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Andersson Hagiwara, Magnus
Alternative names
Publications (10 of 83) Show all publications
Wästerhed, J., Ekenberg, E. & Andersson Hagiwara, M. (2024). Ambulance nurses’ experiences as the sole caregiver with critical patients during long ambulance transports: an interview study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 32(1), Article ID 6.
Open this publication in new window or tab >>Ambulance nurses’ experiences as the sole caregiver with critical patients during long ambulance transports: an interview study
2024 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, E-ISSN 1757-7241, Vol. 32, no 1, article id 6Article in journal (Refereed) Published
Abstract [en]

Background

Working in rural areas involves tackling long distances and occasional lack of supportive resources. Ambulance nurses are faced with the responsibility of making immediate autonomous decisions and providing extended care to critically ill patients during prolonged ambulance transport to reach emergency medical facilities. This study aims to expose the experiences of ambulance nurses acting as primary caregivers for critically ill patients during lengthy ambulance transfers in rural regions.

Method

Fifteen nurses employed in an ambulance service within sparsely populated rural areas were subjected to semi-structured interviews. The collected data underwent qualitative content analysis.

Result

The analysis resulted in one overarching theme with two categories. The theme is ‘Safety in the Professional Role,’ and the two categories are ‘Working in sparsely populated areas presents challenges’ and ‘Rare events: when routine cannot be established.’ The findings suggest that working as an ambulance nurse in a rural setting poses various challenges that can be highly stressful. Delivering care to critically ill patients during extended ambulance transports requires the knowledge, experience, and careful planning of the healthcare provider in charge.

Conclusions

The findings underscore the necessity for thorough planning and adaptable thinking when attending to critically ill patients during extended transport scenarios. The absence of supporting resources can render the task demanding. Nevertheless, participants reported an inherent tranquility that aids them in maintaining focus amid their responsibilities.

National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-31420 (URN)10.1186/s13049-024-01178-1 (DOI)2-s2.0-85182864679 (Scopus ID)
Available from: 2024-01-24 Created: 2024-01-24 Last updated: 2024-02-01
Larsson, G., Axelsson, C., Andersson Hagiwara, M., Herlitz, J., Klementsson, H., Troëng, T. & Magnusson, C. (2024). Epidemiology of patients assessed for trauma by Swedish ambulance services: a retrospective registry study. BMC Emergency Medicine, 24(1), Article ID 11.
Open this publication in new window or tab >>Epidemiology of patients assessed for trauma by Swedish ambulance services: a retrospective registry study
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2024 (English)In: BMC Emergency Medicine, E-ISSN 1471-227X, Vol. 24, no 1, article id 11Article in journal (Refereed) Published
Abstract [en]

Background

There is a lack of knowledge regarding the epidemiology of severe trauma assessed by Swedish emergency medical services (EMS).

Aim

To investigate the prevalence of trauma in Sweden assessed by EMS from a national perspective and describe patient demography, aetiology, trauma type, prehospital triage and clinical outcomes.

Methods

Data from two national quality registries, the Swedish Ambulance Registry and the Swedish Trauma Registry (SweTrau) were collected from January 1 to December 31, 2019. Inclusion criteria were an Emergency Symptoms and Signs code equivalent to trauma in the Swedish Ambulance Registry and criteria fulfilled for SweTrau inclusion. Exclusion criteria were patients < 18 years old, those not transported to a hospital and those without a personal identification number.

Results

In total, 53,120 patients with trauma were included (14% of primary EMS missions involving a personal identification number). Of those, 2,278 (4.3%) patients (median age: 45 years; 32% women) were reported in SweTrau to have severe or potentially severe trauma (penetrating: 7%, blunt: 93%). In terms of including all causes of trauma, the code for ‘trauma alert activation’ was most frequent (55%). The most frequent injury mechanism was an injury caused by a car (34%). Most (89%) cases were assigned Priority 1 (life-threatening condition) at the dispatch centre. 62% were regarded as potentially life threatening upon EMS arrival, whereas 29% were assessed as non-life-threatening. Overall, 25% of the patients had new injury severity scores > 15. 12% required invasive treatment, 11% were discharged with severe disability and the 30-day mortality rate was 3.6%.

