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Karlsson, M., Karlsson, N. & Hilli, Y. (2017). Ethical dilemmas during cardiac arrest incidents in the patient’s home. Nursing Ethics, 1-13
Open this publication in new window or tab >>Ethical dilemmas during cardiac arrest incidents in the patient’s home
2017 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, p. 1-13Article in journal (Refereed) Published
Abstract [en]

Background: The majority (70%) of cardiac arrests in Sweden are experienced in the patient’s home. In these situations, the ambulance nurses may encounter several ethical dilemmas.

 Aim: The aim was to investigate Swedish specialist ambulance nurses’ experiences of ethical dilemmas associated with cardiac arrest situations in adult patients’ homes.

Methods: Nine interviews were conducted with specialist ambulance nurses at four different ambulance stations in the southeast region of Sweden. Data were analysed using content analysis.

Ethical considerations: Ethical principles mandated by the Swedish Research Council were carefully followed during the whole process.

Findings: Two main themes with six sub-themes were identified: The scene – creating a sheltered space for caring and Ethical decision-making. The results showed that ethical dilemmas might occur when trying to create a sheltered space to preserve the patients’ integrity and dignity. A dilemma could be whether or not to invite significant others to be present during the medical treatment. Ethical decision-making was dependent on good communication and ethical reasoning among all parties. In certain situations, decisions were made not to commence or to terminate care despite guidelines. The decision was guided by combining the medical/nursing perspectives and ethical competence with respect to the human being’s dignity and a will to do good for the patient. The nurses followed the voice of their heart and had the courage to be truly human.

Conclusion: The ambulance nurses were guided by their ethos, including the basic motive to care for the patient, to alleviate suffering, to confirm the patient’s dignity and to serve life and health.

Keywords
Ambulance nurse, cardiac arrest, ethical dilemmas, ethos, interview, patient’s home, qualitative study
National Category
Health Sciences Nursing
Identifiers
urn:nbn:se:hb:diva-12138 (URN)10.1177/0969733017709337 (DOI)
Available from: 2017-05-05 Created: 2017-05-05 Last updated: 2018-01-03Bibliographically approved
Røkholt, G., Davidsen, L.-S., Ness Johnsen, H. & Hilli, Y. (2017). Helsepersonells erfaringer med å implementere kunnskapsbasert praksis på et sykehus i Norge. Nordisk sygeplejeforskning, 7(3), 195-208
Open this publication in new window or tab >>Helsepersonells erfaringer med å implementere kunnskapsbasert praksis på et sykehus i Norge
2017 (Norwegian)In: Nordisk sygeplejeforskning, ISSN 1892-2678, E-ISSN 1892-2686, Vol. 7, no 3, p. 195-208Article in journal (Refereed) Published
Abstract [no]

Bakgrunn: Helsetjenester skal være kunnskapsbaserte, men å omsette forskningsfunn til klinisk praksis beskrives gjennomgående som komplekst og utfordrende. Studien som presenteres i denne artikkelen var første del av et aksjonsforskningsprosjekt i samarbeid mellom et universitetssykehus og en høgskole.  Formålet var å understøtte implementering av kunnskapsbasert praksis som arbeidsform på sykehuset for å bidra til å styrke kvalitet på praksis og å utvikle praksisplassen som læringsarena. Hensikt med denne første delstudien var å avdekke faktorer av betydning for implementerings-prosessen blant ansatte.  Studiens forskningsspørsmål var: Hvordan erfarer helsepersonell kunnskapsbasert praksis i sin arbeidshverdag?

Metode: For å innhente deltagernes erfaringer ble det utført en kulturanalyse ved fire enheter på et sykehus i Sør Norge. Brevmetoden ble brukt datainnsamlingsmetode og data ble analysert med systematisk tekstkondensering. 

