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  • 1.
    Ednell, Anna-Karin
    et al.
    Intensive Care Unit, Gällivare Hospital.
    Siljegren, Sara
    Intensive Care Unit, Kiruna Hospital.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The ICU Patient Diary: a Nursing Intervention that is Complicated in its Simplicity : a Qualitative Study2017Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 40, s. 70-76Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Writing a diary for intensive care patients has been shown to facilitate patientrecovery and prevent post-traumatic stress following hospitalisation.

    Aim

    This study aimed to describe the experiences of critical care nurses’ (CCNs’) in writing personal diaries for ICU patients.

    Method

    The study was conducted with a qualitative design. Ten CCNs from two hospitals participated. Data were collected with semi-structured interviews and analysed using a qualitative thematic content analysis.

    Findings

    The result consists of a theme: Patient diary: a complex nursing intervention in all its simplicity, as well as four categories: Writing informatively and with awareness shows respect and consideration; The diary is important for both patient and CCN; To jointly create an organisation that facilitates and develops the writing; Relatives’ involvement in the diary is a matter of course.

    Conclusion

    CCNs are aware of the diary’s importance for the patient and relatives, but experience difficulties in deciding which patients should get this intervention and how to prioritize it. Writing a personal diary for an ICU patient is a nursing intervention that is complicated in its simplicity.

  • 2.
    Engström, Birgitta
    et al.
    Ambulance Care, Department of Health Care Centre, Pajala.
    Uusitalo, Anders
    Ambulance Care, Department of Health Care Centre, Pajala.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Relatives' involvement in nursing care: a qualitative study describing critical care nurses' experiences2011Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 27, nr 1, s. 1-9Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    ObjectivesWhen patients become critically ill it also affects their relatives. The aim of this study was to describe critical care nurses’ experience of relatives’ involvement in the nursing care of patients in an intensive care unitMethodSemi-structured personal interviews with eight critical care nurses in an intensive care unit in the northern part of Sweden were conducted during 2010. The interview texts were subjected to qualitative content analysis which resulted in the formulation of two main categories and five sub-categories.FindingsThe findings showed that relatives’ involvement was appreciated and seen as great resource for both patients and critical care nurses. Protecting the integrity of patients was one reason for limiting their involvement. The environment and lack of time were experienced as other obstacles to the involvement of relatives.ConclusionAligning the needs of the relatives to be involved in the care with the needs of the patient and the work situation of the nurses requires open communication between all three parties.

  • 3.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Andersson, Staffan
    Söderberg, Siv
    Re-visiting the ICU Experiences of follow-up visits to an ICU after discharge: a qualitative study2008Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 24, nr 4, s. 233-241Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study is to describe how people who have been critically ill, and their close relatives experience a post-discharge, follow-up visit to the intensive care unit (ICU) that provided the care. There is a lack of studies from such a standpoint. The study design is qualitative. A total of 18 adults participated; nine had been critically ill and nine were close relatives, all made a post-discharge follow-up visit to an ICU in the northern part of Sweden. The study data was collected through personal interviews, conducted after the follow-up visit, using a narrative approach. The data were then subjected to qualitative thematic content analysis which resulted in four themes: receiving strength from returning together; making sense of the critical-illness experience; feeling grateful to have survived and the possibility of improving the care. People who had been critically ill and close relatives felt that returning together was valuable. Meeting the staff, with whom participants felt they had developed a relationship, made it possible for them to express their gratitude for the treatment and nursing care received, and to suggest improvements. The interviews revealed that the follow-up visit was seen as an important way of learning what had happened and why during the period of critical illness.

  • 4.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nyström, Natalie
    ICU/Emergency Department, Kiruna Hospital.
    Sundelin, Gunilla
    Strömsund's Health Care Centre.
    Rattray, Janice
    School of Nursing and Midwifery, University of Dundee.
    People's experiences of being mechanically ventilated in an ICU: a qualitative study2013Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 29, nr 2, s. 88-95Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In previous studies people receiving mechanical ventilation treatment have described experiencing distress over their inability to speak and feelings such as anxiety. More research is needed to improve their experience in the intensive care unit and promote recovery. The aim of this study was to describe the intensive care unit experiences of people undergoing mechanical ventilation.MethodQualitative, personal interviews were conducted during 2011 with eight people who were mechanically ventilated in an intensive care unit in the northern part of Sweden. Interview transcripts were analysed using qualitative content analysis.FindingsTwo themes emerged, with four and three categories, respectively. Being dependent for survival on other people and technical medical equipment created a sense of being vulnerable in an anxious situation and a feeling of uncertainty about one's own capacity to breathe. Having lines and tubes in one's body was stressful. Being given a diary and follow-up visit to the intensive care unit after the stay were important tools for filling in the missing time, but there was also one participant who did not want to remember his stay in the intensive care unit.ConclusionTo be dependent on other people and technical medical equipment for survival creates a sense of being delivered into the hands of others, as the people being mechanically ventilated could not trust their body to function.

  • 5. Engström, Åsa
    et al.
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The experiences of partners of critically ill persons in an intensive care unit2004Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 20, nr 5, s. 299-310Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to describe partners' experiences when their spouses received care in an intensive care unit (ICU). Seven partners were interviewed using a narrative approach. The interview texts were subjected to qualitative thematic content analysis. The analysis resulted in three themes; being present, putting oneself in second place and living in uncertainty. It was a shocking experience for the partners to see their critically ill spouse in the ICU. It was important to be able to be present; nothing else mattered. Showing respect, confirming the integrity and dignity of their critically ill spouse were also essential for partners. Receiving support from family and friends was important, as were understanding and accepting what had happened, obtaining information and the way in which this was given. The state of uncertainty concerning the outcome for the critically ill person was difficult to cope with. The partners wanted to hope, even though the prognosis was poor

  • 6.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    From reaching the end of the road to a new lighter life: People's experiences of undergoing Gastric Bypass surgery2014Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, nr 2, s. 93-100Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    ObjectivesIt is limited research that focuses on people's experiences from prior to surgery to the postoperative period after a gastric bypass. The aim of this retrospective study was to describe people's experiences of undergoing gastric bypass surgery.MethodA qualitative approach was used. Interviews with ten participants were subjected to qualitative content analysis.ResultsThe analysis of the interviews resulted in one theme: from reaching the end of the road to a new lighter life. Prior to surgery participants described a sense of inferiority and that they were not able to ‘take any more’. Shortly after surgery participants felt both vulnerable and safe in the unknown environment and expressed needs of orientation and to have the staff close. Despite information prior to surgery it was difficult to imagine ones’ situation after homecoming, thus it was worth it so far.ConclusionThe care given in the acute postoperative phase for people who undergo gastric bypass surgery, should aim to provide predictability and management based on individual needs. Being treated with respect, receiving closeness, and that the information received prior to surgery complies with what then happens may facilitate postoperative recovery after a gastric bypass surgery.

  • 7.
    Gustavsson, Linda
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap. Department of Anaesthesia, Central Operation Ward, Sunderby Hospital.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyström, Cecilia
    Intensive Care Unit 57, Sunderby Hospital.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Sore throat in women after intubation with 6.5 or 7.0 mm endotracheal tube: a quantitative study2014Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, nr 6, s. 318-324Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Women experience more sore throats than men after endotracheal intubation.Aim: The aim of this study was to investigate the incidence of self-rated sore throat immediately,and 2—4 hours postoperatively, in women after elective gynaecological surgery under generalanaesthesia using an endotracheal tube (ETT) size 6.5 or 7.0 mm in inner diameter.Method: Eighty-two female participants who had undergone elective gynaecological surgeryparticipated, 44 and 38 were intubated with size 6.5 mm ETT and 7.0 mm ETT respectively.They estimated the occurrence of sore throat preoperatively and postoperatively, according toa 4-point Likert scale. Statistical data were analysed using the Package for Social Science (SPSS)19.Results: Sore throat was present in 29.5% of participants who were intubated with size 6.5 mmETT immediately postoperatively and in 39.5% of those who were intubated with size 7.0 mmETT.Conclusion: Nurses specialising in the supervision of daily care specific to the intubated patientshould note and alleviate sore throat as part of their nursing care.

  • 8.
    Jansson, Anna Berg
    et al.
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Arbetsvetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Working Together: Swedish Critical Care Nurses' Experiences of Temporary staffing within Swedish health care: a Qualitative Study2017Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 41, s. 3-10Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives

    The aim of this study is to describe critical care nurses (CCN’s) experiences of working with or as temporary agency staff.

    Research methodology

    This explorative qualitative study is based on interviews with five agency CCNs and five regular CCNs, a total of ten interviews, focusing on the interviewees’ experiences of daily work and temporary agency staffing. The interviews were analysed manually and thematically following an inductive approach.

    Findings

    Four themes that illustrate both similarities and differences between regular and temporary agency CCNs emerged: “working close to patients versus being responsible for everything”, “teamwork versus independence”, “both groups needed” and “opportunities and challenges”.

    Conclusion

    The study findings illustrate the complexity of the working situation for agency and regular staff in terms of the organisation and management of the temporary agency nurses and the opportunities and challenges faced by both groups.

  • 9.
    Sandström, Linda
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nilsson, Carina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Experiences of suffering multiple trauma: A qualitative study2019Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 54, s. 1-6Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 10.
    Sandström, Linda
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nilsson, Carina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Experiences of nursing patients suffering from trauma: preparing for the unexpected: a qualitative study2016Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 36, s. 58-65Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    SummarySettings and objectivesA midsize hospital in the north of Sweden with a high-tech intensive care unit and space for up to 10 patients, with an attached postoperative ward for up to 15 patients. The wards are manned by critical care nurses who are also responsible for carrying a trauma pager. When the alarm goes off, the critical care nurse leaves her/his duties and joins a trauma team. The aim of the study was to describe critical care nurse's experiences of nursing patients suffering from trauma.MethodA qualitative descriptive design was used. Data were collected through four focus group discussions with 15 critical care nurses analysed using qualitative content analysis.FindingsOne theme: Preparing for the unexpected with four subthemes: (1) Feeling competent, but sometimes inadequate; (2) Feeling unsatisfied with the care environment; (3) Feeling satisfied with well-functioning communication; and (4) Feeling a need to reflect when affected.ConclusionsNursing trauma patients require critical care nurses to be prepared for the unexpected. Two aspects of trauma care must be improved in order to fully address the challenges it poses: First, formal preparation and adequate resources must be invested to ensure delivery of quality trauma care. Secondly, follow-ups are needed to evaluate care measures and to give members of the trauma team the opportunity to address feelings of distress or concern.

  • 11.
    Strandberg, Sandra
    et al.
    Intensive Care Unit 57, Sunderby Hospital.
    Vesterlund, Lisa
    Intensive Care Unit 57, Sunderby Hospital.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The contents of a patient diary and its significance for persons cared for in an ICU: a qualitative study2018Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 45, s. 31-36Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives

    The aim of this study was to describe the contents of a patient diary and its significance for persons cared for in an ICU.

    Research Methodology

    An empirical study with a qualitative design. Eight telephone interviews and one face-to-face interview were conducted with nine persons previously been treated in an ICU and been given a patient diary. In addition, the person would have read his/her diary. The data have been analysed with qualitative content analysis.

    Findings

    The study identified one overarching theme; Gaining understanding, and four categories; The diary is written for me, Creating memories from the time of care, Who writes in the diary and, The ability to return to the diary. The diary meant that participants gained an understanding of their time in the ICU while they were critically ill and the diary was important to be able to return to.

    Conclusion

    What formerly critically ill patients appreciate most about the diary is that the diary is personally written, which makes them feel confirmed and valuable as a person. Guidelines for how and when a diary should be written and used would likely encourage critical care nurses and relatives to write in it.

  • 12.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Wälivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Realising the seriousness – the experience of suffering a second myocardial infarction: A qualitative study2019Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 51, s. 1-6Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 13.
    Tunlind, Adam
    et al.
    Intensive Care Unit, Sunderby Hospital.
    Granström, John
    Thoracal Intensive Care Unit, Karolinska Hospital, Stockholm.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nursing care in a high-technologica lenvironment: experiences of critical care nurses2015Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 31, nr 2, s. 116-123Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    SummaryObjectives: Management of technical equipment, such as ventilators, infusion pumps, monitorsand dialysis, makes health care in an intensive care setting more complex. Technology can bedefined as items, machinery and equipment that are connected to knowledge and managementto maximise efficiency. Technology is not only the equipment itself, but also the knowledge ofhow to use it and the ability to convert it into nursing care. The aim of this study is to describecritical care nurses’ experience of performing nursing care in a high technology healthcareenvironment.Research methodology: Qualitative, personal interviews were conducted during 2012 with eightcritical care nurses in the northern part of Sweden. Interview transcripts were analysed usingqualitative content analysis.Findings: Three themes with six categories emerged. The technology was described as a securitythat could facilitate nursing care, but also one that could sometimes present obstacles. Theimportance of using the clinical gaze was highlighted.Conclusion: Nursing care in a high technological environment must be seen as multi-facetedwhen it comes to how it affects CCNs’ experience. The advanced care conducted in an ICU couldnot function without high-tech equipment, nor could care operate without skilled interpersonalinteraction and maintenance of basal nursing. That technology is seen as a major tool andsimultaneously as a barrier to patient-centred care.

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