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  • 1.
    Abelsson, Anna
    et al.
    Jönköping University, HHJ, Avdelningen för omvårdnad.
    Nygårdh, Annette
    Jönköping University, HHJ, Avdelningen för omvårdnad.
    The nurse anesthetist perioperative dialog2020In: BMC Nursing, E-ISSN 1472-6955, Vol. 19, no 1, article id 37Article in journal (Refereed)
    Abstract [en]

    Background In the perioperative dialogue, pre-, intra- and postoperatively, the patient shares their history. In the dialogue, the nurse anesthetist (NA) gets to witness the patient's experiences and can alleviate the patients' suffering while waiting for, or undergoing surgery. The aim of this study was to describe the nurse anesthetist's experiences of the perioperative dialogue. Methods The study had a qualitative design. Interviews were conducted with 12 NA and analyzed with interpretive content analysis. The methods were conducted in accordance with the COREQ guidelines. Results In the result, three categories emerge: A mutual meeting (the preoperative dialogue) where the patient and the NA through contact create a relationship. The NA is present and listens to the patient, to give the patient confidence in the NA. In the category, On the basis of the patient's needs and wishes (the intraoperative dialogue), the body language of the NA, as well as the ability to read the body language of the patient, is described as important. In the category, To create a safe situation (the postoperative dialogue) the NA ensures that the patient has knowledge of what has happened and of future care in order to restore the control to the patient. Conclusion The patient is met as a person with their own needs and wishes. It includes both a physical and a mental meeting. In a genuine relationship, the NA can confirm and unreservedly talk with the patient. When the patients leave their body and life in the hands of the NA, they can help the patients to find their inherent powers, which allows for participation in their care. Understanding the patient is possible when entering in a genuine relationship with the patient and confirm the patient. The perioperative dialogue forms a safety for the patients in the operating environment.

  • 2.
    Andersson, Henrik
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindholm, Maria
    Pettersson, Margareta
    Jonasson, Lise-Lotte
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Nurses competencies in Home health care: An interview study.2017In: BMC Nursing, E-ISSN 1472-6955, Vol. 16, no 65Article in journal (Refereed)
    Abstract [en]

    Background:Nurses working in Home health care (HHC) are facing major challenges when more advanced care and treatment are performing in the patient's home. The aim of this study was to explore how nurses experiencing their competencies in HHC. 

    Methods:This study has a qualitative and explorative design. Ten nurses were interviewed and data were analysed by content analysis.

    Results:The themes “Being a capable nurse”, “Being a useful nurse” and “Being a subordinate and dependent nurse” were identified. Nurses want to be capable to take care of patients, develop their competencies and perform their duties in the way that are requested. They also want to be useful in their work and providing good and safe HHC. Finally, nurses want to improve the care in HHC with their competencies. Simultaneously, they are subordinate and dependent in the relation with their manager and manager's interest to encourage nurses’ competence development.

    Conclusions:Nurses in HHC are responsible for many seriously ill patients and they want to contribute to a good and safe patient care. To maintain patient safety, reduce the risk for burnout and staff turnover as well as to contribute to a sustainable development of the work, strategies for transfer competencies between nurses and efforts for competence development are needed. 

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  • 3.
    Andersson, Ulf
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. University of Borås.
    Norberg Boysen, Gabriella
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Sterner, Anders
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Simulation-based education as a provider of fieldwork insights – experiences of ambulance nurse specialist students2023In: BMC Nursing, E-ISSN 1472-6955Article in journal (Refereed)
    Abstract [en]

    Background: Medicine is facing a global shortage of nurses, including those with postgraduate education. One suggested educational method for undergraduate and postgraduate education, such as specialist ambulance nurse education, is simulation-based education (SBE). The implementation of SBE is motivated, in part, by the desire to attract and retain students, but also to contribute to student learning. Consequently, the use of SBE is increasing in specialist ambulance nurse education. The aim of this study was to explore how specialist ambulance nursing students experience SBE.

    Methods: This qualitative survey study involved the collection of study data using a purposefully designed, paper-based survey comprising five open-ended questions that required participant free-text answers. The answers were analysed using inductive content analysis and searching for descriptions of the participants’ experiences. The survey was presented to 35 specialist ambulance nursing students.

    Results: The results are presented in two themes: SBE as learning and SBE as an educational method. Participating in SBE during the programme provides students with a realistic understanding of their future profession and its expected demands. The learning experience disregards prior work experience in ambulance services.

