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Backman, T., Juuso, P., Borg, R. & Engström, Å. (2019). Ambulance nurses’ experiences of deciding a patient does not require ambulance care. Nursing Open
Open this publication in new window or tab >>Ambulance nurses’ experiences of deciding a patient does not require ambulance care
2019 (English)In: Nursing Open, E-ISSN 2054-1058Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim: To describe ambulance nurses’ experience of deciding a patient does not require ambulance care.

Design:An inductive, empirical study with a qualitative approach.Methods: Data collection was conducted through semi‐structured interviews, and collected data were analysed with qualitative manifest content analysis. Data were collected during the spring 2017, and eight ambulance nurses participated.Results:The findings are presented in one main category, which is “Not very ill but a difficult decision” with totally three subcategories. The ambulance nurse's experi‐ence of making the assessment when the patient has no need for ambulance care is like walking the balance of slack line. This means that the assessment can be both easy and very difficult but something that definitely requires experience, knowledge and dedication.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
ambulance care, clinical decision‐making, patient safety, qualitative research, refusal of care
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-73270 (URN)10.1002/nop2.255 (DOI)
Available from: 2019-03-20 Created: 2019-03-20 Last updated: 2019-03-20
Gabrielsson, S., Engström, Å. & Gustafsson, S. (2019). Evaluating reflective practice groups in a mental health context: Swedish translation and psychometric evaluation of the clinical supervision evaluation questionnaire. BMC Nursing, 18, Article ID 2.
Open this publication in new window or tab >>Evaluating reflective practice groups in a mental health context: Swedish translation and psychometric evaluation of the clinical supervision evaluation questionnaire
2019 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 18, article id 2Article in journal (Refereed) Published
Abstract [en]

Background

Implementation of reflective practice groups in psychiatric and mental health contexts might improve the quality of care through promoting self-awareness, clinical insight, and facilitating stress management and team building. There is a need for valid and reliable instruments to test the outcomes of reflective practice groups in the mental health context. This study aimed to test the validity and reliability of the Swedish version of the Clinical Supervision Evaluation Questionnaire.

Methods

The instrument was translated from English to Swedish using a translation and back-translation procedure. Data for the calculation of content validity was collected from an expert group. Data for the reliability analysis was collected from rehabilitation assistants and ward managers participating in reflective practice groups (n = 20). Content validity was measured by computing a content validity index. Construct validity was assessed by calculating the corrected item-total correlation statistics. Reliability was evaluated by analysing the Cronbach’s alpha coefficient, the intraclass correlation coefficient and inter-item correlations.

Results

The content validity index for the scale as a whole was 0.94. Item-total correlations ranged between 0.23 and 0.81, and deletion of an item did not notably improve Cronbach’s alpha. Cronbach’s alpha for the scale was 0.89. The intraclass correlation coefficient for single measures was 0.35. The mean inter-item correlation was .37.

Conclusion

The Swedish version of the Supervision Evaluation Questionnaire has a degree of reliability and validity that is comparable to the original version in English, indicating that it can be used as an assessment of reflective practice groups in the mental health context.

Place, publisher, year, edition, pages
Biologisk institutt, 2019
Keywords
reflective practice, clinical supervision, mental health, psychometric evaluation
National Category
Nursing Psychiatry Social Sciences
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-72769 (URN)10.1186/s12912-019-0326-2 (DOI)000461656300001 ()
Note

Validerad;2019;Nivå 2;2019-02-11 (svasva)

Available from: 2019-02-02 Created: 2019-02-02 Last updated: 2019-04-11Bibliographically approved
Jobe, I., Lindberg, B. & Engström, Å. (2019). Perceptions of healthcare services and preference of factors related to care planning among active older persons. In: : . Paper presented at ICIC 19- 19th International Conference on Integrated Care.
Open this publication in new window or tab >>Perceptions of healthcare services and preference of factors related to care planning among active older persons
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Introduction

The care-planning process offers people active involvement in deciding, agreeing and owning how their care will be managed. It is intended to be a process of collaboration supported by the principles of person-centredness, partnership and empowerment. According to Swedish legislation, coordinated individual planning must occur for patients transferring to another level of care or when an individual, living in their own home, has the need of efforts from different welfare actors. Awareness of older peoples’ preferences regarding different factors related to the care-planning process may generate knowledge that can facilitate bridging the gaps between care recipients’ preferences and caregivers’ decisions during the care-planning process. The aim of the study was to explore active older persons’ perceptions of healthcare services and preferences of factors related to care planning.

