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  • 1.
    Andersson, Elin
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Bohlin, Linda
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Herlitz, Johan
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Fekete, Zoltán
    Andersson Hagiwara, Magnus
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Prehospital Identification of Patients with a Final Hospital Diagnosis of Stroke.2018In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Introduction the early phase of stroke, minutes are critical. Since the majority of patients with stroke are transported by the Emergency Medical Service (EMS), the early handling and decision making by the EMS clinician is important. Problem The study aim was to evaluate the frequency of a documented suspicion of stroke by the EMS nurse, and to investigate differences in the clinical signs of stroke and clinical assessment in the prehospital setting among patients with regard to if there was a documented suspicion of stroke on EMS arrival or not, in patients with a final hospital diagnosis of stroke.

    METHODS: The study had a retrospective observational design. Data were collected from reports on patients who were transported by the EMS and had a final diagnosis of stroke at a single hospital in western Sweden (630 beds) in 2015. The data sources were hospital and prehospital medical journals.

    RESULTS: In total, 454 patients were included. Among them, the EMS clinician suspected stroke in 52%. The findings and documentation on patients with a suspected stroke differed from the remaining patients as follows: a) More frequently documented symptoms from the face, legs/arms, and speech; b) More frequently assessments of neurology, face, arms/legs, speech, and eyes; c) More frequently addressed the major complaint with regard to time and place of onset, duration, localization, and radiation; d) Less frequently documented symptoms of headache, vertigo, and nausea; and e) More frequently had an electrocardiogram (ECG) recorded and plasma glucose sampled. In addition to the 52% of patients who had a documented initial suspicion of stroke, seven percent of the patients had an initial suspicion of transitory ischemic attack (TIA) by the EMS clinician, and a neurologist was approached in another 10%.

    CONCLUSION: Among 454 patients with a final diagnosis of stroke who were transported by the EMS, an initial suspicion of stroke was not documented in one-half of the cases. These patients differed from those in whom a suspicion of stroke was documented in terms of limited clinical signs of stroke, a less extensive clinical assessment, and fewer clinical investigations. Andersson E , Bohlin L , Herlitz J , Sundler AJ , Fekete Z , Andersson Hagiwara M . Prehospital identification of patients with a final hospital diagnosis of stroke.

  • 2.
    Arkkukangas, M
    et al.
    Mälardalens högskola.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Söderlund, A
    Mälardalens Högskola.
    Eriksson, S
    Umeå University.
    Johansson, A-C
    Mälardalens högskola.
    Older persons’ experiences of home-based exercise with behaviour change support2017In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 12, p. 905-913Article in journal (Refereed)
    Abstract [en]

    Background: It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons.

    Purpose: This descriptive study used a qualitative inductive approach to describe older persons’ experiences of a fall-preventive, home-based exercise program with support for behavioral change. Methods: Semi-structured interviews were conducted with 12 elderly persons aged 75 years or older, and a qualitative content analysis was performed.

    Results: Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise.

    Conclusion: With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age. 

  • 3.
    Berglund, Mia
    et al.
    University of Skövde.
    Westin, Lars
    University of Skövde.
    Svanström, Rune
    University of Skövde.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Suffering caused by care--patients' experiences from hospital settings.2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, no 1Article in journal (Refereed)
    Abstract [en]

    Suffering and well-being are significant aspects of human existence; in particular, suffering and well-being are important aspects of patients' experiences following diseases. Increased knowledge about existential dimensions of illness and healthcare experiences may be needed in order to improve care and reduce unnecessary suffering. Therefore, the aim of this paper is to illuminate the phenomenon of suffering experienced in relation to healthcare needs among patients in hospital settings in Sweden. In this study, we used a reflective lifeworld approach. The data were analysed with a focus on meanings. The results describe the essential meaning of the phenomenon of suffering in relation to healthcare needs. The patients were suffering during care-giving when they felt distrusted or mistreated and when their perspective on illness and health was overlooked. Suffering was found to arise due to healthcare actions that neglected a holistic and patient-centred approach to care. Unfortunately, healthcare experiences that cause patients to suffer seem to be something one needs to endure without being critical. The phenomenon can be described as having four constituents: to be mistreated; to struggle for one's healthcare needs and autonomy; to feel powerless; and to feel fragmented and objectified. The study concludes that there are problems associated with patients experiencing suffering at the hands of healthcare providers, even if this suffering may not have been caused deliberately to the patient. Consequently, conscious improvements are needed to lessen the suffering caused by care-giving, as are strategies that promote more patient-centred care and patient participation.

  • 4.
    Bisholt, Birgitta
    et al.
    University of Borås, School of Health Science.
    Ohlsson, Ulla
    University of Borås, School of Health Science.
    Kullén Engström, Agneta
    University of Borås, School of Health Science.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Gustafsson, Margareta
    University of Borås, School of Health Science.
    Nursing students' assessment of the learning environment in different clinical settings2014In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 14, no 3, p. 304-310Article in journal (Refereed)
    Abstract [en]

    Introduction Nursing students perform their clinical practice in different types of clinical settings. The clinical learning environment is important for students to be able to achieve desired learning outcomes. Knowledge is lacking about the learning environment in different clinical settings. Aim The aim was to compare the learning environment in different clinical settings from the perspective of the nursing students. Design A cross-sectional study with comparative design was conducted. Method Data was collected from 185 nursing students at three universities by means of a questionnaire involving the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) evaluation scale. An open-ended question was added in order to ascertain reasons for dissatisfaction with the clinical placement. Results The nursing students' satisfaction with the placement did not differ between clinical settings. However, those with clinical placement in hospital departments agreed more strongly that sufficient meaningful learning situations occurred and that learning situations were multi-dimensional. Some students reported that the character of the clinical setting made it difficult to achieve the learning objectives. Conclusion In the planning of the clinical placement, attention must be paid to whether the setting offers the student a meaningful learning situation where the appropriate learning outcome may be achieved.