Resultat: Studiens resultat presenteres under tre hovedkategorier: Lederen angir tonen som motivator og pådriver; Positiv holdning til og bruk av kunnskapsbasert praksis i arbeidshverdagen; Organisatoriske forhold av betydning. Studien viser at for å lykkes med implementering av kunnskapsbasert praksis er det viktig å ha en leder med positiv holdning som motiverer ansatte og skaper forutsetninger for utviklingsarbeid. Når en slik holdning preger arbeidsmiljøet understøtter det åpenhet og samarbeid og gjør det mulig å dele erfaring og reflektere over praksis. I tillegg trengte en ildsjeler med kompetanse og interesse for kunnskapsbasert praksis. Tidspress, travelhet og varierende kompetanse ble beskrevet som hindringer for implementering av kunnskapsbasert praksis.

Konklusjon: Det kreves et samspill mellom alle disse faktorene for at implementeringen og utviklingsarbeidet skal lykkes.

Abstract [en]

Background: Health care services should be evidence-based, but exploiting the potential of new and existing clinical practice knowledge is challenging. The research presented in this article was the first sub-study in an action research project – a collaboration between a university hospital and a university of applied science. The joint project aimed to support the implementation of evidence-based practice at the hospital in order to strengthen the quality of its clinical practice and to develop practice placements as an arena for learning. The purpose of the first sub-study was to unfold the experiences and attitudes of the staff concerning the implementation of evidence-based practice. The research question was, ‘How do the health care personnel experience evidence-based practice in their daily work’?

Method: A cultural analysis was conducted using the letter-writing method to grasp the staff´s lived experiences. The data were analysed via a content analysis.

Results: The results are presented as three main categories: (1) The leader sets the tone as a motivator and an instigator; (2) a positive attitude towards the use and understanding of evidence-based practice in the working environment; and (3) organizational circumstances of importance. The study showed the importance of a leader who has a positive attitude regarding the development of the working environment and the importance of a leader who motivates staff and creates opportunities for implementation of evidence -based practice. The leader’s manner of attitude is revealed through a culture of openness and cooperation that enables sharing experiences and reflection. Furthermore, real enthusiasts with competence and interest in evidence-based practice are needed. Hindering factors affecting the implementation of evidence-based practice were lack of time, heavy work load and insufficient knowledge about the topic.

Conclusion: For health care services to successfully implement evidence-based practice, there must be an interplay between the leader as a motivator, staff with a positive attitude towards development and an organization that encourages development.

Keywords
Action research, cultural analysis, health care, letter-writing method, physiotherapist, qualitative, quality assurance, registered nurse, Aksjonsforskning, brevmetoden, fysioterapeuter, helsefag, kulturanalyse, kvalitativ studie, kvalitetssikring, sykepleier
National Category
Health Sciences Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-12241 (URN)10.18261/issn.1892-2686-2017-03-03 (DOI)
Available from: 2017-06-20 Created: 2017-06-20 Last updated: 2017-12-13Bibliographically approved
Hilli, Y. (2017). Hemmet (2ed.). In: Wiklund Gustin Lena & Bergbom Ingegerd (Ed.), Vårdvetenskapliga begrepp i teori och praktik: (pp. 257-268). Stockholm: Studentlitteratur AB
Open this publication in new window or tab >>Hemmet
2017 (Swedish)In: Vårdvetenskapliga begrepp i teori och praktik / [ed] Wiklund Gustin Lena & Bergbom Ingegerd, Stockholm: Studentlitteratur AB, 2017, 2, p. 257-268Chapter in book (Refereed)
Abstract [sv]

Vad innebär hemmet i djup mening för människan? Hemmet relateras kanske i första hand till den konkreta platsen där människan vuxit upp, barndomshemmet, familjen, hembygden och fosterlandet. Allt detta är fysiskt påtagbart. Men vad innebär det egentligen att känna sig hemma eller hemlös? Handlar hemma om en känsla och upplevelse som berör frågor om identitet, gemenskap och tillhörighet? Människor med samma kulturbakgrund delar ofta språket, sättet att uttrycka sig, humorn, gemensamma traditioner och värderingar. Är det detta som gör att man känner sig hemma med det bekanta och med människor som delar ens värderingar?

I mötet med andra människor och nya situationer finns hemmet som en klangbotten mot vilket allt det nya speglas, men kan hemmet innebär något mera? Hemma är inte nödvändigtvis bundet till en geografisk plats utan kan mera handla om en känsla.

