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  • 1. Campbell, Ann-Mari
    et al.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Pilhammar Andersson, Ewa
    Natten är dagens förutsättning: En studie av nattpersonalens arbetsförhållanden och arbetsuppgifter2004Report (Other academic)
  • 2.
    Campbell, Ann-mari
    et al.
    Malmö Univ, Inst Hlth Soc, Malmö, Sweden.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Pilhammar-Andersson, Ewa
    Univ Gothenburg, Sahlgrenska Acad, Inst Hlth Care Sci.
    Night duty as an opportunity for learning2008In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 62, no 3, p. 346-353Article in journal (Refereed)
    Abstract [en]

    Aim. This paper is a report of a study to examine what opportunities night nurses have to learn in terms of being able to distinguish variations in the patients' conditions.

    Background. Night nurses often lack access to the formalized in-service training offered to day nurses. As every clinical experience can be seen as an opportunity for learning, learning takes place even at night. However, the learning of night nurses has not been studied previously.

    Method. This study is based on interviews with a convenience sample of 10 night nurses at a medium-sized Swedish hospital in 2001. These interviews were reanalysed in 2006 concerning learning situations. The interviews were tape-recorded, transcribed verbatim, coded and examined using latent content analysis.

    Findings. There are certain opportunities for learning during the night shift, and three learning situations come to the fore: (1) the report situation, (2) the personal assessment round, where the nurses form their own picture of the patient, (3) in assessment prior to contact with the doctor on duty. Nurses learn from variations in patients' conditions and when they have to report their experience verbally. Learning does take place at night and gestalt psychology is a helpful tool for understanding how former knowledge and experience affect night nurses' learning.

    Conclusion. Knowledge developed during the night shift is a neglected field. There is a need for further investigations of what night nurses learn, and this knowledge ought to be integrated in the body of nursing knowledge.

  • 3.
    Carlsson, Christina
    et al.
    Department of Oncology, Institute of Clinical Sciences, Lund University, SE-221 85 Lund, Sweden / Department of Oncology, Institute of Clinical Sciences, Lund University Hospital, SE - 221 85 Lund, Sweden.
    Bendahl, Pär-Ola
    Department of Oncology, Institute of Clinical Sciences, Lund University, SE-221 85 Lund, Sweden.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Nilbert, Mef
    Department of Oncology, Institute of Clinical Sciences, Lund University, SE-221 85 Lund, Sweden.
    Benefits from membership in cancer patient associations: Relations to gender and involvement2006In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 45, no 5, p. 559-563Article in journal (Refereed)
    Abstract [en]

    Cancer patient associations report a growing number of members and increasing possibilities to influence health care, but knowledge about the members' views on the benefit of involvement is scarce. We therefore investigated how members (n = 1742) of Swedish patient associations for breast cancer and prostate cancer rate the benefit of membership for their physical and psychological well-being and social adjustment to cancer. Using a scoring scale, 2/3 of the members reported that membership had benefit for psychological well-being, whereas half of the members reported benefit for physical well-being and social adjustment. Individuals who had been actively involved in board work and/or contact person activities within the associations reported significantly more benefit for all three parameters. Gender differences were observed with men, represented by individuals affected by prostate cancer, reporting greater benefit for all three parameters, although especially evident for psychological well-being. Individuals who obtained membership within two years of diagnosis reported greater benefit for psychological well-being and social adjustment compared to those who became members later. In conclusion, members in patient associations for cancer report benefit particularly for their psychological well-being and actively involved members and men affected by prostate cancer perceive the greatest benefit from membership.

  • 4.
    Carlsson, Christina
    et al.
    Department of Oncology, Institute of Clinical Sciences, Lund University Hospital, SE-221 85 Lund, Sweden / Department of Research and Development, County Hospital, SE-301 85 Halmstad, Sweden.
    Nilbert, Mef
    Department of Oncology, Institute of Clinical Sciences, Lund University Hospital, SE-221 85 Lund, Sweden.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Patients' involvement in improving cancer care: experiences in three years of collaboration between members of patient associations and health care professionals2006In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 61, no 1, p. 65-71Article in journal (Refereed)
    Abstract [en]

    Objective

    The aim of this study was to explore how members of patient associations (PACPs) and health care professionals (HCPs) experience collaboration in a network initiated by the health care system and aimed at improving cancer care.

    Methods

    The participants were asked to describe, after 1 and 3 years, their experiences of collaboration. Data collected were in the form of a written answer to a single, open-ended question, and the answers were analysed using inductive content analysis.

    Results

    The analysis revealed four themes: the impact of processes that occur within the network, the impact of learning, the impact of innovation and development in cancer care, and the impact of PACP members’ personal cancer experience. Statements about the impact of the processes that occur within the network dominated at both occasions.

    Conclusion

    This study of experiences of collaboration provides new data on the importance ascribed to such efforts between patients in an organised association and HCPs.

