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  • 1.
    Ahlstrand, Inger
    et al.
    Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Larsson, Ingrid
    School of Health and Welfare, Halmstad University.
    Larsson, Margaretha
    School of Health and Education, University of Skövde, Skövde, Sweden.
    Ekman, Aimée
    Department of Social Work, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Hedén, Lena
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Laakso, Katja
    Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Lindmark, Ulrika
    Department of Health Sciences, Karlstad University, Karlstad, Sweden; Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Nunstedt, Håkan
    Department of Health Sciences, University West, Trollhättan, Sweden.
    Oxelmark, Lena
    Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Pennbrant, Sandra
    Department of Health Sciences, University West, Trollhättan, Sweden.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hallgren, Jenny
    School of Health and Education, University of Skövde, Skövde, Sweden.
    Health-promoting factors among students in higher education within health care and social work: a cross-sectional analysis of baseline data in a multicentre longitudinal study2022In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 1314Article in journal (Refereed)
    Abstract [en]

    Background

    Educational environments are considered important in strengthening students’ health status and knowledge, which are associated with good educational outcomes. It has been suggested to establish healthy universities based on a salutogenic approach – namely, health promotion. The aim of this study was to describe health-promoting resources and factors among first-semester students in higher education in healthcare and social work.

    Methods

    This cross-sectional study is based on a survey distributed among all students in seven healthcare and social work programmes at six universities in southern Sweden. The survey was carried out in 2018 using a self-reported, web-based questionnaire focussing on general health and well-being, lifestyle factors together with three validated instruments measuring health-promoting factors and processes: the Sense of Coherence (SOC) scale, Salutogenic Health Indicator Scale (SHIS) and Occupational Balance Questionnaire (OBQ).

    Results

    Of 2283 students, 851 (37.3%) completed the survey, of whom 742 (87.1%) were women; 722 (84.8%) were enrolled on healthcare programmes, and 129 (15.2%) were enrolled on social work programmes. Most reported good general health and well-being (88.1% and 83.7%, respectively). The total mean scores for the SOC scale, SHIS and OBQ were, respectively, 59.09 (SD = 11.78), 44.04 (SD = 9.38) and 26.40 (SD = 7.07). Well-being and several healthy lifestyles were related to better general health and higher SOC, SHIS and OBQ scores. Multiple linear and logistic regressions showed that perceived well-being and no sleeping problems significantly predicted higher general health and higher SOC, SHIS and OBQ scores. Being less sedentary and non-smoking habits were significant predictors of higher SOC.

    Conclusions

    Swedish students in higher education within the healthcare and social work sector report good general health and well-being in the first semester, as well as health-promoting resources (i.e. SOC, SHIS and OBQ), and in some aspects, a healthy lifestyle. High-intensity exercise, no sleeping problems and non-smoking seem to be of importance to both general health and health-promotive resources. This study contributes to knowledge about the health promotive characteristics of students in the healthcare and social work fields, which is of importance for planning universities with a salutogenic approach.

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  • 2.
    Berglund, Mia
    et al.
    School of Health and Education, Research Centre: Aging and Long-Term Health Problems, University of Skövde,Sweden.
    Nässén, Kristina
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hedén, Lena
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Gillsjö, Catharina
    School of Health and Education, Research Centre: Aging and Long-Term Health Problems, University of Skövde,Sweden.
    Older Adults' Experiences of Reflective STRENGTH-Giving Dialogues: An Interview Study.2016In: Journal of Gerontology & Geriatric Research, ISSN 2167-7182Article in journal (Refereed)
    Abstract [en]

    Background: A major health problem that frequently accompanies old age is long-term pain, but pain must be acknowledged by older adults and health care providers. Interventions are needed to alleviate pain and suffering while holistically providing health care that promotes wellbeing. The intervention project, Reflective STRENGTHGiving Dialogues© (STRENGTH) was implemented to increase health and wellbeing among community dwelling older adults living with long-term musculoskeletal pain at home. Aim: The aim of this study was to describe the older adults' experiences of the intervention Reflective STRENGTH-Giving Dialogue. Method: A life world hermeneutic approach was used in collection and analysis of data. Twenty community dwelling older adults participated were interviewed in their homes after the intervention. Findings: The findings consisted of five themes and showed that the older adults experienced the Reflective STRENGTH-Giving Dialogues as a continuous and trusting relationship that alleviates the pain and breaks the loneliness. They expressed it as a new way to talk about life with pain. The dialogues supported reflection and memory and resulted in a transition in orientation in life. Conclusion: The Reflective STRENGTH-Giving Dialogues helped the older adults to increase their intellectual, emotional, and physical engagement in daily living. The dialogues facilitated a transition in orientation from past to present, to the future, and from obstacles to opportunities. The dialogues were oriented towards enjoyments, meaning, courage and strength in life as a whole which promoted the older adults’ sense of well-being and vitality. The dialogues also facilitated carrying out small and large life projects. The Reflective STRENGTH-Giving Dialogues created a deepened caring relationship that contributed to an increased sense of security, strength and courage, all of which enhanced the potential for better health and wellbeing.

  • 3.
    Gustafsson, Tanja
    et al.
    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.
    Hedén, Lena
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Maurin Söderholm, Hanna
    University of Borås, Faculty of Librarianship, Information, Education and IT. 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.
    Walk a fine line between meaningfulness or discomfort: the complexity of emotional communication2022Conference paper (Refereed)
    Abstract [en]

    Background: 

    The home care of older persons includes inter-personal interactions and communication needed to care for and respond to diverse needs of older people. Previous research has focused on emotional expressions of older persons and responses by nursing staff. Research on the meaning of the interaction in these sequences is sparse. Therefore, the aim of this study was to illuminate the meaning attached to sequences of emotional communication and the interaction during these sequences between older persons and nursing assistants during home care visits.