  • 5.
    Björk, Maria
    et al.
    Jönköping University.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hallstöm, Inger
    Lund university.
    Hammarlund, Kina
    Högskolan i Skövde.
    Like being covered in a wet and dark blanket - Parents' lived experiences of losing a child to cancer2016In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 25, p. 40-45Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to illuminate parents' lived experiences of losing a child to cancer. Method: Interviews and a narrative about parents' experiences of losing a child to cancer were gathered from six parents of children whom had participated in a longitudinal study across the child's illness trajectory. The analysis of the data was inspired by van Manen's hermeneutic phenomenological approach. Results: One essential theme emerged: Like being covered in a wet and dark blanket, as well as six related themes: Feeling conflicting emotions, Preparing for the moment of death, Continuing parenting after death, Recollecting and sharing memories, Working through the sorrow and New perspectives in life. Conclusion: There is a need for good palliative care. If not, there is a risk that the parent will perseverate and blame themselves for not being a good parent during the suffering child's last time in life. Meetings with the parents six months and two years after the child's death might facilitate healing through the grief process.

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

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

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

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

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

  • 7. 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.

  • 8. Blomberg, Karin
    et al.
    Isaksson, Ann-Khristin
    Allvin, Renée
    Bisholt, Birgitta
    Ewertsson, Mona
    Kullén Engström, Agneta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ohlsson, Ulla
    Sundler Johansson, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Gustafsson, Margareta
    Work stress among newly graduated nurses in relation to workplace and clinical group supervision2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 1, p. 80-87Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate occupational stress among newly graduated nurses in relation to the workplace and clinicla group supervision. Being a newly graduated nurse is particulary stressful. Whar remains unclear is wehter teh workplace and clinical group supervision affect the stress. A cross-sectional comperative study was performed. Data were collected by means of a numerical scale measuring occupational stress, questions about workplace and clinicla group supervision. One hundred and thirteen nusres were included in the study. Conclusions: Newly graduated nurses experience great strss and need support. Nusrse participating in clinical group supervision reported significantly less stress.

  • 9.
    Gustafsson, Margareta
    et al.
    Örebro Universitet.
    Kullén Engström, Agneta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ohlsson, Ulla
    Örebro Universitet.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Bisholt, Birgitta
    Karlstad universitet.
    Nurse teacher models in clinical education from the perspective of student nurses - A mixed method study2015In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, no 12, p. 1289-1294Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim was to describe and compare the clinical teacher's role in different models of clinical practice from the perspective of student nurses.

    DESIGN AND SETTINGS: The study took place in collaboration with two Swedish universities that applied different educational models in clinical practice. A mixed method approach was used. The quantitative part had a comparative design and the qualitative part had a descriptive design.

    PARTICIPANTS: The study group consisted of 114 student nurses (response rate 87%). Fifty-three of them had met clinical teachers employed at the university and not participating in the daily clinical work (University Nurse Teachers, UNTs), whilst 61 had met clinical teachers dividing their time between teaching and nursing (Clinical Nurse Teachers, CNTs). Eight students participated in the qualitative part of the study.

    METHODS: A questionnaire including the CLES+T scale was used to ascertain the students' perception of the clinical teacher's role, complemented by interviews directed towards an enrichment of this perception.

    RESULTS: Students meeting CNTs agreed more strongly than those meeting UNTs that the teacher had the ability to help them integrate theory and practice. Whilst spontaneous meetings between students and CNTs occurred, students mostly met UNTs in seminars. Students meeting UNTs felt alone but did appreciate having someone outside the clinical environment to provide support if they did not get along with their preceptor.

    CONCLUSIONS: In the case of UNTs, it is important that they keep their knowledge of clinical issues updated and visit the clinical placement not only for seminars but also to give students emotional support. In the case of CNTs, it is important that they are members of the faculty at the university, take part in the planning of the clinical courses and are able to explain the learning goals to the students.

  • 10. Hafskjold, Linda
    et al.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Holmström, Inger K
    Sundling, Vibeke
    van Dulmen, Sandra
    Eide, Hilde
    A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol.2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 4Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of the COMHOME study is to generate knowledge on person-centred communication with older people (>65 years) in home healthcare services, radiographic and optometric practice.

    METHODS AND ANALYSIS: This study will explore the communication between care providers and older persons in home care services. Home healthcare visits will be audiorecorded (n=500) in Norway, the Netherlands and Sweden. Analyses will be performed with the Verona Coding Definitions for Emotional Sequences (VR-CoDES), the Roter Interaction Analysis System (RIAS) and qualitative methods. The content of the communication, communicative challenging situations as well as empathy, power distance, decision-making, preservation of dignity and respect will be explored. In Norway, an additional 100 encounters, 50 in optometric practice (video recorded) and 50 in radiographic practice (audiorecorded), will be analysed. Furthermore, healthcare providers' self-reported communication skills, empathy, mindfulness and emotional intelligence in relation to observed person-centred communication skills will be assessed using well-established standardised instruments.

    ETHICS AND DISSEMINATION: Depending on national legislation, approval of either the central ethical committees (eg, nation or university), the national data protection officials or the local ethical committees (eg, units of home healthcare) was obtained. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The research findings will add knowledge to improve services provided to this vulnerable group of patients. Additionally, the findings will underpin a training programme for healthcare students and care providers focusing on communication with older people.

  • 11.
    Hammar, Lena Marmstål
    et al.
    Karolinska Institutet.
    Holmström, Inger K
    Mälardalens University.
    Skoglund, Karin
    Mälardalens University.
    Meranius, Martina Summer
    Mälardalens University.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    The care of and communication with older people from the perspective of student nurses. A mixed method study.2017In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 52, p. 1-6, article id S0260-6917(17)30025-4Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Undergraduate nurse education needs to prepare student nurses to meet the demands and to have the necessary communication skills for caring for an increasing older population. The challenges involve how best to support and empower student nurses to learn the communication skills needed to care for older people.