Methods

A qualitative interpretive description framework was chosen for the study. Five focus-group were conducted with 40 members, aged between 70 to 88 years, from six different organizations and associations. Participants represent the growing older population in society that remains active for many years after retirement. The general principles of interpretative descriptions were used in the analysis.

Results

The results showed that the participants thought that many organizational changes that had been made had not improved healthcare services. The participants wanted more flexibility regarding decisions and the possibility to change them. Personal freedom and making choices independently were momentous. They worried about the lack of continuity and perceived that no one assumed overall responsibility. Overall, participants cared more about the quality of the interactions with personnel than about how services were organized. The majority of participants were not aware of the development of a coordinated individual plan. A new service of being able to access the coordinated individual plan on the Internet is offered. A majority of the participants did not have Internet access; they saw themselves as the generation between the old and new systems. They did not resist the new technology but stressed the importance of not excluding anyone.

Discussions

Older persons want their views and preferences to be taken into consideration, and they want to be actively engaged in the decision-making process and make decisions themselves. Older people’s lives have become more individualized with the rest of society, and this requires healthcare service solutions that are more tailored and include different options.

Conclusions

Older persons’ want to be active partners in healthcare and social services and they value a personal relation with the professional actor, easy access and well-coordinated and more personalized and flexible services. They value their independency and want to stay active as long as possible.

Lessons learned

Older persons value their independency and want to remain active and maintain functioning. Views of older people must be considered on different levels, from planning healthcare and social services to individualized care-planning processes.

Limitations

It is important to remember that older people are not a homogeneous group. The participants in this study are active in society and chose to participate. Majority of the participants had no previous experiences of the coordinated individual planning however, they can still have other experiences of healthcare and social services that influence their preferences, and made them participate in the study. Their views do not necessarily correspond with older persons’ views in general.

Suggestions for future research

More knowledge is needed about how individuals and their relatives experiences the Coordinated individual planning process.

National Category
Nursing
Identifiers
urn:nbn:se:ltu:diva-73468 (URN)
Conference
ICIC 19- 19th International Conference on Integrated Care
Available from: 2019-04-05 Created: 2019-04-05 Last updated: 2019-04-05
Engström, Å. & Forsberg, A. (2019). Peripheral intravenous catheter difficulty: A clinical survey of registered nurse and critical care nurse performance. Journal of Clinical Nursing, 28(3-4), 686-694, Article ID 15960276.
Open this publication in new window or tab >>Peripheral intravenous catheter difficulty: A clinical survey of registered nurse and critical care nurse performance
2019 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 3-4, p. 686-694, article id 15960276Article in journal (Refereed) Published
Abstract [en]

Objectives To describe the characteristics, problems and interventions associated with performing peripheral intravenous catheterisation in difficult situations when registered nurses need support from critical care nurses. Background Only a few studies have focused on peripheral intravenous catheterisation problems or interventions to promote success. There is limited research on the education, knowledge, confidence and skills of registered nurses associated with successful peripheral intravenous catheterisations. Design A descriptive cross‐sectional survey design was used. Results A total of 101 questionnaires were completed by critical care nurses (n = 32) and 92 by registered nurses (n = 83); the total number of participants was 115. The same critical care nurses and registered nurses could participate several times on different occasions. Statistical analyses were performed using descriptive statistics. The patterns differed in part between the registered nurses who needed support and the critical care nurses who provided the support. Both registered nurses and critical care nurses used ultrasound to a very low extent (2.2% vs. 1.0%). The registered nurses indicated to a significantly higher extent (p = 0.02) that the veins were invisible and that they had performed the optional interventions. The success rate for critical care nurses was considerably high (86.1%). The most common place for successful insertion was the wrist. Critical care nurses performed fewer interventions, and they informed the patients and assessed that the veins were fragile to a higher extent. Conclusions Superior nursing skills are required in order to adapt and assess specific situations related to peripheral intravenous catheterisation difficulties and to choose the adequate interventions. Young and newly graduated registered nurses should be offered individualised training during the post‐educational period on how to assess problems and perform peripheral intravenous catheterisations in specific difficult situations. Relevance to Clinical Practice Simulation is suggested for practical training in order to increase patient safety related to the performance of technical skills such as peripheral intravenous catheterisation.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
critical care nurses, interventions, performance, peripheral intravenous catheterisation, questionnaire, registered nurses
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-70682 (URN)10.1111/jocn.14668 (DOI)000455244400029 ()30178617 (PubMedID)2-s2.0-85053663197 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-01-25 (inah)

