Ändra sökning
Avgränsa sökresultatet
123 1 - 50 av 119
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Träffar per sida
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
Markera
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 1.
    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 care2019Ingår i: Nursing Open, E-ISSN 2054-1058, Vol. 6, nr 3, s. 783-789Artikel i tidskrift (Refereegranskat)
    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.

  • 2.
    Dabija, Marius
    et al.
    Division of Surgery, Sollefteå Hospital.
    Fedog, Fredrik
    Division of Surgery-Anaesthesia, Stavanger University Hospital.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Gustafsson, Silje
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Difficult airways: key factors for sucessful management2019Ingår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 34, nr 1, s. 151-159Artikel i tidskrift (Refereegranskat)
    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.

  • 3.
    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 questionnaire2019Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 18, artikel-id 2Artikel i tidskrift (Refereegranskat)
    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.

  • 4.
    Sandström, Linda
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nilsson, Carina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Experiences of suffering multiple trauma: A qualitative study2019Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 54, s. 1-6Artikel i tidskrift (Refereegranskat)
    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.

  • 5.
    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 Patients2019Ingår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 34, nr 5, s. 956-964Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

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

    Design

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

    Methods

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

    Findings

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

    Conclusions

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

    DOI:10.1016/j.jopan.2019.01.009

  • 6.
    Jobe, Ingela
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lindberg, Birgitta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Knowledge and views about coordinated individual planning from the perspective of active older adults2019Ingår i: Clinical Journal of Nursing Care and Practice, ISSN 2639-9911, Vol. 3, s. 17-26Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

    Aim

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

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

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

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

  • 7.
    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.
    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 environment2019Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Artikel, forskningsöversikt (Refereegranskat)
    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.

  • 8.
    Jobe, Ingela
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lindberg, Birgitta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Perceptions of healthcare services and preference of factors related to care planning among active older persons2019Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction

    The care-planning process offers people active involvement in deciding, agreeing and owning how their care will be managed. It is intended to be a process of collaboration supported by the principles of person-centredness, partnership and empowerment. According to Swedish legislation, coordinated individual planning must occur for patients transferring to another level of care or when an individual, living in their own home, has the need of efforts from different welfare actors. Awareness of older peoples’ preferences regarding different factors related to the care-planning process may generate knowledge that can facilitate bridging the gaps between care recipients’ preferences and caregivers’ decisions during the care-planning process. The aim of the study was to explore active older persons’ perceptions of healthcare services and preferences of factors related to care planning.

    Methods

    A qualitative interpretive description framework was chosen for the study. Five focus-group were conducted with 40 members, aged between 70 to 88 years, from six different organizations and associations. Participants represent the growing older population in society that remains active for many years after retirement. The general principles of interpretative descriptions were used in the analysis.

    Results

    The results showed that the participants thought that many organizational changes that had been made had not improved healthcare services. The participants wanted more flexibility regarding decisions and the possibility to change them. Personal freedom and making choices independently were momentous. They worried about the lack of continuity and perceived that no one assumed overall responsibility. Overall, participants cared more about the quality of the interactions with personnel than about how services were organized. The majority of participants were not aware of the development of a coordinated individual plan. A new service of being able to access the coordinated individual plan on the Internet is offered. A majority of the participants did not have Internet access; they saw themselves as the generation between the old and new systems. They did not resist the new technology but stressed the importance of not excluding anyone.

    Discussions

    Older persons want their views and preferences to be taken into consideration, and they want to be actively engaged in the decision-making process and make decisions themselves. Older people’s lives have become more individualized with the rest of society, and this requires healthcare service solutions that are more tailored and include different options.

    Conclusions

    Older persons’ want to be active partners in healthcare and social services and they value a personal relation with the professional actor, easy access and well-coordinated and more personalized and flexible services. They value their independency and want to stay active as long as possible.

    Lessons learned

    Older persons value their independency and want to remain active and maintain functioning. Views of older people must be considered on different levels, from planning healthcare and social services to individualized care-planning processes.

    Limitations

    It is important to remember that older people are not a homogeneous group. The participants in this study are active in society and chose to participate. Majority of the participants had no previous experiences of the coordinated individual planning however, they can still have other experiences of healthcare and social services that influence their preferences, and made them participate in the study. Their views do not necessarily correspond with older persons’ views in general.

    Suggestions for future research

    More knowledge is needed about how individuals and their relatives experiences the Coordinated individual planning process.