    Practice implications

    We suggest that differences in perceptions and expectations should be taken into account in future collaborations between representatives of patient associations and of health care systems in order to reach out and to influence developments in cancer care.

  • 5.
    Carlsson, Christina
    et al.
    Department of Oncology, Institute of Clinical Sciences Lund, Lund University, SE - 221 85 Lund, Sweden / Dept. of Research and Development, County Hospital, SE - 301 85 Halmstad, Sweden.
    Nilbert, Mef
    Department of Oncology, Institute of Clinical Sciences Lund, Lund University, SE - 221 85 Lund, Sweden.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Supporter or obstructer: experiences from contact person activities among Swedish women with breast cancer2005In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 5, p. 9-Article in journal (Refereed)
    Abstract [en]

    Background: Swedish patient associations for breast cancer patients (PABCPs) offer patients with breast cancer unlimited meetings with a breast cancer survivor, a contact person (CP). We applied the voluntary action perspective in this interview study with members of Swedish PABCPs in order to explore how women with breast cancer experienced their contact with a CP from a PABCP.

    Methods: Audio-taped narratives from 8 women were analysed using Reissman's monitoring and Gee's analysis structure.

    Results: Three themes appeared: 1. Shared experiences give new perspectives on having cancer, 2. Feelings of isolation are a part of the identity of the illness and 3. Relations with others enable self-help. However, the relationship with the CP is sensitive to timing, correct information and understanding.

    Conclusions: CPs act as sounding boards and should optimally have capacity for listening, gives support and act as partner in this conversation. On the other hand, CPs should be aware that their presence and limited general medical knowledge could at times disturb the patient's psychological recovery and strengthen feelings of isolation. Thus, PABCPs must be careful in selecting CPs and offer relevant educational activities related to the themes identified herein.

  • 6.
    Carlén, Kristina
    et al.
    University of Skövde, School of Life Sciences.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Andlighet i vården: en intervjustudie bland vårdpersonal2008In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 28, no 1, p. 13-17Article in journal (Refereed)
    Abstract [en]

    Previous research found that spirituality seems difficult to give meaning and to work with in caring. The aim of this interview study was to explore how the nursing staff experienced the spiritual dimension within caring. Data was obtained from ten nursing staff at a Swedish infection department and analyzed with content analyze. The result shows that conditions to discover and to meet spirituality depend on the staff’s ripeness, that self-knowledge affect consciousness about spirituality and in the relationship of care spirituality is visible. The meaning of spirituality is to relate to God and other people, seeking the meaning of life and attitude at fateful occasions. This study shows there is a lot of knowledge released about patients’ spiritual needs only by asking: what do you believe in? The knowledge from this study is usable booth in nursing and in educational settings.

  • 7.
    Engqvist, Inger
    et al.
    University of Skövde, School of Life Sciences.
    Ferszt, Ginete
    University of Rhode Island.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Swedish registered psychiatric nurses' descriptions of presence when caring for women with post-partum psychosis: An interview study2010In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 19, no 5, p. 313-321Article in journal (Refereed)
    Abstract [en]

    The concept of nursing presence has been widely used in nursing and is a significant component of nursing practice. In order to increase our understanding of nursing presence, it needs to be studied in different contexts. In this study, a secondary analysis of interviews with 10 registered psychiatric nurses (RPN) in Sweden was conducted to explore nurses’ descriptions of presence when caring for women with post-partum psychosis (PPP). Based on the research question: ‘How do RPN describe nursing presence in the context of caring for women with PPP?’ content analysis was used to analyze the data. Three categories emerged: the use of presence to protect, the use of presence to facilitate recovery, and the use of presence for learning. The findings underscore the importance of recognizing nursing presence as a strategy to improve psychiatric nursing for the benefit of the woman and her child, and as an important part of psychiatric nursing when providing compassionate and effective nursing care to this population.

  • 8.
    Engqvist, Inger
    et al.
    University of Skövde, School of Life Sciences.
    Ferszt, Ginette
    College of Nursing, University of Rhode Island, Kingston, RI, United States.
    Åhlin, Arne
    Skaraborg Hospital, Skövde, Sweden / Clinical Neuroscience, Section of Psychiatry, Karolinska Institute, Solna, Sweden.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Psychiatric Nurses' Descriptions of Women with Postpartum Psychosis and Nurses' Responses: An Exploratory Study in Sweden2009In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 30, no 1, p. 23-30Article in journal (Refereed)
    Abstract [en]

     Postpartum psychosis is the most serious type of psychiatric illness related to childbirth. This interview study with nine psychiatric nurses in Sweden explored psychiatric nurses’ descriptions of women with psychosis occurring in the postpartum period and nurses’ responses when providing care to these women. Content analysis was used to analyze the data. The nurses described delusions, disconnection, aggression, changed personality, self-absorption, insomnia, chaos, quietness, suicidal ideation, and ‘strange eyes.’ The description of strange eyes noted by the nurses has not been found in the literature, warranting further investigation. When providing care, the nurses responded with sadness, sympathy, empathy and compassion, discomfort, anger, anxiety, and happiness. These findings underscore the importance of nurses recognizing their negatively charged emotions which could interfere with providing compassionate and effective nursing care to this population.

