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  • 1.
    Nordin, Anna
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. Department of Health Science, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Strömbäck, Ulrica
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Andersson, Maria
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. Swedish Red Cross University College, Huddinge, Sweden.
    Close relatives' perspective of critical illness due to COVID-19: Keeping in touch at a distance2024Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 11, nr 1, artikkel-id e2068Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To elucidate the meaning of being a close relative of a critically ill person cared for in intensive care during the initial phase of the COVID-19 pandemic.

    Design: A narrative inquiry design following the COREQ guidelines.

    Methods: Individual interviews with fifteen close relatives of patients critically ill with COVID-19 were analysed using phenomenological hermeneutics.

    Results: The surreal existence of not being allowed to be near was emotionally difficult. While distancing due to restrictions was challenging, physicians' phone calls served as a connection to their relatives and brought a sense of security. Keeping notes helped them remember what happened and brought order to a chaotic situation.

    Conclusion: Close relatives feel secure when they receive regular information about their critically ill relative, not just when their condition worsens. They wish to be physically near to their critically ill person; when this is impossible, digital technology can provide support, but further accessibility developments are needed.

    Fulltekst (pdf)
    fulltext
  • 2.
    Pesämaa, Ossi
    et al.
    Luleå tekniska universitet, Institutionen för ekonomi, teknik, konst och samhälle, Industriell ekonomi.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Johansson, Jeaneth
    Luleå tekniska universitet, Institutionen för ekonomi, teknik, konst och samhälle, Industriell ekonomi.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    B2B procurement of alternative health services: An interview study of the ecosystem of key stakeholders2023Konferansepaper (Fagfellevurdert)
  • 3.
    Johansson, Gunilla
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Experiences of a nature-based intervention program in a northern natural setting: A longitudinal case study of two women with stress-related illness2023Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 18, nr 1, artikkel-id 2146857Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose

    This study explored the experiences of people with stress-related illness participating in a nature-based intervention programme in a northern natural setting.

    Methods

    A longitudinal case study was conducted with two women participating in a nature-based intervention programme on a farm. Data were collected by semi-structured interviews, diaries, rating scales, and self-assessment. Qualitative data were analysed by qualitative content analysis and quantitative data are presented descriptively.

    Results

    The theme of finding a source for recovery and well-being permeates all categories. The participants perceived the farm and nature to be a calming refuge; they learned to be in the present and could manage the tasks. In togetherness with each other and the facilitator on the farm they felt understood and confident, experienced joy, and found opportunities for change. They gained knowledge and positive memories and found new approaches in life. Self-assessment questionnaires indicated improvements of functioning in everyday life and reduced stress-related exhaustion at the end of the NBI programme.

    Conclusions

    Nature-based interventions lasting for a relatively short period seem to promote health and may be a complement to other treatments of stress-related illness. Further research is needed with a larger number of participants and in various natural settings.PurposeThis study explored the experiences of people with stress-related illness participating in a nature-based intervention programme in a northern natural setting.

    Fulltekst (pdf)
    fulltext
  • 4.
    Nordin, Anna
    et al.
    Karlstad University, Department of Health Science, Faculty of Health, Science and Technology, Karlstad, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Andersson, Maria
    Swedish Red Cross University, SE-141 21 Huddinge, Sweden.
    Fredholm, Angelica
    Karlstad University, Department of Health Science, Faculty of Health, Science and Technology, Karlstad, Sweden.
    Intensive Care Managers' Experiences of the COVID-19 Pandemic: A Dramatic Change of the Intensive Care Landscape2023Inngår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, artikkel-id 3052994Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. To describe intensive care managers' experiences of premises and resources of care in intensive care units during the COVID-19 pandemic.

    Background. Intensive care units (ICUs) were enormously pressured during the COVID-19 pandemic from many ill patients, requiring advanced care. Hospital and community volunteers increased staff strength. Obligatorily, recruitments were also conducted using transfer of staff from different hospital departments. However, there is little knowledge about intensive care managers' (ICMs) experiences of leadership during the COVID-19 pandemic.

    Methods. A qualitative descriptive study was conducted from March to April 2022. Semistructured interviews were held with 12 ICMs who were purposively sampled from the ICU in ten Swedish hospitals. Data were analysed using qualitative content analysis.

    Results. Two themes emerged: a dramatic change of the intensive care landscape and we could handle more than we thought, but at a steep price. Participants described that the ICUs had to perform extraordinary changes at a very fast pace, which initially created a sense of cohesion. Training and introduction to war-like conditions associated with uncertainty meant that ICMs had to support ICU staff in prioritising interventions. Participants described how ICUs stood strong against a pandemic, but stress, worries, and anxiety took a heavy toll on ICU staff and ICMs. The pandemic eroded the resilience in ICUs. Participants described a deterioration in health and said that sick leaves and resignations occurred.

    Conclusion. Our findings show ICMs' experiences as a field of tension between resources and demands, whereby the changes created a heavy burden that left intensive care weakened.

    Implications for Nursing Management. Findings emphasised the importance of creating working conditions using human resources and materials in order to rebuild resilience in intensive care with the ability to conduct safe patient care.

    Fulltekst (pdf)
    fulltext
  • 5.
    Nordin, Anna
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. Karlstad University, The Faculty of Health, Science and Technology, Department of Health Sciences, 651 88 Karlstad, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Fredholm, Angelica
    County Council of Värmland, Sweden; Karlstad University, The Faculty of Health, Science and Technology, Department of Health Sciences, 651 88 Karlstad, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Sweden.
    Persenius, Mona
    Karlstad University, The Faculty of Health, Science and Technology, Department of Health Sciences, 651 88 Karlstad, Sweden.
    Andersson, Maria
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. The Swedish Red Cross University College, Stockholm, Sweden.
    Measuring moral distress in Swedish intensive care: Psychometric and descriptive results2023Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 76, artikkel-id 103376Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To investigate the construct validity and psychometric properties of the Swedish version of the Moral Distress Scale–Revised and to describe moral distress in an intensive care context.