  • 9.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Forsberg, Angelica
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Peripheral intravenous catheter difficulty: A clinical survey of registered nurse and critical care nurse performance2019Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, nr 3-4, s. 686-694, artikel-id 15960276Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives To describe the characteristics, problems and interventions associated with performing peripheral intravenous catheterisation in difficult situations when registered nurses need support from critical care nurses. Background Only a few studies have focused on peripheral intravenous catheterisation problems or interventions to promote success. There is limited research on the education, knowledge, confidence and skills of registered nurses associated with successful peripheral intravenous catheterisations. Design A descriptive cross‐sectional survey design was used. Results A total of 101 questionnaires were completed by critical care nurses (n = 32) and 92 by registered nurses (n = 83); the total number of participants was 115. The same critical care nurses and registered nurses could participate several times on different occasions. Statistical analyses were performed using descriptive statistics. The patterns differed in part between the registered nurses who needed support and the critical care nurses who provided the support. Both registered nurses and critical care nurses used ultrasound to a very low extent (2.2% vs. 1.0%). The registered nurses indicated to a significantly higher extent (p = 0.02) that the veins were invisible and that they had performed the optional interventions. The success rate for critical care nurses was considerably high (86.1%). The most common place for successful insertion was the wrist. Critical care nurses performed fewer interventions, and they informed the patients and assessed that the veins were fragile to a higher extent. Conclusions Superior nursing skills are required in order to adapt and assess specific situations related to peripheral intravenous catheterisation difficulties and to choose the adequate interventions. Young and newly graduated registered nurses should be offered individualised training during the post‐educational period on how to assess problems and perform peripheral intravenous catheterisations in specific difficult situations. Relevance to Clinical Practice Simulation is suggested for practical training in order to increase patient safety related to the performance of technical skills such as peripheral intravenous catheterisation.

  • 10.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Wälivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Realising the seriousness – the experience of suffering a second myocardial infarction: A qualitative study2019Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 51, s. 1-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives

    The aim of this study was to describe people’s experiences of suffering a second myocardial infarction.

    Research methodology

    A descriptive qualitative design. Interviews were conducted with eight persons afflicted by two myocardial infarctions. Data were analysed with qualitative content analysis.

    Findings

    The analysis resulted in one theme and four categories. The theme was ‘Realising the seriousness’ and the categories were: 1) Knowledge from previous experience; 2) A wake-up call for lifestyle changes; 3) The future becomes unpredictable; 4) Trying to find balance in life. The participant’s previous experience contributed to a better understanding of the symptoms of myocardial infarction and how to act when suffering a second myocardial infarction. After their second myocardial infarction, the participants became really aware of the need to implement a healthier lifestyle, as doing so might avoid a third myocardial infarction. The risk of suffering or even dying due to yet another myocardial infarction felt more tangible after their second one.

    Conclusion

    A second myocardial infarction is a different event in comparison to the first one, which makes afflicted people realise the seriousness and importance of making life style changes. They are more affected both physically and psychologically.

  • 11.
    Persson, Anna-Carin
    et al.
    Ambulance Care in Ålem and Oskarshamn.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Burström, Oskar
    Resource unit in ambulance care, Jämtland/Härjedalen.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Specialist Ambulance Nurses' Experiences of Births Before Arrival2019Ingår i: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 43, s. 45-49Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Working as an ambulance nurse means interacting with and caring for acutely ill and injured patients. It can even involve births before arrival to the hospital (BBA), which are rare but increasing due to the centralization of maternity wards.

    Aim

    This study describes the experiences of specialist ambulance nurses with BBA.

    Method

    A qualitative study was conducted, and nine specialist ambulance nurses who had assisted with one or more prehospital births were interviewed. Data were analysed with thematic content analysis.

    Findings

    The analysis revealed three categories that were compiled into a theme of feeling fright and exhilaration. The findings showed that BBA causes feelings of anxiety and stress. The experience is also associated with joy and relief when the baby is born. Childbirth is a situation for which specialist ambulance nurses feel less prepared, lack of knowledge, and wish for more education.

    Conclusion

    Specialist ambulance nurses face challenges in the pre-hospital care environment during BBA, with long distances, a lack of equipment aboard the ambulance, and no assistance from midwives. To feel secure in the complex role that is required when assisting with a BBA, specialist ambulance nurses should be given the opportunity to receive scenario training.

  • 12.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Critical care nurses'  experiences of performing successful peripheral intravenous catherisation i difficult situations2018Ingår i: Journal of Vascular Nursing, ISSN 1062-0303, E-ISSN 1532-6578, Vol. 36, nr 2, s. 64-70Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    he aim of this study is to describe the experiences of critical care nurses (CCNs) when performing successful peripheral intravenous catheterization (PIVC) on adult inpatients in difficult situations. This study uses a descriptive design with a qualitative approach. Semistructured interviews were given to CCNs (n = 22) at a general central county hospital in northern Sweden. The interview text was analyzed with qualitative thematic content analysis. Three themes emerged: “releasing time and creating peace,” “feeling self-confidence in the role of expert nurse,” and “technical interventions promoting success.” CCNs stated that apart from experience, releasing enough time is the most crucial factor for a successful PIVC. They emphasized the importance of identifying the kinds of difficulties that may occur during the procedure, for example, fragile or/and invisible veins. CCNs explained that compared to when they were newly graduated, the difference in their approach nowadays has changed to using their hands more than their eyes and that they feel comfortable with bodily palpations. To further optimize PIVC performing skills, continued possibilities to train and learn in hospital settings are necessary, even after formal education has been completed.

