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Simonsson, J., Keijzer, K., Södereld, T. & Forsberg, A. (2020). Intensive critical care nurses' with limited experience: Experiences of caring for an organ donor during the donation process. Journal of Clinical Nursing, 29(9-10), 1614-1622
Open this publication in new window or tab >>Intensive critical care nurses' with limited experience: Experiences of caring for an organ donor during the donation process
2020 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 29, no 9-10, p. 1614-1622Article in journal (Refereed) Published
Abstract [en]

Objective

To describe how intensive critical care nurses, whose experience is limited, experience caring for an organ donor during the donation process.

Background

Intensive critical care nurses are involved in the care of organ donors and their relatives. This may be challenging and evoke a sense of providing an inhumane care. Few studies have explored how intensive critical care nurses whose experience is limited experience caring for an organ donor during the donation process.

Design

An interview study with an inductive qualitative approach was conducted. The study was reported according to COREQ guidelines.

Methods

This study was performed during 2019. Participants were intensive critical care nurses (n = 7) from different hospitals (n = 4) with <3 years of experience and involvement in the donation process at least once but no more than three times. Data were analysed using qualitative content analysis.

Findings

Five categories emerged: the donation process is emotionally challenging; supporting relatives is an essential but demanding task; a complex and multifaceted process involving a high level of responsibility; needing appropriate prerequisites in the form of education and collegial support; and providing a dignified care based on respect for the organ donor.

Conclusions

Having limited experience as an intensive critical care nurse may not automatically mean that caring for an organ donor is experienced as more challenging than it is for a more‐experienced colleague. However, certain intensive critical care nurses whose experience caring for an organ donor is limited found it to be highly demanding due to its complexity, specifically in regard to informing relatives of the loss of their loved one and providing them with support.

Relevance to clinical practice

Our study revealed a need for further education. This need could be met by simulation tasks during the specialist education in intensive critical care nursing, where primarily ethical aspects and strategies for meeting with and supporting relatives should be examined and practiced.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
donation process, intensive critical care nurses, limited experiences, organ donor, qualitative
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-77349 (URN)10.1111/jocn.15195 (DOI)000511503700001 ()31971283 (PubMedID)2-s2.0-85079145501 (Scopus ID)
Note

Validerad;2020;Nivå 2;2020-04-16 (alebob)

Available from: 2020-01-10 Created: 2020-01-10 Last updated: 2020-04-16Bibliographically approved
Eklund, I., Larsson, A.-S., Gustafsson, S. & Forsberg, A. (2020). Patients' Experiences of Pain and Postoperative Nausea and Vomiting in the Early Postoperative Period After an Elective Knee Arthroplasty. Journal of Perianesthesia Nursing
Open this publication in new window or tab >>Patients' Experiences of Pain and Postoperative Nausea and Vomiting in the Early Postoperative Period After an Elective Knee Arthroplasty
2020 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473Article in journal (Refereed) In press
Abstract [en]

Purpose

The aim of this study is to explore patients' experience of pain and postoperative nausea and vomiting (PONV) in the early postoperative period after knee arthroplasties.

Design

This is a retrospective cohort study with a quantitative approach. Data from patients registered in the Swedish Perioperative Registry were used. We used the Strenghtening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies.

Methods

Data were collected from patients (N = 439) undergoing knee arthroplasties. The analysis was performed with descriptive and analytic statistics.

Findings

The findings indicate that women experienced significantly higher levels of pain than men and suffered significantly more often from PONV. However, the relationship of postoperative pain and PONV was not significant. There was also no significance for the relationship among postoperative pain, PONV, and age.

Conclusions

Care needs to be sensitive to differences in experiencing pain and PONV depending on sex or gender bias, with a goal of increasing the equality in care.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
postoperative, pain, PONV, knee arthroplasty, sex
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-77115 (URN)10.1016/j.jopan.2019.11.010 (DOI)2-s2.0-85083659347 (Scopus ID)
Available from: 2019-12-09 Created: 2019-12-09 Last updated: 2020-05-05
Sandström, L., Engström, Å., Nilsson, C., Juuso, P. & Forsberg, A. (2020). Trauma patients' health-related quality of life and perceptions of care: A longitudial study based on data from the Swedish Trauma Registry. International Emergency Nursing, Article ID 100850.
Open this publication in new window or tab >>Trauma patients' health-related quality of life and perceptions of care: A longitudial study based on data from the Swedish Trauma Registry
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2020 (English)In: International Emergency Nursing, ISSN 1755-599X, article id 100850Article in journal (Refereed) Epub ahead of print
Place, publisher, year, edition, pages
Elsevier, 2020
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-73260 (URN)10.1016/j.ienj.2020.100850 (DOI)32245684 (PubMedID)2-s2.0-85082823678 (Scopus ID)
Note

Artikeln har tidigare förekommit som manuskript i avhandling.

