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  • 1.
    Andersson, Morgan
    et al.
    Chalmers tekniska Högskola.
    Fridh, Isabell
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Is it possible to feel at home in a patient room in an intensive care unit? Reflections on environmental aspects in technology dense environments: Is it possible to feel at home in a patient room in an intensive care unit?2019In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800Article in journal (Refereed)
    Abstract [en]

    This paper focuses on the patient’s perspective and the philosophical underpinnings that support what might be considered optimal for the future design of the Intensive Care Unit (ICU) patient room. It also addresses the question of whether the aspects that support at-homeness are applicable to ICU patient rooms. The concept of ‘at-homeness’ in ICUs is strongly related to privacy and control of space and territory. This study investigates whether the sense of at-homeness can be created in an ICU, when one or more patients share a room. From an interdisciplinary perspective, we critically reflect on various aspects associated with conflicts surrounding the use of ICU patient rooms. Thus, from an architectural and a caring perspective, the significance of space and personal territory in ICU patient rooms is emphasized. Recommendations for further research are suggested. In conclusion, privacy and control are deemed to be essential factors in the stimulation of recovery processes and the promotion of wellbeing in situations involving severe illness or life-threatening conditions.

  • 2.
    Björk, Kristofer
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Department of Intensive Care Northern Älvsborg Hospital.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Fridh, Isabell
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Family members’ experiences of waiting in intensive care: a concept analysis2019In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, p. 1-18Article in journal (Refereed)
    Abstract [en]

    AIM:

    The aim of this study was to explore the meaning of family members' experience of waiting in an intensive care context using Rodgers' evolutionary method of concept analysis.

    METHOD:

    Systematic searches in CINAHL and PubMed retrieved 38 articles which illustrated the waiting experienced by family members in an intensive care context. Rodgers' evolutionary method of concept analysis was applied to the data.

    FINDINGS:

    In total, five elements of the concept were identified in the analysis. These were as follows: living in limbo; feeling helpless and powerless; hoping; enduring; and fearing the worst. Family members' vigilance regarding their relative proved to be a related concept, but vigilance does not share the same set of attributes. The consequences of waiting were often negative for the relatives and caused them suffering. The references show that the concept was manifested in different situations and in intensive care units (ICUs) with various types of specialties.

    CONCLUSIONS:

    The application of concept analysis has brought a deeper understanding and meaning to the experience of waiting among family members in an intensive care context. This may provide professionals with an awareness of how to take care of family members in this situation. The waiting is inevitable, but improved communication between the ICU staff and family members is necessary to reduce stress and alleviate the suffering of family members. It is important to acknowledge that waiting cannot be eliminated but family-centred care, including a friendly and welcoming hospital environment, can ease the burden of family members with a loved one in an ICU.

    The full text will be freely available from 2020-03-13 16:00
  • 3.
    Dahlborg, Elisabeth
    et al.
    Högskolan Väst.
    Brink, Eva
    Högskolan Väst.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    A Theoretical Framework for Emancipatory Nursing With a Focus on Environment and Persons’ Own and Shared Lifeworld: A Theoretical Framework for Emancipatory Nursing2018In: Advances in Nursing Science, ISSN 0161-9268, E-ISSN 1550-5014, Vol. 41, no 4, p. 340-350Article in journal (Refereed)
    Abstract [en]

    By giving a brief overview of the meta concepts in nursing, with a focus on environment, we sketch a theoretical framework for an emancipatory perspective in nursing care practice. To meet the requirements of equality in care and treatment, we have in our theoretical framework added a critical lifeworld perspective to the anti oppressive practice, to meet requirements of equity in health care encounter. The proposed model of emancipatory nursing goes from overall ideological structures to ontological aspects of the everyday world. Based on the model, nurses could identify what kind of theoretical critical knowledge and thinking they require to conduct equal care and encounter the person behind the patient role.