  • 13.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Rogmalm, Katarina
    ICU, Piteå hospital.
    Marklund, Lisa
    Medical Division, Piteå hospital.
    Wälivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Follow-up visit in an ICU: receiving a sense of coherence2018Ingår i: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 23, nr 6, s. 308-315Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AimTo describe patients' experiences of a follow-up visit to an intensive care unit (ICU) after being critically ill and nursed there.BackgroundKnowledge about the follow-up visit needs to be developed, with the previously critically ill patient in focus.DesignQualitative descriptive.MethodSemi-structured interviews were conducted with nine patients and analysed using qualitative content analysis. The data collection occurred during spring 2014.FindingsDuring the follow-up visits in ICU, the relatives, the patient diary, and those who took part in the care contribute to fill memory gaps to create a picture and an explanation of the care period.ConclusionThe follow-up visit is an important tool in the patients' struggle to create a context and coherence from a missing or unreal time. The patient diary is essential to subsequently be able to relate to the period of care.Relevance to clinical practiceThe follow-up visit, together with a personal diary, after an ICU stay could be seen as significant for strengthening the patients' feeling of coherence and better health.

  • 14.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad. ICU 57, Sunderby Hospital.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Välivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Rattray, Janice
    chool of Nursing and Health Sciences, University of Dundee.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Patient's perceptions of perioperative quality of care in relation to self-rated health2018Ingår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, nr 6, s. 834-843Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To explore (1) associations between patient and perioperativefactors and dimensions of quality of care and (2) perioperative patients’self-rated physical health in relation to information, encouragement, andparticipation.Design: A nonexperimental descriptive exploratory design (n 5 170participants).Methods: Analyses were performed using quantitative techniques;collected data were quantitative in nature. Multiple logistic regressionand Mann-Whitney U tests were used to analyze the data.Findings: The factor associatedwith patients’ satisfaction within the dimensionof ‘‘identity-oriented approach of the caregivers,’’ including the qualityof information, encouragement, and participation, was self-estimated physicalhealth. Those who estimated their physical health as being good weregenerally more satisfied. Patients who rated their physical health as beingless thangoodwere significantly less satisfiedwith the informationprovidedbefore surgery about their stay in the postanesthesia care unit (PACU).Conclusions: Nurses should chart patients’ estimations of their physicalhealth initially in care to provide reinforced support for patients who estimatetheir physical health is less than good. Before surgery, patients whohave estimated their physical health as being less than good should begiven realistic information about their stay in the PACU—that they willbe in a PACU after surgery, what that stay means, and why it is necessary.

  • 15.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Forsberg, Angelica
    Sunderby sjukhus.
    Patients’ perceptions of short-term recovery after a gastric bypass2018Ingår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, nr 5, s. 681-688Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    To explore gastric bypass patients' perceptions of their postoperative recovery over 1 month.

    Design

    A standardized questionnaire, the postoperative recovery profile, was used.

    Methods

    Postoperative recovery profile is a multi-item questionnaire for self-assessment of general postoperative recovery. Participants were patients who had undergone gastric bypass surgery (n = 39). The changes in recovery between 1 day and 1 month postsurgery were evaluated by a statistical method developed specifically for analyzing changes in paired ordered data over time.

    Findings

    Most of the symptoms and/or functions were significantly improved on a group level. The most marked improvement was to pain and sleeping difficulties followed by mobilization. In terms of the psychological items, the proportion of patients who indicated no problems was high at both endpoints. The items that deviated from the improvement pattern were appetite changes and gastrointestinal function which demonstrated a relatively high proportion of deterioration, and the individual variability was prominent.

    Conclusions

    There is a need for interventions to improve recovery on a group as well as an individual level.

  • 16.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Välivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Patterns of changes in patients' postoperative recovery from a short-term perspective2018Ingår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, nr 2, s. 188-199Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    To explore patterns of changes in patients' postoperative recovery over 1 month within different surgery groups.

    Design

    A quantitative longitudinal survey design was used.

    Methods

    A standardized questionnaire was used (N = 167 patients); the postoperative recovery profile for self-assessment of recovery. The postoperative recovery profile developed for hospitalized patients contains 17 items distributed over five dimensions: physical symptoms, physical function, psychological function, social function, and activity.

    Findings

    Overall, orthopaedic patients perceived a lower recovery than general surgery patients. All major surgery groups and subgroups except for joint replacement patients indicated significant systematic changes toward lower levels of problems. The orthopaedic patients assessed their psychological functioning as impaired, and the gastric bypass group was the most recovered.

    Conclusions

    The patients' expectations should be charted initially, and patients should be given realistic information to achieve a realistic hope for a good life in the future. A patient's recovery trajectory may not start after the surgery is completed. Rather, it has already commenced before surgery.

  • 17.
    Jobe, Ingela
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lindberg, Birgitta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nordmark, Sofi
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad. Health Department, Norrbotten Region, Luleå.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The care‐planning conference: Exploring aspects of person-centered interactions2018Ingår i: Nursing Open, E-ISSN 2054-1058, E-ISSN 2054-1058, Vol. 5, nr 2, s. 120-130Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim

    The aim of this study was to describe the care-planning conference from the participants' and researchers' perspectives, focusing on exploring aspects of person-centred interactions.

    Design

    A single-instrumental, qualitative case study design was used describing a care-planning conference taking place in the home of an older woman and her daughter.

