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Fridh, Isabell
Publications (10 of 37) Show all publications
Lindahl, B., Fridh, I. & Andersson, M. (2019). Can an ICU-patient roompromote wellbeing and improve healthcare quality?. In: : . Paper presented at EfCCNA conference in Ljublijana Slovenien, 13-16 February, 2019.. EfCCNA
Open this publication in new window or tab >>Can an ICU-patient roompromote wellbeing and improve healthcare quality?
2019 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

To present novel reflections on environment regarding the design of the patient room in intensive care units(ICUs).Introduction: An ICU and the patient room in particular, is a protected and closed area in that other hospital staff and visitors have no immediate access to such environment. The ICU environment often appears frightening to patients and their loved ones due to presence of technology and advanced treatments. There is evidence that sounds, light, sleep deprivation and ICU delirium impact on patients’ health and recovery. Research has described negative effects of ICU environment to staff concerning noise, high work-load, heavy responsibilities and a complex psychological proximity to patients and their loved ones. A health care environment and patient room should be safe and attractive to staff so that they continue to contribute to caring processes. However, research about ICU’s physical environment and ICU-patient room design are sparse and thus evidence about how to design such areas is weak. Recommendations: Recommendations based on evaluation of a research program concerning evidence-based design in ICU-patient rooms will be shared. Components like light, sound environment, shape, colours, decoration and view to nature will be presented, pros and con with single rooms and the concepts privacy and control will be articulated. The research program was performed within a caring science perspective and so far it has generated three PhD theses with a forth on its way. Directions for further research such as interdisciplinary collaboration, the need for development of the meta-paradigm concept environment will be suggested. The latter needs to be theorized, problematized and practically explored. ICU-nurses, nursing researchers and former patients should collaborate with architects, building planners and economists in planning of new ICUs. Concepts like enriching and healing environments should be a part of ICU-nurses education curricula.

Place, publisher, year, edition, pages
EfCCNA: , 2019
Keywords
Intensive care unit, caring environment, evidence-based design, sustainable environment
National Category
Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-15885 (URN)
Conference
EfCCNA conference in Ljublijana Slovenien, 13-16 February, 2019.
Projects
Evidensbaserad design inom intensivvård - en framtida utmaning
Funder
Swedish Research Council, 521-2013-969
Available from: 2019-03-19 Created: 2019-03-19 Last updated: 2019-04-11Bibliographically approved
Listerfeldt, S., Fridh, I. & Lindahl, B. (2019). Facing the unfamiliar: Nurses' transcultural care in intensive care - A focus group study.. Intensive & Critical Care Nursing, Article ID 102752.
Open this publication in new window or tab >>Facing the unfamiliar: Nurses' transcultural care in intensive care - A focus group study.
2019 (English)In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, article id 102752Article in journal (Refereed) Epub ahead of print
Abstract [en]

INTRODUCTION: Western Europe today is a culturally diverse society and expected to become more so in the future. When patients from unfamiliar cultures become critically ill and require intensive care, this places considerable demands on the cultural and linguistic competencies of the intensive care staff. Existing research regarding the transcultural aspects of intensive care is scarce and, in Sweden, non-existent.

OBJECTIVE: To explore the experiences of critical care nurses and enrolled nurses in caring for culturally diverse patients in intensive care units.

METHOD: Four focus group interviews were conducted with a total of 15 interviewees. The collected data were subjected to qualitative content analysis.

FINDINGS: The findings mostly concerned the nursing staff's experiences of caring for relatives. Caring for the relatives of culturally diverse patients was described as challenging due to linguistic and cultural barriers.

CONCLUSIONS: To overcome linguistic and cultural barriers, intensive care units should be reorganised and restructured to create a more welcoming environment for relatives. Alternative communication methods should be developed and traditional ways of using support from interpreters support must be re-evaluated. Education to ensure cultural competence and the promotion of an intercultural approach is key and the development of research programmes is recommended.

Keywords
Cultural competence, Culturally diverse, Focus groups interview, Intensive care unit, Intercultural care, Nursing staff, Relatives, Transcultural care
National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-21925 (URN)10.1016/j.iccn.2019.08.002 (DOI)31416669 (PubMedID)
Available from: 2019-11-05 Created: 2019-11-05 Last updated: 2019-11-11Bibliographically approved
Björk, K., Lindahl, B. & Fridh, I. (2019). Family members’ experiences of waiting in intensive care: a concept analysis. Scandinavian Journal of Caring Sciences, 1-18
Open this publication in new window or tab >>Family members’ experiences of waiting in intensive care: a concept analysis
2019 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, p. 1-18Article in journal (Refereed) Published
Abstract [en]

AIM:

The aim of this study was to explore the meaning of family members' experience of waiting in an intensive care context using Rodgers' evolutionary method of concept analysis.

