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  • 1. Almerud, S
    et al.
    Alapack, R.J.
    Fridlund, Bengt
    Växjö University.
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Caught in an Artificial Split: A Phenomenological Study of Being a Caregiver in the Technologically Intense Environment2007In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 24, no 2, p. 130-136Article in journal (Refereed)
    Abstract [en]

    A symbiotic relationship exists between technology and caring, however, technologically advanced environments challenge caregivers. The aim of this study is to uncover the meaning of being a caregiver in the technologically intense environment. Ten open-ended interviews with intensive care personnel comprise the data. A phenomenological analysis shows that ambiguity abounds in the setting. The act of responsibly reading and regulating instruments easily melds the patient and the machinery into one clinical picture. The fusion skews the balance between objective distance and interpersonal closeness. The exciting captivating lure of technological gadgets seduces the caregivers and lulls them into a fictive sense of security and safety. It is mind-boggling and heart-rending to juggle ‘moments’ of slavish mastery and security menaced by insecurity in the act of monitoring a machine while caring for a patient. Whenever the beleaguered caregiver splits technique from human touch, ambiguity decays into ambivalence. Caring and technology become polarized. Everyone loses. Caregiver competence wanes; patients suffer. The intensive care unit should be technologically sophisticated, but also build-in a disclosive space where solace, trust, and reassurance naturally happen. Caring professionals need to balance state-of-the-art technology with integrated and comprehensive care and harmonize the demands of subjectivity with objective signs.

  • 2. Blom, Helen
    et al.
    Gustavsson, Christina
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Participation and support in intensive care as experienced by close relatives of patients: a phenomenological study.2013In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 29, no 1, p. 1-8Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to explore participation and support as experienced by close relatives of patients at an intensive care unit (ICU).

    METHOD: This study used the phenomenological approach as developed by Dahlberg et al. (2008) as a method for reflective lifeworld research. Seven close relatives of critically ill patients cared for at an ICU were interviewed. The data were analysed with a focus on meanings.

    RESULTS: Being allowed to participate in the care of critically ill patients at an ICU is important for close relatives to the patients. Their experiences can be described as having four constituents: participation in the care of and being close to the patient; confidence in the care the patient receives; support needed for involvement in caregiving; and vulnerability.

    CONCLUSION: Participation with and support from health-care professionals are important for the relatives' well-being and their ability to contribute to the patients' care. Health-care professionals, especially critical care nurses, need to create an atmosphere that invites relatives to participate in the care provided at an ICU.

  • 3.
    Engwall, Marie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Fridh, Isabell
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Johansson, Lotta
    Bergbom, Ingegerd
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lighting, sleep and circadian rhythm: An intervention study in the intensive care unit.2015In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 31, no 6, p. 325-335Article in journal (Refereed)
    Abstract [en]

    Patients in an intensive care unit (ICU) may risk disruption of their circadian rhythm. In an intervention research project a cycled lighting system was set up in an ICU room to support patients' circadian rhythm. Part I aimed to compare experiences of the lighting environment in two rooms with different lighting environments by lighting experiences questionnaire. The results indicated differences in advantage for the patients in the intervention room (n=48), in perception of daytime brightness (p=0.004). In nighttime, greater lighting variation (p=0.005) was found in the ordinary room (n=52). Part II aimed to describe experiences of lighting in the room equipped with the cycled lighting environment. Patients (n=19) were interviewed and the results were presented in categories: "A dynamic lighting environment", "Impact of lighting on patients' sleep", "The impact of lighting/lights on circadian rhythm" and "The lighting calms". Most had experiences from sleep disorders and half had nightmares/sights and circadian rhythm disruption. Nearly all were pleased with the cycled lighting environment, which together with daylight supported their circadian rhythm. In night's actual lighting levels helped patients and staff to connect which engendered feelings of calm.