  • 4.
    Dahlborg, Elisabeth
    et al.
    Högskolan Väst.
    Brink, Eva
    Högskolan i Väst.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    A theoretical framework for emancipatory nursing – with focus on environment and persons` own and shared lifeworld2018In: Advances in Nursing Science, ISSN 0161-9268, E-ISSN 1550-5014, Vol. 41, no 4, p. 340-350Article in journal (Refereed)
  • 5. Dahlborg-Lyckhage, Elisabeth
    et al.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Living in Liminality: Being Simultaneously Visible and Invisible: Caregivers' Narratives of Palliative Care2013In: Journal of Social Work in End-of-life & Palliative Care, ISSN 1552-4256, Vol. 9, no 4, p. 272-288Article in journal (Refereed)
    Abstract [en]

    Palliative care is an integral part of care and takes place in many settings—including the home, special accommodations, and hospitals. However, research shows that palliative care often ends with a death in the hospital due to the heavy burden on the primary caregiver. This study explores the meaning of being the primary caregiver of a close one who is terminally ill and is based on qualitative interviews with six primary caregivers of a terminally ill individual at home. The findings are discussed in the light of the theoretical concepts of liminality, lived body, and power. A potential impending risk exists of being abandoned when one is the primary caregiver to a close one who is terminally ill. This situation calls for professional caregivers to take responsibility and to respond to these, often unspoken, needs. This is particularly important concerning bodily care and the medical treatment regimen. In addition, when friends and relatives are absent, there is an ethical demand on professional caregivers to compensate for this lack and to compensate for this need. Palliative home care demands care that is person-centered—including the individual’s history, family and loved ones, and individual strengths and weaknesses.

  • 6.
    Egerod, Ingrid
    et al.
    Köpenhamns universitet.
    Granberg, Anetteh
    Sjukhuset i Halmstad.
    Bergbom, Ingegerd
    Göteborgs Universitet.
    Henricson, Maria
    Högskolan i Jönköping.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Storlie, Sissel
    Universitetet i Trömsö.
    The patient experience of intensive care: a meta-synthesis of Nordic studies.2015In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 52, no 8, p. 1354-1361Article in journal (Refereed)
  • 7.
    Engwall, Marie
    et al.
    University of Borås, School of Health Science.
    Bergbom, Ingegerd
    University of Borås, School of Health Science.
    Fridh, Isabell
    University of Borås, School of Health Science. University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Let there be light and darkness: findings from a prestudy concerning cycled light in the intensive care unit environment.2014In: Critical Care Nursing Quarterly, ISSN 0887-9303, E-ISSN 1550-5111, Vol. 37, no 3, p. 273-298Article in journal (Refereed)
    Abstract [en]

    The present study reports findings concerning light in an intensive care unit setting presented from 3 aspects, giving a wide view. The first part is a systematic review of intervention studies concerning cycled light compared with dim light/noncycled light. The findings showed that cycled light may be beneficial to preterm infant health. Second, a lighting intervention in the intensive care unit is presented, comparing and assessing experience of this lighting environment with that of an ordinary room. Significant differences were shown in hedonic tone, favoring the intervention environment. In the third part, measured illuminance, luminance, and irradiance values achieved in the lighting intervention room and ordinary room lighting are reported.

  • 8.
    Engwall, Marie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Fridh, Isabell
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Johansson, Lotta
    Bergbom, Ingegerd
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lighting, sleep and circadian rhythm: An intervention study in the intensive care unit.2015In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 31, no 6, p. 325-335Article in journal (Refereed)
    Abstract [en]

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

  • 9.
    Engwall, Marie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Sahlgrenska University Hospital.
    Fridh, Isabell
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Jutengren, Göran
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Bergbom, Ingegerd
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Sahlgrenska University Hospital.
    Sterner, Anders
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Sahlgrenska University Hospital.
    The effect of cycled lighting in the intensive care unit on sleep, activity and physiological parameters: A pilot study2017In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 41, p. 26-32, article id S0964-3397(17)30032-0Article in journal (Refereed)
    Abstract [en]

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

  • 10.
    Eriksson, Thomas
    et al.
    Sahlgrenska University Hospital, University of Gothenburg.
    Bergbom, I
    Sahlgrenska Academy, University of Gothenburg.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    The experiences of patients and their families of visiting during whilst in an intensive care unit: A hermeneutic interview study2011In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 27, no 2, p. 60-67Article in journal (Refereed)
    Abstract [en]

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

  • 11.
    Eriksson, Thomas
    et al.
    University of Borås, School of Health Science.
    Bergbom, Ingegerd
    Lindahl, Berit
    University of Borås, School of Health Science.
    Hermeneutiska observationsstudier: från ett metodologiskt perspektiv.2013Conference paper (Refereed)
    Abstract [sv]

