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  • 1. Aronsson, Kenneth
    et al.
    Björkdahl, Ida
    Wireklint Sundström, Birgitta
    University of Borås, School of Health Science.
    Prehospital emergency care for patients with suspected hip fractures after falling: older patients’ experiences2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 21-22, p. 3115-3123Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: The aim of this study was to describe and explain elderly patients’ lived experiences of prehospital emergency care in cases of suspected hip fractures after falling. Background: Hip fractures represent a major health problem for older people and are a common assignment for the Emergency Medical Services (EMS), but there is little information on how patients experience prehospital emergency care. Design: A reflective lifeworld approach based on phenomenological epistemology was used in an interview study within the context of healthcare science. Methods: Ten elderly patients were interviewed. These depth interviews were tape-recorded, transcribed verbatim and analysed for meanings. Results: The comprehensive understanding of the phenomenon is: ‘Happy to have been rescued, despite bad experiences as well as good’. The elderly patient is offered care in an open and friendly atmosphere concurrently with feeling anxiety about the treatment. Intervention with streamlined care and treatment can thus simultaneously be beneficial as well as doing harm. Patients experience confusion and the need to ask questions about what really happened in the ambulance. Bad experiences remain unexplained. This study is based on three themes with relevant sub-themes: efficiency, concerned encounters and suffering from care. Conclusions: Our study contribute to this field of discussion, showing that administering drugs which cause side effects in already fragile older people is compatible with neither evidence-based care nor evidenced-based medicine. The side effects of pain relief – however efficient that pain relief may be – are taken seriously. Relevance to clinical practice: Pain relief in the EMS should be individualised. Responsibility for patients’ safety regarding pain relief is emphasised. This development should focus on care that is already good and gradually eradicate compassionless care. Keywords: caring science, hip fracture, lived experiences, phenomenology, emergency medical services, ambulance, care pathway, prehospital emergency nurse

  • 2.
    Berg, AL
    et al.
    University of Borås, School of Health Science.
    Bergh, CH
    Friberg, Febe
    How do nurses record pedagogical activities? Nurses' documentation in patient records in a cardiac rehabilitation unit for patients who have undergone coronary artery bypass surgery.2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 10, p. 1898-1907Article in journal (Refereed)
    Abstract [en]

    Aims. To describe the use of pedagogically related keywords and the content of notes connected to these keywords, as they appear in nursing records in a coronary artery bypass graft (CABG) surgery rehabilitation unit. Background. Nursing documentation is an important component of clinical practice and is regulated by law in Sweden. Studies have been carried out in order to evaluate the educational and rehabilitative needs of patients following CABG surgery but, as yet, no study has contained an in-depth evaluation of how nurses document pedagogical activities in the records of these patients. Methods. The records of 265 patients admitted to a rehabilitation unit following CABG surgery were analysed. The records were structured in accordance with the VIPS model. Using this model, pedagogically related keywords: communication, cognition/development and information/education were selected. The analysis of the data consisted of three parts: the frequency with which pedagogically related keywords are used, the content and the structure of the notes. Results. Apart from the term 'communication', pedagogically related keywords were seldom used. Communication appeared in all records describing limitations, although no explicit reference was made to pedagogical activities. The notes related to cognition/development were grouped into the following themes: nurses' actions, assessment of knowledge and provision of information, advice and instructions as well as patients' wishes and experiences. The themes related to information were the provision of information and advice in addition to relevant nursing actions. The structure of the documentation was simple. Conclusions. The documentation of pedagogical activities in nursing records was infrequent and inadequate. Relevance to clinical practice. The patients' need for knowledge and the nurses' teaching must be documented in the patient records so as to clearly reflect the frequency and quality of pedagogical activities.

  • 3.
    Bergh, Anne-Louise
    et al.
    University of Borås, School of Health Science.
    Bergh, Claes-Håkan
    Friberg, Febe
    How do nurses record pedagogical activities? An investigation of nurses’ documentation inpatients´ records in a cardiac rehabilitation unit for patients following coronary artery bypass surgery.2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 10, p. 1898-1907Article in journal (Refereed)
    Abstract [en]

