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  • 1.
    Altersved, Ewa
    et al.
    University of Skövde, School of Life Sciences.
    Zetterlund, Lone
    University of Skövde, School of Life Sciences.
    Lindblad, Ulf
    Univ Gothenburg, Sahlgrenska Acad, Dept Publ Hlth & Community Med Primary Hlth Care, Gothenburg, Sweden / Skaraborg Inst, Skovde, Sweden.
    Fagerstrom, Lisbeth
    Buskerud Univ Coll, Dept Hlth Sci, N-3045 Drammen, Norway.
    Advanced practice nurses: A new resource for Swedish primary health-care teams2011In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 17, no 2, p. 174-180Article in journal (Refereed)
    Abstract [en]

    Advanced practice nurses: A new resource for Swedish primary health-care teams This study is associated with the first evaluation of the four first advanced practice nurses (APNs), part of a primary health-care team in Sweden. The aim is to describe health-care teams' experiences of the new APN role and investigate what opportunities and barriers to the role exist. Eighty-one respondents answered a 14-question questionnaire with a Likert scale and one open-ended question. The Kruskal-Wallis test was used to investigate differences between professional groups' answers. The qualitative material was analysed using deductive content analysis. Though mostly positive experiences of the role were found, differences did exist between the professional groups. APNs are considered a resource in that access to care, cooperation and patient flow increased. Barriers include APNs' limited autonomy and inability to prescribe medication. To further develop the role, the right to prescribe medication and strategic leadership within the Swedish health-care system, policy and legislation are needed.

  • 2.
    Bergman, Karin
    et al.
    Skaraborg Primary Health Care, Skövde, Sweden.
    Perhed, Ulla
    Skaraborg Primary Health Care, Skövde, Sweden.
    Eriksson, Irene
    University of Skövde, School of Life Sciences.
    Lindblad, Ulf
    Department of Public Health and Community Medicine/Primary Health Care, University of Gothenburg, Gothenburg, Sweden.
    Fagerström, Lisbeth
    Faculty of Health Sciences, Buskerud University College, Drammen, Norway.
    Patients' satisfaction with the care offered by advanced practice nurses: A new role in Swedish primary care2013In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 19, no 3, p. 326-333Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to describe patients' satisfaction with the new role of advanced practice nurses (APNs) in Swedish primary care. A questionnaire pertaining to patient satisfaction with the care offered by APNs was sent to respondents. Descriptive statistics, a chi-squared test and manifest qualitative content analysis were used during analysis. Although the results show an overall high level of patient satisfaction as regards APN-led care, those patients informed of the APN role prior to a consultation were significantly more satisfied. Respondents' comments indicate that professional treatment and competence are characteristic of the care offered by APNs and also relate the concepts of increased availability of and continuity in health care to the APN role. In order to guarantee the positive development of the APN role in Sweden, continued research is needed from patient, organizational and interprofessional perspectives, including intervention studies of cost effectiveness and the quality of care.

  • 3.
    Eriksson, Irene
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Lindblad, Monica
    Faculty of Caring Science, Work Life, and Social Welfare, University of Borås, Borås, Sweden.
    Möller, Ulrika
    Bräcke diakoni, Skara, Sweden.
    Gillsjö, Catharina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. affilierad College of Nursing, University of Rhode Island, USA.
    Holistic health care: Patients' experiences of health care provided by an Advanced Practice Nurse2018In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 24, no 1, article id e12603Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system.

    AIM: To describe patients' experiences of health care provided by an APN in primary health care.

    METHODS: An inductive, descriptive qualitative approach with qualitative open-ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze.

    RESULTS: The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care.

    CONCLUSION: The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context.

  • 4.
    Johansson, Anna
    et al.
    Department of Cardiology, Kärnsjukhuset, Skövde Hospital, Skövde / Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Karlsson, Johan
    Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Brödje, Karin
    University Hospital, Linköping / Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Edell-Gustafsson, Ulla
    Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Self-care strategies to facilitate sleep in patients with heart disease—A qualitative study2012In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 18, no 1, p. 44-51Article in journal (Refereed)
    Abstract [en]

    This study aimed at exploring and describing the self-care management strategies used by patients with coronary artery disease to facilitate sleep. Qualitative interviews in a dialogue manner, in a phenomenographic reference frame analyzed according to manifest and latent principles of qualitative content analysis, were performed. A purposeful sampling technique was used including 11 patients with coronary heart disease in a Heart Medical Unit in a general hospital setting. Two main themes were identified: 'sleep-rhythm' and 'sleep-hygiene' including four descriptive categories. The categories reveal five basic responses including emotions, cognition, physical symptoms (reactions), behaviours and/or the sleep environment, which were related to perceived or actual presence of sleep-wake problems and health that were the underlying reason for the self-care management strategies. Basically, intervention studies that address these five responses for choice of non-pharmacological methods based on cognitive behavioural therapy provided by nurses are needed.