Conclusion

In this cross-sectional study, 14% of the primary EMS missions for one year were caused by trauma. However, only a small proportion of these cases are severe injuries, and the risk of severe disabilities and death appears to be limited. The most frequent aetiology of a severe trauma is injury caused by a car, and most severe traumas are blunt. Severe traumas are given the highest priority at the dispatch centre in the vast majority of cases, but nearly one-third of these cases are considered a low priority by the EMS nurse. The latter leaves room for improvement.

Keywords
Trauma, Injury, Emergency medical services, Ambulance services, Patient, Severity, Mortality
National Category
Nursing
Research subject
The Human Perspective in Care; The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-31161 (URN)10.1186/s12873-023-00924-5 (DOI)001138257800002 ()2-s2.0-85181723478 (Scopus ID)
Available from: 2024-01-10 Created: 2024-01-10 Last updated: 2024-02-01Bibliographically approved
Larsson, G., Axelsson, C., Andersson Hagiwara, M., Herlitz, J. & Magnusson, C. (2023). Characteristics of a trauma population in an ambulance organisation in Sweden: results from an observational study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 31(1), Article ID 33.
Open this publication in new window or tab >>Characteristics of a trauma population in an ambulance organisation in Sweden: results from an observational study
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2023 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, E-ISSN 1757-7241, Vol. 31, no 1, article id 33Article in journal (Refereed) Published
Abstract [en]

Background

Globally, injuries are a major health problem, and in Sweden, injuries are the second most common reason for ambulance dispatch. However, there is a knowledge gap regarding the epidemiology of injuries requiring assessment by emergency medical services (EMS) in Sweden. The aim of the present study was to describe the prehospital population with injuries that have been assessed and treated by EMS.

Methods

A randomly selected retrospective sample was collected from 1 January through 31 December 2019 in a region in southwestern Sweden. Data were collected from ambulance and hospital medical records.

Results

Among 153,724 primary assignments, 26,697 (17.4%) were caused by injuries. The study cohort consisted of 5,235 patients, of whom 50.5% were men, and the median age was 63 years. The most common cause of injury was low-energy fall (51.4%), and this was the cause in 77.8% of those aged > 63 years and in 26.7% of those aged ≤ 63 years. The injury mechanism was a motor vehicle in 8.0%, a motorcycle in 2.1% and a bicycle in 4.0%. The most common trauma location was the residential area (55.5% overall; 77.9% in the elderly and 34.0% in the younger group). In the prehospital setting, the most frequent clinical sign was a wound (33.2%), a closed fracture were seen in 18.9% and an open fracture in 1.0%. Pain was reported in 74.9% and 42.9% reported severe pain. Medication was given to 42.4% of patients before arrival in the hospital. The most frequent triage colour according to the RETTS was orange (46.7%), whereas only 4.4% were triaged red. Among all patients, 83.6% were transported to the hospital, and 27.8% received fracture treatment after hospital admission. The overall 30-day mortality rate was 3.4%.

Conclusion

Among EMS assignments in southwestern Sweden, 17% were caused by injury equally distributed between women and men. More than half of these cases were caused by low-energy falls, and the most common trauma location was a residential area. The majority of the victims had pain upon arrival of the EMS, and a large proportion appeared to have severe pain.