    Conclusions: Based on the findings, conclusions are that SBE is an appreciated educational method among nursing students, regardless of their prior experience in the field of prehospital care. To some extent, this differs from previous research findings related to this subject. Furthermore, SBE contributes to the provision of field work insights, preparing the ambulance nurse specialist students.

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  • 4.
    Claesson, Maria
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Jonasson, Lise-Lotte
    Jönköping University.
    Josefsson, Karin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Next of kin’s experiences of registered nurses’ leadership close to older adults in municipal home care in Sweden: an interview study2021In: BMC Nursing, E-ISSN 1472-6955, Vol. 20, no 1, article id 213Article in journal (Refereed)
    Abstract [en]

    Background: Next of kin to older adults over 65 years in municipal home care are concerned whether their older adults’ needs are being met. In municipal home care, the registered nurses’ leadership is important and complex, entailing multi-artist skills involving the older adults and their next of kin. Yet, little is known about next of kin’s experiences of registered nurses’ leadership. Thus, the aim of this study was to explore next of kin’s experiences of registered nurses’ leadership close to older adults in municipal home care. Methods: Individual telephone interviews were conducted with next of kin (n = 11) of older adults from April to September 2020 in two municipalities in western Sweden. Data were analysed using qualitative content analysis. Results: The results are presented with the theme, registered nurses do what they can, including two categories, interaction and competence, and the subcategories, relationship, communication, availability, responsibility, team leadership and cooperation. Registered nurses’ leadership was experienced as a balancing act between their commitments and what they were able to achieve. Conclusions: Next of kin’s experiences of registered nurses’ leadership can contribute knowledge that will strengthen and prepare registered nurses for their leadership roles. This knowledge can support the development of policies for organisational preconditions that ensure quality and safe care to older adults in municipal home care. © 2021, The Author(s).

  • 5.
    Claesson, Maria
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Josefsson, Karin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Jonasson, Lise-Lotte
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindberg, Elisabeth
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    What implies registered nurses’ leadershipclose to older adults in municipal homehealth care? A systematic review2020In: BMC Nursing, E-ISSN 1472-6955, Vol. 19, no 30, p. 1-11, article id 1472-6955Article in journal (Refereed)
    Abstract [en]

    Background: Registered nurses are key figures in municipal home health care for older adults. Thus, registerednurses’ leadership is crucial to a successful and preventive care process as well as a supportive organization in orderto achieve safe care. However, there is limited research on what registered nurses’ leadership implies close to olderadults in municipal home health care. Thus, the aim is to compile and critically evaluate how international researchresults describe registered nurses’ leadership close to older adults in municipal home health care.

    Methods: A systematic literature review was performed in accordance with a qualitative research study. The mainsearch was conducted on 20 April 2018. The review was reported according to the PRISMA guidelines and is registeredin the PROSPERO database (ID# CRD42019109206). Nine articles from PubMed and CINAHL meet the quality criteria. Asynthesis of data was performed in four stages according to qualitative research synthesis.

    Results: Ten themes describe what registered nurses’ leadership close to older adults in municipal home health careentails: trust and control; continuous learning; competence through knowledge and ability; nursing responsibility on anorganizational level; application of skills; awareness of the individual’s needs and wholeness; mutual support; mutualrelationships; collaborating on organizational and interpersonal levels; and exposure to challenges.

    Conclusions: Registered nurses leading close to older adults in municipal home health care implies being multi-artists.Nursing education, including specialist education for registered nurses, should prepare individuals for their unique andcomplex leadership role as a multi-artist. Municipal employers require knowledge about what registered nurses’leadership implies in order to create adequate conditions for their leadership objectives to achieve safe care. Furtherresearch is warranted to explore registered nurses’ leadership close to older adults in municipal home health care fromdifferent perspectives, such as older adults and next of kin.