    Aims. To describe the use of pedagogically related keywords and the content of notes connected to these keywords, as they appear in nursing records in a coronary artery bypass graft (CABG) surgery rehabilitation unit. Background. Nursing documentation is an important component of clinical practice and is regulated by law in Sweden. Studies have been carried out in order to evaluate the educational and rehabilitative needs of patients following CABG surgery but, as yet, no study has contained an in-depth evaluation of how nurses document pedagogical activities in the records of these patients. Methods. The records of 265 patients admitted to a rehabilitation unit following CABG surgery were analysed. The records were structured in accordance with the VIPS model. Using this model, pedagogically related keywords: communication, cognition/development and information/education were selected. The analysis of the data consisted of three parts: the frequency with which pedagogically related keywords are used, the content and the structure of the notes. Results. Apart from the term 'communication', pedagogically related keywords were seldom used. Communication appeared in all records describing limitations, although no explicit reference was made to pedagogical activities. The notes related to cognition/development were grouped into the following themes: nurses' actions, assessment of knowledge and provision of information, advice and instructions as well as patients' wishes and experiences. The themes related to information were the provision of information and advice in addition to relevant nursing actions. The structure of the documentation was simple. Conclusions. The documentation of pedagogical activities in nursing records was infrequent and inadequate. Relevance to clinical practice. The patients' need for knowledge and the nurses' teaching must be documented in the patient records so as to clearly reflect the frequency and quality of pedagogical activities.

  • 4. Björk Brämberg, Elisabeth
    et al.
    Sandman, Lars
    University of Borås, School of Health Science.
    Communication through in-person interpreters: a qualitative study of home care providers' and social workers' views2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 1-2, p. 159-167Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe the experiences of home care providers and social workers in communication, via in-person interpreters, with patients who do not share a common language, and to offer suggestions for practice based on this description. BACKGROUND: The use of interpreters is essential for successful communication to provide equal access to health care for patients not sharing a common language with care providers. Successful bilingual communication is probably even more complex within the home care services with its focus on medical treatment, care and daily support in relation to the more exclusive focus on medical treatment within hospital care. DESIGN: An explorative, qualitative, descriptive study. METHODS: Data were collected in seven focus group interviews. A total of 27 persons, working as registered nurses, assistant nurses and social workers in municipal home care, participated. The analysis was inspired by inductive content analysis. RESULTS: The results express a traditional view on interpretation where the in-person interpreter is supposed to act to a greater or lesser extent as an objective and neutral conduit or communicator of what is said. The interpreter is also expected to observe when medical terms and other concepts need to be explained, which thus exceeds the basic role as a communicator of what was said. CONCLUSIONS: This study emphasises the need to view the interpreter as an active and explicit party in a three-way communication. RELEVANCE TO CLINICAL PRACTICE: Viewing the interpreter as an active and explicit party in a three-way communication and as an essential part of the care team might reduce the possible threat to patient confidentiality, and could contribute to solve the problem of interpreting the patient's non-verbal signs.

  • 5. Blomberg, Karin
    et al.
    Bisholt, Birgitta
    Kullén Engström, Agneta
    University of Borås, School of Health Science.
    Olsson, Ulla
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Gustafsson, Margareta
    Swedish nursing students' experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 15-16, p. 2264-2271Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe nursing students' experience of stress during clinical practice and evaluate the risk of stress in relation to the clinical setting characteristics and the organisation of the clinical education. BACKGROUND: Stress during clinical practice is well documented, but there is a lack of knowledge concerning whether the clinical setting characteristics and the organisation of the education make a difference. DESIGN: A cross-sectional study with evaluative design. METHODS: Data were collected by means of a numerical rating scale for the assessment of stress and questions about the clinical setting characteristics and the organisation of the education. One hundred and eighty-four students who had completed their final year on the nursing programme at three universities in Sweden were included. RESULTS: Nearly half of the students (43%) experienced high level of stress during clinical practice. Measured by decision in the tree analysis, the absolute risk of stress was 57% in students with placements in hospital departments, as compared to 13% in students with placements in other clinical settings. The risk of stress increased to 71% if the students with placement in a hospital took the national clinical final examination. Performance of practice in a hospital department overcrowded with patients was also associated with increased risk of stress. The organisation of supervision and number of students at the clinical placement had an effect on the experience of stress, but did not prove to be risk factors in the analysis. CONCLUSIONS: The risk of stress in nursing students during their clinical practice differs depending on clinical setting characteristics. The taking of the national clinical final examination could be a source of stress, but this requires further investigation. RELEVANCE TO CLINICAL PRACTICE: It is important that supervisors are aware that students in hospital departments overcrowded with patients are at risk of stress and may have increased need of support.