    Methods: 

    A descriptive observational design was used. The data consisted of 44 audio recordings of real-life conversations between older persons and nursing assistants during home care visits. A hermeneutic phenomenological analysis was conducted.

    Findings: 

    Preliminary results indicate sequences of emotional communication being a window of opportunities. The interaction that followed were linked to dual and sometimes incongruent meanings. Expressions being actively blocked or ignored could cause an increase of unpleasant emotions or distract away from negative feelings. Simultaneously, such conversations could both ease or add to the complexity of the interaction and communication. Conversations elaborating on the older persons’ emotions seemed to instill trust and create meaningfulness, at the same time as these situations contained unpleasant moments with sad or angry feelings. The risk for discomfort in these sequences could threaten the trust in the relationship.

    Discussion: 

    Conversations on older persons worries can be complex: the findings point to a fine line between meaningfulness and distress in these sequences. Unpleasant emotions call for attention and caution, these may need to be noticed at the same time as they cannot be forced out. 

  • 4.
    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.
    Hedén, Lena
    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.
    Maurin Söderholm, Hanna
    University of Borås, Faculty of Librarianship, Information, Education and IT. University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    An educational intervention to improve communication skills in home care – a feasibility study2022Conference paper (Refereed)
    Abstract [en]

    An educational intervention to improve communication skills in home care – a feasibility study

    Background

    An educational intervention focused on person-centred communication with older persons in home care was developed. Twenty-three nursing assistants (NAs) from two home care units were offered the intervention. This feasibility study was conducted to capture benefits and pit falls with study processes before large scale interventions, such as acceptability and appropriateness of evaluation methods.

    Aim

    To explore the feasibility of proposed methods for evaluating a novel educational intervention on person-centered communication for NAs in home care.

    Method

    Feasibility study with pre- and post-assessments, including evaluation of data collection procedures, completion rates, and missing data for two questionnaires: Self-efficacy Questionnaire measuring communication skills and Measure of Job Satisfaction. Descriptive and statistical analysis was conducted. 

    Results

    The results showed a completion rate of 83% and 61% in pre- and post-assessment respectively, and a low proportion of missing data. The questionnaires were feasible and acceptable for NAs to complete and understand. Stress due to staff shortages and high workload negatively affected NAs’ participation in data collection. Overall, NAs rated their communication skills as high with a tendency towards higher communication self-efficacy after the intervention, however, this difference was not statistically significant. Job satisfaction remained unchanged pre- and post-intervention.

    Conclusion

    Low follow-up rates suggest that the data collection procedures need refinement. Although the outcomes are preliminary at this point, they indicate a ceiling effect in NAs’ self-efficacy ratings. The ceiling effect limits possibilities for improvement and suggests that studies with a larger sample is needed.

    Implications for caring in a changing world

    In a changing world, where a rapid aging population challenges home care services, there is a need for innovative interventions that support and strengthen health care professionals’ communication skills, aiming at improving older persons’ well-being This study contributes with knowledge to the complexity of developing and evaluating complex interventions on communication in home care.

  • 5.
    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.
    Hedén, Lena
    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.
    Maurin Söderholm, Hanna
    University of Borås, Faculty of Librarianship, Information, Education and IT. University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Communication in home care—A feasibility study of an educational intervention in self‐efficacy and job satisfaction2023In: Nursing Open, E-ISSN 2054-1058, Vol. 10, no 3, p. 1375-1382Article in journal (Refereed)
    Abstract [en]

    Aim

    To explore the feasibility of evaluating a novel educational intervention on person-centered communication for nursing assistants (NAs) in home care.

    Design

    A feasibility study with pre- and post-assessments.

    Methods

    Feasibility was assessed pre- and post-intervention, including evaluation of data collection procedures, completion rates and missing data in two questionnaires: Self-efficacy Questionnaire measuring communication skills and Measure of Job Satisfaction, analysed descriptively and statistically.

    Results

    The questionnaires were feasible and acceptable for the NAs to complete and understand. The pre- and post-assessments showed 83% and 61% completion rates, respectively, and a low proportion of missing data. Barriers for not participating in data collection were stress caused by staff shortages and high workload. Preliminary analysis of the questionnaires showed no significant difference pre- and post-intervention, even though an overall tendency of increased communication self-efficacy was observed. The NAs' self-efficacy ratings also revealed a ceiling effect.

     

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  • 6.
    Hedén, Lena E
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Berglund, Mia
    School of Health Sciences, University of Skövde, Skövde, Sweden..
    Gillsjö, Catharina
    School of Health Sciences, University of Skövde, Skövde, Sweden..
    Effects of the Intervention "Reflective STRENGTH-Giving Dialogues" for Older Adults Living with Long-Term Pain: A Pilot Study.2020In: Journal of Aging Research, ISSN 2090-2204, E-ISSN 2090-2212, Vol. 2020, article id 7597524Article in journal (Refereed)
    Abstract [en]

    Background: Long-term musculoskeletal pain is a major, often undertreated, disabling health problem among an increasing number of older adults. Reflective STRENGTH-giving dialogues (STRENGTH) may be a tool to support older adults living with long-term pain. The main aim of this pilot study was to investigate the immediate and longitudinal effect of the intervention STRENGTH on levels of pain, wellbeing, occurrence of depression symptoms, and sense of coherence (SOC) among community-dwelling older adults suffering from musculoskeletal pain compared to a control group.