    OBJECTIVE: The aim of this study was to investigate student nurses' views on the care of and communication with older people.

    DESIGN: A descriptive study with a mixed-method approach was conducted.

    METHODS: Quantitative and qualitative data were collected from a questionnaire completed by third-year Swedish student nurses in 2015.

    RESULTS: The student nurses reported positive attitudes to the care of and communication with older people. The findings focus on the central aspects related to relationship building, techniques for communication and external prerequisites.

    CONCLUSIONS: Despite positive attitudes, student nurses had a limited view of communication with older people. Educators need to increase student nurses' capacity to communicate effectively with older people. Educational interventions to improve and evaluate the communication competency of nurses and student nurses are needed.

  • 12. Hammarlund, Kina
    et al.
    Andersson, Emilie
    Tenenbaum, Hanna
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    We are also interested in how fathers feel: a qualitative exploration of child health center nurses' recognition of postnatal depression in fathers2015In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 15Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: To become a parent is an emotionally life-changing experience. Paternal depression during the postnatal period has been associated with emotional and behavioral problems in children. The condition has predominantly been related to mothers, and the recognition of paternal postnatal depression (PND) has been paid less attention to. PND in fathers may be difficult to detect. However, nurses in pediatric services meet a lot of fathers and are in a position to detect a father who is suffering from PND. Therefore, the aim of this study was (a) to explore Child Health Center nurses' experiences of observing depression in fathers during the postnatal period; and (b) to explore hindrances of observing these fathers.

    METHODS: A qualitative descriptive study was conducted. Ten nurses were interviewed in 2014. A thematic data analysis was performed and data were analyzed for meaning.

    RESULTS: Paternal PND was experienced as being vague and difficult to detect. Experiences of fathers with such problems were limited, and it was hard to grasp the health status of the fathers, something which was further complicated when routines were lacking or when gender attitudes influenced the daily work of the nurses.

    CONCLUSION: This study contributes to an increased awareness of hindrances to the recognition of PND in fathers. The importance to detect all signals of paternal health status in fathers suffering from PND needs to be acknowledged. Overall, more attention needs to be paid to PND in fathers where a part of the solution for this is that they are screened just like the mothers.

  • 13. Henoch, Ingela
    et al.
    Browall, Maria
    Melin-Johansson, Christina
    Danielson, Ella
    Udo, Camilla
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Björk, Maria
    Ek, Kristina
    Hammarlund, Kina
    Bergh, Ingrid
    Strang, Susann
    The Swedish version of the Frommelt Attitude Toward Care of the Dying scale: aspects of validity and factors influencing nurses' and nursing students' attitudes.2014In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 37, no 1, p. 1-11Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Nurses' attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language.

    OBJECTIVES: The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients.

    METHODS: A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used.

    RESULTS: The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach α's. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients.

    CONCLUSIONS: Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses' attitudes toward caring for dying patients.

    IMPLICATION FOR PRACTICE: Care culture might influence nurses' attitudes toward caring for dying patients; the benefits of education need to be explored.

  • 14. 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.

  • 15.
    Holmström, Inger
    et al.
    Mälardalens Högskola.
    Krantz, A
    Ängens vårdcentral, Örebro.
    Karagacil, L
    Hemsjukvården, Vård och omsorg Västerås stad.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Frequent callers in primary healthcare – a nursing perspective2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 3, no 3, p. 622-632Article in journal (Refereed)
    Abstract [en]

    AIM:

    To: (a) describe how telephone nurses define a frequent caller; and (b) describe their experiences with calls from frequent callers to primary healthcare centres.

    BACKGROUND:

    Telephone nursing has been noted to be a cost-effective method to enhance access to and use of health care. Some patients use these services extensively and are called 'frequent callers'. Little is known about this group of callers, the reasons behind these calls and telephone nurses' experiences and strategies to manage the calls.

    DESIGN:

    Descriptive design with a qualitative inductive approach.

    METHODS:

    Interviews were conducted with ten telephone nurses in Sweden in 2015. Qualitative content analysis was conducted.

    RESULTS:

    A main theme was established, called 'Balancing between the experienced and assessed needs', which described the telephone nurses' experiences with calls made by frequent callers to primary healthcare centres and was further described in five categories with 15 subcategories. The categories described telephone nurses' definitions of frequent callers, telephone nurses' views of the underlying reasons for the calls, challenges related to frequent callers, experiences with an increased work load and strategies used to manage and help frequent callers.

    CONCLUSION:

    Frequent callers were commonly encountered by telephone nurses' in this study. Their calls were experienced as complex and demanding to manage. The findings point to needs for guidelines and routines to improve the care of frequent callers. In addition, support and training in communication skills to encounter this group of callers in an optimal and safe way may be required.

  • 16.
    Håkansson Eklund, Jakob
    et al.
    Mälardalen University.
    Holmström, Inger K
    Mälardalen University.
    Kumlin, Tomas
    Mälardalen University.
    Kaminsky, Elenor
    Uppsala University.
    Skoglund, Karin
    Mälardalen University.
    Höglander, Jessica
    Mälardalen University.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Condén, Emilie
    Uppsala University.
    Summer Merenius, Martina
    Mälardalen University.
    Same same or different? A review of reviews of person-centred and patient-centred care.2018In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134Article in journal (Refereed)
    Abstract [en]

    Objective

    To provide a synthesis of already synthesized literature on person-centered care and patient-centered care in order to identify similarities and differences between the two concepts.