  • 4.
    Engwall, Marie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Sahlgrenska University Hospital.
    Fridh, Isabell
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Jutengren, Göran
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Bergbom, Ingegerd
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Sahlgrenska University Hospital.
    Sterner, Anders
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Sahlgrenska University Hospital.
    The effect of cycled lighting in the intensive care unit on sleep, activity and physiological parameters: A pilot study2017In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 41, p. 26-32, article id S0964-3397(17)30032-0Article in journal (Refereed)
    Abstract [en]

    Patients in intensive care suffer from severe illnesses or injuries and from symptoms related to care and treatments. Environmental factors, such as lighting at night, can disturb patients' circadian rhythms. The aim was to investigate whether patients displayed circadian rhythms and whether a cycled lighting intervention would impact it. In this pilot study (N=60), a cycled lighting intervention in a two-bed patient room was conducted. An ordinary hospital room functioned as the control. Patient activity, heart rate, mean arterial pressure and body temperature were recorded. All data were collected during the patients' final 24h in the intensive care unit. There was a significant difference between day and night patient activity within but not between conditions. Heart rates differed between day and night significantly for patients in the ordinary room but not in the intervention room or between conditions. Body temperature was lowest at night for all patients with no significant difference between conditions. Patients in both conditions had a natural circadian rhythm; and the cycled lighting intervention showed no significant impact. As the sample size was small, a larger repeated measures study should be conducted to determine if other types of lighting or environmental factors can impact patients' well-being.

  • 5.
    Eriksson, Thomas
    et al.
    Sahlgrenska University Hospital, University of Gothenburg.
    Bergbom, I
    Sahlgrenska Academy, University of Gothenburg.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    The experiences of patients and their families of visiting during whilst in an intensive care unit: A hermeneutic interview study2011In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 27, no 2, p. 60-67Article in journal (Refereed)
    Abstract [en]

    Aim The aim of this study was to interpret and understand the meanings of the lived experiences of visiting of patients in an ICU and their families. Method The research design was hermeneutic, based on interviews. This study includes 12 interviews with seven patients and five relatives who had been in an ICU. The interview text was interpreted in a Gadamerian manner as different plays with actors and plots. Findings Patients’ narratives could be divided into two parts; recall of real life and unreal life experiences, the unreal being more common. Relatives’ narratives are described as being on stage and being backstage, i.e. in the room with the patient and outside it. Conclusion The final interpretation elucidated the experience of visiting as the sudden shift between being present in real life vs. being present in the real life of unreality. It was a process whereby the patient and the family build a new understanding of life that creates a new form of interplay within the family. The pre-critical illness life is no longer there – a new life has begun. To support patients and their families in this process of change a family-centred care perspective is necessary.

  • 6.
    Eriksson, Thomas
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Bergbom, Ingegerd
    Göteborgs Universitet.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    The experiences of patients and their families of visiting whilst in an intensive care unit--a hermeneutic interview study.2011In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 27, no 2, p. 60-66Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to interpret and understand the meanings of the lived experiences of visiting of patients in an ICU and their families. METHOD: The research design was hermeneutic, based on interviews. This study includes 12 interviews with seven patients and five relatives who had been in an ICU. The interview text was interpreted in a Gadamerian manner as different plays with actors and plots. FINDINGS: Patients' narratives could be divided into two parts; recall of real life and unreal life experiences, the unreal being more common. Relatives' narratives are described as being on stage and being backstage, i.e. in the room with the patient and outside it. CONCLUSION: The final interpretation elucidated the experience of visiting as the sudden shift between being present in real life vs. being present in the real life of unreality. It was a process whereby the patient and the family build a new understanding of life that creates a new form of interplay within the family. The pre-critical illness life is no longer there--a new life has begun. To support patients and their families in this process of change a family-centred care perspective is necessary.