     

  • 9.
    Engqvist, Inger
    et al.
    University of Skövde, School of Life Sciences.
    Ferszt, Ginette
    College of Nursing, University of Rhode Island, Kingston, United States.
    Åhlin, Arne
    Skaraborg Hospital.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Women's Experience of Postpartum Psychotic Episodes: Analyses of Narratives From the Internet2011In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 25, no 5, p. 376-387Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to gain an insight into women's experiences of postpartum psychosis (PPP). Ten narratives taken from the Internet, which met the definition of PPP, were analyzed using cross-case and content analyses. The results revealed women's experience of having unfulfilled dreams, being enveloped by darkness, having disabling symptoms, and being abandoned. The women's experiences point to the importance of further education of nurses and doctors concerning PPP. It is vital not only for those working in psychiatric health care but also midwives and nurses who are working in maternity wards and child welfare centers. This would facilitate early recognition of signs and symptoms of the disorder, which, in turn, would make early treatment possible, thus supporting recovery. Furthermore, greater knowledge could contribute to providing more effective and compassionate care for these women.

  • 10.
    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

  • 11.
    Engqvist, Inger
    et al.
    University of Skövde, School of Life Sciences.
    Nilsson, Kerstin
    Institute of Health and Caring Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg , Sweden.
    Experiences of the first days of postpartum psychosis: An interview study with women and next of Kin in Sweden2013In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 34, no 2, p. 82-89Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore accounts of the first days of postpartum psychosis from different perspectives, that is, that of the women and their next of kin. Interviews were conducted with seven women with postpartum psychosis and six interviews were done with the next of kin. The overall theme was Shades of Black with A Ray of Light, revealing a difficult experience of darkness, despair, and suffering. For the women, the experience cannot be shared fully other than with those who have lived through it themselves. For the next of kin, the illness is incomprehensible and it proved difficult to express in words what these relatives believe the women were going through. The women and their next of kin spoke about loss of sleep, being in an unreal world, thoughts that moved from having a wanted to an unwanted baby, being infanticidal, and having suicidal ideation. The women and their next of kin described the situations in different ways. The women gave an account of their illness in the strongest of terms, while the language used by the next of kin was much milder. The findings underscore the importance of recognizing the next of kin as key sources in early recognition of the disorder, which would make early treatment possible and support recovery. © 2013 Informa Healthcare USA, Inc.

  • 12.
    Engqvist, Inger
    et al.
    University of Skövde, School of Life Sciences. Department of Psychiatry, Skaraborg Hospitals, Falköping, Sweden.
    Nilsson, Kerstin
    Institute of Health and Caring Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Involving the family in the care and treatment of women with postpartum psychosis: Swedish psychiatrists' experiences2013In: Psychiatry Journal, ISSN 2314-4327, E-ISSN 2314-4335, article id 897084Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe Swedish psychiatrists’ experiences of involving the family in the treatment of women with postpartum psychosis. A qualitative design was used, and semistructured qualitative research interviews were conducted with nine psychiatrists from the south of Sweden. Data were analysed using qualitative content analysis. Four categories were found: the family as a resource, the family as coworkers, preparing the family for the future, and the family as a burden. The result showed that the psychiatrists considered the family to be a resource to which they devoted a great deal of care and effort. It was particularly important to involve the partner, informing about the course of the illness and the steps that need to be taken in the event of a relapse and reducing any guilt feelings. The psychiatrists instilled confidence and hope for a future of health and further child bearing. The family members’ limited understanding of the treatment may impede the involvement of the family. Conclusion of the study was that the goal for family involvement was to facilitate the women’s care and treatment. Further studies are needed to provide suggestions on how to develop family involvement in the care of women suffering from postpartum psychosis.

  • 13.
    Engqvist, Inger
    et al.
    University of Skövde, School of Life Sciences.
    Åhlin, A.
    University of Rhode Island.
    Ferszt, G.
    Skaraborg Hospital, Skövde.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Nurses - psychiatrists' main collaborators when treating women with postpartum psychosis2010In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 17, no 6, p. 494-502Article in journal (Refereed)
    Abstract [en]