    Sedan några år har det varit en pågående diskussion om hur observationer kan användas i den vårdvetenskapliga forskningen, när det gäller att samla in kvalitativa forskningsdata och att tolka dessa data med hjälp av hermeneutik. Syftet med denna artikel var att reflektera, argumentera och bidra med ett innehåll i en pågående diskurs som rör utveckling av hermeneutisk tolkning av observationer som vetenskaplig metod via ett exempel genomfört inom intensivvård. I den hermeneutiska observationsstudie som används för att belysa metoden ligger forskningens fokus på att fånga det vårdande i besöken av patienter som vårdas på intensivvårdsavdelning. Den främsta anledningen till varför det finns ett behov av att utveckla och använda observation som datainsamling i det kliniska fältet är behovet av att få insikt i och synliggöra vad vårdandets innersta kärna kan innebära. Men det innefattar även kunskapsbildning om det som innebär att kunna se och vittna om vad som händer.

  • 12.
    Eriksson, Thomas
    et al.
    University of Borås, School of Health Science.
    Bergbom, Ingegerd
    Lindahl, Berit
    University of Borås, School of Health Science.
    The visiting situation in an ICU: an observational hermeneutic study –oral presentation2011Conference paper (Refereed)
    Abstract [en]

    Aim: The aim was to interpret the interplay between critically ill patients and their next of kin in an ICU to understand the visiting situation. Method: A hermeneutic research design with non-participant observation was chosen as the data collection method. Ten observations of 10 patients and 24 loved ones over a 20 hour period were conducted. The text describing the observations of the interplay was interpreted in accordance with Gadamer. Data were analysed by considering the text as a play with scenes, actors and plots. Results: The interpretation of the scenes revealed two themes describing the patient’s interplay and six themes describing the next of kin’s interplay. The understanding of the plot concerns people who had entered a situation where normal everyday life was disconnected. The path from health to illness was a totally unfamiliar environment and perception of life, where the body constituted a new and unknown world. As a result of the fact that the patients were unable to use their bodies in the usual way, which sends different signals to their loved ones, who in turn have difficulty deciding how to respond. Both parties become trapped or locked out by their own bodies. Conclusion: A hindrance to the interplay could be the room, which was designed for medical and technical use and thus did not promote healing. The professionals were crucial for interpreting the signals from both patients and next of kin, as well as for finding caring strategies, such as physical contact, that promote interplay, which in turn create a caring and healing atmosphere.

  • 13.
    Eriksson, Thomas
    et al.
    University of Borås, School of Health Science.
    Egerod, Ingrid
    Granberg Axell, Anetth
    Storli, Sissel Lisa
    Lindahl, Berit
    University of Borås, School of Health Science.
    Ågård, Anne Sophie
    Henricson, Maria
    Harden, Sue
    Danielsen, Astrid
    The Nordic Association for Intensive Care Nursing Research (NOFI)2011Conference paper (Other academic)
    Abstract [en]

    Nordic nursing studies have a strong tradition within the qualitative approach. This approach has been applied to explore the lived experience of critical illness and intensive care therapy from the perspectives of the patient and the patient’s family. In 2003, the Nordic Association for Intensive Care Nursing Research (NOFI) was established by nursing scholars from Denmark, Norway, and Sweden. The purpose of NOFI was to encourage research in intensive care nursing in the Nordic countries, to establish a network of intensive care nursing scholars, to exchange research experience and research outcomes among the Nordic research communities, and to increase the visibility of research in intensive care nursing in the Nordic countries. Although the focus was on nursing research, an interdisciplinary approach has also been encouraged with joint research and conference activities. NOFI have arranged biannual conferences for members and other individuals interested in the activities of the network. The venue has rotated among the tree Nordic countries, and the themes of the meetings have been: Intensive Care Unit (ICU) environment and acoustics, relatives of ICU-patients, ways of knowing, sedation, ethics, patient diaries, multimodal interventions, research designs, ICU-delirium, psychometrics, burns, and mechanical ventilation. Other activities have been presentations of newly completed PhD-studies in the Nordic countries. Since 2006, nursing scholars from the three Scandinavian countries have collaborated on a study of diaries written for ICU patients (patient diaries). The three countries share common values, culture and language, which has facilitated the exchange of ideas among the Nordic nurses. Intensive care nursing is a young domain of research. We still need to encourage more scholars within this area to increase our knowledge base, improve the ICU-experience and formalize rehabilitation of post-ICU patients. Intensive care is a collaborative practice and future research should reflect the interdisciplinary aspect of the field.