 

National Category
Nursing
Research subject
The Human Perspective in Care; The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30003 (URN)10.1186/s13049-023-01090-0 (DOI)001020635300003 ()2-s2.0-85163314491 (Scopus ID)
Available from: 2023-06-29 Created: 2023-06-29 Last updated: 2024-02-01Bibliographically approved
Lee, E., Sjöqvist, B. A., Andersson Hagiwara, M., Maurin Söderholm, H. & Candefjord, S. (2023). Development of Verified Innovation Process for Healthcare Solutions (VIPHS): A Stepwise Model for Digital Health. In: Maria Hägglund, Madeleine Blusi, Stefano Bonacina, Lina Nilsson, Inge Cort Madsen, Sylvia Pelayo, Anne Moen, Arriel Benis, Lars Lindsköld, Parisis Gallos (Ed.), Studies in Health Technology and Informatics: Volume 302. Paper presented at The 33rd Medical Informatics Europe Conference, MIE2023, Gothenburg, Sweden, 22-25 May, 2023. (pp. 736-740).
Open this publication in new window or tab >>Development of Verified Innovation Process for Healthcare Solutions (VIPHS): A Stepwise Model for Digital Health
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2023 (English)In: Studies in Health Technology and Informatics: Volume 302 / [ed] Maria Hägglund, Madeleine Blusi, Stefano Bonacina, Lina Nilsson, Inge Cort Madsen, Sylvia Pelayo, Anne Moen, Arriel Benis, Lars Lindsköld, Parisis Gallos, 2023, p. 736-740Conference paper, Published paper (Refereed)
Abstract [en]

Many digital health projects often stop in the pilot or test phase. Realisation of new digital health services is often challenging due to lack of guidelines for the step-by-step roll-out and implementation of the systems when changing work processes and procedures are needed. This study describes development of the Verified Innovation Process for Healthcare Solutions (VIPHS) – a stepwise model for digital health innovation and utilisation using service design principles. A multiple case study (two cases) involving participant observation, role play, and semi-structured interviews were conducted for the model development in prehospital settings. The model might be helpful to support realisation of innovative digital health projects in a holistic, disciplined, and strategic way.

Series
Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365 ; 302
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-29845 (URN)10.3233/shti230250 (DOI)001071432900191 ()2-s2.0-85159770221 (Scopus ID)
Conference
The 33rd Medical Informatics Europe Conference, MIE2023, Gothenburg, Sweden, 22-25 May, 2023.
Available from: 2023-05-30 Created: 2023-05-30 Last updated: 2024-02-01Bibliographically approved
Bakidou, A., Caragounis, E.-C., Andersson Hagiwara, M., Jonsson, A., Sjöqvist, B. A. & Candefjord, S. (2023). On Scene Injury Severity Prediction (OSISP) model for trauma developed using the Swedish Trauma Registry. BMC Medical Informatics and Decision Making, 23, Article ID 206.
Open this publication in new window or tab >>On Scene Injury Severity Prediction (OSISP) model for trauma developed using the Swedish Trauma Registry
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2023 (English)In: BMC Medical Informatics and Decision Making, E-ISSN 1472-6947, Vol. 23, article id 206Article in journal (Refereed) Published
Abstract [en]

Background

Providing optimal care for trauma, the leading cause of death for young adults, remains a challenge e.g., due to field triage limitations in assessing a patient’s condition and deciding on transport destination. Data-driven On Scene Injury Severity Prediction (OSISP) models for motor vehicle crashes have shown potential for providing real-time decision support. The objective of this study is therefore to evaluate if an Artificial Intelligence (AI) based clinical decision support system can identify severely injured trauma patients in the prehospital setting.

Methods

The Swedish Trauma Registry was used to train and validate five models – Logistic Regression, Random Forest, XGBoost, Support Vector Machine and Artificial Neural Network – in a stratified 10-fold cross validation setting and hold-out analysis. The models performed binary classification of the New Injury Severity Score and were evaluated using accuracy metrics, area under the receiver operating characteristic curve (AUC) and Precision-Recall curve (AUCPR), and under- and overtriage rates.

Results

There were 75,602 registrations between 2013–2020 and 47,357 (62.6%) remained after eligibility criteria were applied. Models were based on 21 predictors, including injury location. From the clinical outcome, about 40% of patients were undertriaged and 46% were overtriaged. Models demonstrated potential for improved triaging and yielded AUC between 0.80–0.89 and AUCPR between 0.43–0.62.