Place, publisher, year, edition, pages
Stockholm: Studentlitteratur AB, 2017 Edition: 2
National Category
Health Sciences Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-12478 (URN)978-91-44-11243-5 (ISBN)
Available from: 2017-08-10 Created: 2017-08-10 Last updated: 2017-12-15Bibliographically approved
Hilli, Y. & Wasshede, K. (2017). Swedish School Nurses’ Perspectives on Caring for and Promoting the Health of Adolescents with Mental Health Problems – A Qualitative Study. Clinical Nursing Studies, 5(3), 1-9
Open this publication in new window or tab >>Swedish School Nurses’ Perspectives on Caring for and Promoting the Health of Adolescents with Mental Health Problems – A Qualitative Study
2017 (English)In: Clinical Nursing Studies, ISSN 2324-7940, E-ISSN 2324-7959, Vol. 5, no 3, p. 1-9Article in journal (Refereed) Published
Abstract [en]

Background: Over the last few decades, there has been an increase in mental health problems among adolescents, manifested as physical symptoms, such as stomach pain, headaches, feelings of anxiety, worry, stress and sleeping problems. Surveys among school nurses’ have revealed that mental health work now forms a key part of their role. Although an increasing number of adolescents are suffering from mental health problems in upper-secondary schools (16-19 years), there are few studies focusing on this matter. Therefore we wanted to explore the matter from the school nurses’ point of view. The aim of this study was to explore Swedish school nurses’ experiences of caring for and promoting the health of students suffering from mental health problems.

Methods: The present study had a descriptive design and a qualitative approach. A purposeful sample of eight (n = 8) school nurses was interviewed. Their working experience varied between 4 and 29 years. The data were analysed using content analysis. The ethical principles stipulated by the Swedish Research Council were carefully followed throughout the study.

Results: Three main themes with sub-themes were found: A caring relationship as the foundation for health promotion, organizing health-promoting work and interprofessional cooperation as a prerequisite for good caring.

Conclusions: The findings strengthen the evidence of the importance of the health dialogue as a tool for the school nurses to identify students with mental health problems. Creating a caring relationship with the students is a prerequisite for caring and health promotion. Further education concerning mental health and evidence-based-practice should be arranged on regular basis. More research and cooperation between different stakeholders is needed.

Keywords
Adolescents, Caring, Health dialogue, Interview, Mental health, Qualitative, School Nurse
National Category
Health Sciences Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-12192 (URN)10.5430/cns.v5n3p1 (DOI)
Available from: 2017-05-31 Created: 2017-05-31 Last updated: 2017-12-15Bibliographically approved
Hilli, Y. & Eriksson, K. (2017). The Home as Ethos of Caring - a concept determination. Nursing Ethics
Open this publication in new window or tab >>The Home as Ethos of Caring - a concept determination
2017 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989Article in journal (Refereed) Published
Abstract [en]

Background: Within nursing, the concepts of home and homelike have been used indiscriminately to describe characteristics of health care settings that resemble a home more than an institution.

Objectives: The aim of this study was to investigate the concept of home (hem in Swedish). The main questions were as follows: What does the concept of home entail etymologically and semantically? Of what significance is the meaning of the concept to caring science and nursing?

Design and methods: This study had a qualitative design with a hermeneutical approach guided by Gadamer. Eriksson’s model of concept determination was partly used to determine the etymology and semantics, the essence and epistemic category of the concept of home. In this study, etymological dictionaries and 17 Swedish language dictionaries published between 1850 and 2001 were investigated.

Findings: The home, framed as the ethos of caring, can be drawn as a three-dimensional picture where the three dimensions have a common core, enclosed and inviolable. Symbolically, the picture of home can be seen as the ethos of the human being’s innermost room, the human being’s manner of being and the tone cxpressed in the external or abstract room where the human being lives and interacts with others.

Conclusions: Based on the findings in this study we conclude that home as ethos is an inner ethical dimension within the human being. Human beings who are in contact with their ethos, the self, feel at home and dare to follow the voice of their heart. Nurses who experience at-homeness have an ability to invite the patient into a caring relationship. The home and the feeling of being at home have significant meaning in terms of human beings’ health and well-being.