    Methods

    Data collection consisted of observation and digital recording of the care-planning conference and individual interviews with all the participants before and after the conference. Data were analysed in several phases: first, a narrative description followed by a general description and, thereafter, qualitative content analysis.

    Results

    The findings revealed that the care-planning conference conducted had no clear purpose and did not fulfil all parts of the planning process. Three themes emerged related to aspects of person-centred interactions. The theme “expectations meet reality” showed different expectations, and participants could not really connect during the conference. The theme “navigate without a map” revealed health professionals' lack of knowledge about the care-planning process. The theme “lose the forest for the trees” described that the conference was conducted only as part of the health professionals' duties. Management and healthcare professionals cannot automatically assume that they are delivering person-centred care. Healthcare professionals need to be sensitive to the context, use the knowledge and tools available and continuously evaluate and reassess the work carried out.

  • 18.
    Strandberg, Sandra
    et al.
    Intensive Care Unit 57, Sunderby Hospital.
    Vesterlund, Lisa
    Intensive Care Unit 57, Sunderby Hospital.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The contents of a patient diary and its significance for persons cared for in an ICU: a qualitative study2018Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 45, s. 31-36Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives

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

    Research Methodology

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

    Findings

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

    Conclusion

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

  • 19.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lundqvist, Robert
    Department of Research, Norrbotten County Council, Luleå, Sweden.
    Lundblad, Dan
    Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University, Sweden.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    The second myocardial infarction: Is there any difference in symptoms and prehospital delay compared to the first myocardial infarction?2018Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, nr 7, s. 652-659Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Knowledge is limited concerning the type of symptoms and the time from onset of symptoms to first medical contact at first and second myocardial infarction in the same patient.

    AIM:

    This study aimed to describe the type of symptoms and the time from onset of symptoms to first medical contact in first and second myocardial infarctions in men and women affected by two myocardial infarctions. Furthermore, the aim was to identify factors associated with prehospital delays ≥2 h at second myocardial infarction.

    METHODS:

    A retrospective cohort study with 820 patients aged 31-74 years with a first and a second myocardial infarction from 1986 through 2009 registered in the Northern Sweden MONICA registry.

    RESULTS:

    The most common symptoms reported among patients affected by two myocardial infarctions are typical symptoms at both myocardial infarction events. Significantly more women reported atypical symptoms at the second myocardial infarction compared to the first. Ten per cent of the men did not report the same type of symptoms at the first and second myocardial infarctions; the corresponding figure for women was 16.2%. The time from onset of symptoms to first medical contact was shorter at the second myocardial infarction compared to the first myocardial infarction. Patients with prehospital delay ≥2 h at the first myocardial infarction were more likely to have a prehospital delay ≥2 h at the second myocardial infarction.

    CONCLUSIONS:

    Symptoms of second myocardial infarctions are not necessarily the same as those of first myocardial infarctions. A patient's behaviour at the first myocardial infarction could predict how he or she would behave at a second myocardial infarction.

  • 20.
    Sandström, Linda
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nilsson, Carina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    CCNs experiences of nursing trauma patients2017Konferensbidrag (Refereegranskat)
  • 21.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Jansson, Anna
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Arbetsvetenskap.
    Critical Care Nurses Experiences of Temporary Staffing in ICU2017Konferensbidrag (Refereegranskat)
  • 22.
    Söderberg, Anja
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Sundbaum, Johanna
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nursing students' reflections after meetings with patients and their relatives enacted by professional actors: Being touched and feeling emphaty2017Ingår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 38, nr 2, s. 139-144Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    When professional actors have been used in mental health simulations with nursing students, the experiencehas been regarded as a meaningful contribution to their education and described as a safe way ofexperiencing challenging situations that can occur in clinical settings. The aim was to study nursing students’reflections aftermeetings with nursing patients and their relatives, as enacted by professional actors,in psychiatric/elderly care. The design was a qualitative descriptive research approach. Gibbs’s (1988) reflectivecycle was the basis for the questions thatwere asked.Written reflections with 60 nursing studentswereanalysed using qualitative thematic content analysis. The analysis produced the theme “being touched andfeeling empathy,”with four categories: “becoming aware of what knowledge and skills are needed,” “wantingto dowell and to have the right answer,”“daring to get close and being present,”and “knowledge comesalive.” Simulation with real people who act as patients or relatives in vulnerable situations creates feelingsof empathy. To talk with them, experience eye contact, and see how they react on touch makes nursingstudents feel they have experienced closeness and their knowledge has become alive

  • 23.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Välivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Patients' perceptions of quality of care during the perioperative procedure2017Ingår i: ACORN: The Journal of Perioperative Nursing in Australia, ISSN 1448-7535, Vol. 30, nr 3, s. 13-22Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 24.
    Sandström, Linda
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nilsson, Carina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The helicopter as a caring context: Experiences of people suffering trauma2017Ingår i: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 32, s. 34-38Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction

    When emergency medical services (EMS) are needed, the choice of transport depends on several factors. These may include the patient’s medical condition, transport accessibility to the accident site and the receiving hospital’s resources. Emergency care research is advancing, but little is known about the patient’s perspective of helicopter emergency medical services (HEMS).

