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  • 1.
    Andersson, Susanne
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Svanström, Rune
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ek, Kristina
    University of Skövde, Health and Education.
    Rosén, Helena
    Health Sciences, University of Lund, Lund.
    Berglund, Mia
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    'The challenge to take charge of life with long-term illness': Nurses' experiences of supporting patients' learning with the didactic model2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 23-24, p. 3409-3416Article in journal (Refereed)
  • 2.
    Blomberg, Karin
    et al.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Bisholt, Birgitta
    Department of Nursing, Karlstad University, Karlstad, Sweden.
    Kullén Engström, Agneta
    School of Health, University of Borås, Borås, Sweden.
    Ohlsson, Ulla
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Johansson Sundler, Annelie
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Gustafsson, Margareta
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    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)
  • 3.
    Browall, Maria
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden.
    Forsberg, Christina
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden.
    Wengström, Yvonne
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden / Karolinska University Hospital, Breast and Sarcoma Unit, Radiumhemmet, Sweden.
    Assessing patient outcomes and cost effectiveness of nurse-led follow-up for women with breast cancer: have relevant and sensitive evaluation measures been used?2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 13-14, p. 1770-1786Article, review/survey (Refereed)
    Abstract [en]

    Aim

    To explore how interventions using nurse-led follow-up in breast cancer care have been evaluated with a focus on patient outcomes and cost effectiveness.

    Background

    As part of the advancement of breast care, nurse-led follow-up is increasingly used as an alternative to routine hospital follow-up in outpatient clinics. There is evidence suggesting that patients appear to be satisfied with the nurse-led follow-up, but there is a lack of evidence of whether this perception equates to patients’ satisfaction with the model of physician-led follow-up.

    Design

    Systematic review.

    Method

    Three databases were searched, and 29 RCT were initially screened. Finally, 13 articles were critically appraised. Searches included articles between 2005 and 2013. The quality of appraisal assessment was inspired by the GRADE system.

    Results

    The results show that there are many different instruments used when evaluating nurse-led follow up which makes it difficult to compare the studies. Several of the studies used QoL as an outcome measure; this is a broad concept that includes several aspects ranging from social role and psychosocial issues to symptoms and therefore difficult to use as an outcome measure. Only two of the studies made any cost-effective analyses and the results are hard to interpret.

    Conclusions

    Nurse-led follow-up can potentially result in better continuity of care and the availability of more time to provide psychosocial support and address patients’ information needs. However, more well-conducted research is needed before equivalence to physician-led follow-up can be assessed in terms of survival, recurrence, patient well-being and cost-effectiveness.

  • 4.
    Engqvist, Inger
    et al.
    University of Skövde, School of Life Sciences.
    Nilsson, Agneta
    Academy of Sahlgrenska, University of Gothenburg, Institute of Nursing, Gothenburg, Sweden.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Strategies in caring for women with Postpartum Psychosis: an interview study with psychiatric nurses2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 7, p. 1333-1342Article in journal (Refereed)
    Abstract [en]

    Aim and objective. The aim of this study was to explore strategies in caring for women with postpartum psychosis used by nurses.

    Background. The most serious type of psychiatric illness in connection with childbirth is postpartum psychosis. Nearly two in 1000 newly delivered women are stricken by postpartum psychosis. Most of these patients need psychiatric care to recover. While earlier studies point to the need for psychiatric care, knowledge of specific nursing strategies in caring for postpartum psychosis patients remains limited.

    Methods. Interviews with 10 experienced psychiatric nurses were carried out, transcribed verbatim and an inductive content analysis was made.

    Result. The main strategies for care found in this study were: (i) To create a patient–nurse relationship and (ii) To apply nursing therapeutic interventions. Presence, continuity and nurse-patient partnership contributed to create a relationship and incorporate the rest of the care team. To satisfy the patients’ basic needs and feeling of security was the foundation of the nursing therapeutic interventions. Confirmation and giving hope were also used as nursing therapeutics as well as information to the patient and her relatives about her illness.

    Conclusion. The conclusion of the study is that strategies used by nurses are a combination of general and psychiatric nursing approaches but the specificity in caring knowledge for caring patients with postpartum psychosis requires further development.