Keywords
caring science, concept determination, ethos, hermeneutics, home
National Category
Health Sciences Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-12190 (URN)10.1177/0969733017718395 (DOI)
Available from: 2017-05-31 Created: 2017-05-31 Last updated: 2017-12-15Bibliographically approved
Rökholt, G., Davidsen, L.-S., Ness Johansen, H. & Hilli, Y. (2016). Hvordan opplever helsefaglig ansatte kunnskapsbasert praksis i sin arbeidshverdag?. In: : . Paper presented at Fag- og forskningsdager for sykepleietjensten i Helse Sör-Öst, Lillehammer, March 9-10, 2016.
Open this publication in new window or tab >>Hvordan opplever helsefaglig ansatte kunnskapsbasert praksis i sin arbeidshverdag?
2016 (Norwegian)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-9565 (URN)
Conference
Fag- og forskningsdager for sykepleietjensten i Helse Sör-Öst, Lillehammer, March 9-10, 2016
Projects
Implementering av kunnskapsbasert praksis som arbeidsform på sykehus. Ett aksjonsorientert samarbeidsprosjekt mellom Akershus universitetssykehus og Högskolan i Oslo og Akerhus.
Available from: 2016-04-08 Created: 2016-04-08 Last updated: 2017-11-09Bibliographically approved
Hilli, Y., Salmu, M. & Jonsén, E. (2016). Perspectives on good preceptorship: A matter of ethics.. In: : . Paper presented at NET 2016. 27th International Networking for Healthcare Education Conference, Cambridge, September 6-8, 2016..
Open this publication in new window or tab >>Perspectives on good preceptorship: A matter of ethics.
2016 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Background: Changes have occurred in the nursing education system in Finland and Sweden as a result of the Bologna declaration.  At present, based on the European Directive, approximately 50% of a general nursing program is arranged as clinical practice (Zabalegui, Macia, Márgues, Ricomá, Nuin, Mariscal, Pedraz, Germán & Moncho, 2006). The one-to-one preceptorship model is rather common in undergraduate nursing education in the Scandinavian countries in order to prepare student nurses for the shift to the graduate nursing role (Luhanga, Billay, Grundy, Myrick & Yonge, 2010). The preceptor plays a vital role in the development of student nurses becoming professional nurses. Smith (1987; 1991) found that the emotional aspects of care associated with the nursing process emerged as an important component of the relationship between student nurses and preceptors. A recent study (Epstein & Carlin, 2012) found that the students’ encounters with the preceptors had ethical dimensions. Values which support the good care of patients are evident in the practice environment. As such, it follows that if the environment doesn’t provide a moral climate, the preceptors may not be able to recognize ethical issues.

Aim: The aim of this Nordic qualitative study was to explore the experiences of good preceptorship in relation to undergraduate student nurses in clinical education from the perspective of the preceptors themselves.

Method: Data was collected by narrative interviews with 27 preceptors in Finland and Sweden and analyzed using a hermeneutical approach.

Findings: The findings are presented as three themes in order to present the perceived experiences of good preceptorship among the research group. The three themes are as follows: The caring relationship as the foundation of learning and development; Mutual respect – a prerequisite for fellowship and a good atmosphere; A deep sense of responsibility towards the student and the profession. A caring relationship, based on caring ethics, is seen as the foundation for learning and development. Moreover, a mutual respect is a prerequisite for fellowship and a good atmosphere. As such, encounters are characterized by reciprocity and mutuality. The preceptors have a deep sense of responsibility toward the students and the profession. Furthermore, the preceptors have an inner responsibility to guide the students into working life and to share their knowledge by acting as role models.  Conclusions: Good preceptorship is based on caring ethics. The preceptors with a sense of ‘being at home’ have the motive and will to invite the students into a caring relationship and care for the students. Preceptorship has a great impact on student nurses in their process of becoming caring nurses and to remain in nursing. The findings suggest that preceptorship should be examined through new lenses. Moreover, preceptorship is an ethical issue that should be recognized by all stakeholders.

References

 

Epstein, I, Carlin, K. Ethical concerns in the student/preceptor relationship: A need for change. Nurse Educ Today. 2012;(32):897-902. doi:10.1016/j.nedt.2012.03.009.

Luhanga, FL, Billay, D, Grundy, Q, Myrick, F, Yonge, O. The one-to-one relationship: Is it really key to an effective preceptorship experience? A review of the literature. Int J Nurs Educ Scholarsh. 2010; 7(1):1-15.

Smith, P. The relationship between quality of nursing care and the ward as a learning environment: developing a methodology. J Adv Nurs. 1987;(12):413-20.

Smith, P. 1991. The nursing process: raising the profile of emotional care in nurse training. J Adv Nurs. 1991; 16:74-81.

Zabalegui, A, Macia, L, Márgues, J, Ricomá, R, Nuin, C, Mariscal, I, Pedraz, A, Germán, C, Moncho, J. Changes in Nursing Education in the European Union. J Nurs Scholarsh. 2006; 38 (2):114-118.

 

Keywords
Preceptorship, clinical education, nurse student, interview, hermeneutics
National Category
Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-10616 (URN)
Conference
NET 2016. 27th International Networking for Healthcare Education Conference, Cambridge, September 6-8, 2016.
Projects
SuperNurseBotnia 2
Available from: 2016-08-28 Created: 2016-08-28 Last updated: 2018-05-07Bibliographically approved
Røkholt, G., Davidsen, L.-S., Ness Johnsen, H. & Hilli, Y. (2016). Possibilities and challenges in evidence-based practice (EBP)  in a hospital setting. In: : . Paper presented at 27th International Networking for Healthcare Education Conference, September 6-8, 2016.
Open this publication in new window or tab >>Possibilities and challenges in evidence-based practice (EBP)  in a hospital setting
2016 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Nursing Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-10820 (URN)
Conference
27th International Networking for Healthcare Education Conference, September 6-8, 2016
Available from: 2016-10-03 Created: 2016-10-03 Last updated: 2017-11-09Bibliographically approved
Larsson, Å. & Hilli, Y. (2016). The ethos of caring within midwifery in the early 1900s: A History of Ideas study. Nursing Ethics
Open this publication in new window or tab >>The ethos of caring within midwifery in the early 1900s: A History of Ideas study
2016 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989Article in journal (Refereed) Accepted
Abstract [en]

Background: The midwifery profession in Sweden has a history since the early 1700s when government training for midwives began. Midwifery is historically well described, but the idea of caring within midwifery is not described.

Aim: The aim was to describe the patterns of ideas of caring as they appeared in midwifery during the first half of the 20th century.

Research design: This study has a hermeneutic approach and the method is history of ideas. Sources of material are taken from the journal Jordemodern (Midwifery), textbooks for midwives, and midwifery regulations. The study has a caring science perspective according to Eriksson.

Ethical considerations: This study is conducted in accordance with the ethical guidelines for good scientific practice issued by The Finnish Advisory Board on Research Integrity. The special demands on approach to the analyzed text in history of ideas have been met.

Findings: Three themes were identified: Serving as a way of life, Acting in a redemptive spirit, and Having independence with heavy responsibility. The various themes are not refined, but current ideas are woven into the weave that were characteristic of midwifery during the first half of the 20th century.

Conclusion: History of ideas is a fruitful method for understanding and re-finding valuable cultural goods. We can once more stress the manner of being within the midwife’s profession where inner values, ethos, shape the manner of conduct in the care of women in childbirth.

Keywords
Caritative caring, childbirth, ethos, history of ideas, midwifery
National Category
Nursing Medical and Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-10614 (URN)10.1177/0969733016669866 (DOI)
Available from: 2016-08-28 Created: 2016-08-28 Last updated: 2017-11-21Bibliographically approved
Lindwall, L. & Hilli, Y. E. (2015). 35 years of the Nordic College of Caring Science - heading for the future. , 29
Open this publication in new window or tab >>35 years of the Nordic College of Caring Science - heading for the future
2015 (English)Other (Refereed)
National Category
Health Sciences Nursing
Identifiers
urn:nbn:se:hb:diva-4112 (URN)10.1111/scs.12257 (DOI)
Note

Vitenskapelig foredrag

Available from: 2015-12-18 Created: 2015-12-16 Last updated: 2018-04-29Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0209-0658

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