    Aim

    The aim of this study was to describe trauma patients’ experiences of HEMS.

    Method

    Thirteen persons (ages 21–76) were interviewed using an interview guide. Data were analyzed using qualitative content analysis.

    Findings

    The analysis resulted in three themes: Being distraught and dazed by the event – patients experienced shock and tension, as well as feelings of curiosity and excitement. Being comforted by the caregivers – as the caregivers were present and attentive, they had no need for relatives in the helicopter. Being safe in a restricted environment – the participants’ injuries were taken seriously and the caregivers displayed effective teamwork.

    Conclusion

    For trauma patients to be taken seriously and treated as ‘worst cases’ enables them to trust their caregivers and ‘hand themselves over’ to their care. HEMS provide additional advantageous circumstances, such as being the sole patient and having proximity to a small, professional team.

  • 25.
    Sandström, Linda
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The helicopter as a caring context: trauma patients’ experiences2017Konferensbidrag (Refereegranskat)
  • 26.
    Ednell, Anna-Karin
    et al.
    Intensive Care Unit, Gällivare Hospital.
    Siljegren, Sara
    Intensive Care Unit, Kiruna Hospital.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The ICU Patient Diary: a Nursing Intervention that is Complicated in its Simplicity : a Qualitative Study2017Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 40, s. 70-76Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

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

    Aim

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

    Method

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

    Findings

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

    Conclusion

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

  • 27.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lundblad, Dan
    Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University.
    Lundqvist, Robert
    Department of Research, Norrbotten County Council, Luleå.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The second myocardial infarction: Higher risk factor burden and earlier second myocardial infarction in women compared to men : The Northern Sweden MONICA study2017Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr 5, s. 418-424Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Several studies have examined various parameters and experiences when patients suffer their first myocardial infarction (MI), but knowledge about when they suffer their second MI is limited.

    AIM:

    To compare risk factors for MI, that is, diabetes, hypertension and smoking, for the first and second MI events in men and women affected by two MIs and to analyse the time intervals between the first and second MIs.

    METHODS:

    A retrospective cohort study of 1017 patients aged 25-74 years with first and second MIs from 1990 through 2009 registered in the Northern Sweden MONICA registry.

    RESULTS:

    More women than men have diabetes and hypertension and are smokers at the first MI. Similar differences between the genders remain at the time of the second MI for diabetes and hypertension, although both risk factors have increased. Smoking decreased at the second MI without any remaining difference between genders. Women suffer their second MI within a shorter time interval than men do. Within 16 months of their first MI, 50% of women had a second MI. The corresponding time interval for men was 33 months.

    CONCLUSION:

    Patients affected by an MI should be made aware of their risk of recurrent MI and that the risk of recurrence is highest during the first few years after an MI. In patients affected by two MIs, women have a higher risk factor burden and suffer their second MI earlier than men do and thus may need more aggressive and more prompt secondary prevention.

  • 28.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Lundblad, Dan
    Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The second myocardial infarction: Higher risk factor burden and earlier second myocardial infarction in women compared with men2017Ingår i: EuroHeartCare 2017, 2017Konferensbidrag (Övrigt vetenskapligt)
  • 29.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lundblad, Dan
    Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University.
    Lundqvist, Robert
    Department of Research, Norrbotten County Council, Luleå.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The second myocardial infarction: Women have a higher risk factor burden and suffer a second myocardial infarction earlier than men do. The Northern Sweden MONICA study2017Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr Suppl. 1, s. S62-S63, artikel-id 165Artikel i tidskrift (Refereegranskat)
  • 30.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Boström, Jonas
    Division of Surgery, Skellefteå Hospital, Sweden.
    Karlsson, Ann-Christin
    Department of Public Health and Caring Sciences, Uppsala University.
    Women's experiences of undergoing total knee joint replacement surgery2017Ingår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 32, nr 2, s. 86-95Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    The purpose of the study was to describe women's experiences of undergoing total knee joint replacement surgery.

    Design

    A qualitative approach was used.

    Method

    A content analysis of the text from interviews with five women was conducted.

    Findings

    The time before surgery was marked by the experience of constant pain, which affected the women negatively in their everyday lives. During surgery, the information provided by the staff gave each woman a sense of security; the women handed over responsibility to the staff and experienced a sensation of relief. The postoperative period was characterized by a feeling of joy when the surgery was over, although a rough and tedious rehabilitation phase then began. Challenges in everyday life were a factor for motivation and confidence, although postoperative pain was experienced as discouraging.

    Conclusion

    Support from health care staff is an important factor for coping with everyday life during the preoperative, perioperative and postoperative phases of undergoing knee joint replacement.