    Methods

    A synthesis of reviews was conducted to locate synthesized literature published between January 2000 and March 2017. A total of 21 articles deemed relevant to this overview were synthesized using a thematic analysis.

    Results

    The analysis resulted in nine themes present in person-centered as well as in patient-centered care: (1) empathy, (2), respect (3), engagement, (4), relationship, (5) communication, (6) shared decision-making, (7) holistic focus, (8), individualized focus, and (9) coordinated care. The analysis also revealed that the goal of person-centered care is a meaningful life while the goal of patient-centered care is a functional life.

    Conclusions

    While there are a number of similarities between the two concepts, the goals for person-centered and patient-centered care differ. The similarities are at the surface and there are important differences when the concepts are regarded in light of their different goals.

    Practice implications

    Clarification of the concepts may assist practitioners to develop the relevant aspects of care. Person-centered care broadens and extends the perspective of patient-centered care by considering the whole life of the patient.

  • 17. Höglander, J
    et al.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Spreeuwenberg, P
    Holmström, I K
    Eide, H
    van Dulmen, S
    Håkansson Eklund, J
    Female gender explains emotional communication in home care2018Conference paper (Refereed)
  • 18.
    Höglander, Jessica
    et al.
    Mälardalen University.
    Eklund, Jakob Håkansson
    Mälardalen University.
    Eide, Hilde
    University College of Southeast Norway.
    Holmström, Inger K
    Uppsala University.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Registered Nurses' and nurse assistants' responses to older persons' expressions of emotional needs in home care.2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2923-2932Article in journal (Refereed)
    Abstract [en]

    AIM: This study aims to explore nurse assistants' and Registered Nurses' responses to older persons' expressions of emotional needs during home care visits.

    BACKGROUND: Communication is a central aspect of care. Older persons might express different emotions and needs during home care visits and such expressions can be challenging to respond to. Little is known about communication in home care or nursing staff responses to older persons' expressed emotional needs.

    DESIGN: Descriptive, cross-sectional design on nursing staff responses to older persons' negative emotions in home care.

    METHODS: Collected data consisted of audio recordings of home care visits between older persons and nursing staff. Data were collected between August 2014-November 2015. The nursing staff responses to older persons' negative emotions in the communication were analysed with the Verona Coding Definitions of Emotional Sequences (VR-CoDES).

    RESULTS: The nursing staff most often give non-explicit responses, providing space for further disclosure of older persons' expressed negative emotions. Such responses were more frequent if the nursing staff had elicited the older persons' expressions of a negative emotion than if such expressions were elicited by the older persons themselves. Most frequent types of responses were backchannel, active invitation or information advice.

    CONCLUSION: The nursing staff responses were mainly non-explicit responses providing space for older persons to tell more about their experiences. Such responses can be discussed in terms of person-centred communication and is important for the comfort of emotional concerns.

  • 19.
    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.

  • 20. Larsson, Margaretha
    et al.
    Björk, Maria
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Striving to make positive difference: School nurses’ experiences of promoting the health and well-being of adolecents girls’2014In: Journal of School Nursing, ISSN 1059-8405, E-ISSN 1546-8364, Vol. 30, no 5, p. 358-365Article in journal (Refereed)
    Abstract [en]

    In Sweden, school nurses are part of the School Health Service with the main objective of health promotion to support students’ health and attainment of educational goals. The aim in this phenomenological study was to illuminate the experiences of school nurses in promoting the health and well-being of adolescent girls. Seventeen school nurses were interviewed, both in groups and individually, to facilitate personal disclosure and expressions from their lived experiences. To achieve their goal of improving the health of adolescent girls, school nurses require flexibility in their approach and in endeavoring to make a positive difference they experience many challenges. This study concluded that school nurses can tactfully provide adolescent girls with knowledge and health guidance adjusted to individual needs and empowering the individual girl to participate in her own health process.

  • 21. Larsson, Margaretha
    et al.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    The influence of living conditions on adolescent girls' health2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, no 1, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Adolescence is described by the Swedish National Board of Health and Welfare as the healthiest period in life. However, adolescent girls differ in that they self-report that their health decreases with age. The aim of this hermeneutical study was to describe the meaning of living conditions in relation to adolescent girls’ health. Guided by principles of reflective lifeworld research, 15 interviews with adolescent girls were analysed. The result section consists of four narratives with their existential interpretations illustrating different ways of approaching living conditions and their meaning for health and well-being. The narratives are: Approaching everyday life in a balanced way—feeling harmonious; approaching everyday life with ambiguity—feeling confused; approaching everyday life as an intellectual project—striving for control; approaching everyday life as a struggle—feeling forlorn. In addition, a comprehensive understanding was developed by using the lifeworld dimensions: lived body, lived room, lived time, and lived relations. These dimensions may deepen the understanding of important parts of those living conditions which are meaningful for the girls’ health and well-being. By using the dimensions, complex living conditions have been explored and the meaning of different parts clarified. The girls’ thoughts and feelings are often ambiguous and sometimes contradictory, depending on the situation. The health of adolescent girls needs to be understood against the background of their experiences of living conditions. One way to support their health and well-being seems to be to supply them with forums where they can talk about their living conditions.

  • 22. Larsson, Margaretha
    et al.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ekebergh, M
    University of Borås, School of Health Science.
    Beyond Self-Rated Health: The Adolescent Girl's Lived Experience of Health in Sweden2013In: Journal of School Nursing, ISSN 1059-8405, E-ISSN 1546-8364, Vol. 29, no 1, p. 71-79Article in journal (Refereed)
    Abstract [en]

    The aim of this phenomenological study was to describe the phenomenon of health as experienced by adolescent girls in Sweden. Fifteen adolescent girls were interviewed with a focus on what made them feel well in their everyday life. This study reveals that the adolescent girl's health is a complex phenomenon interwoven with their lives. Health arises in meaningful contexts, in an adolescent girl's relations to others as well as in her ability to manage her life. Health is shaped in their everyday life and can be understood as a mood of "being" well that involves actions and practices. The results show that it is important to meet these girls from an open approach in order to support and strengthen their health and well-being. The health of adolescent girls can be supported, and it is a challenge for professionals, particularly school nurses, who meet these girls in everyday life to improve their health.