  • 6.
    Gustafsson, Ingrid
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Faculty of Health and Life Sciences, Linnaeus University, Växjö, S-351 95, Sweden; Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, S-351 95, Sweden.
    Elmqvist, Carina
    Faculty of Health and Life Sciences, Linnaeus University, Växjö, S-351 95, Sweden; Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, S-351 95, Sweden; Department of Research and Development, Region Kronoberg, Växjö, 352 57, Sweden.
    Fridlund, Bengt
    Faculty of Health and Life Sciences, Linnaeus University, Växjö, S-351 95, Sweden; Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, S-351 95, Sweden.
    Schildmeijer, Kristina
    Faculty of Health and Life Sciences, Linnaeus University, Växjö, S-351 95, Sweden; Faculty of Health and Life Sciences, Linnaeus University, Kalmar, S-391 82, Sweden.
    Rask, Mikael
    Faculty of Health and Life Sciences, Linnaeus University, Växjö, S-351 95, Sweden; Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, S-351 95, Sweden.
    Nurse anesthetists’ perceptions of heat conservation measures in connection with surgery – a phenomenographic study2023In: BMC Nursing, E-ISSN 1472-6955, Vol. 22, article id 321Article in journal (Refereed)
    Abstract [en]

    Background: To minimize the risk of perioperative hypothermia, it is recommended that healthcare professionals be familiar with heat conservation measures and use passive and active warming methods, in line with international guidelines. However, there is a low level of adherence perioperatively to the use of heat conservation measures. To understand why, there is a need to capture the nurse anesthetists’ perspective. The aim is to describe nurse anesthetists’ perceptions of heat conservation measures in connection with surgery. Methods: An inductive descriptive design with a phenomenographic approach was chosen. A total of 19 nurse anesthetists participated and were interviewed. Data were analyzed according to Larsson and Holmström’s phenomenographic seven-step model. Results: Six ways of understanding the phenomenon heat conservation measures in connection with surgery were found: the preventive, the useable, the untenable, the caring, the adaptive, and the routine care approach. These approaches were related to each other in a flexible way, allowing for several to co-exist at the same time, depending on the situation. Conclusions: Nurse anesthetists want to prevent the patients’ heat loss and maintain normothermia, regardless of the type of surgery. This willingness, motivation, and intention enable the use of heat conservation measures. However, there are perceptions that have an impact, such as doubts and uncertainty, access, time and financial constraints, preconditions, routines or habits, and lack of availability of education/training. These barriers will require support from an organizational level to promote lifelong education and guidelines. As well as offer education at the nurse anesthetists’ program. 

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  • 7.
    Gustafsson, Tanja
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindberg, Elisabeth
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Karlsson, Pernilla
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Maurin Söderholm, Hanna
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Process evaluation of the ACTION programme: a strategy for implementing person‐centred communication in home care2021In: BMC Nursing, E-ISSN 1472-6955, Vol. 20, no 1, article id 56Article in journal (Refereed)
    Abstract [en]

    Background: There is currently a strong emphasis on person-centred care (PCC) and communication; however, little research has been conducted on how to implement person-centred communication in home care settings. Therefore, the ACTION (A person-centred CommunicaTION) programme, which is a web-based education programme focusing on person-centred communication developed for nurse assistants (NAs) providing home care for older persons, was implemented. This paper reports on the process evaluation conducted with the aim to describe and evaluate the implementation of the ACTION programme. Methods: A descriptive design with a mixed method approach was used. Twenty-seven NAs from two units in Sweden were recruited, and 23 of them were offered the educational intervention. Quantitative and qualitative data were collected from multiple sources before, during and after the implementation. Quantitative data were used to analyse demographics, attendance and participation, while qualitative data were used to evaluate experiences of the implementation and contextual factors influencing the implementation. Results: The evaluation showed a high degree of NA participation in the first five education modules, and a decrease in the three remaining modules. Overall, the NAs perceived the web format to be easy to use and appreciated the flexibility and accessibility. The content was described as important. Challenges included time constraints; the heavy workload; and a lack of interaction, space and equipment to complete the programme. Conclusions: The results suggest that web-based education seems to be an appropriate strategy in home care settings; however, areas for improvement were identified. Our findings show that participants appreciated the web-based learning format in terms of accessibility and flexibility, as well as the face-to-face group discussions. The critical importance of organizational support and available resources are highlighted, such as management involvement and local facilitation. In addition, the findings report on the implementation challenges specific to the dynamic home care context. Trial registration: This intervention was implemented with nursing assistants, and the evaluation only involved nursing staff. Patients were not part of this study. According to the ICMJE, registration was not necessary (). © 2021, The Author(s).