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

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

  • 15.
    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.

  • 16.
    Israelsson-Skogsberg, Åsa
    et al.
    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.
    Personal care assistants' experiences of caring for people on home mechanical ventilation.2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to describe personal care assistants' (PCA) experiences of working with a ventilator-assisted person at home. METHODS: Data were collected from fifteen audiotaped semistructured interviews with PCAs supporting a child or adult using home mechanical ventilation (HMV). Thirteen women and two men participated; their working experience with HMV users ranged from one to 17 years (median 6 years). Data were subjected to qualitative content analysis in an inductive and interpretive manner. FINDINGS: Five categories emerged from the data: Being part of a complex work situation; Taking on a multidimensional responsibility; Caring carried out in someone's home; Creating boundaries in an environment with indistinct limits; and Being close to another's body and soul. CONCLUSIONS: The participants felt very close to the person they worked with, both physically and emotionally. They had a great responsibility and therefore a commensurate need for support, guidance and a well-functioning organisation around the HMV user. There is international consensus that advanced home care will continue to expand and personal care assistance is key in this development. We suggest that one way to move forward for PCAs working with HMV users is to create multiprofessional teams led by a key-person who coordinates the individual needs. More research is needed within this area from a broad perspective including the HMV-assisted persons, relatives, personal care assistants and management organisations.

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

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

  • 18. Johansson, Lotta
    et al.
    Bergbom, Ingegerd
    Lindahl, Berit
    University of Borås, School of Health Science.
    Meanings of Being Critically Ill in a Sound-Intensive ICU Patient Room: A Phenomenological Hermeneutical Study2012In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 6, p. 108-116Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate the meanings of being critically ill in a sound-intensive ICU patient room, as disclosed through patients’ narratives. Patient rooms in ICUs are filled with loud activity and studies have revealed sound levels comparable to those of a busy road above the patient’s head. There is a risk that the sound or noise is disturbing and at worst a major problem for the patient, but there is a lack of knowledge concerning the patients’ own experiences. Thirteen patients were asked to narrate their experiences of the sound environment in ICU patient rooms. The interviews were analyzed using a phenomenological- hermeneutical method inspired by the philosophy of Ricoeur. Six themes emerged from the analysis. Conclusion: The meanings of being a patient in a sound- intensive environment were interpreted as never knowing what to expect next regarding noise, but also of being situated in the middle of an uncontrollable barrage of noise, unable to take cover or disappear. This condition is not to be seen as static; for some patients there is movement and change over time. The meanings indicate that the unpredictable shifts between silence and disturbing sounds stress the critically ill patient and impede sleep and recovery. Our findings indicate the need to reduce disturbing and unexpected sounds and noise around critically ill patients in high-tech environments in order to facilitate wellbeing, sleep and recovery. Nurses have a vital role in developing such an environment.

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

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

  • 20.
    Karlsson, Jonas
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Eriksson, Thomas
    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.
    Fridh, Isabell
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    The Patient’s Situation During Interhospital Intensive Care Unit-to-Unit Transfers: A Hermeneutical Observational Study2019In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, p. 1-12Article in journal (Refereed)
    Abstract [en]

    Interhospital intensive care unit-to-unit transfers are an increasing phenomenon, earlier mainly studied from a patient safety perspective. Using data from video recordings and participant observations, the aim was to explore and interpret the observed nature of the patient’s situation during interhospital intensive care unit-to-unit transfers. Data collection from eight transfers resulted in over 7 hours of video material and field notes. Using a hermeneutical approach, three themes emerged: being visible and invisible; being in a constantly changing space; and being a fettered body in constant motion. The patient’s situation can be viewed as an involuntary journey, one where the patient exists in a constantly changing space drifting in and out of the health personnel’s attention and where movements from the journey become part of the patient’s body. Interhospital transfers of vulnerable patients emerge as a complex task, challenging the health personnel’s ability to maintain a caring atmosphere around these patients.