  • 23. Larsson, Margaretha
    et al.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ekebergh, Margaretha
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Björk, Maria
    Altering the Parenting Role: Parents’ Experience of Supporting the Health and Well-Being of Their Adolescent Girls. 2015In: Child and Youth Care Forum, ISSN 1053-1890, E-ISSN 1573-3319, Vol. 44, no 3, p. 419-432Article in journal (Refereed)
  • 24. Peilot, Birgitta
    et al.
    Andréll, Paulin
    Samuelsson, Anita
    Mannheimer, Clas
    Frodi, Ann
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Time to gain trust and change--experiences of attachment and mindfulness-based cognitive therapy among patients with chronic pain and psychiatric co-morbidity.2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, no 1Article in journal (Refereed)
    Abstract [en]

    The treatment of patients with chronic pain disorders is complex. In the rehabilitation of these patients, coping with chronic pain is seen as important. The aim of this study was to explore the meaning of attachment and mindfulness-based cognitive therapy (CT) among patients with chronic pain and psychiatric co-morbidity. A phenomenological approach within a lifeworld perspective was used. In total, 10 patients were interviewed after completion of 7- to 13-month therapy. The findings reveal that the therapy and the process of interaction with the therapist were meaningful for the patients' well-being and for a better management of pain. During the therapy, the patients were able to initiate a movement of change. Thus, CT with focus on attachment and mindfulness seems to be of value for these patients. The therapy used in this study was adjusted to the patients' special needs, and a trained psychotherapist with a special knowledge of patients with chronic pain might be required.

  • 25.
    Råberus, Anna
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Holmström, I K
    Galvin, Kathleen
    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.
    The nature of patient complaints: a resource for healthcareimprovements2018In: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677Article in journal (Refereed)
  • 26. Skoglund, K
    et al.
    Holmström, I K
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hammar Marmstål, L
    Previous work experience and age do not affect final semester nursing student self-efficacy in communication skills2018In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 68, p. 182-187Article in journal (Refereed)
  • 27. Skoglund, K
    et al.
    Holmström, I
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hammar Marmstål, L
    Communication skills nursing education2018Conference paper (Refereed)
  • 28.
    Sundler, Annelie Johansson
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    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.
    Holmström, I K
    ACTION - A person-centred communication intervention in home care of older persons2018Conference paper (Refereed)
  • 29.
    Sundler, Annelie Johansson
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hjertberg, F
    Keri, H
    Holmström, I K
    Attributes of person-centred communication. A Qualitative Exploration of communication with older persons during home healthcare visits2018Conference paper (Refereed)
  • 30.
    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 1469-9567Article 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.

  • 31.
    Sundler, Annelie Johansson
    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.
    Nilsson, Christina
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Palmér, Lina
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Qualitative thematic analysis – based on phenomenology2018Conference paper (Refereed)
  • 32.
    Sundler, Annelie Johansson
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Råberus, Anna
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Holmström, Inger K
    Mälardalens Högskolan, Uppsala Universitet.
    Mänskliga rättigheter ochrätten till hälsa. En analys av anmälningar till patientnämnderna i VästraGötaland2017Report (Other academic)
    Abstract [sv]

    Denna rapport visar att patienters rättigheter är otydliga när det gäller rätten till hälso- och sjukvård. Otydligheten kan leda till att hälso- och sjukvården framstår som rättsosäker. Det finns möjligheter att förbättra kvalitet, trygghet och patientsäkerhet, där anmälningar från patienter och närstående kan utgöra ett värdefullt underlag. En av rapportens slutsatser är att det finns ett behov av en mer patient- och personcentrerad hälso- och sjukvård.

    I denna rapport beskrivs resultaten från ett forskningsprojekt där anmälningar till patientnämnderna i Västra Götaland analyserats med fokus på mänskliga rättigheter. Ett strategiskt urval av 170 anmälningar som patienter eller närstående lämnat till patientnämnderna under år 2015 har här analyserats.

    Resultaten beskrivs i fyra delar. I den första delen presenteras beskrivande statistik för anmälningarna. Den andra delen beskriver innehållet i anmälningarna, vilket handlar om att inte ha tillgång till hälso- och sjukvård, brister i kontinuitet och uppföljning, felaktigheter eller vårdskador till följd av hälso- och sjukvård, brister i kommunikation och samverkan, bemötande, attityder och förhållningssätt i möten med hälso- och sjukvårdspersonal, samt hälso- och sjukvård som går emot patientens vilja. Därefter följer den del där anmälningarna analyserats utifrån ett patient- och mäniskorättsperspektiv. Här beskrivs fem teman som berör rätten till hälsa och patienters rättigheter vid ohälsa och sjukdom, rätten till hälso- och sjukvård och patienters rättigheter vid akuta tillstånd, rätten till god och säker hälso- och sjukvård och patienters säkerhet, rätten till värdighet och ett bra bemötande, samt hälso- och sjukvårdspersonalens rättigheter. I den fjärde och sista delen av resultaten har anmälningarna granskats utifrån ett normkritiskt och intersektionellt perspektiv. Här framträder vissa grupper av patienter som mer sårbara än andra, och den utsatthet och maktaspekter som framträder i analysen beskrivs.

    I anmälningarna till patientnämnderna framkommer situationer där patienters rättigheter brister i möten med hälso- och sjukvården, där det kan vara svårt för patienter att utkräva sin rätt. Anmälningarna synliggör patienters upplevelser av att kvalitet, trygghet och patientsäkerhet brister, och patientnämndernas verksamhet spelar en viktig roll i att synliggöra dessa brister för att kunna bidra till förbättringar inom hälso- och sjukvården. För att säkerställa de mänskliga rättigheterna och rätten till hälsa behöver hälso- och sjukvården anpassas utifrån invånares behov.

    Anmälningarna visar att det ibland finns brister i hälso- och sjukvårdens förmåga att utgå från en helhetssyn på patienten. Enskilda personer är sårbara i kontakt med hälso- och sjukvården, och patienters utsatthet och olika maktförhållanden mellan patienter och hälso-  och sjukvårdspersonal behöver hanteras ansvarsfullt för att inte skapa ojämlikheter eller leda till upplevelser av diskriminering. Ett professionellt bemötande kräver också kommunikativ kompetens och empati hos hälso- och sjukvårdspersonal. En slutsats av detta är att det finns behov av en mer patientcentrerad hälso- och sjukvård, som tydligare beaktar enskilda personers förutsättningar och behov, liksom organisatoriska förbättringar som främjar patientens vårdkedja och samverkan mellan vårdverksamheter.

  • 33.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Svåra samtal2016In: Äldre i centrum, ISSN 1401-5110, Vol. 3, p. 30-31Article in journal (Other (popular science, discussion, etc.))
  • 34.
    Sundler J, Annelie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Bisholt, Birgitta
    Ohlsson, Ulla
    Björk, Maria
    Kullén Engström, Agneta
    University of Borås, School of Health Science.
    Gustafsson, Margareta
    Student nurses' experiences of the clinical learning environment in relation to the organization of supervision: A questionnaire survey2014In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 34, no 4, p. 661-666Article in journal (Refereed)
    Abstract [en]

    Aim The aim was to investigate student nurses' experiences of the clinical learning environment in relation to how the supervision was organized. Background The clinical environment plays an essential part in student nurses' learning. Even though different models for supervision have been previously set forth, it has been stressed that there is a need both of further empirical studies on the role of preceptorship in undergraduate nursing education and of studies comparing different models. Method A cross-sectional study with comparative design was carried out with a mixed method approach. Data were collected from student nurses in the final term of the nursing programme at three universities in Sweden by means of a questionnaire. Results In general the students had positive experiences of the clinical learning environment with respect to pedagogical atmosphere, leadership style of the ward manager, premises of nursing, supervisory relationship, and role of the nurse preceptor and nurse teacher. However, there were significant differences in their ratings of the supervisory relationship (p < 0.001) and the pedagogical atmosphere (p 0.025) depending on how the supervision was organized. Students who had the same preceptor all the time were more satisfied with the supervisory relationship than were those who had different preceptors each day. Students' comments on the supervision confirmed the significance of the preceptor and the supervisory relationship. Conclusion The organization of the supervision was of significance with regard to the pedagogical atmosphere and the students' relation to preceptors. Students with the same preceptor throughout were more positive concerning the supervisory relationship and the pedagogical atmosphere.

  • 35.
    Sundler J, Annelie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Dahlberg, Karin
    Ekebergh, Margaretha
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Living with experiences following a myocardial infarction.2003In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 2, no 3, p. 229-236Article in journal (Refereed)
    Abstract [en]

    Coronary heart disease is a major cause of sudden death and morbidity in the developed world, as well as a cause of great suffering. Research within this area has primarily focused symptoms, risk factors and treatment. The aim of this paper was to explore women's experiences following a myocardial infarction (MI). Eight women were interviewed; the interviews were audiotaped and transcribed into text and analysed using a phenomenological approach. To explore the meaning that is experienced in the lived world of the patient a method of reflective lifeworld research, based upon phenomenological epistemology has been used. The results indicate that the body is vital for the women in their lifeworlds. After a MI the patient's natural and unreflective relationship with the body and the lived world is interrupted. Uncertainty about life and death as well as the body is experienced as a suffering in the women's lifeworlds. In relation to this, the women's existence is characterised by an uncertainty and a loss of context. It is through reconciliation with their bodies and their illnesses that the women can achieve a sense of well-being and harmony in life. In that process the women can re-establish a natural relationship with their bodies and lifeworlds.

  • 36.
    Sundler J, Annelie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Dahlberg, Karin
    Ekenstam, Claes
    The meaning of close relationships and sexuality: women's well-being following a myocardial infarction.2009In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 19, no 3, p. 375-387Article in journal (Refereed)
    Abstract [en]

    Relationships and sexuality following heart attack (MI) have been studied; nevertheless, little is known about the meaning of social support and relationships to health and well-being after an MI. To our knowledge, no qualitative studies have further investigated the phenomenon. In this study we explore the meaning of close relationships and sexuality to women's health and well-being following MI. Ten women were interviewed using a reflective lifeworld approach and phenomenological epistemology. The meaning of women's close relationships following an MI appears to be closely intertwined with their long-term health process; both health processes and the relationships are affected. Suffering after an MI can be compared to taking a fall in that close relationships can become a safety net. Close relationships and sexuality are integrated into their lived bodies, and in that way have profound influence in their lifeworld experiences. Not all close relationships are intimate; however, all close and meaningful relationships can provide power and strength to the women's health processes. At the same time, these relationships also appear to drain energy and cause suffering.

  • 37.
    Sundler J, Annelie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Eide, Hilde
    van Dulmen, Sandra
    Holmström, Inger K
    Communicative challenges in the home care of older persons - a qualitative exploration.2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 10, p. 2435-2444Article in journal (Refereed)
    Abstract [en]

    AIM: To explore communicative challenges in encounters between nurse assistants and older persons during home care visits.