  • 7. Eriksson, Thomas
    et al.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Bergbom, I
    Visits in an intensive care unit: an observational hermeneutic study2010In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 26, no 1, p. 51-57Article in journal (Refereed)
    Abstract [en]

    Aim The aim was to interpret the interplay between critically ill patients and their next of kin in an ICU and to disclose a deeper understanding of the visiting situation. Method A hermeneutic research design with non-participant observation was chosen as the data collection method. Ten observations of 10 patients and 24 loved ones over a 20-h period were conducted. The text describing the observations of the interplay was interpreted in accordance with Gadamer's thoughts. Data were analysed by considering the text as a play with scenes, actors and plots. Findings Due to their medical condition the patients were unable to use their bodies in the usual way, which sends different signals to their loved ones, who in turn have difficulty deciding how to respond. Both parties become, in a manner of speaking, trapped or locked out by their own bodies. Conclusion The physical environment became a hindrance to the interplay as it was designed for medical and technical use and thus did not promote healing. The professionals are important for interpreting the signals from both patients and next of kin, as well as for finding caring strategies, such as physical contact that promote interplay, which in turn strengthens connectedness.

  • 8. Forsberg, Anna
    et al.
    Flodén, Anne
    Lennerling, Annette
    Karlsson, Veronika
    Nilsson, Madeleine
    Fridh, Isabell
    University of Borås, School of Health Science.
    The core of after death in relation to organ donation: A grounded theory study2014In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, no 5, p. 275-282Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of this study was to investigate how intensive and critical care nurses experience and deal with after death care i.e. the period from notification of a possible brain dead person, and thereby a possible organ donor, to the time of post-mortem farewell. RESEARCH METHODOLOGY: Grounded theory, based on Charmaz' framework, was used to explore what characterises the ICU-nurses concerns during the process of after death and how they handle it. Data was collected from open-ended interviews. FINDINGS: The core category: achieving a basis for organ donation through dignified and respectful care of the deceased person and the close relatives highlights the main concern of the 29 informants. This concern is categorised into four main areas: safeguarding the dignity of the deceased person, respecting the relatives, dignified and respectful care, enabling a dignified farewell. CONCLUSION: After death care requires the provision of intense, technical, medical and nursing interventions to enable organ donation from a deceased person. It is achieved by extensive nursing efforts to preserve and safeguard the dignity of and respect for the deceased person and the close relatives, within an atmosphere of peace and tranquillity.

  • 9.
    Fridh, Isabell
    University of Borås, School of Health Science.
    Caring for the dying patient in the ICU: The past, present and the future2014In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, no 6, p. 306-311Article in journal (Refereed)
    Abstract [en]

    The aim of this paper is to present the state of the science concerning issues in end-of-life (EOL) care which have an impact on intensive care nurses possibilities to provide nursing care for dying patients and their families. The perspective of families is also illuminated and finally ethical challenges in the present and for the future are discussed. The literature review revealed that the problem areas nurses report concerning EOL care have been the same over three decades. Most problems are related to inter-disciplinary collaboration and communication with the medical profession about the transition from cure to comfort care. Nurses need enhanced communication skills in their role as the patient's advocate. Education in EOL care and a supportive environment are prerequisites for providing EOL care. Losing a loved one in the ICU is a stressful experience for close relatives and nursing care has a profound impact on families' memories of the EOL care given to their loved ones. It is therefore important that ICU nurses are aware of families' needs when a loved one is dying and that follow-up services are appreciated by bereaved family members. Ethical challenges are related to changed sedation practices, organ donation, globalisation and cultural sensitivity.

  • 10.
    Fridh, Isabell
    et al.
    Insitutionen för vårdvetenskap och hälsa, Sahlgrenska akademin, Göteborgs universitet.
    Forsberg, Anna
    Bergbom, Ingegerd
    Close relatives' experiences of caring and of the physical environment when a loved one dies in an ICU.2009In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 25, no 3Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to explore close relatives' experiences of caring and the physical environment when a loved one dies in an intensive care unit (ICU).

    METHOD: Interviews were conducted with 17 close relatives of 15 patients who had died in three adult ICUs. The interviews were analysed using a phenomenological-hermeneutic method.