  • 21.
    Karlsson, Jonas
    et al.
    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.
    Förflyttningar och överföringar mellan rum och olika vårdande institutioner i samband med intensivvård2017In: Fenomener i intensivsykepleie / [ed] Sven-Tore Dreyer Fredriksen och Kristin Halvorsen, Oslo: Cappelen Akademisk Forlag, 2017Chapter in book (Other academic)
  • 22. Karlsson, Veronika
    et al.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Bergbom, Ingegerd
    Patients' statements and experiences concerning receiving mechanical ventilation: a prospective video-recorded study2012In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 19, no 3, p. 247-258Article in journal (Refereed)
    Abstract [en]

    Patients' statements and experiences concerning receiving mechanical ventilation: a prospective video-recorded study Prospective studies using video-recordings of patients during mechanical ventilator treatment (MVT) while conscious have not previously been published. The aim was to describe patients' statements, communication and facial expressions during a video-recorded interview while undergoing MVT. Content analysis and hermeneutics inspired by the philosophy of Gadamer were used. The patients experienced almost constant difficulties in breathing and lost their voice. The most common types of communication techniques patients used were nodding or shaking the head. Their expressions were interpreted as stiffened facial expression, tense body position and feelings of sadness and sorrow. Nursing care for patients' conscious during MVT is challenging as it creates new demands regarding the content of the care provided. In caring for patients undergoing MVT while conscious, establishing a caring relationship, making patients feel safe and helping them to communicate seem to be most important for alleviating discomfort and instilling hope.

  • 23.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Att vara beroende av ventilator: patienters skildringar över tid2007Conference paper (Refereed)
  • 24.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Att vårda på evidensbaserad grund2010In: Att bli sjuksköterska - en introduktion till yrke och ämne, Lund: Studentlitteratur AB , 2010, p. 181-204Chapter in book (Other academic)
  • 25.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Being the parent of a ventilator-assisted child: perceptions of the family-health care provider relationship when care is offered in the family home2013In: Journal of Family Nursing, ISSN 1074-8407, E-ISSN 1552-549X, Vol. 19, no 4, p. 489-508Article in journal (Refereed)
    Abstract [en]

    The number of medically fragile children cared for at home is increasing; however, there are few studies about the professional support these families receive in their homes. The aim of the study was to understand the meanings that parents had about the support they received from health care professionals who offered care for their ventilator-assisted child in the family home. A phenomenological-hermeneutic method was used. Data included the narratives of five mother-father couples living in Sweden who were receiving professional support for their ventilator-assisted child. The findings indicate that receiving professional support meant being at risk of and/or exposed to the exercise of control over family privacy. The professional support system in the families' homes worked more by chance than by competent and sensible planning. In good cases, caring encounters were characterized by a mutual relationship where various occupational groups were embraced as a part of family life. The findings are discussed in light of compassionate care, exercise of power, and the importance of holistic educational programs.

  • 26.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Being the parent of a ventilator-dependent child: the need for support from compassionate professional care2015Conference paper (Refereed)
  • 27.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Can an ICU-patient room promote wellbeing and improve healthcare quality?2019Conference paper (Refereed)
    Abstract [en]

    Aim: To present novel reflections on environment regarding the design of the patient room in intensive care units (ICUs).

    Introduction: An ICU and the patient room in particular, is a protected and closed area in that other hospital staff and visitors have no immediate access to such environment. The ICU environment often appears frightening to patients and their loved ones due to presence of technology and advanced treatments. There is evidence that sounds, light, sleep deprivation and ICU delirium impact on patients’ health and recovery. Research has described negative effects of ICU environment to staff concerning noise, high work-load, heavy responsibilities and a complex psychological proximity to patients and their loved ones. A health care environment and patient room should be safe and attractive to staff so that they continue to contribute to caring processes. However, research about ICU’s physical environment and ICU-patient room design are sparse and thus evidence about how to design such areas is weak.

    Recommendations: Recommendations based on evaluation of a research program concerning evidence-based design in ICU-patient rooms will be shared. Components like light, sound environment, shape, colours, decoration and view to nature will be presented, pros and con with single rooms and the concepts privacy and control will be articulated. The research program was performed within a caring science perspective and so far it has generated three PhD theses with a forth on its way. Directions for further research such as interdisciplinary collaboration, the need for development of the meta-paradigm concept environment will be suggested. The latter needs to be theorized, problematized and practically explored. ICU-nurses, nursing researchers and former patients should collaborate with architects, building planners and economists in planning of new ICUs. Concepts like enriching and healing environments should be a part of ICU-nurses education curricula.