    Methods: The study was semiexperimental with an intervention group and a control group. The effect of a single STRENGTH intervention was reported on the Numeric Rating Scale (NRS) regarding pain and wellbeing. To evaluate the longitudinal effect of STRENGTH, using the Brief Pain Inventory-Short Form (BPI-SF), the Geriatric Depression Scale-20 (GDS-20), SOC-13 at baseline (T1), and six months after the intervention/no intervention (T2), a total of 30 older adults, aged 72 to 97 years (Mdn 86 years), were included consecutively and fulfilled the intervention series (n = 18) or untreated controls (n = 12).

    Results: The intervention with STRENGTH decreases pain (NRS 6 Mdn versus NRS 4 Mdn, p < 0.001) and increases wellbeing (NRS 7 Mdn versus NRS 8 Mdn, p < 0.001). After a six-month study period with STRENGTH, no longitudinal effect difference was found compared to baseline. Compared to the control group, there was an increasing trend between decreased pain level and increased SOC level for STRENGTH intervention.

    Conclusions: This pilot study supports STRENGTH's effect as a pain-alleviating model that provides a decrease in pain levels and an increase of wellbeing in older adults with long-term pain. STRENGTH dialogues could be a useful intervention to provide individually holistic care in older adults living with long-term pain.

  • 7.
    Hedén, Lena E
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ljungman, Gustaf
    Department of Women’s and Children’s Health, Pediatric Oncology, Uppsala University.
    Do children's self-reports differ from the proxy reports of fear levels during needle procedures in children with cancer?2019Conference paper (Refereed)
    Abstract [en]

    Introduction

    Needle procedures in relation to cancer disease and treatment are often experienced as frightening and painful for children. To assess fear a proxy report by nurses or parents are often clinically used.

    Objective

    To investigate fear levels experienced by children in connection with needle procedures and use findings to optimise the recurring needle process.

    Aim

    The aim was to determine if child self-report and proxy report of needle fear levels are in agreement.

    Methods

    Data was collected during 90 needle insertions in children 7 to 18 years of age, included consecutively when undergoing routine needle insertion into a subcutaneously implanted intravenous port following topical anaesthesia. Fear in connection with the needle procedure was independently assessed on a 100 mm Visual Analogue Scale (VAS) with anchors at the extreme ends (no fear - worst possible fear) by the child, nurse and parent and investigated with one-way ANOVA within subjects and post hoc with Bonferroni correction.

    Results

    The reported fear level differed between children’s self-reports (VAS mean 14 mm), nurse ratings (VAS mean 21 mm), and parents ratings (VAS mean 21 mm) during a needle insertion in a subcutaneously implanted port (F(2, 178)= 6.211, p=0.002). Post hoc tests revealed differences between (i) children’s self-reports and nurses reports (p=0.017) and (ii) children’s self-reports vs. parents reports (p=0.006) but showed no differences between nurses reports and parents reports (p=1).

    Conclusion

    Nurses and parents significantly overestimated the child’s fear level of the needle procedure. Therefore children, as far as possible, should be (i) more actively involved as partners throughout the needle procedures and (ii) encouraged to self-report their fear level in connection with needle procedures for improved analysis and treatment.

  • 8.
    Hedén, Lena E
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    von Essen, Louise
    Department of Public Health and Caring Sciences, Clinical Psychology in Healthcare, Uppsala University.
    Frykholm, Peter
    Department of Surgical Sciences, Anesthesia and Intensive Care, Uppsala University Hospital.
    Ljungman, Gustaf
    Department of Women's and Children's Health, Pediatric Oncology, Uppsala University.
    Low-dose oral midazolam reduces fear and distress during needle procedures in children with cancer2009In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017Article in journal (Refereed)
  • 9.
    Hedén, Lena E
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    von Essen, Louise
    Department of Women's and Children's Health, Clinical Psychology in Healthcare, Uppsala University.
    Ljungman, Gustaf
    Department of Women’s and Children’s Health, Pediatric Oncology, Uppsala University.
    Children's self‐reports of fear and pain levels during needle procedures2019In: Nursing Open, E-ISSN 2054-1058, Vol. 7, no 1, p. 376-382Article in journal (Refereed)
    Abstract [en]

    Aim: The objective was to determine the levels of and potential relationships be‐ tween, procedure‐related fear and pain in children.

    Design: Clinical based cross‐sectional.

    Methods: Ninety children aged between 7–18 years were included consecutively and self‐reported levels of pain and fear on a 0–100 mm visual analogue scales (VAS) when undergoing routine needle insertion into a subcutaneously implanted intrave‐ nous port following topical anaesthesia.

    Results: The needle‐related fear level was reported to be as high as the needle‐re‐ lated pain level (mean VAS: 14 mm and 12 mm, respectively, N = 90). With fear as the dependent variable, age and pain were significantly associated and explained 16% of the variance. With pain as the dependent variable, fear was significantly associated and explained 11% of the variance. A post hoc analysis indicated that younger chil‐ dren reported their fear levels to be higher than their pain levels.

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  • 10.
    Hedén, Lena E
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    von Essen, Louise
    Ljungman, Gustaf
    Effect of morphine in needle procedures in children with cancer.2011In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 15, no 10Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The aim was to investigate whether children experience less fear, distress, and/or pain when they receive oral morphine vs. placebo before a needle is inserted in a subcutaneously implanted intravenous port when combined with topical anesthesia.