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  • 8.
    Höglander, Jessica
    et al.
    School of Health, Care and Social Welfare, Mälardalen University, SE-721 23 Västerås, Sweden..
    Eklund, Jakob Håkansson
    School of Health, Care and Social Welfare, Mälardalen University, SE-721 23 Västerås, Sweden..
    Spreeuwenberg, Peter
    NIVEL (Netherlands Institute for Health Services Research), Utrecht, the Netherlands.
    Eide, Hilde
    Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Roter, Debra
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA..
    Holmström, Inger K
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Exploring patient-centered aspects of home care communication: a cross-sectional study.2020In: BMC Nursing, E-ISSN 1472-6955, Vol. 19, article id 91Article in journal (Refereed)
    Abstract [en]

    Background: Communication is a cornerstone in nursing and aims at both information exchange and relationship building. To date, little is known about the naturally occurring communication between older persons and nurses in home care. Communication might heal through different pathways and a patient- or person-centered communication could be important for health and well-being of older persons. However, the delivery of individualized home care is challenged by routines and organizational demands such as time constraints. Therefore, the aim of this study was to explore the patient-centered aspects of home care communication between older persons and registered nurses.

    Methods: In total 37 older persons (aged 65 years or older) and eleven RNs participated in 50 audio-recorded home care visits. Roter Interaction Analysis System (RIAS) was used to code verbal communication. A ratio from these codes, establishing the degree of patient-centeredness, was analyzed using a Generalized Linear Mixed Model.

    Results: The present home care communication contained more socio-emotional than task-oriented communication and the emotional tone was largely positive. The global affect ratings reflected an overall positive tone (m = 39.88, sd = 7.65), with higher ratings on dimensions of, for example, responsiveness/engagement and interactivity or interest were more frequent than those that may be considered as less-positive emotions (m = 15.56, sd = 3.91), e.g. hurried, dominance or anger. The ratio of the degree of patient-centered communication in the home care visits was an average of 1.53, revealing that the communication could be considered as patient-centered. The length of the visits was the only characteristic significantly associated with the degree of patient-centeredness in the communication, with a peak in patient-centeredness in visits 8-9 min long. Sex, age or procedural focus showed no significant effects on the degree of patient-centeredness.

    Conclusion: Overall, the degree of patient-centeredness and a positive emotional tone, which might have a positive outcome on older persons' health, was high. Longer visits provided a higher degree of patient-centeredness, but no linear increase in patient-centeredness due to length of visit could be observed. The findings can be used for education and training of nurses, and for providing individualized care, e.g. patient- or person-centered care.

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  • 9.
    Israelsson, Johan
    et al.
    Linköping University, .
    Lilja, Gisela
    Lund University.
    Bremer, Anders
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Stevenson-Ågren, Jean
    University of Sheffield.
    Årestedt, Kristofer
    Linnaeus University.
    Post cardiac arrest care and follow-up in Sweden – a national survey2016In: BMC Nursing, E-ISSN 1472-6955, Vol. 15, no 1Article in journal (Refereed)
    Abstract [en]

    Background

    Recent decades have shown major improvements in survival rates after cardiac arrest. However, few interventions have been tested in order to improve the care for survivors and their family members. In many countries, including Sweden, national guidelines for post cardiac arrest care and follow-up programs are not available and current practice has not previously been investigated. The aim of this survey was therefore to describe current post cardiac arrest care and follow-up in Sweden.

    Methods

    An internet based questionnaire was sent to the resuscitation coordinators at all Swedish emergency hospitals (n = 74) and 59 answers were received. Quantitative data were analysed with descriptive statistics and free text responses were analysed using manifest content analysis.

    Results

    Almost half of the hospitals in Sweden (n = 27, 46 %) have local guidelines for post cardiac arrest care and follow-up. However, 39 % of them reported that these guidelines were not always applied. The most common routine is a follow-up visit at a cardiac reception unit. If the need for neurological or psychological support are discovered the routines are not explicit. In addition, family members are not always included in the follow-up.

    Conclusions

    Although efforts are already made to improve post cardiac arrest care and follow-up, many hospitals need to focus more on this part of cardiac arrest treatment. In addition, evidence-based national guidelines will have to be developed and implemented in order to achieve a more uniform care and follow-up for survivors and their family members. This national survey highlights this need, and might be helpful in the implementation of such guidelines.

