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  • 1. Abrandt Dahlgren, Madeleine
    et al.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Richardson, Barbara
    Professions as communities of practice2004In: Developing Practice Knowledge for Health Professionals / [ed] Joy Higgs, Barbara Richardson, Madeleine Abrandt Dahlgren, Butterworth-Heinemann, 2004, p. 71-88Chapter in book (Other academic)
  • 2.
    Andersson, Sten-Ove
    et al.
    Swedish Armed Forces, Centre for Defence Medicine, Box 5155, S-426 05 V Frölunda, Göteborg, Sweden.
    Dahlgren, Lars Owe
    Department of Behavioural Science, Linköping University, Linköping, Sweden.
    Lundberg, Lars
    Swedish Armed Forces, Centre for Defence Medicine, Box 5155, S-426 05 V Frölunda, Göteborg, Sweden.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    The criteria nurses use in assessing acute trauma in military emergency care2007In: Accident and Emergency Nursing, ISSN 0965-2302, E-ISSN 1532-9267, Vol. 15, no 3, p. 148-156Article in journal (Refereed)
    Abstract [en]

    Emergency medical care for seriously injured patients in war or warlike situations is highly important when it comes to soldiers’ survival and morale. The Swedish Armed Forces sends nurses, who have limited experience of caring for injured personnel in the field, on a variety of international missions. The aim of this investigation was to identify the kind of criteria nurses rely on when assessing acute trauma and what factors are affecting the emergency care of injured soldiers. A phenomenographic research approach based on interviews was used. The database for the study consists of twelve nurses who served in Bosnia in 1994–1996. The criteria nurses rely on, when assessing acute trauma in emergency care, could be described in terms of domain-specific criteria such as a physiological, an anatomical, a causal and a holistic approach as well as contextual criteria such as being able to communicate, having a sense of belonging, the military environment, the conscript medical orderly and familiarity with health-caring activity. The present study shows that the specific contextual factors affecting emergency care in the field must also be practised before the nurse faces military emergency care situations. This calls for realistic exercises and training programs, where experience from civilian emergency care is interwoven with the knowledge specific to military medical care.

  • 3.
    Bergh, Ingrid
    et al.
    University of Skövde, School of Life Sciences.
    Gunnarsson, Magnus
    Department of Linguistics, Göteborg University, Göteborg, Sweden.
    Allwood, Jens
    Department of Linguistics, Göteborg University, Göteborg, Sweden.
    Odén, Anders
    Department of Geriatric Medicine, Göteborg University, Göteborg, Sweden.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Steen, Bertil
    Department of Geriatric Medicine, Göteborg University, Göteborg, Sweden.
    Descriptions of pain in elderly patients following orthopaedic surgery2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 2, p. 110-118Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to investigate what words elderly patients, who had undergone hip surgery, used to describe their experience of pain in spoken language and to compare these words with those used in the Short-Form McGill Pain Questionnaire (SF-MPQ) and Pain-O-Meter (POM). The study was carried out at two orthopaedic and two geriatric clinical departments at a large university hospital in Sweden. Altogether, 60 patients (mean age =77) who had undergone orthopaedic surgery took part in the study. A face-to-face interview was conducted with each patient on the second day after the operation. This was divided into two parts, one tape-recorded and semi-structured in character and one structured interview. The results show that a majority of the elderly patients who participated in this study verbally stated pain and spontaneously used a majority of the words found in the SF-MPQ and in the POM. The patients also used a number of additional words not found in the SF-MPQ or the POM. Among those patients who did not use any of the words in the SF-MPQ and the POM, the use of the three additional words 'stel' (stiff), 'hemsk' (awful) and 'räd(d)(sla)' (afraid/fear) were especially marked. The patients also combined the words with a negation to describe what pain was not. To achieve a more balanced and nuanced description of the patient's pain and to make it easier for the patients to talk about their pain, there is a need for access to a set of predefined words that describe pain from a more multidimensional perspective than just intensity. If the elderly patient is allowed, and finds it necessary, to use his/her own words to describe what pain is but also to describe what pain is not, by combining the words with a negation, then the risk of the patient being forced to choose words that do not fully correspond to their pain can be reduced. If so, pain scales such as the SF-MPQ and the POM can create a communicative bridge between the elderly patient and health care professionals in the pain evaluation process.