  • 5.
    Johansson, Anna
    et al.
    University of Skövde, School of Life Sciences. Department of Cardiology, Skaraborgs Hospital, Skövde, Sweden, Department of Medical and Health Sciences, University of Linköping, Sweden.
    Svanborg, Eva
    Department of Clinical Neurophysiology and Department of Clinical and Experimental Medicine Linköping University Hospital, Faculty of Health Sciences, University of Linköping, Sweden.
    Edéll-Gustafsson, Ulla
    Department of Medical and Health Sciences, University of Linköping, Sweden.
    Sleep-wake activity rhythm and health-related quality of life among patients with coronary artery disease and in a population-based sample: An actigraphy and questionnaire study2013In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 19, no 4, p. 390-401Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore whether there are gender differences in sleep and health-related quality of life in patients with coronary artery disease (CAD) and a matched population-based sample and to see how subjectively rated sleep is associated with actigraphy. Secondly, to explore whether factors that predict patients' sleep quality could be identified. Fifty-seven patients with stable CAD and 47 participants from a population-based sample were included. All participants completed the Uppsala Sleep Inventory (USI), the Epworth Sleepiness Scale and the SF-36. Actigraphy recordings and a sleep diary were performed for seven 24-h periods. Multiple stepwise regression analysis showed that sleep duration, sleep onset latency, nocturnal awakenings, vitality (SF-36) and body mass index explained 60% of the sleep quality outcome (USI). Sleep duration, sleep efficiency and fragmentation index assessed with actigraphy and sleep diary accounted for 36% of the sleep quality outcome (diary). The result can form the basis for a non-pharmacological, self-care programme supported and led by nurses. © 2013 Wiley Publishing Asia Pty Ltd.

  • 6.
    Lindblad, Emma
    et al.
    University of Stockholm.
    Hallman, Elsie-Britt
    University of Skövde, School of Life Sciences.
    Gillsjö, Catharina
    University of Skövde, School of Life Sciences.
    Linblad, Ulf
    Örebro University.
    Fagerström, Lisbeth
    University of Skövde, School of Life Sciences.
    Experiences of the new role of advanced practice nurses in Swedish primary health care - A qualitative study2010In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 16, no 1, p. 69-74Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate and describe the experiences of the first advanced practice nurses (APNs), a new profession for Swedish health care, and of their supervising general practitioners (GPs), regarding the new role and scope of practice of APNs in primary health care. Individual interviews were conducted with the four first APNs and one focus group interview was conducted with five supervising physicians. The material was transcribed verbatim and analysed using latent content analysis. The respondents expressed confidence and trust in the new role of APNs. Some opposition to this new role from the GPs and other colleagues was observed, but was nonetheless overcome. The experiences of the APN role indicate that the new role is clearly demarcated from the role of physicians. The APNs were considered an extra resource for both the GPs and other nurses, which contributed to an increased availability of care for patients. The APN role requires an explicit definition and demarcation in relation to responsibility and roles among colleagues. Further development of the APN role presupposes the right to prescribe medication and order treatments, as well as an evaluation of patient, organizational and inter-professional perspectives on the matter.

  • 7.
    Nilsson, Kerstin
    et al.
    University of Skövde, School of Life Sciences.
    Lundgren, Solveig
    University of Gothenburg, The Sahlgrenska Academy, Institute of Health and Care Sciences, Göteborg, Sweden.
    Furåker, Carina
    University of Gothenburg, The Sahlgrenska Academy, Institute of Health and Care Sciences, Göteborg, Sweden.
    Registered nurses' everyday activities in municipal health care: A study of diaries2009In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 15, no 6, p. 543-552Article in journal (Refereed)
    Abstract [en]

    This study described the work content of registered nurses (RNs) employed in municipal health care. Diary notes of three working days from 34 RNs were analysed using content analysis, and a total of 3185 activities were identified. Of these, 2807 were analysed further and grouped by comparing similarities and differences. The content of the RNs' nursing activities consisted of assessing health, giving treatments and conducting check-ups, handling pharmaceuticals and teaching. In the administration category, the content comprised planning and reporting, followed by documentation. The RNs' role in municipal health care is consultative, which reinforces their need for competence in advanced nursing, as well as in leadership and pedagogy. RNs mostly work without colleagues and they are responsible for many seriously ill patients. In order to be confident in providing qualified nursing, specialist nursing education in elderly care is needed.

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