    Relevance to clinical practice. The result of the study indicates that it is important to organize patient care for postpartum psychosis with continuity and consistency and to support the nurse to create a relationship and therapeutic intervention with the patient. The present study shows the importance of further developing specific nursing theories that can be applied when caring for patients with postpartum psychosis. It also shows the need for further pedagogical education for mental health

  • 5.
    Eriksson, Irene
    et al.
    University of Skövde, School of Life Sciences.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Preconditions needed for establishing a trusting relationship during health counselling - an interview study2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 17, p. 2352-2359Article in journal (Refereed)
    Abstract [en]

    Aim. To examine the preconditions needed by district nurses to build a trusting relationship during health counselling of patients with hypertension. Background. Trust has been found to be an important aspect of the patient-nurse relationship. Little research has focused on how trust is formed in patient-nurse relationships or the conditions the development process requires when working with health counselling; in particular not in relation to hypertension. Design. Qualitative study. Method. Qualitative data were collected through open-ended interviews with all (10) district nurses from three primary health care districts of western Sweden. All interviewees work with the health counselling of patients with hypertension. A latent content analysis was performed with thematic coding of the content of the interviews. Results. The first theme that emerged from the analysis, the nurses' competence, describes the nurses' consciousness of their method of expression, both oral and non-verbal, as well as their pedagogical competence and their ability to be reliable in their profession. The second theme, the patient meeting, describes the continuity in the patient meeting and creating respectful communication. Conclusion. The results show an awareness of preconditions influencing building a trusting relationship. When creating a trusting relationship the communication and pedagogical competences of district nurses have considerable importance. Despite this awareness they state that it is easy to fall into a routinised way of working. Relevance to clinical practice. The implications of this study might be used as support and guidance for district nurses when developing their competence in health counselling in relations to patients with hypertension. This knowledge is also important when planning for nurse-led clinics for this patient group.

  • 6.
    Eriksson, Irene
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Olofsson, Birgitta
    Department of Nursing Umeå University, Umeå, Sweden.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
    Fagerström, Lisbeth
    Department of Health Sciences, University of Buskerud, Drammen, Norway.
    Older women's experiences of suffering from urinary tract infections2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 9-10, p. 1385-1394Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To describe and explore older women's experiences of having had repeated urinary tract infections (UTIs). Background: UTIs are one of the most common bacterial infections among older women. Approximately one-third of very old women suffer from at least one UTI each year. Despite the high incidence of UTI, little is known about the impact of UTI on health and daily life in older women. Design: A qualitative descriptive design. Methods: A qualitative study using semi-structured interviews was conducted with 20 Swedish women aged 67-96 years who suffered from repeated UTIs the preceding year. The data were analysed using qualitative content analysis. Results: Two main themes were identified: being in a state of manageable suffering and depending on alleviation. Being in a state of manageable suffering was described in terms of experiencing physical and psychological health problems, struggling to deal with the illness and being restricted in daily life. Depending on alleviation was illustrated in terms of having access to relief but also receiving inadequate care. Conclusions: This study demonstrated that UTIs are a serious health problem among older women that not only affects both physical and mental health but also has serious social consequences. The women in this study described the physical and psychological health problems, struggling to deal with the illness, being restricted in daily life, depending on access to relief and receiving inadequate care. Relevance to clinical practice: It is important to improve the knowledge about how UTI affects the health of older women. This knowledge may help nurses develop strategies to support these women. One important part in the supportive strategies is that nurses can educate these women in self-care. © 2013 John Wiley & Sons Ltd.

  • 7.
    Feo, Rebecca
    et al.
    University of Adelaide, Australia.
    Conroy, Tiffany
    University of Adelaide, Australia.
    Jangland, Eva
    Uppsala University, Sweden / Uppsala University Hospital, Uppsala, Sweden.
    Muntlin Athlin, Åsa
    Uppsala University, Sweden / Uppsala University Hospital, Uppsala, Sweden.
    Browall, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Parr, Jenny
    Counties Manukau District Health Board, Auckland, New Zealand / Auckland University of Technology, New Zealand.
    Blomberg, Karin
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Kitson, Alison
    University of Adelaide, Australia / Flinders University, Australia.
    Towards a standardised definition for fundamental care: a modified Delphi study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 11-12, p. 2285-2299Article in journal (Refereed)
    Abstract [en]

    AIMS: To generate a standardised definition for fundamental care and identify the discrete elements that constitute such care.

    BACKGROUND: There is poor conceptual clarity surrounding fundamental care. The Fundamentals of Care Framework aims to overcome this problem by outlining three core dimensions underpinning such care. Implementing the Framework requires a standardised definition for fundamental care that reflects the Framework's conceptual understanding, as well as agreement on the elements that comprise such care (i.e., patient needs, such as nutrition, and nurse actions, such as empathy). This study sought to achieve this consensus.

    DESIGN: Modified Delphi study.

    METHODS: Three phases: (1) engaging stakeholders via an interactive workshop; (2) using workshop findings to develop a preliminary definition for, and identify the discrete elements that constitute, fundamental care; and (3) gaining consensus on the definition and elements via a two-round Delphi approach (Round 1 n=38; Round 2 n=28).

    RESULTS: Delphi participants perceived both the definition and elements generated from the workshop as comprehensive, but beyond the scope of fundamental care. Participants questioned whether the definition should focus on patient needs and nurse actions, or more broadly on how fundamental care should be delivered (e.g., through a trusting nurse-patient relationship), and the outcomes of this care delivery. There were also mixed opinions whether the definition should be nursing specific.

    CONCLUSIONS: This study has initiated crucial dialogue around how fundamental care is conceptualised and defined. Future work should focus on further refinements of the definition and elements with a larger, international group of practising nurses and service users. This article is protected by copyright. All rights reserved.

  • 8.
    Göransson, Carina
    et al.
    School of Health and Welfare, Halmstad University, Halmstad, Sweden / Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Wengström, Yvonne
    Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden.
    Ziegert, Kristina
    School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Langius-Eklöf, Ann
    Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Irene
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kihlgren, Annica
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Blomberg, Karin
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Perspectives of health and self-care among older persons-To be implemented in an interactive information and communication technology-platform2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 23-24, p. 4745-4755Article in journal (Refereed)
    Abstract [en]

    AIM AND OBJECTIVES: To acquire knowledge regarding the contents to be implemented in an interactive information and communication technology-platform perceived to be relevant to health and self-care among older persons based on the literature, healthcare professionals and the older persons themselves.

    BACKGROUND: The growing ageing population places demands on the healthcare system to promote healthy ageing and to strengthen the older person's self-care ability. This requires innovative approaches to facilitate communication between the older person and healthcare professionals, and to increase the older person's participation in their care. An information and communication technology-platform could be used for this purpose, but the content needs to be relevant to both the older persons and the healthcare professionals.

    DESIGN: Descriptive qualitative design.

    METHODS: This study was based on three samplings: a scoping review of the literature (n = 20 articles), interviews with healthcare professionals (n = 5) and a secondary analysis of interviews with older persons (n = 8) and nursing assistants (n = 7). The data were analysed using qualitative content analysis.

    RESULTS: Four areas were identified to be of relevance to older persons' perceived health: frame of mind, having relationships and social activities, physical ability and concerns, and maintaining self-care. Self-care was described in the literature and by the healthcare professionals more than by the older persons.

    CONCLUSIONS: The results show a concordance in the data samplings that give a clear indication of the areas relevant to older persons' health and self-care that can be integrated in an interactive information and communication technology-platform for use in regular daily care assessments. Descriptions of self-care were limited indicating a possible gap in knowledge that requires further research.

    RELEVANCE TO CLINICAL PRACTICE: Areas relevant to older persons' health and self-care could be used for regular assessment to support and promote healthy ageing.

  • 9.
    Johansson, Anna
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Cardiology, Skaraborgs Hospital, Skövde / Department of Medical and Health Sciences, University of Linköping, Sweden.
    Adamson, Anita
    Department of Physical Therapy, Skaraborgs Hospital, Skövde, Sweden.
    Ejdebäck, Jan
    Department of Cardiology, Skaraborgs Hospital, Skövde, Sweden.
    Edéll-Gustafsson, Ulla
    Department of Medical and Health Sciences, University of Linköping, Sweden.
    Evaluation of an individualised programme to promote self-care in sleep-activity in patients with coronary artery disease - a randomised intervention study2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 19-20, p. 2822-2834Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To evaluate the effectiveness of an individualised programme to promote self-care in sleep-activity in patients with coronary artery disease. Background: Recent scientific findings have shown that low physical exercise and stress interfere with coronary artery disease patients' sleep quality and sleep efficiency independent of gender, age and co-morbidity. Design: A randomised pretest-post-test control design. Methods: Forty-seven patients who had undergone a coronary revascularisation procedure and/or pharmacological treatment three to seven weeks earlier at a general hospital were randomised to either an intervention group or a control group. Data collection was carried out by questionnaires, a study-specific sleep diary and actigraphy registration for 10 consecutive 24-hour periods, with a follow-up after three to four months. The intervention group underwent a nurse-led individualised education programme to promote self-care of sleep-activity. Sleep habits and sleep-related lifestyle together formed the basis for setting up individual goals together with the nurse. Individual advice on physical training, relaxation exercise and a CD-based relaxation programme was provided by a physiotherapist. Both groups received a brochure about sleep and stress. Results: At a three- to four-month follow-up, the main improvements were seen in the intervention group regarding sleep quality, sleep duration and sleep efficiency in the sleep diary and sleep efficiency in actigraphy. Statistical improvements in health-related quality of life were revealed. This was not so obvious in the control group. Conclusions: An individualised intervention programme to promote self-care of sleep-activity including relaxation in patients with coronary artery disease led by a nurse may improve sleep quality. However, a longitudinal study to promote self-care in sleep-activity should be performed using a larger sample and multiple sites with continuous follow-ups to determine whether any positive effects remain stable over time. Relevance to clinical practice: Implementation of a multiprofessional individualised programme to promote self-care of sleep-activity including relaxation based on patients' needs, supported by a healthcare team and led by nurses, is important in clinical practice. © 2014 John Wiley & Sons Ltd.

  • 10.
    Johansson, Anna
    et al.
    Department of Cardiology, Kärnsjukhuset, Skövde Hospital, Skövde / Department of Medical and Health Sciences, University of Linköping.
    Svanborg, Eva
    Department of Clinical and Experimental Medicine/Clinical Neurophysiology, University of Linköping/University Hospital.
    Swahn, Eva
    Department of Medical and Health Sciences, Division of Cardiology, Linköping University, Linköping.
    Ejdebäck, Jan
    Department of Cardiology, Kärnsjukhuset, Skövde Hospital, Skövde.
    Tygesen, Hans
    Department of Cardiology, Borås Hospital, Borås.
    Edell-Gustafsson, Ulla
    Department of Medical and Health Sciences, Division of Nursing Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Sleep, arousal and health-related quality of life in men and women with coronary artery disease2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 19-20, p. 2787-2801Article in journal (Refereed)
    Abstract [en]

    AIM: To evaluate whether there are gender differences in insomnia, sleep quality, sleep efficiency (%), general arousal, disease-specific and health-related quality of life in patients with coronary artery disease, compared with an age- and gender-matched randomly selected group from the general population.

    BACKGROUND: There are gender difference effects of sleep disturbances in the general population, but this perspective among patients with coronary artery disease has been poorly analysed.

    DESIGN: In this prospective study, comparative, descriptive and model testing designs were used.

    METHOD: The patients with coronary artery disease, 556 men and 324 women aged 25-86, were compared with a matched population-based group. Data were collected by validated and reliability-tested questionnaires.

    RESULTS: The prevalence of severe insomnia varied between 17-44% in all four groups. The severe insomniac coronary artery disease patients displayed a two- or threefold higher presleep arousal, had two hours shorter nocturnal sleep duration/night and were more limited in their physical exercise level than the population-based group. Gender differences in sleep quality, sleep efficiency (%) and general arousal disappeared with increased insomnia severity.

    CONCLUSIONS: Independent of gender, age and comorbidity, physical exercise, general arousal behaviour and delayed poststress recovery after mental stress were found to have a negative impact on the coronary artery disease patients' sleep quality and sleep efficiency (%), interfering with their health-related quality of life. The variables significantly explained 41% of the sleep quality outcome and 29% of the sleep efficiency (%).

    RELEVANCE TO CLINICAL PRACTICE: Insomnia because of hyperarousal behaviour can be an important factor in the development of an individual self-care management programme supported by a healthcare team.

  • 11.
    Karlsson, Christina
    et al.
    Department of Nursing, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Sidenvall, Birgitta
    Department of Nursing, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bergh, Ingrid
    University of Skövde, School of Life Sciences.
    Ernsth-Bravell, Marie
    School of Health Sciences, Institute of Gerontology, Jönköping University, Jönköping, Sweden.
    Certified nursing assistants' perception of pain in people with dementia: a hermeneutic enquiry in dementia care practice2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 13-14, p. 1880-1889Article in journal (Refereed)
    Abstract [en]

    Aims and objectives To interpret certified nursing assistants' perception of pain in people with dementia in nursing care practice. Background Detection and understanding of pain in people with dementia remains a challenge due to their difficulty in verbalising their pain. Nursing assistants provide daily nursing care and therefore play a vital role in pain detection. Nevertheless, pain research from the nursing assistants' perspective is sparse. Design A qualitative approach within the interpretive tradition was adopted. Methods Individual interviews with twelve certified nursing assistants, all working in dementia care, were conducted and interpreted using philosophical hermeneutics. Results Nursing assistants' perception of pain is on three levels. Each level consists of a theme. The first theme Being in the facing phase' refers to the initial perception of the person's expressions. The second theme Being in the reflecting phase' means ability to reflect more deeply on one's perception, together with other colleagues and next of kins. The third theme Being in the acting phase' means perception arising from preventive and protective care focusing on contributing to well-being. The themes served as a basis for comprehensive understanding, where perception of pain arises from closeness, compassion and dialogue based on personhood, accompanied by professional knowledge of pain and dementia. Conclusion Nursing assistants' perception of pain is based on ethical concerns and on their own subjective pain experiences rather than on medical skills. Their perception derives from fundamental values that are important aspects of nursing care. Interdisciplinary solidarity may strengthen cooperation amongst CNAs and RNs to achieve best pain management practice. Relevance to clinical practice Attention to nursing assistants' perception of pain needs to be highlighted when they are front-line staff and have developed important pain detection skills. Their skills are essential complements and must be used in the development of pain management in dementia care practice.

  • 12.
    Klaeson, Kicki
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Oncology Department, Skaraborgs hospital, Sweden.
    Hovlin, Lina
    Home care, Skara Municipality, Skara, Sweden .
    Guvå, Hanna
    Psychiatric Department, Skaraborgs hospital, Sweden.
    Kjellsdotter, Anna
    University of Skövde, Health and Education. University of Skövde, School of Health and Education.
    Sexual Health in Primary Healthcare: A Qualitative Study of Nurses' Experiences2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 11-12, p. 1545-1554Article in journal (Refereed)
    Abstract [en]

    Aim and objectives: To illuminate nurses’ experiences and opportunities to discuss sexual health with patients in primary healthcare.

    Background: Sexual health is a concept associated with many taboos and research shows that nurses feel uncomfortable talking to patients about sexual health and therefore avoid it. This avoidance forms a barrier between patient and nurse which prevents nurses from giving satisfactory healthcare to patients.

    Design: A qualitative descriptive design.

    Method: Semi-structured interviews were conducted with nine nurses in primary healthcare in Sweden. Data were analysed by using qualitative content analysis.

    Results: During the analysis phase, five subcategories and two main categories were identified. The two main categories were: “Factors that influence nurses’ opportunities to talk to patients about sexual health” and “Nurses’ experiences of talking to patients about sexual health”. Social norms in society were an obstacle for health professionals’ opportunities to feel comfortable and act professionally. The nurses’ personal attitude and knowledge were of great significance in determining if they brought up the topic of sexual health or not. The nurses found it easier to bring up the topic of sexual health with middle-aged men with for example diabetes. One reason for this is that they found it easier to talk to male patients. A further reason is the fact that they had received training in discussing matters of sexual health in relation to diabetes and other conditions affecting sexual health.

    Conclusion: Nurses in primary care express the necessity of additional education and knowledge on the subject of sexual health. The healthcare organization must be reformed to put focus on sexual health.

    Relevance for clinical practiceGuidelines for addressing the topic of sexual health must be implemented to establish conditions that will increase nurse's knowledge and provide them with the necessary tools for discussing sexual health with patients.

  • 13.
    Larsson, Christel
    et al.
    Department of Otorhinolaryngology, Central Hospital, S-541 85 Skövde, Sweden.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Experiences of problems in individuals with hypersensitivity to odours and chemicals2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 5, p. 737-744Article in journal (Refereed)
    Abstract [en]

    Aim. The purpose of the study was to describe how individuals with hypersensitivity to odours and chemicals handle their problems.

    Background. One group of patients we often encounter consists of those with upper and lower respiratory problems who also have a pronounced sensitivity to odours and chemicals. Earlier studies have shown that these symptoms can be related to sensory hyperreactivity (SHR). This hyperreactivity is characterised by respiratory tract symptoms triggered by odours and chemicals, along with high sensitivity to inhaled capsaicin and a positive score on the chemical sensitivity scale for SHR. However, there is still a lack of studies in which SHR sufferers describe their situations in their own words.

    Design. The study was conducted using a qualitative approach.

    Methods. Eight individuals with confirmed SHR were selected from a population-based epidemiological study and interviewed. A qualitative content analysis was performed on the data.

    Results. Four themes emerged from the data analysis: Limitations in one's life situation, Lack of understanding from others, Concern that the symptoms will develop into a serious disease and Disparagement of one's own personal experience. The results show how individuals manage their daily lives with the help of various strategies, how they relate to other people, how they cope with their concerns and the fact that they sometimes choose to disparage their own experience of their problems.

    Conclusion. The results indicate that people with SHR experience limitations in their life situations. These limitations consist of the adjustments they make to avoid triggering factors.

    Relevance to clinical practice. To improve care, nurses need to know how people experience SHR and how they cope with their hypersensitivity to odours and chemicals.

  • 14.
    Modin, Marina
    et al.
    Department of Surgery, Central Hospital, S-541 85 Skövde, Sweden.
    Ramos, Telmo
    Department of Orthopaedic, Central Hospital, Skövde, Sweden.
    Warrén Stomberg, Margareta
    University of Skövde, School of Life Sciences.
    Postoperative impact of daily life after primary treatment of proximal/distal tibiafracture with Ilizarov external fixation.2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702Article in journal (Refereed)
    Abstract [en]

     

     

    Aims and objectives. To describe patients’ experience of the impact of their health-related life situation on their daily life two and four weeks after primary fracture treatment with Ilizarov external fixation.

    Background. A few studies have been conducted postoperatively focussing on fracture treatment with Ilizarov fixation.

    Design. A prospective descriptive research design.

    Method. Patients who had been treated for a proximal/distal tibial fracture were invited to participate in the study. Data were collected with a semi-structured questionnaire where 20 patients described in their own words their situation at home two and four weeks postoperatively. The process used when analysing the data was similar to content analysis.

    Results. Four key themes were identified: 'limitations in the home environment', 'limitations outside the home', 'limitations to social relations' and 'experience of having an Ilizarov fixation'. The patient's life situation was strongly affected during the first postoperative month. This took the form of clear limitations on activities outside the home and a degree of limitation on coping with household chores and personal hygiene. These limitations became less severe after between 2-4 weeks and were very much a consequence of using crutches.

    Conclusion. This study points to limitations in the patient's daily life situation in the home. The results from the study make it obvious that the information given to patients prior to discharge, concerning the value of putting weight on the leg, had not been clear or that the patients had not understood it. This had a negative impact on the patient's daily life after discharge. Further data are needed to uncover the extent of the issue to be able to optimise patient outcomes.

    Relevance to clinical practice. There is a need for clearer and more active information from the nurse before discharge but also a need to follow up how the information given is understood.

     

     

  • 15.
    Muntlin Athlin, Åsa
    et al.
    Uppsala University, Sweden / University of Adelaide, SA, Australia / Uppsala University Hospital, Sweden.
    Browall, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Karolinska Institutet, Huddinge, Sweden.
    Wengström, Yvonne
    Karolinska Institutet, Huddinge, Sweden / Karolinska University Hospital, Radiumhemmet, Stockholm, Sweden.
    Conroy, Tiffany
    University of Adelaide, SA, Australia.
    Kitson, Alison L
    University of Adelaide, SA, Australia / Flinders University, Adelaide, SA, Australia.
    Descriptions of Fundamental Care needs in cancer care - an exploratory study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 11-12, p. 2322-2332Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore the experiences of the fundamentals of care for people with a cancer diagnosis, from diagnosis to after adjuvant treatment.

    BACKGROUND: More focus is needed on the experience of people living with cancer, as current cancer care more emphasises on independence and resilience without fully acknowledging that there will be moments in the cancer journey where patients will need 'basic nursing care' to manage their symptoms and care pathways.

    DESIGN: Secondary analysis of qualitative data.

    METHOD: Secondary thematic analysis of interview data from 30 people with a diagnosis of breast (n=10), colorectal (n=10) or prostate (n=10) cancer was undertaken.

    RESULTS: The findings revealed vivid descriptions of the fundamentals of care (i.e. basic needs) and participants described physical, psychosocial and relational aspects of the delivery of care. Both positive (e.g. supportive and kind) and negative (e.g. humiliating) experiences related to the relationship with the healthcare professionals were re-counted and affected the participants' experiences of the fundamentals of care. Participants' accounts of their fundamental care needs were provided without them identifying who, within the health care system, was responsible for providing these needs. Specific nursing interventions were seldom described.

    CONCLUSION: Some people with a cancer diagnosis have to strive for help and support from the nursing staff to manage to regain control over their recovery. Nurses in cancer care need to focus on the patients' fundamental care needs to optimise their patients' recovery. This article is protected by copyright. All rights reserved.

  • 16.
    Sahlsten, Monika J. M.
    et al.
    Institute of Nursing, Health and Care Sciences, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Larsson, Inga E.
    Doctoral student at Institute of Nursing, Health and Care Sciences, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden and Lecturer, Department of Nursing, Health and Culture, University West, Vänersborg, Sweden.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Lindencrona, Catharina S. C.
    Senior investigator (ret.), Department of Health and Welfare, Stockholm, Sweden.
    Plos, Kaety A. E.
    Senior Lecturer, Institute of Nursing, Health and Care Sciences, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Patient participation in nursing care: towards a concept clarification from a nurse perspective2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 4, p. 630-637Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this study was to investigate the meanings of the concept of patient participation in nursing care from a nurse perspective.

    Background. Participation is essential and increases patients’ motivation and satisfaction with received care. Studies of patient participation in nursing care are not congruent regarding definition, elements and processes. This lack of clarity is amplified by several terms used; patient/client/consumer involvement or collaboration, partnership and influence. Despite the fact that several nursing theories have emphasized the importance of patient participation, an empirically grounded theory has yet to be published.

    Methods. Seven focus group interviews were held with nurses providing inpatient physical care at five hospitals in West Sweden. The focus groups consisted of Registered Swedish nurses (n = 31) who described the meaning and implementation of patient participation in nursing care. A Grounded Theory approach has been applied to tape-recorded data. Constant comparative analysis was used and saturation was achieved.

    Results. Mutuality in negotiation emerged as the core category for explaining nurses’ perspectives on patient participation in nursing care. It is characterized by four interrelated sub-core categories: interpersonal procedure, therapeutic approach, focus on resources and opportunities for influence. Mutuality in negotiation constitutes the dynamic nurse–patient interaction process.

    Conclusions. The study clarifies that patient participation can be explained as an interactional process identified as mutuality in negotiation based on four components.

    Relevance to clinical practice. The results are important and can be used in nursing practice and education. Application in a clinical context means nursing care organized to include all the components presented. The results can also be used in quality assurance to improve and evaluate patient participation.

  • 17.
    Thorstensson, Stina
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Blomgren, Carola
    Neighborhood Management North, Borås, Sweden.
    Sundler, Annelie J.
    University of Borås, Borås, Sweden.
    Larsson, Margaretha
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    To break the weight gain: A qualitative study on the experience of school nurses working with overweight children in elementary school2018In: 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.

  • 18.
    Warrén-Stomberg, Margareta
    et al.
    University of Skövde, School of Life Sciences.
    Öhman, Ulla-Britt
    Surgical Department, Hospital of Falköping, Sweden.
    Patients undergoing total hip arthroplasty: a perioperative pain experience2006In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 15, no 4, p. 451-458Article in journal (Refereed)
    Abstract [en]

    Aim. The aim was to evaluate patient’s perioperative pain experience after total hip replacement and patients’ satisfaction with pain management.

    Background. Total hip arthroplasty is a common surgical procedure intended to reduce pain and return patients to better function. Realistic expectations about total hip arthroplasty is important for optimal postoperative recovery and the information must be adapted to fit the individual patient.

    Methods. A descriptive design was used comparing patients outcome data. Pitman’s test was used for statistical analyses. Adult patients (n ¼ 112) undergoing surgical hip replacement procedures answered a 17-item questionnaire on the fourth postoperative day. The questionnaire included given alternatives and visual analogue scales (0–100 mm) for the pain assessment.

    Result. The patients’ postoperative pain experience after hip replacement surgery was in average low, 33Æ1 mm on a 100 mm visual analogue scale. Patient’s pain experience was reported to be highest on the first postoperative day for most of the patients. The preoperative pain experience tends to be higher than the postoperative

    pain experience. Older patients reported less average pain level postoperatively. Satisfaction with pain management was high.

    Conclusion. The pain experience tends to be higher preoperatively than postoperatively. Patients who reported a higher pain experience postoperatively reported that their pain experience was significant higher than preoperative expected.

    Relevance to practice. It is important for the postoperative outcome measure that the patients have a realistic expectation of pain experiences after total hip arthroplasty. The nurse is one of the staff members responsible for information to the individual patient.

  • 19.
    Wennerström, Berith
    et al.
    Skaraborg Hospital, Kärnsjukhuset.
    Warrén Stomberg, Margareta
    University of Skövde, School of Life Sciences.
    Modin, Marina
    Skaraborg Hospital, Kärnsjukhuset.
    Skullman, Stefan
    Skaraborg Hospital, Kärnsjukhuset.
    Patient symptoms after colonic surgery in the era of enhanced recovery - a long-term follow-up2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 5-6, p. 666-672Article in journal (Refereed)
    Abstract [en]

    Aims. The main purpose of this study was to analyse, prospectively, patient symptoms during the first four weeks following elective colon surgery. A secondary aim was to find areas to improve inpatient information and postoperative care.

    Background. Fast-track recovery following colon surgery has been proven beneficial to patients in the early postoperative phase. Less is known about the continuous recovery at home.

    Design. A prospective follow-up survey.

    Methods. Consecutive patients (n = 32) planned for elective colon surgery were evaluated. Both open and laparoscopic operations were included. All followed a fast-track protocol in hospital. Patient symptoms were recorded by validated quality of life questionnaires (EORTC QLQ-C 30, EORTC QLQ-CR 38 and Brief Pain Inventory). An interview was conducted five weeks and one year after surgery.

    Results. The hospital stay was six days, and 10% of patients were readmitted. The fast-track concept worked well. The main problems after discharge were fatigue, nausea and bowel disturbances. Pain was not a significant issue. Most symptoms had disappeared after four weeks.

    Conclusions. The first period at home is troublesome, and better information about common symptoms is needed. A direct telephone line has been set up to answer questions and to lower patient anxiety.

    Relevance to clinical practice. Clinical guidelines for patient’s discharge planning can be performed based on the results from this study. Further improvement regarding the epidural anaesthesia is needed to reduce minor side effects.

  • 20.
    Wickström Ene, Kerstin
    et al.
    The Sahlgrenska Academy at Gothenburg University, Institute of Health and Care Sciences, Gothenburg, Sweden / Departments of Anesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Nordberg, Gunnar
    Departments of Anesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Bergh, Ingrid
    The Sahlgrenska Academy at Gothenburg University, Institute of Health and Care Sciences, Gothenburg, Sweden.
    Gaston Johansson, Fannie
    Johns Hopkins University School of Nursing, Baltimore, MD, USA.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Postoperative pain management - the influence of surgical ward nurses2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 15, p. 2042-2050Article in journal (Refereed)
    Abstract [en]

    Aim. To compare pain levels reported by patients with those documented by ward nurses and to find out to what extent the amount of opioids given correlated with the pain level. Secondly, to study if pain management and nurses' approaches to this task had improved during a two-year period, including an educational pain treatment program for ward staff. Background. The management of postoperative pain continues to remain problematic and unsatisfactory and ward nurses play an important role for this task. Design. The study was a cross-sectional, descriptive, two-part study based on survey data from both patients and nurses on two urology surgical wards. Methods. Part I of the study included 77 patients and 19 nurses. Part II took place approximately two years later and included 141 patients and 22 nurses. Data were collected the day after surgery by asking patients about 'worst pain' experienced. The pain scores given by the patients were compared with those documented in the patients' records and with the doses of opioids administered. Nurses' approaches to pain management were sought after, by using a categorical questionnaire. Results. The nurses' ability to assess pain in accordance with the patients' reports had increased slightly after two years even if and the number of documented pain scores had decreased. Forty per cent of the nurses reported that they did not use visual analogue scale and that they did not assess pain at both rest and activity, neither did one fourth evaluate the effect of given analgesics. Conclusion. The study showed a discrepancy in pain scoring between nurses and patients, where active treatment was related to nurses' documentation rather than to patients' scoring. Relevance to clinical practice. The study shows a need for more accurate pain assessment, since the patient experiences and suffers pain and the nurse determines upon treatment.

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