sweden.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    Primary care nurses' communication and its influence on patient talk during motivational interviewing2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 11, p. 2844-2856Article in journal (Refereed)
    Abstract [en]

    Aim

    To describe what verbal behaviors/kinds of talk occur during recorded motivational interviewing sessions between nurses in primary care and their patients. The aim was also to examine what kinds of nurse talk predict patient change talk, neutral talk and/or sustain talk.

    Background

    Motivational interviewing is a collaborative conversational style. It has been shown to be effective, in addressing health behaviors such as diet, exercise, weight loss and chronic disease management. In Sweden, it is one of the approaches to disease prevention conversations with patients recommended in the National Guidelines for Disease Prevention. Research on the mechanisms underlying motivational interviewing is growing, but research on motivational interviewing and disease prevention has also been called for.

    Design

    A descriptive and predictive design was used.

    Methods

    Data were collected during 2011-2014. Fifty audio-recorded motivational interviewing sessions between 23 primary care nurses and 50 patients were analyzed using Motivational Interviewing Sequential Code for Observing Process Exchanges. The frequency of specific kinds of talk and sequential analysis (to predict patient talk from nurse talk) were computed using the software Generalized Sequential Querier 5.

    Findings

    The primary care nurses and patients used neutral talk most frequently. Open and negative questions, complex and positive reflections were significantly more likely to be followed by change talk and motivational interviewing-inconsistent talk, positive questions and negative reflections by sustain talk.

    Conclusions

    To increase patients’ change talk, primary care nurses need to use more open questions, complex reflections as well as questions and reflections directed toward change.

  • 40.
    Östlund, Ann-Sofi
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Wadensten, Barbro
    Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Motivational interviewing: Experiences of primary care nurses trained in the method2015In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 15, no 2, p. 111-118Article in journal (Refereed)
    Abstract [en]

    Motivational interviewing is a person-centered counseling style used to promote behavioral change regarding a wide variety of lifestyle problems. Use of motivational interview is growing worldwide and among many different healthcare professions, including primary care nursing. The study aim was to describe motivational interview trained nurses' experiences of motivational interviewing in primary care settings. The study had a qualitative descriptive design. It was carried out in Swedish primary care settings in two county council districts, with 20 primary care nurses trained in motivational interviewing. Half of them used the method in their work, half did not. Qualitative semi-structured interviews were used. Data were analyzed using qualitative content analysis. The nurses experienced that openness to the approach and an encouraging working climate are required to overcome internal resistance and to increase use of motivational interviewing. They also experienced mutual benefit: motivational interviewing elicits and develops abilities in both nurses and patients. For the nurses using it, motivational interviewing is perceived to facilitate work with patients in need of lifestyle change. Lack of training/education, support, interest and appropriate work tasks/patients are reasons for not using motivational interviewing.

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