    METHOD: Fifty children 1-18 years of age who were treated in a pediatric oncology and hematology setting were included consecutively when undergoing routine needle insertion into an intravenous port. All children were subjected to one needle insertion following topical anesthetic (EMLA) application in this randomized, triple-blind, placebo-controlled study comparing orally administered morphine (n=26) 0.25 mg/kg body weight with placebo (n=24). The patients' fear, distress, and pain were reported by parents, nurses and the children themselves (if ≥ 7 years of age) on 0-100 mm Visual Analogue Scales. In addition, observational methods were used to measure distress and procedure pain.

    RESULTS: No differences between the morphine and the placebo group were found with respect to age, weight, height, physical status, sex, weeks from diagnosis, or weeks from latest needle insertion. According to, parents, nurses, and children, oral morphine at a dose of 0.25 mg/kg body weight did not reduce fear, distress or pain compared with placebo.

    CONCLUSION: We could not reject the null hypothesis that there is no difference between the oral morphine and placebo groups assuming an effect size of 15 mm on VAS. Therefore it seems that oral morphine at 0.25 mg/kg does not give any additional reduction of fear, distress or pain compared with placebo when combined with topical anesthesia in pediatric patients undergoing subcutaneous port needle insertion, and would not be expected to be of any advantage for similar procedures such as venipuncture and venous cannulation when topical anesthesia is used.

  • 11.
    Hedén, Lena E
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    von Essen, Louise
    Department of Public Health and Caring Sciences, Clinical Psychology in Healthcare, Uppsala University.
    Ljungman, Gustaf
    Department of Women's and Children's Health, Pediatric Oncology, Uppsala University.
    Randomized interventions for needle procedures in children with cancer2009In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354Article in journal (Refereed)
    Abstract [en]

    Twenty-eight children, 2-7 years, cared for at a paediatric oncology unit, undergoing a routine needle insertion in an intravenous port were included consecutively. All children were subjected to two needle insertions; at the first they received standard care, and at the second standard care + a randomized intervention. Parents and nurses assessed children's fear, distress and pain on 0-100 mm visual analogue scales. According to parents' report, children experienced less fear when subjected to intervention vs. standard care reported by parents (P < 0.001). Children also experienced less fear (P < 0.05) and distress (P < 0.05) when subjected to standard care + blowing soap bubbles vs. standard care (n = 14), and less fear when subjected to standard care + heated pillow vs. standard care (P < 0.05). Nurses' reports did not show any differences for standard care + intervention vs. standard care. Blowing soap bubbles or having a heated pillow is more effective than standard care in reducing children's fear and distress in needle procedures, according to parents' report.

  • 12.
    Hedén, Lena
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Pöder, Ulrika
    von Essen, Louise
    Ljungman, Gustaf
    Parents' perceptions of their child's symptom burden during and after cancer treatment.2013In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 46, no 3Article in journal (Refereed)
    Abstract [en]

    CONTEXT: Previously reported studies of children with cancer mostly provide cross-sectional knowledge of the prevalence of symptoms but do not show when during the disease trajectory and after the end of successful treatment certain symptoms are most prevalent and/or distressing.

    OBJECTIVES: The aim was to describe parents' perceptions of their child's symptom burden longitudinally during and after cancer treatment and to investigate whether parents' perceptions vary with child characteristics and parent gender.

    METHODS: One hundred sixty parents (49% fathers) of 89 children answered a modified version of the Memorial Symptom Assessment Scale (MSAS) 10-18 at six different time points from one week after the child's diagnosis (T1) to 12-18 months after the end of successful treatment (T6).

    RESULTS: Feeling drowsy, pain, and lack of energy are initially the most prevalent symptoms. During treatment, the most prevalent symptom is less hair than usual. Pain, feeling sad, and nausea are initially the most distressing symptoms. Pain is both prevalent and distressing throughout the treatment. The child's symptom burden decreases over time. There is no difference regarding the reported symptom burden between the parents of a daughter or a son, or parents of a child older or younger than seven years of age. Mothers' and fathers' assessments of the symptom number, total MSAS and the subscales, are associated, but mothers' assessments are often higher than fathers' assessments.

    CONCLUSION: The prevalence and distress of symptoms and symptom burden decrease over time. However, even though the cancer is cured, feeling sad is reported as being prevalent and psychological distress is an issue. A dialogue between staff and the family about distressing symptoms and when they can be expected may increase acceptance and adaptation in children and parents during the disease trajectory.

  • 13.
    Hedén, Lena
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    von Essen, L
    Department of Public Health and Caring Sciences, Clinical Psychology in Healthcare, Uppsala University, Sweden.
    Ljungman, G
    Department of Women's and Children's Health, Pediatric Oncology, Uppsala University, Sweden.
    The relationship between fear and pain levels during needle procedures in children from the parents' perspective.2016In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 20, no 2Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The primary objective was to determine the levels of and potential relationships between procedure-related fear and pain in children. Secondary objectives were to determine if there are associations between the child's age and sex, diagnostic group, time since diagnosis, time since last needle insertion, cortisol levels and the parent's fear level in relation to fear and pain.

    METHODS: The child's level of pain and fear was reported by parents on 0-100 mm visual analogue scales (VAS). One hundred and fifty-one children were included consecutively when undergoing routine needle insertion into a subcutaneously implanted intravenous port. All children were subjected to one needle insertion following topical anaesthesia (EMLA) application. The effect of the child's age and sex, diagnostic group, time since diagnosis, time since last needle insertion, cortisol change levels and the parent's fear level, on fear and pain levels was investigated with multiple regression analysis.