METHOD:

Systematic searches in CINAHL and PubMed retrieved 38 articles which illustrated the waiting experienced by family members in an intensive care context. Rodgers' evolutionary method of concept analysis was applied to the data.

FINDINGS:

In total, five elements of the concept were identified in the analysis. These were as follows: living in limbo; feeling helpless and powerless; hoping; enduring; and fearing the worst. Family members' vigilance regarding their relative proved to be a related concept, but vigilance does not share the same set of attributes. The consequences of waiting were often negative for the relatives and caused them suffering. The references show that the concept was manifested in different situations and in intensive care units (ICUs) with various types of specialties.

CONCLUSIONS:

The application of concept analysis has brought a deeper understanding and meaning to the experience of waiting among family members in an intensive care context. This may provide professionals with an awareness of how to take care of family members in this situation. The waiting is inevitable, but improved communication between the ICU staff and family members is necessary to reduce stress and alleviate the suffering of family members. It is important to acknowledge that waiting cannot be eliminated but family-centred care, including a friendly and welcoming hospital environment, can ease the burden of family members with a loved one in an ICU.

Place, publisher, year, edition, pages
London: , 2019
Keywords
family members, waiting, intensive care, crit- ical care, Rodgers’ evolutionary method of concept analysis
National Category
Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-21048 (URN)10.1111/scs.12660 (DOI)
Available from: 2019-05-21 Created: 2019-05-21 Last updated: 2019-05-28Bibliographically approved
Fridh, I. & Åkerman, E. (2019). Family-centred end-of-life care and bereavement services in Swedish intensive care units: A cross-sectional study.. Nursing in Critical Care
Open this publication in new window or tab >>Family-centred end-of-life care and bereavement services in Swedish intensive care units: A cross-sectional study.
2019 (English)In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Post-intensive care syndrome-family is a common problem in relatives of patients who die in an intensive care unit. Family-centred end-of-life care with support for the family during and after the death is supposed to prevent suffering and avoid illness.

AIMS AND OBJECTIVES: This study aimed to investigate family-centred end-of-life care and bereavement follow-up services offered to family members of patients who die in Swedish intensive care units.

DESIGN, METHODS: A cross-sectional study using a 16-question survey based on family-centred end-of-life care was sent to all 81 adult intensive care units. Data were analysed by descriptive statistics and chi-square. Respondents were able to add individual comments to the questionnaire.

RESULTS: Although the majority (76.7%) offered some kind of follow up, this service was not always offered. Modes for invitation, timing, and contents in the follow up varied between the units. The staff tried to individualize the follow-up service according to the family's needs. Nurses and social workers were the only professionals who provided follow-up conversations on their own. Most of the intensive care units (97.3%) kept diaries that were handed over to the family when they left the unit after the patient's death or at a follow-up visit. Only 8.8% reported that they always offer the family the opportunity to be present during resuscitation. Most respondents reported that patients (60.6%) died in a private room.

CONCLUSIONS: Family-centred end-of-life care varied among the intensive care units, and some families were not offered any follow up at all. Timing, invitation, and elements in the follow up differ between the units. Diaries were commonly kept and usually given to the family. Few units offered the family to be present during resuscitation.

RELEVANCE TO CLINICAL PRACTICE: There is a need for national guidelines to ensure that all bereaved families receive equal and individual family-centred end-of-life care.

Keywords
bereavement, cross-sectional study, end-of-life, family-centred care
National Category
Health Sciences
Identifiers
urn:nbn:se:hb:diva-21926 (URN)10.1111/nicc.12480 (DOI)000492041800001 ()31647161 (PubMedID)
Available from: 2019-11-05 Created: 2019-11-05 Last updated: 2019-11-11Bibliographically approved
Sundberg, F., Fridh, I., Olausson, S. & Lindahl, B. (2019). Room Design - A Phenomenological-Hermeneutical Study: A Factor in Creating a Caring Environment.. Critical Care Nursing Quarterly, 42(3), 265-277, Article ID 31135477.
Open this publication in new window or tab >>Room Design - A Phenomenological-Hermeneutical Study: A Factor in Creating a Caring Environment.
2019 (English)In: Critical Care Nursing Quarterly, ISSN 0887-9303, E-ISSN 1550-5111, Vol. 42, no 3, p. 265-277, article id 31135477Article in journal (Refereed) Published
Abstract [en]

