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  • 1.
    Berglund, Mia
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Gillsjö, Catharina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Reflekterande KRAFT-givande samtal2017In: Vägen till patientens värld och personcentrerad vård: Att bli lyssnad på och förstådd / [ed] Karin Dahlberg, Inger Ekman, Stockholm: Liber, 2017, 1, p. 317-334Chapter in book (Refereed)
  • 2.
    Berglund, Mia
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Gillsjö, Catharina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Reflekterande KRAFT-givande samtal i vården av äldre som lever med långvarig smärta i hemmet2015In: Ä. Riksföreningen för Sjuksköterskan inom äldrevård, ISSN 2001-1164, no 1, p. 14-16Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Reflekterande KRAFT-givande samtal är en metod utvecklad för att användas som ett verktyg i vården. Syftet är att stärka människors hälsa och välbefinnande samt den egna förmågan att bemästra sin situation på ett sätt som ger glädje och mening i livet. För den äldre kan det innebära en möjlighet att kunna bo kvar längre i det egna hemmet. Metoden har utvecklats utifrån resultaten av två avhandlingar, en om hemmets betydelse och att leva med långvarig smärta samt en om lärande vid långvarig sjukdom.

  • 3.
    Berglund, Mia
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Gillsjö, Catharina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. College of Nursing, University of Rhode Island, USA.
    Svanström, Rune
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Keys to person-centred care to persons living with dementia: Experiences from an educational program in Sweden2018In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, p. 1-15Article in journal (Refereed)
    Abstract [en]

    Growing old entails an increased risk of disabilities and illnesses such as dementia. The orientation in Sweden on national level is that individuals remain in their own homes if desired and receive person-centred home care. The aim of this study was to describe the experience of an educational program and its influence on daily provision of care to persons with dementia. A lifeworld approach was used. Data were collected through group interviews with care providers in the context of home. The findings are presented in five themes: Increased knowledge about dementia and treatment, Relationship-building in order to provide good care, Open and flexible approach conveys calm, Continuity and flexibility are cornerstones in the care and Perceived improvements. This person-centred educational intervention resulted in a care that was based on each individual’s personality, preferences and priorities in life. Education given with continuity over time is key to improving provision of care to person with dementia.

  • 4.
    Berglund, Mia
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nässén, Kristina
    Academy of Care, Working Life and Social Welfare, University of Borås, Borås, Sweden.
    Gillsjö, Catharina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. College of Nursing, University of Rhode Island, Kingston, USA.
    Fluctuation between Powerlessness and Sense of Meaning: A Qualitative Study of Health Care Professionals’ Experiences of Providing Health Care to Older Adults with Long-Term Musculoskeletal Pain2015In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, article id 96Article in journal (Refereed)
    Abstract [en]

    Background: There is an increasing number of older adults living with long-term musculoskeletal pain and related disabilities. These problems are frequently unrecognized, underreported, and inadequately treated. Since many older adults desire to remain at home for as long as possible, it is important that individualized and holistically tailored care is provided in these settings. However, there is a complexity in providing care in this context.

    The aim of this study was to describe health care professionals’ experiences of providing health care to older adults living with long-term musculoskeletal pain at home.

    Methods: The phenomenon, “To provide health care to older adults living with long-term musculoskeletal pain at home”, was studied using reflective lifeworld research (RLR) which is based on phenomenological epistemology. Ten health care providers (nurse, physiotherapists, and occupational therapists) were interviewed and data was analysed.

    Results: The health care professional’s emotions fluctuated between powerlessness and meaningfulness. Needs, opportunities, understanding and respect had to be balanced in the striving to do good in the provision of health care in differing situations. Caring for older adults with long-term pain required courage to remain in the encounter despite feelings of insecurity and uncertainty about the direction of the dialogue. The essence of caring for older adults with long-term pain consisted of the following constituents: Sense of powerlessness; striving to provide good health care; and understanding and respect.

    Conclusions: The findings indicated that the health care professionals strived to do good and to provide health care that was holistic and sensitive to the older adults’ needs. A significant sense of powerlessness in the situation was experienced by the health care professionals. These findings address and support the need to develop methods that can be used to guide health care providers who support older adults in the context of their homes.