    The focus was to describe Swedish psychiatrists’ experiences of collaboration with healthcare professionals when treating women with postpartum psychosis (PPP). A qualitative design was used, and semi-structured interviews were performed with nine psychiatrists working in psychiatric hospitals in Sweden. Data were analysed using manifest and latent content analysis. The results of these experiences were categorized in this study as: collaboration related to admission, collaboration during inpatient care and collaboration related to discharge. Collaboration with midwives and obstetricians was important in diagnosing the illness, as this often occurred on postnatal wards; and decisions about the form of care for the woman with PPP and for her baby demanded collaboration with various healthcare professionals. Collaboration with nurses was based on expectations and confidence in nurses’ competence, and was exceedingly important during inpatient care. When the woman was to be discharged, collaboration with healthcare teams, e.g. outpatient clinic, child health clinic and community services, was required. The conclusions were that psychiatrists collaborate with different professionals in the various phases of the caring process. They rely extensively on nurses’ competence when caring for women with PPP, and consider nurses to be their most important collaborators. Collaboration with midwives and obstetricians was

  • 14.
    Engqvist, Inger
    et al.
    University of Skövde, School of Life Sciences.
    Åhlin, Arne
    Skaraborg Hospitals, Skövde, Sweden.
    Ferszt, Ginette
    University of Rhode Island, Rhode Island, United States.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences. University of Gothenburg, Gothenburg, Sweden.
    Comprehensive Treatment of Women with Postpartum Psychosis across Health Care Systems from Swedish Psychiatrists' Perspectives2011In: Qualitative Report, ISSN 1052-0147, Vol. 16, no 1, p. 66-83Article in journal (Refereed)
    Abstract [en]

    Studies concerning the psychiatrist’s experiences of treating women with postpartum psychosis (PPP) or how they react to these women are limited in the literature. In this study a qualitative design is used. Data collection includes semi-structured interviews with nine Swedish psychiatrists working in psychiatric hospitals. The audio-taped interviews are transcribed verbatim and analyzed using content analysis. The findings consist of the categories: Protection, Treatment, Care, and Reactions.The psychiatrists describe emotions such as compassion, empathy and distress. A conclusion is that the psychiatrists focus on protecting the women from suicide and/or infanticide. Given the degree of stress the psychiatrists can experience caring for high risk challenging patients, health care organizations need to provide support and/or opportunities for peer supervision.

  • 15.
    Erichsen Andersson, Annette
    et al.
    University of Gothenburg.
    Bergh, Ingrid
    University of Skövde, School of Life Sciences.
    Karlsson, Jon
    University of Gothenburg.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Patients' experiences of acquiring a deep surgical site infection: An interview study2010In: American Journal of Infection Control, ISSN 0196-6553, E-ISSN 1527-3296, Vol. 38, no 9, p. 711-717Article in journal (Refereed)
    Abstract [en]

    Background: The negative impact of surgical site infection (SSI) in terms of morbidity, mortality, additional costs, and length of stay (LOS) in the hospital is well described in the literature, as are risk factors and preventive measures. Given the lack of knowledge regarding patients’ experiences of SSI, the aim of the present study was to describe patients’ experiences of acquiring a deep SSI. Methods: Content analysis was used to analyze data obtained from 14 open interviews with participants diagnosed with a deep SSI. Results: Patients acquiring a deep SSI suffer significantly from pain, isolation, and insecurity. The SSI changes physical, emotional, social, and economic aspects of life in extremely negative ways, and these changes are often persistent. Conclusion: Health care professionals should focus on strategies to enable early diagnosis and treatment of SSIs. The unacceptable suffering related to the infection, medical treatment, and an insufficient patient-professional relationship should be addressed when planning individual care, because every effort is needed to support this group of patients and minimize their distress. All possible measures should be taken to avoid bacterial contamination of the surgical wound during and after surgery to prevent the development of SSI.

  • 16.
    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.

  • 17.
    Furåker, Carina
    et al.
    University of Gothenburg, The Sahlgrenska Academy, Institute of Health and Care Sciences, Göteborg, Sweden.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences. University of Gothenburg, The Sahlgrenska Academy, Institute of Health and Care Sciences, Göteborg, Sweden.
    The consultative work of occupational therapists working in municipal healthcare2011In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 18, no 2, p. 101-108Article in journal (Refereed)
    Abstract [en]

    The work of occupational therapists (OTs) in municipal healthcare has become more consultative in recent years. The aim of this study is to explore the content of the OTs’ consultative role in everyday activities in municipal healthcare. The study is based on data consisting of diary notes with additional reflections made by 23 OTs during three days. The data were subjected to content analysis. OTs are contacted via referrals (telephone calls or personal communication) to arrange consultations with patients, relatives, assistant staff, and colleagues. The OTs' consultative work consists of discussion, negotiation, information, or instruction, in relation to the advice and recommendations given. They also provide supervision and support to patients, relatives, and assistant staff. The advice and recommendations are evaluated. Thus, OTs' counselling consists of more than assessments and advice, as it also includes information, instruction, supervision, support, and evaluation. Further investigations are necessary in order to understand the competence that is needed and used in the consultative role of OTs in municipal healthcare. An implication for practice is that the healthcare managers need to support the OTs' possibility to provide supervision and support, especially in relation to assistant staff as they are responsible for everyday rehabilitation.