    FINDINGS: The analysis resulted in seven themes; Being confronted with the threat of loss, Maintaining a vigil, Trusting the care, Adapting and trying to understand, Facing death, The need for privacy and togetherness and Experiencing reconciliation. The experience of a caring relationship was central, which meant that the carers piloted the close relatives past the hidden reefs and through the dark waters of the strange environment, unfamiliar technology, distressing information and waiting characterised by uncertainty. Not being piloted meant not being invited to enter into a caring relationship, not being allowed access to the dying loved one and not being assisted in interpreting information.

    CONCLUSION: The participants showed forbearance with the ICU-environment. Their dying loved one's serious condition and his or her dependence on the medical-technical equipment were experienced as more frightening than the equipment as such. Returning for a follow-up-visit provided an opportunity for reconciliation and relief from guilt.

  • 11.
    Fridh, Isabell
    et al.
    Instiutionen för vårdvetenskap och hälsa,Sahlgrenska akademin, Göteborgs universitet.
    Forsberg, Anna
    Bergbom, Ingegerd
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Doing one's utmost: nurses' descriptions of caring for dying patients in an intensive care environment.2009In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 25, no 5, p. 233-241Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to explore nurses' experiences and perceptions of caring for dying patients in an intensive care unit (ICU) with focus on unaccompanied patients, the proximity of family members and environmental aspects.

    METHOD: Interviews were conducted with nine experienced ICU nurses. A qualitative descriptive approach was employed. The analysis was performed by means of conventional content analysis [Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res 2005;15:1277-88] following the steps described by e.g. Elo and Kyngas [Elo S, Kyngas H. The qualitative content analysis process. J Adv Nurs 2008;62:107-15].

    FINDINGS: The analysis resulted in a main category; Doing one's utmost, described by four generic categories and 15 sub-categories, comprising a common vision of the patients' last hours and dying process. This description was dominated by the nurses' endeavour to provide dignified end-of-life care (EOLC) and, when relatives were present, to give them an enduring memory of their loved one's death as a calm and dignified event despite his/her previous suffering and death in a high-technological environment.

    CONCLUSION: This study contributes new knowledge about what ICU nurses focus on when providing EOLC to unaccompanied patients but also to those whose relatives were present. Nurses' EOLC was mainly described as their relationship and interaction with the dying patient's relatives, while patients who died alone were considered tragic but left a lesser impression in the nurses' memory.

  • 12.
    Henricson, Maria
    et al.
    University of Borås, School of Health Science.
    Segesten, Kerstin
    University of Borås, School of Health Science.
    Berglund, Anna-Lena
    Määttä, Sylvia
    University of Borås, School of Health Science.
    Enjoying tactile touch and gaining hope when being cared for in intensive care: A phenomenological hermeneutical study2009In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 25, no 6, p. 323-331Article in journal (Refereed)
    Abstract [en]

    Touch has been a part of the healing process in many civilisations and cultures throughout the centuries. Nurses frequently use touch to provide comfort and reach their patients. The aim of this study was to illuminate the meaning of receiving tactile touch when being cared for in an intensive care unit. Tactile touch is a complementary method including the use of effleurage, which means soft stroking movements along the body. The context used to illuminate the meaning of receiving tactile touch was two general intensive care units (ICUs). Six patients, who have been cared for in the two ICUs, participated in the study. A phenomenological–hermeneutical method based on the philosophy of Ricoeur and developed for nursing research by Lindseth and Norberg [Lindseth A, Norberg A. A phenomenological hermeneutical method for researching lived experience. Scandinavian Journal of Caring Sciences, 2004;18:145–53] was chosen for the analysis. Data consisted of narratives, which were analysed in three recurring phases: naïve understanding, structural analyses and comprehensive understanding. Two main themes were found: being connected to oneself and being unable to gain and maintain pleasure. The comprehensive understanding of receiving tactile touch during intensive care seems to be an expression of enjoying tactile touch and gaining hope for the future. This study reveals that it is possible to experience moments of pleasure in the midst of being a severely ill patient at an ICU and, through this experience also gain hope.

  • 13. Johansson, Lotta
    et al.
    Bergbom, Ingegerd
    Persson Waye, Kerstin
    Ryherd, Erica
    Lindahl, Berit
    University of Borås, School of Health Science.
    The sound environment in an ICU patient room--A content analysis of sound levels and patient experiences2012In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 28, no 5, p. 269-279Article in journal (Refereed)
    Abstract [en]

    This study had two aims: first to describe, using both descriptive statistics and quantitative content analysis, the noise environment in an ICU patient room over one day, a patient's physical status during the same day and early signs of ICU delirium; second, to describe, using qualitative content analysis, patients' recall of the noise environment in the ICU patient room. The final study group comprised 13 patients. General patient health status data, ICU delirium observations and sound-level data were collected for each patient over a 24-hour period. Finally, interviews were conducted following discharge from the ICU. The sound levels in the patient room were higher than desirable and the LAF max levels exceed 55dB 70-90% of the time. Most patients remembered some sounds from their stay in the ICU and whilst many were aware of the sounds they were not disturbing to them. However, some also experienced feelings of fear related to sounds emanating from treatments and investigations of the patient beside them. In this small sample, no statistical connection between early signs of ICU delirium and high sound levels was seen, but more research will be needed to clarify whether or not a correlation does exist between these two factors.

  • 14.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lighting, sleep and circadian rhythm: An intervention study in the intensive care unit.2015In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 1, no 6, p. 325-335Article in journal (Refereed)
  • 15.
    Lindahl, Berit
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Johansson, Lotta
    Göteborgs Universitet.
    Bergbom, Ingegerd
    Göteborgs universitet.
    Knutsson, Susanne
    Högskolan Jönköping.
    Noise in the ICU patient room -- Staff knowledge and clinical improvements2016In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, no 35, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Introduction

    The acoustic environment in the intensive care unit patient room, with high sound levels and unpredictable sounds, is known to be poor and stressful. Therefore, the present study had two aims: to investigate staff knowledge concerning noise in the intensive care unit and: to identify staff suggestions for improving the sound environment in the intensive care unit patient room.

    Method

    A web-based knowledge questionnaire including 10 questions was distributed to 1047 staff members at nine intensive care unit. Moreover, 20 physicians, nurses and enrolled nurses were interviewed and asked to give suggestions for improvement.

    Results

    None of the respondents answered the whole questionnaire correctly; mean value was four correct answers. In the interview part, three categories emerged: improving staff's own care actions and behaviour; improving strategies requiring staff interaction; and improving physical space and technical design.

    Conclusion

    The results from the questionnaire showed that the staff had low theoretical knowledge concerning sound and noise in the intensive care unit. However, the staff suggested many improvement measures, but also described difficulties and barriers. The results from this study can be used in the design of future interventions to reduce noise in the intensive care unit as well as in other settings.

  • 16.
    Lindahl, Berit
    et al.
    University of Borås, School of Health Science.
    Sandman, PO
    The role of advocacy in critical care nursing: a caring response to another1998In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 14, no 4, p. 179-186Article in journal (Refereed)
    Abstract [en]

    With the aim of clarifying critical care nursing, six critical care nurses, working in a Swedish intensive care unit (ICU) were each asked to narrate a care situation with which they had been satisfied or dissatisfied. The stories were tape-recorded and analysed using a phenomenological-hermeneutic approach inspired by the philosophy of Ricoeur. The themes uncovered in the analysis describe the nurse's role of advocacy as: to build a caring relationship, to carry out a commitment, to empower, to make room for and interconnect, to be a risk-taker, to be a moral agent and to create a trusting atmosphere conducive to recovery. The meaning of the role of advocacy lies in a moral and existential response to another human being, an expression of caring. Advocacy rests on the patient-nurse relationship and occurs as an outspoken demand of another human being whose autonomy is threatened. The results are discussed from the ethical perspectives of Lögstrup, Watson's concept of care, and existential advocacy as expressed by Gadow.

  • 17.
    Olausson, Sepideh
    et al.
    University of Borås, School of Health Science.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Ekebergh, Margareta
    University of Borås, School of Health Science.
    The ICU patient room: Views and meanings as experienced by the next of kin: A phenomenological hermeneutical study2012In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 28, no 3, p. 176-184Article in journal (Refereed)
    Abstract [en]

    The rooms in Intensive Care Units are considered as high-tech environments and believed to affect recovery process and wellbeing of patients. Moreover, the design and interiors affect the interplay between the patient and the next of kin. Objective The aim of this study was to describe and interpret the meanings of the intensive care patient room as experienced by next of kin. Design Next of kin (n = 14) from two different intensive care units participated. Data were collected through photo-voice and analysed using aphenomenological hermeneutical method. Results Three major themes emerged; dwelling in the room and time, becoming at home and extension of the room. The results show that the room is perceived as a lived and extended place and space. The design, interiors and furnishing in the patient room are fundamental in shaping the next of kin's experiences in the room and affect wellbeing. Conclusions How intensive care patient rooms are designed, the place given to next of kin and the way they are received in the room are decisive for the support given to the loved one. Simple interventions can make the patient room a more healing environment.

  • 18.
    Olausson, Sepideh
    et al.
    University of Borås, School of Health Science.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    A phenomenological study of being cared for in a critical care setting: The meanings of the patient room as a place of care.2013In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 29, no 4, p. 234-243Article in journal (Refereed)
    Abstract [en]

    Summary Previous research highlights the impact of care and treatment in ICUs on the patient recovery process and wellbeing. However, little is known about how the interior design in the ICU settings may affect patients’ wellbeing. Objective The aim of this study is, by using a lifeworld perspective, to reveal the meanings of the ICU settings as a place of care. Design Nine patients from three ICUs in Sweden participated. Data were collected using photo-voice methodology and were analysed using a reflective lifeworld phenomenological approach. Results The ICU setting as a place of care for critically ill patients is a complex and multidimensional phenomenon. The place is constituted of patients, staff and technical equipment. The struggle for life and occurrences taking place there determine how the room is perceived. The tone and touch of caring together with interior design are fundamental for the room as lived. The room is experienced in various moods; a place of vulnerability, a place inbetween, a place of trust and security, a life-affirming place, a place of tenderness and care and an embodied place. Conclusion Promoting patients’ well-being and satisfaction of care involves integrating a good design and a caring attitude and paying attention to patients’ needs.

  • 19. Rosengren, Kristina
    et al.
    Bondas, Terese
    Nordholm, Lena
    University of Borås, Central Administration.
    Nordström, Gun
    Nurses’ views of shared leadership in ICU: A case study2010In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 26, no 4, p. 226-233Article in journal (Refereed)
  • 20.
    Sundberg, Fredrika
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Olausson, Sepideh
    University of Gothenburg.
    Fridh, Isabell
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Nursing staff's experiences of working in an evidence-based designed ICU patient room-An interview study.2017In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, article id S0964-3397(17)30057-5Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: It has been known for centuries that environment in healthcare has an impact, but despite this, environment has been overshadowed by technological and medical progress, especially in intensive care. Evidence-based design is a concept concerning integrating knowledge from various research disciplines and its application to healing environments.

    OBJECTIVE: The aim was to explore the experiences of nursing staff of working in an evidence-based designed ICU patient room.

    METHOD: Interviews were carried out with eight critical care nurses and five assistant nurses and then subjected to qualitative content analysis.

    FINDINGS: The experience of working in an evidence-based designed intensive care unit patient room was that the room stimulates alertness and promotes wellbeing in the nursing staff, fostering their caring activities but also that the interior design of the medical and technical equipment challenges nursing actions.

    CONCLUSIONS: The room explored in this study had been rebuilt in order to create and evaluate a healing environment. This study showed that the new environment had a great impact on the caring staffs' wellbeing and their caring behaviour. At a time when turnover in nurses is high and sick leave is increasing, these findings show the importance of interior design of intensive care units.

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