  • 5.
    Berglund, Mia
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nässén, Kristina
    Academy of Care, Working Life and Social Welfare, University of Borås, Sweden.
    Hedén, Lena
    Academy of Care, Working Life and Social Welfare, University of Borås, Sweden.
    Gillsjö, Catharina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Older Adults' Experiences of Reflective STRENGTH-Giving Dialogues: An Interview Study2016In: Journal of Gerontology & Geriatric Research, ISSN 2167-7182, Vol. 5, no 3, article id 1000304Article in journal (Refereed)
    Abstract [en]

    Background: A major health problem that frequently accompanies old age is long-term pain, but pain must be acknowledged by older adults and health care providers. Interventions are needed to alleviate pain and suffering’ while holistically providing health care that promotes wellbeing. The intervention project, Reflective STRENGTHGiving Dialogues© (STRENGTH) was implemented to increase health and wellbeing among community dwelling older adults living with long-term musculoskeletal pain at home.

    Aim: The aim of this study was to describe the older adults’ experiences of the intervention Reflective STRENGTH-Giving Dialogue.

    Method: A life world hermeneutic approach was used in collection and analysis of data. Twenty community dwelling older adults participated were interviewed in their homes after the intervention.

    Findings: The findings consisted of five themes and showed that the older adults experienced the Reflective STRENGTH-Giving Dialogues as a continuous and trusting relationship that alleviates the pain and breaks the loneliness. They expressed it as a new way to talk about life with pain. The dialogues supported reflection and memory and resulted in a transition in orientation in life.

    Conclusion: The Reflective STRENGTH-Giving Dialogues helped the older adults to increase their intellectual, emotional, and physical engagement in daily living. The dialogues facilitated a transition in orientation from past to present, to the future, and from obstacles to opportunities. The dialogues were oriented towards enjoyments, meaning, courage and strength in life as a whole which promoted the older adults’ sense of well-being and vitality. The dialogues also facilitated carrying out small and large life projects. The Reflective STRENGTH-Giving Dialogues created a deepened caring relationship that contributed to an increased sense of security, strength and courage, all of which enhanced the potential for better health and wellbeing.

  • 6.
    Curtin, Alicia
    et al.
    Department of Family Medicine, Memorial Hospital of Rhode Island, Pawtucket, RI, USA.
    Martins, Diane C.
    University of Rhode Island, College of Nursing, Kingston, RI, USA.
    Gillsjö, Catharina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Schwartz-Barcott, Donna
    University of Rhode Island, College of Nursing, Kingston, RI, USA.
    Ageing out of place: The meaning of home among hispanic older persons living in the United States2017In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 12, no 3, article id e12150Article in journal (Refereed)
    Abstract [en]

    Aim

    To explore the meaning of home among older Hispanic immigrants who are “aging out of place.”

    Background

    Emerging evidence supports the concept of older persons ageing in place. Nurse researchers have demonstrated that older person who age in place have better physical, psychological and cognitive outcomes. Less, however, is known about older persons who are “aging out of place,” meaning out of their country of origin. With the growth of home health care, there is a need to understand the older immigrants' meaning of home when ageing out of their country of origin.

    Design and Method

    An inductive, qualitative descriptive research design was used. Seventeen Hispanic participants, ranging in age from 65 to 83 years were interviewed using a semi-structured interview protocol.

    Findings

    Two major finding of the study focused on participants' descriptions of home in their country of origin and in the USA. The majority of participants described their home in their native country as the community, countryside or town (pueblo) and in the U.S.A. as family. The level of social isolation and loneliness among participants was evident.

    Conclusions

    Older Hispanic immigrants who are “aging out of place” integrate their past experiences of sense of place in their native country with their present experiences of home in the USA. The need to understand the role of the community and the family in the provision of nursing care in the home may be more important than the physical structure or setting in which it is delivered. Further intra- and cross-national studies are needed to provide a framework for understanding the issues of ageing and immigration globally.

    Implications for Practice

    Gerontological nurses need to recognise the complexity of family relationships for older Hispanic persons who are ageing out of place of origin and their risk of depression, social isolation, and loneliness.

  • 7.
    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.

  • 8.
    Gillsjö, Catharina
    University of Skövde, School of Life Sciences.
    Older adults' conceptions of home and experiences of living with long-term musculoskeletal pain at home2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Worldwide there are an increasing number of older adults, many of whom desire to age in place, remaining at home. This makes home increasingly important for health care delivery. Long-term musculoskeletal pain often accompanies old age and is one of the most prevailing and disabling health problems among community dwelling older adults. However, limited research exists on older adults' conceptions of home and their experiences of living with musculoskeletal pain at home. Nurses need this kind of understanding for individualized and holistic care of older adults living at home.

    Three studies were conducted. The Hybrid Model for Concept Development was used to define the concept of home and its meaning in the lives of three older women. Home consisted of three components, place, relationship and experience and was defined as a place to which one is attached, feels comfortable and secure and has the experience of dwelling. Secondly, hermeneutical text interpretation was used to understand the experience of home from interviews with six older adults. Home was intimate and integral to one's sense of being and life itself. Participants could not really imagine living without it. There was an underlying tension and fear of being forced to leave home one day. Lastly, qualitative interviews with 19 older adults, phenomenography and content analysis, were used to describe differences and commonalities in the experience of living with long-term musculoskeletal pain at home. Four ways of dealing with daily life were identified: ignore, struggle, adjust and resign. Participants learned how to endure pain in their daily life. Common themes included: taking the pain as it comes, one day at a time; balancing the pain with activity, thoughts and emotions; self talking; trying to be less of a burden to family and others; capturing, enjoying and valuing moments of pleasure. Three major concepts in symbolic interactionism: role, negotiation and meaning making illuminated findings. Increased understanding of home among older adults and the enduring associated with living with long-term musculoskeletal pain may enhance the quality of life at home, preserve and promote the older adult's sense of being at home, health and overall well-being and maximize care and minimize intrusion.

  • 9.
    Gillsjö, Catharina
    University of Skövde, School of Life Sciences.
    Äldre personers erfarenheter av att leva med långvarig muskeloskeletal smärta i hemmet2013In: Smärta, ISSN 1402-1048, no 4, p. 11-14Article in journal (Other (popular science, discussion, etc.))
  • 10.
    Gillsjö, Catharina
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. College of Nursing, University of Rhode Island, USA.
    Berglund, Mia
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Reflective STRENGTH-Giving Dialogue Developed to Support Older Adults in Learning to Live with Long-Term Pain: A Method and a Study Design2014In: Journal of Gerontology & Geriatric Research, ISSN 2167-7182, Vol. 3, no 5, article id 187Article in journal (Refereed)
    Abstract [en]

    Background: Long-term musculoskeletal pain is a major health problem that significantly impacts quality of life among older adults. Many lack professional guidance and must learn on their own to live with pain. This calls for a holistic method that addresses older adults’ needs in their situations. The developed method has its foundation in the didactic model: “The challenge – to take control of one’s life with long-term illness.

    Aim: The aim was to describe the method, Reflective STRENGTH-Giving Dialogue, and present a study design where the method is learned and used by health care providers to support older adults in learning to live their lives with long-term pain at home in a way that promotes health, well-being, meaning and strength in life.

    Methods: The pilot study design consists of an educational program including continuous supervision to health care providers during the accomplishment of dialogues with community dwelling older adults. The key dimensions in Reflective STRENGTH-Giving Dialogue are:

    Situation: Confront and ascertain the facticity in the current situation; Transition from “one to I” and Take charge in the situation; Reflect upon possibilities and choices; Engagement in fulfilling small and large life projects that gives joy and meaning in life; Get inner strength and courage; Tactful and challenging approach and Holistic perspective. Data will be collected through interviews and questionnaires. Qualitative and quantitative methods (NRS, BPI-SF, GDS, KASAM, MSQ) will be used for analysis. A control-group will be enrolled.

    Discussion and Relevance of Study: STRENGTH can be used to secure and enhance the quality of personcentered care. The method for dialogues can be a way to holistically and individually guide and support older adults in finding ways to live a meaningful life despite pain and to fulfill their desire to remain at home as long as possible .

  • 11.
    Gillsjö, Catharina
    et al.
    University of Skövde, School of Life Sciences.
    Bergman, Karin
    University of Skövde, School of Life Sciences.
    Klinisk undersökning och kliniskt beslutsfattande på en avancerad nivå2011In: Avancerad klinisk sjuksköterska: Avancerad klinisk omvårdnad i teori och praxis / [ed] Lisbeth Fagerström, Lund: Studentlitteratur, 2011, 1, p. 211-244Chapter in book (Refereed)
    Abstract [sv]

    KLINISK PRAXIS på avancerad nivå innebär för en avancerad klinisk sjuksköterska att självständigt ansvara för ett kliniskt beslutsfattande inom sitt kompetensområde och att utifrån omvårdnadsteoretiska perspektiv ge en god omvårdnad. Förvärvade kunskaper och färdigheter tillämpas för att lösa komplexa hälsoproblem genom att identifiera, bedöma, diagnostisera, ordinera, genomföra och utvärdera omvårdnad och medicinsk behandling utifrån patientens helhetssituation samt genomföra hälsofrämjande och förebyggande åtgärder. I detta kapitel ges en vägledning i hur en avancerad klinisk sjuksköterska på ett systematiskt sätt kan inhämta patientens hälsohistoria, genomföra en klinisk undersökning samt utifrån detta fatta kliniska beslut och slutligen dokumentera händelseförloppet.

  • 12.
    Gillsjö, Catharina
    et al.
    University of Skövde, School of Life Sciences.
    Schwartz-Barcott, Donna
    College of Nursing, University of Rhode Island, USA.
    A concept analysis of home and its meaning in the lives of three older adults2011In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 6, no 1, p. 4-12Article in journal (Refereed)
    Abstract [en]

    Aim. To identify and define the concept of home and its meaning in the lives of three older women. Background. For many older adults home is the centre of daily life and increasingly important as a place where health care is delivered. Yet, as a concept, home remains theoretically and empirically underdeveloped. Methods. The  Hybrid  Model  of  Concept  Development  was  used  to  interface theoretical  analysis  and  empirical  observation  with  a  focus  on  definition.  A comprehensive, interdisciplinary literature review, semi-structured interviews with three older women and case and cross-case analysis were completed. Results. Interviewees  spoke  of  childhood,  community,  residential,  church  and heavenly homes. Feelings of comfort and security were associated with residential homes,  peace  and  quiet  with  church  homes,  safety  and  pleasure  with  heavenly homes. The experience of home as being taken for granted, unselfconscious and unrecognized, became obvious when one woman tried to consciously establish a sense of being at home in her new residence. Conclusion. No single comprehensive and measurable definition was found. However, three major components were identified (place, relationship and experience) and used to define home as a place to which one is attached, feels comfortable and secure and has the experience of dwelling. Relevance to clinical practice. Every day assumptions about the meaning of home and home as just another place where health care is provided are called into question. Increased awareness and dialogue is needed among health-care providers working with older adults in their homes. Future research needs to explore the impact of home care on the older adult’s meaning of home and its potential impact on recovery.

  • 13.
    Gillsjö, Catharina
    et al.
    University of Skövde, School of Life Sciences.
    Schwartz-Barcott, Donna
    College of Nursing, University of Rhode Island, USA.
    Bergh, Ingrid
    University of Skövde, School of Life Sciences.
    Learning to Endure Long-Term Musculoskeletal Pain in Daily Life at Home: A Qualitative Interview Study of the Older Adult’s Experience2013In: Gerontology & Geriatric Research, ISSN 2167-7182, Vol. 2, no 4, article id 1000136Article in journal (Refereed)
  • 14.
    Gillsjö, Catharina
    et al.
    University of Skövde, School of Life Sciences. College of Nursing, University of Rhode Island, USA.
    Schwartz-Barcott, Donna
    College of Nursing, University of Rhode Island, USA.
    Bergh, Ingrid
    University of Skövde, School of Life Sciences. College of Nursing, University of Rhode Island, USA.
    Learning to endure long-term musculoskeletal pain in daily life at home: The older adult's experienceManuscript (preprint) (Other academic)
  • 15.
    Gillsjö, Catharina
    et al.
    University of Skövde, School of Life Sciences. College of Nursing, The University of Rhode Island, Kingston, RI, USA.
    Schwartz-Barcott, Donna
    College of Nursing, The University of Rhode Island, Kingston, RI, USA.
    Bergh, Ingrid
    University of Skövde, School of Life Sciences. College of Nursing, The University of Rhode Island, Kingston, RI, USA.
    Dahlgren, Lars Owe
    Linköping University, Linköping, Sweden.
    Older Adults' Ways of Dealing With Daily Life While Living With Long-Term Musculoskeletal Pain at Home2012In: Journal of Applied Gerontology, ISSN 0733-4648, E-ISSN 1552-4523, Vol. 31, no 5, p. 685-705Article in journal (Refereed)
    Abstract [en]

    Long-term musculoskeletal pain is a global health problem among older adults. Yet little is known about how these older adults actually deal with daily life. This study’s aim is to describe the ways these older adults dealt with daily life at home. Phenomenography is used to collect and analyze data from semistructured interviews with 19 older adults and to identify the range in which they dealt with daily life. Findings consist of an outcome space that encompassed four categories: ignore, struggle, adjust, and resign. The different ways older adults dealt with daily life when living with long-term pain at home strengthen the importance of individualized plans of care in the home and a holistic perspective. Findings contribute to enhanced understanding of a common health problem among older adults that can be used to promote quality of care and improve the quality of life of older adults.

  • 16.
    Gillsjö, Catharina
    et al.
    University of Skövde, School of Life Sciences.
    Schwartz-Barcott, Donna
    University of Rhode Island.
    von Post, Iréne
    Åbo Academy University, Vasa.
    Home: The place the older adult can not imagine living without2011In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 11, no 10Article in journal (Refereed)
    Abstract [en]

    Background: Rapidly aging populations with an increased desire to remain at home and changes in health policy that promote the transfer of health care from formal places, as hospitals and institutions, to the more informal setting of one's home support the need for   further research that is designed specifically to understand the experience of home among older adults. Yet, little is known among health care providers about the older adult's experience of home. The aim of this study was to understand the experience of home as experienced by older adults living in a rural community in Sweden.

    Methods: Hermeneutical interpretation, as developed by von Post and Eriksson and based on Gadamer's philosophical hermeneutics, was used to interpret interviews with six older adults. The interpretation included a self examination of the researcher's experiences and   prejudices and proceeded through several readings which integrated the text with the   reader, allowed new questions to emerge, fused the horizons, summarized main and sub-themes and allowed a new understanding to emerge.

    Results: Two main and six sub-themes emerged. Home was experienced as the place the older adult could not imagine living without but also as the place one might be forced to leave. The older adult's thoughts vacillated between the well known present and all its comforts and the unknown future with all its questions and fears, including the underlying   threat of loosing one's home.

    Conclusions: Home has become so integral to life itself and such an intimate part of the older adult's being that when older adults lose their home, they also loose the place closest   to their heart, the place where they are at home and can maintain their identity, integrity and way of living. Additional effort needs to be made to understand the older adult's experience of home within home health care in order to minimize intrusion and maximize care. There is a need to more fully explore the older adult's experience with health care providers in the home and its impact on the older adult's sense of "being at home" and their health and overall well-being.

  • 17.
    Hallman, Elsie-Britt
    et al.
    University of Skövde, School of Life Sciences.
    Gillsjö, Catharina
    University of Skövde, School of Life Sciences.
    Avancerad specialistsjuksköterska: från idé till verklighet2005In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 25, no 3, p. 76-78Article in journal (Refereed)
    Abstract [en]

    The role of the Nurse Practitioner has successfully been developed internationally within different areas of health care. To satisfy the needs of health care of the population in Sweden, an optimal utilization of the available resources is demanded and treatment of health care problems at an appropriate level of care is required to be able to give health care with good availability, high quality and safety. A collaboration started between the Primary Health Care in the county of Skaraborg and the University of Skövde to develop the role of the district nurses in primary health care toward a more specialized function with the competence to independently make decisions and solve health care problems. The plans of this new role in the health care system gained approval at the National Board of Health and Welfare and other public authorities. St Martin´s College, Great Britain and University of Rhode Island, USA have also been partners of collaboration. The result of the work became a curriculum of a new education in Sweden – Advanced Nursing Practice in Primary Health Care.

  • 18.
    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.

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