Medical technology has progressed tremendously over the last few decades, but the same development cannot be seen in the design of these intensive care unit environments. Authors report results of a study of evidence-based room design, emphasizing the impact on conveying a caring attitude to patients. Ten nonparticipant observations were conducted in patient rooms with 2 different designs, followed by interviews. The data were analyzed using a phenomenological-hermeneutical approach. The results did not reveal that it was obvious that redesigned spaces resulted in a more caring attitude. The meanings of caring displayed during nursing activities were interpreted by interpreting gazes. Some of the nursing staff had an instrumental gaze, interpreted as caring with a task-orientated approach, while others communicated their caring with an attentive and attuned gaze, where the needs of the patients regulated the working shift. The study findings indicated that caring may not be perceived when nurses use a task-oriented approach. However, when nurses practice a person-centered approach, using an attentive and attuned gaze, caring is conveyed. Caring in intensive care contexts needs to be assisted by a supportive environment design that cultivates the caring approach.

Place, publisher, year, edition, pages
USA: Wolters Kluwer, 2019
National Category
Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-21134 (URN)10.1097/CNQ.0000000000000267 (DOI)
Funder
Swedish Research Council, 521-2013-969
Available from: 2019-05-31 Created: 2019-05-31 Last updated: 2019-06-17Bibliographically approved
Bazzi, M., Bergbom, I., Hellström, M., Fridh, I., Ahlberg, K. & Lundgren, S. M. (2019). Team composition and staff roles in a hybrid operating room: A prospective study using video observations.. Nursing Open, 6(3), 1245-1253
Open this publication in new window or tab >>Team composition and staff roles in a hybrid operating room: A prospective study using video observations.
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2019 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 3, p. 1245-1253Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of the study was to evaluate team composition and staff roles in a hybrid operating room during endovascular aortic repairs.

Design: Quantitative descriptive design.

Methods: Nine endovascular aortic repairs procedures were video-recorded between December 2014 and September 2015. The data analysis involved examining the work process, number of people in the room and categories of staff and their involvement in the procedure.

Results: The procedures were divided into four phases. The hybrid operating room was most crowded in phase 3 when the skin wound was open. Some staff categories were in the room for the entire procedure even if they were not actively involved. The largest number of people simultaneously in the room was 14.

Keywords
endovascular aortic repairs, hybrid operating room, nursing staff, staff presence, staff roles, team composition, video observations
National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-21924 (URN)10.1002/nop2.327 (DOI)000476917700065 ()31367451 (PubMedID)
Available from: 2019-11-05 Created: 2019-11-05 Last updated: 2019-11-11Bibliographically approved
Bazzi, M., Lundgren, S. M., Hellström, M., Fridh, I., Ahlberg, K. & Bergbom, I. (2019). The drama in the hybrid OR: video observations of work processes and staff collaboration during endovascular aortic repair.. Journal of Multidisciplinary Healthcare, 12, 453-464
Open this publication in new window or tab >>The drama in the hybrid OR: video observations of work processes and staff collaboration during endovascular aortic repair.
Show others...
2019 (English)In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 12, p. 453-464Article in journal (Refereed) Published
Abstract [en]

Introduction: A hybrid operating room (OR) is a surgical OR with integrated imaging equipment and the possibility to serve both open surgery and image-guided interventions.

Aim: This study aimed to investigate the work processes and types of collaboration in a hybrid OR during endovascular aortic repair (EVAR).

Methods: Data consisted of video recordings from nine procedures, with a total recording time of 48 hrs 39 mins. The procedures were divided into four episodes (Acts). A qualitative cross-case analysis was conducted, resulting in a typical case. The type of collaboration during specific tasks was discussed and determined based on Thylefors´ team typology.

Results: An extensive amount of safety activities occurred in the preparation phase (Acts 1 and 2), involving a number of staff categories. After the skin incision (Act 3), the main activities were performed by fewer staff categories, while some persons had a standby position and there were persons who were not at all involved in the procedure.

Discussion: The different specialist staff in the hybrid OR worked through different types of collaboration: multi-, inter- and transprofessional. The level of needed collaboration depended on the activity performed, but it was largely multiprofessional and took place largely in separate groups of specialties: anesthesiology, surgery and radiology. Waiting time and overlapping tasks indicate that the procedures could be more efficient and safe for the patient.

Conclusion: This study highlights that the three expertise specialties were required for safe treatment in the hybrid OR, but the extent of interprofessional activities was limited. Our results provide a basis for the development of more effective procedures with closer and more efficient interprofessional collaboration and reduction of overlapping roles. Considerable waiting times, traffic flow and presence of people who were not involved in the patient care are areas of further investigation.