    Research Methodology/Design: The Italian Moral Distress Scale–Revised was translated and semantically adjusted to the Swedish intensive care context. A web survey with 14 moral distress items, as well as three additional and eight background questions was answered by critical care nurses (N = 71) working in intensive care units during the second year of the coronavirus disease pandemic. Inferential and descriptive statistics were used to investigate the Italian four-factor model and to examine critical care nurses’ moral distress.

    Results: The result shows a factor model of four components differing from the previous model. Critical care nurses demonstrated significant differences in moral distress regarding priorities compared to before the pandemic, type of household; experience as critical care nurses and whether they had supervised students during the pandemic.

    Conclusion: The component structure might have originated from the specific situation critical care nurses perceived during the pandemic. The health care organisations’ role in preventing and healing the effects of moral distress is important for managers to understand.

    Implications for clinical practice: Moral distress is common in intensive care and it is necessary to use valid instrument when measuring it. A psychometrical investigation of the Swedish version of the Moral Distress Scale–Revised, adapted for intensive care shows need for further semantic and cultural adaptation. Perceived priorities during the pandemic, household type, supervising during the pandemic and working experience were related to critical care nurses’ experience of moral distress and managers need to be aware of conditions that may trigger such a response.

    Fulltekst (pdf)
    fulltext
  • 6.
    Andersson, Maria
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. 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 tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. Department of Health Science, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Moral Distress, Health and Intention to Leave: Critical Care Nurses’ Perceptions During COVID-19 Pandemic2023Inngår i: Sage Open Nursing, E-ISSN 2377-9608, Vol. 9Artikkel i tidsskrift (Fagfellevurdert)
    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.

    Fulltekst (pdf)
    fulltext
  • 7.
    Bäckström, Marice
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Leijon-Sundqvist, Katarina
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Lundvall, Liselott
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. 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 tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    On the edge of decision-making in trauma care: A focus group study on radiographers’ experiences of interprofessional collaboration2023Inngår i: Radiography, ISSN 1078-8174, E-ISSN 1532-2831, Vol. 29, nr 6, s. 1123-1129Artikkel i tidsskrift (Fagfellevurdert)
    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.

    Fulltekst (pdf)
    fulltext
  • 8.
    Larsson, Fanny
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Strömbäck, Ulrica
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Gustafsson, Silje Rysst
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Perception of feeling safe perioperatively: a concept analysis2023Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 18, nr 1, artikkel-id 2216018Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose

    The purpose of this study was to explore the concept of feeling safe, from the patient perspective, in a perioperative context.

    Method

    The eight-step concept analysis approach proposed by Walker and Avant was utilized to examine the attributes of feeling safe. Uses of the concept, defining attributes as well as antecedents, consequences and empirical referents are presented to describe the concept. Case examples are provided in order to assist the understanding of the defining attributes.

    Results

    Feeling safe is defined as: a person that does not feel worried or threatened. Three attributes were identified: Participation, Control and Presence. Knowledge and Relationship are the antecedents of feeling safe, while Feeling Acknowledged and Trust are the consequences. Empirical referents are explored in order to find a way to measuring the perceived feeling of safety.

    Conclusion

    This concept analysis underscores the importance of including patients’ perceptions in traditional patient safety work. Patients who feel safe perceive that they participate in their care, that they are in control, and that they feel the presence of both healthcare staff and relatives. The perceived feeling of security could, by extension, promote the postoperative recovery of patients undergoing surgery by positively affect the process of recovery.

    Fulltekst (pdf)
    fulltext
  • 9.
    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 tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    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 dexmedetomidine2023Inngår i: Pediatric Anaesthesia, ISSN 1155-5645, E-ISSN 1460-9592, Vol. 33, nr 11, s. 962-972Artikkel i tidsskrift (Fagfellevurdert)
    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.

    Fulltekst (pdf)
    fulltext
  • 10.
    Johansson, Jeaneth
    et al.
    Luleå tekniska universitet, Institutionen för ekonomi, teknik, konst och samhälle, Industriell ekonomi. Högskolan i Halmstad, Halmstad, Sverige.
    Pesämaa, Ossi
    Luleå tekniska universitet, Institutionen för ekonomi, teknik, konst och samhälle, Industriell ekonomi.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Strukturella förutsättningar för landsbygdens entreprenörskap: Institutionella logiker och naturbaserade sociala innovationer2023Konferansepaper (Fagfellevurdert)
  • 11.
    Andersson, Maria
    et al.
    Swedish Red Cross University College, SE-141 21 Huddinge, Sweden.
    Nordin, Anna
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. 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 tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    The four domains of the person-centred practice framework from the perspective of critical care nurses in intensive care units during a pandemic2023Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 78, artikkel-id 103449Artikkel i tidsskrift (Fagfellevurdert)
  • 12.
    Jansson, Anna Berg
    et al.
    Luleå tekniska universitet, Institutionen för ekonomi, teknik, konst och samhälle, Människa och teknik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Conditions for Workplace Learning Among Professional ‘Temps’: A Qualitative Study of Temporary Agency Nurses in Sweden2022Inngår i: Vocations and Learning, ISSN 1874-785X, E-ISSN 1874-7868, Vol. 15, nr 1, s. 155-176Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Adopting a theoretical perspective that acknowledges both formal and informal learning as crucial and emphasises reproductive and developmental learning as complementary, this article analyses and discusses temporary agency nurses’ experiences of working and learning, focusing on conditions for workplace learning. This provides opportunities to address questions about conditions for the integration of work and learning in a work situation characterised by flexibilization and individualisation. More specifically, among individuals moving between different organizational contexts rather than working at ‘a’ (single and stable) workplace provided by the employer. By presenting findings based on a thematic analysis of 21 interviews with individual temporary agency nurses working in Swedish health care, both opportunities and challenges for workplace learning is highlighted. While opportunities for informal learning linked to the movement between various client organizations as well as to nursing as common ground and as valued and recognized competence, is identified, at the same time, challenges connected to both formal and informal learning, are also illuminated. Regarding informal learning, challenges in terms of varied and general support and feedback as well as scarce opportunities and low expectations for the temporary agency nurses’ participation in development work in daily work/at client organizations, is identified. The findings thus also illuminate a risk for temporary agency nurses adjusting to prevailing working conditions rather than engaging in developmental learning. Regarding formal learning, challenges in terms of few opportunities for planned learning activities, is identified. All in all, the findings illuminate conditions for workplace learning for temporary agency nurses as clearly dependent not only on the offers of specific temporary work agencies and client organisations, but also on temporary agency nurses’ interest in and views regarding responsibility for learning, and thus highly varying.

  • 13.
    Stenman, Lina
    et al.
    Critical Care Nurse, Skellefteå Hospital, Skellefteå, Sweden.
    Högberg, Lisa
    Critical Care Nurse, Lycksele Hospital, ICU, Lycksele, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Critical Care Nurses’ Experiences Caring for Patients When Relatives Were not Allowed in the ICUs due to COVID-19 Pandemic2022Inngår i: Sage Open Nursing, E-ISSN 2377-9608, Vol. 8, s. 1-10Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Health care workers faced new challenges during the COVID-19 pandemic when physical contact with relatives more or less disappeared.

    Objectives: The aim of this study is to describe the experiences of critical care nurses (CCNs) working in intensive care units (ICUs) under the visiting restrictions imposed as a result of COVID-19.

    Method: This study followed a qualitative design. The purposive sample included CCNs with at least 1 year of experience working in an ICU with a visiting policy affected by the pandemic. Data collection was carried out via semi-structured interviews and analyzed through a qualitative content analysis with an inductive approach.

    Results: The study results are presented in three categories with 10 subcategories. CCNs value the presence of patients’ relatives at the bedside and described many challenges when relatives could not be present with the patient during the pandemic.

    Conclusion: Close relatives are able to share essential information about the patients and provide much-needed emotional support to them, the relatives’ role is of central importance and CCNs value their presence in ICUs more than any positive consequences of them not being there.

  • 14.
    Andersson, Maria
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Nordin, Anna
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Critical care nurses’ experiences of working during the first phase of the COVID-19 pandemic –Applying the Person-centred Practice Framework2022Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 69, artikkel-id 103179Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 15.
    Andersson, Maria
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. Swedish Red Cross University College, SE-141 21 Huddinge, Sweden.
    Nordin, Anna
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Critical care nurses’ perception of moral distress in intensive care during the COVID-19 pandemic – A pilot study2022Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 72, artikkel-id 103279Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 16.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Fredholm, Angelica
    County Council, Värmland, Sweden; Department of Health Science, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.
    Nordin, Anna
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. Department of Health Science, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.
    Andersson, Maria
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. Swedish Red Cross University College, Huddinge, Sweden.
    Institutional Constraints as an Obstacle for Prioritizing Nursing Interventions During the COVID-19 Pandemic—Critical Care Nurses’ Experiences2022Inngår i: Sage Open Nursing, E-ISSN 2377-9608, Vol. 8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: The demands of the pandemic such as staff shortages and limited resources combined with new guidelines regarding infection control may have required the prioritizing of nursing interventions.

    Objectives: The aim of this study was to describe critical care nurses’ experiences of prioritizing nursing interventions for patients with COVID-19 in intensive care units (ICUs) during the pandemic.

    Method: A qualitative descriptive study was gathered from open-ended questions included in a cross-sectional online questionnaire. Characteristics were presented using descriptive statistics, and open-ended questions were analyzed using qualitative content analysis with an inductive approach. The study was conducted in Sweden and focused on critical care nurses working in ICUs during spring 2021 and the second year of the COVID-19 pandemic.

    Results: During the COVID-19 pandemic, 87% of the critical care nurses had provided orientations for new co-workers, and 52% had supervised intensive care nursing students. In all, 70 answered the question of whether they had prioritized nursing care differently during the pandemic; 86% reported that they had and 14% had not. The qualitative analysis resulted in one theme, Institutional constraints as an obstacle for nursing interventions, with three categories: Prioritizing lifesaving interventions, Performing nursing interventions less frequently, and Not able to provide the nursing care I wish to provide.

    Conclusion: Institutional constraints as an obstacle for nursing interventions is the overall theme. It illustrates how critical care nurses have been forced to prioritize, thereby not being able to provide the nursing interventions they wanted to do provide, and it describes their feelings in this situation. The nurses need recovery and possibilities for reflection. The organization must also recover and not only return to how it was before the pandemic but also to learn from recent events and take actions to reduce the long-term effects on staffing.

  • 17.
    Fredholm, Angelica
    et al.
    Centre for Clinical Research, County Council of Värmland, Karlstad, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Andersson, Maria
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Nordin, Anna
    Faculty of Health, Science, and Technology, Department of Health Science, Karlstad University, Karlstad, Sweden.
    Persenius, Mona
    Faculty of Health, Science, and Technology, Department of Health Science, Karlstad University, Karlstad, Sweden.
    Learning in intensive care during the COVID-19 pandemic - postgraduate critical care nursing students’ experiences2022Inngår i: International Journal of Medical Education, E-ISSN 2042-6372, Vol. 13, s. 335-344Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: This study explored postgraduate critical care nursing students’ experiences of learning in the ICU during the COVID-19 pandemic and to understand these experiences in relation to self-directed learning and professional development.

    Methods: An explorative qualitative design was used. Eight postgraduate critical care nursing students from two different universities were interviewed. Questions focused on learning, supervision, ethically difficult situations, issues regarding communication, as well as the impact of the pandemic on students’ health. Interviews thematically analyzed, and further analyzed using a theoretical framework focusing self-directed learning and professional development containing the concepts of autonomy, authenticity, and attachment.

    Results: The result consists of three themes: 1) Attachment with subthemes Attachment to the patient, Attachment to family and friends, Attachment to the ICU-context, and Attachment to the clinical supervisor.  2) Authenticity with subthemes Experiencing a varying degree of authenticity, Clinical reasoning about how to prioritize care. 3) Autonomy with subthemes Being just a student – with limited responsibility, taking responsibility, and having worries regarding one’s professional development.Conclusion: Findings show the need for participation in the ICU community of practice without the demands and responsibility of full participation. Students need to be given the opportunity to form a relationship with practice. For attachment, participation, and consequently professional development to take place, there is need for inviting students to be a part of the team even during such straining circumstances as an ongoing pandemic. These findings can advance the understanding of how to organize clinical education during future crisis such as a new pandemic.

    Fulltekst (pdf)
    fulltext
  • 18.
    Jacobzon, Anna
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Lindberg, Birgitta
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Gustafsson, Silje Rysst
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Mothers’ strategies for creating positive breastfeeding experiences: a critical incident study from Northern Sweden2022Inngår i: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 17, nr 1, artikkel-id 35Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Positive breastfeeding experiences positively influence subsequent attitudes towards breastfeeding, and increase mothers’ confidence, self-efficacy, motivation and intention to breastfeed. However, the strategies that mothers find useful and effective for creating positive breastfeeding experiences remain largely unknown. The aim of our study was thus to describe experience-based knowledge from mothers about strategies for creating positive breastfeeding experiences.

    Methods: The study followed a qualitative design involving the critical incident technique. Data were collected with an online survey containing open-ended questions that was administered to a Sweden-based parenting group on Facebook in September 2018. Ultimately, 340 incidents from 176 women were identified as offering strategies for creating positive breastfeeding experiences. Data from the written replies were extracted as textual units, condensed and categorised until categories were mutually exclusive, which resulted in six categories.

    Results: Participating women were on average 31.2 years old and the median number of children per participant was two. Mothers’ strategies for creating positive breastfeeding experiences generally included being calm and accepting that initiating breastfeeding takes time and can be difficult initially. Participants described feeling close to the baby by maintaining skin-to-skin contact and being present in the moment by taking time to appreciate the child and the breastfeeding situation, and temporarily forgetting about the world and simply being with the child in the here and now. Participants advocated baby-led breastfeeding and following correct techniques. They also described the importance of keeping an effortless mindset about breastfeeding to prevent perceiving breastfeeding as a compulsion. Mothers described acquiring knowledge about breastfeeding so that they could be prepared if breastfeeding problems occurred and getting support from professionals and family was described as significant for having a positive breastfeeding experience. Caring for oneself and one’s body, with aids if necessary, were described as important strategies, as were having a positive attitude and a strong desire to breastfeed.

    Conclusion: Because positive breastfeeding experiences and support are predictors of future breastfeeding initiation and duration, assisting women in creating positive breastfeeding experiences is important. Asking mothers to formulate strategies that they find useful could facilitate breastfeeding by making their approaches more conscious and visible.

  • 19.
    Johansson, Jeaneth
    et al.
    Luleå tekniska universitet, Institutionen för ekonomi, teknik, konst och samhälle, Industriell ekonomi.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Naturbaserade interventioner och nya samverkansmodeller2022Inngår i: Social innovation för hållbar utveckling / [ed] Bonnedahl, Karl Johan; Egan Sjölander, Annika; Lindberg, Malin, Lund: Studentlitteratur AB, 2022, 1, s. 85-98Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 20.
    Johansson, Gunilla
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Nature-based interventions to promote health for people with stress-related illness: An integrative review2022Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 36, nr 4, s. 910-925Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background

    Stress-related illness is increasing and is a common cause of sick leave. Spending time in nature have a positive effect on health and well-being for instance by reducing stress. Specific programmes with nature-based interventions (NBI) with the intention to involve people in activities in a supportive natural environment have been developed for people with stress-related illness.AimTo identify and summarise scientific studies of NBIs to promote health for people with stress-related illness.

    Method

    The design used in this study is integrative literature review. Scientific studies focusing on any type of NBI for people with stress-related illness were sought in Cinahl, PubMed, PsycInfo, AMED and Scopus. In total, 25 studies using both qualitative and quantitative designs were included in the review.ResultThe reviewed studies focused on garden or forest interventions. In the majority of the studies, NBIs were performed in groups, including individual activities, and the length of programmes varied. Interventions in natural environments have unique qualities for individualised, meaningful activities and interactions with others in a non-demanding atmosphere. NBIs offer restoration that reduces stress, improves health and well-being and strengthen self-efficacy and work ability. Connectedness with nature support existential reflections and people with stress-related illness can achieve balance in everyday life.

    Conclusion

    In conclusion, NBIs may have advantages to promote health for people with stress-related illness and should therefore be considered as an alternative to those affected. Further research from different perspectives, including nursing, is needed to understand the possibilities of NBIs and how they can be integrated into practice.

    Fulltekst (pdf)
    fulltext
  • 21.
    Gustafsson, Silje
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Jacobzon, Anna
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Lindberg, Birgitta
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Parents’ strategies and advice for creating a positive sleep situation in the family2022Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 36, nr 3, s. 830-838Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim

    The aim of this study was to describe the experience-based knowledge of parents of children aged 0–3 years for creating a positive sleep situation in the family.

    Design

    This study has a qualitative design. Data were collected using an online survey and analysed using the critical incident technique.

    Methods

    The study participants were recruited through an announcement posted in parenting groups on a social media platform in September 2018. A total of 93 parents answered the questionnaire; 76 of the parents matched the study's selection criteria, and their responses were included in the analysis.

    Results

    The results are presented from the two main questions in the survey: “Strategies for creating a positive sleep situation” and “Advice to new parents regarding sleep”. Having routines and reading the child's signals were important strategies, as were creating good conditions for sleep and making sure the child was well-fed and content at bedtime. Winding down and giving the child closeness and touch was described as important, and some parents would co-sleep to soothe the child quickly and create a sense of security and belonging. Parents’ most frequent advice to other parents was to accept the situation and to let go of the idea that the child should sleep without waking up in a separate bed or room.

    Conclusion

    Personal preferences and needs are likely to vary among individuals, and it is important that nurses tailor sleep advice in accordance with families’ preferences and needs, taking individual variations and views into account.

  • 22.
    Siirilä, Heli
    et al.
    Vasa universitet, Finland.
    Ylilauri, Martta
    Vasa universitet, Finland.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Johansson, Gunilla
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Piloter inom Green Care servicemodeller: [Green Care-palvelumallien pilotointi]2022Inngår i: Naturvärden som källa till välbefinnande: Nordic NaBS projektets resultat: [Luontoarvot hyvinvoinnin lähteeksi: Nordic NaBS -hankkeen tulokset] / [ed] Sanna Vinblad, Leena Välimaa, Nordic NaBS , 2022, s. 9-24Kapittel i bok, del av antologi (Annet (populærvitenskap, debatt, mm))
  • 23.
    Larsson, Fanny
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Strömbäck, Ulrica
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Rysst Gustafsson, Silje
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Postoperative Recovery: Experiences of Patients Who Have Undergone Orthopedic Day Surgery2022Inngår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 37, nr 4, s. 515-520Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: Day surgery is a common phenomenon and is associated with several benefits including cost-effectiveness. However, patients are required to manage their postoperative recovery at home. Patients undergoing orthopedic surgery are a particularly vulnerable group, and their postoperative recovery requires further investigation. This study aimed to describe the experiences of postoperative recovery of patients who had undergone orthopedic day surgery.

    Design: A qualitative and descriptive study design was used

    Methods: Participants were selected purposefully and included 18 orthopedic day-surgery patients who underwent surgery in October and November 2020. Semi-structured interviews were conducted from December 2020 to February 2021. All interviews were recorded and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis with an inductive approach. The process of analysis was done in several steps and resulted in four categories

    Findings: Four categories that described the postoperative recovery experiences of patients who underwent orthopedic day surgery were developed: (1) Questions arose when I got home; (2) I wanted confirmation that I was on the right path; (3) I felt lonely and dependent on others; and (4) I strove to find a balance between activity and rest

    Conclusions: For most patients, there was no follow-up after day surgery. However, patients expressed a desire for confirmation that their recovery process was within the normal trajectory. Most of the recovery takes place at home, leading to feelings of loneliness and highlighting the need for support from healthcare providers and close relatives. A phone call from a nurse after surgery might offer support, reduce feelings of loneliness, and promote a sense of safety. This study highlights the importance of systematic follow-up following orthopedic day surgery.

  • 24.
    Gabrielsson, Sebastian
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Lindgren, Britt-Marie
    Department of Nursing, Umeå University, Umeå, Sweden.
    Molin, Jenny
    Department of Nursing, Umeå University, Umeå, Sweden; Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umeå, Sweden.
    Gustafsson, Silje
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Self-rated reflective capacity in post-registration specialist nursing education students2022Inngår i: Reflective Practice, ISSN 1462-3943, E-ISSN 1470-1103, Vol. 23, nr 5, s. 539-551Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study aimed to describe self-rated reflective capacity in students enrolled in post-registration specialist nursing education at the advanced level. We applied a non-experimental and cross-sectional design. A survey of 156 specialist nursing students at two universities in Northern Sweden was conducted. Data were collected in 2019 using a web-based questionnaire assessing self-rated reflective capacity through the Reflective Capacity Scale of the Reflective Practice Questionnaire. Data were analyzed descriptively using frequencies and proportions. Correlations were analyzed using Spearman’s rho. Results show that students specializing in psychiatric care and oncological care report a higher reflective capacity than students specializing in other areas. We found no significant correlations between reflective capacity and gender, and reflective capacity in total did not correlate with age or work experience. We conclude that reflective capacity might vary between nursing students in different areas of specialization. Further research is needed to understand causes and impacts of variations in nursing students’ reflective capacities.

    Fulltekst (pdf)
    fulltext
  • 25.
    Ejderlöf, Jennifer
    et al.
    Intensive Care Unit, Gällivare Hospital, Gällivare, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    The Helicopter Transports of Patients Critically ill with COVID-192022Inngår i: Sage Open Nursing, E-ISSN 2377-9608, Vol. 8, s. 1-10Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 26.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Andersson, Maria
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. Faculty of Health, Science, and Technology, Department of Health Science, Karlstad University, Karlstad, Sweden.
    Nordin, Anna
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. Faculty of Health, Science, and Technology, Department of Health Science, Karlstad University, Karlstad, Sweden.
    Strömbäck, Ulrica
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    The Meaning of Critical Illness for People Suffering From COVID-19: When a Frightening Unreality Becomes Reality2022Inngår i: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 32, nr 1, s. 135-144Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to elucidate the meaning of critical illness for people with COVID-19. This study used a qualitative design. Thirteen people who were critically ill with COVID-19 during 2020 and admitted to a COVID-19 intensive care unit in northern Sweden participated in the study. Data collection was conducted as individual interviews with a narrative approach, and data were analyzed with phenomenological hermeneutic interpretation. The participants did not think they would get critically ill with this unexpected illness. They experienced terrible nightmares where their relatives had been killed, and they missed their relatives both in their dreams and in reality, as they had not been allowed to be with them due to the virus. Gratefulness was described for surviving. Participants described thoughts of not being able to imagine going through this again. They felt fear and loneliness, as a terrifying unreality had become a reality.

  • 27.
    Nord-Ljungquist, Helena
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Fridlund, Bengt
    Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, Sweden.
    Elmqvist, Carina
    Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, Sweden; Department of Research and Development, Region Kronoberg, Sweden.
    ‘Time is our utmost enemy’: First responders’ experiences of ‘While Waiting For the Ambulance’ assignments in rural environments – A phenomenological study2022Inngår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 42, nr 3, s. 166-174Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Firefighters around the world have the ability to provide first aid before ambulance staff arrive. In Sweden, this assignment is called ‘While Waiting For the Ambulance’ (WWFA). There is limited knowledge about WWFA in rural environments, therefore the aim of this study was to describe the WWFA assignment in a rural environment from the perspective of the firefighters and the ambulance staff. A descriptive design was used with a reflective lifeworld approach, including 16 telephone interviews with firefighters and ambulance staff. The COREQ checklist was applied. A directed responsibility emerges towards affected persons with a situation-adapted attitude during alarms in a WWFA assignment. The firefighters and ambulance staff are each other’s support with a simultaneous need for support from involved organisations. To strengthen this support, training is required, consisting of interprofessional training, feedback from relevant organisations about first aid efforts and expansion of WWFA assignments. Finally, there is a need for a more coordinated picture in order to provide better conditions for future action by the organisations involved, with increased opportunities to save lives in individual local environments. 

  • 28.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Juuso, PäiviLuleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.Liljegren, MadeleineGöteborgs universitet, Sweden; Chalmers tekniska högskola, Sweden.Lundmark Alfredsson, LottaUnicare Bakke, Sweden; Branak, Sweden.
    Vård, omsorg och rehabilitering utomhus: teori, praktik och nya perspektiv2022Collection/Antologi (Annet vitenskapelig)
  • 29.
    Larsson, Fanny
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Strömbäck, Ulrica
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Gustafsson, Silje
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Development and psychometric evaluation of the Feeling Safe During Surgery Scale2021Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 8, nr 5, s. 2452-2460Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim

    The aim of this study is to develop and psychometrically test the Feeling Safe During Surgery Scale.

    Design

    The study design was non-experimental and cross-sectional.

    Method

    The evaluation followed classical test theory, and the instrument was evaluated regarding reliability, construct validity and content validity. For the reliability analysis, a postal questionnaire consisting of the 16 items of the scale was dispatched in March 2020 to a consecutive sample (N = 242) of patients who had undergone hip or knee replacement arthroplasties with regional anaesthesia. Five experts in nursing care evaluated the content validity of the scale.

    Result

    Internal consistency was 0.841. Three items were excluded due to deficits in reliability, resulting in a 13-item scale. A principal component analysis revealed a two-dimensional solution, labelled internal and external aspects of feeling safe. Two items were rephrased to improve clarity and content validity. The average content validity for the scale was 0.88, indicating acceptable content validity.

  • 30.
    Jobe, Ingela
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Lindberg, Birgitta
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    Exploration of how to make the collaborative planning process work - a grounded theory study2021Inngår i: Cogent Medicine, E-ISSN 2331-205X, Vol. 8, nr 1, artikkel-id 1896426Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The integration of healthcare and social services has made collaborative care plans an important tool for health and social care professionals and the person involved. The collaborative planning process is challenging, and studies have revealed that its implementation and outcomes are not satisfactory for all participants. The study aimed to explore the collaborative planning process and attributes contributing to making the process work for all participants. The study focused on older adults in need of a collaborative care plan and adopted a grounded theory approach. Several sources were used to collect data from participants. The findings revealed an overarching process and two sub-processes. The overarching process “holding the links together” described the identified core attributes, joint philosophy, everyday practice and planning through partnership. The two sub-processes, “the missing link” and “connecting the links”, described the participants’ perspectives. The conceptual model explained the identified attributes and the connections between the overarching process and the two sub-processes. The study confirmed the complexity of collaboration between actors, professionals, older adults and informal caregivers. When one or more attribute did not function optimally or was missing, it affected the collaborative care planning process and participants involved, with consequences for the older adult. A joint philosophy, an ethic, could facilitate and guide professionals in everyday practice through all steps of the collaborative care planning process and contribute in making the process successful.

  • 31.
    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 tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    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 dexmedetomidine2021Inngår i: Pediatric Anaesthesia, ISSN 1155-5645, E-ISSN 1460-9592, Vol. 31, nr 11, s. 1225-1233Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 32.
    Gustafsson, Silje
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Lindgren, Britt-Marie
    Department of Nursing, Umeå University.
    Gabrielsson, Sebastian
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Reflective capacity in nurses in specialist education: Swedish translation and psychometric evaluation of the Reflective Capacity Scale of the Reflective Practice Questionnaire2021Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 8, nr 2, s. 546-552Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim

    This study aimed to test the validity and reliability of the Swedish version of the Reflective Capacity Scale of the Reflective Practice Questionnaire in a nursing context.

    Design

    Non‐experimental and cross‐sectional.

    Methods

    The instrument was translated from English to Swedish using a translation and back‐translation procedure. Data for the validity and reliability analysis were collected from Registered Nurses in specialist education (n = 156) at two Swedish universities.

    Results

    The Swedish version of the Reflective Capacity Scale of the Reflective Practice Questionnaire is a valid and reliable instrument that assesses the reflective capacity of healthcare practitioners. Our findings suggest a unidimensional structure of the instrument, excellent internal consistency and good reliability.

    Conclusion

    The Swedish version of the Reflective Capacity Scale of the Reflective Practice Questionnaire has a degree of reliability and validity that is satisfactory, indicating that the instrument can be used as an assessment of reflective capacity in nurses.

  • 33.
    Alerby, Eva
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Pedagogik, språk och ämnesdidaktik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    ‘The pine tree, my good friend’: The other as more-than-human2021Inngår i: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 22, nr 4, artikkel-id e12366Artikkel i tidsskrift (Fagfellevurdert)
  • 34.
    Ljungquist, Helena Nord
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik. Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, Sweden.
    Bohm, Katarina
    Karolinska Institute, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Department of Emergency Medicine, Södersjukhuset, Stockholm, Sweden.
    Fridlund, Bengt
    Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, Sweden.
    Elmqvist, Carina
    Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, Sweden; Head of Research in County Council Kronoberg and Research Manager for the Centre of Interprofessional Collaboration within Emergency Care (CICE) at the Department of Health and Caring Science, Linnaeus University, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Omvårdnad och medicinsk teknik.
    “Time that save lives” while waiting for ambulance in rural environments2021Inngår i: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 59, artikkel-id 101100Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim

    Firefighters perform first aid before the ambulance arrives in areas with a long response time in Sweden; this is called ‘While Waiting for the Ambulance’ (WWFA). The aim was to describe WWFA assignments in rural environments, focusing on frequency, event time, actions and survival >30 days after cardiopulmonary resuscitation (CPR) was performed.

    Methods

    Retrospective descriptive and comparative design.

    Results

    Firefighters in the northern part of Sweden were involved in 518 WWFA assignments between 2012 and 2016. From alarm call until ambulance dispatch, median time was 2:20 min; for firefighters, nearly four minutes. Median dispatch time at out-of-hospital cardiac arrests (OHCA) (n = 52) was 1:40 min for ambulance and three minutes for firefighters. Maximal dispatch time was nearly 10 min for ambulance and 44 min for firefighters. Firefighters arrived first at the scene, after 17 min’ median, for 95 % of assignments, while the ambulance took nearly twice the amount of time. In OHCA situations, time for firefighters was over 19 min versus ambulance at nearly twice the time. CPR was terminated by ambulance staff at 83% (n = 43) of 52 when firefighters performed prolonged CPR. Return to spontaneous circulation after OHCA was 17%, and 9% were alive after >30 days.

    Conclusion

    The efficiency of incident time and utilisation rate for WWFA assignments can be increased for the benefit of affected persons, especially in OHCA.

  • 35.
    Sandström, Linda
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    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.
    Forsberg, Angelica
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Trauma patients' health-related quality of life and perceptions of care: A longitudinal study based on data from the Swedish Trauma Registry2021Inngår i: International Emergency Nursing, ISSN 1755-599X, Vol. 55, artikkel-id 100850Artikkel i tidsskrift (Fagfellevurdert)
  • 36.
    Gustafsson, Silje
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Strömqvist, Magnus
    Skellefteå Hospital, Intensive Care Unit, Skellefteå, Sweden.
    Ekelund, Johanna
    Helsingborg Hospital, Intensive Care Unit, Helsingborg, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Factors Influencing Early Postoperative Recovery After Laparoscopic Cholecystectomy2020Inngår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 35, nr 1, s. 80-84Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [sv]

    Purpose

    To study the factors influencing early postoperative recovery after laparoscopic cholecystectomy.

    Design

    A nonexperimental retrospective study.

    Methods

    The study was performed using records from all patients who had undergone laparoscopic cholecystectomy at a hospital in Northern Sweden in 2017 (219 patients in total). Nonparametric data were analyzed using Spearman's rho, Mann-Whitney U test, and logistic regression. Parametric data were analyzed using Pearson's correlation, an independent t test, and analysis of variance.

    Findings

    The length of stay in the postanesthesia care unit was not predicted by factors such as age, gender, body mass index, American Society of Anesthesiologists classification, postoperative nausea and vomiting, premedication, or type of surgery. Younger age and high classification level were significant predictors of pain during rest and pain when in motion. No significant predictors of postoperative nausea were found. The majority of study participants experienced little or no pain or nausea. The documentation of pain, nausea, and premedication was inadequate in many cases.

    Conclusions

    Nurses in postanesthesia care units should work to preventively identify and address patients’ medical and emotional needs so that optimal conditions for postoperative recovery can be provided.

  • 37.
    Jobe, Ingela
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Lindberg, Birgitta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Health and social care professionals’ experiences of collaborative planning: Applying the person‐centred practice framework2020Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 7, nr 6, s. 2019-2028Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim

    To explore how person‐centred practice framework can be applied to professionals participating in collaborative planning.

    Design

    An explorative, deductive approach.

    Method

    Eleven professionals from health care and social care participated in the study. A deductive content analysis was performed using a framework for person‐centred practice for the analysis.

    Results

    Practicing person‐centred care and collaborative planning is a complex process that needs to take into account system factors on both the macro‐ and the microlevel. Everyone working within the system needs to apply the same approach. Using a framework analysis offered new insights into how person‐centred care is expressed in practice during collaborative planning between the patient, and healthcare and social care professionals.

  • 38.
    Nord-Ljungquist, Helena
    et al.
    Department of Health and Caring Science, Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Växjö, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Fridlund, Bengt
    Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden.
    Elmqvist, Carina
    Centre of Interprofessional Collaboration within Emergency care (CICE), Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Lone and lonely in a double ambivalence situation as experienced by callers while waiting for the ambulance in a rural environment2020Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 34, nr 3, s. 566-574Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background

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

    Aim

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

    Method

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

    Results

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

    Conclusion

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

  • 39.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Jumisko, Eija
    Development Manager, Lapland University of Applied Sciences, Rovaniemi, Finland.
    Shahim, Pashtun
    Clinical Neurochemistry Laboratory, Institute of Neuroscience & Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Molndal, Sweden.
    Lehto, Niklas
    Luleå tekniska universitet, Institutionen för teknikvetenskap och matematik, Materialvetenskap.
    Blennow, Kaj
    Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg & Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Molndal, Sweden.
    Zetterberg, Henrik
    Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg & Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Molndal, Sweden. Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square & UK Dementia Research Institute at UCL, London, UK .
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Losing the identity of a hockey player: the long-term effects of concussions2020Inngår i: Concussion, E-ISSN 2056-3299, Vol. 5, nr 2, artikkel-id CNC74Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To describe what suffering multiple concussions meant for former semi-professional or professional hockey players who were forced to end their career. Results: Nine former Swedish hockey players, who once played on national or professional teams were interviewed. The interviews were analyzed with reference to hermeneutic phenomenology to interpret and explain their experiences. The theme of losing one’s identity as a hockey player was constructed from five subthemes: being limited in everyday life, returning to the hockey stadium as soon as possible, forming a post career identity, lacking understanding and support, and preventing injuries by respecting other players. Conclusion: The former hockey players struggled with developing their off-the-ice identities and with finding other sources of meaning for their lives.

    Lay abstract

    Despite considerable attention to improving the initial management of concussions suffered by hockey players, few studies have examined their long-term effects. In response, the study reported here aimed to describe what suffering multiple concussions meant for former semi-professional or professional hockey players who were forced to end their career. Nine former Swedish hockey players, who once played on national or professional teams were interviewed and the interviews were analyzed in order to interpret and explain their experiences. The overall theme was formulated as losing one’s identity as a hockey player. In conclusion, the former hockey players seem to struggle with developing their off-the-ice identities and with finding other sources of meaning for their lives.

  • 40.
    Gard, Anna
    et al.
    Department of Clinical Sciences Lund, Neurosurgery, Lund University, Skåne University Hospital, Lund 222 41, Sweden.
    Lehto, Niklas
    Luleå tekniska universitet, Institutionen för teknikvetenskap och matematik, Materialvetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Shahim, Pashtun
    Clinical Neurochemistry Laboratory, Institute of Neuroscience & Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal 431 41, Sweden.
    Zetterberg, Henrik
    Clinical Neurochemistry Laboratory, Institute of Neuroscience & Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal 431 41, Sweden.
    Blennow, Kaj
    Clinical Neurochemistry Laboratory, Institute of Neuroscience & Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal 431 41, Sweden.
    Marklund, Niklas
    Department of Clinical Sciences Lund, Neurosurgery, Lund University, Skåne University Hospital, Lund 222 41, Sweden.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Quality of life of ice hockey players after retirement due to concussions2020Inngår i: Concussion, E-ISSN 2056-3299, Vol. 5, nr 3, artikkel-id CNC78Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Sports-related concussion (SRC) is increasingly recognized as a potential health problem in ice hockey. Quality of life (QoL) in players retiring due to SRC has not been thoroughly addressed. Materials & methods: QoL using the Sports Concussion Assessment Tool 5th Edition, Impact of Event Scale-Revised and Short Form Health Survey was measured in Swedish ice hockey players who retired due to persistence of postconcussion symptoms or fear of attaining additional SRC. Results: A total of 76 players were assessed, on average of 5 years after their most recent SRC. Overall, retired players had a high burden of postconcussion symptoms and reduced QoL. Conclusion: Retired concussed ice hockey players have a reduced QoL, particularly those retiring due to postconcussion symptoms. Symptom burden should be continuously evaluated and guide the decision to retire.

  • 41.
    Clair, Cecilia
    et al.
    Department of Anesthesia, Trelleborg Hospital, Trelleborg, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Strömbäck, Ulrica
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Strategies to Relieve Patients' Preoperative Anxiety Before Anesthesia: Experiences of Nurse Anesthetists2020Inngår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 35, nr 3, s. 314-320Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 42.
    Andersson, Viktor
    et al.
    Surgery Department, Östersund Hospital, Sweden.
    Bergstrand, Josefine
    Surgery Department, Östersund Hospital, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Gustafsson, Silje
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    The Impact of Preoperative Patient Anxiety on Postoperative Anxiety and Quality of Recovery After Orthopaedic Surgery2020Inngår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 35, nr 3, s. 260-264Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 43.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Wälivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Lundblad, Dan
    Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    To be seen as a unique person after suffering a second myocardial infarction: Expressed needs of patients and descriptions of personnel2020Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 57, artikkel-id 102797Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives

    The aim of this study was to describe patients’ expressed needs during cardiac rehabilitation after suffering a second myocardial infarction in comparison to personnel’s descriptions of how they work with these patients.

    Research methodology

    A descriptive qualitative design. Interviews were conducted with patients affected by two myocardial infarctions and registered nurses, physiotherapists and cardiologists working with cardiac rehabilitation. Data were analysed with qualitative content analysis.

    Findings

    An interpretation of the underlying meaning in the categories was formulated into one theme: ‘To be seen as a unique person’. Patients expressed a need for individualised care; they wanted the cardiac rehabilitation to be customised to their condition and prognosis; however, they did not perceive their care was individualised. Personnel described the importance of the care being individualised, although they had guidelines to follow. It was crucial for them to see the individual and discover what was important for each patient.

    Conclusions

    There was a shared opinion from patients and personnel that individual care is essential. Using the concept and working in accordance with person-centred care could meet the patients’ need for individualised care.

  • 44.
    Berg Jansson, Anna
    et al.
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Människa och teknik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Parding, Karolina
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Människa och teknik.
    What about learning? A study of temporary agency staffing and learning conditions in Swedish health care2020Inngår i: Journal of Workplace Learning, ISSN 1366-5626, E-ISSN 1758-7859, Vol. 32, nr 1, s. 63-75Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 45.
    Svedberg, Elina
    et al.
    Falck Ambulance, Söderbytorpsvägen 7, SE-136 67 Haninge, Stockholm, Sweden.
    Strömbäck, Ulrica
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Women's experiences of unplanned pre-hospital births: A pilot study2020Inngår i: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 51, artikkel-id 100868Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction

    Prehospital births are fairly rare in Sweden but occasionally occur in the ambulance care system. The ambulance nurse's experience of prehospital births has previously been studied, but there is a lack of research that depicts the woman's perspective of a prehospital birth.

    Aim

    To describe women's experiences of unplanned prehospital births.

    Method

    A qualitative questionnaire consisting of six open-ended questions that encouraged participants to describe their prehospital-birth experience. Eight women answered the survey and nine birth stories were included. A qualitative content analysis with an inductive approach was used as an analysis method.

    Results

    The analysis of the texts resulted in four main categories. The main categories were an unpredictable event, the woman's suffering, her perceived gratitude and the importance of the ambulance nurse now and in the future. The main category of women's suffering resulted in two subcategories: physical stresses and psychological and emotional suffering.

    Conclusion

    The women are not prepared to give birth to a child outside the hospital, and the course of events happen quickly. A prehospital birth is described as a tumultuous event for women. The ambulance nurse has a central role in the care outside the hospital. The advice women suggest to ambulance nurses are remaining calm and safe no matter what the situation looks like, listening to the mother and meeting the woman's wishes. Proposals for further research are to investigate the importance of further education in childbirth care for ambulance nurses and how that affects the care of women and their family.

  • 46.
    Backman, Tess
    et al.
    Ambulance Care, Mora, Sweden.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Borg, Ronja
    Västerås Hospital, Region of Västmanland, Västerås, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Ambulance nurses' experiences of deciding a patient does not require ambulance care2019Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 6, nr 3, s. 783-789Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 47.
    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 tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Gustafsson, Silje
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Difficult Airways: Key Factors for Successful Management2019Inngår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 34, nr 1, s. 151-159Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 48.
    Gabrielsson, Sebastian
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Gustafsson, Silje
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Evaluating reflective practice groups in a mental health context: Swedish translation and psychometric evaluation of the clinical supervision evaluation questionnaire2019Inngår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 18, artikkel-id 2Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

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

    Methods

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

    Results

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

    Conclusion

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

  • 49.
    Sandström, Linda
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    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.
    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.

  • 50.
    Larson, Fanny
    et al.
    Anesthesia Unit, Piteå Hospital, Region Norrbotten, Piteå, Sweden.
    Nyström, Ingela
    Anesthesia Unit, Piteå Hospital, Region Norrbotten, Piteå, Sweden.
    Gustafsson, Silje
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Key Factors for Successful General Anesthesia of Obese Adult Patients2019Inngår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 34, nr 5, s. 956-964Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

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

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

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

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

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