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  • 1.
    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.

  • 2.
    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.

  • 3.
    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.

  • 4.
    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.

  • 5.
    Fridh, Isabell
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Institutionen för vårdvetenskap och hälsa, Sahlgrenska akademin, Göteborgs universitet.
    Bergbom, Ingegerd
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Att vaka — en begreppsanalytisk studie2006In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 26, no 1, p. 4-8Article in journal (Refereed)
  • 6.
    Fridh, Isabell
    et al.
    Institutionen för vårdvetenskap och hälsa, Sahlgrenska akademin, Göteborgs universitet.
    Forsberg, A
    Bergbom, Ingegerd
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Family presence and environmental factors at the time of a patient's death in an ICU.2007In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 51, no 4, p. 395-401Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In an intensive care unit (ICU), privacy and proximity are reported to be important needs of dying patients and their family members. It is assumed that good communication between the ICU team and families about end-of-life decisions improves the possibilities of meeting families' needs, thus guaranteeing a dignified and peaceful death in accordance with end-of-life care guidelines. The aim of this study was to explore the circumstances under which patients die in Swedish ICUs by reporting on the presence of family and whether patients die in private or shared rooms. An additional aim was to investigate the frequency of end-of-life decisions and whether nurses and family members were informed about such decisions.

    METHODS: A questionnaire based on the research questions was completed when a patient died in the 10 ICUs included in the study. Data were collected on 192 deaths.

    RESULTS: Forty per cent of the patients died without a next of kin at the bedside and 46% of deaths occurred in a shared room. This number decreased to 37% if a family member was present. Patients without a family member at their bedside received less analgesics and sedatives. There was a significant relationship between family presence, expected death and end-of-life decisions.

    CONCLUSIONS: The results indicate the necessity of improving the ICU environment to promote the need for proximity and privacy for dying patients and their families. The study also highlights the risk of underestimating the needs of patients without a next of kin at their bedside at the time of death.

  • 7.
    Fridh, Isabell
    et al.
    Instiutionen för vårdvetenskap och hälsa,Sahlgrenska akademin, Göteborgs universitet.
    Forsberg, Anna
    Bergbom, Ingegerd
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Doing one's utmost: nurses' descriptions of caring for dying patients in an intensive care environment.2009In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 25, no 5, p. 233-241Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 8.
    Fridh, Isabell
    et al.
    Institutionen för vårdvetenskap och hälsa, Sahlgrenska akademin, Göteborgs universitet.
    Forsberg, Anna
    Bergbom, Ingegerd
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    End-of-life care in intensive care units: family routines and environmental factors.2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 1, p. 25-31Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to describe family care routines and to explore environmental factors when patients die in Swedish intensive care units (ICUs). The main research questions were: what are the physical environmental circumstances and facilities when caring for patients in end-of-life and are there any routines or guidelines when caring for dying patients and their families? A questionnaire was sent to 79 eligible Swedish ICUs in December 2003, addressed to the unit managers. The response rate was 94% (n = 74 units). The findings show that, despite recommendations highlighting the importance of privacy for dying ICU patients and their families, only 11% of the respondents stated that patients never died in shared rooms in their ICU. If a patient dies in a shared room, nurses strive to ensure a dignified goodbye by moving the body to an empty room or to one specially designated for this purpose. The majority (76%) of the units had waiting rooms within the ICU. The study also revealed that there is a need for improvements in the follow-up routines for bereaved families. Many units reported (51%) that they often or almost always offer a follow-up visit, although in most cases the bereaved family had to initiate the follow-up by contacting the ICU. Guidelines in the area of end-of-life care were used by 25% of the ICUs. Further research is necessary to acquire a deeper knowledge of the circumstances under which patients die in ICUs and what impact the ICU environment has on bereaved families.

  • 9.
    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

  • 10.
    Skyman, Eva
    et al.
    Sahlgrenska Universitetssjukhuset Göteborg.
    Lindahl, Berit
    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 Akademin.
    Thunberg Sjöström, Harrieth
    Västra Götalands regionen.
    Åhrén, Christina
    Sahlgrenska Universitetssjukhuset Göteborg.
    Being Met as marked – patients’ experiences of beinginfected with community-acquired methicillin-resistantStaphylococcus aureus (MRSA)2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
    Abstract [en]

    Background: It is known that patients who acquiredmethicillin-resistant Staphylococcus aureus (MRSA) in hospitalssuffer and feel as plague. Moreover, the patientinteraction with nurses and physicians is described asfrightening. Little is known about patient experiencesafter having acquired CA-MRSA concerning care andeveryday life.Aim: To reveal and interpret otherwise healthy patients’lived experiences of receiving care and their everyday lifeafter having acquired community MRSA (CA-MRSA).Methods: A phenomenological hermeneutic approachguided by Ricouer was conducted. Interviews withtwelve patients were transcribed verbatim into a text.The text was analysed in three phases: naive understanding,structural analysis and comprehensive understandingto reveal a possible being in the world. In thisstudy, this referred to what it means to be infected withCA-MRSA.Results: The findings indicate that patients who acquiredMRSA experience a changed body image. They sufferfrom ignorant and frightened behavior from healthcareworkers, social contacts, and also of being bullied by colleagues.Despite this, patients assume great responsibilityfor protecting others. However, knowledgeable staff alleviatesuffering and bring peace of mind to the patients.Conclusions: Preventing patient’s feelings of being a pest,an outsider living with fear, requires urgent educationand understanding about resistant bacteria and how tomeet an infected patient. The results describing patients,affected with MRSA, may contribute and touch the readersto better understanding of patient’s changed bodyimage and suffering and how to mitigate these feelings.

  • 11. Wiklund Gustin, Lena
    et al.
    Bergbom, Ingegerd
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Vårdvetenskapliga begrepp i teori och praktik2012Book (Other academic)
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