  • 28.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Caring or being cared for in the home: a metasynthesis describing the encounters between patients, informal caregivers and professionals2007Conference paper (Refereed)
  • 29.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Challenges and practical experiences concerning clinical research in the ICU.2015Conference paper (Refereed)
  • 30.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Could application and reflections based on Julia Kristeva’s philosophy to caring science bring a deeper understanding of what a life on a ventilator may be like?2015In: http://ki.se/ipons2015, 2015Conference paper (Refereed)
  • 31.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Dagligt liv och livssituation för barn med HMV och deras syskon2010Conference paper (Refereed)
  • 32.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Developing complex interventions.2016Conference paper (Refereed)
  • 33.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Experiences of exclusion when living on a ventilator: reflections based on the application of Julia Kristeva's philosophy to caring science2011In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 12, no 1, p. 12-21Article in journal (Refereed)
    Abstract [en]

    The research presented in this work represents reflections in the light of Julia Kristeva's philosophy concerning empirical data drawn from research describing the everyday life of people dependent on ventilators. It also presents a qualitative and narrative methodological approach from a person-centred perspective. Most research on home ventilator treatment is biomedical. There are a few published studies describing the situation of people living at home on a ventilator but no previous publications have used the thoughts in Kristeva's philosophy applied to this topic from a caring science perspective. The paper also addresses what a life at home on a ventilator may be like and will hopefully add some new aspects to the discussion of philosophical issues in nursing and the very essence of care. Kristeva's philosophy embraces phenomena such as language, abjection, body, and love, allowing her writings to make a fruitful contribution to nursing philosophy in that they strengthen, expand, and deepen a caring perspective. Moreover, her writings about revolt having the power to create hope add an interesting aspect to the work of earlier philosophers and nursing theorists.

  • 34.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Forskningsdesigner inom intensivvård: ljudmiljön på intensivvårds avdelning2007Conference paper (Other academic)
  • 35.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Föräldrars upplevelser av vardagsliv då de har ett barn med ventilatorbehandling: att vara i behov av inkännande och innerligt professionellt stöd.rdic College of Caring Science2013Conference paper (Refereed)
  • 36.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Intensivvårdsrummet – att leva plats och rum i en högteknologisk miljö.2017In: Antologi om sykepleie och fenomenologi). Oslo: Capellen Damm Akademisk / [ed] Dreyer Fredriksen, S-T. & Halvorsson, K., Oslo: Cappelen Damm Akademisk, 2017, , p. 38-53Chapter in book (Other (popular science, discussion, etc.))
  • 37.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    “It’s all about stories”: on the use of narrative approaches in nursing research2018Conference paper (Refereed)
    Abstract [en]

    Nordic conference in Nursing Research

    Title: It is all about stories – on the use of narrative approaches in nursing research

    Background:  Nursing researchers often use the expression “to give voice to” in their publications. In collecting data in-depth interviews are often used where the research participants are asked to narrate their stories.  From a constructionist/constructivist perspective narrations do not represent reality, i.e. are not absolute true stories. But represent what we are, how we see something and what this means to us. Consequently, when people tell a story about themselves it is the voice of their lived experience that is heard. This story is open for interpretation, and for the researcher to analyze and publish so the main findings can be shared by others.

    Objective: The aim is to present approaches used in nursing research from a caring and phenomenological- hermeneutic and narrative perspective. 

    Method: A brief overview of various narrative approaches used in data collection processes, analyses and mediation of findings will be presented.

    Results: The presentation will focus on locating my research work within the narrative perspective through giving examples from my own research. Moreover, narrative interviewing and the act of reading, following, analyzing and presenting a story will be reflected on.

    Conclusion and implication for practice: Narrative approach is both an academic exercise but serves everyday practical issues in nursing and ordinary life. As nursing research often uses qualitative research methods narrative theory and praxis are important aspects in PhD-programmes and in nursing research.