    RESULTS: The needle-related fear level (VAS mean 28 mm) was higher than the needle-related pain level (VAS mean 17 mm) when topical anaesthesia is used according to parents' reports (n = 151, p < 0.001). With fear as the dependent variable, age and pain were significantly associated and explained 33% of the variance, and with pain as the dependent variable, fear, parents' fear and change in cortisol level were significantly associated and explained 38% of the variance.

    CONCLUSIONS: According to parents, children experienced more fear than pain during needle insertion when topical anaesthesia is used. Therefore, in addition to pain management, an extended focus on fear-reducing interventions is suggested for needle procedures.

  • 14.
    Hedén, Lena
    et al.
    University of Borås, School of Health Science. University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    von Essen, Louise
    Ljungman, Gustaf
    Effect of high-dose paracetamol on needle procedures in children with cancer: a RCT2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 3, p. 314-319Article in journal (Refereed)
    Abstract [en]

    AIM: The aim was to investigate whether children experience less pain, fear and/or distress when they receive high-dose paracetamol compared with placebo, using a needle insertion in a subcutaneously implanted intravenous port as a model. METHODS: Fifty-one children ranging from 1 to 18 years of age being treated in a paediatric oncology setting were included consecutively when undergoing routine needle insertion into a subcutaneously implanted intravenous port. All children were subjected to one needle insertion following topical anaesthetic (EMLA) application in this double-blind, placebo-controlled RCT, comparing orally administered paracetamol (n = 24) 40 mg/kg body weight (max 2000 mg) with placebo (n = 27). The patients' pain, fear and distress were reported by parents, nurses and children (≥7 years of age) using 0- to 100-mm visual analogue scales (VAS). In addition, pain observation, procedure time and cortisol reduction were assessed. RESULTS: No differences between the paracetamol and the placebo group were found with respect to demographic characteristics. According to VAS reports, paracetamol did not reduce pain, fear and distress compared with placebo. Pain observation, cortisol reduction and procedure time did not differ between the study groups. CONCLUSION: Paracetamol provides no additive effect in reducing pain, fear and distress when combined with topical anaesthesia in children undergoing port needle insertion.

  • 15.
    Hedén, Lena
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Åhlström, Linda
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Individual response technology to promote active learning within the caring sciences: An experimental research study.2015In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: One major challenge in delivering lectures to large and diverse classes is the maintenance of a high standard of lecturing in order to engage students and increase their participation and involvement. The lecturer's assignment is to arrange and prepare the lecture before teaching, hence enabling students' enhanced learning. Individual response technology could encourage students' active learning and activate higher cognitive levels.

    OBJECTIVES: The aim of this study was to evaluate individual response technology as a complement during lectures for students in higher education, in terms of the students' experiences of participation, engagement, and active learning. Also of interest was whether this technology can be considered a supportive technical system.

    DESIGN: Data were collected through a questionnaire where levels of each condition were reported on a numeric rating scale (0-10) at baseline and after the introduction of individual response technology. To get a broader perspective, two types of lectures (pediatric and statistical) were included, giving a total of four assessment times.

    PARTICIPANTS: The participants comprised 59 students in Bachelor of Nursing program at a Swedish metropolitan university.

    RESULTS: Overall, when individual response technology was used, students reported increased experience of engagement (n=82, mean 6.1 vs. n=65, mean 7.3, p<0.001), participation (n=92, mean 6.1 vs. n=79, mean 7.7, p<0.001), and active learning (n=92, mean 7.3 vs. n=79, mean 8.2 p<0.001). Additionally, the students experienced this technology as a supportive technical system during lectures (mean 6.6 vs. mean 8.1, p<0.001).

    CONCLUSIONS: The use of individual response technology during teaching is one way to enhance students' experiences of engagement, participation, and learning within the caring sciences.

  • 16.
    Höglander, Jessica
    et al.
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Holmström, Inger K.
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Gustafsson, Tanja
    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.
    Maurin Söderholm, Hanna
    University of Borås, Faculty of Librarianship, Information, Education and IT. University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hedén, Lena
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    von Heideken Wågert, Petra
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Implementing A person-centred CommunicaTION (ACTION) educational intervention for in-home nursing assistants – a study protocol2023In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 23, no 1, article id 112Article in journal (Refereed)
    Abstract [en]

    Background: In this study, the focus is on how to support the competence development needed for nursing assistants in home care. Home care services for older persons can be challenging concerning the nature of the interpersonal interaction and communication needed to care for and respond to the diverse needs of older people who seek to live well in our communities. This implies a need to offer more person-centred care (PCC) to older persons. However, there is a lack of knowledge on how to develop such competence. We, therefore, developed A Person-centred CommunicaTION (ACTION) programme, which is a web-based educational intervention aimed at supporting competence development for nursing assistants. The research objective is to evaluate the ACTION programme with respect to participants’ responses to and the effect of the intervention. Methods: A multicentre case–control study with pre- and post-assessments was designed. The ACTION programme will be implemented at home care units, in two different geographic areas in Sweden. A total of 300 nursing assistants will be recruited: 150 for the intervention group and 150 for the control group. We will evaluate the impact measures and the process. Pre- and post-assessments will be performed with data collected via a) audio recordings of communication, b) a questionnaire on self-efficacy communication skills, PCC, empathy and job satisfaction, c) user data, evaluation forms, field notes and observations, and d) interviews. The data will be analysed with descriptive and analytic statistics and/or qualitative methods for meanings. Discussion: This study has the potential to contribute to the evidence supporting competence development required to offer person-centred and quality home care to older persons and to meet upcoming needs for flexible and easily accessible competence development. Trial registration: ISRCTN64890826. Registered 10 January 2022, https://www.isrctn.com/ISRCTN64890826 