  • 31.
    Jansson, Anna Berg
    et al.
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Arbetsvetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Working Together: Swedish Critical Care Nurses' Experiences of Temporary staffing within Swedish health care: a Qualitative Study2017Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 41, s. 3-10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives

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

    Research methodology

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

    Findings

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

    Conclusion

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

  • 32.
    Ejneborn-Looi, Git-Marie
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Sävenstedt, Stefan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Easy but not simple: Nursing students’ descriptions of the process of care in a psychiatric context2016Ingår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, nr 1, s. 34-42Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 33.
    Sandström, Linda
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nilsson, Carina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Juuso, Päivi
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Experiences of nursing patients suffering from trauma: preparing for the unexpected: a qualitative study2016Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 36, s. 58-65Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 34.
    Shahim, Pashtun
    et al.
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Gustafsson, Bengt
    Capio Artro Clinic, Stockholm.
    Gren, Magnus
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Ärlig, Johan
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Olsson, Martin
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Lehto, Niklas
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Höglund, Kina
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Portelius, Erik
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Zetterberg, Henrik
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal.
    Blennow, Kaj
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Neurochemical Aftermath of Repetitive Mild Traumatic Brain Injury2016Ingår i: JAMA Neurology, ISSN 2168-6149, E-ISSN 2168-6157, Vol. 73, nr 11, s. 1308-1315Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Importance:

    Evidence is accumulating that repeated mild traumatic brain injury (mTBI) incidents can lead to persistent, long-term debilitating symptoms and in some cases a progressive neurodegenerative condition referred to as chronic traumatic encephalopathy. However, to our knowledge, there are no objective tools to examine to which degree persistent symptoms after mTBI are caused by neuronal injury.

    Objective:

    To determine whether persistent symptoms after mTBI are associated with brain injury as evaluated by cerebrospinal fluid biochemical markers for axonal damage and other aspects of central nervous system injury.

    Design, Settings, and Participants:

    A multicenter cross-sectional study involving professional Swedish ice hockey players who have had repeated mTBI, had postconcussion symptoms for more than 3 months, and fulfilled the criteria for postconcussion syndrome (PCS) according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) matched with neurologically healthy control individuals. The participants were enrolled between January 2014 and February 2016. The players were also assessed with Rivermead Post Concussion Symptoms Questionnaire and magnetic resonance imaging.

    Main Outcomes and Measures:

    Neurofilament light protein, total tau, glial fibrillary acidic protein, amyloid β, phosphorylated tau, and neurogranin concentrations in cerebrospinal fluid.

    Results:

    A total of 31 participants (16 men with PCS; median age, 31 years; range, 22-53 years; and 15 control individuals [11 men and 4 women]; median age, 25 years; range, 21-35 years) were assessed. Of 16 players with PCS, 9 had PCS symptoms for more than 1 year, while the remaining 7 returned to play within a year. Neurofilament light proteins were significantly increased in players with PCS for more than 1 year (median, 410 pg/mL; range, 230-1440 pg/mL) compared with players whose PCS resolved within 1 year (median, 210 pg/mL; range, 140-460 pg/mL) as well as control individuals (median 238 pg/mL, range 128-526 pg/mL; P = .04 and P = .02, respectively). Furthermore, neurofilament light protein concentrations correlated with Rivermead Post Concussion Symptoms Questionnaire scores and lifetime concussion events (ρ = 0.58, P = .02 and ρ = 0.52, P = .04, respectively). Overall, players with PCS had significantly lower cerebrospinal fluid amyloid-β levels compared with control individuals (median, 1094 pg/mL; range, 845-1305 pg/mL; P = .05).

    Conclusions and Relevance:

    Increased cerebrospinal fluid neurofilament light proteins and reduced amyloid β were observed in patients with PCS, suggestive of axonal white matter injury and amyloid deposition. Measurement of these biomarkers may be an objective tool to assess the degree of central nervous system injury in individuals with PCS and to distinguish individuals who are at risk of developing chronic traumatic encephalopathy.

  • 35.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Johansson, Maria
    Intensive Care Unit, Gällivare Hospital.
    Mattsson, Mia
    Intensive Care Unit 57, Sunderby Hospital.
    Strömbäck, Ulrica
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Nursing Care of ICU Patients Lightly Sedated with Dexmedetomidine2016Ingår i: Journal of Clinical Intensive Care and Medicine, Vol. 1, s. 5-13Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Intensive care patients are often in need of sedation to endure being intubated. Lightsedation is increasingly common since it has been proved to offer benefi ts such as faster recovery to patients.Aim: The aim of this study was to describe critical care nurses’ experiences of nursing patients lightlysedated with dexmedetomidine.Research Methodology: Qualitative personal interviews were conducted during 2015 with 10 critical carenurses in Sweden. Interview transcripts were analysed using inductive qualitative thematic analysis.Results: Light sedation of the patient facilitated communication and interaction with him or her, and therelationship between the patient and his or her family members. Dexmedetomidine was described as a fairlynew drug, and the critical care nurses stated that they needed more knowledge about it and about sedationscales in order to learn more about the drug’s mechanism of action and its potential side effects on patients.Conclusion: It is important to critical care nurses to learn more about dexmedetomidine and about sedationscales to assess levels of sedation, as light sedation has been shown to benefi t the patient as opposed to deepsedation that can increase recovery time.