Available from: 2018-08-31 Created: 2018-08-31 Last updated: 2019-04-09Bibliographically approved
Strömbäck, U., Engström, Å. & Wälivaara, B.-M. (2019). Realising the seriousness – the experience of suffering a second myocardial infarction: A qualitative study. Intensive & Critical Care Nursing, 51, 1-6
Open this publication in new window or tab >>Realising the seriousness – the experience of suffering a second myocardial infarction: A qualitative study
2019 (English)In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 51, p. 1-6Article in journal (Refereed) Published
Abstract [en]

Objectives

The aim of this study was to describe people’s experiences of suffering a second myocardial infarction.

Research methodology

A descriptive qualitative design. Interviews were conducted with eight persons afflicted by two myocardial infarctions. Data were analysed with qualitative content analysis.

Findings

The analysis resulted in one theme and four categories. The theme was ‘Realising the seriousness’ and the categories were: 1) Knowledge from previous experience; 2) A wake-up call for lifestyle changes; 3) The future becomes unpredictable; 4) Trying to find balance in life. The participant’s previous experience contributed to a better understanding of the symptoms of myocardial infarction and how to act when suffering a second myocardial infarction. After their second myocardial infarction, the participants became really aware of the need to implement a healthier lifestyle, as doing so might avoid a third myocardial infarction. The risk of suffering or even dying due to yet another myocardial infarction felt more tangible after their second one.

Conclusion

A second myocardial infarction is a different event in comparison to the first one, which makes afflicted people realise the seriousness and importance of making life style changes. They are more affected both physically and psychologically.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Common sense model, Experience, Qualitative content analysis, Second myocardial infarction
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-71445 (URN)10.1016/j.iccn.2018.12.002 (DOI)30579827 (PubMedID)2-s2.0-85058654313 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-03-12 (inah)

Available from: 2018-11-05 Created: 2018-11-05 Last updated: 2019-03-12Bibliographically approved
Persson, A.-C., Engström, Å., Burström, O. & Juuso, P. (2019). Specialist Ambulance Nurses' Experiences of Births Before Arrival. International Emergency Nursing, 43, 45-49
Open this publication in new window or tab >>Specialist Ambulance Nurses' Experiences of Births Before Arrival
2019 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 43, p. 45-49Article in journal (Refereed) Published
Abstract [en]

Background

Working as an ambulance nurse means interacting with and caring for acutely ill and injured patients. It can even involve births before arrival to the hospital (BBA), which are rare but increasing due to the centralization of maternity wards.

Aim

This study describes the experiences of specialist ambulance nurses with BBA.

Method

A qualitative study was conducted, and nine specialist ambulance nurses who had assisted with one or more prehospital births were interviewed. Data were analysed with thematic content analysis.

Findings

The analysis revealed three categories that were compiled into a theme of feeling fright and exhilaration. The findings showed that BBA causes feelings of anxiety and stress. The experience is also associated with joy and relief when the baby is born. Childbirth is a situation for which specialist ambulance nurses feel less prepared, lack of knowledge, and wish for more education.

Conclusion

Specialist ambulance nurses face challenges in the pre-hospital care environment during BBA, with long distances, a lack of equipment aboard the ambulance, and no assistance from midwives. To feel secure in the complex role that is required when assisting with a BBA, specialist ambulance nurses should be given the opportunity to receive scenario training.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Specialist ambulance nurse, Prehospital birth, Birth before arrival, Experience, Nursing, Qualitative content analysis
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-70514 (URN)10.1016/j.ienj.2018.08.002 (DOI)000460680600008 ()2-s2.0-85052753074 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-03-20 (oliekm)

Available from: 2018-08-21 Created: 2018-08-21 Last updated: 2019-04-12Bibliographically approved
Forsberg, A. & Engström, Å. (2018). Critical care nurses'  experiences of performing successful peripheral intravenous catherisation i difficult situations. Journal of Vascular Nursing, 36(2), 64-70
Open this publication in new window or tab >>Critical care nurses'  experiences of performing successful peripheral intravenous catherisation i difficult situations
2018 (English)In: Journal of Vascular Nursing, ISSN 1062-0303, E-ISSN 1532-6578, Vol. 36, no 2, p. 64-70Article in journal (Refereed) Published
Abstract [en]

he aim of this study is to describe the experiences of critical care nurses (CCNs) when performing successful peripheral intravenous catheterization (PIVC) on adult inpatients in difficult situations. This study uses a descriptive design with a qualitative approach. Semistructured interviews were given to CCNs (n = 22) at a general central county hospital in northern Sweden. The interview text was analyzed with qualitative thematic content analysis. Three themes emerged: “releasing time and creating peace,” “feeling self-confidence in the role of expert nurse,” and “technical interventions promoting success.” CCNs stated that apart from experience, releasing enough time is the most crucial factor for a successful PIVC. They emphasized the importance of identifying the kinds of difficulties that may occur during the procedure, for example, fragile or/and invisible veins. CCNs explained that compared to when they were newly graduated, the difference in their approach nowadays has changed to using their hands more than their eyes and that they feel comfortable with bodily palpations. To further optimize PIVC performing skills, continued possibilities to train and learn in hospital settings are necessary, even after formal education has been completed.

Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-67788 (URN)10.1016/j.jvn.2018.02.002 (DOI)29747785 (PubMedID)
Note

Validerad;2018;Nivå 2;2018-05-09 (andbra)

Available from: 2018-02-28 Created: 2018-02-28 Last updated: 2018-06-13Bibliographically approved
Engström, Å., Rogmalm, K., Marklund, L. & Wälivaara, B.-M. (2018). Follow-up visit in an ICU: receiving a sense of coherence (ed.). Nursing in Critical Care, 23(6), 308-315
Open this publication in new window or tab >>Follow-up visit in an ICU: receiving a sense of coherence
2018 (English)In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 23, no 6, p. 308-315Article in journal (Refereed) Published
Abstract [en]

AimTo describe patients' experiences of a follow-up visit to an intensive care unit (ICU) after being critically ill and nursed there.BackgroundKnowledge about the follow-up visit needs to be developed, with the previously critically ill patient in focus.DesignQualitative descriptive.MethodSemi-structured interviews were conducted with nine patients and analysed using qualitative content analysis. The data collection occurred during spring 2014.FindingsDuring the follow-up visits in ICU, the relatives, the patient diary, and those who took part in the care contribute to fill memory gaps to create a picture and an explanation of the care period.ConclusionThe follow-up visit is an important tool in the patients' struggle to create a context and coherence from a missing or unreal time. The patient diary is essential to subsequently be able to relate to the period of care.Relevance to clinical practiceThe follow-up visit, together with a personal diary, after an ICU stay could be seen as significant for strengthening the patients' feeling of coherence and better health.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-6266 (URN)10.1111/nicc.12168 (DOI)000447157800006 ()25690677 (PubMedID)47780223-b8ed-45c0-b848-af3c920a3221 (Local ID)47780223-b8ed-45c0-b848-af3c920a3221 (Archive number)47780223-b8ed-45c0-b848-af3c920a3221 (OAI)
Note

Validerad;2018;Nivå 2;2018-10-16 (johcin)

Available from: 2016-09-29 Created: 2016-09-29 Last updated: 2018-11-22Bibliographically approved
Engström, Å. & Forsberg, A. (2018). Patients’ perceptions of short-term recovery after a gastric bypass. Journal of Perianesthesia Nursing, 33(5), 681-688
Open this publication in new window or tab >>Patients’ perceptions of short-term recovery after a gastric bypass
2018 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, no 5, p. 681-688Article in journal (Refereed) Published
Abstract [en]

Purpose

To explore gastric bypass patients' perceptions of their postoperative recovery over 1 month.

Design

A standardized questionnaire, the postoperative recovery profile, was used.

Methods

Postoperative recovery profile is a multi-item questionnaire for self-assessment of general postoperative recovery. Participants were patients who had undergone gastric bypass surgery (n = 39). The changes in recovery between 1 day and 1 month postsurgery were evaluated by a statistical method developed specifically for analyzing changes in paired ordered data over time.

Findings

Most of the symptoms and/or functions were significantly improved on a group level. The most marked improvement was to pain and sleeping difficulties followed by mobilization. In terms of the psychological items, the proportion of patients who indicated no problems was high at both endpoints. The items that deviated from the improvement pattern were appetite changes and gastrointestinal function which demonstrated a relatively high proportion of deterioration, and the individual variability was prominent.

Conclusions

There is a need for interventions to improve recovery on a group as well as an individual level.

Place, publisher, year, edition, pages
American Society of PeriAnesthesia Nurses, 2018
Keywords
bariatric, obese, postoperative care, questionnaire design, survey, statistics
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-63314 (URN)10.1016/j.jopan.2017.05.008 (DOI)000444879000016 ()30236576 (PubMedID)
Note

Validerad;2018;Nivå 2;2018-10-10 (svasva)

Available from: 2017-05-11 Created: 2017-05-11 Last updated: 2018-10-10Bibliographically approved
Forsberg, A., Vikman, I., Välivaara, B.-M. & Engström, Å. (2018). Patterns of changes in patients' postoperative recovery from a short-term perspective (ed.). Journal of Perianesthesia Nursing, 33(2), 188-199
Open this publication in new window or tab >>Patterns of changes in patients' postoperative recovery from a short-term perspective
2018 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, no 2, p. 188-199Article in journal (Refereed) Published
Abstract [en]

Purpose

To explore patterns of changes in patients' postoperative recovery over 1 month within different surgery groups.

Design

A quantitative longitudinal survey design was used.

Methods

A standardized questionnaire was used (N = 167 patients); the postoperative recovery profile for self-assessment of recovery. The postoperative recovery profile developed for hospitalized patients contains 17 items distributed over five dimensions: physical symptoms, physical function, psychological function, social function, and activity.

Findings

Overall, orthopaedic patients perceived a lower recovery than general surgery patients. All major surgery groups and subgroups except for joint replacement patients indicated significant systematic changes toward lower levels of problems. The orthopaedic patients assessed their psychological functioning as impaired, and the gastric bypass group was the most recovered.

Conclusions

The patients' expectations should be charted initially, and patients should be given realistic information to achieve a realistic hope for a good life in the future. A patient's recovery trajectory may not start after the surgery is completed. Rather, it has already commenced before surgery.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
recovery, changes, patterns, orthopaedic, general surgery, acute, elective
National Category
Nursing Physiotherapy
Research subject
Nursing; Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-6209 (URN)10.1016/j.jopan.2016.03.015 (DOI)000429206400011 ()2-s2.0-85016440739 (Scopus ID)467eea8e-597d-4be8-ba67-c88956f488e9 (Local ID)467eea8e-597d-4be8-ba67-c88956f488e9 (Archive number)467eea8e-597d-4be8-ba67-c88956f488e9 (OAI)
Note

Validerad;2018;Nivå 2;2018-04-06 (rokbeg)

Available from: 2016-09-29 Created: 2016-09-29 Last updated: 2018-04-26Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6244-6401

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