Keywords
collaboration, cross case analysis, hybrid operating room, tasks, video recording, work processes
National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-21923 (URN)10.2147/JMDH.S197727 (DOI)31354284 (PubMedID)
Available from: 2019-11-05 Created: 2019-11-05 Last updated: 2019-11-11Bibliographically approved
Sepideh, O., Fridh, I., Lindahl, B. & Torkildsby, A.-B. (2019). The meanings of comfort in intensive care settings: the fusion of care and interior design revealed through a lexical and content analysis. Intensive and Critical Care Nursing Quarterly, 42(3), 329-341
Open this publication in new window or tab >>The meanings of comfort in intensive care settings: the fusion of care and interior design revealed through a lexical and content analysis
2019 (English)In: Intensive and Critical Care Nursing Quarterly, ISSN 0887-9303, Vol. 42, no 3, p. 329-341Article in journal (Refereed) Published
Abstract [en]

Providing comfort in an ICU setting is often related to pain relief and end-of-life care; environmental factors are often neglected, despite the major role of the environment on the patients’ wellbeing and comfort. The aim of this paper is to explore the meanings of comfort from a theoretical and empirical perspective to increase the understanding of what comfort means in ICU settings. A lexical analysis and serials of workshops were performed, and data were analysed using a qualitative content analysis. The findings from the theoretical analysis show that comfort has a broad range of synonyms related both to subjective experiences and objective and physical qualities. The findings from the empirical part reveal four themes: comfort in relation to nature, comfort in relation to situation and people, comfort in relation to place and comfort in relation to objects and material. Materiality, functionality, memory, culture and history stipulate comfort. It is challenging to discern what comfort is when it comes to an individual’s function and emotions. We also found that comfort is closely linked to nature and wellbeing.

Keywords
Patients’ rooms, health facilities, seminars and workshops, lexical analysis, content analysis
National Category
Health Sciences
Identifiers
urn:nbn:se:hb:diva-21044 (URN)10.1097/CNQ.0000000000000268 (DOI)000474247200013 ()
Funder
Swedish Research Council, 521-2013-969
Available from: 2019-05-21 Created: 2019-05-21 Last updated: 2019-10-18Bibliographically approved
Karlsson, J., Eriksson, T., Lindahl, B. & Fridh, I. (2019). The Patient’s Situation During Interhospital Intensive Care Unit-to-Unit Transfers: A Hermeneutical Observational Study. Qualitative Health Research, 1-12
Open this publication in new window or tab >>The Patient’s Situation During Interhospital Intensive Care Unit-to-Unit Transfers: A Hermeneutical Observational Study
2019 (English)In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, p. 1-12Article in journal (Refereed) Epub ahead of print
Abstract [en]

Interhospital intensive care unit-to-unit transfers are an increasing phenomenon, earlier mainly studied from a patient safety perspective. Using data from video recordings and participant observations, the aim was to explore and interpret the observed nature of the patient’s situation during interhospital intensive care unit-to-unit transfers. Data collection from eight transfers resulted in over 7 hours of video material and field notes. Using a hermeneutical approach, three themes emerged: being visible and invisible; being in a constantly changing space; and being a fettered body in constant motion. The patient’s situation can be viewed as an involuntary journey, one where the patient exists in a constantly changing space drifting in and out of the health personnel’s attention and where movements from the journey become part of the patient’s body. Interhospital transfers of vulnerable patients emerge as a complex task, challenging the health personnel’s ability to maintain a caring atmosphere around these patients.

Place, publisher, year, edition, pages
Sage Publications, 2019
National Category
Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-15874 (URN)10.1177/1049732319831664 (DOI)
Projects
Interhospitala överföringar inom intensivvård
Available from: 2019-03-07 Created: 2019-03-07 Last updated: 2019-03-13Bibliographically approved
Sundberg, F., Fridh, I. & Lindahl, B. (2018). Abstracts, Poster Presentation for Qualitative Health Research Conference, 2017. Paper presented at Qualitative Health Research Conference. International Journal of Qualitative Methods, 17(1), 1-31
Open this publication in new window or tab >>Abstracts, Poster Presentation for Qualitative Health Research Conference, 2017
2018 (English)In: International Journal of Qualitative Methods, ISSN 1609-4069, E-ISSN 1609-4069, Vol. 17, no 1, p. 1-31Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Alberta: Sage Publications, 2018
National Category
Medical and Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-14297 (URN)10.1177/1609406917748703 (DOI)
Conference
Qualitative Health Research Conference
Available from: 2018-05-31 Created: 2018-05-31 Last updated: 2018-07-04Bibliographically approved
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