  • 10.
    Jimenez-Herrera, Maria F.
    et al.
    Nursing Department, Universitat Rovira i Virgili (URV), Av/ Catalunya, 35 43002, Tarragona, Spain.
    Llaurado-Serra, Mireia
    Faculty of Medicine and Health science, Nursing Department, University Internacional of Catalonia (UIC), Barcelona, Spain.
    Acebedo-Urdiales, Sagrario
    Nursing Department, Universitat Rovira i Virgili (URV), Av/ Catalunya, 35 43002, Tarragona, Spain.
    Bazo-Hernandez, Leticia
    Nursing Department, Universitat Rovira i Virgili (URV), Av/ Catalunya, 35 43002, Tarragona, Spain.
    Font-Jimenez, Isabel
    Nursing Department, Universitat Rovira i Virgili (URV), Av/ Catalunya, 35 43002, Tarragona, Spain.
    Axelsson, Christer
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Emotions and feelings in critical and emergency caring situations: a qualitative study2020In: BMC Nursing, E-ISSN 1472-6955, Vol. 19, no 1Article in journal (Refereed)
    Abstract [en]

    Background Moral emotions are a key element of our human morals. Emotions play an important role in the caring process. Decision-making and assessment in emergency situations are complex and they frequently result in different emotions and feelings among health-care professionals. Methods The study had qualitative deductive design based on content analysis. Individual interviews and focus groups were conducted with sixteen participants. Results The emerging category “emotions and feelings in caring” has been analysed according to Haidt, considering that moral emotions include the subcategories of “Condemning emotions”, “Self-conscious emotions”, “Suffering emotions” and “Praising emotions”. Within these subcategories, we found that the feelings that nurses experienced when ethical conflicts arose in emergency situations were related to caring and decisions associated with it, even when they had experienced situations in which they believed they could have helped the patient differently, but the conditions at the time did not permit it and they felt that the ethical conflicts in clinical practice created a large degree of anxiety and moral stress. The nurses felt that caring, as seen from a nursing perspective, has a sensitive dimension that goes beyond the patient’s own healing and, when this dimension is in conflict with the environment, it has a dehumanising effect. Positive feelings and satisfaction are created when nurses feel that care has met its objectives and that there has been an appropriate response to the needs. Conclusions Moral emotions can help nurses to recognise situations that allow them to promote changes in the care of patients in extreme situations. They can also be the starting point for personal and professional growth and an evolution towards person-centred care.

  • 11.
    Johanna, Zetterberg
    et al.
    Department of Ambulance Service, Region Sörmland, Eskilstuna, Sweden.
    Elin, Visti
    Department of Ambulance Service, Region Sörmland, Eskilstuna, Sweden.
    Holmberg, Mats
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Andersson, Henrik
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden.
    Jonas, Aléx
    Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden; Department of Nursing, Umeå University, 901 87, Umeå, Sweden.
    Nurses’ experiences of encountering patients with mental illness in prehospital emergency care – a qualitative interview study2022In: BMC Nursing, E-ISSN 1472-6955, Vol. 21, no 1Article in journal (Refereed)
    Abstract [en]

    Nurses working in prehospital emergency care (PEC) encounter patients with all types of health conditions. Increasingly, they are encountering patients suffering from mental illness and this trend reflects the worldwide increase in mental illness. There is very little current knowledge of encounters between nurses and patients with mental illness in ‘PEC’, especially from the nurses’ perspectives.

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  • 12.
    Nygårdh, Annette
    et al.
    Jönköping University, HHJ, Avdelningen för omvårdnad.
    Malm, Dan
    Jönköping University, HHJ, Avdelningen för omvårdnad.
    Wikby, Kerstin
    Linneus University, Växjö SE- 351 95, Sweden.
    Ahlström, Gerd
    Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 187, Lund SE-221 00, Sweden.
    The complexity in the implementation process of empowerment-based chronic kidney care: a case study2014In: BMC Nursing, E-ISSN 1472-6955, Vol. 13, no 22, p. 1-10Article in journal (Refereed)
    Abstract [en]

    Background: This study is part of an interactive improvement intervention aimed to facilitate empowerment-based chronic kidney care using data from persons with CKD and their family members. There are many challenges to implementing empowerment-based care, and it is therefore necessary to study the implementation process. The aim of this study was to generate knowledge regarding the implementation process of an improvement intervention of empowerment for those who require chronic kidney care.

    Methods: A prospective single qualitative case study was chosen to follow the process of the implementation over a two year period. Twelve health care professionals were selected based on their various role(s) in the implementation of the improvement intervention. Data collection comprised of digitally recorded project group meetings, field notes of the meetings, and individual interviews before and after the improvement project. These multiple data were analyzed using qualitative latent content analysis.

    Results: Two facilitator themes emerged: Moving spirit and Encouragement. The healthcare professionals described a willingness to individualize care and to increase their professional development in the field of chronic kidney care. The implementation process was strongly reinforced by both the researchers working interactively with the staff, and the project group. One theme emerged as a barrier: the Limitations of the organization. Changes in the organization hindered the implementation of the intervention throughout the study period, and the lack of interplay in the organization most impeded the process.

    Conclusions: The findings indicated the complexity of maintaining a sustainable and lasting implementation over a period of two years. Implementing empowerment-based care was found to be facilitated by the cooperation between all involved healthcare professionals. Furthermore, long-term improvement interventions need strong encouragement from all levels of the organization to maintain engagement, even when it is initiated by the health care professionals themselves.

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  • 13.
    Nygårdh, Annette
    et al.
    Jönköping University, HHJ, Avdelningen för omvårdnad.
    Wikby, Kerstin
    Malm, Dan
    Jönköping University, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Ahlstrom, Gerd
    Empowerment in outpatient care for patients with chronic kidney disease - from the family member's perspective2011In: BMC Nursing, E-ISSN 1472-6955, Vol. 10, no 21, p. 2-8Article in journal (Refereed)
    Abstract [en]

    Background: Family members of persons with pre-dialysis chronic kidney disease may experience feelings of vulnerability and insecurity as the disease follows its course. Against this background, the aim of the present study was to explore empowerment in outpatient care as experienced by these family members.

    Methods: An inductive approach for qualitative data analysis was chosen. The study sample comprised 12 family members of pre-dialysis patients at an outpatient kidney clinic. Two interviews with each family member were subjected to content analysis to gain an understanding of empowerment from the family members' perspective.

    Results: Having strength to assume the responsibility was the main theme that emerged from the following five sub-themes: Being an involved participant, Having confirming encounters, Trusting in health-care staff, Comprehending through knowledge, and Feeling left out. Four of these five sub-themes were positive. The fifth subtheme illuminated negative experience, indicating the absence of empowerment.

    Conclusions: Family members' experience of empowerment is dependent on their ability to assume the responsibility for a relative with chronic kidney disease when needed. The findings emphasise the need for a family perspective and the significance of a supportive environment for family members of persons in outpatient care.

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  • 14.
    Rosell, Linn
    et al.
    Regional Cancer Centre South, Region Skåne, Lund, Sweden; Division of Oncology, Department of Clinical Sciences Lund, Lund University, Scheeletorget 1, 22 363, Lund, Sweden.
    Melander, Wenche
    Regional Cancer Centre South, Region Skåne, Lund, Sweden; Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden; Department of Surgery and Gastroenterology, Skåne University Hospital, Lund, Sweden.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Nilbert, Mef
    Division of Oncology, Department of Clinical Sciences Lund, Lund University, Scheeletorget 1, 22 363, Lund, Sweden.
    Malmström, Marlene
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden; Department of Surgery and Gastroenterology, Skåne University Hospital, Lund, Sweden.
    Registered nurses’ views on consideration of patient perspectives during multidisciplinary team meetings in cancer care2022In: BMC Nursing, E-ISSN 1472-6955, Vol. 21, no 1, article id 350Article in journal (Refereed)
    Abstract [en]

    Background

    Multidisciplinary team meetings (MDTMs) represent an integral component of modern cancer care and have increasingly been implemented to ensure accurate and evidence-based treatment recommendations. During MDTMs, multiple and complex medical and patient-related information should be considered by a multi-professional team whose members contribute various perspectives. Registered nurses (RNs) are expected to share information on the patient perspective at MDTMs. However, research suggests that RNs’ contributions to case discussions are limited and that patient perspective is generally underrepresented. Our aim was to explore RNs’ views of the prerequisites for and barriers to the inclusion of the patient perspective in MDTMs in Swedish cancer care.

    Methods

    Data were collected from four focus group interviews with 22 RNs who worked as contact nurses in Swedish cancer care. Interviews were transcribed and analysed using inductive content analysis.

    Results

    The analysis identified two categories and five subcategories. The participants presented different views and expressed ambivalence about the patient perspective in MDTMs. Subcategories were related to medical versus holistic perspectives, the added value of patient perspective, and possibilities for patient contributions. The participants also discussed prerequisites for the patient perspective to be considered in MDTM decision-making process, with subcategories related to structures promoting attention to the patient perspective and determinants of RNs’ contributions to case discussions in MDTMs.

    Conclusions

    This study demonstrates various views related to the patient perspective in MDTMs and identifies a great need to clarify the RN’s role. Our results indicate that if enhanced presentation of the patient perspective in MDTMs is desired, key information points and structures must be established to collect and present relevant patient-related information.

  • 15.
    Rydström, Ingela
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Dalheim Englund, Ann-Charlotte
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Dellve, Lotta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ahlstrom, Linda
    Importance of social capital at the workplace for return to work among women with a history of long-term sick leave: a cohort study.2017In: BMC Nursing, E-ISSN 1472-6955, ISSN ISSN 1472-6955, Vol. 14, no 16Article in journal (Refereed)
    Abstract [en]

    Background

    The workplace is an essential source of social capital for many people; it provides mutual support and gives meaning to life. However, few prospective studies have thoroughly investigated the importance of aspects of social capital in the workplace. The aim of this study was to investigate the associations between aspects of social capital (social support, sense of community, and quality of leadership) at the workplace, and work ability, working degree, and vitality among women with a history of long-term sick leave from human service organizations.

    Methods

    A longitudinal cohort study was performed among women with a history of long-term sick leave. The study started in 2005, and the women were followed up at 6 months, 1 year, and 6 years using self-reported questionnaires (baseline n = 283). Linear mixed models were used for longitudinal analysis of the repeated measurements of prospective degree of work ability, working degree, and vitality. Analyses were performed with different models; the explanatory variables for each model were social support, sense of community, and quality of leadership and time.

    Results

    Social capital in terms of quality of leadership (being good at solving conflicts and giving high priority to job satisfaction), sense of community (co-operation between colleagues) and social support (help and support from immediate superiors and colleagues) increased the women’s work ability score (WAS) as well as working degree over time. Additionally, social capital in terms of quality of leadership increased the women’s vitality score over time.

    Conclusions

    A sustainable return-to-work process among individuals with a history of long-term sick leave, going in and out of work participation, could be supported with social support, good quality of leadership, and a sense of community at the workplace. The responsibility for the rehabilitation process can not be reduced to an individual problem, but ought to include all stakeholders involved in the process, such as managers, colleagues, health care services, and the social security agency.

  • 16.
    Sterner, Anders
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Säfström, Emma
    Palmér, Lina
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ramstrand, Nerrolyn
    Andersson Hagiwara, Magnus
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Development and initial validation of an instrument to measure novice nurses’ perceived ability to provide care in acute situations – PCAS2020In: BMC Nursing, E-ISSN 1472-6955, Vol. 19, no 13Article in journal (Refereed)
    Abstract [en]

    Background: Novice nurses need to be better prepared to provide care in acute situations. There is currently no validated scale specifically measuring nurses’ perception of their ability to provide care in acute situations. The aim of this study was to develop and examine the psychometric properties of a scale that measures novice nurses selfreported perception of ability to provide care in acute situations.

    Method: Development and test of the psychometric properties of the Perception to Care in Acute Situations (PCAS) scale. Items were generated from interviews with novice nurses (n = 17) and validated using opinions of an expert panel and cognitive interviews with the target group. Two hundred nine novice nurses tested the final scale. Exploratory factor analysis (EFA) was used to test construct validity, item reduction and underlying dimensions between the measured variables and the latent construct.

    Result: The PCAS scale contains 17 items grouped into three factors. EFA demonstrated a clean three factor logic construct solution with no cross-loadings, high correlation for the total scale in both Cronbach’s alfa 0.90 and ordinal alpha 0.92.

    Conclusions: The PCAS scale has proven to have acceptable validity. The factors,” confidence in provision of care”, “communication” and “patient perspective” are likely to be important aspects of providing care in acute situations. Additional testing of the PCAS is needed to conclude if it is sensitive enough to evaluate interventions aimed at improving novice nurses competence and suitable as a guide for reflection for novice nurses.