  • 36.
    Söderberg, Anja
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Sundbaum, Johanna
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nursing students' perceptions of learning through complex meetings with standard psychatric patients2016Konferensbidrag (Övrigt vetenskapligt)
  • 37.
    Lestander, Örjan
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Lehto, Niklas
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nursing students' perceptions of learning after High Fidelity simulation: Effects of a Three-step Post-Simulation Reflection Model2016Ingår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 40, s. 219-224Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    High-fidelity simulation (HFS) has become a bridge between theoretical knowledge and practical skills. A safe and realistic environment is commonly used in nursing education to improve cognitive, affective and psychomotor abilities. Debriefing following a simulation experience provides opportunities for students to analyse and begin to reflect upon their decisions, actions and results. The nursing literature highlights the need to promote the concept of reflective practice and to assist students in reflection, and research indicates the need to refine and develop debriefing strategies, which is the focus of the current paper.

  • 38.
    Kruse, Johan
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Lehto, Niklas
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Riklund, Katrine
    Department of Radiation Sciences, Diagnostic Radiology, Umeå University.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Scrutinized with inadequate control and support Interns' experiences communicating with and writing referrals to hospital radiology departments: a qualitative study2016Ingår i: Radiography, ISSN 1078-8174, E-ISSN 1532-2831, Vol. 22, nr 4, s. 313-318Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    IntroductionInterns' experiences communicating with and writing referrals to hospital radiology departments are important for patient safety, image quality, and decision-making in the diagnostic process. Understanding roles within the department and in the diagnostic process is important for communication. This study aimed to describe interns' experiences communicating with and writing referrals to their hospital's radiology department.MethodA qualitative study design was used. Data was collected from focus discussions with ten interns in three focus groups in Northern Sweden during 2012. The data were subjected to qualitative content analysis.ResultsOne theme, “a feeling of being scrutinized and lacking control”, was identified in the final categories. The interns experienced that the radiology department placed high demands on them and desired more diagnostic skills training, resources and feedback. The interns suggested the following improvements: enhanced dialogue and feedback, improved education, handy guidelines, and practice writing referrals.ConclusionInterns need more feedback from, and dialogue with, members of the Department of Radiology. They also need more knowledge of referral guidelines, appropriateness criteria and more practice to develop their knowledge and skill for writing referrals. They describe feelings of inadequate support and feel scrutinized in demanding work conditions and need more collaboration. They also need more time and more control of radiology outcomes, and they are eager to learn.

  • 39.
    Aitken, Leanne M.
    et al.
    School of Nursing & Midwifery & NHMRC Centre of Research Excellence in Nursing (NCREN), Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University.
    Castillo, Maria I.
    School of Nursing & Midwifery & NHMRC Centre of Research Excellence in Nursing (NCREN), Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University.
    Ullman, Amanda
    School of Nursing & Midwifery & NHMRC Centre of Research Excellence in Nursing (NCREN), Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Cunningham, Kathryn
    Population Health Sciences, Medical Research Institute, University of Dundee.
    Rattray, Janice
    Population Health Sciences, Medical Research Institute, University of Dundee.
    What is the relationship between elements of ICU treatment and memories after discharge in adult ICU survivors?2016Ingår i: Australian Critical Care, ISSN 1036-7314, E-ISSN 1878-1721, Vol. 29, nr 1, s. 5-14Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 40.
    Ejneborn-Looi, Git-Marie
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Sävenstedt, Stefan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    A self-destructive care: Self-reports of people who experienced coercive measures and their suggestions for alternatives2015Ingår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 36, nr 2, s. 96-103Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 41.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Activity: What is the relationship between elements of ICU treatment and memories after discharge in adult ICU survivors?2015Konferensbidrag (Övrig (populärvetenskap, debatt, mm))
  • 42.
    Senften, Jonah
    et al.
    Intensive Care Unit, Gällivare Hospital.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Critical care nurses' experiences of helicopter transfers2015Ingår i: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 20, nr 1, s. 25-33Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundIntensive care is conducted in intensive care units (ICUs), and also during the transportation of critically ill people.AimThe aim of the study was to describe critical care nurses' (CCNs) experiences of nursing critically ill patients during helicopter transport.ParticipantsSeven CCNs, five women and two men participated in this study. DesignSeven participants from two centres in Sweden were recruited. The design uses an inductive, qualitative approach with data collected by means of qualitative interviews with seven CCNs. MethodsThe interviews were transcribed verbatim and subjected to qualitative thematic content analysis. ResultsThe analysis resulted in one theme which is safe nursing care, but sometimes feeling afraid and six categories as follows: experiencing the care environment as an ICU with limited space; a loud environment complicates communication; planning and checking to minimize risks; experience and good co-operation; facing the dilemma of allowing relatives to accompany the patient or not; feeling the patient's and their own fear. ConclusionCCNs plan for the transportation and control of patients to improve patient safety, but can sometimes feel afraid. Good co-operation is necessary. Relevance to clinical practiceThe possibilities for CCNs to provide effective nursing care in helicopters are good, although in some cases limited by the environmental conditions.