Conclusions

AI based OSISP models have potential to provide support during assessment of injury severity. The findings may be used for developing tools to complement field triage protocols, with potential to improve prehospital trauma care and thereby reduce morbidity and mortality for a large patient population.

National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30608 (URN)10.1186/s12911-023-02290-5 (DOI)001082654300001 ()2-s2.0-85173661225 (Scopus ID)
Funder
European Regional Development Fund (ERDF)Chalmers University of Technology
Available from: 2023-10-12 Created: 2023-10-12 Last updated: 2023-10-31Bibliographically approved
Andersson, U., Maurin Söderholm, H., Andersson, H., Wireklint Sundström, B., Andersson Hagiwara, M. & Puaca, G. (2023). Organizational factors influencing clinical reasoning in a Swedish emergency medical service organization: An explorative qualitative case study. Paramedicine
Open this publication in new window or tab >>Organizational factors influencing clinical reasoning in a Swedish emergency medical service organization: An explorative qualitative case study
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2023 (English)In: Paramedicine, ISSN 2753-6386Article in journal (Refereed) Published
Abstract [en]

Introduction

Clinical reasoning (CR) among healthcare professionals working in emergency medical services (EMS) who focus on ambulance care is a vital part of ensuring timely and safe patient care. The EMS environment continually fluctuates, so clinicians constantly need to adapt to new situations. Organizational support is described as important for CR, but overall, research on organizational influences for CR in an EMS context is lacking. An increased understanding of these influencing factors can assist in the development of EMS by strengthening CR among clinicians. Therefore, the purpose of this study was to investigate the organizational factors influencing EMS clinicians’ CR.

Methods

Using a qualitative single case study design, an EMS organization in southwestern Sweden was explored. Data were collected from participant observations of patient encounters, individual and group interviews with clinicians and organizational representatives, and organizational document audits. Data were analyzed using qualitative content analysis and triangulation of data sources.

Results

The results revealed several organizational influencing factors. Collaboration and information sharing internally and externally were emphasized as essential components influencing CR. Additionally, the structure for the clinicians’ ‘room for action’ appeared confused and created uncertainties for CR related to decision mandates.

Conclusion

The conclusion is that organizational factors do play an important role in clinicians’ CR. Moreover, the EMS community needs to develop suitable forums for discussing and developing these influencing factors across organizational hierarchies. Finally, clarification is needed on clinicians’ ‘room for action’ within their own organization but also with possible collaborators.

 

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
health and well-being, qualitative analysis and interpretation, clinical reasoning, decision making, emergency medicalservices, work and healthcare environment
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30241 (URN)10.1177/27536386231189011 (DOI)2-s2.0-85175415486 (Scopus ID)
Available from: 2023-08-11 Created: 2023-08-11 Last updated: 2024-02-01Bibliographically approved
Olander, A., Magnusson, C., Sundler, A. J., Bremer, A., Andersson, H., Herlitz, J., . . . Andersson Hagiwara, M. (2023). Prediction of the Risk of Sepsis by Using Analysis of Plasma Glucose and Serum Lactate in Ambulance Services: A Prospective Study. Prehospital and Disaster Medicine, 38(2), 160-167
Open this publication in new window or tab >>Prediction of the Risk of Sepsis by Using Analysis of Plasma Glucose and Serum Lactate in Ambulance Services: A Prospective Study
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2023 (English)In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 38, no 2, p. 160-167Article in journal (Refereed) Published
Abstract [en]

Introduction: The early recognition of patients with sepsis is difficult and the initial assessment outside of hospitals is challenging for ambulance clinicians (ACs). Indicators that ACs can use to recognize sepsis early are beneficial for patient outcomes. Research suggests that elevated point-of-care (POC) plasma glucose and serum lactate levels may help to predict sepsis in the ambulance service (AS) setting. 

Study Objective: The aim of this study was to test the hypothesis that the elevation of POC plasma glucose and serum lactate levels may help to predict Sepsis-3 in the AS. 

Methods: A prospective observational study was performed in the AS setting of Gothenburg in Sweden from the beginning of March 2018 through the end of September 2019. The criteria for sampling POC plasma glucose and serum lactate levels in the AS setting were high or intermediate risk according to the Rapid Emergency Triage and Treatment System (RETTS), as red, orange, yellow, and green if the respiratory rate was >22 breaths/minutes. Sepsis-3 were identified retrospectively. A primary and secondary analyses were carried out. The primary analysis included patients cared for in the AS and emergency department (ED) and were hospitalized. In the secondary analysis, patients who were only cared for in the AS and ED without being hospitalized were also included. To evaluate the predictive ability of these biomarkers, the area under the curve (AUC), sensitivity, specificity, and predictive values were used. 

Results: A total of 1,057 patients were included in the primary analysis and 1,841 patients were included in the secondary analysis. In total, 253 patients met the Sepsis-3 criteria (in both analyses). The AUC for POC plasma glucose and serum lactate levels showed low accuracy in predicting Sepsis-3 in both the primary and secondary analyses. Among all hospitalized patients, regardless of Sepsis-3, more than two-thirds had elevated plasma glucose and nearly one-half had elevated serum lactate when measured in the AS. 

Conclusions: As individual biomarkers, an elevated POC plasma glucose and serum lactate were not associated with an increased likelihood of Sepsis-3 when measured in the AS in this study. However, the high rate of elevation of these biomarkers before arrival in hospital highlights that their role in clinical decision making at this early stage needs further evaluation, including other endpoints than Sepsis-3.

Keywords
ambulance clinician, ambulance service, glucose, lactate, sepsis
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-29443 (URN)10.1017/s1049023x23000110 (DOI)000929336400001 ()2-s2.0-85150666227 (Scopus ID)
Available from: 2023-02-13 Created: 2023-02-13 Last updated: 2024-02-01Bibliographically approved
Andersson, U., Maurin Söderholm, H., Andersson Hagiwara, M. & Andersson, H. (2023). Situation awareness in Sweden’s emergency medical services: a goal-directed task analysis. Discover Health Systems, 2, Article ID 44.
Open this publication in new window or tab >>Situation awareness in Sweden’s emergency medical services: a goal-directed task analysis
2023 (English)In: Discover Health Systems, ISSN 2731-7501, Vol. 2, article id 44Article in journal (Refereed) Published
Abstract [en]

Situation awareness is knowing what is going on in the situation. Clinicians working in the emergency medical services (EMS) encounter numerous situations in various conditions, and to be able to provide efficient and patient safe care they need to understand what is going on and possible projections of the current situation. The design of this study encompassed a Goal-Directed Task analysis where situation awareness information requirements were mapped in relation to goals related to various aspects of the EMS mission. A group of 30 EMS subject matter experts were recruited and answered a web-based survey in three rounds related to what they though themselves or a colleague might need to achieve situation awareness related to the specific goals of various situations. The answers were analysed using content analysis and descriptive statistics. Answers reached consensus at a predetermined level of 75%. Those who reached consensus were entered into the final goal-directed task analysis protocol. The findings presented that EMS clinicians must rely on their own, or their colleagues prior experience or knowledge to achieve situation awareness. This suggests that individual expertise plays a crucial role in developing situation awareness. There also seems to be limited support for situation awareness from organizational guidelines. Furthermore, achieving situation awareness also involves collaborative efforts from the individuals involved in the situation. These findings could add to the foundation for further investigation in this area which could contribute to the development of strategies and tools to enhance situation awareness among EMS clinicians, ultimately improving patient care and safety.

National Category
Nursing
Research subject
The Human Perspective in Care; The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30937 (URN)10.1007/s44250-023-00061-7 (DOI)
Available from: 2023-11-28 Created: 2023-11-28 Last updated: 2024-01-18Bibliographically approved
Olander, A., Andersson, H., Sundler, A. J., Andersson Hagiwara, M. & Bremer, A. (2023). The onset of sepsis as experienced by patients and family members: A qualitative interview study. Journal of Clinical Nursing, 1-10
Open this publication in new window or tab >>The onset of sepsis as experienced by patients and family members: A qualitative interview study
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2023 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, p. 1-10Article in journal (Refereed) Published
Abstract [en]

Aims and Objectives: To explore the onset of sepsis based on patients' and family members' experiences.

Background: Knowledge about the onset of sepsis is limited among patients and their families, which makes early recognition of sepsis difficult. Previous studies argue that their stories are important to recognising sepsis and reduced suffering and mortality.

Design: A descriptive design with a qualitative approach was used.Methods: In total, 29 patients and family members participated in 24 interviews with open-ended questions, including five dyadic and 19 individual interviews. The interviews were conducted during 2021, and participants were recruited from a sepsis group on social media. A thematic analysis based on descriptive phenomenology was performed. The study followed the COREQ checklist.

Findings: Two themes emerged from the experiences: (1) When health changes into something unknown, including the two subthemes; Bodily symptoms and signs being vague but still tangible and Feelings of uncertainty, and (2) Turning points when warnings signs are deemed as serious, including the two subthemes Passing borders when feeling out of control and Difficulties understanding the seriousness.

Conclusions: Patients' and family members' stories of the onset of sepsis indicate that symptoms and signs appeared insidiously and then noticeably worsen. The symptoms and signs seemed not be attributed to sepsis; instead, there was uncertainty about what the symptoms and signs meant. It was mainly family members who possibly understood the seriousness of the disease.

Implications for the profession and patient care: Patients' experiences of their symptoms and signs and family members' unique knowledge of the patient, indicate that healthcare professionals should listen and try to understand what the patient and family members are telling and take their concerns seriously. How the condition appears, and family members' concerns are important pieces of the assessment to recognise patients with sepsis.

Patient or public contribution: Patients and family members contributed to the data collected.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2023
Keywords
experience, family member, interviews, onset, patient, sepsis, sign, symptom
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:hb:diva-29881 (URN)10.1111/jocn.16785 (DOI)001002252000001 ()2-s2.0-85161467777 (Scopus ID)
Available from: 2023-06-06 Created: 2023-06-08 Last updated: 2024-02-01Bibliographically approved
Herlitz, J., Wireklint Sundström, B., Andersson Hagiwara, M., Lundgren, P., Larsson, G., Magnusson, C., . . . Axelsson, C. (2023). Över 100 doktorsavhandlingar inom den prehospitala akutsjukvården i Sverige. Läkartidningen, 120
Open this publication in new window or tab >>Över 100 doktorsavhandlingar inom den prehospitala akutsjukvården i Sverige
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2023 (Swedish)In: Läkartidningen, ISSN 1652-7518, Vol. 120Article, review/survey (Refereed) Epub ahead of print
Abstract [sv]

HUVUDBUDSKAP

  • Över 100 avhandlingar har i dagsläget skrivits om den prehospitala akutsjukvården i Sverige.
  • Dessa täcker ett omfattande kunskapsfält, allt ifrån prognostiska faktorer vid akut sjukdom till ambulans personalens psykiska och fysiska hälsa.
  • Endast ett kunskapsområde har belysts mera om fattande, och det är hjärt–lungräddning vid plötsligt hjärtstopp.
  • Vården av patienter med psykisk ohälsa har inte belysts i någon avhandling.
  • Det finns stora kunskapsluckor, och vidare forskning inom området behövs.
Place, publisher, year, edition, pages
Läkartidningen Förlag AB, 2023
National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-30677 (URN)37860864 (PubMedID)2-s2.0-85174866154 (Scopus ID)
Available from: 2023-10-23 Created: 2023-10-23 Last updated: 2024-01-11Bibliographically approved
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