  • 17.
    Sundberg, Fredrika
    et al.
    Högskolan i Skövde, Institutionen för hälsovetenskaper.
    Baid, Heather
    School of Education, Sport and Health Sciences, University of Brighton, UK.
    Israelsson-Skogsberg, Åsa
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    A mountain of waste created daily: a thematic analysis of environmental sustainability experiences of postgraduate intensive care nursing students2024In: BMC Nursing, E-ISSN 1472-6955, Vol. 23, no 1, article id 679Article in journal (Refereed)
    Abstract [en]

    Background: The healthcare sector has a negative ecological impact, and intensive care is one of the most resource-consuming areas. Nurses have a duty to contribute to climate change reduction, design climate-resilient healthcare systems, and support individuals and communities in adapting to the effects of the planetary health crisis. It is essential to incorporate environmental sustainability into nursing education so that nurses can advocate for conscientious and ethically sustainable healthcare that benefits both patients and the planet. This study aimed to explore postgraduate intensive care nursing student experiences of environmental sustainability in clinical practice at intensive care units.

    Methods: Data were collected using a qualitative questionnaire, and the data were analysed using inductive thematic analysis. The participants were 24 registered nurses studying postgraduate, specialist intensive care nursing courses at four universities in the south and west regions of Sweden.

    Results: The results describe critical care students’ environmental sustainability experiences in one overarching theme with five subthemes. Intensive care is a challenging context in terms of sustainability, where saving lives is the number one priority. There were good and bad sustainability habits among the staff, and awareness was key to improving. Clinical supplies come in unsustainable packages, and the participants wished for better alternatives and they wanted more knowledge and education on sustainable practices. The findings also emphasized the importance of a holistic perspective throughout each patient’s pathway.

    Conclusions: Sustainability in intensive care units is somewhat unrecognised today, although intensive care nurses want that to change. The context where saving lives is prioritized makes implementing ecologically responsible practices a challenge. However, environmental sustainability in intensive care is feasible, with education needed for nurses to take on the responsibility of making improvements. Hospital management prioritizing sustainability is also important to support clinicians in implementing sustainable practices in intensive care units.

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  • 18.
    Wireklint Sundström, Birgitta
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Holmberg, Mats
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Herlitz, Johan
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Andersson, Henrik
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Karlsson, Thomas
    Sahlgrenska Universitetssjukhuset.
    Possible effects of a course in cardiovascular nursing on prehospital care of patients experiencing suspected acute coronary syndrome: a cluster randomised controlled trial2016In: BMC Nursing, E-ISSN 1472-6955, Vol. 15, no 52Article in journal (Refereed)
    Abstract [en]

    Background

    Current research suggests that nurses can influence the outcome for patients with acute coronary syndrome (ACS). The aim of this study has been to evaluate whether a course in cardiovascular nursing (CVN) can improve ambulance nurses’ (ANs’) prehospital care of patients experiencing suspected ACS, related to pain intensity.

    Methods

    This is a cluster randomised controlled trial that was conducted in the ambulance services. Patients were allocated to one of two groups: in the first group, patients were treated by ANs who had attended the CVN course and in the second group patients were treated by ANs without this qualification. Inclusion criteria were: 1/pain raising suspicion of ACS, and 2/pain score ≥4 on a visual analogue scale (VAS). The primary outcome was the estimated intensity of pain or discomfort according to VAS 15 min after randomisation. Secondary outcomes were estimated intensity of pain or discomfort on admission to hospital and further requirement of pain treatment, as well as symptoms such as paleness and/or cold sweat; nausea and/or vomiting; anxiety, dyspnea, degree of alertness, respiratory depression and aggressiveness. A further secondary outcome measured was survival to 30 days. Lastly, a final diagnosis was made. A total of 38 ANs attended the CVN course. There were 1,747 patients who fulfilled the inclusion criteria.

    Results

    The pain score did not differ significantly between the two groups fifteen minutes after randomisation (median value of VAS was 4.0 in both groups). On admission to hospital the pain score was significantly lower for patients treated by an AN who had attended the CVN course (n = 332) compared with those treated by an AN who had not attended the course (n = 1,415) (median 2.5 and 3.0 respectively, p = 0.001). The ANs who had attended the course used higher doses of morphine.

    Conclusions

    An educational intervention with a CVN course did not relate significantly to more efficient pain relief in suspected ACS during the first 15 min. However, this intervention was associated with more effective pain relief later on in the prehospital setting. Thus, a CVN course for ANs appears to be associated with reduced pain intensity among patients experiencing suspected ACS. This result needs however to be confirmed in further trials.

    Trial registration

    The ClinicalTrials.gov Protocol Registration System (registration number NCT00792181).

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