  • 38.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lighting, sleep and circadian rhythm: An intervention study in the intensive care unit.2015In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 1, no 6, p. 325-335Article in journal (Refereed)
  • 39.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Månadens forskare. Möten mellan människor och teknologi: Sammanfattning av avhandling2007In: Vårdfacket, ISSN 0347-0911, Vol. 30, no 11, p. 55-56Article in journal (Other (popular science, discussion, etc.))
  • 40.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Möten mellan människor och teknologi: berättelser från intensivvårdssjuksköterskor och personer som ventilatorbehandlas i hemmet2005Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The overall aim of this thesis is to illuminate meanings of the relation between human beings, technology and care, as narrated by critical care nurses and people in need of home mechanical ventilation (HMV). The data are based on narrative research interviews with six intensive care nurses (I), 13 people who were about to start HMV (II), these 13 people were interviewed for a second time six to eight months after HMV had started (III), and nine persons with more than two years HMV experience (IV). The text was analysed using a phenomenological-hermeneutic research method as described by Lindseth and Norberg. The method is developed from the writings of the French philosopher Paul Ricoeur. The findings illuminate meanings of nursing care in an intensive care unit (I) as undertaking the role of advocacy as a caring response to another human being. The basic condition for this caring response depends on the nurses' openness and sensitivity to the needs of patients or patients' next of kin. The nurses were aware of the influence of technology and tried to modify its negative effects. Meanings of becoming dependent on HMV (II) are interpreted and metaphorically expressed as "to get one's breath" and "to hold one's breath" respectively. On the one hand, breathing ensures the cellular oxidation process within the body, but on the other hand there can be "shortness of breath" in "spiritual breathing", and starting HMV will influence patients' whole life situation, body and spirit. After using a ventilator six to eight months, meanings of a life dependent on a ventilator was interpretd as either a closure or an opening of the lived body to oneself, other people and the world. This interpretation is illustrated by two images. A life on a ventilator at home is not to be seen as static being. On the contrary, it is a being which moves and changes over time. Being dependent on a ventilator and living at home, as narrated by adults with more than two years of HMV experience (IV), was interpreted as being able to rise above yourself and your personal boundaries in order to live a good life. These meanings are bound up with experiencing a vital force and interdependency, and despite fragility being able to reach others and the outside world. Design and function of technology had an impact on the lived body. The comprehensive understanding of the four articles (I-IV) unfolded meanings of the relation between human beings, technology and care, as an interchange and a creation of physical and spiritual energy among humans and between human and technology. It could be an experience of the lived body being filled with as well as emptied of energy. This interpretation points at a call for the caring personnel to be attentive and to listen to the voices of the lived body in health and illness, and to bear witness to those who suffer. Technology acts between the person and the world and in order to be embodied, technology must be "transparent", i.e. beautiful and fit to its use.

  • 41.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Määttä, Sylvia (Editor)
    University of Borås, School of Health Science.
    Om metaforer I vårdarbete och vårdforskning.2007In: Vårdens språk – en antologi., Liber , 2007, p. 63-91Chapter in book (Other academic)
  • 42.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    On locating the metaparadigm concept environment within caring science2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 997-998Article in journal (Other academic)
    The full text will be freely available from 2019-09-25 16:00
  • 43.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Patients' suggestions about how to make life at home easier when dependent on ventilator treatment: a secondary analysis2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 4, p. 684-692Article in journal (Refereed)
    Abstract [en]

    Patients' suggestions about how to make life at home easier when dependent on ventilator treatment - a secondary analysis Background: While quantitative research has provided valuable information, studies presenting patients' experiences have been lacking in the field of knowledge of home mechanical ventilation. The aim of this study was, therefore, to present patient views and suggestions about how to improve home ventilator care and treatment. Method: Data in the present study comprise 35 qualitative research interviews collected for a primary project carried out in the years 2002-2005 and now analysed using qualitative content analysis, the most established method for secondary analysis. Results: The results are presented as six categories: the start-up process, to attach to oneself and the ventilator, to experience home as a shelter, to seek knowledge and understanding, to build up confidence in technology and the need to have people to relate to and depend on. The article presents a brief summary of patients' ideas and requests to healthcare providers and manufacturers involved in home ventilator treatment. Conclusions: The patients' perspectives and experiences include much useful knowledge of interest for nursing and medical professional practices. More attention needs to be given to these experiences in both home ventilator treatment and research. It is also of great importance for nurses and researchers to encourage manufacturers to develop beautiful and user-friendly design in their products, suitable for 'home use' and not just in hospitals.