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  • 17.
    Israelsson-Skogsberg, Åsa
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hedén, Lena E
    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.
    Laakso, Katja
    Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg.
    'I'm almost never sick': Everyday life experiences of children and young people with home mechanical ventilation.2018In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 1, no 13Article in journal (Refereed)
    Abstract [en]

    Developments in medical technology and treatment have increased the survival rates of children with serious illnesses or injuries, including those receiving home mechanical ventilation, which is a small but growing group. The aim of this study was to explore everyday life experiences of children and young people living with home mechanical ventilation (HMV). Data were obtained through interviews with nine participants. The interviews were supported by photovoice methodology: photographs taken by the participants before or during the interviews were used to facilitate conversation. Interview data were analyzed using qualitative content analysis. The findings revealed that everyday life on a ventilator can be described as including power but simultaneously as characterized by vulnerability to the outside world, comparable to balancing on a tightrope. Various types of technology, both information and communication technology (ICT) and vital medical technology, enabled the participants to engage with the world around them. This study contributes knowledge about the experiences of children and young people with HMV, who depict their lives as good and valuable. The study also underscores, when designing plans and home support, it is necessary to take a sensible approach to personal experiences of what a good life is and what resources are needed to attain and maintain health.

  • 18.
    Kamsvåg, Tove
    et al.
    Department of Women's and Children's Health, Pediatric Oncology, Uppsala University, Uppsala, Sweden..
    Hedén, Lena E
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Department of Women's and Children's Health, Pediatric Oncology, Uppsala University, Uppsala, Sweden..
    von Essen, Louise
    Department of Women's and Children's Health, Clinical Psychology in Healthcare, Uppsala University, Uppsala, Sweden.
    Ljungman, Gustaf
    Department of Women's and Children's Health, Pediatric Oncology, Uppsala University, Uppsala, Sweden.
    Ibuprofen in needle procedures in children with cancer: A feasibility and pilot study2021In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 110, no 2, p. 704-710Article in journal (Refereed)
    Abstract [en]

    AIM: To investigate the feasibility, and perform a pilot study, of a randomised clinical trial, investigating whether children experience less pain, fear and/or distress when they receive oral ibuprofen vs placebo before a needle is inserted in a subcutaneously implanted intravenous port.

    METHODS: Twenty-three children were included consecutively and randomised to either oral ibuprofen (n = 12) 7.5 mg/kg body weight or placebo (n = 11). The child's pain, fear and distress were reported by parents, nurses and the children (if ≥7 years of age). Feasibility criteria were defined as (a) ≥4 children included/month, (b) ≥80% of eligible patients agreed to participate, (c) >90% treated according to protocol, (d) <5% missing data, (e) s-cortisol samples analysed in ≥90% of the children.

    RESULTS: All feasibility criteria were met except recruitment and consent. Parents, nurses and children reported no trend of benefit of oral ibuprofen with regard to pain, fear and distress compared with placebo.

    CONCLUSION: The study failed to meet important feasibility criteria and was closed due to low recruitment rate and absence of trend of effect. From this data, we cannot state that ibuprofen is not helpful in needle procedures but that it seems unlikely.

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  • 19.
    Kleye, Ida
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Darcy, Laura
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Karlsson, Katarina
    Hedén, Lena E
    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.
    "This is the way i want it": Children's strategies for dealing with fear and pain during hospital care2019In: / [ed] Ida Kleye, 2019Conference paper (Refereed)
    Abstract [en]

    Introduction

    The aim of this study was to describe children's self-identified strategies for dealing with fear and pain during hospital care and treatment

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  • 20.
    Kleye, Ida
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hedén, Lena E
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Karlsson, Katarina
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Darcy, Laura
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Children's individual voices are required for adequate management of fear and pain during hospital care and treatment2021In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 35, no 2, p. 530-537Article in journal (Refereed)
    Abstract [en]

    Background: Children often report both fear and pain in conjunction with clinical care and treatment. Interventions developed in the field have still not been sufficient to prevent and relieve children’s fear and pain. More knowledge, from children’s own perspectives, is needed about how they deal with their experiences.

    Aim: To explore child-identified strategies that children use to manage fear and pain during needle-related medical procedures in hospital.

    Methods: Interviews with children, age 4–12 years, with experience of hospital care were analysed qualitatively using content analysis.

    Results: Children have self-identified strategies for dealing with fear and pain during hospital care and treatment. The strategies vary depending on examination or treatment and on how the child felt at that particular day. Children describe what they can do themselves, how adults can empower them and support from surroundings as strategies that give them a choice and a voice. Children wished to have influence, decide when and how information should be given, scream out loud or squeeze something hard, to deal with fear and pain. The results also show that children tried to be brave, gain control and think positively. Something nice to look at and opportunities to play with others also contributed.

    Conclusions: Strategies vary between children and are used differently on different occasions. Healthcare professionals pose a threat to the child’s needs and ability to use their strategies due to lack of knowledge of the child’s chosen strategies.

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  • 21.
    Kleye, Ida
    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.
    Darcy, Laura
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Karlsson, Katarina
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hedén, Lena E
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Children's communication of emotional cues and concerns during a preoperative needle procedure2022In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 105, no 6, p. 1518-1523Article in journal (Refereed)
    Abstract [en]

    Objective

    This study explores children’s expressions of emotional cues and concerns during needle procedures, nurses’ responses and findings in relation to children’s age and sex.

    Methods

    Twenty-six children aged 6–12 years were video recorded during a preoperative needle procedure. Emotional communication was analyzed using Verona Coding Definitions of Emotional Sequences.