  • 6.
    Dalheim Englund, Ann-Charlotte
    et al.
    University of Borås, School of Health Science.
    Rydström, Ingela
    University of Borås, School of Health Science.
    Rasmussen, Birgit
    Möller, Christian
    Sandman, Per-Olof
    Having a child with asthma--quality of life for Swedish parents.2004In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, no 3, p. 386-395Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Asthma is the most common chronic childhood disease. Childhood asthma contributes significantly to morbidity among children and has a significant impact on the quality of life (QoL) and daily routines of both the children and their parents. AIM AND OBJECTIVE: The purpose of this study was to investigate how Swedish parents of children with asthma experience their QoL, and to investigate whether there were differences concerning QoL between parents within the same family. The purpose was also to investigate possible connections between their QoL and background variables. METHOD: A total of 371 parents of children with asthma (57% mothers and 43% fathers) participated in the study. The Paediatric Asthma Caregiver's Quality Of Life Questionnaire (PACQLQ) was used to measure the parents' QoL, i.e. how the child's asthma interferes with the parents' normal activities and how it has made them feel. RESULTS: The findings show that most parents of children with asthma evaluated their QoL as close to the positive end of the scale, and there was close agreement in the scoring between parents within the same family. Significant associations were found between parents' lower QoL outcome and living in the North of Sweden. There were also significant associations between fathers' lower QoL outcome and having a child younger than 13 years of age and mothers' lower QoL outcome and having a child with severe asthma. Although the result shows that a child's asthma did not influence the parents' QoL to a greater degree, it is still important for healthcare workers to help these parents to sustain and improve their well-being. CONCLUSIONS: The fact that they just evaluated their QoL during the preceding week only, and did so at the time when their children were being treated with asthma medication, might have influenced the results in a positive direction. Comment in Commentary on Dalheim-Englund et al. (2004) Having a child with asthma: quality of life for Swedish parents. Journal of Clinical Nursing 13, 386-395. [J Clin Nurs. 2005]

  • 7. Friberg, Febe
    et al.
    Bergh, Anne-Louise
    University of Borås, School of Health Science.
    Lepp, M.
    In search in patient teaching in nursing documentation: an analysis of patient records in a medical ward in Sweden2006In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 15, no 12, p. 1550-1558Article in journal (Refereed)
    Abstract [en]

    Keywords:need for knowledge;nursing;nursing documentation;patient education;patient records;teaching intervention Aim.  The aim of this study was to identify terms and expressions indicating patients’ need for knowledge and understanding, as well as nurses’ teaching interventions, as documented in nursing records. Background.  Previous international studies have shown that nursing documentation is often deficient in terms of recording patient teaching. Methods.  Patient records (N = 35) were collected in a general medical ward in a hospital in Sweden. The data contain 206 days of nursing documentation. The records were analysed with regard to content and structure. Terms and expressions indicating patients’ need for knowledge and understanding and terms and expressions indicating nurses’ teaching activities were analysed. Results.  The results showed that patients’ need for knowledge is implicitly indicated by conceptions and experiences as well as questions. Furthermore, nurses’ implicit teaching interventions consist of information, motivating conversations, explanations, instructions and setting expectations. However, the content and structure of the pedagogical activities in the patient records are fragmented and vague. Relevance to clinical practice.  Efforts must be directed towards elaborating upon the above-mentioned terms and expressions as indications of patients’ need for knowledge and nurses’ teaching interventions. Moreover, these terms and expressions must be recognized and acknowledged.

  • 8. Henricsson, Maria
    et al.
    Berglund, Anna-Lena
    Määttä, Sylvia
    University of Borås, School of Health Science.
    Segesten, Kerstin
    University of Borås, School of Health Science.
    Ekman, Rolf
    The outcome of tactile touch on oxytocin in intensive care patients: a randomised controlled trial2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 19, p. 2624-2633Article in journal (Refereed)
    Abstract [en]