  • 18. Hertting, Anna
    et al.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Vårdenhetschefen i en föränderlig hälso- och sjukvårdsorganisation2005In: Att vara chef och ledare för omvårdnadsarbete / [ed] Kerstin Nilsson, Lund: Studentlitteratur, 2005, p. 51-78Chapter in book (Other academic)
  • 19.
    Hertting, Anna
    et al.
    Natl. Inst. for Phychosocial Med., Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Theorell, Töres
    Natl. Inst. for Phychosocial Med., Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Sätterlund Larsson, Ullabeth
    Institute of Health Care Pedagogics, The Sahlgrenska Academy, Göteborg University, Gothenburg, Sweden.
    Assistant Nurses in the Swedish Healthcare Sector during the 1990s: A Hard-hit Occupational Group with a Tough Job2005In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 33, no 2, p. 107-113Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of the study was to explore hospital-based assistant nurses' experiences of psychosocial “stressors”, following a period of substantial layoffs (43%) and ongoing healthcare reorganizations. Methods: An interview study was carried out with 11 assistant nurses working in the same hospital. The interviews took place in 1997, in connection with the last round of redundancies, and were followed up in 1998 and then in 2001. Interviews were audiotaped and transcribed; the content was then analysed. Results: Two main themes were identified from the women's perceived stressors: (a) a hard-hit occupational group experiencing “energy-consuming adjustments”, and a “weak position” at the continuing workplace. Job insecurity meant fear of losing valued work tasks in nursing care (de-skilling). The common feature was the duality in the women's descriptions of feeling qualified in nursing care but being treated like a maid, or having intimate practical knowledge but no formal competence; (b) a tougher but underpaid job including “heavy workload” concurrent with “organizational shortcomings”, and “frozen salary trends” with a simultaneous feeling of lacking the power to improve their situation. Conclusions: Our results underscore the importance of the employer's attention to the remaining workers in connection with downsizing, particularly when the reduction of the workforce has been as dramatic as in this case. It is also important to understand the ongoing dilemma (strain) for the assistant nurses, who are faced with increasing demands for further formal qualifications in hospital care, while maintaining a strong occupational desire to keep their highly valued job working close to the patient.

  • 20. Hertting, Anna
    et al.
    Petterson, Inga-Lill
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Stabil hälsa i en föränderlig sjukvårdsorganisation2005In: Den höga sjukfrånvaron: problem och lösningar, Arbetsmiljöinstitutet , 2005, p. 201-348Chapter in book (Other academic)
  • 21.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Att vara chef och ledare för omvårdnadsarbete2005Collection (editor) (Other academic)
  • 22.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Introduktion2005In: Att vara chef och ledare för omvårdnadsarbete / [ed] Kerstin Nilsson, Lund: Studentlitteratur, 2005, p. 11-18Chapter in book (Other academic)
  • 23.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Ledarskapsteoretiska utgångspunkter2005In: Att vara chef och ledare för omvårdnadsarbete / [ed] Kerstin Nilsson, Lund: Studentlitteratur, 2005, p. 19-50Chapter in book (Other academic)
  • 24.
    Nilsson, Kerstin
    et al.
    University of Skövde, School of Life Sciences. University of Gothenburg.
    Campbell, Ann-Mari
    Malmö University.
    Pilhammar Andersson, Ewa
    University of Gothenburg.
    Night nursing: staff's working experiences2008In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 7, article id 13Article in journal (Refereed)
    Abstract [en]

    Background

    Although the duties and working conditions of registered, and enrolled nurses have previously been described from different perspectives, they have not been examined from the night nursing aspect. The aim of the study was to describe the night nursing staff’s working experiences.

    Methods

    The design of the study is qualitative and descriptive. Interviews were conducted with 10 registered and 10 enrolled nurses working as night staff at a Swedish University Hospital. The interview guide was thematic and concerned the content of their tasks, as well as the working conditions that constitute night nursing. In addition, the interviews were transcribed verbatim and analyzed using content analysis.

    Results

    The night duties have to be performed under difficult conditions that include working silently in dimmed lighting, and making decisions when fatigue threatens. According to the night staff, its main goals are to provide the patients with rest and simultaneously ensure qualified care. Furthermore, the night nursing staff must prepare the ward for the daytime activities.

    Conclusions

    The most important point is the team work, which developed between the registered and enrolled nurses and how necessary this team work is when working at night. In order for nurses working at night to be fully appreciated, the communication between day and night staff in health care organizations needs to be developed. Furthermore, it is important to give the night staff opportunities to use its whole field of competence.

     

  • 25.
    Nilsson, Kerstin
    et al.
    University of Skövde, School of Life Sciences.
    Hertting, Anna
    National Institute for Psychosocial Medicine (IPM), Stockholm, Sweden.
    Petterson, Inga-Lill
    Department of Public Health Sciences, Department of Occupational and Environmental Health, Stockholm, Sweden.
    Theorell, Töres
    National Institute for Psychosocial Medicine (IPM), Stockholm, Sweden.
    Pride and confidence at work: potential predictors of occupational health in a hospital setting2005In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 5, p. 92-Article in journal (Refereed)
    Abstract [en]

    Background

    This study focuses on determinants of a healthy work environment in two departments in a Swedish university hospital. The study is based on previously conducted longitudinal studies at the hospital (1994–2001), concerning working conditions and health outcomes among health care personnel in conjunction with downsizing processes. Overall, there was a general negative trend in relation to mental health, as well as long-term sick leave during the study period. The two departments chosen for the current study differed from the general hospital trend in that they showed stable health development. The aim of the study was to identify and analyse experiential determinants of healthy working conditions.

    Methods

    Thematic open-ended interviews were carried out with seventeen managers and key informants, representing different groups of co-workers in the two departments. The interviews were transcribed verbatim and an inductive content analysis was made.

    Results

    In the two studied departments the respondents perceived that it was advantageous to belong to a small department, and to work in cooperation-oriented care. The management approaches described by both managers and co-workers could be interpreted as transformational, due to a strain of visionary, delegating, motivating, confirmative, supportive attitudes and a strongly expressed solution-oriented attitude. The daily work included integrated learning activities. The existing organisational conditions, approaches and attitudes promoted tendencies towards a work climate characterised by trust, team spirit and professionalism. In the description of the themes organisational conditions, approaches and climate, two core determinants, work-pride and confidence, for healthy working conditions were interpreted. Our core determinants augment the well-established concepts: manageability, comprehensiveness and meaningfulness. These favourable conditions seem to function as a buffer against the general negative effects of downsizing observed elsewhere in the hospital, and in the literature.

    Conclusion

    Research illuminating health-promoting aspects is rather unusual. This study could be seen as explorative. The themes and core dimensions we found could be used as a basis for further intervention studies in similar health-care settings. The result could also be used in future health promotion studies in larger populations. One of the first steps in such a strategy is to formulate relevant questions, and we consider that this study contributes to this.

  • 26.
    Nilsson, Kerstin
    et al.
    University of Skövde, School of Life Sciences.
    Hertting, Anna
    Örebro University, Department of Health Sciences, Örebro, Sweden.
    Pettersson, Inga-Lill
    Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden / Department of Occupational and Environmental Health, Stockholm Centre for Public Health, Stockholm, Sweden.
    "It depends on us": Employee perspective of healthy working conditions during continual reorganisations in a radiology department2009In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 33, no 2, p. 191-200Article in journal (Refereed)
    Abstract [en]

    Background: This study focuses on employees' experience of occupational health in a radiology department within a Swedish university hospital during years of continual reorganisations. This department's stable personal health trends in terms of self-rated mental health and sick-leave rates diverged from the general trends of deteriorating working conditions in the hospital.

    Aim: The aim was to identify dimensions of working conditions as positive determinants contributing to occupational health in a department of radiology undergoing continual reorganisations.

    Method: Open-ended interviews with twelve employees were transcribed and analyzed using content-analysis.

    Result: The employees experienced their new stimulating working tasks and a supporting organizational climate as important contributors to the healthy work condition.

    Conclusion: The positive effects of handling new technical challenges and the positive organisational climate, which were characterized by mutual trust, as well as work-confidence and respect for each others' competence, seem to function as buffering factors, balancing the negative effects of parallel downsizing and restructuring processes.

  • 27.
    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.

  • 28.
    Nilsson, Kerstin
    et al.
    University of Skövde, School of Life Sciences.
    Sätterlund Larsson, Ullabeth
    Institute of Health Care Pedagogics, Sahlgrenska Acad. at Goteborg Univ., Faculty of Health Care Sciences, Göteborg, Sweden.
    Conceptions of gender: a study of female and male head nurses’ statements2005In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 13, no 2, p. 179-186Article in journal (Refereed)
    Abstract [en]

    Background Gender can be seen as a construction in which history, culture and social relation are central. Thus, the construction remains strong can be explained by the fact that the existing conceptions about gender are continually passed on. It is not known how conceptions about gender in the context of Swedish health care are expressed by head nurses or what significance the conceptions have for their leadership.

    Aim To study head nurses' statements about their conceptions of gender and what significance these conceptions have in carrying out their work.

    Methods Thematic interviews were held with 36 head nurses, and the contents of the transcribed interviews were analysed.

    Results The results showed conceptions about men's direct and women's roundabout ways of communicating. Statements were also made concerning how men are oriented towards technical matters and women towards relationships, and how men are expected to show what they can do to a greater extent than women. These conceptions have an effect on head nurses in their work, as they are expected to live up to them. As we wished to obtain variation in the respondents' statements about gender, we conducted an interview study. Hence, the transferability of the findings is a question of conceptualization, and the conceptions we recorded cannot be seen as representative for all head nurses. The results imply, however, that greater awareness about conceptions of gender may promote greater equality in women's and men's careers and allow greater freedom to head nurses to do what they themselves feel they should do instead of what they are expected to do.

  • 29.
    Nilsson, Kerstin
    et al.
    University of Skövde, School of Life Sciences.
    Warrén-Stomberg, Margareta
    University of Skövde, School of Life Sciences.
    Nursing students motivation toward their studies: a survey study2008In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 7, article id 6Article in journal (Refereed)
    Abstract [en]

    Background

    This study focuses on Swedish nursing students' motivation toward their studies during their three year academic studies. Earlier studies show the importance of motivation for study commitment and result. The aim was to analyze nursing students' estimation of their degree of motivation during different semester during their education and to identify reasons for the degree of motivation.

    Methods

    A questionnaire asking for scoring motivation and what influenced the degree of motivation was distributed to students enrolled in a nursing programme. 315 students who studied at different semesters participated. Analyzes were made by statistical calculation and content analysis.

    Results

    The mean motivation score over all semesters was 6.3 (ranked between 0–10) and differed significantly during the semesters with a tendency to lower score during the 5th semester. Students (73/315) with motivation score <4 reported explanations such as negative opinion about the organisation of the programme, attitude towards the studies, life situation and degree of difficulty/demand on studies. Students (234/315) with motivation score >6 reported positive opinions to becoming a nurse (125/234), organization of the programme and attitude to the studies. The mean score value for the motivation ranking differed significantly between male (5.8) and female (6.8) students.

    Conclusion

    Conclusions to be drawn are that nursing students mainly grade their motivation positive distributed different throughout their entire education. The main motivation factor was becoming a nurse. This study result highlights the need of understanding the students' situation and their need of tutorial support.

  • 30.
    Nilsson, Maria
    et al.
    University of Skövde, School of Humanities and Informatics. University of Skövde, The Informatics Research Centre.
    van Laere, Joeri
    University of Skövde, School of Humanities and Informatics. University of Skövde, The Informatics Research Centre.
    Experts´Views on User Activities in Information Fusion System Development Processes2009In: Proceedings of the 3rd Skövde Workshop on Information Fusion Topics (SWIFT 2009) / [ed] Ronnie Johansson, Joeri van Laere and Jonas Mellin, University of Skövde , 2009, p. 33-38Conference paper (Refereed)
    Abstract [en]

     The role of the user in information fusion has gained increasing attention during the last years. However, looking at the research performed within the community it remains difficult to acquire a good understanding of the role of users, especially in terms of the information fusion system development process. To address this, a questionnaire was distributed during FUSION 2009 conference which aimed to explore these issues. Here, we present an initial analysis of the responses obtained. A consensus was found regarding how users have been incorporated in the development process. Specifically, they are seen as part of the concept generation phase, the requirement gathering phase or the evaluation phase rather than of the design phase. Also, the typical activities performed with users were found to be interviews and using users as advisers. However, results from the questionnaire also indicated that a consensus regarding what information is needed from users for automating a manual information fusion process is still lacking. The reasons for, and implications of this lack are discussed in the light of current research.

     

  • 31.
    Sandmark, Hélène
    et al.
    School of Health and Medical Sciences, Public Health Science, Örebro University, Sweden / Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Akademiska Sjukhuset, Uppsala, Sweden.
    Hägglund, Karin
    Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Akademiska Sjukhuset, Uppsala, Sweden.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences. Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Hertting, Anna
    School of Health and Medical Sciences, Public Health Science, Örebro University, Sweden.
    Understanding work ability: Experiences of female assistant nurses in elderly care2009In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 34, no 3, p. 373-383Article in journal (Refereed)
    Abstract [en]

    Few studies to date have investigated retained work ability. The aim of this explorative study was to describe female assistant nurses’ experiences of high work attendance over the years. The setting is a municipality in mid-Sweden that employs 466 female assistant nurses permanently within municipal elderly care. A qualitative methodology was chosen and thematic, open-ended, interviews were carried out with 12 female assistant nurses. The interviewees were selected from the 117 women who had taken the least amount of sick leave over the past five years, which meant no sick leave at all or no more than 5 days. The interviews were transcribed verbatim, and thereafter a content analysis was carried out. Three main themes connected with the aim of the study emerged from the interviews: “a desirable job, despite low status”, “supportive social networks”, and “coping ability”. In order to strengthen work ability among female employees in elderly care, the findings indicate that it is crucial to support mobility in working life, and to promote social support and networks at the workplace and in private life, as well as a coping-oriented approach to health issues and social life.

  • 32.
    Warrén Stomberg, Margareta
    et al.
    University of Skövde, School of Life Sciences. The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences. The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Nursing Students' Self-Graded Motivation to Complete their Programme of Study2010In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 4, p. 42-47Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore variation in nursing students’ motivation to complete their programme of study,  as  well  as  factors  relating  to  low  versus  high  motivation  and  students’  opinions  of  what  would  increase  their motivation to complete their programme of study. A study was carried out between April 2006 and December 2007. A total of 872 students registered in a 3-year nursing programme  randomly  participated  in  self-rating  their  motivation  score  once  each  semester.  Descriptive  statistics, statistical calculations and content analysis regarding open-ended questions were performed. Most of the students, 73%, rated their motivation as ≥6 on a 0-10 Likert scale; and 16% gave a rating of ≤4. The desire to become  a registered nurse (RN)  and having  a positive  attitude towards the  studies were  the main factors influencing high motivation to complete the programme of study. Having a negative attitude towards the studies was an explanation of decreased motivation. There was a significant decrease (p=0.001) in the motivation score with respect to number of semesters, and motivation increased with the student’s age (p=0.0119). Suggestions for increasing motivation given by those who rated their motivation as ≤4 mainly focused on improvements in didactics and study organisation.

  • 33.
    Ydreborg, Berit
    et al.
    Örebro Cty Council, Dept Community Med & Publ Hlth, Örebro, Sweden / Linköping Univ, Dept Hlth & Soc, Natl Ctr Work & Rehabil, S-58183 Linköping, Sweden.
    Ekberg, Kerstin
    Linköping Univ, Dept Hlth & Soc, Natl Ctr Work & Rehabil, S-58183 Linköping, Sweden.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Swedish social insurance officers' experience of their working conditions when dealing with applications for disability pension2008In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 31, no 4, p. 451-459Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe how Swedish social insurance officers experienced their working conditions, when dealing with applications for disability pensions (DPs). A qualitative research design was selected to describe their experiences. Open-ended interviews with ten social insurance officers were analyzed with inductive content analysis. This analysis showed that the working conditions were influenced by rules and regulations and the social insurance officers' competence. The social insurance officers' powerful positions and how their discretion was implemented made them feel responsible for performing their work well. They felt that the large number of clients hampered them from being able to offer the clients the activities they were entitled to, and from paying each client sufficient attention. There was a need for time to reflect and to improve management, in order to better develop the way in which DPs were handled. There was a difference in culture between the older social insurance officers, who had experience-based training, and the younger social insurance officers, who had academic qualifications. The results from this study could be used to better develop the organisation of work in the social insurance agency, and in further educational activities.

  • 34.
    Ydreborg, Berit
    et al.
    Department of Community Medicine and Public Health, Örebro County Council, Örebro, Sweden / National Centre for Work and Rehabilitation, Department of Health and Society, Linköping University, Linköping, Sweden.
    Ekberg, Kerstin
    National Centre for Work and Rehabilitation, Department of Health and Society, Linköping University, Linköping, Sweden.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Swedish social insurance officers' experiences of difficulties in assessing applications for disability pensions: an interview study2007In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 7, p. 128-Article in journal (Refereed)
    Abstract [en]

    Background

    In this study the focus is on social insurance officers judging applications for disability pensions. The number of applications for disability pension increased during the late 1990s, which has resulted in an increasing number of disability pensions in Sweden. A more restrictive attitude towards the clients has however evolved, as societal costs have increased and governmental guidelines now focus on reducing costs. As a consequence, the quantitative and qualitative demands on social insurance officers when handling applications for disability pensions may have increased. The aim of this study was therefore to describe the social insurance officers' experiences of assessing applications for disability pensions after the government's introduction of stricter regulations.

    Methods

    Qualitative methodology was employed and a total of ten social insurance officers representing different experiences and ages were chosen. Open-ended interviews were performed with the ten social insurance officers. Data was analysed with inductive content analysis.

    Results

    Three themes could be identified as problematic in the social insurance officers' descriptions of dealing with the applications in order to reach a decision on whether the issue qualified applicants for a disability pension or not: 1. Clients are heterogeneous. 2. Ineffective and time consuming waiting for medical certificates impede the decision process. 3. Perspectives on the issue of work capacity differed among different stakeholders. The backgrounds of the clients differ considerably, leading to variation in the quality and content of applications. Social insurance officers had to make rapid decisions within a limited time frame, based on limited information, mainly on the basis of medical certificates that were often insufficient to judge work capacity. The role as coordinating actor with other stakeholders in the welfare system was perceived as frustrating, since different stakeholders have different goals and demands. The social insurance officers experience lack of control over the decision process, as regulations and other stakeholders restrict their work.

    Conclusion

    A picture emerges of difficulties due to disharmonized systems, stakeholder-bound goals causing some clients to fall between two stools, or leading to unnecessary waiting times, which may limit the clients' ability to take an active part in a constructive process. Increased communication with physicians about how to elaborate the medical certificates might improve the quality of certificates and thereby reduce the clients waiting time.

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