Available from: 2019-03-19 Created: 2019-03-19 Last updated: 2020-04-22
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
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. & 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: 2019-12-06Bibliographically 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
Sandström, L. & Forsberg, A. (2018). Problems associated with performance of peripheral intravenous catheterization in relation to working experience. Journal of Vascular Nursing, 36(4), 196-202
Open this publication in new window or tab >>Problems associated with performance of peripheral intravenous catheterization in relation to working experience
2018 (English)In: Journal of Vascular Nursing, ISSN 1062-0303, E-ISSN 1532-6578, Vol. 36, no 4, p. 196-202Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to explore general registered nurses’ (RNs) assessments of problems associated with difficult peripheral intravenous catheterization (PIVC) depending on their years of working experience, that is, those who had worked 3 years or less and those who had worked more than 3 years. The design was a quantitative, nonexperimental, descriptive, and analytic survey. The participating RNs (n = 83) were divided into two groups according to the length of their working experience, and the analysis was performed using the SPSS, version 24, software. The RNs also had the opportunity to answer a free-text question related to the aim. The results showed that less experienced RNs assessed to a significantly higher extent that they lacked time, experience, and ability and that there was no blood return; however, they assessed that the peripheral venous catheters were in the vein. If critical care nurses had been requested for support earlier, this request was seen as a reason not to try PIVC at all because critical care nurses were assessed as more experienced and skilled. To develop the kind of effective problem-solving and clinical reasoning needed for practice, a supportive setting must be created throughout nursing education as well as after graduation. Further research should focus on the education needs associated with PIVC and seek to understand to what extent learning in clinical skill simulation laboratories is transferred to actions in the clinical setting.

Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-69465 (URN)10.1016/j.jvn.2018.06.002 (DOI)000450370900007 ()30458942 (PubMedID)2-s2.0-85049917096 (Scopus ID)
Note

Validerad;2018;Nivå 2;2018-11-23 (johcin)

Available from: 2018-06-13 Created: 2018-06-13 Last updated: 2019-01-10Bibliographically approved
Forsberg, A., Vikman, I., Välivaara, B.-M. & Engström, Å. (2017). Patients' perceptions of quality of care during the perioperative procedure. ACORN: The Journal of Perioperative Nursing in Australia, 30(3), 13-22
Open this publication in new window or tab >>Patients' perceptions of quality of care during the perioperative procedure
2017 (English)In: ACORN: The Journal of Perioperative Nursing in Australia, ISSN 1448-7535, Vol. 30, no 3, p. 13-22Article in journal (Refereed) Published
Abstract [en]

Purpose: To describe patients' perceptions of quality of care during the perioperative period and to identify areas for quality improvement. Design: A cross-sectional descriptive survey design was used. Method: The data was collected (N=170) using a questionnaire for perioperative care. The methods were descriptive statistics, reported as percentages, and a manifest content analysis of the free text. Finding: The areas identified for improvement were information and participation. The participants lacked knowledge, preferred to hand over decision making to the hospital staff, and indicated that having personalised information about the surgery and perioperative period was important. However, too detailed information before surgery could cause increased anxiety. Conclusions: This study indicates that participation and information needs in perioperative settings seem to be situation specific. In addition, these needs seem to be personal and surgery specific. Further studies are required to clarify the differences in the satisfaction and quality of care between groups of patients in the perioperative context.

Place, publisher, year, edition, pages
Australian College of Perioperative Nurses, 2017
National Category
Nursing Physiotherapy
Research subject
Nursing; Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-65770 (URN)10.26550/303/13.22 (DOI)2-s2.0-85030831854 (Scopus ID)
Available from: 2017-09-22 Created: 2017-09-22 Last updated: 2018-08-09Bibliographically approved
Forsberg, A. (2015). Patients' experiences of undergoing surgery: From vulnerability towards recovery -including a new, altered life (ed.). (Doctoral dissertation). Paper presented at . Luleå tekniska universitet
Open this publication in new window or tab >>Patients' experiences of undergoing surgery: From vulnerability towards recovery -including a new, altered life
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to explore patients’ experiences of undergoing surgery, including their perceptions of quality of care and recovery. A mixed methods design was used, and studies with qualitativemethods (I, II) and quantitative methods (III, IV, V) were performed. Data were collected through interviews with ten patients after gastric bypass surgery (I) and nine patients after lower limb fracture surgery (II) and weresubjected to qualitative content analysis. Data were also collected using two standardized questionnaires; The Quality from Patient’s Perspective (III) and Postoperative Recovery Profile (IV, V). A total of 170 orthopedicand general surgery patients participated in study III. In study IV and V, 180 patients participated. Accordingly, 170 of patients were the same in study III, IV and V. Data were analyzed by descriptive statistics (III, IV, V)and a manifest content analysis of the free-text answers (III) as well as with analytical statistics (IV, V). Prior to surgery, patients undergoing gastric bypass surgery (I) described a sense of inferiority related to their obesity. In the post-anesthesia care unit, patients felt both omitted and safe in the unknown environment and expressed needs to have the staff close by. Despite the information provided prior to surgery it was difficult toimagine one’s situation after homecoming, thus it was worth it so far and visions of a new life were described. Patients undergoing lower limb surgery (II) described feelings of helplessness when realizing the seriousness oftheir injury. The wait prior to surgery was strain, and patients needed orientation for the future. They remained awake during surgery and expressed feelings of vulnerability during this procedure. In the post-anesthesia careunit, patients expressed a need to have control and to feel safe in their new environment. Mobilizing and regaining their autonomy were struggles, and patients stated that their recovery was extended. The quality of theperioperative care was assessed as quite good (III). While undergoing a surgical procedure (III), the areas identified for improvement were information and participation. Patients preferred to hand over the decisionmakingto staff and indicated that having personalized information about their surgery was important. However, too detailed information before surgery could cause increased anxiety (III). After surgery, orthopedic patientswere substantially less recovered than general surgery patients (IV, V). Approximately two-thirds of orthopedic patients and half of general surgery patients perceived severe or moderate pain in the first occasion (day 1-4after surgery) (IV). Both the orthopedic and general surgery group showed a significant systematic change at a group level towards higher levels of recovery after one month compared with day 1-4 after surgery. The same patterns occurred regarding acute and elective surgery (V). Patients overall recovered better (IV, V) after a gastric bypass, than after other surgeries. Compared with the period prior to surgery; certain Gastric bypass patients felt after one month that they had improved (IV). The orthopedic groups assessed their psychologicalfunction as being impaired after one month compared with the first occasion (IV, V). The overall view of patients’ experiences of undergoing surgery (I-V) can be understood as a trajectory, from vulnerability towards recovery, including a new, altered life. Patients’ experiences and perceptions of the caregiven (I, II, III) are embedded within this trajectory. As a thread in this thesis, through all studies, patients expressed vulnerability in numerous ways. A progress towards recovery with regards to regaining preoperativelevels of dependence/independence could be concluded. Thus, for patients undergoing gastric bypass surgery, a view of a new, altered life after surgery was also discernible. While undergoing surgery, satisfaction with theprovision of information not necessarily include receiving as much and the most detailed information as possible; nevertheless, the need for information to a great extent is personal. The recovery-period for orthopedic patients is strain, and the support must be improved. In conclusion, the perioperative support may contain a standardized part, made-to-order to the general procedure commonly for all patients, such as information about the stay in the post anesthesia care unit. Moreover, the support should be person-centered, accounting for the patients’ expectations about the future but also tailored to the specific surgical procedure; with its limitations and possibilities. Then, patients in a realistic way would be strengthened towards recovery, including a new, altered life.

Place, publisher, year, edition, pages
Luleå tekniska universitet, 2015
Series
Doctoral thesis / Luleå University of Technology 1 jan 1997 → …, ISSN 1402-1544
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-18715 (URN)9fa90c82-3a4b-45ac-980d-677168df881d (Local ID)978-91-7583-268-5 (ISBN)978-91-7583-269-2 (ISBN)9fa90c82-3a4b-45ac-980d-677168df881d (Archive number)9fa90c82-3a4b-45ac-980d-677168df881d (OAI)
Note

Godkänd; 2015; 20150317 (angfor); Nedanstående person kommer att disputera för avläggande av filosofie doktorsexamen, Namn: Angelica Forsberg Ämne: Omvårdnad / Nursing Avhandling: Patients’ Experiences of Undergoing Surgery From Vulnerability Towards Recovery – Including a New, Altered Life Opponent: Professor Ewa Idvall Institutionen för vårdvetenskap Malmö högskola/Skånes universitetssjukhus Ordförande: Universitetslektor Agneta Larsson Institutionen för hälsovetenskap Luleå tekniska universitet Tid: Fredag den 24 april 2015, kl. 09.00 Plats: D770, Luleå tekniska universitet

Available from: 2016-09-29 Created: 2016-09-29 Last updated: 2017-11-24Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-4789-7006

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