    Aim. To explore the effects of five-day tactile touch intervention on oxytocin in intensive care patients. The hypotheses were that tactile touch increases the levels of oxytocin after intervention and over a six-day period. Background. Research on both humans and animals shows a correlation between touch and increased levels of oxytocin which inspired us to measure the levels of oxytocin in arterial blood to obtain information about the physiological effect of tactile touch. Design. Randomised controlled trial. Method. Forty-four patients from two general intensive care units, were randomly assigned to either tactile touch (n = 21) or standard treatment - an hour of rest (n = 23). Arterial blood was drawn for measurement of oxytocin, before and after both treatments. Results. No significant mean changes in oxytocin levels were found from day 1 to day 6 in the intervention group (mean -3.0 pM, SD 16.8). In the control group, there was a significant (p = 0.01) decrease in oxytocin levels from day 1 to day 6, mean 26.4 pM (SD 74.1). There were no significant differences in changes between day 1 and day 6 when comparing the intervention group and control group, mean 23.4 pM (95% CI -20.2-67.0). Conclusion. Our hypothesis that tactile touch increases the levels of oxytocin in patients at intensive care units was not confirmed. An interesting observation was the decrease levels of oxytocin over the six-day period in the control group, which was not observed in the intervention group. Relevance to clinical practice. Tactile touch seemed to reduce the activity of the sympathetic nervous system. Further and larger studies are needed in intensive care units to confirm/evaluate tactile touch as a complementary caring act for critically ill patients.

  • 9. Holmström, Inger K
    et al.
    Nokkoudenmäki, Mai-Britt
    Zukancic, Selma
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    It is important that they care - older persons' experiences of telephone advice nursing.2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 11-12, p. 1644-1653Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim of the study was to explore older persons' experiences of telephone advice nursing at primary healthcare centres.

    BACKGROUND: Telephone advice nursing is expanding worldwide, and the older population is increasing. Little is known about older persons' experiences of telephone advice nursing provided by primary healthcare.

    DESIGN: This study has a descriptive design with a qualitative inductive approach.

    METHODS: Data were collected via interviews with a purposive sample of 10 older persons in 2014. The data were analysed using qualitative content analysis.

    RESULTS: The older persons' experiences were described in two themes: the patient-friendly aspects of telephone advice nursing and the patient-unfriendly aspects of telephone advice nursing. The themes can be understood as two sides of the same coin; the differences point to both the advantages and disadvantages of the service and are further illuminated through seven subthemes.

    CONCLUSIONS: This study contributes to increased awareness of the advantages and disadvantages of the telephone advice nursing system as experienced by older persons. To be the focus of attention during calls was highlighted as important; and clear communication was deemed crucial. When the communication between the nurse and the older persons was perceived as good and the perspective of the caller was the focus, an experience of safety and satisfaction was described. Older persons had great confidence in the telephone nurses' competence and perceived their ability to access the service as mostly good, even if it was sometimes difficult to use the service.

    RELEVANCE TO CLINICAL PRACTICE: The communicative competence of telephone nurses is essential when providing telephone advice nursing to older persons. In addition, a person-centred approach is important to provide optimal care in telephone advice nursing.

  • 10.
    Höglund, Erik
    et al.
    Örebro University.
    Schröder, Agneta
    Örebro University.
    Möller, Margareta
    Örebro University.
    Andersson Hagiwara, Magnus
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ohlsson-Nevo, Emma
    Örebro University.
    The ambulance nurse experiences of non-conveying patients.2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 1, no 10Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore ambulance nurses' (ANs) experiences of non-conveying patients to alternate levels of care.

    BACKGROUND: Increases in ambulance utilisation and in the number of patients seeking ambulance care who do not require medical supervision or treatment during transport have led to increased nonconveyance (NC) and referral to other levels of care.

    DESIGN: A qualitative interview study was conducted using an inductive research approach.

    METHODS: The study was conducted in a region in the middle of Sweden during 2016-2017. Twenty nurses were recruited from the ambulance departments in the region. A conventional content analysis was used to analyse the interviews. The study followed the COREQ checklist.

    RESULTS: The ANs experienced NC as a complex and difficult task that carried a large amount of responsibility. They wanted to be professional, spend time with the patient and find the best solution for him or her. These needs conflicted with the ANs' desire to be available for assignments with a higher priority. The ANs could feel frustrated when they perceived that ambulance resources were being misused and when it was difficult to follow the NC guidelines.

    CONCLUSION: If ANs are expected to nonconvey patients seeking ambulance care, they need a formal mandate, knowledge and access to primary health care.

    RELEVANCE TO CLINICAL PRACTICE: This study provides new knowledge regarding the work situation of ANs in relation to NC. These findings can guide future research and can be used by policymakers and ambulance organisations to highlight areas that need to evolve to improve patient care.

