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  • 1.
    Aitken, Leanne M.
    et al.
    School of Nursing & Midwifery & NHMRC Centre of Research Excellence in Nursing (NCREN), Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University.
    Castillo, Maria I.
    School of Nursing & Midwifery & NHMRC Centre of Research Excellence in Nursing (NCREN), Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University.
    Ullman, Amanda
    School of Nursing & Midwifery & NHMRC Centre of Research Excellence in Nursing (NCREN), Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Cunningham, Kathryn
    Population Health Sciences, Medical Research Institute, University of Dundee.
    Rattray, Janice
    Population Health Sciences, Medical Research Institute, University of Dundee.
    What is the relationship between elements of ICU treatment and memories after discharge in adult ICU survivors?2016In: Australian Critical Care, ISSN 1036-7314, E-ISSN 1878-1721, Vol. 29, no 1, p. 5-14Article in journal (Refereed)
    Abstract [en]

    ObjectivesPatients admitted to an intensive care unit (ICU) often experience distressing memories during recovery that have been associated with poor psychological and cognitive outcomes. The aim of this literature review was to synthesise the literature reporting on relationships between elements of ICU treatment and memories after discharge in adult ICU survivors.Review method usedIntegrative review methods were used to systematically search, select, extract, appraise and summarise current knowledge from the available research and identify gaps in the literature.Data sourcesThe following electronic databases were systematically searched: PubMed, Ovid EMBASE, EBSCOhost CINAHL, PsycINFO and Cochrane Central Register of Controlled Trials. Additional studies were identified through searches of bibliographies. Original quantitative research articles written in English that were published in peer-review journals were included.Review methodsData extracted from studies included authors, study aims, population, sample size and characteristics, methods, ICU treatments, ICU memory definitions, data collection strategies and findings. Study quality assessment was based on elements of the Critical Appraisal Skills Programme using the checklists developed for randomised controlled trials and cohort studies.ResultsFourteen articles containing data from 13 studies met the inclusion criteria and were included in the final analysis. The relatively limited evidence about the association between elements of ICU treatment and memories after ICU discharge suggest that deep sedation, corticoids and administration of glucose 50% due to hypoglycaemia contribute to the development of delusional memories and amnesia of ICU stay.ConclusionsThe body of literature on the relationship between elements of ICU treatment and memories after ICU discharge is small and at its early stages. Larger studies using rigorous study design are needed in order to evaluate the effects of different elements of ICU treatment on the development of memories of the ICU during recovery.

  • 2.
    Alerby, Eva
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Education, Language, and Teaching.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    ‘The pine tree, my good friend’: The other as more-than-human2021In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 22, no 4, article id e12366Article in journal (Refereed)
  • 3.
    Andersson, Gun
    et al.
    Enterostomal-therapist, Division of Surgery, Sunderby Hospital, Sunderbyn, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    A chance to live: Women's experiences of living with a colostomy after rectal cancer surgery2010In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 16, no 6, p. 603-608Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe women's experience of living with a colostomy after rectal cancer surgery. Interviews with five women about their experiences were subjected to thematic content analysis. The findings showed that receiving a cancer diagnosis gave rise to thoughts about life and death. For the women to feel comfortable, the information and health-care measures need to focus on supporting them through the entire process, also when the treatment is completed. After the surgery, the women adjusted to living with colostomy and carried on as before the cancer diagnosis, but they constantly worried about leakage or flatulence. The women were happy to have survived the cancer and this realization helped them to accept and have a good life with colostomy. In conclusion, women with colostomy because of rectal surgery need specific rehabilitation and nursing care that focuses on adjustment to temporary or permanent changes in life.

  • 4.
    Andersson, Maria
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Swedish Red Cross University College, Huddinge, Sweden.
    Fredholm, Angelica
    County Council Värmland, Karlstad, Sweden; Department of Health Science, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.
    Nordin, Anna
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Department of Health Science, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Moral Distress, Health and Intention to Leave: Critical Care Nurses’ Perceptions During COVID-19 Pandemic2023In: Sage Open Nursing, E-ISSN 2377-9608, Vol. 9Article in journal (Refereed)
    Abstract [en]

    Introduction: Moral distress increases the risk that critical care nurses will lose the ability to provide quality nursing care.

    Aims: To describe person-related conditions and perceptions of moral distress, health and intention to leave among critical care nurses in intensive care units, and to examine the relationship between person-related conditions, moral distress, health and intention to leave.

    Method: Cross-sectional, with 220 critical care nurses in 15 Swedish ICUs, and data gathered via a self-reported questionnaire.

    Results: Highest moral distress scores were reported in futile care and poor teamwork and 21% reported entertaining an intention to leave. Self-reported health was lower than before the COVID-19 pandemic and 4.1% reported pronounced exhaustion disorder. Self-reported health, reduced capacity to tolerate demands under time pressure, emotional instability or irritability, physical weakness, or being more easily fatigued and with decreased well-being were factors that had a relationship with futile care. Sleeping problems and intention to leave had a relationship with poor teamwork.

    Conclusions: Different strategies are needed to reduce moral distress and the leadership is crucial for managing crises such as the COVID-19 pandemic.

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  • 5.
    Andersson, Maria
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Nordin, Anna
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Critical care nurses’ experiences of working during the first phase of the COVID-19 pandemic –Applying the Person-centred Practice Framework2022In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 69, article id 103179Article in journal (Refereed)
    Abstract [en]

    Aim:

    The aim of the study was to deductively study person-centred care, based on critical care nurses’ experiences during the first phase of the covid-19 pandemic.

    Design:

    The study used a qualitative design.

    Method:

    Data collection was conducted as individual interviews and was analysed with qualitative content analysis with a deductive approach.

    Participants:

    Six critical care nurses working in a special covid-19 intensive care unit during the first phase of the pandemic participated.

    Findings:

    The findings are presented within the four domains of person-centred practice: the prerequisites, the care environment, person-centred processes and person-centred outcomes. While the ambition and knowledge about how to work in accordance with person-centred practice were high, there were several obstacles to perform it.

    Conclusion:

    We need to prepare ahead of time so that nurses have optimal organisational prerequisites to be able to work in accordance with person-centred practice, also during pandemics and other crisis, which means to be able to give nursing care in accordance with the ill person’s needs and resources.

  • 6.
    Andersson, Maria
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Swedish Red Cross University College, SE-141 21 Huddinge, Sweden.
    Nordin, Anna
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Critical care nurses’ perception of moral distress in intensive care during the COVID-19 pandemic – A pilot study2022In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 72, article id 103279Article in journal (Refereed)
    Abstract [en]

    Objectives: To describe critical care nurses’ perception of moral distress during the second year of the COVID-19 pandemic.

    Design/Methods: A cross-sectional study involving a questionnaire was conducted. Participants responded to the Italian version of the Moral Distress Scale-Revised, which consists of 14 items divided in dimensions Futile care (three items), Ethical misconduct (five items), Deceptive communication (three items) and Poor teamwork (three items). For each item, participants were also invited to write about their experiences and participants’ intention to leave a position now was measured by a dichotomous question. The data were analysed with descriptive statistics and qualitative content analysis. The study followed the checklist (CHERRIES) for reporting results of internet surveys.

    Setting: Critical care nurses (n = 71) working in Swedish adult intensive care units.

    Results: Critical care nurses experienced the intensity of moral distress as the highest when no one decided to withdraw ventilator support to a hopelessly ill person (Futile care), and when they had to assist another physician or nurse who provided incompetent care (Poor teamwork). Thirty-nine percent of critical care nurses were considering leaving their current position because of moral distress.

    Conclusions: During the COVID-19 pandemic, critical care nurses, due to their education and experience of intensive care nursing, assume tremendous responsibility for critically ill patients. Throughout, communication within the intensive care team seems to have a bearing on the degree of moral distress. Improvements in communication and teamwork are needed to reduce moral distress among critical care nurses.

  • 7.
    Andersson, Maria
    et al.
    Swedish Red Cross University College, SE-141 21 Huddinge, Sweden.
    Nordin, Anna
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden.
    Fredholm, Angelica
    Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden; Centre for Clinical Research, County Council of Värmland, Karlstad, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    The four domains of the person-centred practice framework from the perspective of critical care nurses in intensive care units during a pandemic2023In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 78, article id 103449Article in journal (Refereed)
  • 8.
    Andersson, Viktor
    et al.
    Surgery Department, Östersund Hospital, Sweden.
    Bergstrand, Josefine
    Surgery Department, Östersund Hospital, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing and Medical technology.
    Gustafsson, Silje
    Luleå University of Technology, Department of Health Sciences, Nursing and Medical technology.
    The Impact of Preoperative Patient Anxiety on Postoperative Anxiety and Quality of Recovery After Orthopaedic Surgery2020In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 35, no 3, p. 260-264Article in journal (Refereed)
    Abstract [en]

    Purpose

    To study how preoperative anxiety affects postoperative recovery in orthopaedic surgery based on two specific issues: does preoperative anxiety affect postoperative anxiety, pain, and nausea in the postanesthesia care unit (PACU) and does preoperative anxiety affect the quality of recovery.

    Design

    This was a nonexperimental quantitative observational study.

    Methods

    Patients (N = 37) were included through consecutive selection. Anxiety, pain, and nausea were measured preoperatively, 30 minutes after arrival at PACU and before discharge from PACU. Three days after discharge, participants completed the Quality of Recovery Questionnaire by telephone.

    Findings

    There was a significant correlation between preoperative anxiety and anxiety in PACU as well as anxiety, sadness, and depression 3 days after discharge from PACU.

    Conclusions

    Patients who experience preoperative anxiety also experience anxiety in PACU. The quality of recovery 3 days after surgery is also affected by preoperative anxiety. Patients experience continued anxiety as well as sadness and depression.

  • 9.
    Backman, Tess
    et al.
    Ambulance Care, Mora, Sweden.
    Juuso, Päivi
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Borg, Ronja
    Västerås Hospital, Region of Västmanland, Västerås, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Ambulance nurses' experiences of deciding a patient does not require ambulance care2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 3, p. 783-789Article in journal (Refereed)
    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.

  • 10.
    Berg Jansson, Anna
    et al.
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Humans and technology.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing and Medical technology.
    Parding, Karolina
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Humans and technology.
    What about learning? A study of temporary agency staffing and learning conditions in Swedish health care2020In: Journal of Workplace Learning, ISSN 1366-5626, E-ISSN 1758-7859, Vol. 32, no 1, p. 63-75Article in journal (Refereed)
    Abstract [en]

    Purpose

    The purpose of this paper is to discuss conditions for workplace learning (WPL) in relation to temporary agency staffing (TAS), focusing on temporary and regular nurses’ experiences of social relations.

    Design/methodology/approach

    Data were gathered using qualitative semi-structured interviews with five agency nurses and five regular nurses. Thematic analysis was used to analyse the data.

    Findings

    Similarities and differences regarding conditions for WPL among “temps” and “regulars” emerged, pointing towards both challenges and opportunities for WPL on various levels. Moreover, although challenges stood out, the context of professional work provides certain opportunities for WPL through, for example, knowledge sharing among nurses.

    Research limitations/implications

    Results are valid for the interviewees’ experiences of WPL conditions. However, the findings may also have currency in other but similar workplaces and employment circumstances.

    Practical implications

    Client organisations and temporary work agencies could benefit from developing management and HR strategies aimed at strengthening the opportunities for WPL, related to professional work, to ensure that these opportunities are leveraged fully.

    Originality/value

    This study adopts a WPL perspective on TAS in the context of professional work, which is still rare.

  • 11.
    Bergman, Maria
    et al.
    Division of Surgery, Sunderby Hospital.
    Stenudd, Monica
    Division of Surgery, Sunderby Hospital.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    The experience of being awake during orthopaedic surgery under regional anaesthesia2012In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 16, no 2, p. 88-96Article in journal (Refereed)
    Abstract [en]

    To undergo orthopaedic surgery and then return home the same day is becoming more common. People feel there are benefits with day surgery as it affects their daily life less than having to spend several days in hospital. The aim of this study was to describe people’s experience of being awake while undergoing orthopaedic surgery under regional anaesthesia. Ten people who had orthopaedic day surgery under regional anaesthesia participated; eight women and two men. Data were collected in personal, qualitative interviews and analysed using qualitative thematic content analysis. The analysis resulted in two themes and seven categories. The findings show that the staffs’ consideration and professionalism were significant for the participants’ wellbeing during surgery. The environment in the operating theatre ward is described as inspiring safety, calm and warmth. A good exchange of information between the person who will undergo orthopaedic surgery and the nurse does not depend primarily on how long they spend together; it is more about how they make contact with each other and how the nurse’s presence is experienced by the person.

  • 12.
    Boström, Madelene
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Magnusson, Klara
    ICU, Northern Älvsborgs County Hospital.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Nursing patients suffering from trauma: critical care nurses narrate their experiences2012In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 16, no 1, p. 21-29Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe critical care nurses' experiences of nursing patients suffering from trauma. Eight critical care nurses were interviewed. Qualitative thematic content analysis was applied to the data and resulted in one theme; 'Needing to feel in control and part of a team', with six categories; 'different ways of dealing with uncertainty', 'feelings of responsibility and security', 'wanting to relieve the pain', 'supporting the relatives', 'suppressing one's own feelings', and 'reflecting over one's work'. The findings show the importance of preparation for caring for a patient suffering from trauma. Standardized care of the patient according to Advanced Trauma Life Support was described as a good basis, but for the quality of care to be good this always had to be complemented with personal nursing care for the patient and care for their relatives. This study contributes knowledge about meeting critically ill patients suffering from trauma and suggestions about how to cope with thoughts that might arise after a serious situation in nursing care

  • 13.
    Bromfalk, Åsa
    et al.
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden.
    Hultin, Magnus
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden.
    Myrberg, Tomi
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine (Sunderbyn), Umeå University, Umeå, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Walldén, Jakob
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine (Sundsvall), Umeå University, Umeå, Sweden.
    Postoperative recovery in preschool‐aged children: A secondary analysis of a randomized controlled trial comparing premedication with midazolam, clonidine, and dexmedetomidine2023In: Pediatric Anaesthesia, ISSN 1155-5645, E-ISSN 1460-9592, Vol. 33, no 11, p. 962-972Article in journal (Refereed)
    Abstract [en]

    Background

    Preoperative anxiety in pediatric patients can worsen postoperative outcomes and delay discharge. Drugs aimed at reducing preoperative anxiety and facilitating postoperative recovery are available; however, their effects on postoperative recovery from propofol-remifentanil anesthesia have not been studied in preschool-aged children. Thus, we aimed to investigate the effects of three sedative premedications on postoperative recovery from total intravenous anesthesia in children aged 2–6 years.

    Methods

    In this prespecified secondary analysis of a double-blinded randomized trial, 90 children scheduled for ear, nose, and throat surgery were randomized (1:1:1) to receive sedative premedication: oral midazolam 0.5 mg/kg, oral clonidine 4 μg/kg, or intranasal dexmedetomidine 2 μg/kg. Using validated instruments, outcome measures including time for readiness to discharge from the postoperative care unit, postoperative sedation, emergence delirium, anxiety, pain, and nausea/vomiting were measured.

    Results

    After excluding eight children due to drug refusal or deviation from the protocol, 82 children were included in this study. No differences were found between the groups in terms of median time [interquartile range] to readiness for discharge (midazolam, 90 min [48]; clonidine, 80 min [46]; dexmedetomidine 100.5 min [42]). Compared to the midazolam group, logistic regression with a mixed model and repeated measures approach found no differences in sedation, less emergence delirium, and less pain in the dexmedetomidine group, and less anxiety in both clonidine and dexmedetomidine groups.

    Conclusions

    No statistical difference was observed in the postoperative recovery times between the premedication regimens. Compared with midazolam, dexmedetomidine was favorable in reducing both emergence delirium and pain in the postoperative care unit, and both clonidine and dexmedetomidine reduced anxiety in the postoperative care unit. Our results indicated that premedication with α2-agonists had a better recovery profile than short-acting benzodiazepines; although the overall recovery time in the postoperative care unit was not affected.

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  • 14.
    Bromfalk, Åsa
    et al.
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine (Sunderbyn), Umeå University, Umeå, Sweden.
    Myrberg, Tomi
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine (Sunderbyn), Umeå University, Umeå, Sweden.
    Walldén, Jakob
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine (Sundsvall), Umeå University, Umeå, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Hultin, Magnus
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden.
    Preoperative anxiety in preschool children: A randomized clinical trial comparing midazolam, clonidine, and dexmedetomidine2021In: Pediatric Anaesthesia, ISSN 1155-5645, E-ISSN 1460-9592, Vol. 31, no 11, p. 1225-1233Article in journal (Refereed)
    Abstract [en]

    Introduction: Anxiety in pediatric patients may challenge perioperative anesthesiology management and worsen postoperative outcomes. Sedative drugs aimed to reducing anxiety are available with different pharmacologic profiles, and there is no consensus on their effect or the best option for preschool children. In this study, we aimed to compare the effect of three different premedications on anxiety before anesthesia induction in preschool children aged 2−6 years scheduled for elective surgery. The secondary outcomes comprised distress during peripheral catheter (PVC) insertion, compliance at anesthesia induction, and level of sedation.

    Patients and methods: In this double-blinded randomized clinical trial, we enrolled 90 participants aged 2−6 years, who were scheduled for elective ear-, nose-and-throat surgery. The participants were randomly assigned to three groups: those who were administered 0.5 mg/kg oral midazolam, 4 µg/kg oral clonidine, or 2 µg/kg intranasal dexmedetomidine. Anxiety, distress during PVC insertion, compliance with mask during preoxygenation, and sedation were measured using the modified Yale Preoperative Anxiety Scale, Behavioral Distress Scale, Induction Compliance Checklist, and Ramsay Sedation Scale, respectively.

    Results: Six children who refused premedication were excluded, leaving 84 enrolled patients. At baseline, all groups had similar levels of preoperative anxiety and distress. During anesthesia preparation, anxiety was increased in the children who received clonidine and dexmedetomidine; however, it remained unaltered in the midazolam group. There were no differences in distress during PVC insertion or compliance at induction between the groups. The children in the clonidine and dexmedetomidine groups developed higher levels of sedation than those in the midazolam group.

    Conclusions: In preschool children, midazolam resulted in a more effective anxiolysis and less sedation compared to clonidine and dexmedetomidine.

  • 15.
    Bäckström, Marice
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Leijon-Sundqvist, Katarina
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Lundvall, Liselott
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Department of Radiology, Linköping University Hospital, Linköping, Sweden; Department of Radiology, Västerviks Hospital, Västervik, Sweden.
    Jonsson, K.
    Department of Nursing, Umeå University, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    On the edge of decision-making in trauma care: A focus group study on radiographers’ experiences of interprofessional collaboration2023In: Radiography, ISSN 1078-8174, E-ISSN 1532-2831, Vol. 29, no 6, p. 1123-1129Article in journal (Refereed)
    Abstract [en]

    Introduction: The temporary trauma teams in trauma alerts consist of a diverse group of unique professionals requiring interprofessional collaboration and coordination to achieve efficient, high-quality care. The uncertain situation and complex care environment impose high demands on team dynamics such as individual attitudes and team behaviours. Within interprofessional teams, interaction and coordination reflect the collective success of collaboration and the achievement of goals. Interactions with radiographers have increased in trauma teams given computed tomography's prominent role in providing crucial knowledge for decision-making in trauma care. This study aimed to explore radiographers' experiences of interprofessional collaboration during trauma alerts.

    Method: The study was designed with focus group methodology, including 17 radiographers participating in five focus groups, analysed with an inductive focus group analysis.

    Results: An overarching theme, “On the edge of decision-making”, emerged along with three sub-themes: “Feeling included requires acknowledgement”, “Exclusion precludes shared knowledge”, and “Experience and mutual awareness facilitate team interaction”.

    Conclusions: Interprofessional collaboration from the radiographer's perspective within trauma teams requires a sense of inclusion and the ability to interact with the team. Exclusion from vital decision-making obstructs radiographers' comprehension of situations and thereby the interdependence in interprofessional collaboration. Implications for practice: Common platforms are needed for knowledge sharing and team practices, including radiographers’ areas of responsibility and relational coordination to foster interprofessional relationships. Through these means interdependence through awareness and shared knowledge can be facilitated on trauma teams.

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  • 16.
    Clair, Cecilia
    et al.
    Department of Anesthesia, Trelleborg Hospital, Trelleborg, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing and Medical technology.
    Strömbäck, Ulrica
    Luleå University of Technology, Department of Health Sciences, Nursing and Medical technology.
    Strategies to Relieve Patients' Preoperative Anxiety Before Anesthesia: Experiences of Nurse Anesthetists2020In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 35, no 3, p. 314-320Article in journal (Refereed)
    Abstract [en]

    Purpose

    To investigate nurse anesthetists' experiences of strategies that alleviate adult patients' preoperative anxiety before anesthesia administration.

    Design

    The study has a qualitative approach wherein the data were collected through semistructured interviews. The study included interviews with six active nurse anesthetists with at least 5 years of experience who worked in a hospital in southern Sweden.

    Methods

    Critical incident technology was used to analyze the data.

    Findings

    Four different categories emerged: behavior of nurse anesthetist, preoperatively providing information, diverting attention to create security, and medicine as an alternative.

    Conclusions

    Awareness can increase the use of different strategies by both new and experienced nurse anesthetists, as well as by nurses in preoperative units, which in turn alleviates patient anxiety about anesthesia. This may result in a better perioperative experience for the patient.

  • 17.
    Dabija, Marius
    et al.
    Division of Surgery, Sollefteå Hospital, Sollefteå, Sweden.
    Fedog, Fredrik
    Division of Surgery-Anaesthesia, Stavanger University Hospital, Stavanger, Norway.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Gustafsson, Silje
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Difficult Airways: Key Factors for Successful Management2019In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 34, no 1, p. 151-159Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe anesthetic nurses’ experiences of key factors for thesuccessful management of difficult airways in adult patients.Design: This study had a qualitative observational and descriptive designfollowing the critical incident technique.Methods: Twelve experienced anesthetic nurses were interviewed.Findings: We identified five key factors for the successful management ofdifficult airways: identification of the difficult airway, creating a plan ofaction, remaining calm and focusing on the task, technical skills, and usingthe equipment. Identification of the difficult airway implies preassessmentwith standardized methods and actively observing for signsindicative of a difficult airway. Having all equipment available atbedside during induction and creating a backup plan increases the actionforce in unexpected situations. A calm and methodical work procedurefacilitates the management of the difficult airway as well as selectingtechniques and equipment according to the patient and situation.Conclusions: Reflective practice can aid the anesthetic nurse in drawingon experience and remaining calm in acute situations.

  • 18.
    Ednell, Anna-Karin
    et al.
    Intensive Care Unit, Gällivare Hospital.
    Siljegren, Sara
    Intensive Care Unit, Kiruna Hospital.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    The ICU Patient Diary: a Nursing Intervention that is Complicated in its Simplicity : a Qualitative Study2017In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 40, p. 70-76Article in journal (Refereed)
    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.

  • 19.
    Ejderlöf, Jennifer
    et al.
    Intensive Care Unit, Gällivare Hospital, Gällivare, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    The Helicopter Transports of Patients Critically ill with COVID-192022In: Sage Open Nursing, E-ISSN 2377-9608, Vol. 8, p. 1-10Article in journal (Refereed)
    Abstract [en]

    Objective

    The aim of our study was to describe specialist nurses’ experiences with the helicopter transport of patients critically ill with COVID-19.

    Method

    Our study followed a descriptive qualitative design anchored in the naturalistic paradigm and was based on qualitative content analysis. The study followed the consolidated criteria for reporting qualitative research.

    Results

    Six semi-structured interviews were conducted with specialist nurses who have cared for patients critically ill with COVID-19 during helicopter transport. The analysis of the interviews resulted in three themes—designing new routines before transport, working under new conditions and post-transport and reflections—with 11 categories. The goal of the intensive care transport of patients with COVID-19 was twofold: to prevent the spread of infection by using personal protective equipment and to prevent the contamination of the helicopter.

    Conclusion

    For the nurses, working in personal protective equipment created a feeling of distance from patients that compromised patient–nurse intimacy. Our results suggest that ensuring the sufficiency of equipment required in the event of major accidents and pandemics is critical.

  • 20.
    Ejneborn-Looi, Git-Marie
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    A self-destructive care: Self-reports of people who experienced coercive measures and their suggestions for alternatives2015In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 36, no 2, p. 96-103Article in journal (Refereed)
    Abstract [en]

    Coercive measures are commonly used as a method of intervention, despite insufficient evidence for their effectiveness and benefits. The aim of this study was to describe how people who self-harm perceive alternatives to coercive measures in relation to actual experiences of psychiatric care. A total of 19 self-reports have been analysed with qualitative content analysis, resulting in three categories: a wish for understanding instead of neglect; a wish for mutual relation instead of distrust; a wish for professionalism instead of a counterproductive care. In conclusion, if the caregivers can understand and collaborate with the patient, there is seldom any need for coercive measures

  • 21.
    Ejneborn-Looi, Git-Marie
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Easy but not simple: Nursing students’ descriptions of the process of care in a psychiatric context2016In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 1, p. 34-42Article in journal (Refereed)
    Abstract [en]

    The nurse-patient interaction is the cornerstone of psychiatric care, yet the concept “mental health nursing” is difficult to describe. This article aims to address this problem through the experiences of nursing students. Online journals from 14 nursing students were analyzed using qualitative content analysis, resulting in three categories: Trusting the Trusting Relationship, Voicing the Unspoken Needs, and Balancing the Dynamics of Doing and Being. This study demonstrates that providing nursing care based on trusting relationships is not a demanding task, but it takes place in a complex environment that has a tendency to make easy things complicated.