    BACKGROUND: The older population is increasing worldwide. Currently, there is a shift in care for older people from institutional care to home care. Providing home care in a person's home involves several challenges, including the complexity of communication.

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

    METHODS: The data consisted of audio recordings of real-life encounters during home care visits between nurse assistants and older persons, collected in 2014. A hermeneutic phenomenological analysis was conducted.

    RESULTS: Communicative challenges were identified: (a) in situations where the older persons had a different view than the nurse assistants on the care task and its content; and (b) when unexpected actions or turns occurred in the communication. Challenges included older person's existential issues, fragility and worries and concerns, which often appeared to be only vaguely expressed and difficult to verbally detect and tackle. This engendered a risk of misinterpretation or ignorance of these challenges.

    CONCLUSION: The findings point to the importance of communication as the key to facilitate person-centred home care. Communication training should focus more on addressing needs and existential issues in older persons. Person-centred home care for older persons needs to be addressed at both an individual and an organizational level.

  • 38.
    Sundler J, Annelie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ekebergh, Margaretha
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    The Meaning of Well-being and Participation in the Process of Health and Care: Women’s experiences following a myocardial infarction.2006In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 1, no 2, p. 100-108Article in journal (Refereed)
  • 39.
    Sundler J, Annelie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hallström, Inger
    Hammarlund, Kina
    Björk, Maria
    University of Skövde.
    Living an everyday life through a child's cancer trajectory: families' lived experiences 7 years after diagnosis.2013In: Journal of Pediatric Oncology Nursing, ISSN 1043-4542, E-ISSN 1532-8457, Vol. 30, no 6, p. 293-300Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate the lived experiences of families where a child had survived 7 years from a diagnosis of childhood cancer. This article describes one part of an inductive and longitudinal research project that included 17 families. Four families whose child was diagnosed with cancer 7 years previously were interviewed using a hermeneutical phenomenological approach. The families lived experience was described in one essential theme, "Living an everyday life through the child's cancer trajectory," further illuminated in 3 related themes: "Leaving the disease behind yet feeling its presence," "Being the same yet always different," and "Feeling stronger yet vulnerable." The results suggest that family members feel vulnerable even if a long period of time has passed since completion of treatment. To varied degrees they still may need support. When moving forward in life, the family members are helped if they can reconcile their memories and experiences derived from the childhood cancer trajectory.

  • 40.
    Sundler J, Annelie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Höglander, Jessica
    Mälardalens Högskola.
    Eklund, Jakob Håkansson
    Mälardalens Högskola.
    Eide, Hilde
    University College of Southeast Norway.
    Holmström, Inger K
    Mälardalens Högskola.
    Older persons' expressions of emotional cues and concerns during home care visits. Application of the Verona coding definitions of emotional sequences (VR-CoDES) in home care.2017In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 100, no 2, p. 276-282Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study aims to a) explore to what extent older persons express emotional cues and concerns during home care visits; b) describe what cues and concerns these older persons expressed, and c) explore who initiated these cues and concerns.

    METHODS: A descriptive and cross-sectional study was conducted. Data consisted of 188 audio recorded home care visits with older persons and registered nurses or nurse assistants, coded with the Verona coding definitions on emotional sequences (VR-CoDES).

    RESULTS: Emotional expressions of cues and concerns occurred in 95 (51%) of the 188 recorded home care visits. Most frequent were implicit expressions of cues (n=292) rather than explicit concerns (n=24). Utterances with hints to hidden concerns (63,9%, n=202) were most prevalent, followed by vague or unspecific expressions of emotional worries (15,8%, n=50). Most of these were elicited by the nursing staff (63%, n=200).

    CONCLUSION: Emotional needs expressed by the older persons receiving home care were mainly communicated implicitly. To be attentive to such vaguely expressed emotions may demand nursing staff to be sensitive and open.

    PRACTICE IMPLICATIONS: The VR-CoDES can be applied on audio recorded home care visits to analyse verbal and emotional communication, and may allow comparative research.

  • 41.
    Sundler J, Annelie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Pettersson, Annika
    Berglund, Mia
    Undergraduate nursing students' experiences when examining nursing skills in clinical simulation laboratories with high-fidelity patient simulators: A phenomenological research study.2015In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, no 12Article in journal (Refereed)
    Abstract [en]

    Simulation has become a widely used and established pedagogy for teaching clinical nursing skills. Nevertheless, the evidence in favour of this pedagogical approach is weak, and more knowledge is needed in support of its use. The aim of this study was (a) to explore the experiences of undergraduate nursing students when examining knowledge, skills and competences in clinical simulation laboratories with high-fidelity patient simulators and (b) to analyse these students' learning experiences during the examination. A phenomenological approach was used, and qualitative interviews were conducted among 23 second-year undergraduate nursing students-17 women and 6 men. The findings revealed that, irrespective of whether they passed or failed the examination, it was experienced as a valuable assessment of the students' knowledge and skills. Even if the students felt that the examination was challenging, they described it as a learning opportunity. In the examination, the students were able to integrate theory with practice, and earlier established knowledge was scrutinised when reflecting on the scenarios. The examination added aspects to the students' learning that prepared them for the real world of nursing in a safe environment without risking patient safety. The study findings suggest that examinations in clinical simulation laboratories can be a useful teaching strategy in nursing education. The use of high-fidelity patient simulators made the examination authentic. The reflections and feedback on the scenario were described as significant for the students' learning. Undergraduate nursing students can improve their knowledge, understanding, competence and skills when such examinations are performed in the manner used in this study.