  • 4.
    Bergh, Ingrid
    et al.
    University of Skövde, School of Life Sciences.
    Jakobsson, Eva
    University of Skövde, School of Life Sciences.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Worst experiences of pain and conceptions of worst pain imaginable among nursing students2008In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 61, no 5, p. 484-491Article in journal (Refereed)
    Abstract [en]

    This paper is a report of a study to explore nursing students' own worst experiences of pain as well as their conceptions of the worst pain imaginable. Background.

    Pain is a personal experience, often assessed using a visual analogue scale. The endpoints of this scale are labelled with the extremes for pain experience (e.g. no pain to worst pain imaginable). People may understand the meaning of `no pain', but it is unclear what meaning they assign to `worst pain imaginable'. This indicates that a rating along the Visual Analogue Scale-line is dependent on the individual's previous experiences. Methods. Data were collected during the autumn of 2002. In total, 549 nursing students completed a questionnaire focusing on two main questions: `What is the worst experience of hurt, ache or pain you have had?' and `What is the worst pain imaginable for you?' Content analysis was used for data analysis. Results. The students' worst experience of pain was mostly related to acute or traumatic painful conditions, pain associated with female physiology, inflicted pain, psychological suffering and chronic painful conditions. The worst pain imaginable was described as condition-related pain, overwhelming pain, experiences of losses, deliberately inflicted pain, psychological suffering and as vicarious pain. Conclusion. The findings imply that nursing students, when they are imagining pain, include dimensions such as hope of relief, grief, control over the situation, powerlessness and empathy for and suffer with other people's pain. Further research is needed to explore why professional experience as a nurse diminishes the ability to imagine patients' pain.

  • 5.
    Bergh, Ingrid
    et al.
    University of Skövde, School of Life Sciences.
    Jakobsson, Eva
    University of Skövde, School of Life Sciences.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Steen, Bertil
    University of Skövde, School of Life Sciences.
    Ways of talking about experiences of pain among older patients following orthopaedic surgery2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 52, no 4, p. 351-359Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this study was to examine how older patients who had undergone hip surgery described their experience of pain.

    Background. A verbal report of pain is considered to be the single most reliable indicator of a person's pain experience. When assessing pain, healthcare professionals must be able to interpret the content of pain reports in order to understand older patient's pain experiences.

    Methods. The study was carried out in two orthopaedic and two elder care wards in a large university hospital in Sweden in 2000. Altogether, 38 patients with hip replacement (mean age = 75) and 22 patients with hip fracture (mean age = 81) took part. A face-to-face interview was conducted with each patient on the second day after operation. Data were transcribed and analysed using descriptive qualitative content analysis.

    Findings. Participants expressed their pain in a nuanced and detailed way in everyday language. Four main themes with sub-themes emerged: (a) objectification (localizing; quantifying; characterizing; temporalizing); (b) compensating (substitution; picturing); (c) explaining (functionalizing pain and its relief; externalizing pain and its relief); (d) existentializing (present pain orientation; future pain orientation).

    Conclusions. Exploring the ways older patients talk about pain is expected to result in a better understanding of the older patient's need of empathic individualized care and in the optimization of pain management.

  • 6.
    Bergh, Ingrid
    et al.
    Department of Geriatric Medicine, Göteborg University, Sweden.
    Sjöström, Björn
    Department of Geriatric Medicine, Göteborg University, Sweden.
    A comparative study of nurses' and elderly patients' ratings of pain and pain tolerance1999In: Journal of Gerontological Nursing, ISSN 0098-9134, E-ISSN 1938-243X, Vol. 25, no 5, p. 30-36Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to compare elderly patients' and nurses' ratings of pain and pain tolerance. Data were collected through structured interviews with the patients. The attending nurses completed a questionnaire after conducting a pain assessment. Independent of each other, patients and nurses were asked to rate on a VAS when pain should be treated (pain tolerance) and pain intensity. The VAS has been used both by patients and nurses. The initial selection consisted of 43 patients; however, 9% (n = 4) were unable to complete the VAS. These patients were not significantly older than those who completed the study (n = 39). The results shows that nurses tend to overestimate mild pain and underestimate severe pain. Nurses rated pain tolerance significantly lower than patients. The results also suggest that nurses with training beyond basic nursing education tend to assess patients' pain more accurately than those without additional training. For patients who reported that they had pain prior to hospitalization, the nurses' pain ratings showed a higher agreement than for those who reported that they did not have pain before being hospitalized. At the time of the interviews, 21% (n = 8) of patients felt that their pain was so great they needed treatment. Those patients also were recognized by the attending nurses as being in pain. To improve elderly patients' pain management, practicing nurses must collaborate with researchers to develop specific empirical research nursing knowledge within geriatric pain management. This research-based knowledge should be incorporated into nurses' clinical practice regarding pain management. Specific guidelines must be developed for the assessment, treatment, and documentation of elderly patients' pain.

  • 7.
    Bergh, Ingrid
    et al.
    University of Skövde, School of Life Sciences.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Quantification of the pain terms hurt, ache and pain among nursing students2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 2, p. 163-168Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to determine the quantitative meaning nursing students ascribe to the pain terms hurt (ont), ache (värk) and pain (smärta). In total, 549 nursing students filled in a questionnaire including questions about age, gender, and health care work experience. The students were also requested to rate response using a Visual Analogue Scale (VAS) rating for different statements about hurt, ache and pain. The results show that there were significant differences (p < 0.001) between rated intensity of the statements of hurt, ache and pain. There were, however, large variations in the students’ ratings of the pain terms; hurt ranged from 3 to 97 mm, ache from 7 to 97 mm and pain from 27 to 100 mm. There were no significant differences between male and female students regarding their ratings of hurt and ache when they were used to describe the worst self-experienced pain. Female students rated their experience of pain significantly higher (p < 0.001) on the VAS compared with male students. There was no significant correlation between previous experience of health care work and rated intensity of hurt, ache and pain. In conclusion, this study shows that there exist significant differences between the pain terms hurt, ache and pain according to a rating on a VAS. However, the results also demonstrate that there are large individual variations in how the students quantify the fictitious patient statements of hurt, ache and pain.

  • 8.
    Bertilsson, Sara
    et al.
    University of Skövde, School of Life Sciences.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Bedömning av smärta hos barn : En review2005In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 25, no 3, p. 13-18Article in journal (Refereed)
    Abstract [en]

    Assessing pain in children is one of nurses’ most difficult tasks and provides the foundation for efficient pain management. Young children lack the verbal skills to describe their experience of pain and they also have problems in differentiating pain from other unpleasant experiences. The aim of this study was to review current research regarding pain assessment in children. A literature search was carried out in the CINAHL and Medline databases, using the search words «pain assessment», «pain measurement», «pain rating scales», «children» and «nursing» and was limited to the years 1997–2002. Twelve articles satisfied the inclusion criteria and were analysed. The results are highlighted in five areas: Assessment of pain in children; Assessment of pain in infants; Tools and scales for assessing pain; Factors influencing the nurse’s assessment of pain; pain assessment as a basis of efficient pain therapy. The results of the study point to problems in pain assessment and the importance of children’s pain being adequately assessed. Accordingly, it is of utmost importance when possible to be able to take into account the individual child’s experience of pain.

  • 9.
    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

  • 10.
    Johansson, Anders
    et al.
    Linköping Univ, Dept Behav Sci, S-58183 Linköping, Sweden.
    Odén, Anders
    Chalmers, Dept Math Sci, S-41296 Gothenburg, Sweden.
    Dahlgren, Lars-Owe
    Linkoping Univ, Dept Behav Sci, S-58183 Linkoping, Sweden.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    A comparison of experiences of training emergency care in military exercises and competences among conscript nurses with different levels of education2007In: Military medicine, ISSN 0026-4075, E-ISSN 1930-613X, Vol. 172, no 10, p. 1046-1052Article in journal (Refereed)
    Abstract [en]

    The military emergency care education of nurses is primarily concerned with the treatment of soldiers with combat-related injuries. Even though great progress has been made in military medicine, there is still the pedagogical question of what emergency care education for military nurses should contain and how it should be taught. The aim of this study was to describe and compare experiences of training emergency care in military exercises among conscript nurses with different levels of education. A descriptive study was performed to describe and compare experiences of training emergency care in military exercises among conscript nurses with different levels of education in nursing. There were statistical differences between nurses with general nursing education and nurses with a general nursing education and supplementary education. A reasonable implication of the differences is that the curriculum must be designed differently depending on the educational background of the students. Hence, there is an interaction between background characteristics, e.g., the level of previous education and differences pertaining to clinical experience of the participants, and the impact of the exercise itself.

  • 11.
    Kim, Hesook Suzie
    et al.
    College of Nursing, University of Rhode Island, 2 Heathman Road, White Hall, Kingston, RI 02881-2021, United States / Buskerud University College, Drammen, Norway.
    Schwartz-Barcott, Donna
    College of Nursing, University of Rhode Island, 2 Heathman Road, White Hall, Kingston, RI 02881-2021, United States.
    Tracy, Susanne M.
    College of Nursing, University of Rhode Island, 2 Heathman Road, White Hall, Kingston, RI 02881-2021, United States.
    Fortin, Jacqueline D.
    College of Nursing, University of Rhode Island, 2 Heathman Road, White Hall, Kingston, RI 02881-2021, United States.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Strategies of pain assessment used by nurses on surgical units2005In: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635, Vol. 6, no 1, p. 3-9Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to identify the criteria nurses actually used to assess postoperative pain and the kind of knowledge they drew on from past experience. A series of semistructured interviews were performed with 10 nurses while they conducted pain assessments with 30 postsurgical patients. Data were analyzed on the basis of Dahlgren and Fallsberg’s (1991) analytic approach called phenomenography. Findings were compared with Sjöström’s 1995 study of nurses in Sweden. Nurses in this study, much like the group in Sweden, used three categories of criteria (i.e., how the patient looked, what the patient said, and experience with similar circumstances) and drew on their past experiences in four different ways (i.e., in terms of a typology of patients, a focus on listening to patients, what to look for, and what to do for patients) when assessing postoperative pain. In the most frequently reported strategy, nurses relied on criteria related to the patient’s appearance and drew on their past experience in terms of what physical signs to look for (e.g., facial expressions, bodily movement, and heart rate). The variety of strategies used by nurses in this study opens an avenue for further investigating the linkage between underlying conceptions of pain (as essentially subjective vs. objective phenomenon) and the quality and effectiveness of nurses’ assessments of pain and its management in postoperative and other contexts across nursing.

  • 12.
    Kim, Hesook Suzie
    et al.
    Buskerud University College, Drammen, Norway.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Schwartz-Barcott, Donna
    Pain assessment in the perspective of action science2006In: Research and Theory for Nursing Practice, ISSN 1541-6577, E-ISSN 1945-7286, Vol. 20, no 3, p. 215-228Article in journal (Refereed)
    Abstract [en]

    Pain assessment is examined in the perspective of action science with the aim to discover espoused theories and theories-in-use for pain assessment. In action science there are 2 sets of theories of action: espouse theories and theories-in-use, which often exist in practice inconsistently with each other resulting in haphazard actions. Espoused theories of pain and pain assessment and a set of theories-in-use were revealed. Alignments between the espoused theories and the theories-in-use, and disparities between these theories were found in the pain assessment situations. The findings point to possible explanations regarding problems in pain assessment, and provide insights into our understanding of nursing practice especially in relation to pain assessment.

  • 13.
    Klopper, Hester
    et al.
    Department of Nursing Education, North-West University, South Africa / Faculty of Nursing, North-West University, South Africa.
    Andersson, Helena
    University of Skövde, School of Life Sciences.
    Minkkinen, Maria
    University of Skövde, School of Life Sciences.
    Ohlsson, Cecilia
    University of Skövde, School of Life Sciences.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Strategies in assessing post operative pain: A South African study2005In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 22, no 1, p. 12-21Article in journal (Refereed)
    Abstract [en]

    The purpose of this validation study was to describe strategies used in postoperative pain assessment among a group of nurses in South Africa. A mixed qualitative and quantitative study was conducted in a 950-bed academic hospital complex. Surgical nurses (n = 12) carried out pain assessments of postoperative patients (n = 36) in pain. Data were collected using detailed interviews and pain intensity was estimated on a visual analogue scale (VAS, 0–10 cm). Nurses used four categories of criteria (a) how the patient looks, (b) what the patient says, (c) the patient's way of talking, and (d) experience of similar circumstances and drew on their past experiences in five different ways: (a) some patients report lower pain intensity than expected, (b) a typology of patients, (c) a focus on listening to patients, (d) what to look for, and (e) what to do for patients were identified.

    The system of categories described by Sjöström [Sjöström B. Assessing acute postoperative pain. Assessment strategies and quality of clinical experience and professional role. Göteborg: Acta Universitatis Gothoburgensis; 1995] was valid for this sample with an additional category. The different categories seem to be complementary and necessary for assessing pain in others. The findings have implications for professionals who provide care for patients in pain.

  • 14.
    Larsson, Inga E.
    et al.
    Institute of Health and Care Sciences, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden / Department of Nursing, Health and Culture, University West, Vänersborg, Sweden / Granvägen 12, SE-468 30 Vargön, Sweden.
    Sahlsten, Monika J. M.
    Institute of Health and Care Sciences, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Lindencrona, Catharina S. C.
    Department of Health and Welfare, Stockholm, Sweden.
    Plos, Kaety A. E.
    Institute of Health and Care Sciences, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Patient participation in nursing care from a patient perspective: a Grounded Theory study2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 3, p. 313-320Article in journal (Refereed)
    Abstract [en]

    The study's rationale: Patients’ active participation in their own care is expected to contribute to increased motivation to improve their own condition, better treatment results and greater satisfaction with received care. Knowledge of patients’ understanding of participation is of great importance for nurses in their efforts to meet patient expectations and for quality of nursing care.

    Aim: The aim was to explore the meaning of patient participation in nursing care from a patient point of view.

    Methodological design and justification: Six tape-recorded focus group interviews with 26 Swedish informants described opinions on and experiences of patient participation. The informants consisted of patients in somatic inpatient care as well as discharged patients from such a setting. The Grounded Theory method was used and the data were analysed using constant comparative analysis.

    Ethical issues and approval: The ethics of scientific work was followed. Each study participant gave informed consent after verbal and written information. The Ethics Committee of Göteborg University approved the study.

    Findings: The patients emphasised the importance of collaboration to improve participation. The core category, Insight through consideration, was generated from four inter-related categories: (i) Obliging atmosphere; (ii) Emotional response; (iii) Concordance; and (iv) Rights and their 15 subcategories.

    Conclusions: The meaning structures of patient participation in nursing care revealed from a patient point of view, seemed to mainly consist of not only external factors presented by the institutions – by the professionals – but also internal patient factors. The patients’ view of participation should be considered to a greater degree in nursing practice and education, as should also further development of nursing care policy programmes, evaluation and quality assurance criteria. For further development, studies are needed in similar and other settings.

  • 15.
    Lindblad, Christina
    et al.
    Institute of Health Care Pedagogics, Göteborg Univ. Swed. Armed Forces, Göta Logistic Regiment, S-541 29 Skövde, Sweden.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Battlefield emergency care: a study of nurses’ perspectives2005In: Accident and Emergency Nursing, ISSN 0965-2302, E-ISSN 1532-9267, Vol. 13, no 1, p. 29-35Article in journal (Refereed)
    Abstract [en]

    Recent implementation of modern armoured fighting vehicles in Swedish army forces has been substantial. In consequence, changes in the knowledge area of battlefield emergency care have been so large that a new professional competence is demanded. The aim of this study was to explore and describe how nurses perceive battlefield emergency care. A qualitative design was used comprising in-depth research interviews with 11 male registered nurses who all had been trained as company nurses in the Armed Forces. Three major themes were described; Unpredictable and invisible, a contextual leadership and assimilation acts. From the first major theme, the characteristic of battlefield emergency care is that it is unpredictable and invisible with the subthemes: menacing, unknown, challenging and complicated. From the next major theme, that a contextual leadership is important to have, with the subthemes: field manners, responsibility capacity and capacity to determine. The third major theme assimilation acts with the subthemes: experience from combat casualty care, education, working experience and by utilizing research findings.

    If we are to be able to offer patients individualised and qualitatively good professional care, emergency care must be conducted on the basis of scientific and well-tried experience.

  • 16. Lundberg, Dag
    et al.
    Axelsson, Susanna
    Boivie, Jörgen
    Eckerlund, Ingemar
    Gerdle, Björn
    Gullacksen, Ann-Christine
    Johansson, Eva
    Kristiansson, Marianne
    List, Thomas
    Mannheimer, Clas
    Marké, Lars-Åke
    Olsson, Gunnar L.
    Segerdahl, Märta
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Svensson, Åsa
    Söderlund, Anne
    Willman, Ania
    Metoder för behandling av långvarig smärta: En systematisk litteraturöversikt2006Report (Other academic)
  • 17.
    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.

  • 18.
    Sahlsten, Monika J. M.
    et al.
    University of Skövde, School of Life Sciences.
    Larsson, Inga E.
    Univ West, Dept Nursing Hlth & Culture, Trollhattan, Sweden .
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Plos, Kaety A. E.
    Gothenburg Univ, Sahlgrenska Acad, Inst Hlth & Care Sci, Gothenburg, Sweden.
    Nurse strategies for optimising patient participation in nursing care2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 3, p. 490-497Article in journal (Refereed)
    Abstract [en]

    The study's rationale: Patient participation is an essential factor in nursing care and medical treatment and a legal right in many countries. Despite this, patients have experienced insufficient participation, inattention and neglect regarding their problems and may respond with dependence, passivity or taciturnity. Accordingly, nurses strategies for optimising patient participation in nursing care is an important question for the nursing profession. Aim and objective: The aim was to explore Registered Nurses' strategies to stimulate and optimise patient participation in nursing care. The objective was to identify ward nurses' supporting practices. Methodological design and justification: A qualitative research approach was applied. Three focus groups with experienced Registered Nurses providing inpatient somatic care (n = 16) were carried out. These nurses were recruited from three hospitals in West Sweden. The data were analysed using content analysis technique. Ethical issues and approval: The ethics of scientific work was adhered to. According to national Swedish legislation, no formal permit from an ethics committee was required. The participants gave informed consent after verbal and written information. Results: Nurse strategies for optimising patient participation in nursing care were identified as three categories: 'Building close co-operation', 'Getting to know the person' and 'Reinforcing self-care capacity' and their 10 subcategories. Conclusions: The strategies point to a process of emancipation of the patient's potential by finding his/her own inherent knowledge, values, motivation and goals and linking these to actions. Nurses need to strive for guiding the patient towards attaining meaningful experiences, discoveries, learning and development. The strategies are important and useful to balance the asymmetry in the nurse-patient relationship in daily nursing practice and also in quality assurance to evaluate and improve patient participation and in education. However, further verification of the findings is recommended by means of replication or other studies in different clinical settings.

  • 19.
    Sahlsten, Monika
    et al.
    Institute of Health and Care Sciences, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Larsson, Inga E.
    Institute of Health and Care Sciences, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden / Department of Nursing, Health and Culture, University West, Trollhättan, Sweden.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Plos, Kaety A. E.
    Institute of Health and Care Sciences, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    An Analysis of the Concept of Patient Participation2008In: Nursing Forum, ISSN 1744-6198, Vol. 43, no 1, p. 2-11Article in journal (Refereed)
    Abstract [en]

    The concept of patient participation has an array of interpretations and lacks clarity. The purpose of this article is to explore the concept of patient participation within the context of nursing practice. The method described by Walker and Avant (1995) is used. The critical attributes of the concept are identified. Formation of model, borderline, and contrary cases exemplifies key characteristics. Antecedents, consequences, and empirical referents presented allow for further refinement of the key attributes defining the concept. Patient participation in nursing practice can be defined as an established relationship between nurse and patient, a surrendering of some power or control by the nurse, shared information and knowledge, and active engagement together in intellectual and/or physical activities.

  • 20.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    A meta-analysis of qualitative research on patients´experiences of chronic pain2006In: HTAi 2006 - 3rd Annual Meeting Health Technology Assessment International, 2006, p. 72-73Conference paper (Refereed)
  • 21.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Patienters erfarenheter av långvarig smärta: En systematisk litteraturöversikt2005Report (Other academic)
  • 22.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Patient’s experiences of long term pain in relation to Kim’s domains of nursing2004In: Kim’s Nursing Domains: Application to Pain, 2004Chapter in book (Other academic)
  • 23.
    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.

  • 24.
    Wickström Ene, Kerstin
    et al.
    The Sahlgrenska Acedemy at Göteborg University, Institute of Health and Care Sciences, Gothenburg, Sweden / Departments of Anesthesiology and Intensive Care, Sahlgrenska University, Sweden.
    Nordberg, Gunnar
    Departments of Anesthesiology and Intensive Care, Sahlgrenska University, Sweden.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Bergh, Ingrid
    The Sahlgrenska Acedemy at Göteborg University, Institute of Health and Care Sciences, Gothenburg, Sweden.
    Prediction of postoperative pain after radical prostatectomy2008In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 7, no 14Article in journal (Refereed)
    Abstract [en]

    Background: There is a belief that the amount of pain perceived is merely directly proportional to the extent of injury. The intensity of postoperative pain is however influenced by multiple factors aside from the extent of trauma.The purpose of the study was to evaluate the relationship between preoperative factors that have been shown to predict postoperative pain and the self- reports of pain intensity in a population of 155 men undergoing radical prostatectomy (RP), and also to investigate if previous pain score could predict the subsequent pain score.Methods: The correlation between potential pain predictors and the postoperative pain experiences during three postoperative days was tested (Pitmans´ test). By use of a logistic regression analysis the probability that a Visual Analogue Scale (VAS) score at one occasion would exceed 30mm or 70mm was studied, depending on previous VAS score, age, depression and pain treatment method.Results: Age was found to be a predictor of VAS >30mm, with younger patients at higher risk for pain, and preoperative depression predicted VAS >70mm. The probability that VAS would exceed 30mm and 70mm was predicted only by previous VAS value. Day two however, patients with epidural analgesia were at higher risk for experiencing pain than patients with intrathecal or systemic opioid analgesia.Conclusion: The results show that it would be meaningful to identify RP patients at high risk for severe postoperative pain; i.e. younger and/or depressive patients who might benefit from a more aggressive therapy instituted in the very early postoperative period.

     

     

     

     

     

  • 25.
    Wickström-Ene, Kerstin
    et al.
    Sahlgrenska Academy, Gothenburg University, Institution of Health and Care Sciences, Gothenburg, Sweden / Departments of Anaesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Nordberg, Gunnar
    Departments of Anaesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Gaston-johansson, Fannie
    Johns Hopkins University, School of Nursing, Baltimore, MD, United States.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Pain, psychological distress and health-related quality of life at baseline and 3 months after radical prostatectomy2006In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 5, p. Article number 8-Article in journal (Refereed)
    Abstract [en]

    Background

    Inadequate management of postoperative pain is common, and postoperative pain is a risk factor for prolonged pain. In addition to medical and technical factors, psychological factors may also influence the experience of postoperative pain.

    Methods

    Pain was measured postoperatively at 24, 48, and 72 hr in hospital and after 3 months at home in 140 patients undergoing radical prostatectomy (RP). Patients answered questionnaires about anxiety and depression (HAD scale) and health-related quality of life (SF-36) at baseline and 3 months after surgery.

    Results

    In the first 3 postoperative days, mild pain was reported by 45 patients (32%), moderate pain by 64 (45%), and severe pain by 31 (22%) on one or more days. High postoperative pain scores were correlated with length of hospital stay and with high pain scores at home. Forty patients (29%) reported moderate (n = 35) or severe (n = 5) pain after discharge from hospital. Patients who experienced anxiety and depression preoperatively had higher postoperative pain scores and remained anxious and depressed 3 months after surgery. The scores for the physical domains in the SF-36 were decreased, while the mental health scores were increased at 3 months. Anxiety and depression were negatively correlated with all domains of the SF-36.

    Conclusion

    There is a need for nurses to be aware of the psychological status of RP patients and its impact upon patients' experience of postoperative pain and recovery. The ability to identify patients with psychological distress and to target interventions is an important goal for future research.

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