  • 43.
    Tunlind, Adam
    et al.
    Intensive Care Unit, Sunderby Hospital.
    Granström, John
    Thoracal Intensive Care Unit, Karolinska Hospital, Stockholm.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nursing care in a high-technologica lenvironment: experiences of critical care nurses2015Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 31, nr 2, s. 116-123Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 44.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Wälivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Patients' perceptions of quality of care during the perioperative procedure2015Ingår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 30, nr 4, s. 280-289Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 45.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Wälivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Patients' perceptions of their postoperative recovery for one month2015Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, nr 13-14, s. 1825-1836Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectivesTo explore orthopaedic and general surgery patients' perceptions of their postoperative recovery for one month.BackgroundIn general, nursing research in the postoperative context has been directed towards a single symptom or area, which is valuable. However, there is a lack of studies of orthopaedic and general surgery patients' perceptions of postoperative recovery from a short-term perspective.DesignA quantitative approach with a longitudinal design was used.MethodsA total of 180 patients participated in the study. Data were collected using a standardised questionnaire, the Postoperative Recovery Profile, for self-assessment of recovery. Descriptive statistics reported as proportions were used for the categorical variables. Analytic statistics were used to identify statistically significant differences. Mean values and t-tests were used for quantity variables, and Mann–Whitney U-tests and Chi-squared tests were used for nonparametric variables.ResultsOverall, the orthopaedic patients were substantially less recovered than the general surgery patients. Two-thirds of the orthopaedic patients and half of the general surgery patients perceived severe or moderate pain in the acute recovery phase. Within the general surgery group, there were significant differences in the recovery between the Gastric Bypass patients and colon/ileum surgery patients. The gastric bypass patients were overall more recovered than the other groups of patients. The Gastric Bypass patients reported that they had improved after one month compared to their own status prior to surgery.Conclusions and relevance to clinical practiceNursing support for orthopaedic patients must be improved, especially after they are discharged from the hospital. To structure and monitor individual recovery, a top-five priority profile of the most important problems should be used during follow-up calls after the patient is discharged from the hospital. Postoperative pain continues to represent a clinical problem that requires attention. Heterogeneity in the perceptions of recovery within the general surgery group was indicated, which may depend on the surgical procedure as well as the patients' expectations and comparisons with their lives before surgery. Rather than return to their preoperative levels, certain patients tend to continue towards a new or different life postoperatively.

  • 46.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Dicksson, Eric
    Intensive Care Unit, Kalmar Hospital, Department of Anaesthesia and Intensive Care.
    Contreras, Pernilla
    Intensive Care Unit, Piteå River Valley Hospital.
    The desire of parents to be involved and present2015Ingår i: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 20, nr 6, s. 322-330Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundIntensive care of children means not only caring for a child; it means care for the whole family.AimThe aim of the study was to describe parents' experiences of having a critically ill child in an intensive care unit (ICU).ParticipantsA purposive sample of seven parents who had their child treated in an ICU during 2012 in Sweden.DesignThe design uses an inductive, qualitative approach with data collected by means of qualitative interviews.MethodsThe interviews were transcribed verbatim and subjected to qualitative content analysis.ResultsThe analysis resulted in one theme: the desire of parents to be involved and present, with four categories such as wanting to understand and know what is happening, feeling frustration about their child's care and treatment, a health care environment that arouses emotions, and needs for support and processing.ConclusionIt is of great importance to parents to be informed continuously about their child's condition and the care and treatment that are planned. This may increase parents' sense of ownership, control and security.Relevance to clinical practiceProviding answers to those questions that can be answered and being available to parents when they have questions about their critically ill child, the meaning of it all, and what the future will hold are suggested in clinical practice.

  • 47.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Activity: Nursing mothers in an ICU after complicated childbirth2014Konferensbidrag (Övrig (populärvetenskap, debatt, mm))
  • 48.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Aktivitet: Member on International Advisory Board of Intensive & Critical Care Nursing2014Övrigt (Övrig (populärvetenskap, debatt, mm))
  • 49.
    Nordén, Charlotte
    et al.
    Falck Ambulans AB, Hässleholm.
    Hult, Karin
    Jokkmokk Ambulace.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Ambulance nurses’ experiences of nursing critically ill and injured children: a difficult aspect of ambulance nursing care2014Ingår i: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 22, s. 75-80Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundAmbulance nurses work daily in both emergency and non-emergency situations that can be demanding. One emotionally demanding situation for ambulance nurses is to nurse children who are ill.AimThe aim of this study was to describe ambulance nurses’ experiences of nursing critically ill or injured children.MethodEight specialist ambulance nurses were interviewed and the interviews were analyzed using qualitative content analysis.FindingsThe analysis resulted in one theme, a difficult aspect of ambulance nursing care, with five categories. The security of both child and parents was considered to be paramount. Ambulance nurses felt relieved when they handed over the responsibility and the child to the receiving unit. The ambulance nurses felt that more training, education and follow-up was desirable in order to increase their security when nursing children.ConclusionAmbulance nurses are subject to stressful feelings while nursing children. As providing reassurance to the child and its parents is a cornerstone of the treatment, it is important for the ambulance nurses to take the time to build up a trusting relationship in such an encounter. Skill development in the area might lead to increased security and reduce the mental burden resulting from negative stress

  • 50.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    From reaching the end of the road to a new lighter life: People's experiences of undergoing Gastric Bypass surgery2014Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, nr 2, s. 93-100Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

123 1 - 50 av 119
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf