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BETA
Wireklint Sundström, Birgitta, Ass professorORCID iD iconorcid.org/0000-0001-8536-1910
Alternative names
Biography [eng]

Sjuksköterskeutbildning                                               

Högskolan i Malmö                                                                       Exam. 1972

                                              

Vidareutbildning anestesisjukvård                                               

 Umeå universitet                                                                            Exam. 1975

 

Vårdlärarutbildning                                                                     

Göteborgs universitet                                                                    Exam. 1979

 

Kandidatexamen i Omvårdnad med

inriktning mot handledning                                                          

Göteborgs universitet                                                                    1997

 

Magisterexamen i Omvårdnad                                                     

Högskolan i Halmstad                                                                   1998

 

Doktorsexamen i Vårdvetenskap

Växjö universitet                                                                           2005

 

Postdoc tjänst 80 %                                                                 

Högskolan i Borås                                                                         2007

 

Docent                                                                                     

Högskolan i Borås                                                                          2013

 

Biography [swe]

Forskningen har
ett speciellt fokus på tidig bedömning och optimal vårdnivå för olika
patientgrupper inom ambulanssjukvård. Drivs av ett stort intresse att vara med
och bygga upp evidens inom vård och behandling för de akuta insatser som görs
dagligen, till exempel inom ambulanssjukvård och larmcentral.

Publications (10 of 58) Show all publications
Hansson, P.-O., Andersson Hagiwara, M., Herlitz, J., Brink, P. & Wireklint Sundström, B. (2019). Prehospital assessment of suspected stroke and TIA: an observational study.. Acta Neurologica Scandinavica
Open this publication in new window or tab >>Prehospital assessment of suspected stroke and TIA: an observational study.
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2019 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Symptoms related to stroke diverge and may mimic many other conditions.

AIMS: To evaluate clinical findings among patients with a clinical suspicion of stroke in a prehospital setting and find independent predictors of a final diagnosis of stroke or transient ischemic attack (TIA) METHODS: An observational multi-centre study including nine emergency hospitals in western Sweden. All patients transported to hospital by ambulance and in whom a suspicion of stroke was raised by the EMS clinician before hospital admission during a four-month period were included.

RESULTS: Of 1,081 patients, a diagnosis of stroke was confirmed at hospital in 680 patients (63%), while 69 (6%) were diagnosed as TIA and 332 patients (31%) received other final diagnoses. In a multiple logistic regression analysis, factors independently associated with a final diagnosis of stroke or TIA were increasing age, odds ratio (OR) per year: 1.02, p=0.007, a history of myocardial infarction (OR: 1.77, p= 0.01), facial droop (OR: 2.81, p<0.0001), arm weakness (OR: 2.61, p<0.0001), speech disturbance (OR: 1.92, p<0.0001) and high systolic blood pressure (OR: 1.50, p=0.02), while low oxygen saturation was significantly associated with other diagnoses (OR: 0.41, p=0.007). More than half of all patients among patients with both stroke/TIA and other final diagnoses died during the five-year follow-up.

CONCLUSIONS: Seven factors including the three symptoms included in the Face Arm Speech Test (FAST) were significantly associated with a final diagnosis of stroke or TIA in a prehospital assessment of patients with a suspected stroke. This article is protected by copyright. All rights reserved.

Keywords
Emergency Medical Services, diagnosis, mortality, stroke
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:hb:diva-16022 (URN)10.1111/ane.13107 (DOI)31009075 (PubMedID)
Available from: 2019-04-24 Created: 2019-04-24 Last updated: 2019-04-29Bibliographically approved
Gabre, M., Wireklint Sundström, B. & Olausson, S. (2018). 'A little good with the bad': Newly diagnosed type 2 diabetes patients' perspectives onself-care: A phenomenological approach. Nordic journal of nursing research
Open this publication in new window or tab >>'A little good with the bad': Newly diagnosed type 2 diabetes patients' perspectives onself-care: A phenomenological approach
2018 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593Article in journal (Refereed) Published
Abstract [en]

Increased knowledge is needed about what self-care means from the patients’ perspective, especially since the patient population with type 2 diabetes has been rising. The aim was to describe self-care, as experienced by patients with newly diagnosed type 2 diabetes. This study adopted a phenomenological approach. Eight patients were interviewed. A combination of photos and interviews were used. The essential meaning of self-care was found to be an existential struggle that evokes feelings of being in-between one’s old unhealthy life and a new healthier one. In this in-between condition, tension exits between contradictorily emotions of anxiety, hopelessness and hope. This struggle also means questioning one’s identity. It is important that diabetes nurses create an opening for reflection and dare to challenge their patients to reflect on this existential struggle.

Keywords
lived experiences, newly diagnosed, phenomenology, reflective lifeworld research, self-care, type 2 diabetes
National Category
Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-14344 (URN)10.1177/2057158518775319 (DOI)
Available from: 2018-06-19 Created: 2018-06-19 Last updated: 2018-07-10Bibliographically approved
Andersson Hagiwara, M., Wireklint Sundström, B., Brink, P., Herlitz, J. & Hansson, P.-O. (2018). A shorter system delay for haemorrhagic stroke than ischaemic stroke among patients who use emergency medical service.. Acta Neurologica Scandinavica
Open this publication in new window or tab >>A shorter system delay for haemorrhagic stroke than ischaemic stroke among patients who use emergency medical service.
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2018 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVES: We compare various aspects in the early chain of care among patients with haemorrhagic stroke and ischaemic stroke.

MATERIALS & METHODS: The Emergency Medical Services (EMS) and nine emergency hospitals, each with a stroke unit, were included. All patients hospitalised with a first and a final diagnosis of stroke between 15 December 2010 and 15 April 2011 were included. The primary endpoint was the system delay (from call to the EMS until diagnosis). Secondary endpoints were: (i) use of the EMS, (ii) delay from symptom onset until call to the EMS; (iii) priority at the dispatch centre; (iv) priority by the EMS; and (v) suspicion of stroke by the EMS nurse and physician on admission to hospital.

RESULTS: Of 1336 patients, 172 (13%) had a haemorrhagic stroke. The delay from call to the EMS until diagnosis was significantly shorter in haemorrhagic stroke. The patient's decision time was significantly shorter in haemorrhagic stroke. The priority level at the dispatch centre did not differ between the two groups, whereas the EMS nurse gave a significantly higher priority to patients with haemorrhage. There was no significant difference between groups with regard to the suspicion of stroke either by the EMS nurse or by the physician on admission to hospital.

CONCLUSIONS: Patients with a haemorrhagic stroke differed from other stroke patients with a more frequent and rapid activation of EMS.

Keywords
EMS, prehospital, stroke, system delay
National Category
Clinical Medicine
Identifiers
urn:nbn:se:hb:diva-13521 (URN)10.1111/ane.12895 (DOI)000429693800010 ()29315463 (PubMedID)2-s2.0-85040200414 (Scopus ID)
Available from: 2018-01-17 Created: 2018-01-17 Last updated: 2018-12-07Bibliographically approved
Holmberg, M., Andersson, H., Winge, K., Lundberg, C., Karlsson, T., Herlitz, J. & Wireklint Sundström, B. (2018). Association between the reported intensityof an acute symptom at first prehospital assessment and the subsequent outcome:a study on patients with acute chest painand presumed acute coronary syndrome. BMC Cardiovascular Disorders, 1-10, Article ID 18:216.
Open this publication in new window or tab >>Association between the reported intensityof an acute symptom at first prehospital assessment and the subsequent outcome:a study on patients with acute chest painand presumed acute coronary syndrome
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2018 (English)In: BMC Cardiovascular Disorders, p. 1-10, article id 18:216Article in journal (Refereed) Published
Abstract [en]

Background: To decrease the morbidity burden of cardiovascular disease and to avoid the development ofpotentially preventable complications, early assessment and treatment of acute coronary syndrome (ACS) areimportant. The aim of this study has therefore been to explore the possible association between patients’ estimatedintensity of chest pain when first seen by the ambulance crew in suspected ACS, and the subsequent outcomebefore and after arrival in hospital.

Methods: Data was collected both prospectively and retrospectively. The inclusion criteria were chest pain raisingsuspicion of ACS and a reported intensity of pain ≥4 on the visual analogue scale.

Results: All in all, 1603 patients were included in the study. Increased intensity of chest pain was related to: 1) moreheart-related complications before hospital admission; 2) a higher proportion of heart failure, anxiety and chest painafter hospital admission; 3) a higher proportion of acute myocardial infarction and 4) a prolonged hospitalisation.However, there was no significant association with mortality neither in 30 days nor in three years. Adjustment forpossible confounders including age, a history of smoking and heart failure showed similar results.

Conclusion: The estimated intensity of chest pain reported by the patients on admission by the ambulance team wasassociated with the risk of complications prior to hospital admission, heart failure, anxiety and chest pain after hospitaladmission, the final diagnosis and the number of days in hospital.

National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-15352 (URN)10.1186/s12872-018-0957-3 (DOI)000451531300001 ()30486789 (PubMedID)
Available from: 2018-11-30 Created: 2018-11-30 Last updated: 2018-12-07Bibliographically approved
Wireklint Sundström, B., Bremer, A., Lindström, V. & Vicente, V. (2018). Caring science research in the ambulance services: an integrative systematic review.. Scandinavian Journal of Caring Sciences
Open this publication in new window or tab >>Caring science research in the ambulance services: an integrative systematic review.
2018 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: The ambulance services are associated with emergency medicine, traumatology and disaster medicine, which is also reflected in previous research. Caring science research is limited and, since no systematic reviews have yet been produced, its focus is unclear. This makes it difficult for researchers to identify current knowledge gaps and clinicians to implement research findings.

AIM: This integrative systematic review aims to describe caring science research content and scope in the ambulance services.

DATA SOURCES: Databases included were MEDLINE (PubMed), CINAHL, Web of Science, ProQDiss, LibrisDiss and The Cochrane Library. The electronic search strategy was carried out between March and April 2015. The review was conducted in line with the standards of the PRISMA statement, registration number: PROSPERO 2016:CRD42016034156.

REVIEW METHODS: The review process involved problem identification, literature search, data evaluation, data analysis and reporting. Thematic data analysis was undertaken using a five-stage method. Studies included were evaluated with methodological and/or theoretical rigour on a 3-level scale, and data relevance was evaluated on a 2-level scale.

RESULTS: After the screening process, a total of 78 studies were included. The majority of these were conducted in Sweden (n = 42), fourteen in the United States and eleven in the United Kingdom. The number of study participants varied, from a case study with one participant to a survey with 2420 participants, and 28 (36%) of the studies were directly related to patients. The findings were identified under the themes: Caregiving in unpredictable situations; Independent and shared decision-making; Public environment and patient safety; Life-changing situations; and Ethics and values.

CONCLUSION: Caring science research with an explicit patient perspective is limited. Areas of particular interest for future research are the impact of unpredictable encounters on openness and sensitivity in the professional-patient relation, with special focus on value conflicts in emergency situations.