  • 11. Johansson, Kristina
    et al.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Moving between rooms--moving between life and death: nurses' experiences of caring for terminally ill patients in hospitals2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 13/14, p. 2034-2043Article in journal (Refereed)
    Abstract [en]

    Aim. This study describes the meanings of generalist registered nurses' experiences of caring for palliative care patients on general wards in hospitals. Background. Earlier research shows that work with patients in palliative care is demanding. More research concerning palliative care is undertaken in oncological care, in hospice and in home-care settings than in general wards. It is therefore important to examine the palliative care in the context of acute-care settings to discover more about this phenomenon, to understand the experiences of nurses in this situation and to develop patient care. Design. Qualitative, descriptive and interpretive study. Method. Eight registered nurses in two different hospitals in Sweden were interviewed. The patients on these wards suffered from surgical and medical conditions, i.e. both curative and palliative care were administered. The interviews were analysed using a phenomenological hermeneutical approach inspired by Ricoeur's philosophy. Results. The registered nurses' experiences are presented as seven themes and a comprehensive, interpreted whole. This latter revealed the significance of contrasts, contradictions and movement between the material and psychological experiences of the room and nursing care in this care context. Conclusions. The registered nurses say that something momentous occurred during the care process and they showed a strong determination and commitment to being part of the ending of the patient's life circle, despite the situation often being one of stress. Relevance to clinical practice. The findings highlight the need for various forms of support for the nurses to meet their need for new and updated knowledge and support in existential matters. This may promote a better quality of care and confirm the nurses in their caring practice. Moreover, there is a need to introduce the hospice philosophy into acute-care settings in hospitals.

  • 12.
    Josefsson, Karin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Do you accept violence at your work2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, no 17, p. 1255-1256Article, review/survey (Other academic)
  • 13.
    Josefsson, Karin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Violence in municipal elderly care in Sweden as perceived by registered nurses2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 5, p. 900-910Article in journal (Refereed)
  • 14.
    Josefsson, Karin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Violence in municipal elderly care in Sweden as perceived by registered nurses2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 5, p. 900-910Article in journal (Refereed)
  • 15.
    Knutsson, Susanne
    et al.
    University of Borås, School of Health Science.
    Bergbom, I.
    Custodians´ viewpoints and experiences from their child´s visit to an ill or injured nearest being cared for at an adult intensive care unit.2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 2, p. 362-371Article in journal (Refereed)
  • 16.
    Kristensen, Dorte V
    et al.
    University College of Southeast Norway.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Eide, Hilde
    University College of Southeast Norway.
    Hafskjold, Linda
    University College of Southeast Norway.
    Ruud, Iren
    University College of Southeast Norway.
    Holmström, Inger K
    Mälardalen University.
    Characteristics of communication with older people in home care: A qualitative analysis of audio recordings of home care visits.2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 23-24, p. 4613-4621Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe the characteristics of communication practice in home care visits between older people (over 65 years old) and nurse assistants and to discuss the findings from a person-centered perspective.

    BACKGROUND: The older population is increasing worldwide, along with the need for healthcare services in the person's home. To achieve a high-quality care, person-centered communication is crucial.

    DESIGN: A descriptive design with a qualitative inductive approach was used.

    METHOD: Fifteen audio recordings of naturally occurring conversations between 12 nurse assistants and 13 older people in Norway were analysed by qualitative content analysis.

    RESULTS: Four categories were revealed through analysis: (i) supporting older people's connection to everyday life; (ii) supporting older people's involvement in their own care; (iii) attention to older people's bodily and existential needs; and (iv) the impact of continuity and predictability on older people's well-being.

    CONCLUSIONS: The communication between the older people and the nurse assistants during home care visits was mainly task-oriented, but also related to the person. The older people were involved in the tasks to be carried out and humour was part of the communication. Greater attention was paid to bodily than existential needs. The communication was connected with the older people's everyday life in several ways. Time frames and interruptions concern the older people; hearing and speech impairments were a challenge to communication. To enhance person-centred communication, further studies are needed, especially intervention studies for healthcare professionals and students.

    RELEVANCE TO CLINICAL PRACTICE: Being responsive to older people's subjective experiences is important in meeting their needs in home care. Communication that addresses the need for trust and predictability is important for older people. Responding to existential needs require more attention. The home care setting has an impact on communication.

