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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, 6(3), 783-789
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 2054-1058, Vol. 6, no 3, p. 783-789Article in journal (Refereed) Published
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)000476917700014 ()31367400 (PubMedID)2-s2.0-85069793633 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-08-20 (johcin)

Available from: 2019-03-20 Created: 2019-03-20 Last updated: 2019-08-22Bibliographically approved
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
Sandström, L., Nilsson, C., Engström, Å. & Juuso, P. (2019). Experiences of suffering multiple trauma: A qualitative study. Intensive & Critical Care Nursing, 54, 1-6
Open this publication in new window or tab >>Experiences of suffering multiple trauma: A qualitative study
2019 (English)In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 54, p. 1-6Article in journal (Refereed) Published
Abstract [en]

Objectives

In an effort to strengthen health care professionals’ ability to anticipate and address multiple trauma patients’ needs, this study aims to explore the experience of suffering from multiple trauma.

Design

This is a qualitative descriptive study. Nine interviews were analysed using content analysis.

Setting

The study included patients who had been registered in the Swedish Intensive Care registry [SIR] due to suffering multiple trauma.

Findings

The analysis revealed one theme, A detour in life, based on three sub-themes: (a) Feeling lost and not knowing what to expect, (b) Striving to get life back on track and (c) Dealing with ‘dead ends’ during rehabilitation. The theme showed that those who suffered multiple trauma did not know what to expect of their recovery and they expressed experiencing a lack of understanding and guidance from healthcare professionals. As it was important to focus on the present and find ways to move on in life, they sought for other ways to find direction in matters of rehabilitation and care.

Conclusions

A shared understanding is essential in order to define a person’s needs. By setting short-term goals and improving documentation, healthcare professionals across the trauma recovery continuum could more easily gain insight of their patients’ needs and address them with supportive guidance.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Life change events, Multiple trauma, Patient care planning, Qualitative research, Recovery, Wounds and Injuries
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-73259 (URN)10.1016/j.iccn.2019.07.006 (DOI)000483965500001 ()31351691 (PubMedID)
Note

Validerad;2019;Nivå 2;2019-09-24 (johcin)

Available from: 2019-03-19 Created: 2019-03-19 Last updated: 2019-09-24Bibliographically approved
Larson, F., Nyström, I., Gustafsson, S. & Engström, Å. (2019). Key Factors for Successful General Anesthesia of Obese Adult Patients. Journal of Perianesthesia Nursing, 34(5), 956-964
Open this publication in new window or tab >>Key Factors for Successful General Anesthesia of Obese Adult Patients
2019 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 34, no 5, p. 956-964Article in journal (Refereed) Published
Abstract [en]

Purpose

To study nurse anesthetists' experiences of key factors for successful airway management in general anesthesia of adult obese patients.

Design

The study was a qualitative observational study with a descriptive approach.

Methods

Eight semistructured interviews were conducted. Data were analyzed using the critical incident technique.

Findings

Five key factors for successful general anesthesia of adult obese patients were identified. These factors were preparing and planning the anesthesia, optimizing patient position, optimizing ventilation through proper preoxygenation and increasing positive end-expiratory pressure, quickly securing the airway, and working in teams.

Conclusions

Knowledge of key factors that facilitate and improve the anesthesia care of obese patients is important to provide safe and quality anesthesia to this patient group as obese patients often have small margins and urgent situations can quickly arise. This knowledge enables the nurse anesthetist to be one step ahead and to be ready to take action if complications occur.

DOI:10.1016/j.jopan.2019.01.009

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
obesity, general anesthesia, anesthesiologic nursing, critical incident technique
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-76231 (URN)10.1016/j.jopan.2019.01.009 (DOI)31151885 (PubMedID)
Note

Validerad;2019;Nivå 2;2019-10-03 (johcin)

Available from: 2019-10-03 Created: 2019-10-03 Last updated: 2019-11-20Bibliographically approved
Jobe, I., Engström, Å. & Lindberg, B. (2019). Knowledge and views about coordinated individual planning from the perspective of active older adults. Clinical Journal of Nursing Care and Practice, 3, 17-26
Open this publication in new window or tab >>Knowledge and views about coordinated individual planning from the perspective of active older adults
2019 (English)In: Clinical Journal of Nursing Care and Practice, ISSN 2639-9911, Vol. 3, p. 17-26Article in journal (Refereed) Published
Abstract [en]

Background Today’s older adults are often well informed and want to participate in decision-making processes. The coordinated individual planning process offers them active involvement in deciding and owning how their care will be managed.