    Results

    A total of 111 cues or concerns were identified in the observed needle procedures, with a distribution of 77 cues and 34 concerns. A majority of children (85%) expressed emotional cues through non-verbal communication. No differences between child age or sex related to expressed emotion were found. The child elicited the communicated emotion in 98% of sequences. Nurses' responses were coded as not providing space for communication in 75% of sequences.

    Conclusion

    Children are capable of expressing their emotional distress, primarily non-verbally, during needle procedures. A child showing less overt expressions during a needle procedure does not necessarily experience less fear or pain. The nurses’ communication focused on practical information during the needle procedure, with less attention to the child’s distress.

    Practice implications

    Nurses need to develop strategies to be aware of emotions the child communicates before, during and after a needle procedure.

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  • 22.
    Kleye, Ida
    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.
    Karlsson, Katarina
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Darcy, Laura
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hedén, Lena
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Positive effects of a child‐centered intervention on children's fear and pain during needle procedures2023In: Paediatric and Neonatal Pain, ISSN 2637-3807, Vol. 5, no 1, p. 23-30Article in journal (Refereed)
    Abstract [en]

    To examine whether children experience less fear or pain using a child-centered intervention and if there were differences between the intervention group and the control group regarding heart rate, time required for the procedure, success rate for the cannula insertion, and patient satisfaction. A controlled single-center case study of observational design, with one control and one intervention group. Child self-reported fear or pain levels did not reveal any differences for those receiving the intervention compared with controls. However, according to a behavioral observation measure with the Procedure Behavior Check List, effects of the intervention were lower distress in relation to fear and pain during the cannula insertion. The time it took to perform the cannula insertion also decreased significantly in the intervention group. More children in the intervention group reported that they were satisfied with the needle procedure compared with the children in the control group. The child-centered intervention provides reduced observed distress related to fear and pain in children undergoing a cannula insertion and reduced total time by more than 50%. This study found that child involvement in care strengthen their ability to manage a needle procedure. 

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  • 23.
    Lindmark, U
    et al.
    Centre for Oral Health, Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Ahlstrand, I
    Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Ekman, A
    Department of Social Work, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Berg, L
    Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Hedén, Lena E
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Källstrand, J
    School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Larsson, M
    School of Health and Education, University of Skövde, Skövde, Sweden.
    Nunstedt, H
    Department of Health Sciences, University West, Trollhättan, Sweden.
    Oxelmark, L
    Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Pennbrant, S
    Department of Health Sciences, University West, Trollhättan, Sweden.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Larsson, I
    School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Health-promoting factors in higher education for a sustainable working life - protocol for a multicenter longitudinal study.2020In: BMC Public Health, E-ISSN 1471-2458, Vol. 20, no 1, article id 233Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The World Health Organization has highlighted the importance of health promotion for health service providers in order to ensure sustainable working life for individuals involved in providing health services. Such sustainability begins when students are preparing to manage their own future health and welfare in working life. It has been suggested that universities, employees and trainee health professionals should adopt or follow a salutogenic approach that not only complements the providing of information on known health risks but also favors health promotion strategies. This paper describes the study design and data collection methods in a planned study aiming to explore health-promoting factors for a sustainable working life among students in higher education within healthcare and social work.

    METHODS: This protocol describes a multicenter longitudinal study involving Swedish students on higher education programs in the healthcare and social work sectors. In 2018, the study invited students on seven education programs at six universities to participate. These programs were for qualification as: biomedical laboratory scientists (n = 121); dental hygienists (n = 87); nurses (n = 1411); occupational therapists (n = 111); physiotherapists (n = 48); radiographers (n = 60); and, social workers (n = 443). In total, 2283 students were invited to participate. Participants completed a baseline, a self-reported questionnaire including six validated instruments measuring health-promoting factors and processes. There are to be five follow-up questionnaires. Three while the students are studying, one a year after graduating, and one three years after graduating. Each questionnaire captures different health-promoting dimensions, namely: health-promoting resources (i.e. sense of coherence); occupational balance; emotional intelligence; health and welfare; social interaction; and work and workplace experiences/perceptions.

    DISCUSSION: This study focuses on the vastly important aspect of promoting a sustainable working life for healthcare and social work employees. In contrast to previous studies in this area, the present study uses different, validated instruments in health promotion, taking a salutogenic approach. It is hoped that, by stimulating the implementation of new strategies, the study's findings will lead to education programs that prepare students better for a sustainable working life in healthcare and social work.

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  • 24.
    Sundler, Annelie Johansson
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hedén, Lena
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Holmström, Inger K
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    van Dulmen, Sandra
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands; Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands.
    Bergman, Karin
    Östensson, Sofia
    Östman, Malin
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden; Region Västra Götaland, Närhälsan Källstorp Healthcare Centre, Trollhättan, Sweden; Education, Development & Innovation, Primary Health Care, Region Västra Götaland, Research, Sweden; General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    The patient’s first point of contact (PINPOINT) – protocol of a prospective multicenter study of communication and decision-making during patient assessments by primary care registered nurses2023In: BMC Primary Care, E-ISSN 2731-4553, Vol. 24, no 1, article id 249Article in journal (Refereed)
    Abstract [en]

    Background

    A major challenge for primary care is to set priorities and balance demands with available resources. The registered nurses in this study are practice nurses working in primary care offices, playing a large role in initial assessments. The overall objective of this research is to investigate practices of communication and decision-making during nurses’ initial assessment of patients’ health problems in primary care, examine working mechanisms in good practices and develop feasible solutions.