  • 44.
    Lindahl, Berit
    [external].
    Patients’ suggestions on how to make life easier at home when being dependent on ventilator treatment: A secondary analysis2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 4, p. 684-892Article in journal (Refereed)
    Abstract [en]

    Background:  While quantitative research has provided valuable information, studies presenting patients’ experiences have been lacking in the field of knowledge of home mechanical ventilation. The aim of this study was, therefore, to present patient views and suggestions about how to improve home ventilator care and treatment. Method:  Data in the present study comprise 35 qualitative research interviews collected for a primary project carried out in the years 2002–2005 and now analysed using qualitative content analysis, the most established method for secondary analysis. Results:  The results are presented as six categories: the start-up process, to attach to oneself and the ventilator, to experience home as a shelter, to seek knowledge and understanding, to build up confidence in technology and the need to have people to relate to and depend on. The article presents a brief summary of patients’ ideas and requests to healthcare providers and manufacturers involved in home ventilator treatment. Conclusions:  The patients’ perspectives and experiences include much useful knowledge of interest for nursing and medical professional practices. More attention needs to be given to these experiences in both home ventilator treatment and research. It is also of great importance for nurses and researchers to encourage manufacturers to develop beautiful and user-friendly design in their products, suitable for ‘home use’ and not just in hospitals.

  • 45.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    The development and implementation of a complex clinical intervention project in an ICU2017In: Working together – achieving more, Exeter: European Academy of Nursing Science , 2017Conference paper (Refereed)
    Abstract [en]

    Aim: The poster presents an example of a complex intervention research in an intensive care unit (ICU).

    Design: The intervention comprised a refurbishment of one two-bed patient room in a general ICU. An identical room was kept as a control. The Medical Research Council’s (MRC) guideline directed the project. Principal concepts were: health geography, evidence-based design and healing environments, viewed from a caring science perspective.

    Results: Central aspects investigated were a cyclic light system, sound environment and changes in interior design. Light and sound measurements were carried out and instruments were used to identify light experiences. Interviews and data from patients’ records were also used. Some results from the initial evaluation process are reported.

    Conclusion: It is complicated to carry out intervention research in ICUs due to the patients’ and next of kin’s situation, staffing and environmental issues. Close contact with the clinical field are of vital importance.

  • 46.
    Lindahl, Berit
    University of Borås, School of Health Science.
    The ICU patient room as a healing environment: a research programme based on evidence-based desig2011Conference paper (Refereed)
  • 47.
    Lindahl, Berit
    University of Borås, School of Health Science.
    The process of developing and implementing a complex nursing interventioin study in an ICU2012Conference paper (Refereed)
  • 48.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Vård i högteknologiska vårdmiljöer2012Conference paper (Other academic)
  • 49.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    What happens when technology enters the home: a systematic integrative review focusing home mechanical ventilator treatment2018Conference paper (Refereed)
  • 50.
    Lindahl, Berit
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Bergbom, Ingegerd
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Göteborgs universitet.
    Bringing research into a closed and protected place – the development and implementation of a complex clinical intervention project in an ICU.2015In: Critical Care Nursing Quarterly, ISSN 0887-9303, E-ISSN 1550-5111, Vol. 38, no 4, p. 393-404Article in journal (Refereed)
    Abstract [en]

    This article reports a Swedish research project designed to study the impact of a cyclic light system,sound absorbents, and selected interior design changes in rooms within an intensive care unit.The authors describe the limitations of many previously reported intensive care unit (ICU) designresearch projects, and believe that much more knowledge is needed, which reflects a multidisciplinaryperspective. It is complicated to carry out intervention research in ICUs because of thecondition of patients, family presence, staffing, and other issues. A combination of methodologicalapproaches, close contact with the clinical field, secure funding, and clear communication withinthe multidisciplinary research team are of vital importance. The results from the authors’ initialevaluation process are reported including patient interviews and data from medical records. TheMedical Research Council’s guideline for design and evaluation of complex interventions directedthe actual project and forms the structure for this article. Key words: environment, experimentalstudy, intensive care, nursing intervention, research

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