Aim

The aim of the study was to explore active older adults’ knowledge and views regarding coordinated individual planning.

MethodsThe study has an exploratory inductive approach. Five focus-group discussions were conducted with 40 participants from different organizations and associations. A qualitative interpretive description framework was used, and the analysis resulted in four unique themes.

ResultsThe four themes resulting from the analysis are collaboration and continuity, participation and involvement in decision, individual need for support, and access to information and service. Collaboration between different levels of the healthcare system and between professionals is crucial. Older adults wanted to be participating actors in their healthcare. They worried about the lack of continuity and thought that services were not responsive or did not meet individuals’ needs.

ConclusionsOlder adults want their views and preferences to be taken into consideration, and they want to be actively engaged in the decision-making process regarding their care.

Place, publisher, year, edition, pages
Heighten Science, 2019
Keywords
older adults, care planning, coordinated individual planning, integrated care, interpretive description, qualitative research
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-74238 (URN)10.29328/journal.cjncp.1001012 (DOI)
Available from: 2019-06-07 Created: 2019-06-07 Last updated: 2019-06-17Bibliographically approved
Nord-Ljungquist, H., Engström, Å., Fridlund, B. & Elmqvist, C. (2019). Lone and lonely in a double ambivalence situation as experienced by callers while waiting for the ambulance in a rural environment. Scandinavian Journal of Caring Sciences
Open this publication in new window or tab >>Lone and lonely in a double ambivalence situation as experienced by callers while waiting for the ambulance in a rural environment
2019 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article, review/survey (Refereed) Epub ahead of print
Abstract [en]

Background

In a rural environment where distances and access to ambulance resources in people’s immediate area are limited, other responders like firefighters dispatched to perform a first aid before ambulance arrives in areas where a longer response time exists; an assignment called ‘While Waiting for the Ambulance’ (WWFA). Knowledge is limited about the experience from a caller’s perspective when a person has a life‐threatening condition needing emergency help and both firefighters in a WWFA assignment and ambulance staff are involved.

Aim

The aim of the study is to describe the emergency situation involving a WWFA assignment in a rural environment from the caller's perspective.

Method

A descriptive design using qualitative methodology with a reflective lifeworld research (RLR) approach was used for this study, including in‐depth interviews with eight callers.

Results

An emergency situation involving WWFA assignment in a rural environment mean a sense of being lone and lonely with a vulnerability in while waiting to hand over responsibility for the affected person. Ambivalence in several dimensions arises with simultaneous and conflicting emotions. A tension between powerlessness and power of action where the throw between doubt and hope are abrupt with a simultaneous pendulum between being in a chaos and in a calm.

Conclusion

A double ambivalence emerges between, on one hand feeling alone in the situation and having full control, on the other hand, with trust handing over the responsibility, thereby losing control. Contact with the emergency medical dispatcher becomes a saving lifeline to hold onto, and access to emergency help in the immediate area of WWFA is valuable and important. Trust and confidence are experienced when callers are met with empathy, regardless of personal acquaintance with arriving responders.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
ambulance staff, caller, CPR, emergency medical dispatcher, emergency situation, firefighters, first aid, reflective lifeworld research, responder rural environment
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-76536 (URN)10.1111/scs.12767 (DOI)000492266600001 ()31614024 (PubMedID)
Available from: 2019-10-28 Created: 2019-10-28 Last updated: 2019-11-21
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. Ubiquity Press, 19, Article ID 360.
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.

Place, publisher, year, edition, pages
Ubiquity Press, 2019
Series
International Journal of Integrated Care, E-ISSN 1568-4156
Keywords
care-planning process, person-centredness, partnership, empowerment
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-73468 (URN)10.5334/ijic.s3360 (DOI)000493776000356 ()
Conference
ICIC 19- 19th International Conference on Integrated Care
Available from: 2019-04-05 Created: 2019-04-05 Last updated: 2019-11-22Bibliographically approved
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 ()30190223 (PubMedID)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: 2019-12-09Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6244-6401

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