    Methods

    Project PINPOINT aims for a prospective multicenter study using various methods for data collection and analysis. A purposive sample of 150 patient‒nurse consultations, including 30 nurses and 150 patients, will be recruited at primary care centers in three different geographic areas of southwest Sweden. The study will report on outcomes of communication practices in relation to patient-reported expectations and experiences, communication processes and patient involvement, assessment and decision-making, related priorities and value conflicts with data from patient questionnaires, audio-recorded real-time communication, and reflective interviews with nurses.

    Discussion

    This research will contribute to the knowledge needed for the guidance of first-line decision-making processes to best meet patient and public health needs. This knowledge is necessary for the development of assessments and decisions to be better aligned to patients and to set priorities. Insights from this research can empower patients and service providers and help understand and enhance feasible person-centered communication strategies tailored to patients’ level of health literacy. More specifically, this research will contribute to knowledge that can strengthen nurses’ communication, assessments, and clinical decision-making in primary care. In the long term, this will contribute to how the competencies of practice nurses and other professionals are organized and carried out to make the best use of the resources within primary care.

    Trial registration

    ClinicalTrials.gov Identifier: NCT06067672.

     

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  • 25.
    Sundler, Annelie Johansson
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Johansson, E
    Anaesthesia care unit, Västmanlands Sjukhus, Västerås, Sweden.
    Johansson, L
    Anaesthesia and intensive care unit, Hallands Sjukhus, Varberg, Sweden.
    Hedén, Lena E
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Incidents reported by nurse anesthetists in the operating room2018In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 32, no 6, p. 699-705Article in journal (Refereed)
    Abstract [en]

    The quality of health care and patient safety in the operating room is a major concern for nurse anaesthetists. However, few studies have focused on the experiences of nurse anaesthetists’ and their contributions to safety in this setting. Therefore, this study aims to explore the content and frequency of incidents reported by nurse anaesthetists in the operating room and the risks involved in these incidents. A retrospective study with a descriptive design was conduct. Data were gathered concerning 220 incidents reported by nurse anaesthetists from 2012 to 2015 in operating rooms at a middle-sized hospital in Sweden. These were analysed with a method for qualitative and quantitative content analysis. The findings are presented in five categories: communication and teamwork; routines and guidelines; patient care; nurses’ work environment; devices, materials and technologies. In 184 (73%) of the incidents, there was either a risk of harm or there was an actual harm to patients or nurses. Of all incidents only 23 (10%) had harmed patients or nurses. Few of these incidents involved patient harm (= 6), while a greater number involved harm to nurses (= 17). The findings reveal lack of communication and interprofessional teamwork as the two most common areas for the reported incidents, followed by problems related to lack of compliance with guidelines and routines. The findings suggest that strategies are needed to improve these areas. Patient safety reporting systems may be important to identify risk in preventing patients and health care professionals from being harmed. In addition, the findings indicate that the nurses sought to prevent harm to patients rather than to themselves. Consequently, increased attention to the work environments of nurses, and most likely other professionals, in the operating room may be needed to prevent health care professionals from being harmed.

  • 26.
    Östman, Malin
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hedén, Lena
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    van Dulmen, Sandra
    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.
    Holmström, Inger K
    The patient's first point-of-contact in primary care – registered nurse – patient communication coded by VR-CoDES2023Conference paper (Refereed)
  • 27.
    Östman, Malin
    et al.
    Mälardalen University.
    Holmström, Inger K
    Mälardalen University.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hedén, Lena
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    The patient's first point of contact in primary care – registered nurses' communication and initial assessment2023Conference paper (Refereed)
    Abstract [en]

    Overall information:

    This is a postdoc project that includes three work packages (WP). The purpose of this research is to investigate key principles and conflicts of goals in registered nurses’ (RNs) initial assessments and nurse-patient communication related to the priority of patients’ needs and care provision in primary care. This abstract focuses on the first WP.

    Background:

    Primary care is central to the Swedish healthcare system, for “good quality, local health care”, with focus on accessibility and continuity. In primary care, RNs are usually the patient's first point of contact and those who carry out initial assessments and priorities. The RNs communication and interaction with the patient is important for the initial exploration and understanding about patient’s health concerns, and RNs assessment includes data gathering, the interpretation of these data and decision-making on what action needs to be taken. Communication strategies used can optimize RNs assessment and clinical reasoning. However, assessments and priorities are complex, as health problems and illness severity must be weighed against accessibility and available resources. There is a lack of research on RNs communication strategies used to address individual patients’ need in their initial contact with primary care.

    Aim:

    To explore nurse-patient communication during initial assessments and RNs’ priorities with focus on expressed needs and concerns.

    Methods:

    The first WP is based on observational data, subjects for the project are RNs and patients from primary care units in Region Västra Götaland, Sweden. Data will be gathered on real time nursepatient communication using audio recordings with ten RNs doing five recordings each. A purposeful sampling will be made to collect data related to patients with a first point of contact with different disease conditions and illness complexities. The processing and analysis of data collected on audio recordings will be coded with the Verona Coding Definitions on Emotional Sequences (VR-CoDES). The data will allow for both statistical and qualitative analysis.

    Expected findings:

    This study can contribute to more knowledge about RNs communication strategies in relation to RNs’ assessment in patient’s first point of contact in primary care, but also whether gender differences or other inequalities exist.

    Timeplan:

    The first WP will start in Spring 2023 and by the end of the year, reporting and dissemination of findings is expected to be possible

    Request for feedback:

    We have planned to code the data with VR-CoDES. Other methods or approaches that may be suitable?

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