Keywords
ambulance, caring science, emergency medical services, holistic approach, patient perspective, prehospital, review, systematic
National Category
Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-15212 (URN)10.1111/scs.12607 (DOI)30252151 (PubMedID)2-s2.0-85054421374 (Scopus ID)
Projects
PreHospen
Available from: 2018-10-15 Created: 2018-10-15 Last updated: 2018-11-16Bibliographically approved
Wennberg, P., Andersson, H. & Wireklint Sundström, B. (2018). Patients with suspected hip fracture in the chain of emergency care: An integrative review of the literature. International Journal of Orthopaedic and Trauma Nursing
Open this publication in new window or tab >>Patients with suspected hip fracture in the chain of emergency care: An integrative review of the literature
2018 (English)In: International Journal of Orthopaedic and Trauma NursingArticle in journal (Refereed) In press
Keywords
Hip fractures, Emergency care, Pain assessment
National Category
Orthopaedics
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-13979 (URN)10.1016/j.ijotn.2017.11.002 (DOI)000432461300004 ()29631852 (PubMedID)2-s2.0-85046756618 (Scopus ID)
Available from: 2018-04-16 Created: 2018-04-16 Last updated: 2018-12-21Bibliographically approved
Hansson, P.-O., Andersson Hagiwara, M., Brink, P., Herlitz, J. & Wireklint Sundström, B. (2018). Prehospital identification of factors associated with death during one-year follow-up after acute stroke.. Brain and Behavior, Article ID e00987.
Open this publication in new window or tab >>Prehospital identification of factors associated with death during one-year follow-up after acute stroke.
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2018 (English)In: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, article id e00987Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVES: In acute stroke, the risk of death and neurological sequelae are obvious threats. The aim of the study was to evaluate the association between various clinical factors identified by the emergency medical service (EMS) system before arriving at hospital and the risk of death during the subsequent year among patients with a confirmed stroke.

MATERIAL AND METHODS: All patients with a diagnosis of stroke as the primary diagnosis admitted to a hospital in western Sweden (1.6 million inhabitants) during a four-month period were included. There were no exclusion criteria.

RESULTS: In all, 1,028 patients with a confirmed diagnosis of stroke who used the EMS were included in the analyses. Among these patients, 360 (35%) died during the following year. Factors that were independently associated with an increased risk of death were as follows: (1) high age, per year OR 1.07; 95% CI 1.05-1.09; (2) a history of heart failure, OR 2.08; 95% CI 1.26-3.42; (3) an oxygen saturation of <90%, OR 8.05; 95% CI 3.33-22.64; and (4) a decreased level of consciousness, OR 2.19; 95% CI 1.61-3.03.

CONCLUSIONS: Among patients with a stroke, four factors identified before arrival at hospital were associated with a risk of death during the following year. They were reflected in the patients' age, previous clinical history, respiratory function, and the function of the central nervous system.

Keywords
acute stroke, early chain, mortality, one-year follow-up
National Category
Clinical Medicine
Identifiers
urn:nbn:se:hb:diva-14200 (URN)10.1002/brb3.987 (DOI)000434409200019 ()29770601 (PubMedID)2-s2.0-85047512969 (Scopus ID)
Available from: 2018-08-16 Created: 2018-08-16 Last updated: 2018-08-17Bibliographically approved
Wireklint Sundström, B., Andersson Hagiwara, M., Brink, P., Herlitz, J. & Hansson, P.-O. (2017). The early chain of care and risk of death in acute stroke in relation to the priority given at the dispatch centre: A multicentre observational study. European Journal of Cardiovascular Nursing, 16(7), 623-631
Open this publication in new window or tab >>The early chain of care and risk of death in acute stroke in relation to the priority given at the dispatch centre: A multicentre observational study
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2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, Vol. 16, no 7, p. 623-631Article in journal (Refereed) Published
Abstract [en]