  • 17.
    Lindahl, Berit
    et al.
    University of Borås, School of Health Science.
    Efraimsson, E
    Lindblad, BM
    Caring and being cared for at home: a meta-synthesis describing the relationships between patients, informal caregivers and health professionals2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 3-4, p. 454-463Article in journal (Refereed)
    Abstract [en]

    AIM: The present study describes, through a meta-synthesis, the relationship between patients, informal caregivers and health professionals involved in home care. BACKGROUND: Today, many people receive help from health care professionals in their homes with the consequence that, for many health care professionals, their working place is the patients' homes. Research that addresses the dynamics in the caring relationship in home care seems to be rare. DESIGN: A meta-synthesis is an integrated interpretation of qualitative research findings, which is more substantive than the results from each individual investigation. METHOD: We performed a systematic literature search regarding studies published during the period 1992-2005, using the search terms home nursing, professional and home health care. The included studies described relations in a home care context, between health professionals and patients or relations between health professionals, patients and their informal caregivers published in the same study. RESULTS: The findings showed that when professionals entered people's home, the private area changed. The study presents an interpretation of the changed meanings of home as the place and space for professional care. We described the meanings of the relationship in two main themes with subthemes. The main themes are 'being there' and 'home care as a co-creation'. The understanding of relationships in home care is seen as the development of a professional friendship. This concept is reflected on through the writings of Aristotle and Alberoni. CONCLUSION: To address these concerns, it is important that home care providers, recipients and their family members develop friendships. These friendships should be a part of any professional relationship. RELEVANCE TO CLINICAL PRACTICE: When health professionals enter patients' homes, they have to be aware of the risk of transgressing borders of privacy. In addition, devaluing patients' or their informal caregivers' knowledge and their opinions about the care is interpreted as an exercise of institutional power.

  • 18.
    Lindahl, Berit
    et al.
    University of Borås, School of Health Science.
    Lidén, Eva
    University of Borås, School of Health Science.
    Lindblad, Britt-Marie
    University of Borås, School of Health Science.
    A meta-synthesis describing the relationships between patients, informal caregivers and health professionals in home-care settings2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 3-4, p. 454-463Article in journal (Refereed)
    Abstract [en]

    Aim. The present study describes, through a meta-synthesis, the relationship between patients, informal caregivers and health professionals involved in home care. Background. Today, many people receive help from health care professionals in their homes with the consequence that, for many health care professionals, their working place is the patients' homes. Research that addresses the dynamics in the caring relationship in home care seems to be rare. Design. A meta-synthesis is an integrated interpretation of qualitative research findings, which is more substantive than the results from each individual investigation. Method. We performed a systematic literature search regarding studies published during the period 1992–2005, using the search terms home nursing, professional and home health care. The included studies described relations in a home care context, between health professionals and patients or relations between health professionals, patients and their informal caregivers published in the same study. Results. The findings showed that when professionals entered people's home, the private area changed. The study presents an interpretation of the changed meanings of home as the place and space for professional care. We described the meanings of the relationship in two main themes with subthemes. The main themes are 'being there' and 'home care as a co-creation'. The understanding of relationships in home care is seen as the development of a professional friendship. This concept is reflected on through the writings of Aristotle and Alberoni. Conclusion. To address these concerns, it is important that home care providers, recipients and their family members develop friendships. These friendships should be a part of any professional relationship. Relevance to clinical practice. When health professionals enter patients' homes, they have to be aware of the risk of transgressing borders of privacy. In addition, devaluing patients' or their informal caregivers' knowledge and their opinions about the care is interpreted as an exercise of institutional power.

  • 19.
    Lindahl, Berit
    et al.
    University of Borås, School of Health Science.
    Norberg, A
    Clinical group supervision in an intensive care unit: a space for relief, and for sharing emotions and experiences of care2002In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 11, no 6, p. 809-818Article in journal (Refereed)
    Abstract [en]

    Much has been written about models, aims and the concept of clinical group supervisional, although few studies are empirical or focus on intensive care. The aim of the study was to illuminate the process and describe, using qualitative content analysis, the content of conversations carried out during the course of clinical group supervision sessions among Registered Nurses (RN) and enrolled nurses (EN) working in an intensive care unit (ICU). During the supervision sessions, ENs talked about their life-world from a caring perspective, while RNs focused on their professional development. Both ENs and RNs regarded the supervision sessions as a space for relief and for sharing emotions and caring experiences, which helped to manage complex nursing care. The findings are viewed in the light of Roach's theoretical framework describing the attributes of professional care as five Cs. Clinical group supervision is interpreted as supportive in developing interpersonal skills and a sensitive nursing practice.

  • 20. Nydén, K
    et al.
    Petersson, M
    Nyström, Maria
    University of Borås, School of Health Science.
    Unsatisfied basic needs of older people in emergency care environments: obstacles to an active role in decision making2003In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 2, p. 268-274Article in journal (Refereed)
    Abstract [en]

    Little attention is paid in Emergency Care Units (ECUs) in Sweden to the special needs of older people. The aim of this study was thus to analyse older people's basic needs in the emergency care environment. The study was carried out with a life-world interpretative approach, and the theoretical framework for interpretation was Abraham Maslow's theory of motivation and personality. Seven informants aged between 65 and 88 years, with various experiences of being patients with urgent as well as non-urgent health-related problems, were interviewed about their experiences of ECU care. Their basic needs at the lower levels of Maslow's hierarchy were well-represented in the data. Higher needs, such as desire to know and understand, appeared to be totally neglected. Safety needs dominated the whole situation. Our conclusion is that standards of care must be developed in Sweden to make older patients feel safer and more secure in ECUs. Furthermore, the principles of nursing care for older patients need to be defined in order to encourage them to take an active part in their own health process.

  • 21.
    Nyström, Maria
    University of Borås, School of Health Science.
    Professional Aphasia Care Trusting the Patient's Competence while Facing Existential Issues2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 17, p. 2503-2510Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. The aim of this study was to complement 'expert' knowledge about speech-language therapy by studying the phenomenon of professional aphasia care from the patient's perspective. Background. The methods for assisting patients with aphasia have mainly been based on speech language therapy with methods for training language. However, the effectiveness of mereley training has not been conclusively proven. In this study, it was assumed that patients with impaired use of language require professional caring interventions as a base for training. Design. A phenomenological approach was used to gain understanding of patients' lived experiences of professional aphasia care. Method. Data consisted of eight in-depth interviews, four follow-up interviews, two notes from diaries and two biographies. Data were analysed according to a descriptive phenomenological method. Results. The essential meaning of the phenomenon was: trusting the patient's competence while facing existential issues. To enhance understanding, the essential meaning was specified in terms of the following constituents: preventing isolation, straightforwardness, provision of security, recognition of caring needs, encouraging efforts to practise language, equality and supporting maintenance of identity. Conclusions. This study adds to the knowledge about speech-language therapy that professional aphasia care presupposes a secure base and a carer who recognises and trusts the patient's ability to think and communicate. Relevance to clinical practice. Implications for clinical practice are outlined under the following main headings, a secure caring base, encourage a fighting spirit and expressions of feelings, facilitate communication, try to understand the patient's existential situation and enable patients to recognise that their self-image derives from the painful experience of losing the world of symbols. Inside is the same person and carers should make it clear that they are aware of that.

  • 22. Ring, N
    et al.
    Malcolm, C
    Commentary on Asthma: quality of life for Swedish children.2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 9, p. 1766-1768Article in journal (Other (popular science, discussion, etc.))
  • 23.
    Rydström, Ingela
    University of Borås, School of Health Science.
    Response to Commentary on Asthma: quality of life for Swedish children.2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 9, p. 1768-1769Article in journal (Other (popular science, discussion, etc.))
  • 24.
    Rydström, Ingela
    et al.
    University of Borås, School of Health Science.
    Dalheim Englund, Ann-Charlotte
    University of Borås, School of Health Science.
    Rasmussen, Birgit
    Möller, Christian
    Sandman, Per-Olof
    Asthma: quality of life for Swedish children2005In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 14, no 6, p. 739-749Article in journal (Refereed)
    Abstract [en]

    Aims and objectives.  The purpose of this study was to describe how Swedish children with asthma experience their QoL and to search for possible associations between their experience of QoL and some determinants. Background.  Asthma is a chronic disorder that can restrict a child's life, physically, emotionally, socially and spiritually, and this has an impact on a child's quality of life (QoL). Methods.  Two hundred and twenty-six children with asthma (37% girls and 63% boys) and 371 parents of these children participated in the study. The Paediatric Asthma Quality Of Life Questionnaire (PAQLQ) was used to measure the children's QoL. This questionnaire reveals how the children's asthma interferes with their normal activities, their symptoms and how this interference has made them feel. Results.  The findings show that most children with asthma estimated their QoL towards the positive end of the scale. The children reported more impairment in the domain of activities than in emotions and symptoms. The most commonly restricted activity was the children's ability to run. Significant associations were found between a higher QoL outcome and being a boy, as well as living in the south of Sweden. A higher QoL was also found in children with mothers older than 40 years of age and in children with cohabiting parents. It was also associated with their fathers’ QoL in a positive direction. Conclusions.  It is important that children with asthma will maintain a high QoL. In this study the children were being treated with asthma medication when they evaluated their QoL. Perhaps this fact might have influenced the results in a positive direction. Relevance to clinical practice.  The findings of our study underline the importance of accurate nursing assessment including background variables of the children. Nurses also have to be aware that some of the children in the study have a low QoL and these children must not be forgotten. In addition, as caring tends to focus on the patients’ limitations, another important issue for nurses is to try to discover those aspects in a child's daily life that contribute to a high QoL in order to improve and maintain the child's wellbeing.

  • 25.
    Thorstensson, Stina
    et al.
    University of Skövde.
    Blomgren, Carola
    Neighborhood Management North.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Larsson, Margaretha
    University of Skövde.
    To break the weight gain-A qualitative study on the experience of school nurses working with overweight children in elementary school.2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 1-2, p. e251-e258Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe the experiences of school nurses working with overweight schoolchildren.

    BACKGROUND: School nurses play an important role in health promotion of overweight children. Lifestyle changes and interventions to address being overweight can improve health outcomes and decrease the risk for future health problems.

    DESIGN: A descriptive and qualitative design with a phenomenological approach was used. Data were gathered through interviews with school nurses working with overweight schoolchildren in Swedish elementary school; the data were subsequently analysed for meanings.

    RESULTS: Working with overweight children was perceived as demanding and challenging by the school nurses who found conversations on this topic emotionally loaded and complex. In addition, the school nurses needed to be sensitive and supportive to succeed in their support for a healthier everyday life for the schoolchildren. It was stated as important to find ways to break the child's weight gain and to cooperate with the parents in this work. The children's decrease in weight was experienced to be more successful when making small, step-by-step changes together with the child and his or her parents.

    CONCLUSIONS: This study concludes that health talks about being overweight may be a challenge for school nurses. Strategies used to manage and succeed in this work included engaging in motivational conversations, working step by step and cooperating with the child's parents. Furthermore, the nurses experienced that they needed to provide emotional support for overweight children during school time.

    RELEVANCE TO CLINICAL PRACTICE: The school nurses' health promotion needs to focus on how to break weight gain in overweight children. In this work, the nurses' sensitiveness seems pivotal. Further research is needed on school nurses' work with health promotion and support of overweight children concerning how to perform efficient communication and cooperation with the children and their parents.

  • 26.
    Wallengren, Catarina
    et al.
    University of Borås, School of Health Science.
    Segesten, Kerstin
    University of Borås, School of Health Science.
    Friberg, Febe
    Relatives' information needs and the characteristics of their search for information: in the words of relatives of stroke survivors2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 19-20, p. 2888-2896Article in journal (Refereed)
    Abstract [en]

    Aim and objectives. To explore relatives’ information needs and the characteristics of their information-seeking process shortly after the stroke event and six months later. Background. Providing relatives of stroke survivors with information is important, as lack of information increases their uncertainty and risk becoming the ‘second patient in the family’ and early death. Therefore, it is essential to be aware of relatives’ information needs and information-seeking process the first six months after stroke. Design. This qualitative study has a descriptive design. Method. Open-ended interviews were conducted with sixteen relatives after stroke survivor’s admission to stroke unit and six months later with nine of these relatives. Data were analysed by means of content analysis. Results. The identified information needs covered the spectrum from stroke survivor’s medical condition because nurses’ actions to relatives’ changed health and life situation. Furthermore, relatives’ information-seeking process was found to be related to their level of personal involvement, situational circumstances, different forms of knowledge and sources of information. Conclusions. Relatives’ search for information emerges when health and lifestyle changes occur in survivors or themselves. It is important that this information affect them personally. Also, they need to develop different forms of knowledge when they cannot trust their own competences. As a result, instead of following established curricula based on their beliefs of relatives’ information needs, nurses need to practice on identifying relatives’ information needs. Relevance to practice. Different information needs and characteristics described in the study can serve as guidance in the development and implementation of pedagogical interventions to support relatives of stroke survivors. One pedagogical implication is to explore what a specific relative wants to know by how he/she talks or thinks about it. Thus, it must be taken into consideration that level of personal involvement, situational circumstances, sources of information and factual knowledge, understanding and skills are intertwined.

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