  • 22.
    Ekholm, Maria
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Patienters upplevelse av högteknologisk vårdmiljö2002In: Röret, ISSN 0283-9202, no 4, p. 12-15Article in journal (Other academic)
  • 23. Ekholm, Maria
    et al.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Patienters upplevelser av högteknologisk vårdmiljö2002In: Ventilen, ISSN 0348-6257, Vol. 27, no 4, p. 27-31Article in journal (Other academic)
  • 24. Ekholm, Maria
    et al.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Patienters upplevelser av högteknologisk vårdmiljö: en litteraturstudie2003In: Ventilen, ISSN 0348-6257, Vol. 15, no 4, p. 8-13Article in journal (Other academic)
  • 25.
    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 University of Technology, Department of Health Sciences, Nursing Care.
    Relatives' involvement in nursing care: a qualitative study describing critical care nurses' experiences2011In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 27, no 1, p. 1-9Article in journal (Refereed)
    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.

  • 26.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    3 frågor till...2013Other (Other (popular science, discussion, etc.))
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  • 27.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    A wish to be near: experiences of close relatives within intensive care from the perspective of close relatives, formerly critically ill people and critical care nurses2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this doctoral thesis was to describe the experiences of close relatives within intensive care, from the perspective of close relatives, formerly critically ill people and critical care nurses. Data were collected by means of qualitative research interviews with close relatives of people who had been critically ill and cared for in an intensive care unit (ICU) and with the people themselves. Data were also collected by means of focus-group discussions with critical care nurses. Collected data were analysed using qualitative thematic content analysis and phenomenological hermeneutic interpretation. This thesis reveals that it was a frightening experience for close relatives to see the person critically ill in an unknown environment. It was important to be able to be near the ill person. Showing respect for and confirming the dignity of the ill person were essential. The uncertainty concerning the outcome for the ill person was hard to manage. Close relatives wanted to feel hope, even though the prognosis was poor. The presence of close relatives was taken for granted by critical care nurses. Information from close relatives made it possible for critical care nurses to provide personal care for the critically ill person. Critical care nurses supported close relatives by giving them information and being near. Close relatives were described as an important but demanding part of the critical care nurses' work. People who had been critically ill had felt their close relatives' presence. Through the help of close relatives they felt they were understood and safe. Close relatives made it possible for them to do various things, which were appreciated, but they also engendered feelings of guilt. They realized their own, and the close relatives' significance, which gave them the power to continue the struggle. The possibility for people who had been critically ill, and their close relatives, to return together to the ICU for a follow-up visit after discharge and talk about what happened during and after their stay in the ICU was appreciated. Receiving explanations and being able to discuss one's experience were valuable. Meeting the ICU staff again enabled them to express their gratitude for their work, to give opinions about the care and to suggest improvements. This thesis shows that the critically ill person is the focus of close relatives' existence. The uncertainty of the time causes close relatives' suffering and they felt vulnerable. To be able to be close to the critically ill person, to be allowed to participate in and receive explanations about what was happening and why, to be met by dignity and to be able to keep hope alive are all prerequisites for enduring a radically changed everyday life which close relatives experience when someone they love is, or has been, critically ill. The crucial challenge is how these needs can be met by the staff of the ICU.

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  • 28.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Activity: Cardiovascular nursing on the front line of care, ambulance nurses' experiences2012Conference paper (Other (popular science, discussion, etc.))
  • 29.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Activity: Close relatives’ experiences of transitions when living with a person with traumatic brain injury2011Conference paper (Other (popular science, discussion, etc.))
  • 30.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Activity: Follow up visits to an ICU: Critical care nurses’ experiences2011Conference paper (Other (popular science, discussion, etc.))
  • 31.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Activity: Life Style Health Coaching2012Conference paper (Other (popular science, discussion, etc.))
    Abstract [en]

    Life Style Health Coaching is an eHealth project using telecare to motivate and inspire overweight people withrisk factors to improve their lifestyle and increase their well-being. About 230 people are in the project andthey have all received individual programs. With the help of a personal health diary their progress can be followedand discussed with their health coach who contacts them regularly. Tips and reminders are sent by emailand sms. The project will continue for one year and includes measurements of the effects and experiences.

  • 32.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Activity: Nursing mothers in an ICU after complicated childbirth2014Conference paper (Other (popular science, discussion, etc.))
  • 33.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Activity: Patient-Nurse relationship in ICU pain management2013Conference paper (Other (popular science, discussion, etc.))
  • 34.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Activity: Relatives’ experiences of ICU care2013Conference paper (Other (popular science, discussion, etc.))
  • 35.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Activity: Spouses' experiences of their partners being cared for in an intensive care unit2005Conference paper (Other (popular science, discussion, etc.))
  • 36.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Activity: What is the relationship between elements of ICU treatment and memories after discharge in adult ICU survivors?2015Conference paper (Other (popular science, discussion, etc.))
  • 37.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Allt kretsar kring den som är sjuk: Åsa Engström forskar som hur det är att vara närstående2006Other (Other (popular science, discussion, etc.))
  • 38.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Att vara närstående till en person som vårdats på en intensivvårdsavdelning2005Conference paper (Other (popular science, discussion, etc.))
  • 39.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Dagboken: en hjälp för IVA-patienten2011Other (Other (popular science, discussion, etc.))
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  • 40.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: De anhöriga: länken mellan personalen och de svårt sjuka2004Other (Other (popular science, discussion, etc.))
  • 41.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Få kraft genom bekräftelse: närståendes betydelse för personer inom intensivvård2008Conference paper (Other (popular science, discussion, etc.))
  • 42.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Intensivvårdssjuksköterskors upplevelser av närstående inom intensivvård2005Conference paper (Other (popular science, discussion, etc.))
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  • 43.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Livsstil och livsstilsförändringar2013Conference paper (Other (popular science, discussion, etc.))
    Abstract [sv]

    Vad är ett hälsosamt liv och vad krävs för att förbättra sin livsstil?Åsa Engström, biträdande professor i omvårdnad vid Luleå tekniska universitetoch Anna-Maria Ek, projektledare vid Health Solution, berättar om ett gemensamtprojekt. Syftet har varit att testa om om livscoachning via telefon, kombineratmed stöd via webb, kan bidra till förbättrade levnadsvanor hos personer medförhöjt BMI. Vilka resultat visar projektet och vilka erfarenheter har deltagarnaav att genomföra en livsstilsförändring?

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  • 44.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Member on International Advisory Board of Intensive & Critical Care Nursing2014Other (Other (popular science, discussion, etc.))
  • 45.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Närstående inom intensivvård2005Conference paper (Other (popular science, discussion, etc.))
  • 46.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Närstående inom intensivvård: Att få styrka genom bekräftelse: innebörden av närstående för personer som varit svårt sjuka2007Conference paper (Other (popular science, discussion, etc.))
  • 47.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Närstående inom intensivvård från intensivvårdssjuksköterskors perspektiv2007Conference paper (Other (popular science, discussion, etc.))
  • 48.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Närstående till svårt sjuka personer inom intensivvård2006Conference paper (Other (popular science, discussion, etc.))
  • 49.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Ständig information dämpar närståendes ångest2005Other (Other (popular science, discussion, etc.))
  • 50.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Close relatives of critically ill persons in intensive and critical care: the experiences of close relatives and critical care nurses2006Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of the licentiate thesis was to describe close relatives of critically ill persons within intensive and critical care from the perspective of close relatives and of critical care nurses. The data were collected by means of qualitaive research interviews with seven partners of persons who had been critically ill and cared for in an intensive care unit, and with focus groups discussions with 24 critical care nurses. The data were then analysed using a qualitative thematic content analysis.This study shows it was a frightening experience to see the person critically ill in an unknown environment. It was important to be able to be present; nothing else mattered. Showing respect, confirming the integrity and dignity of the ill person were also essential. recieving support from family and friends was important, as were understanding what had happened, obtaining information and the way in which this was given. The uncertainty concerning the outcome of the ill person was hard to cope with. Close relatives wanted to feel hope, even though the prognosis was poor.The presence of close relatives was taken for granted by critical care nurses and ut was frustrating if the ill person did not have any. Information from close relatives made it possible for critical care nurses to create personal care for the critically ill person. Critical care nurses supported clsoe relatives by giving them information, being near and trying to establish good relationships with them.Close relatives were described as an important and demanding part of the critical care nurses' work something that took time and enegy to deal with, and the critical care nurses missed forums for discussions about the care given.The discussion of this study show the importance for close relatives to be near and advocate for the ill person. Feeling that staff care about the ill person and close relatives make close relatives to feel safe. Recieving explanations to understand what as happening is significant.

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