Background:The early chain of care is critical for stroke patients. The most important part is the so-called 'system delay' i.e. the delay time from call to the emergency medical services until a diagnosis is established (computer tomography).Aim:The purpose of this study was to relate the initial priority level given by the dispatch centre to the early chain of care in acute stroke and to short-term and long-term mortality.Methods:All patients hospitalised with the first and the final diagnosis of acute stroke, 15 December 2010?15 April 2011, were recruited across nine hospitals, each hospital with a stroke care unit.Results:In all, 897 stroke patients were included. Priority at the dispatch centre: 54% received highest priority 1, 41% priority 2 and 5% priority 3. Median system delay from call to emergency medical services until diagnosis by computer tomography was 2 h and 52 min, 4 h and 49 min and 6 h and 33 min respectively in the three priority groups (p<0.0001). There was a similarly strong association between priority level at the dispatch centre and system delay to arrival in a hospital ward, suspicion of stroke by the emergency medical services nurse as well as the physician on hospital admission and the proportion of patients given thrombolysis. Mortality during the subsequent 30 days was 22% among patients with priority 1 and 14% among patients with priority 2.Conclusion:Patients given a lower priority level at the dispatch centre had the longest system delay. Although many of these patients died, the risk of death was highest among those given the highest priority.

National Category
Nursing Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:hb:diva-12231 (URN)10.1177/1474515117704617 (DOI)000412103400008 ()28417645 (PubMedID)2-s2.0-85030251618 (Scopus ID)
Available from: 2017-06-19 Created: 2017-06-19 Last updated: 2017-12-15Bibliographically approved
Norberg Boysen, G., Nyström, M., Christensson, L., Herlitz, J. & Wireklint Sundström, B. (2017). Trust in the early chain of healthcare: lifeworld hermeneutics from the patient's perspective. International Journal of Qualitative Studies on Health and Well-being, 12(1)
Open this publication in new window or tab >>Trust in the early chain of healthcare: lifeworld hermeneutics from the patient's perspective
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2017 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no 1Article in journal, Editorial material (Refereed) Published
Abstract [en]

Purpose: Patients must be able to feel as much trust for caregivers and the healthcare system at the healthcare centre as at the emergency department. The aim of this study is to explain and understand the phenomenon of trust in the early chain of healthcare, when a patient has called an ambulance for non-urgent condition and been referred to the healthcare centre.

Method: A lifeworld hermeneutic approach from the perspective of caring science was used. Ten patient participated: seven female and three male. The setting is the early chain of healthcare in south-wetern Sweden.

Results: The findings show that the phenomenon of trust does not automatically involve medical care. However, attention to the patient's lifeworld in a professional caring relationship enables the patient to trust the caregiver and the healthcare environment. It is clear that the "voice of lifeworld" enables the patient to feel trust.

Conclusion: Trust in the early chain of healthcare entails caregivers' ability to play attention to both medical and existentioal issues in compliance with the patient's information and questions. Thus, the patient must be invited to participate in assessment and decisions concerning his or her own healthcare, in a credible manner and using everyday language.

Keywords
Ambulance, healthcare centre, healthcare level, caring relationship, caring science, trust, lifeworld hermeneutics
National Category
Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-12721 (URN)10.1080/17482631.2017.1356674 (DOI)000407339700001 ()28793852 (PubMedID)2-s2.0-85027691945 (Scopus ID)
Projects
Vård på rätt vårdnivå
Funder
Länsförsäkringar AB
Available from: 2017-09-26 Created: 2017-09-26 Last updated: 2018-12-07Bibliographically approved
Wireklint Sundström, B., Öberg, M., Jylli, L. & Nilsson, R. (2016). Barn och smärta: frakturmisstanke vid fallolycka (2ed.). In: B-O. Suserud & L. Lundberg (Ed.), Prehospital akutsjukvård: (pp. 526-533). Stockholm: Liber
Open this publication in new window or tab >>Barn och smärta: frakturmisstanke vid fallolycka
2016 (Swedish)In: Prehospital akutsjukvård / [ed] B-O. Suserud & L. Lundberg, Stockholm: Liber, 2016, 2, p. 526-533Chapter in book (Other academic)
Place, publisher, year, edition, pages
Stockholm: Liber, 2016 Edition: 2
Keywords
Barn, trauma, prehospitalt
National Category
Medical and Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-8443 (URN)978-91-47-11474-0 (ISBN)
Projects
PreHospen
Available from: 2016-01-12 Created: 2016-01-12 Last updated: 2016-01-14Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8536-1910

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