  • 42.
    Sundler J, Annelie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Svanström, Rune
    Hjärtats osäkerhet: en begrereppsanalys2013In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 33, no 1, p. 42-47Article in journal (Refereed)
  • 43. Sundling, V
    et al.
    Hafskjold, L
    Holmström, I K
    Höglander, J
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Eide, H
    Supportive Communication in Home Health Care: A Cross-national Comparative Study2018Conference paper (Refereed)
  • 44.
    Sundling, Vibeke
    et al.
    University College of Southeast Norway.
    Sundler, Annelie Johansson
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Holmström, Inger K
    Uppsala University.
    Kristensen, Dorte Vesterager
    University College of Southeast Norway.
    Eide, Hilde
    University College of Southeast Norway.
    Mindfulness predicts student nurses' communication self-efficacy: A cross-national comparative study.2017In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 100, no 8, p. 1558-1563, article id S0738-3991(17)30146-5Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of this study was to compare student nurses' communication self-efficacy, empathy, and mindfulness across two countries, and to analyse the relationship between these qualities.

    METHODS: The study had a cross-sectional design. Data was collected from final year student nurses in Norway and Sweden. Communication self-efficacy, empathy, and mindfulness were reported by questionnaires; Clear-cut communication with patients, Jefferson Scale of Empathy, and Langer 14 items mindfulness scale.

    RESULTS: The study included 156 student nurses, 94 (60%) were Swedish. The mean communication self-efficacy score was 119 (95% CI 116-122), empathy score 115 (95% CI 113-117) and mindfulness score 79 (95% CI 78-81). A Mann-Whitney test showed that Swedish students scored significantly higher on communication self-efficacy, empathy, and mindfulness than Norwegian students did. When adjusted for age, gender, and country in a multiple linear regression, mindfulness was the only independent predictor of communication self-efficacy.

    CONCLUSION: The Swedish student nurses in this study scored higher on communication self-efficacy, empathy, and mindfulness than Norwegian students did. Student nurses scoring high on mindfulness rated their communication self-efficacy higher.

    PRACTICE IMPLICATIONS: A mindful learning approach may improve communication self-efficacy and possibly the effect of communication skills training.

  • 45. Svanström, Rune
    et al.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Gradually losing one's foothold--a fragmented existence when living alone with dementia.2015In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 14, no 2, p. 145-163Article in journal (Refereed)
    Abstract [en]

    The number of persons with dementia who lives at home for a longer period of time after diagnosis is increasing. Even if the literature in the dementia field is growing, there is a need for more knowledge about everyday life of persons with a dementia disease; particularly the lived perspective of persons who live alone. The aim of this study was to elucidate the phenomenon of living alone with dementia and having a manifest care need. This phenomenological study was carried out from a reflective lifeworld approach. The data material in the study consisted of field notes from 32 visits and transcriptions from 11 tape-recorded conversations with six participants. The results reveal that the person with dementia who lives alone ends up in a vague existence where they cannot survive alone. The person's level of activity comes to a halt and body movement becomes slower. Daily life becomes more difficult to manage and the person's earlier natural way of relating to the world and the people around them is gradually lost. This is followed by a loneliness and forgetfulness that cloud the meaning of life. This study highlights the importance of the patient's perspective needed to better understand the inner life of a person who suffers from dementia. This understanding is important in the organization of help and care as well as for caregivers to better understand these individuals and their needs.

  • 46. Svanström, Rune
    et al.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Berglund, Mia
    Westin, Lars
    Suffering caused by care-elderly patients' experiences in community care.2013In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, no 1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Growing old involves many changes in life and implies an increased risks of illness and different forms of disabilities. Life may change in a radical way when a person gets a disease like dementia or moves to a nursing home due to disabilities or needs. In both cases, it often leads to an increased dependency on care where the patient becomes exposed and vulnerable and thereby at a higher risk for experiencing different forms of suffering.

    AIM: The aim of this study was to elucidate and gain a deeper understanding of elderly patients' experiences of suffering in relation to community care in nursing homes and home care services.

    MATERIALS AND METHODS: A lifeworld hermeneutical approach was used. Phenomenological interviews and conversations with an open approach were conducted and analysed with a focus on meanings.

    FINDINGS: The findings were presented in four main themes; an absence of the other in care, an absence of dialogues, a sense of alienation and a sense of insecurity. The findings in this study revealed that persons who were cared for in nursing homes and home care services sometimes were exposed to an unnecessary suffering. The suffering sometimes was caused by various caring actions, that is, unnecessary suffering. The suffering caused by care that aroused was due to caregiver's inability to be present, to show their face, and truly meet the patient.

    CONCLUSION: Suffering from care increased the elderly patients' feelings of insecurity, loneliness, and alienation; this seemed to be the foundation for patients' experiences of being outside a human community. There was a lack of knowledge and understanding about the patient's lifeworld.

  • 47.
    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.

  • 48. Westin, Lars
    et al.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Berglund, Mia
    Students' experiences of learning in relation to didactic strategies during the first year of a nursing programme: a qualitative study.2015In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 15Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In university undergraduate nursing programmes, didactic strategies that enable students to learn nursing skills, solve problems and develop reflective and critical thinking and practice are needed. The aim of this study was to explore how different didactic strategies support nursing students' experiences of learning during the first year of a reconstructed nursing curriculum.

    METHODS: This study employed a qualitative approach. The data were gathered through written narratives that were analysed using qualitative content analysis.

    RESULTS: Nursing students' experiences of learning through different didactic strategies, were evident in the text. These perspectives were organised into the following themes: To focus on the patient perspective and paying more attention to others, Learning from discussions and reflections on one's own learning, Training for the professional role and becoming more courage, and Gaining insights into nursing and increasing one's self-awareness. The education increased the students' self-awareness, which helped them to pay greater attention to patients and their relative. During the learning process, the students became more courageous, reflected and discovered their shortcomings.

    CONCLUSION: Stated didactic strategies supported a broad base of knowledge on nursing and the professional role of nurses. Educators are challenged to strengthen meaningful learning in nursing and to facilitate the progression of nursing programmes.

1 - 48 of 48
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